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1.
原发性肝癌DNA含量与核形态学参数关系的分析及其临床意义 总被引:2,自引:0,他引:2
本研究图像分析技术(IAT)对55例原发性肝癌(PHC)病人的DNA含量及核形态学参数进行检测,结果显示:无1例PHC的DNA干系水平睡于DNA含量二倍体区域,3例处于近二倍体(5.45%),52例处于异倍体(94.55%)。DNA含量与有无淋巴结转移(P〈0.05)、瘤体大小(P〈0.01)、生存率(P〈0.001)有相关性。核形态学参数与PHC的DNA含量及PHC有无淋巴结转移亦有统计学意义。 相似文献
2.
胃癌与端粒酶活性表达及DNA倍体关系的研究 总被引:4,自引:0,他引:4
目的揭示胃癌与端粒酶活性及DNA倍体关系。方法检测30例胃癌标本,同时取无瘤残端作为对照。端粒酶检测采用端粒重复扩增-酶到免疫吸附法(TRAP-ELISA法)。DNA倍体的测定采用流式细胞术,一步法检测DNA含量,结果肿瘤瘤体端粒酶阳性率83.3%925/30),无瘤残端端粒酶阳性率3.3%(1/30)(P〈0.05);端粒酶阳性瘤体平均直径6.5cm,阴性瘤体平均直径3.6cm(P〈0.05); 相似文献
3.
作者对43例乳腺肿物进行DNA流式细胞术和AgNOR检测。大多数DNA异倍体为恶性病变(23/24),良性病变的SPF和PI与二倍体癌相近,但低于异倍体癌(P>0.05);二倍体癌SPF和PI低于异倍体癌(P<0.001)。异倍体多见于腋淋巴结转移和年轻患者(P<0.05)。半数左右乳腺癌的mAgNOR高于良性病变的最高值。本研究表明DNAFCM和AgNOR检测可作为良恶性病变鉴别的参考,异倍体癌临床进程较快,DNA异倍体和高S1/S2,mAgNOR肿瘤有较强的浸润性,但对化疗也较敏感,应考虑行辅助化疗。 相似文献
4.
食管鳞癌DNA含量与临床病理及预后的关系 总被引:1,自引:0,他引:1
应用自动化图像分析仪对50例食管鳞癌进行细胞DNA定量分析,结合临床资料,发现肿瘤分化越差、外侵越严重,DNA含量越高。淋巴结转移组DNA含量高于非转移组。二倍体或近二倍体组1、3、5年生存率明显高于异倍体组(P<0.01)。表明DNA含量的测定可从核酸代谢的分子水平揭示食管癌恶性生物学行为,同时可作为估计手术预后的客观定量指标。 相似文献
5.
小肠癌DNA倍体定量分析及其临床意义的研究 总被引:4,自引:0,他引:4
作者应用计算机图像分析DNA定量的方法对28例小肠癌、5例小肠腺瘤、6例正常小肠组织中的异倍体所占的比例及DNA含量的12个参数进行了检测。结果表明:小肠癌中的异倍体数量明显高于小肠腺瘤,其中DNA熵值(ED)、2倍体偏移指数(2CDI)、DNA恶性分级(DGN)、5倍体超过率(5CER)、9倍体超过率(9CER)、2倍体偏移熵数(DDQ)、平均倍体(MP)七个DNA参数对判断小肠良、恶性病变有重要意义;DNA含量与小肠癌的临床病理组织分化程度无关,但异倍体小肠癌较非异倍体小肠癌恶性度高,易发生浸润和转移,术后生存率低,预后较差。DNA参数中的DNA指数(DI)、众数值(MV)、DNA恶性分级(DGN)、干系倍体值(SP)、9倍体超过率(9CER)五个参数与小肠癌的预后关系密切,对分析小肠癌的预后有重要价值 相似文献
6.
作者对本院1979~1991年手术和病理证实的32例胰腺癌、10例邻近癌的胰腺组织、8例胰腺炎以及16例胰岛细胞瘤石蜡包埋组织,用流式细胞仪(FCM)检测其细胞核DNA含量。结果发现:胰腺癌的异倍体率及DNA指数明显高于胰腺非肿瘤病变者(P<0.01);DNA异倍体胰腺癌的S期比例亦明显高于二倍体胰腺癌(P<0.05);胰腺癌细胞核DNA含量的变化是一个相对独立的反映胰腺癌生物学行为的指标。DNA二倍体胰腺癌患者的手术可切除率明显高于异倍体肿瘤患者(P<0.05)。采用Kaplan-Meier生存分析法显示,DNA异倍体胰腺癌较二倍体者生存时间短,预后差(P<0.05%)。 相似文献
7.
目的 探讨肝细胞癌DNA异倍体、nm23-H1、C-erbB-2和P53癌基因蛋白表达与肝细胞癌侵袭性的关系及其临床意义。方法采用DNA图像分析系统定量测定52例肝癌2的肝癌细胞的DNA含量,用免疫组化方法检测癌基因蛋白在肝癌中的表达。结果DNA异倍体在≤5cm肝癌组为50.0%,在〉5cm肝癌为82.1%;DNA异倍体与肝癌肝内转移及合并癌栓有关。肝癌伴有肝内转移者的nm23-H1阳性率是明显 相似文献
8.
用ABC免疫组化技术测定65例胃癌标本中ER、CEA含量,其中36例标本行DNA图像分析测定,并对影响胃癌预后的27种因子进行Cox模型分析。结果发现胃癌ER、CEA阳性率与浸润深度、淋巴结转移正相关,与分化程度负相关,ER、CEA阴性胃癌预后较好,ER阳性胃癌对化疗较敏感。二倍体胃癌预后优于异倍体胃癌,晚期、分化差胃癌细胞核DNA含量高。影响胃癌预后的六种因子依次为,病理类型、病程、DNA含量、 相似文献
9.
应用流式细胞分析术测定54例骨肉瘤的细胞核DNA含量,探讨其与病理和临床特点的关系。结果表明:10例为DNA二倍体,44例为异倍体。DNA指数与骨肉瘤X线分级、肿瘤大小和外科分期有明确关系;S期细胞百分数、增殖指数与骨肉瘤外科分期也有明确相关性。预后分析表明:DNA二倍体、低异倍体、S期细胞百分数<20%、增殖指数<35%的骨肉瘤息者有较高的三年生存率。 相似文献
10.
采用RTPCR方法,观察CD28通路活化后淋巴细胞Th1/Th2细胞因子mRNA表达水平及CsA的抑制作用。取正常人外周血淋巴细胞,培养过程中分别给予抗CD3mAb单独刺激或抗CD3mAb+抗CD28mAb共同刺激。提取细胞总RNA并逆转录成cDNA,对Th1细胞因子(IFNγ、IL2)和Th2细胞因子(IL4、IL10)cDNA进行扩增。结果显示:共刺激信号可使Th1细胞因子基因mRNA转录增加,且对CsA的抑制作用产生抵抗;而对Th2细胞因子则不产生明显影响。研究表明:CD28共刺激信号主要增强淋巴细胞Th1细胞因子基因mRNA表达,并可能参与其分化调节;这一活化通路不被CsA阻断。 相似文献
11.
Vasopressor hormone response following mesenteric traction during major abdominal surgery 总被引:1,自引:0,他引:1
A. Brinkmann W. Seeling C. F. Wolf E. Kneitinger C. Schonberger N. Vogt K. H. Orend M. Buchler P. Radermacher M. Georgieff 《Acta anaesthesiologica Scandinavica》1998,42(8):948-956
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT. 相似文献
12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required. 相似文献
13.
Kai von Appen Christoph Weber Udo Losert† Heinrich Schima† Hans-Jürgen Gurland Dieter Falkenhagen 《Artificial organs》1996,20(6):420-425
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal. 相似文献
14.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2 O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1 , n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1 , n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO. 相似文献
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO. 相似文献
15.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made
of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300
million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly
obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries
were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However,
health-care awareness of obesity and bariatric surgeons are slowly increasing. 相似文献
16.
Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts 总被引:3,自引:0,他引:3
B. Heindl B. F. Becker S. Zahler P. F. Conzen 《Acta anaesthesiologica Scandinavica》1998,42(8):995-1003
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress. 相似文献
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress. 相似文献
17.
D. Ma S. M. Sapsed-Byrne M. K. Chakrabarti J. G. Whitwam 《Acta anaesthesiologica Scandinavica》1998,42(6):670-677
Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg?1 i. v. and 32 μg · kg?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg?1. The mean ED50s, calculated from dose-response curves, were 5.4 mg · kg?1, 3.9 μg · kg?1 and 0.4 mg · kg?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg?1 and 8 μg · kg?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration. 相似文献
18.
Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery 总被引:1,自引:0,他引:1
J. Boldt M. Papsdorf S. Piper W. Padberg G. Hempelmann 《Acta anaesthesiologica Scandinavica》1998,42(8):941-947
Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg?1 · min?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min?1 · m?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO2I) and oxygen consumption index (VO2I) were also significantly increased in the dopexamine group (DO2I: from 416±91 to 717±110 ml/m2 · m2; VO2I: from 98±25 to 157±22 ml/m2 · m2), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow. 相似文献
19.
A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions. 相似文献