腹膜返折以下直肠癌淋巴结转移的规律

目的探讨腹膜返折以下直肠癌淋巴结转移的规律。方法回顾性分析腹膜返折以下直肠癌根治术40例。结果腹膜返折以下直肠癌淋巴结转移率约为35％。术前CT检查对淋巴结转移的诊断有相关性。分析发现肿瘤直径〉4cm的患者其淋巴结转移率高于直径≤4cm者。高分化腺癌患者淋巴结转移明显低于中、低分化者。肿瘤侵及外膜和周围脂肪者淋巴结转移率明显高于局限于黏膜和肌层者。结论肿瘤大小、浸润程度、病理分型与腹膜返折以下直肠癌淋巴结转移有关。     

基质金属蛋白酶及其抑制因子在大肠癌侵袭和转移中的研究

目的　探讨基质金属蛋白酶 (MMPs)及其抑制因子 (TIMPs)在大肠癌表达的意义。方法　大肠癌标本 5 0例 ,病理检验证实 :高分化腺癌 15例 ,低分化腺癌 15例 ,未分化癌 2 0例 ,大肠癌转移组 30例 ,未转移组 2 0例。采用免疫组织化学染色法检测。结果　显示 MMPs的成员 MMP9和 MMP2与大肠癌的浸润及转移密切关系。 MMP9和 MMP2阳性表达率 ,淋巴结转移组明显高于无淋巴结转移组 ;未分化癌和低分化腺癌高于高分化腺癌。 TIMP- 1和 TIMP- 2阳性表达率 ,淋巴结转移组明显低于无淋巴结转移组。结论　表明 MMP9和MMP2及 TIMP- 1和 TIMP- 2在大肠癌细胞突破基底膜向间质内浸润扩散及转移至淋巴结内起重要作用 ,两者参与了大肠癌的转移过程。     

进展期胃癌术后淋巴结转移与病理因素相关性研究

目的 探讨进展期胃癌术后淋巴结转移与病理因素相关性的关系,为制定合理的手术后治疗方案提供依据.方法对65 例进展期胃癌资料进行分析研究,手术后常规解剖原发灶和淋巴结,并进行标记和计数,研究分析肿瘤的大小、浸润的深度及Lauren分型与淋巴结转移率的相关性.结果 进展期胃癌淋巴结转移率为63.1%;肌层、穿透浆膜及浆膜外淋巴结转移率为15.0%、53.5%、59.6%;直径＞2 cm癌灶淋巴结转移率为75%,明显高于直径≤2 cm癌灶淋巴结的转移率（36.4%）（P＜0.05）;弥漫性胃癌淋巴结转移率为80.5%.肠型的64.0%,弥漫性明显高于肠型（P＜0.05）;浸润的深度、Lauren分型和肿瘤的大小是影响淋巴结转移率的重要因素,浸润的深度为独立影响因素.结论 进展期胃癌手术后合理治疗方案的制定应结合肿瘤的大小、浸润的深度及Lauren分型做出判断,并考虑患者的整体身体情况.     

低位直肠癌直肠系膜淋巴结转移规律探讨

目的探讨低位直肠癌直肠系膜淋巴结转移规律,为临床治疗提供依据。方法对124例进行直肠系膜全切除低位直肠癌患者的临床病理资料进行回顾性分析,采用组织切片方法对直肠癌直肠系膜淋巴结转移情况进行检测,并分析探讨其转移规律。结果低位直肠癌系膜转移率为72.58%。分析低位直肠癌直肠系膜淋巴结转移临床病理类型发现肿瘤直径>3cm的转移率明显高于直径<3cm的病例。高分化腺癌病例转移率明显低于中、低分化病例。随着肿瘤TMN分期的增加,其转移率呈明显上升趋势。环周切缘阳性病例的转移率明显高于阴性病例。低位直肠癌直肠系膜转移率与患者性别、年龄、肿瘤侵袭肠壁周径、浸润程度及大体类型没有明显相关性。结论肿瘤直径、浸润深度、分化程度及肿瘤分期与低位直肠癌直肠系膜淋巴结的转移有密切关系,其中环周切缘呈现阳性的患者,会大大增加直肠系膜淋巴结转移的可能性,所以低位直肠癌应尽可能采用全直肠系膜切除原则。     

年轻宫颈癌盆腔淋巴结转移预测的多因素分析

目的探讨年轻宫颈癌盆腔淋巴结转移的相关危险因素。方法回顾性分析142例年轻宫颈癌根治术后盆腔淋巴结转移患者的临床与病理资料，进行单因素、多因素分析年轻宫颈癌盆腔淋巴结转移的相关危险因素。结果盆腔淋巴结总转移率为31．7％．以闭孔淋巴结转移率最高。单因素分析显示，临床分期、肌层浸润深度、宫旁侵犯及脉管浸润与盆腔淋巴结转移相关。多因素分析发现．临床分期和脉管浸润为年轻宫颈癌患者盆腔淋巴结转移的高危因素。结论临床分期晚、存在宫旁侵犯、肌层浸润≥1／2及存在脉管浸润为年轻宫颈癌患者盆腔淋巴结转移的危险因素，可为指导临床治疗提供帮助。     

大肠癌淋巴结转移56例临床病理分析

目的分析大肠癌淋巴结转移相关临床病理因素。方法以2014年1~8月收治的大肠癌患者56例为调查研究对象,分析大肠癌淋巴结转移的相关临床病理因素。结果大肠癌淋巴结转移与性别及肿瘤位置无关,与肿瘤大小、分化程度、浸润深度以及术前癌胚抗原状况存在明显的关系,差异有统计学意义(P<0.05)。结论大肠癌淋巴结转移明显跟患者的年龄大小、肿瘤的大小、分化程度的高低以及浸润的实际深度存在明显的联系。     

268例子宫内膜癌淋巴结转移相关因素分析

目的:探讨影响子宫内膜癌淋巴结转移的相关因素,为制定手术方案提供依据.方法:收集经病理学证实的268例子宫内膜癌患者的临床病理资料并进行回顾性分析.根据患者淋巴结转移情况分为淋巴结转移阳性组和阴性组,分析2组肌层浸润、病理类型、宫旁受累情况、分化程度、年龄、腹腔细胞学结果及血清CA125水平的异同,并对上述指标与淋巴结转移之间的关系进行分析.结果:268例子宫内膜癌的淋巴结转移率为10.07％(27/268),主要转移至髂外淋巴结和闭孔淋巴结(占81.48％),腹主动脉旁淋巴结转移率为9.68％(6/62).淋巴结转移率在深肌层浸润、非内膜样癌、中分化和低分化内膜样癌、累及宫颈或宫旁组织、血清CA125水平升高及年龄≥60岁的患者均分别显著高于无肌层和浅肌层浸润、子宫内膜样癌、高分化内膜样癌、仅限于宫腔内、血清CA125水平正常及年龄＜60岁的患者(均P＜0.01),而腹腔细胞学阳性与阴性者淋巴结转移率差异无统计学意义.多因素分析结果表明内膜样癌分化程度、肌层浸润和血清CA125水平是淋巴结转移的影响因素(均P＜0.05).结论:深肌层浸润、中低分化子宫内膜样癌和较高的血清CA125水平可作为淋巴结转移的高危因素.     

血管内皮生长因子在大肠癌中的表达及其与病理特征的关系探讨

目的 探讨血管内皮生长因子（VEGF）在大肠癌中的表达与病理特征的关系。方法 对99例大肠癌标本进行免疫组织化学染色（SP法），采用单克隆抗体VEGF进行标记。结果 VEGF阳性率：结肠癌51．16％（22／43），直肠癌67-86％（38／56）；高中分化腺癌组62．50％（45／72），其他组55．56％（15／27）；浸肌层组42．86％（12／28），浸浆膜组67．61％（48／71）；有转移组72．00％（36／50），无转移组48．99％（24／49）。VEGF的表达与大肠癌的发生部位、组织学分型无明显关系，与大肠癌浸润深度及淋巴结转移明显相关。结论 VEGF可作为判断大肠癌复发及预后的一个重要指标。     

胃癌淋巴结转移规律的研究

本文根据50例胃癌(窦部33例、体部5例、贲门部12例)切除标本与淋巴结病理检查结果,显示淋巴结转移率为72%(36/50例),转移度为22%(237/1079个淋巴结)。淋巴结转移的程度与癌的部位、范围、浸润深度及病理类型有关,而在9例早期癌的137个淋巴结中,未发现有癌转移。作者认为胃癌根治术时,应根据癌肿的部位、大小、浸润的深度与病人的具体情况,决定淋巴结清除的范围。     

第12组淋巴结清扫在胃癌根治术中的作用（附229例分析）

目的探讨胃癌行D2根治术时,第12组淋巴结的转移情况,为合理地选择淋巴结清扫范围提供依据。方法对我治疗组229例胃癌患者行根治性胃癌淋巴结清扫D2术的临床资料进行回顾性分析,分析肿瘤的浸润深度、病理分化程度及大小,与第12组淋巴结转移情况的关系。结果胃癌患者12a、12b、12p组淋巴结转移率分别为10.9%、0.9%、3.5%,其中12a组淋巴结转移率明显高于其他两组（P〈0.05）;肿瘤浸透浆膜与浆膜未受浸润的第12组淋巴结转移率分别为20.0%和4.3%,浸透浆膜淋巴结转移率明显升高（P〈0.05）;低分化、高-中分化胃癌第12组淋巴结转移率分别为20.5%和6.0%,病理低分化肿瘤淋巴结转移率明显升高（P〈0.05）。肿瘤直径≤5cm及〉5cm者第12组淋巴结转移率分别为8.3%和20.3%,肿瘤直径〉5cm淋巴结转移率明显升高（P〈0.05）。结论 12组淋巴结的转移和胃癌肿瘤浸润深度、分化程度及肿瘤大小有关,胃癌行D2根治术中必须清扫。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.