支气管动脉灌注化疗治疗晚期原发性肺癌近期疗效影响因素分析

目的 探讨经支气管动脉灌注化疗(BAI)治疗晚期肺癌近期疗效的影响因素.方法 回顾性分析1990年3月至2006年6月间胸部X线片复查资料相对完整的82例经BAI治疗的原发性晚期肺癌的近期疗效.结果 完全有效(CR)10例(12.2%)、部分有效(PR)32例(39.0%)、轻微有效(MR)23例(28.0%)、稳定(SD)15例(18.3%)、进展(PD)2例(2.4%).单因素方差分析结果显示,半月时肿瘤缩小率(TDR1/2month)(χ2=25.92,P＜0.01)、BAI次数(TBAI(χ2=17.70,P＜0.01)、肿瘤大小(T size)(χ2=14.21,P＜0.01)和肿瘤血供丰富程度(χ2=6.59,P＜0.01)对近期疗效的影响具有统计学意义.对年龄、病理类型等12项协变量进行二项分类Logistic回归分析,采用向后删除法经10步二次迭代,得到Logistic回归方程:P(1)=1/[1+e-(-8.953+2.656TDR1/2month+1.382TBAI+1.230Tsize)]方程对BAI近期疗效有效与无效的预测正确率分别为85.7%和70.0%.结论 第1次BAI后半月时的肿瘤缩小率、BAI治疗次数和肿瘤的大小是影响BAI近期疗效的因素.     

FAP在胃癌间质中的表达及其与微血管密度的关系

目的 探讨FAP在胃癌间质中的表达及其与微血管密度(microvessel density,MVD)的关系.方法 收集162例胃癌组织,同时建立人胃癌细胞系SGC-7901裸鼠皮下移植瘤模型,采用免疫组织化学染色法检测FAP和CD34的表达.结果 在人胃癌组织中,FAP表达于问质成纤维细胞,表达阳性率为90.74%(147例),而胃癌细胞和正常胃组织中无表达,且FAP表达和MVD分别与胃癌的分化程度(χ2=51.882,P<0.01;χ2=46.383,P<0.01)、侵袭深度(χ2=40.193,P<0.01;χ2=21.617,P<0.01)及淋巴结转移(χ2=24.232,P<0.01;χ2=13.393,P<0.01)有关.在15例裸鼠皮下移植瘤中,所有肿瘤中FAP均不同程度在间质成纤维细胞呈阳性表达.在人胃癌组织(χ2=97.710,P<0.01)和裸鼠皮下移植瘤组织(χ2=11.100,P<0.01)中,不同强度的FAP表达组间肿瘤间质MVD的差异具有统计学意义,且随着FAP表达水平的增高,MVD也随之增加.结论 FAP的表达与胃癌的分化程度、侵袭深度及淋巴结转移有关.FAP可能通过促进肿瘤的微血管生成,加快肿瘤的生长、侵袭和转移.     

放化同期治疗对局部晚期非小细胞肺癌近期疗效和血浆MMP2水平变化

目的:观察放化同期治疗局部晚期非小细胞肺癌的近期疗效及外周血基质金属蛋白酶2(MMP2)水平变化。方法:64例经病理确诊的ⅡB至ⅢB期的非小细胞肺癌患者,平分为成放化同期治疗组和放化序贯治疗组,两组均放疗42-49天,化疗约4个疗程,于治疗前1天、放疗第30天和疗程结束后,采用酶联免疫法检测外周血MMP2表达水平并比较疗效。结果:两组总有效率分别为90.06%和68.8%,放化同期治疗组明显优于放化序贯治疗组(χ2=4.7300,P0.05)。治疗前,两组MMP2水平无显著性差异(t=0.369,P0.05)。治疗30天到治疗结束,放化同期组MMP2水平逐渐下降,序贯组MMP2水平在治疗30天时升高,疗程结束后下降,均与治疗前比较有统计学意义(P0.01);放化同期组治疗30天的MMP2水平明显低于序贯组(t=4.024,P0.01),疗程结束后,两组MMP2水平差异无显著性意义(t=0.469,P0.05)。结论:放化同期治疗能够早期有效降低局部晚期非小细胞肺癌外周血MMP2水平,提高近期疗效。     

北京市老年人抑郁症状的调查

目的:分析北京市老年人抑郁症状的现状和影响因素.方法:在2000年对一个流行病学队列研究人群的55岁以上初老年和老年人的样本2660例,采用自评量表CES-D评定抑郁症状的有无,并和人口学因素(年龄、性别、地区)、慢性病患病情况及日常生活自理能力进行对比分析.结果:不同年龄组抑郁症状的检出率无明显差别(P>0.05).分层分析显示,女性(17.4%)和农村老年人(20.9%)抑郁症状的检出率高于男性(9.6%,χ2=34.6,P<0.01)和城市居民(7.4%,χ2=102.5,P<0.01).抑郁症状与日常生活能力(ADL)(χ2=96,P<0.01)、慢性病患病情况(χ2=39,P<0.01)密切相关.结论:女性、居住于山区、低教育水平并患有慢性病及日常生活能力差的老年人更易出现抑郁情绪.     

单双相抑郁障碍住院患者临床特点比较

目的探讨双相抑郁和复发性抑郁住院患者的临床特征及相关因素。方法回顾性分析1999年到2001年我院诊断情感障碍住院病人506例,比较双相抑郁107例和复发性抑郁399例人口学资料、病程、诊断及疗效等变量。结果复发性抑郁组女性比例高于双相抑郁组(268/399比54/107,χ2=10.17,P<0.01);复发性抑郁组以往多次抑郁发作史低于双相抑郁组(41.4%/57%,χ2=8.4,P<0.01),病程短于双相抑郁组(58.8±4.5/96.3±9.6,t=-3.77,P<0.01),首次抑郁年龄大于双相抑郁组(41.7±0.8/29.4±1.4,t=6.95,P<0.01),首次抗抑郁治疗有效率大于双相抑郁组(81.3%/57%,χ2=95.2,P<0.01),复发抑郁组同一次病程首次诊断符合率高于双相抑郁组(97%/31.8%,χ2=324.4,P<0.01),双相抑郁组中61.7%(66/107)首次诊断为抑郁起病年龄20岁左右者发生双相抑郁概率明显大于60岁以后起病者(OR=2.45)。病程5年以上发生双相抑郁概率大于病程短于1年者(OR=2.75),首次抗抑郁疗效差出现双相抑郁概率大于首次抗抑郁疗效好者(OR=3.18)。双相抑郁组同一次病程61.7%首次诊断抑郁障碍。结论首发抑郁的年龄、病程、首次抗抑郁效果与出现双相抑郁的概率有关。首发抑郁年龄越早,病程越长,首次抗抑郁疗效越差,发生双相抑郁概率越大。2/3双相抑郁首次诊断复发性抑郁。     

紫杉醇联合顺铂化疗在晚期非小细胞肺癌中的疗效与安全性观察

目的：观察紫杉醇联合顺铂化疗在晚期非小细胞肺癌中的临床疗效和安全性。方法将50例初治的晚期非小细胞肺癌患者随机分为治疗组和对照组,每组25例。治疗组用TP方案,对照组应用GP方案,分别接受至少2个周期以上化疗,观察肿瘤客观疗效、生存质量和不良反应。结果①治疗组、对照组肿瘤客观总有效率分别为44%、40%,其差异无统计学意义(P>0.05);②治疗组、对照组生存质量有效率分别为80%、64%;其差异有统计学意义(P<0.05);③两组白细胞、血小板降低情况差异有统计学意义(P<0.05)。结论 TP方案比GP方案更有助于提高患者生存质量,对骨髓造血功能的影响不同,是临床上治疗晚期肺癌的有效方法。     

慢性乙型肝炎外周血单个核细胞内HBV-DNA与血清HBV-DNA及HBeAg表达关系的研究

目的研究慢性乙型肝炎患者外周血单个核细胞(PBMC)内HBV-DNA和血清中HBV-DNA表达量、e抗原表达的关系。方法采用聚合酶链反应(PCR)检测208例慢性乙型肝炎患者PBMC内HBV-DNA,应用荧光定量聚合酶链反应(FQ-PCR)检测血清中HBV DNA含量,应用酶联免疫吸附(ELISA)法检测乙肝血清标志物。结果208例慢性乙型肝炎患者PBMC内HBV-DNA阳性106例、阴性102例。HBV-DNA(PBMC)阳性组、阴性组血清HBV-DNA定量≥1.0E5患者比例分别为91.5%(97例)、45.1%(46例)(χ2=52.12,P<0.01);HBeAg阳性率分别为76.4%(81例)、50.9%(52例)(χ2=21.55,P<0.01)。结论PBMC内HBV-DNA的检测与血清中HBV-DNA定量检测及HBeAg阳性率存在明显的正相关。提示血清HBV-DNA高载量的HBeAg阳性患者外周血单个核细胞感染HBV-DNA明显增加。     

89Sr联合99Tc-MDP内照射治疗肺癌骨转移疼痛的临床观察

目的观察锶(89Sr)联合锝(99Tc-MDP)治疗肺癌骨转移临床疗效。方法将63例肺癌骨转移患者随机分为实验组(30例)与对照组(33例)。实验组应用89Sr联合99Tc-MDP治疗,对照组应用89Sr治疗。随访3个月,主要观察两组患者治疗前后的疼痛、生活质量、血象、骨显像所示骨转移灶数目的改善情况。计数资料采用卡方检验。结果经统计分析,实验组与对照组的止痛有效率分别为80.00%与54.54%;实验组与对照组治疗后骨痛缓解有效率(χ2=4.582)、生活质量改善率(83.33%与57.58%,χ2=4.950)和骨转移病灶治疗有效率(83.33%与60.61%,χ2=3.977)间比较差异有统计学意义(P均0.05),而毒副反应实验组没有明显叠加(χ2=1.880,P0.05)。结论89Sr联合99Tc-MDP的治疗方法较单独使用89Sr能显著提高肺癌骨转移疼痛的临床疗效。     

构架蛋白1及Twist在宫颈癌组织中的表达与临床意义

目的 探讨构架蛋白1(RACK-1)和Twist在宫颈癌中的表达与临床意义.方法 选取2010年5月至2012年5月在深圳市第二人民医院住院并接受手术治疗的宫颈癌患者70例,选取同期本院因宫颈良性病变行肿物剥除或附件切除的20例患者作为对照,应用免疫组化(SP)方法检测70例宫颈癌组织(宫颈癌组)、70例宫颈癌癌旁组织(癌旁组)、正常宫颈组织20例(正常组)中的Twist及RACK-1蛋白表达,分析其与宫颈癌患者临床病理指标的关系.结果 ①Twist在正常宫颈组织、癌旁组织和宫颈癌中的阳性率分别为5.0%(1/20)、22.9%(16/70)和95.7%(67/70)(χ2=24.581,P=0.001);RACK-1在正常宫颈组织、癌旁组织和宫颈癌中的阳性率分别为10.0%(2/20)、61.4%(43/70)和90.0%(63/70)(χ2=11.538,P=0.001).②Twist表达与肿瘤分化程度、淋巴结转移及TNM分期有关(P<0.05).RACK-1表达与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期有关(P<0.05).③Twist及RACK-1存在正相关性(r=0.3,P<0.05).④Twist(+)~(++)表达者和(+++)表达者5年总生存率分别为51.2%和29.2%(HR=11.637,95%CI:4.351~38.213;P=0.002);RACK-1(+)~(++)表达者和(+++)表达者5年总生存率分别为41.3%和35.3%(HR=10.143,95%CI:4.285~33.275;P=0.006).结论Twist及RACK-1的增强表达与宫颈癌侵袭性增强有密切关系,其表达可作为判断宫颈癌患者预后的指标.     

三维立体定向放疗配合化疗治疗局部晚期非小细胞肺癌的临床观察

目的观察三维立体定向放射治疗(SRT)配合化疗治疗局部晚期非小细胞肺癌的近期疗效及患者的耐受性。方法112例局部晚期非小细胞肺癌(Ⅲa或Ⅲb期)患者均行EP方案(DDP 100mg/m2,ivgtt,d1,VP-16 100mg/m2,ivgtt,d1-3,4周为一周期)化疗,同时采用常规全纵隔 原发灶前后两野对穿外照射,肿瘤量达6MV-X DT40-44Gy/20-22次/4-4.4周后,行SRT,剂量为28-35Gy,4--6Gy/次,3次/周。结果112例全部顺利完成治疗计划,肿瘤中位剂量7008cGy(6780 cGy-7350 cGy)近期疗效为肺原发灶完全缓解(CR)占17.8%,部分缓解(PR)占75.0%,总有效率(CR PR)为92.8%。白细胞下降发生率为93.2%,其中3、4级白细胞下降为47.6%;放射性食管炎和放射性肺炎的发生率分别为51.8%和11.3%,均为1、2级。结论由于提高了分割量及总剂量,三维立体定向放射治疗加常规放疗配合化疗治疗局部晚期非小细胞肺癌取得了较好的近期疗效,由于减少了正常组织的照射剂量,并且缩短了治疗时间,能为绝大多数患者耐受。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.