原发性肺癌的介入治疗

原发性肺癌又称支气管肺癌,绝大多数起源于支气管粘膜上皮,它是最常见的肺部原发性恶性肿瘤。为提高肺癌的化疗效果,早在６０年代初期即有人着手研究肺癌的介入治疗,目前此疗法已较为普及。国内８０年代初刘子江等率先应用经导管支气管动脉灌注抗癌药物治疗肺癌,此后在全国各大医院迅速推广,并在此基础上又开辟了其他几种行之有效的疗法,如支气管动脉灌注后行支气管动脉栓塞术,对直径＜５ｃｍ的周围性肺癌经支气管动脉化疗后作经皮穿刺肿瘤内注射无水乙醇（３～１０ｍｌ）或无水乙醇（９ｍｌ）及碘油（１ｍｌ）,以及在经支气管动脉…     

肝细胞癌血供类型及其治疗意义

目的探讨肝细胞癌组织内血供类型及其对治疗中的指导意义。方法采用Seldinger技术对200例肝细胞癌（HCC）患者肝动脉行DSA检查,并对造影资料进行分析研究,根据供血动脉在瘤体内的分布情况进行分型,根据血供类型进行治疗。结果HCC的血供分为4种类型,即肝动脉瘘型、多血供型、中血供型、少血供型。对其中100例根据4种不同的血供类型采用不同介入治疗方法。①肝动脉瘘型：采用明胶海绵或弹簧圈封堵瘘口,灌注小剂量化疗药物后用超液化碘油栓塞（TACE）,联合经皮—肝穿刺瘤体内注射无水乙醇（PEI）;②多血供型：经肝动脉行TACE联合PEI;③中血供型：经肝动脉灌注细胞因子诱导的杀伤细胞（CIK）联合超液化碘油（UFL）栓塞及PEI;④少血供型：经肝动脉灌注CIK联合PEI。显效率分别为31．3％、54、1％、38．9％、44．8％,总有效率为76％。结论对HCC患者根据不同的血供类型采用不同的介入治疗术式,可以弥补单一治疗方法的不足,可增强抗癌效果,改善患者的生存质量,延长患者的生存期。     

胃癌组织血液供应特点分析及意义

目的观察胃癌组织血液供应（血供）特点及其与胃癌病理分期的关系。方法对64例胃癌患者行手术治疗,术前行常规cT强化检查,分别取25（T1）、45（T2）、70（T3）s时相的肿瘤图像,观察强化至峰值时间;术后将肿瘤标本连同部分正常胃组织（30min内）从其供血动脉注入造影剂,直至诸大血管内血液被造影剂取代,CT扫描,观察肿瘤血管网,并与术前强化CT图像对照;取肿瘤标本行病理检查,观察肿瘤微血管密度（MVD）;分析这三种方法获得的胃癌血供特点与胃癌病理分期的关系。结果病理分期越高,CT强化到达峰值时间越提前,Ⅲ期〈Ⅱ期〈Ⅰ期,低分化〈中分化〈高分化（P均〈0．01）,其肿瘤供血血管数量越多,Ⅲ期〉Ⅱ期〉Ⅰ期,低分化〉中分化〉高分化（P均〈0．01）,MVD也越高,Ⅲ期〉Ⅱ期〉Ⅰ期,低分化〉中分化〉高分化（P均〈0．01）。结论胃癌组织呈多血管供血,分期越高、分化程度越低,血管数量越多;强化CT动态显像能反映胃癌MVD及血供情况,有利于其临床分期及恶性程度的正确判断。     

RhD血型筛查与临床血液供应方式的探讨

RhD血型是人类继ABO血型之后最有临床输血意义的血型系统,由于RhD血型不合对临床输血产生的重要意义,越来越受到重视.为满足临床需求,我们对RhD血型筛查、血液采集和临床供应的方式进行了研究探索.笔者就本中心2001年以来RhD血型筛查和RhD阴性血液供应情况进行了统计分析.     

肺癌介入治疗中两种不同化疗方案对疗效的影响

作者对经病理证实Ⅲ期、Ⅳ期无手术指征的２０４例非小细胞肺癌患者随机分成两组，采用环磷酰胺、顺铂（ＣＰ），丝裂霉素、阿霉素、顺铂（ＭＡＰ）两种方案进行支气管动脉灌注治疗并进行疗效分析。结果表明ＣＰ组有效率为３０．２％，ＭＡＰ组有效率为４４％。经统计学处理两组间有很显著差异（Ｐ〈０．０１）。     

选择性支气管动脉灌注治疗肺癌

作者选择80例经病理证实的支气管肺癌病人,经支气管动脉灌注(BAI)化疗药物顺铂或加丝裂霉素。治疗1个月后复查胸片及纤支镜。CR+PR88%。随访3年者存活率40%。     

血液供应紧张原因解析

<正>自2010年以来,血液供应紧张开始逐步常态化,由以前的献血淡季扩展为全年,由某些用血量大的地区蔓延到全国。媒体大幅报道"血荒",医院很多手术不得已停掉。一时间有关无偿献血机制的讨论沸沸扬扬。为什么会发生血液供应紧张?本文将从以下几个方面来探究其发生的原因。1医改的深入及医院的扩张效应随着医改的不断深入,医保的覆盖面不断扩大,居民的刚性医疗需求被释放,过去看不起的病现在能看了,过去治不了的病现在能治了。交通的     

多层螺旋CT对于支气管动脉与肺动脉造影对肺癌血液供应的分析

目的研究多层螺旋CT对于支气管动脉与肺动脉造影在肺癌血液供应的显像效果。方法收集我院收治的74例原发性肺癌患者和23例正常患者的CT胸部扫描图像进行研究。以肺癌患者为实验组,正常患者为对照组,所有研究对象均采用多层螺旋CT获得胸部扫描原始图像,分析时用VR、MPR、MIP进行CTA重建。对扫描图像进行分析,得出肺癌血液供应与BA、PA形态学特征之间的关系。结果 BA向肿瘤方向有明显增多增粗,74例实验组肺癌患者患侧与对照组BA相比,肺癌患者患侧BA明显增粗,差异有统计学意义(P0.05);癌变患者患侧BA总截面积明显大于对照组左侧总截面积,差异有统计学意义(P0.05)。结论采用多层螺旋CT对于支气管动脉与肺动脉造影,对于肺癌血液供应的显示效果良好,值得临床推广应用。     

肺癌患者血液抗凝和纤溶状态的变化及意义

肺癌患者血液抗凝和纤溶状态的变化及意义肖伟佟学一侯明朱媛媛徐从高张茂宏１．病例选择：经纤维支气管镜组织检查（活检）或手术后病理证实肺癌患者男３５例，女１３例，年龄２６～７２岁。血常规、血小板、出凝血时间正常；无心脑血管病及糖尿病，无恶病质状态。健康对...     

肝癌的表观遗传学特征及其临床意义

表观遗传学是研究基因表达的学科,其改变不依赖于基因序列的改变,研究内容包括DNA甲基化、组蛋白修饰和非编码RNA。与基因突变不同,表观遗传学的改变在一定条件下可以逆转,这一特性为疾病的治疗提供了新的机会。肝癌是威胁人类健康的恶性肿瘤之一,发病机制不清。肝癌表观遗传学研究越来越受到人们的重视,本文将对肝癌的表观遗传学改变进行阐述。     

Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients

Study objectiveThis study investigated in a large sample of in-patients the impact of mild-moderate-severe anaemia on clinical outcomes such as in-hospital mortality, re-admission, and death within three months after discharge.MethodsA prospective multicentre observational study, involving older people admitted to 87 internal medicine and geriatric wards, was done in Italy between 2010 and 2012. The main clinical/laboratory data were obtained on admission and discharge. Based on haemoglobin (Hb), subjects were classified in three groups: group 1 with normal Hb, (reference group), group 2 with mildly reduced Hb (10.0–11.9 g/dL in women; 10.0–12.9 g/dL in men) and group 3 with moderately-severely reduced Hb (<10 g/dL in women and men).ResultsPatients (2678; mean age 79.2 ± 7.4 y) with anaemia (54.7%) were older, with greater functional impairment and more comorbidity. Multivariable analysis showed that mild but not moderate-severe anaemia was associated with a higher risk of hospital re-admission within three months (group 2: OR = 1.62; 95%CI 1.21–2.17). Anaemia failed to predict in-hospital mortality, while a higher risk of dying within three months was associated with the degree of Hb reduction on admission (group 2: OR = 1.82;95%CI 1.25–2.67; group 3: OR = 2.78;95%CI 1.82–4.26) and discharge (group 2: OR = 2.37;95%CI 1.48–3.93; group 3: OR = 3.70;95%CI 2.14–6.52). Normocytic and macrocytic, but not microcytic anaemia, were associated with adverse clinical outcomes.ConclusionsMild anaemia predicted hospital re-admission of older in-patients, while three-month mortality risk increased proportionally with anaemia severity. Type and severity of anaemia affected hospital re-admission and mortality, the worst prognosis being associated with normocytic and macrocytic anaemia.     

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??Objective To analyze the frequencies and the clinical features of spinocerebellar ataxia (SCA) in Southwest China.
Methods We performed a retrospective study of CAG repeat genetic analysis in 165 unrelated ataxia patients with unknown causes.We analyzed the frequencies and clinical manifestations of patients with genetically confirmed SCA and SCA phenotypes.
Results 43%patients confirmed to be SCA by genetic analysis among the undetermined ataxia patients in Southwest China??sporadic SCA accounted for over 13.9%??SCA3 was the most frequent phenotype(60.6%)??followed by SCA1??SCA2??SCA6??SCA7.SCA patients appeared with various clinical manifestations including mental disorders(12.5%)??oculomotor disorders(58.3%)??peripheral neuropathy(38.5%)??cerebellar ataxia(100%)??pyramidal signs(54.2%)??autonomic dysfunction(25%)and extra-pyramidal symptoms(6.3%).The features of different phenotypes always overlapped with each other??but there were characteristic clinical features such as optic atrophy for SCA1??hyporeflexia for SCA2??nystagmus for SCA3.
Conclusion SCA3 is the most common phenotype of SCA??sporadic SCA are not unusual.The clinical features of among different SCA phenotypes always present with various clinical manifestations and overlap with each other??and the characteristic clinical features are not as specific as supposed in the past across different ethnic and geographical.Genetic studies for SCA are essential in diagnose.
     

粘着斑激酶在胃癌中的表达及临床意义

目的观察粘着斑激酶(FAK)在胃癌及癌旁组织表达的差异,探讨FAK与胃癌临床病理参数的关系。方法应用免疫组化SP法检测61例胃癌组织及其癌旁组织FAK的表达。结果FAK在胃癌及其癌旁组织阳性表达率分别为86.8%(53/61)和75.4%(46/61),差异无显著性(P>0.05);但FAK较强阳性/强阳性(即++/+++)的表达率分别为59%、26.2%,差异有显著性(P<0.05),且其表达水平与胃癌分化程度、浸润深度、淋巴结转移、临床分期呈正相关。结论在胃癌组织中FAK(++/+++)的表达水平较正常组织明显增高,提示FAK参与胃癌的发病,并与胃癌的浸润、转移关系密切。     

Biological implications and clinical value of mir-210 in gastrointestinal cancer

Introduction: Hypoxia, a common feature of tumor microenvironment, is known to accelerate tumor development and growth by promoting the formation of a neoplastic environment. Recent studies have provided a wealth of evidence that miRNAs are significant members of the adaptive response to low oxygen in tumors. miR-210 is one of the hypoxia-induced miRNAs, which has been reported extensively in cancer researches. However, there is no systematic discussion about the role of miR-210 in gastrointestinal cancer. We conducted a literature research in database including PubMed, Elsevier Science Direct and Medline before 16 September 2016, in order to collect articles of miR-210 in gastrointestinal cancer.

Areas covered: In the present review, we mainly discuss the following aspects: hypoxia-induced dysregulation of miR-210, the expression of miR-210 and tumorigenesis, the resultant changes of miR-210 targets and its roles in different types of gastrointestinal cancer progression, the diagnostic, therapeutic and prognostic value of miR-210 in gastrointestinal cancer.

Expert commentary: Numerous researches have demonstrated the values of miR-210 in cancer diagnosis, prognosis and targeted therapies, especially in gastrointestinal cancers. However, there are also some existing problems and challenges in translating the new research findings into clinical utility. Further investigations and studies are still urgently required.