PCNA、T和Th淋巴细胞在肾透明细胞癌的表达与预后的关系

应用免疫组化方法检测增殖细胞核抗原（ＰＣＮＡ）、Ｔ淋巴细胞（Ｔ）和辅助Ｔ淋巴细胞（Ｔｈ）在５２例肾透明细胞癌中的阳性表达，分析其与预后的关系。结果：ＰＣＮＡ指数（ＰＣＮＡＬＩ）与肿瘤核分级存在相关性，与分期无关；ＰＣＮＡＬＩ≥２０％组的生存率明显低于＜２０％组（Ｐ＜０．０５）。Ｔ淋巴细胞标记指数（ＴＬＩ）≥１０％组生存率明显高于＜１０％组（Ｐ＜０．０５）；辅助Ｔ淋巴细胞标记指数（ＴｈＬＩ）≥１０％及ＴｈＬＩ＜１０％两组间生存率无显著性差异（Ｐ＞０．０５），ＴＬＩ、ＴｈＬＩ与肿瘤分期、核分级无相关性。结论：ＰＣＮＡＬＩ、ＴＬＩ可以作为肾透明细胞癌的预后指标，ＴｈＬＩ与预后无相关性     

膀胱移行细胞癌增殖细胞核抗原表达的研究

采用免疫组化ＬＳＡＢ法对４８例膀胱移行细胞癌增殖细胞核抗原（ＰＣＮＡ）进行检测，发现ＰＣＮＡ增殖指数随肿瘤分级的升高而增高，浸润生长肿瘤ＰＣＮＡ增殖指数明显高于乳头状生长者（Ｐ＜０．００１），ＰＣＮＡ高表达组（增殖指数＞５０％）预后明显差于ＰＣＮＡ低表达组（增殖指数≤５０％）。结果表明ＰＣＮＡ可作为膀胱移行细胞癌恶性程度及预后指标之一。     

睾丸生殖细胞肿瘤中p53与增殖细胞核抗原表达的关系

为探讨生殖细胞肿瘤的细胞增殖状态及ｐ５３蛋白阳性细胞与肿瘤病理特点的关系、细胞增殖与ｐ５３基因在生殖细胞肿瘤中表达的相互关系，本实验采用免疫组化的方法对１３例睾丸生殖细胞肿瘤石蜡切片进行增殖细胞核抗原（ＰＣＮＡ）、ｐ５３蛋白染色。结果显示，浸润性肿瘤组ＰＣＮＡ－ＬＩ显著高于非浸润性肿瘤组（Ｐ＜０．０５）；尽管精原细胞与非精原细胞瘤组ＰＣＮＡ－ＬＩ、ｐ５３表达无显著性差别，但后者的表达高于前者。非精原细胞瘤组中，ＰＣＮＡ－ＬＩ和ｐ５３的表达高度相关（ｒ＝０．６４）。实验结论是：ＰＣ－ＮＡ－ＬＩ和ｐ５３的表达与肿瘤的恶性程度呈正比，且二者表达正相关。     

增殖细胞核抗原在肝硬化,肝细胞不典型增生和肝细胞癌中？…

目的 探讨肝细胞癌（ＨＣＣ）的分析状态与增殖细胞核抗原（ＰＣＮＡ）表达的关系。方法 采用ＰＡＰ酶标法半定量检测（ＰＣＮＡ）在１９例肝硬变、２１例肝细胞不典型增生（ＬＣＤ）和５４例ＨＣＣ中的标记指数（ＬＩ）。结果 ＰＣＮＡ主要定位于肝癌细胞中。在ＨＣＣⅠ级、Ⅱ级、Ⅲ级中ＰＣＮＡ的标记指数（ＬＩ）分别为２０．６％、４２．２％、６８．９％，均存在着显著性差异（Ｐ〈０．０１）；在肝硬变、ＬＣＤ中的ＬＩ分别     

肾癌表皮生长因子受体和增殖细胞核抗原表达的研究

采用免疫组化法对４０例肾癌组织中表皮生长因子受体（ＥＧＦＲ）及增殖细胞核抗原（ＰＣＮＡ）进行检测，取２０例远离癌组织的旁肾组织作为对照。发现肾癌组织ＧＥＦＲ阳性表达显著高于对照组，ＥＧＦＲ表达与肿瘤分级分期无相关性。肾癌组织的ＰＣＮＡ增殖指数随肿瘤分级的上升而增高。ＰＣＮＡ高表达组（增殖指数大于１０％）术后生存时间显著较ＰＣＮＡ低表达组（小于或等于１０％）短，强调指出那些临床低分期但ＰＣＮＡ高表达     

结直肠癌患者术前区域动脉灌注化疗对癌细胞增殖的影响

目的 探讨术前区域动脉灌注化疗对人结直肠癌细胞增殖的影响。方法 选择术前临闲是证实的结直肠癌患者２０例,于术前选择肿瘤供应动脉行区域灌注化疗。１０ｄ后行根治手术,免疫组织化学法测定并比较癌组织增殖细胞核抗原（ＰＣＮＡ）及细胞周期蛋白Ｄ１（ｃｙｃｌｉｎＤ１）的表达水平,同时选择同期未行动脉灌注化疗的结直肠癌患者直接接受根治手术,作为对照组。结果 化疗组及对照组ＰＣＮＡ标记指数（ＬＩ）分别为１６．４％&;#177;１５．２％及３８．１％&;#177;１７．８％（Ｐ＝０．０２）;ｃｙｃｌｉｎＤ１ＬＩ分虽为８．７％&;#177;８．０％及２７．４％&;#177;１６．５％（Ｐ＝０．０００２）。细胞增殖指标ＰＣＮＡ及ｃｙｃｌｉｎＤ１的表达在化疗组显著低于对照组,结论 术前选择性区域动脉灌注化疗对结直肠癌细胞可能有较明显的抑制作用,从而发挥抑制肿瘤生长的治疗作用。     

增殖细胞核抗原在肝外胆管癌组织中的表达及其临床意义

为探讨增殖细胞核抗原（ＰＣＮＡ）在原位检测肝外胆管癌临床中的应用价值及与其预后的关系，采用免疫组织化学方法（ＬＳＡＢ法）研究肝外胆管癌组织中ＰＣＮＡ的表达及其临床意义。结果发现：４０例肝外胆管癌ＰＣＮＡ阳性２９例，定位于肝外胆管癌细胞核，ＰＣＮＡ标记指数（ＰＣＮＡＬＩ）范围为９．５％－８１．３％，ＰＣＮＡ表达与肝外胆管癌分化程度、浸润程度有关。ＰＣＮＡＬＩ与肝外胆管癌术后生存期呈极显著负相关（Ｐ＜０．０１），ＰＣＮＡＬＩ越高，生存期越短，预后越差。结果说明：ＰＣＮＡＬＩ是肝外胆管癌预后判断的良好指标。     

直肠癌周粘膜下注射抗癌药物对癌组织病理学形态及增殖核抗原表达影响的研究

目的探索、评价直肠癌术前辅助性治疗的新方法。方法直肠癌周粘膜多点连续封闭式注射抗癌药物５氟脲嘧啶（５ＦＵ），丝裂霉素Ｃ（ＭＭＣ）和卡铂（ＣＢＰ），次日手术。光学显微镜下观察原发灶和转移淋巴结内癌细胞变性、坏死程度，免疫组织化学染色检测肿瘤细胞增殖核抗原（ＰＣＮＡ）表达，并作为评判疗效的标准。结果直肠癌原发灶癌细胞变性５１例、坏死率８０％（４１／５１）；淋巴结转移灶变性坏死率为８２６％（１７１／２０７）；原发灶ＰＣＮＡ表达，治疗组阳性率７２％（３７／５１），对照组阳性率１００％（３０／３０），二者差异有显著意义（ｕ＝３１６，Ｐ＜００１）。平均ＰＣＮＡ指数（ＰＣＮＡＬＩ）分别为（４７±１９）％和（３８±１６）％，两者差异有显著意义（ｕ＝５４１，Ｐ＜００５）。淋巴结内癌细胞ＰＣＮＡ表达，治疗组阳性率７７３％，平均ＰＣＮＡＬＩ（４０±１３）％，对照组阳性率９１３％（１２６／１３８），平均指数为（５０±１９）％，两组差异有显著意义（Ｐ＜００５）。结论术前癌周粘膜下注射抗癌药物对原发灶和淋巴结内转移癌有杀伤作用并降低其增殖活性。重复给药可加强疗效，是一种安全有效的直肠癌辅助治疗方法。     

血管形成与膀胱癌预后关系的研究(摘要)

采用免疫组织化学方法标记血管内皮细胞及增殖肿瘤细胞，测定膀胱移行细胞癌内肿瘤微血管密度（ｉＭＶ）及增殖细胞指数（ＰＣＮＡＬＩ）；并进一步探讨ｉＭＶ、ＰＣＮＡＬＩ、显微镜下血管浸润（ｍＶＩ）及其它指标与预后的关系。材料与方法１９９１～１９９５年间行开放...     

P53蛋白和增殖细胞核抗原在肾癌中的表达及意义

采用免疫组化法对５３例肾癌组织中Ｐ５３蛋白及增殖细胞核抗原（ＰＣＮＡ）进行检测。发现肾癌组织Ｐ５３蛋白表达与细胞类型、分级、分期及预后均无关。肾癌ＰＣＮＡ表达与细胞类型、分级、分期及预后均相关，透明细胞癌与颗粒细胞癌差异无显著性，梭形细胞癌呈高表达；随肿瘤分级增高，ＰＣＮＡ表达呈明显上升趋势；肿瘤高分期组（Ⅲ、Ⅳ）的ＰＣＮＡ表达明显高于低分期组（Ⅰ，Ⅱ）；ＰＣＮＡ高表达组（３、４级）术后５年生存率明显低于低表达组（１、２级）。结果表明：Ｐ５３蛋白表达在肾癌发生中并不起主导作用或只是多种因素之一，ＰＣＮＡ是判定肾癌恶性度及预后的客观指标，同时发现肾癌Ｐ５３蛋白与ＰＣＮＡ表达间无相关。     

Gender-specific differences in dialysis quality (Kt/V): 'big men' are at risk of inadequate haemodialysis treatment.

BACKGROUND: Inadequate dialysis dose is closely related to mortality and morbidity of maintenance haemodialysis (MHD) patients. According to the DOQI guidelines a minimum prescribed dialysis dose of single-pool Kt/V (Kt/Vsp)=1.3, equivalent to equilibrated double pool Kt/V (e-Kt/Vdp)=1.1, is recommended. Knowledge of patient-related risk factors for inadequate delivery of hacmodialysis would be helpful to select patient subgroups for intensive control ofdialysis adequacy. METHODS: A retrospective survey was conducted to assess the prevalence of inadequate dialysis dose according to DOQI criteria during a 7-month period. A total of 320 e-Kt/Vdp measurements in 62 MHD patients were evaluated (mean effective dialysis time 222+/-32 min). Residual renal function (RRF) was expressed as renal weekly Kt/V (r-Kt/Vweek) and included into assessment of total weekly renal and dialytic Kt/V (t-Kt/Vweek). RESULTS: Inadequacy (e-Kt/Vdp<1.10) was prevalent in 37.2% of all measurements and in 22/62 patients (35.5%). In 54% of underdialysed patients r-Kt/Vweek compensated for insufficient dialytic urea removal. Mean weekly Kt/V was inadequate (t-Kt/Vweek<3.30) in 12/62 patients (19.4%) of whom 91.7% (11/12) were male. Body-weight, urea distribution volume (UDV). and body-surface area (BSA) were significantly higher in inadequately is adequately dialysed males. UDV>42.0 litres or BSA>2.0 m2 and a lack of RRF (r-Kt/Vweek<0.3) put 'big men' at increased risk to receive an inadequate dose of dialysis. CONCLUSION: Our data identify patients at risk for inadequate haemodialysis treatment. Special attention should be focused on 'big men' with UDV>42.0 litres or BSA>2.0 m2. In this subset of patients frequent measurements of t-Kt/Vweek and assessment of RRF should be mandatory.     

肾结核的诊断要点分析

目的:分析和总结肾结核的临床特点,提高早期诊断水平.方法:收集近5年我院收治的69例存档病例资料,系统采集病史资料及各项辅助检查数据.结果:本研究包括28例男性,41例女性.最常见症状依次为膀胱刺激征46例(66.7%),腰腹痛30例(43.5%),肉眼血尿29例(42.0%).尿常规异常58例(85.5%);尿抗酸杆菌检查27例,阳性3例(11.1%).超声、静脉肾盂造影、逆行肾盂造影、CT、MRI、膀胱镜检 活检的诊断率分别为63.2%(43/68)、46.9 oA(15/32)、85.7%(12/14),64.3%(9/14)、90.9%(10/11)、10%(1/10).结论:当就诊患者长期有不能解释的泌尿系症状时,应考虑结核性疾病可能.综合分析病史,联合应用各种实验室和影像学检查结果,是早期诊断的必要条件.     

Clinical statistics of the patients admitted to the Department of Urology, Kobe University Hospital, 1985-1987

Between 1985 and 1987, a total number of 791 inpatients were treated at our department and 683 operations were performed. Urogenital malignant tumors (42.0%) were most frequently treated. Male infertility (14.8%) and urolithiasis (8.5%) followed. Bladder tumor was the most frequent disease in our hospital and transurethral resection of bladder tumor was the most frequent operation. Clearly endourological procedures have replaced so-called open surgeries.     

肺动脉融合术治疗肺动脉闭锁合并大主肺侧支动脉

目的 总结肺动脉融合术治疗肺动脉闭锁、室间隔缺损合并大主肺侧支动脉的初步经验.方法 1999年12月至2007年6月完成肺动脉闭锁,室间隔缺损合并大主肺侧支动脉(PA/VSD/NAPCAs)的肺动脉融合术17例,其中男7例,女10例;年龄0.8～18岁,平均(6.0±5.6)岁;体重6.5～55.0 kg,平均(20.0±14.9)kg.术前固有肺动脉指数(PAJ)为42.0～366.1mm2/m2,平均(133.7±87.8)mm2/m2.手术入路包括正中剖胸10例,正中+左后外侧剖胸5例,正中+右后外侧剖胸2例.一期肺动脉融合及心内畸形矫治术12例,肺动脉融合及姑息性体肺分流术4例,肺动脉融合及姑息性右室流出道扩大1例.全组病儿术前造影发现大主肺侧支动脉共44支;术中融合29支,结扎5支.肺动脉闭锁矫治术及肺动脉融合术前介入栓堵3个侧支1例;肺动脉融合及体肺分流术后介入栓堵2个残留侧支1例.结果 全组术中转流174.3min,主动脉阻断88.7min.术后呼吸机辅助7.4d,术后ICU 11.8d.生存11例,平均新建肺动脉指数(TNPAI)249mm2/m2.6例死亡,其中2例TNPAI<200mm2/m2,死于肺血管发育不良,术后发生低心排出量综合征(低心排)和突发室性心律失常;1例因低心排无法脱离体外循环,尸检发现肺小动脉明显肌型化,管腔高度狭窄,证实术前局部肺段已有严重的肺高压;3例>450 mm2/m2分别死于严重肺部感染、渗出、急性肾功能衰竭,反复气道大量出血和顽固性室性心律失常.其他主要并发症为大脑皮层盲、膈肌麻痹和阴沟杆菌性肺炎肺出血各1例.结论 完全矫治+肺动脉融合是治疗肺动脉闭锁/室间隔缺损合并大主肺侧支动脉最根本的治疗手段,但手术操作复杂.由于同一病儿肺动脉病变的多样性,常见MAPCAs高压及狭窄并存.适应证选择和手术技巧的提高仍需不断的探索.     

Na(+)/H(+) exchanger inhibitor HOE642 offers myoprotection in senescent myocardium independent of ischemic preconditioning mechanisms

BACKGROUND: Inhibition of Na(+)/H(+) exchange has been shown to provide functional protection during ischemia and reperfusion in mature heart. This study was undertaken to elucidate the effect of Na(+)/H(+) exchange inhibitor HOE642 in the aged rabbit heart. METHODS: Isolated rabbit hearts were subjected to 1 h of left descending coronary artery (LAD) ischemia and 1 h of reperfusion. To determine the effects of HOE642 on ischemia/reperfusion injury, seven aged or mature hearts received the Na(+)/H(+) exchange inhibitor HOE642 (1 microM) for 15 min before the ischemia and for 30 min after reperfusion. Seven aged (more than 135 weeks) or mature (15-20 weeks) rabbit hearts served as a control (untreated) with no interventions. Left ventricular pressures, monophasic action potentials and coronary flows were measured throughout the experiment and infarct size was detected at the end of experiment. RESULTS: (1) In the mature hearts, HOE642 improved postischemic functional recovery (63.1 +/- 5.0% vs. 84.4 +/- 5.4%, mature untreated vs. mature HOE, p < 0.05) and reduced infarct size as compared to untreated hearts (42.0 +/- 2.5% vs. 24.8 +/- 2.3%, mature untreated vs. mature HOE, p < 0.05). (2) Although infarct size in aged untreated hearts was significantly decreased as compared to mature untreated hearts (42.0 +/- 2.5% vs. 19.3 +/- 1.6%, mature untreated vs. aged untreated, p < 0.05), there are no significant differences regarding postischemic functional recovery between mature and aged untreated hearts (63.1 +/- 5.0% vs. 59.5 +/- 5.9%, mature untreated vs. aged untreated, p = n.s.). (3) In the aged hearts, HOE642 improved postischemic functional recovery as compared to untreated hearts (59.5 +/- 5.9% vs. 85.9 +/- 8.1%, aged untreated vs. aged HOE, p < 0.05). CONCLUSION: Na(+)/H(+) exchange inhibitor HOE642 is effective against ischemia-reperfusion injury in senescent as well as mature hearts.     

结直肠癌患者的DNA修复基因XRCC1单核苷酸多态研究

目的 探讨DNA碱基切除修复基因XRCC1单核苷酸多态与结直肠癌易感性的关系.方法 采用病例-对照分子流行病学方法,以聚合酶链反应-限制性酶切片段多态性(PCRRFLP)方法分析120例结直肠癌患者和150例正常对照XRCC1基因单核苷酸多态Arg194Trp和Arg399Gln的基因型分布,并比较不同基因型与结直肠癌风险的关系.结果 正常人群中194Arg/Arg、Arg/Trp和Trp/Trp基因型频率分别为52.0%、42.0%和6.0%,而结直肠癌患者中分别为40.8%、46.7%和12.5%,分布差异有统计学意义(P＜0.05,趋势检验).与携带野生基因型Arg/Arg者比较,携带Trp/Trp基因型个体患结直肠癌的风险降低了1. 43倍(校正OR=2.43;95%CI=1.10～5.92).而194Arg/Trp基因型和Arg399Gln遗传多态则与结直肠癌风险无关.结论 DNA修复基因XRCC1 Arg194Trp多态可能是结直肠癌发生的遗传易感因素.     

后路棘旁双切口单节段椎弓根钉固定治疗胸腰椎骨折

目的 探讨后路双侧棘旁切口肌间隙入路,单节段椎弓根钉内固定治疗胸腰椎骨折的临床疗效.方法 自2008年12月～2010年12月采用后路双侧棘旁切口肌间隙入路、切开复位单节段椎弓根钉内固定治疗胸腰椎骨折40例.结果 本组术后X线片测量骨折椎前缘压缩百分比从术前(42.0±3.2)％恢复至(7.9±1.1)％(P＜0.05);骨折椎后凸畸形Cobb角从术前(24.1±3.1)°恢复至(5.1±1.2)°(P＜0.05).所有患者获随访7～27个月,患者腰背部疼痛均明显改善,骨折均于术后3个月愈合,无内固定失败、断裂和松动.结论 后路双侧棘旁切口肌间隙入路、切开复位单节段椎弓根钉固定可以有效治疗胸腰椎骨折,但应严格掌握手术适应证.     

控制性超促排卵患者阴道微生态的监测及护理

目的了解体外受精-胚胎移植(IVF-ET)患者在控制性超促排卵(COH)阶段阴道微生态的变化,提供良好的护理对策。方法对100例IVF-ET周期中控制性超促排卵患者分别在控制性超促排卵前、后进行阴道微生态检查。结果IVF-ET周期中的患者在COH前有13.0%、COH后有42.0%发生阴道微生态失调,COH前后比较,差异有统计学意义(P<0.01)。结论IVF-ET周期中的患者在控制性超促排卵后发生阴道微生态失调的比例较高,要加强相关护理,以减少或避免取卵手术的感染,提高胚胎种植率,降低流产率。     

Does ductal adenocarcinoma of the prostate (DA) have any prognostic impact on patients with de novo metastatic prostate cancer?

Background: The prognostic value of ductal adenocarcinoma of the prostate (DA) in nonmetastatic prostate cancer (PCa) has been identified in many studies. However, it remains unknown whether DA is an adverse prognostic factor in metastatic PCa (mPCa). Method: Data from 634 mPCa patients histopathologically documented with DA or/and acinar adenocarcinoma of the prostate in our center between 2012 and 2018 were retrospectively analyzed. Propensity score matching (PSM) was used to balance the baseline features. Data from the Surveillance, Epidemiology, and End Results (SEER) database were utilized to validate our findings. Castration-resistant PCa-free survival (CFS), overall survival (OS), and cancer-specific survival (CSS) were set as endpoints. Results: DA was confirmed in 35 of 634 (5.5%) patients. Among the DA-positive patients, 7 of 35 (20%) and 28 of 35 (80%) harbored high (DA ≥ 50%) and low (DA < 50%) DA components, respectively. DA was not associated with poorer median CFS (mCFS) or median OS (mOS) either before PSM (mCFS: 16.9 vs 18.4 month, P = .814; mOS: 42.0 vs 70.1 month, P = .796) or after PSM (mCFS: 16.9 vs 16.9 month, P = .949; mOS: 42.0 vs 79.9 month, P = .960). Likewise, in the SEER data, DA-positive patients (n = 15 153) shared similar median CSS (25.0 vs 28.0 month, P = .206) and OS (26.0 vs 35.0 month, P = .095) with DA-negative patients (n = 70). No prognostic difference was found between patients with high and low DA components. Conclusion: We conducted the first study investigating the prognostic value of DA in de novo mPCa. DA was not associated with adverse clinical outcomes in mPCa patients. These findings are helpful for prognostic evaluation, treatment decision making and counseling in mPCa patients.     

荧光原位杂交技术在膀胱尿路上皮癌诊断中的应用价值

目的:评估荧光原位杂交技术(FISH)在膀胱尿路上皮癌诊断中的应用价值。方法:收集60例疑似膀胱癌的血尿患者的尿液标本,分别作尿细胞学检测和荧光原位杂交分析。20例正常人尿液标本,用于建立FISH阀值,作为阳性判断的标准。结果:细胞学和FISH的总敏感性分别为42.0%、82.2%,特异性分别为:93.3%、86.7%。细胞学和FISH在低级别及非肌层浸润性肿瘤等敏感性的均差异有统计学意义(P<0.05)。结论:FISH技术能明显提高膀胱尿路上皮癌的检出率,尤其是早期和低级别病变,可以成为筛查膀胱尿路上皮癌的一种新的无创性检查方法。