血清,胸水TNF比值测定在良,恶性胸水中的诊断价值

近几年来,肿瘤坏死因子(Tumor Necros Factor, TNF)在一些免疫性疾病的发病机制中已引起临床和科研工作者的广泛兴趣。而有关测定血清和胸水中TNF比值测定国内外报道不多,为此,我们进行了探讨,观将我们的结果报道如下。 对象和方法 一、对象:癌性胸水34例(男28,女6),平均年龄42.5岁(18～77岁),均为肺癌病人。结核性胸水31例(男20,女11),平均年龄36岁(17～61岁),所有病例均经X线、CT、细菌学、病理切片等证实)。全部     

肺癌恶性胸水染色体结构改变

肺癌恶性胸水染色体结构改变张旭华，龚五星，李文典染色体检查对于良、恶性渗出液的鉴别是有较高的敏感性和特异性。国内外已有许多报道，但大多数是对染色体众数改变的分析，而对染色体结构异常的分析较少。本文对１１例肺癌恶性胸水染色体Ｇ带分析，获得了一些染色体结...     

胸水腺癌细胞中期染色体扫描电镜样品制作方法

胸水细胞染色体分析已普遍作为恶性胸水细胞诊断与鉴别诊断的重要辅助方法[1]。文献上胸水细胞染色体分析及观察方法多为光镜[1·2],受其分辨率和观察范围的限制,难以进一步了解和分析染色体结构。本文用胸水腺癌细胞直接制备中期染色体SEM样本的方法,效果较好。     

胸水CEA、胸水/血清CEA比及肉眼血性胸水在鉴别良恶性胸水中的价值探讨

我院近三年来开展了胸水及血清CEA测定，并对胸腔穿抽液的外观进行了详细记录，发现在鉴别良恶性胸水有重要的意义：因此作了回顾性的分析，现将结果报告如下。     

肿瘤性胸腹水细胞染色体畸变的观察

胸腹水中检出肿瘤细胞是一个可靠的诊断手段，但阳性率只有２８％～６０％［１］。由于积液是一种良好培养基，良性积液中一定数量的间皮细胞和组织细胞在其中增殖，同时发生退化变性，会引起形态上改变，胞体增大，核肿胀，染色质变粗，有时与恶性细胞不易鉴别。我们观察...     

德昂、景颇、彝、傣族染色体C带多态性方法学研究

中国是一个多民族的国家．由于各民族长期在一定隔离的生态环境中繁衍生息．形成了各自不同的遗传类型。研究各民族间的染色体C带多态性．有助于研究各民族的遗传特征．探讨民族间的遗传差异和起源。鉴于此．目前各民族C带多态性研究工作开展迅速，国内外已有一些报道。但还未见少数民族C带多态性研究方法的报道。本文就其研究方法作些初步探讨，报道如下。     

肺癌病人胸水染色体的制备及其变化

恶性肿瘤染色体的检查对于肿瘤研究具有重要意义．已成为临床肿瘤诊断的重要手段。白血病染色体检测技术已取得了很大的进展．积累了丰富的资料；而对实体瘤染邑体的检测，由于取材困难，技术还不过关．进展较缓慢。有资料提示．产生胸(腹)水的实体瘤直接制备的染色体与胸(腹)水制备的染色体其畸变规律是相一致的。     

9号染色体臂间倒位与流产、不孕不育关系的探讨

9号染色体臂间倒位是一种常见的染色体结构异常，关于9号染色体臂间倒位是否有遗传效应，至今仍有争议，一般认为9号染色体臂间倒位可能是一种正常的多态性现象。而近年来，9号染色体臂间倒位具有遗传效应的报道日渐增多，为探讨9号染色体臂间倒位的细胞遗传效应，我们对2803例有不孕不育或流产史患者进行研究，现报告如下。     

骨髓细胞直接制备染色体方法学研究

近年来染色体异常是血液病细胞遗传学的中心课题，但由于制备技术困难，染色体形态不佳，尤其显带染色体结构变化报道较少。因此我们建立几种方法进行分折比较，现将结果报道如下。     

同源染色体平衡易位合并先天愚型

患儿 女，第1胎，足月顺产，出生体重2500g。不会哭，满月脸、眼距宽，外眼睑上吊，平鼻根，张口吐舌，上额弓高，全身皮肤皱折多，肌张力减退，双脚的大脚趾距宽。母亲在怀孕期间无服药史，父母非近亲婚配，均未接触有毒物品。     

肿瘤标志物检测在良恶性胸腹水鉴别价值研究

目的 研究肿瘤标志物在良恶性胸腹水的临床鉴别价值.方法 169例恶性胸腹水患者设为恶性腹水组,146例良性胸腹水设为良性组,比较两组胸腹水癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原(CA) 125、CA19-9水平,并对各肿瘤标志物对良恶性胸腹水的诊断进行方法学评价.结果 恶性组的CEA为(139.7-±56.4) ng/mL、AFP为(189.2±45.2) ng/mL、CA125为(314.7±86.2) U/mL、CA19-9为(158.5±24.2) U/mL,浓度均高于良性组,差异有统计学意义(均P＜0.05);ROC曲线分析CEA、AFP、CA125以及CA19-9曲线下面积分别为0.811、0.547、0.715和0.769,其对应的诊断切点分别为5.6 ng/mL、63.7 ng/mL、38.9 U/mL和30.4 U/mL;AFP因ROC曲线下面积过低不适于恶性胸腹水的诊断.三种肿瘤标志物单独检测方法学评价的各项指标均以CEA最好,灵敏度为75.7％,特异度为88.6％,联合检测以CEA、CA125以及CA19-9的联合检测效果较好,灵敏度为80.5％,特异度为94.0％.结论 肿瘤标志物联合检测对胸腹水的性质鉴别方面有重要的临床应用价值.     

卵巢和子宫恶性肿瘤患者染色体研究

目的：探讨卵巢子宫恶性肿瘤患者外周血染色体、腹水和实体瘤组织染色体改变与肿瘤临床分期愈后关系。结果：２０例恶性卵巢肿瘤和１０例子宫肿瘤外周血染色体分析,１９例有染色体数目畸变,有超二倍体及异倍体,发生率１９／２７;相应组织类型的良性肿瘤３０例,只有３例出现染色体数目数畸变。实验组染色体数目畸变率明显高于对照组。Ｐ〈０．０１。有染色体数目畸变的恶性肿瘤患者,无论临床转移或病理分级恶性程度都较高。     

济宁地区不良妊娠与大Y染色体的细胞遗传学分析

目的探讨不良妊娠与大Y染色体之间的关系。方法采用外周血淋巴细胞培养和G带染色体核型分析,以核型中Y染色体≥18号染色体作为大Y染色体的诊断标准。结果在所有确诊的278例大Y染色体患者中,有243例其妻有不同类型的生殖异常,17例精子发生各种异常,12例不育,6例生长发育迟缓。结论大Y染色体对精子的生成和其配偶孕早期胚胎停止发育有一定关系。     

北京地区78例性染色体异常患者的细胞遗传学分析

目的探讨78例性染色体异常患者的临床表现并进行细胞遗传学分析。方法对患者外周血淋巴细胞行染色体常规G显带核型分析。结果 78例性染色体异常核型中,性染色体数目异常51例,占异常核型的65.38%;性染色体结构异常12例,占15.39%;Y染色体形态异常11例,占14.10%;另外还有性反转综合征4例,占5.13%。结论性染色体异常可导致性分化异常或生殖异常、智力低下等遗传效应,对患者进行染色体的检查,将有助于临床诊断和治疗。     

Chemical pleurodesis for the management of refractory hepatic hydrothorax in patients with decompensated liver cirrhosis

Background/Aims

Hepatic hydrothorax in patients with decompensated liver cirrhosis is a challenging problem. Treatment with diuretics and intermittent thoracentesis can be effective in selected patients. However, there are few effective therapeutic options in patients who are intolerant of these therapies. This study investigated the clinical usefulness of chemical pleurodesis with or without video-assisted thoracoscopic surgery (VATS) for patients with refractory hepatic hydrothorax.

Methods

Eleven consecutive patients with refractory hepatic hydrothorax who underwent chemical pleurodesis with or without VATS between July 2007 and February 2011 were enrolled in this study. The medical records and radiologic imagings of these patients were thoroughly reviewed.

Results

The median number of chemical pleurodesis sessions performed was 3 (range: 2-10). Successful pleurodesis was achieved in 8 of the 11 patients (72.7%), 5 (62.5%) of whom remained asymptomatic and hydrothorax free for a median follow-up of 16 weeks (range: 2-52 weeks). Complications were low-grade fever/leukocytosis (n=11, 100%), pneumonia (n=1, 9.1%), pneumothorax (n=4, 36.4%), azotemia/acute renal failure (n=6, 54.6%), and hepatic encephalopathy (n=4, 36.4%). Five patients were suspected as having procedure-related mortality (45.5%) due to the occurrence of acute renal failure with hepatic failure. The overall survival was significantly longer in the success group than in the non-success group.

Conclusions

Although chemical pleurodesis may improve the clinical symptoms and the radiologic findings in as many as 72.7% of patients with refractory hepatic hydrothorax, a significantly high prevalence of procedure-related morbidity and mortality hinders the routine application of this procedure for such patients.     

大Y染色体与不良妊娠关系的探讨

目的探讨大Y染色体与不良妊娠之间的关系以及临床意义。方法常规外周血淋巴细胞培养制备染色体标本,G显带核型分析716例检测者。结果检出异常核型124例,男性异常核型56例,大Y染色体携带者38例,占男性异常核型的67．86％,可导致其配偶发生习惯性流产、生育智力低下儿、长期不育、有死胎史、有畸形儿生育史以及新生儿死亡并流产等。结论大Y染色体与不良妊娠有关,有一定的临床意义。     

Diagnosis of four chromosome abnormalities of unknown origin by chromosome microdissection and subsequent reverse and forward painting

A molecular cytogenetic method consisting of chromosome microdissection and subsequent reverse/forward chromosome painting is a powerful tool to identify chromosome abnormalities of unknown origin. We present 4 cases of chromosome structural abnormalities whose origins were ascertained by this method. In one MCA/MR patient with an add(5q)chromosome, fluorescence in situ hybridization (FISH), using probes generated from a microdissected additional segment of the add(5q) chromosome and then from a distal region of normal chromosome 5, confirmed that the patient had a tandem duplication for a 5q35-qter segment. Similarly, we ascertained that an additional segment of an add(3p) chromosome in another MCA/MR patient had been derived from a 7q32-qter segment. In a woman with a history of successive spontaneous abortions and with a minute marker chromosome, painting using microdissected probes from the whole marker chromosome revealed that it was i(15)(p10) or psu dic(15;15)(q11;q11). Likewise, a marker observed in a fetus was a ring chromosome derived from the paracentromeric region of chromosome 19. We emphasize the value of the microdissection-based chromosome painting method in the identification of unknown chromosomes, especially for marker chromosomes. The method may contribute to a collection of data among patients with similar or identical chromosome abnormalities, which may lead to a better clinical syndrome delineation. © 1996 Wiley-Liss, Inc.     

Mosaicism for ring and isopseudodicentric chromosome 13

A three-month-old female infant with multiple malformations was noted on routine cytogenetic evaluation to have dicentric/ring mosaicism of chromosome 13. Additional cytogenic investigations indicated that the dicentric could be further defined as an isopseudodicentric. Unlike the double chromosome break in the more common ring 13 cases, the mechanism for isopseudodicentric/ring generation is attributed to chromosome and chromatid breaks with subsequent bridging, breaking and fusion. The phenotypic features are those of a combined duplication-deficiency of chromosome 13.     

Genotoxicity of hydrochlorothiazide in cultured human lymphocytes. I. Evaluation of chromosome delay and chromosome breakage

Hypertension is often treated with diuretics, like hydrochlorothiazide (HCTZ). Previous results on the in vitro genotoxicity of HCTZ are equivocal. In the present study, we have evaluated the genotoxicity of HCTZ in cultured human lymphocytes using the Cytokinesis Blocked Micronucleus (CBMN) assay. In addition, micronucleus (MN) induction was analyzed by Fluorescence In Situ Hybridization (FISH) with an alpha-satellite DNA centromeric probe to distinguish between clastogenic and aneugenic effects. Lymphocyte cultures from 32 healthy adults were exposed to 5 and 40 microg/ml HCTZ. Age, gender, and smoking were evaluated as factors affecting the MN analysis. We found that HCTZ increased MN frequencies. FISH analysis revealed that HCTZ exerts its genotoxicity more strongly at the 40 microg/ml concentration, and principally through chromosome delay (aneugenicity). Multiregression analysis of our results confirmed the known effect of age and gender on MN induction in human lymphocytes. Smoking was also a confounding factor for MN induction, especially for centromere-negative MN frequencies. Under the experimental conditions used, only age had a clear positive effect on the response of lymphocytes to HCTZ. These data indicate that HCTZ produces micronuclei in cultured human lymphocytes by a mechanism that involves chromosome delay and to a lesser extent through chromosome breakage.     

应用荧光原位杂交诊断性染色体异常和绒毛细胞的产前诊断

本文应用近年发展起来的荧光原位杂交（fluorescence in situ hybridization,FISH)技术,对非整倍体染色体45,XX、47,XXX、47,XXY、47,XYY等性染色体异常以生物素标记的X着线粒探针和Y长臀探针进行检测,同时与正常46,XX和46,XY核型作对照,并对两例绒毛细胞作了产前性别诊断,都取得了良好的诊断效果。与常规的诊断有快速、准确、特异等优点。诊断非整倍体性染色体异常和绒毛细胞的产前性别诊断技术性能可靠。为临床多种材料的FISH技术检测打下了基础。