125I粒子组织植入治疗难治性海绵血管瘤的临床应用

目的:探讨125I粒子组织植入在难治性海绵血管瘤治疗中的可行性。方法:选择2005-01/2006-03长海医院整形外科收治的海绵血管瘤患者4例,经患者知情同意后行I粒子组织植入治疗,且得到医院伦理道德委员会批准。术前行CT/MRI或/和B型超声波检查,详细计算瘤体体积和所需处方剂量。植入粒子时应该避开神经,距离应大于17mm为宜。放射性粒子采用中国原子能科学院生产的外形为圆柱状钛合金封体的125I放射粒子源(批号:国药准字H20045969),长4.5mm,直径0.8mm,平均能量27～35keV,半衰期60.1d,半价层0.025mmPb,组织穿能力为1.7cm。术中经皮组织间永久植入125I粒子,粒子以1.5～2.0cm的间距均匀排布于血管瘤组织中。术后应用CT/MRI检查血管瘤的体积变化,应用X射线检查有无粒子丢失或游走。结果:4例患者全部进入结果分析,无脱落。①全部病例共植入125I粒子97粒,平均24.25粒,其中最少20粒,最多30粒。粒子平均活度1.85×107Bq,共1.79×109Bq。②术中患者未见不良反应,术后血液学检查正常。③所有病例均获得随访,随访时间分别为10,12,14,24个月。随访期内CT/MRI检查可见肿瘤体积均有不同程度的缩小;肿瘤无复发,无明显放疗反应;X射线监测无粒子丢失或游走。结论:应用I粒子植入治疗血管瘤,具有操作简单、患者痛苦小、见效快等优点,初步结果满意,有望成为治疗血管瘤的新方法。     

^125I粒子组织间植入对小鼠Lewis肺癌细胞VEGF—C和COX-2表达影响

目的探讨^125I粒子组织间植入对小鼠Lewis肺癌细胞血管内皮生长因子c（VEGF-C）和环氧化酶2（COX-2）表达的影响。方法建立小鼠Lewis肺癌模型，治疗组（n=17）在瘤体内植入2粒放射活性为9．25MBq的^125I籽源，对照组（n=16）植入2粒无放射活性的空心籽源。治疗21d，记录小鼠的存活率；处死存活小鼠，计算肿瘤体积抑制率。摘除的肿瘤组织行常规病理学检查。采用免疫组织化学方法检测两组VEGF-C和COX-2表达情况。结果治疗组和对照组小鼠存活率分别为82．35％和62．50％，差异无显著性（x^2=1．64，P〉0．05）；治疗组肿瘤体积抑制率为71．13％。病理检查显示治疗组近^125I籽源处肿瘤细胞变性坏死，对照组近空心籽源处可见存活肿瘤细胞。免疫组织化学显示，治疗组COX-2及VEGF-C表达水平低于对照组，差异有显著性（x^2=6．52、9．45，P〈0．01）。结论^125I粒子组织间植入可以抑制小鼠Lewis肺癌细胞的增殖、迁移能力，其效应可能通过抑制COX-2活性进而抑制VEGF-C的表达来实现。     

^125I粒子与^125I粒子联合5-FU缓释粒子同步组织间植入治疗肝癌的实验研究

目的:比较125I粒子组织间植入与125I粒子联合5-FU缓释粒子同步组织间植入对小鼠皮下肝癌移植瘤的治疗效果。方法:24只BALB/C小鼠皮下移植肿瘤细胞H22建瘤,荷瘤鼠随机分为四组,每组6只。A组为125I粒子治疗组,B组为5-FU缓释粒子治疗组,C组为联合125I粒子和5-FU缓释粒子治疗组,D组为对照组。连续观察25 d小鼠存活情况,测量肿瘤大小,进行常规病理学检查。免疫组织化学法检测PCNA、FAS的表达。结果:观察25 d,3个治疗组的小鼠存活率、平均肿瘤体积、病理分别和对照组比较差异有统计学意义(P均<0.01),125I治疗组与联合治疗组间差异有统计学意义(P<0.01)。免疫组化反映治疗组肿瘤细胞凋亡明显,具有统计学意义,125I治疗组与联合治疗组比较差异有统计学意义。结论:125I粒子组织间植入持续照射可以直接杀死肿瘤细胞,抑制肿瘤生长;125I联合5-FU缓释粒子同步植入疗效更好,方法可行。     

125I 粒子组织间植入治疗前列腺癌放射防护研究进展

从125 I 粒子组织间植入治疗的原理与优势、前列腺癌应用125 I 粒子组织间植入治疗现状、外放射防护的基本原则、125 I 粒子组织间植入治疗前列腺癌放射防护、医务人员放射防护存在的问题5个方面综述了125 I 粒子组织间植入治疗前列腺癌的放射防护研究进展。     

125I放射性粒子治疗晚期胰腺癌的护理

晚期胰腺癌是一种常见的消化道恶性肿瘤.由于胰腺癌早期的症状不典型,不易被发现,待肿瘤侵犯及压迫胆道出现黄疸,或侵及周围组织出现疼痛症状而就诊时多数为疾病的晚期;加之肿瘤位置深,周围毗邻组织和器官结构复杂,手术切除率仅在10%～20%.术后生存时间短,5年生存率极低,不到5%.我院近来采用125I放射性粒子治疗晚期胰腺癌取得初步临床效果,现报告如下.     

肝癌患者肝组织中CD105的表达及临床意义

目的:探讨肝癌患者肝组织中CD105的表达特征及其与预后和临床病理参数的关系.方法:选取原发性肝癌根治切除术的石蜡包埋标本100例,用CD105单克隆抗体进行免疫组化染色,进行CD105标记的微血管密度(MVD-CD105)定量计数,并与相应患者的临床病理学参数和无病生存期进行统计学分析.结果:肿瘤组织内CD105染色阳性率为100%(100/100);癌旁肝硬化组织内染色阳性率为40.6%(28/69):癌旁正常组织染色阳性率为4%(4/100);非肝癌患者正常肝组织无阳性染色.肿瘤内MVD-CD105数值与TNM分期、有无静脉侵犯呈正相关(P＜0.05).将肿瘤组织内MVD值的均数作为分界,高MVD-CD105组较低MVD-CD105组的无病生存期明显降低(P＜0.01);癌旁肝硬化组织内CD105阳性组的无病生存期较阴性组明显缩短(P＜0.05).结论:在肝癌患者肝组织中CD105主要表达在肝癌组织及癌旁肝硬化组织中:肿瘤内MVD-CD105能准确地评价肿瘤新生血管,预测原发性肝癌根治术后的复发、转移;癌旁肝硬化组织中CD105的阳性表达可能与癌变相关,CD105可以作为原发性肝癌血管治疗的靶点.     

放射性~(125)I粒子组织间植入治疗肺癌30例分析

我院2003-06~2005-06采用胸腔镜下肿瘤区125I植入或CT引导经皮肺穿刺125I植入治疗中晚期肺癌患者30例,报告如下。1临床资料1.1一般资料本组均经CT、病理或肿瘤标志物检查确诊。男22例,女8例,年龄46~81岁(平均62)岁。鳞癌14例,腺癌12例,腺鳞癌4例。肿瘤直径<3 cm 5例,3~5 cm 22例,>5 cm 3例。TNM分期Ⅱ~Ⅲb。初治15例,化疗后10例,手术后复发5例。本组除外心、肺、肝、肾等器官功能不全;双肺弥漫性病变;肺转移灶<3个;出血倾向及恶液质者。1.2治疗材料和计划的选择放射性粒子由中国原子能科学院生产。本治疗计划系统(3D-TPS)由北京原博生…     

CT引导^125I粒子植入治疗非小细胞肺癌75例分析

目的：探讨CT引导下放射性125I离子植入对非小细胞肺癌的疗效。方法：对75例非小细胞肺癌患者,应用治疗计划系统（Treatment planning system,TPS）估算粒子数量,在CT引导下,穿刺植入粒子。2-3个月后CT复查,用高级肺结节分析（Advanced Lung Analysis,ALA）软件测定治疗前后结节或肿块的大小,按照完全缓解、部分缓解、无变化、进展来评判治疗的效果。结果：完全缓解4例,部分缓解54例,无变化13例,进展4例,有效率77.3%。结论：CT引导粒子植入术对非小细胞肺癌治疗有效且安全,值得推广和应用。     

~(125)I放射粒子种植治疗原发性肝癌26例的护理

总结26例原发性肝癌患者肝组织植入放射性粒子125I的护理。术前护理要点为进行健康教育,讲解有关放射性防护的知识,做好各类术前准备;术后注意预防并发症,观察有无腹腔内出血、粒子移位等,做好患者、医务人员的放射性防护管理及饮食指导。本组术后肝功能无明显异常,术后平均生存时间为12.6个月,最长达17个月。     

CT引导下~（125）I放射性粒子植入术60例的护理

目的探讨CT引导下125I放射性粒子植入术围手术期的护理措施。方法 60例病例在CT引导下接受125I粒子植入术,按照其病情及接受的介入术种类,分别在术前、术中、术后给予针对性的护理。结果 60例均全部成功植入125I粒子,通过开展围手术期的护理,均恢复良好,无粒子脱出,无严重并发症发生。结论重视做好粒子植入术的护理,能大大地提高疗效,同时也最大程度地保证患者生命安全。     

Antigenic differences in nuclear proteins of normal liver and hepatoma

A nuclear antigen was detected in the mouse liver nonhistone protein fraction by using antibodies to whole liver cells. The antigen was purified to homogeneity from perchloric acid extracts of liver tissue. It gave a single band corresponding to tool wt 21,000 in sodium dodecyl sulfate gel electrophoresis. Amino acid and carbohydrate analysis showed predominance of the acidic amino acids, lack of proline, and absence of carbohydrate. Immunofluorescence staining of liver sections confirmed the nuclear localization of the antigen. Its tissue distribution was studied by using radioimmunoassay. Of the various tissues extracted for analysis, the liver contained the highest amounts of the antigen, about 1 μg/mg of solubilized liver protein. Other tissues examined showed 2-4 percent of the amount of antigen present in the liver. Two transplantable hepatomas in C3H/HeJ and C57L/J mice, respectively, and three spontaneous C3H hepatomas showed greatly decreased levels of the antigen compared to normal liver. The amount of antigen in hepatomas varied from nondetectable to 2 percent of the amount of antigen found in the livers of the mice. The antigen was also found in the blood. The antigen was found in high concentrations (up to 13 mg/ml) in the urine of normal mice. This suggests identity with the previously known mouse urinary protein (MUP). In addition to the extremely high urinary output, the properties found to be shared by MUP and the nuclear antigen included similar serum concentrations (2-60 μg/ml), a sex difference with lower values in females, same molecular size as determined by gel filtration, and immunological identity. The nuclear localization of MUP and its disappearance from hepatomas suggest that it may have an important regulatory function.     

N-acetylglucosaminyltransferase III in human serum, and liver and hepatoma tissues: increased activity in liver cirrhosis and hepatoma patients

An N-acetylglucosaminyltransferase III which catalyzes the addition of N-acetylglucosamine through a beta 1-4 linkage (bisecting N-acetylglucosamine) to the beta-linked mannose of the trimannosyl core structure of N-linked oligosaccharides of glycoproteins was measured in human serum, and liver and hepatoma tissues. The enzyme activity in serum was significantly elevated in patients with hepatomas and liver cirrhosis, and the activity markedly decreased on the transcatheter arterial embolization treatment. High activities were also found in the hepatoma and cirrhotic liver tissues, indicating that the serum activity reflected the activity in the tissues. The assaying of the enzyme activity in serum appears to be useful for the detection and monitoring of primary hepatomas.     

肝癌组织和肝癌旁组织中γ-谷氨酰转肽酶糖链结构分析

目的比较肝癌组织和肝癌旁组织中γ-谷氨酰转肽酶(γ-GT)活力及其N-连接型糖链结构的变化.方法用荧光分光光度法测定肝癌组织和肝癌旁组织中的γ GT活力,并用固相凝集素亲和层析测定γ-GT的糖链与刀豆球蛋白(ConA)和曼陀罗凝集素(DSA)结合百分比,以研究肝癌γ-GT糖链结构的变化.结果肝癌组织中γGT活力均较肝癌旁组织明显增高.两者相比,肝癌组织中γ GT与ConA柱不结合的组分明显升高,弱结合和强结合的组分显著降低;在DSA柱上则相反,不结合的γ-GT组分显著降低,弱结合和强结合的γ-GT组分显著升高.结论肝组织癌变后,其γ-GT活力明显增高,而且伴随着γ-GT糖链结构的明显变化二天线糖链结构明显减少,三、四天线糖链结构明显增高.提示带多天线糖链结构的γ-GT可能是一种肝癌标志物.     

肝癌组织和肝癌旁组织中γ—谷氨酰转肽酶糖链结构分析

目的：比较肝癌组织和肝癌旁组织中γ－谷氨酰转肽酶（γ-GT）活力及其N－连接型糖链结构的变化。方法：用荧光分光光度法测定肝癌组织和肝癌旁组织中的γ-GT活力，并用固相凝集素亲和层析测定γ-GT的糖链与刀豆球蛋白（ConA）和曼陀罗凝集素（DSA）结合百分比，以研究肝癌γ-GT糖链结构的变化，结果：肝癌组织中γ-GT活力均较肝癌旁组织明显增高，两者相比，肝癌组织中γ-GT与ConA柱不结合的组分明显升高，弱结合和强结合的组分显著降低，在DSA柱上则相反，不结合的γ-GT组分显著降低，弱结合和弱结合的γ-GT组分显著升高，结论：肝组织癌变后，其γ-GT活力明显增高，而且伴随着γ-GT糖链结构的明显变化：二天线糖链结构明显减少，三、四天线糖链结构明显增高，提示带多天线糖链结构的γ-GT可能是一种肝癌标志物。     

肝移植术后早期桡动脉与股动脉有创血压的差异研究

目的探讨肝移植术后早期患者桡动脉与股动脉有创血压监测的差异性。方法选择2015年1月至2015年12月间我院重症医学科收治的肝移植术后患者22例,对肝移植术后入ICU当时至术后1天内8个时间点,同步进行桡动脉和股动脉有创血压监测。根据股动脉收缩压水平分为3组:A组,收缩压(systolic blood pressure,SBP)90~140 mm Hg(1 mm Hg=0.133 k Pa);B组,SBP140 mm Hg;C组,SBP90 mm Hg,测量桡动脉与股动脉有创血压的差值。结果当股动脉收缩压在正常范围内,股动脉与桡动脉的收缩压、舒张压及平均动脉压无明显差异,差异无统计学意义(P0.05);当股动脉收缩压90 mm Hg时,股动脉的收缩压及平均动脉压明显高于桡动脉压,差异有统计学意义(P0.05);当股动脉收缩压140 mm Hg时,股动脉收缩压明显小于桡动脉,差异有统计学意义(P0.05)。结论肝移植术后患者早期低血压及高血压状态下,桡动脉与股动脉有创血压存在较大差异,低血压状态下桡动脉血压监测易低估患者实际血压水平,而高血压状态下表现为高估患者血压水平。     

Incorporation of 5-fluorouracil into rat liver tumor and normal tissues and the liver nucleotide profile after administration by the hepatic artery during portal venous branch ligation

A therapeutic dose of labelled 5-fluorouracil (5-FU) was infused via the hepatic artery during 30 min with or without ligation of the left portal venous branch in Wistar rats with a secondary liver cancer in the left lateral lobe. After another 60 min, the incorporation of 5-FU into the acid soluble fraction (ASF), ribonucleic acid (RNA) and deoxyribonucleic acid (DNA), was determined in tumor, ligated and unligated liver lobes, small intestine, kidney, and bone marrow. The liver nucleotide profile was examined with isotachophoresis. Portal venous branch ligation (PVBL) caused the following changes, compared with the unligated control group: in the tumor, the incorporation of 5-FU into RNA and DNA decreased and the ratio RNA/acid-soluble fraction labelling decreased. The incorporation increased in intestinal and bone marrow RNA. It was unchanged in liver and kidney. The ratio of tumor to peripheral normal-tissue (small intestine, bone marrow, and kidney) labelling of RNA and DNA decreased. Liver nucleotides (F) UTP, (F)UDP-glucuronic acid, (F)UDP-N-acetylhexosamine, and NAD were lower in the ligated than in the unligated liver lobe. ATP and energy charge did not decrease significantly. In conclusion, PVBL in conjunction with hepatic arterial administration of 5-FU increased systemic drug exposure and possibly decreased hepatic tumor anabolism. It has not been examined how this interferes with the therapeutic effect.     

Differential DNA methylation status between breast carcinomatous and normal tissues

Breast cancer has been considered to be a multifactorial disease with a wide array of well-characterized gene mutations and chromosomal abnormalities. However, it is becoming evident that the onset or development of breast cancer also depends on epigenetic factors, although the mechanisms have not been fully elucidated. We performed a genome-wide analysis of DNA methylation of breast carcinomatous tissues and paired normal tissues to examine the differences in methylation between them. Methylation-specific polymerase chain reaction (MSP) was used to validate the hypermethylated genes screened out by DNA methylation microarray. We found that hypomethylation and hypermethylation occurred in 2753 and 1795 genes, respectively, in breast carcinomatous tissues. Meanwhile, gene ontology analysis and ingenuity pathway analysis revealed the function and pathway of several genes whose methylation status was altered in breast carcinomatous tissues. In addition, we investigated the promoter methylation status of four genes in breast carcinomatous tissue and paired normal tissues (n = 30) by MSP. Promoter hypermethylation of CRABP1, HOXB13, IFNGR2, and PIK3C3 was found in 37% (11/30), 23% (7/30), 17% (5/30), and 2% (2/30) of the carcinomas, respectively. Mutation of these four important genes was critical to many types of cancer. Our results suggest that DNA methylation mechanisms may be involved in regulating the occurrence and development of breast cancer.     

肝病患者的肝组织单细胞悬液与外周血中淋巴细胞亚群的分析比较

目的 探讨肝脏组织单细胞悬液的制备方法,了解慢性肝病患者的肝组织和外周血的淋巴细胞亚群差异.方法 分别选择慢性乙型肝炎（CHB）14例、自身免疫性肝炎（AIH）4例和原发性肝细胞癌（HCC）3例,在超声引导下经皮作肝脏穿刺活检,用单细胞制备仪或物理研磨方法将肝组织制备成单细胞悬液,肝组织中淋巴细胞经4种特异性荧光抗体标记,在流式细胞仪（FCM）上作四色荧光分析,并与外周血测定结果比较.结果 单细胞制备仪和物理研磨方法制备的肝组织单细胞悬液,细胞成活率分别为92.4%和91.5%;检测肝组织单细胞悬液中淋巴细胞亚群,正常对照组和慢性肝病各组间差异均有显著性（P〈0.05）,AIH组和CHB组间差异有显著性（P〈0.05）.而外周血中淋巴细胞亚群检测,HCC组和CHB组间差异有显著性（P〈0.05）.肝组织和外周血相应项目比较差异均有显著性（P〈0.05）.结论 用2种方法制备单细胞悬液能满足FCM检测的特殊需要;肝脏组织中淋巴细胞与外周血的淋巴细胞亚群比例差异有显著性.     

肝病患者的肝组织单细胞悬液与外周血中淋巴细胞亚群的分析比较

目的探讨肝脏组织单细胞悬液的制备方法,了解慢性肝病患者的肝组织和外周血的淋巴细胞亚群差异。方法分别选择慢性乙型肝炎(CHB)14例、自身免疫性肝炎(AIH)4例和原发性肝细胞癌(HCC)3例,在超声引导下经皮作肝脏穿刺活检,用单细胞制备仪或物理研磨方法将肝组织制备成单细胞悬液,肝组织中淋巴细胞经4种特异性荧光抗体标记,在流式细胞仪(FCM)上作四色荧光分析,并与外周血测定结果比较。结果单细胞制备仪和物理研磨方法制备的肝组织单细胞悬液,细胞成活率分别为92.4%和91.5%;检测肝组织单细胞悬液中淋巴细胞亚群,正常对照组和慢性肝病各组间差异均有显著性(P<0.05),AIH组和CHB组间差异有显著性(P<0.05)。而外周血中淋巴细胞亚群检测,HCC组和CHB组间差异有显著性(P<0.05)。肝组织和外周血相应项目比较差异均有显著性(P<0.05)。结论用2种方法制备单细胞悬液能满足FCM检测的特殊需要;肝脏组织中淋巴细胞与外周血的淋巴细胞亚群比例差异有显著性。