耳鼻咽喉肿瘤的激光手术

本文报道应用激光切除耳、鼻、咽喉肿瘤２０例，取得了良好的效果。激光手术具有出血少、切割骨部无震动，骨创面整齐，封闭肿瘤周围血管和淋巴管，减少肿瘤手术扩散和转移等优点。     

B超诊断肿瘤的国内进展

198 3年在国内最早将 B超应用于乳腺肿块的诊断。因其无创伤、直观、方便、无禁忌症、结论较明确、易重复 ,加之价廉 ,B超检查广泛应用于肝、胆、胰、脾、肾、腹腔、膈下、盆腔等部位肿瘤的诊断。本文对近 2 0年 B超诊断肿瘤的国内进展作一综述。1　乳腺肿瘤1977年 ,Wells等人率先在乳腺恶性肿瘤中探测到Doppler信号 ,开创了乳腺疾病的多普勒超声诊断时代。B超诊断乳腺肿块 ,是国内在超声诊断肿瘤方面的第一次尝试。1983年 ,钱云铉对乳腺肿块进行了 B型超声诊断 ,并对 3 0例X线和 B超检查进行了对比分析 〔1〕。1991年那丽莉等〔2〕报道…     

人肿瘤转移抑制基因TMSG-1单克隆抗体的制备、鉴定及在肿瘤检测中的应用

目的　明确人肿瘤转移抑制基因TMSG- 1蛋白分子量大小和细胞定位,制备和鉴定TMSG- 1单克隆抗体,并探讨其在临床肿瘤标本检测的价值。方法　采用多肽固相合成法 (Fmoc法 )合成 15肽TMSG -1抗原片段,并与匙孔槭血蓝蛋白 (mcKLH)偶联,免疫BALB/C小鼠,采用细胞融合、ELISA法检测和快速有限稀释法筛选和制备单克隆抗体,并应用Western印迹和免疫组织化学ABC法染色进行抗体鉴定和肿瘤检测。结果　筛选出抗TMSG- 1抗体的单克隆杂交瘤细胞系C8,免疫球蛋白亚类测定为IgM。半抗原竞争抑制实验证实该抗体是特异的抗TMSG- 1抗体。Western印迹显示不转移癌细胞亚系 2B4和LH7有明显的相对分子质量为 45 .000蛋白条带,而高转移亚系 1E8和BE1则条带很弱。细胞免疫组织化学染色显示 2B4和LH7强阳性,为细胞膜和细胞质着色;而 1E8和BE1则为阴性。石蜡切片ABC法检测 52例乳腺癌和 41例结肠癌组织中TMSG- 1蛋白表达发现:未转移的癌组织多为中度阳性或强阳性,中度以上阳性率分别为 36% (乳腺癌 )和 52. 4% (结肠癌 );而转移的癌组织多为弱阳性或阴性, 中度以上阳性率分别为 7 .4% (乳腺癌 )和 35% (结肠癌 ),统计学分析表明TMSG 1在未转移癌组织中的表达显著高于转移性癌组织 (P<0 .05)。结论　成功制备了抗人肿瘤转移抑制基     

肿瘤坏死因子的促肿瘤生长及浸润作用

肿瘤坏死因子（ＴＮＦ－α）是一种由活化的单核巨噬细胞等产生的细胞因子。它对肿瘤细胞的杀伤作用已被人们所熟知,但现在越来越多的研究表明ＴＮＦ亦可诱导肿瘤细胞异常增殖和促进肿瘤细胞浸润与转移,本文仅对其促进肿瘤生长,浸润及其相关机制和影响因素做一综述。     

细胞粘附分子与肿瘤研究进展

细胞粘附分子与肿瘤研究进展沈峥嵘综述朱建善审校作者单位：上海第二医科大学附属仁济医院病理科２００００１作者简介：沈峥嵘，女，２９岁，医师细胞粘附分子（ｃｅｌａｄｈｅｓｉｏｎｍｏｌｅｃｕｌｅｓ，ＣＡＭｓ）是位于细胞表面的糖蛋白。ＣＡＭｓ通过介导细胞与细...     

2004年WHO胸腺上皮肿瘤分类简介与浅评

WHO肿瘤分类《肺、胸膜、胸腺和心脏肿瘤病理学和遗传学》（2004年）（以下简称新版）由Travis等主编,全世界一百多位专家参加了编写。与以往的各分册相比,体现了发展的思想,有很多新颖和科学的观点,增加了一些新的肿瘤类型以及最新的诊断标准,对病理和临床医生的实际工作均有指导意义。胸腺肿瘤是该书的第3章,由Miiller-Hermelink主编,依然遵循了《胸腺肿瘤组织病理学分类》1999年版（以下简称99版）分类的原则。本文简评其中的胸腺上皮肿瘤（thymic epithelial tumours,TET）分类修改、增补和未完善之处。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.