精氨酸对心肺转流术后红细胞免疫的调节作用

目的 探讨精氨酸（Ｌ－Ａｒｇ）对心肺转流术（ＣＰＢ）后患者红细胞免疫功能的调节作用。方法 随机选择ＣＰＢ术后患者３０例,分为实验组和对照组,对两组患者术后外周血红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）和循环免疫复合物的动态变化进行了对比。结果 实验组红细胞Ｃ３ｂ受体花环率、红细胞免疫复合物花环率术后明显高于对照组,循环免疫复合物也于术后２周恢复正常。结     

膀胱肿瘤患者红细胞免疫功能的测定

为观察膀胱肿瘤患者红细胞免疫功能状况，对４８例膀胱肿瘤患者施行红细胞免疫功能测定，结果红细胞Ｃ３ｂ受体花环率（ＲＢＣ．Ｃ３ｂＲ）较正常组降低，红细胞免疫复合物（ＲＢＣ．ＩＣＲ）升高（Ｐ〈０．０５）；自然肿瘤红细胞花环率（ＮＴＥＲ），直向肿瘤红细胞花环率（ＤＴＥＲ）促肿瘤细胞花环率（ＥＴＥＲ）和协同肿瘤红细胞花环率（ＡＴＥＲ）较正常明显降低（Ｐ〈０．０１）；膀胱肿瘤患者病理分级，分期之间红细胞免疫功     

梗阻性黄疸患者围手术期红细胞免疫功能的临床研究

作者对２６例梗阻性黄疸患者围手术期红细胞免疫功能变化进行了观察。通过梗阻性黄疸患者红细胞Ｃ３ｂ受体花环形成实验，发现红细胞Ｃ３ｂ受体花环促进率（ＲＦＥＲ）明显低于非黄疸患者，而红细胞免疫复合物花环实验（ＩＣＲＴ），红细胞Ｃ３ｂ受体花环抑制率（ＲＦＩＲ）的活性明显高于无黄疸组患者。提示梗阻性黄疸患者红细胞免疫功能紊乱可能是其感染性并发症发生率较高的原因之一。     

泌尿系肿瘤患者红细胞免疫功能的观察

目的：探讨红细胞免疫功能在泌尿系肿瘤中的改变。方法：测定５６例泌尿系肿瘤患者红细胞免疫功能，与正常组及泌尿系非肿瘤患者组相比。结果：红细胞Ｃ３ｂ受体花环率（ＲＢＣ·Ｃ３ｂＲ）降低而红细胞免疫复合物花环率（ＲＢＣ·ＩＣＲ）升高（Ｐ＜０．０５）；自然肿瘤红细胞花环率（ＮＴＥＲ）、直向肿瘤红细胞花环率（ＤＴＥＲ）、促肿瘤红细胞花环率（ＥＴＥＲ）及协同肿瘤红细胞花环率（ＡＴＥＲ）显著降低（Ｐ＜０．０１）。结论：泌尿系肿瘤患者红细胞免疫功能低下或紊乱。     

胃癌大肠癌病人红细胞免疫功能的变化

观察２５例胃癌和１５例大肠癌病人手术前后一周内红细胞Ｃ３ｂ受体花环试验（ＲＢＣ－Ｃ３ｂ）和红细胞免疫复合物花环率试验，结果显示，胃癌大肠癌病人红细胞Ｃ３ｂ受体免疫粘附功能显著低于正常对照组，部分胃癌病人红细胞免疫复合物花环率显著低于正常人，部分胃癌病人变化不明显，手术和化疗不影响细胞免疫功能，提示红细胞免疫功能缺陷可能是原发或继发，红细胞Ｃ３ｂ受体损坏可能是不可逆的，动态观察红细胞免疫功能有重要的     

骨肉瘤患者红细胞免疫功能与T淋巴细胞亚群的变化

目的：探讨骨肉瘤患者红细胞免疫功能与Ｔ淋巴细胞亚群的变化。方法：测定３５例骨肉瘤患者红细胞补体受体花环率（Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＩＣＲ）、红细胞免疫促进因子（ＲＦＥＲ）、红细胞免疫抑制因子（ＲＦＩＲ）和Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）的功能。同时测定３０例健康献血员免疫指标作对照。结果：骨肉瘤患者Ｃ３ｂＲＲ、ＲＦＥＲ、ＣＤ３、ＣＤ４较对照组用明显降低（Ｐ〈０．０５）,而Ｒ     

胆囊结石患者手术前后红细胞免疫功能研究

目的 探讨胆囊结石患者红细胞免疫功能的状况，借以评估其病情转化和预后。方法 对３０例胆囊结石患者手术前后外周血红细胞免疫功能采用酵母花环法进行了动态检测。结果 胆囊结石患者与健康人相比，红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）下降（Ｐ〈０．０５）；红细胞免疫复合物花环率（ＲＩＣＲ）升高（Ｐ〈０．０５）；红细胞免疫粘附促进因子百分率（ＲＦＥＲ）下降（Ｐ〈０．０１）；抑制因子百分率（ＲＦＩＲ）升高     

膀胱肿瘤患者红细胞免疫功能的变化

目的 探讨膀胱肿瘤患者的红细胞免疫功能状态及与Ｔ淋巴细胞亚群改变的关系。方法 测定３４例膀胱移行细胞癌患者的红细胞Ⅰ型补体受体花环率（Ｃ３ｂＲＲ）、免疫复合物花环率（ＩＣＲ）及４项肿瘤红细胞花环率［直向肿瘤红细胞花环试验（ＤＴＥＲ）、促肿瘤红细胞花环试验（ＥＴＥＲ）、协同肿瘤红细胞花环试验（ＡＴＥＲ）及自然肿瘤红细胞花环试验（ＮＴＥＲ）］,同时用流式细胞仪（ＥＴＥＲ）检测Ｔ细胞亚群,与年龄相近的３     

前列腺癌患者的红细胞免疫功能及T淋巴细胞亚群变化观察

目的探讨前列腺癌患者红细胞免疫功能状态及与Ｔ淋巴细胞亚群改变的关系。方法测定１２例前列腺癌患者的红细胞Ｃ３ｂ受体花环率（Ｃ３ｂＲＲ）、免疫复合花环率（ＩＣＲ）及四项肿瘤红细胞花环率（ＤＴＥＲ、ＥＴＥＲ、ＡＴＥＲ、ＮＴＥＲ）,用流式细胞仪（ＦＣＭ）检测Ｔ细胞亚群,与年龄相近的１５例良性前列腺增生症（ＢＰＨ）患者作比较,并测定了２０名健康献血员的红细胞免疫指标作对照。结果前列腺癌组Ｃ３ｂＲＲ降低,ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８均低于ＢＰＨ组。ＢＰＨ组Ｃ３ｂＲＲ和ＤＴＥＲ低于对照组。前列腺癌组Ｃ３ｂＲＲ与ＣＤ４／ＣＤ８比值呈正相关。结论前列腺癌患者红细胞免疫功能低下,Ｔ淋巴细胞免疫活性下降,两者关系密切。前列腺癌易发生血行扩散可能与红细胞免疫功能低下有关。ＢＰＨ患者红细胞免疫粘附能力降低为老年性改变。     

骨肉瘤患者红细胞免疫功能与T淋巴细胞亚群的变化

目的 探讨骨肉瘤患者红细胞免疫功能状态与Ｔ淋巴细胞亚群改变的关系。方法 测定３５例骨肉瘤患者红细胞补体受体花环率（Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＩＣＲ）、红细胞免疫促进因子（ＲＦＥＲ）、红细胞免疫抑制因子（ＲＥＩＲ）和Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）的功能状态。结果 骨肉瘤患者Ｃ３ｂＲＲ、ＲＦＥＲ、ＣＤ３、ＣＤ４较正常对照组降低（Ｐ〈０．０５）,而ＩＲＣＲ、ＲＦＩＲ、ＣＤ８则正常     

T-cell bearing IgG-Fc receptor in patients with bladder cancer

The T-cell bearing Fc receptor (IgG-FcR+ T cell) has been considered as a suppressor or a part of the killer cell, as determined by its function. The population of IgG-FcR+ T cells was determined by Moretta 's method in patients with urinary bladder cancer, urological benign diseases and in normal subjects. The population of IgG-FcR+ T cells in the peripheral lymphocytes of 16 patients with urinary bladder cancer was 20.5 +/- 10.1%, that of 7 patients with urological benign diseases was 9.5 +/- 3.2%, and that of 8 normal subjects was 9.0 +/- 2.1. The population of IgG-FcR+ T cells in the peripheral lymphocytes patients with high stage bladder cancer was significantly higher than that of patients with low stage cancer. In low stage bladder cancer cases, the population of IgG-FcR+ T cells was decreased to the normal range at three weeks after removal of the tumor. But in high stage bladder cancer cases, it was not changed at 3 weeks.     

膀胱癌中AEBP1的表达及预后相关性

目的 通过GEO公共数据库，探索AEBP1高表达组与低表达组在膀胱癌患者临床病理特征的表现差异，判断AEBP1的表达对膀胱癌术后患者特异性生存率与总体生存率的影响。方法 对从NCBI中收集到的膀胱癌公共数据集进行回顾性与预后分析，再利用基因集富集分析方法分析AEBP1推动膀胱癌发展的可能机制。结果 显示在不同侵袭性（P<0.001）、分级（P<0.001）、T分期（P<0.001）、N分期（P=0.002）的膀胱癌患者中，AEBP1的表达均有显著性差异，具体表现为高表达组临床特征差于低表达组；并且有AEBP1的表达与膀胱癌患者术后的总体生存和特异性生存相关联，AEBP1高表达组膀胱癌患者的肿瘤特异性生存期明显差于AEBP1低表达组膀胱癌患者（P=0.0003，HR=0.272，95%CI：0.135～0.548），AEBP1高表达组膀胱癌患者的总体生存期亦明显差于AEBP1低表达组膀胱癌（P=0.0159，HR=0.5479，95%CI：0.3360～0.8934）。AEBP1高表达样本富集了与肌细胞生成、炎症反应、紫外线反应、MYC信号通路、内皮 间质转换、Notch信号通路、KRAS信号通路、IL6、JAK、STAT通路、IL2、STAT5信号通路、Hedgehog通路、TNF-α通路、补体、干扰素γ、顶端结、凝固、黏液、缺氧、血管生成、顶面、同种异体移植排斥相关的基因。结论 AEBP1与膀胱癌中多个病理指标相关联，高表达组的膀胱癌患者临床预后更差，进一步分析AEBP1推动膀胱癌发展的机制，对于膀胱癌的抑制发展和治疗有着重要的意义。     

The study of infiltrating lymphocytes in the tissues of bladder carcinoma

Using 121 patients with bladder cancer operated on at our institutes, the relationship between lymphocyte infiltration and grading, staging or patients' prognosis was studied for evaluating regional immunocompetence in bladder cancer. There was no correlation between number of infiltrating lymphocytes and tumor grading or staging. However, the patients with high grade or advanced stage showed high recurrence rate and mortality. The same tendency was observed in patients whose tumor had few infiltrating lymphocytes. A lymphocyte subset was detected in both peripheral blood and tumor extracts in 15 cases of bladder cancer. Compared with the normal controls, T cell percent was lower and T gamma cell ratio was higher in peripheral blood of bladder cancer patients. T cell percent was almost equal in peripheral blood and in cancer tissue, but the T gamma cell ratio in the cancer patients was much higher than that in blood. In the tumor tissues, high T cell and lower T gamma cell percentages were observed at basal areas than those at superficial portions. These results suggest that infiltrating lymphocytes may take part in the host response to the tumor in bladder cancer. Classification of these lymphocytes based upon function will be necessary for further study.     

Neodymium:YAG laser therapy for infiltrating bladder cancer

There were 32 high risk patients with stages T2 to T4 bladder cancer treated with neodymium:YAG laser irradiation to the tumor base after cautery resection between July 1981 and October 1986. All 12 patients with stage T2 disease followed for 6 to 78 months had no recurrence locally although 4 had stage T1 recurrences elsewhere in the bladder. Of 14 stage T3 cancer patients 8 demonstrated tumor persistence locally but 3 were well 4 to 24 months later without local recurrence (all stage T3a) and 3 were alive 14 to 24 months later with stage T1 recurrences. Of 6 stage T4 cancer patients 4 obtained reasonable hemorrhagic control with laser irradiation used for palliation purposes. A 90-year-old man with stage T3b disease died 5 days postoperatively of a myocardial infarct but no bladder or bowel perforation was documented. We believe that neodymium:YAG laser irradiation is a safe alternative for the treatment of bladder cancer in selected patients.     

再次经尿道电切术治疗非肌层浸润性膀胱癌

目的 总结再次经尿道电切术(Re-TUR)治疗非肌层浸润性膀胱癌的疗效.方法 2004年3月至2008年8月共收治462例非肌层浸润性膀胱癌,男性350例,女性112例,年龄35～83岁.在初次经尿道电切术后根据肿瘤分期和分级,以及标本有无肌层组织进行评估,有125例患者在术后4～6周行Re-TUR,其中Ta期49例,T1期76例;低级别癌58例,高级别癌67例;T1期肿瘤标本内未见肌层组织30例.结果 125例非肌层浸润性膀胱癌患者行Re-TUR,34.4%(43/125)发现有肿瘤残留,其中35例肿瘤未侵犯肌层,Ta期15例,T1期20例;8例肿瘤侵犯肌层.高级别癌的肿瘤残留率较低级别癌高(P<0.05);初次电切标本中无肌层的肿瘤残留率较有肌层的高(P<0.05).12例(9.6%)患者在初次电切术时肿瘤分期被低估.Re-TUR术中发生膀胱穿孔6例,膀胱出血7例.随访3～56个月;Re-TUR发现肿瘤残留的患者,37.2%(16/43)复发,高于Re-TUR未发现肿瘤残留的患者(12.2%,P<0.05).结论 T1期、高级别或初次电切标本无肌层的非肌层浸润性膀胱癌患者术后4～6周应行Re-TUR.Re-TUR能提高分期的准确性.     

Recurrence of Primary Superficial Bladder Cancer Treated with Prophylactic Intravesical Tokyo 172 Bacillus Calmette-Guerin: A Long-Term Follow-up

Background Long-term results after transurethral resection (TUR) and prophylactic intravesical Tokyo 172 bacillus Calmette-Guerin (BCG) therapy for primary superficial bladder cancer were analyzed by multivariate analysis, and factors affecting the recurrence of bladder tumors after this therapy were examined.
Methods One-hundred and forty-one consecutive patients with primary superficial bladder cancer who consulted the Department of Urology at Wakayama Medical College and affiliated hospitals between May 1985 and May 1990 were studied. Tokyo strain BCG was given intravesically (80 mg in 40mL saline) weekly for 6 weeks.
Results The 5-year cumulative recurrence-free rate by the Kaplan-Meier method was 0.702 in 141 patients with primary superficial bladder cancer. The 5-year recurrence-free function using the proportional hazard model was 0.743. Using the Cox proportional hazard model, variables that significantly contributed to recurrence after intravesical BCG included female sex, tumor size less than 1 cm in diameter, and T1 tumor stage. Patient age, tumor type, multiplicity, tumor grade, and concomitant carcinoma in situ did not contribute to recurrence.
Conclusion Long-term results showed that prophylactic intravesical Tokyo strain BCG after TUR for primary superficial bladder cancer is also effective in preventing the recurrence of bladder cancer, and the biologic behavior of superficial bladder cancer other than stage T1 tumor may be altered after intravesical BCG.     

血清VEGF、MCP-1联合LncRNA XIST评估膀胱癌患者预后的价值

目的 探讨血清血管内皮生长因子（VEGF）、单核细胞趋化蛋白-1（MCP-1）联合长链非编码核糖核酸 X染色体失活特异性转录本（LncRNA XIST）评估膀胱癌患者预后的价值。方法 选择2018年6月至2019年6月本院收治的膀胱癌患者52例作为观察组,另选择同期接受体检的健康者43例作为对照组。两组分别于术前和体检时采集空腹状态外周静脉血,测定血清VEGF、MCP-1、LncRNA XIST水平,并进行相关性分析。术后随访1年,记录术后6个月和1年生存率。根据受试者工作特征（ROC）曲线计算血清VEGF、MCP-1、LncRNA XIST预测膀胱癌患者生存的截断值,将患者分为VEGF、MCP-1、LncRNA XIST高表达组和低表达组,分析不同亚组患者的生存情况。结果 观察组的血清VEGF、MCP-1、LncRNA XIST水平显著高于对照组,差异均有统计学意义（均P<0.01）。VEGF表达水平与膀胱癌患者肿瘤最大直径、T分期、分化程度、肿瘤分级、局部肿瘤浸润深度、远处转移、淋巴转移有相关性（P<0.05）;MCP-1表达水平与膀胱癌患者T分期、分化程度、肿瘤分级、局部肿瘤浸润深度有相关性（P<0.05）;LncRNA XIST表达水平与膀胱癌患者T分期、分化程度、肿瘤分级、局部肿瘤浸润深度、淋巴转移有相关性（P<0.05）。血清VEGF、MCP-1联合LncRNA XIST检查对膀胱癌诊断及预后的评估价值均高于单项和双项检查（AUC=0.909,95%CI：0.850～0.968;AUC=0.682,95%CI：0.538～0.826）。VEGF、MCP-1和LncRNA XIST高表达组的膀胱癌患者术后1年生存率显著低于低表达组,差异有统计学意义（P<0.05）。结论 血清VEGF、MCP-1联合LncRNA XIST检测有助于提高膀胱癌患者诊断率,且对预后具有一定评估价值。     

The significance of random bladder biopsies in superficial bladder cancer

Introduction: Today, there is no consensus about taking random bladder biopsies during transurethral resection of superficial bladder tumors for staging and to determine the urothelial abnormalities like dysplasia and carcinoma in situ. The aim of our study was to evaluate the results and indications of random bladder biopsies for primary superficial bladder cancer.Patients and methods: Random bladder biopsies were taken from 84 patients with primary superficial bladder cancer after transurethral resection. 40 patients had Ta and 44 had T1 tumor. The random biopsies were taken from right and left bladder walls, anterior and posterior walls, dome, trigone and prostatic urethra. The incidence of urothelial abnormalities were evaluated according to the stage and grade of the tumor.Results: None of the patients had carcinoma in situ or dysplasia with Ta tumor. In T1 group, 4 patients (9.1%) had carcinoma in situ and 3 patients (6.8%) had dysplasia. There was a statistically significant difference with regard to urothelial abnormalities between groups Ta and T1. The same difference was also seen between low and high grade tumors.Conclusion: In our study, only 7/84 (8.3%) of patients with primary superficial bladder cancer had urothelial abnormalities like carcinoma in situ or dysplasia. All of these pathologies were seen in T1 tumors. According to our results, we believe that random biopsies are not useful in superficial bladder cancers to detect urothelial abnormalities and also do not help for the planning of further treatment.     

Clinical analysis of high grade bladder cancer

The prognosis and other clinical manifestation of 128 patients with high grade bladder tumor were analyzed. Thirty two percent of the total cases of bladder cancer were high grade bladder cancer and 83% of their tumors were invasive tumor at stage T2 and worse. Urinary cytologies were positive in 88% of these patients. The 5-year survival rate in these patients was 32% and those in T1, T2 T3 and T4 cases were 64.2%, 55.6%, 22.7% and 8.0% respectively. The patients treated with radical (total) cystectomy showed a much better survival rate than the cases treated with TUR or partial cystectomy. These results suggest that high grade bladder cancers tend to be invasive and the patients with high grade bladder cancer would have a poorer prognosis than the patients with other histological grade tumors. Thus, these patients should be treated more aggressively including radical cystectomy than the other cases of bladder cancers.