DELETION AND 5

　Objective To investigate the abnormality of p15 gene in brain glioma and the correlation of it with occurrence or malignant progression of brain glioma. Methods Deletion and 5’CPG island methylation of p15 gene were detected by the methods of PCR and PCR-based methylation in 56 cases of brain glioma. Results Out of 43 cases of high grade glioma, 14 cases were found to have homozygous deletion of p15E1, while none of the 13 cases of low grade glioma was found to have deletion of p15E1 (P<0.05). Methylation of 5’CPG Island of p15 gene was found only in four cases of glioma. Conclusion Abnormality of p15 gene may involved in the occurrence and malignant progression of brain glioma. Homozygous deletion of gene is the major mechanism of inactivation for p15 gene in brain glioma.     

重复癌5例

本文报道5例重复癌如下。临床资料(见附表)。讨论(1)病因重复癌与机体免疫缺损有关,史代表一种肿瘤易感表型(cancer-disposig pheno-type )。本组5例均无遗传病史,家谱调查无恶性肿瘤患者。(2)发病率报道不一,国外为2.7％～10.6％,国内为0.3％～0.52％。女性多于男性,尤以三个以上重复癌更为明显,男女之比约1:2。近年,恶性肿瘤长期存活者增多,重复癌发病率有上升趋势。(3)诊断,本组同时癌2例,异时癌3例。所有患者第一次患癌后,机体对肿瘤易感性增加,致使病人有多次患癌的机会。此种易感性可能遗传,患者的家族     

胆囊癌5例报告

胆囊癌较少见。我院自1979年5月～1984年5月,共施行胆囊切除102例,均经病理检查,确诊为胆囊癌者5例,占4.9％。一般认为慢性胆囊炎胆石症是诱发胆囊癌重要因素之一,可能与胆囊粘膜长期受到剌激,导致粘膜上皮细胞癌变。本文5例胆囊癌有4例并发结石,占80％。胆囊癌预后极恶,行胆囊切除或扩大根治,存活期少有超过一年。我院5例胆囊癌术后,4例分别为3个月、6个月、8.5个月、12个月,只1例现己存活3年。因此,已确诊为慢性胆囊炎胆石症患者,应尽早手术,以去除胆囊癌诱发因素,预防胆囊癌的发生。     

术前准备5重点

马上就要做手术了，您和您的家属难免有些紧张和担心，手术台上的事情交给主治医生，在等待手术的时间里，不妨自己也准备一下，除了消除紧张情绪，也可以让自己的手术更加顺利。下面我们就简单介绍一下肿瘤患者手术前常规需要准备的事情。     

Belsey 5号手术

<正>Belsey所设计的4号手术要求食管壁上的缝合需深达黏膜下层,这使许多外科医生执行起来有所顾虑,担心缝合过深会伤及黏膜,进入食管腔,发生穿孔或瘘。食管壁上的缝合如结扎过紧,特别是在膈运动过分激烈时(剧烈咳嗽)会造成肌层切割,使手术失败。有鉴于此,Hiebert与Bane等人设计了缝合线上加聚四氟乙烯垫片的方法,称为Belsey 5号手术。这样可有效地防止肌层切割和手术失败。     

异位脑膜瘤5例

目的;探讨对异位脑膜瘤发病机制的认识。方法：结合文献复习对5例异位脑膜瘤的发病机理、诊断、治疗及预后进行讨论和分析。结果：5例均经手术治疗,2例多发异位脑膜瘤术后附加放疗,随访1－2年未见肿瘤复发。结论：异位脑膜瘤属罕见肿瘤,其发机理复杂,可能为异位蛛网膜细胞的存在,加之内外环境变化及刺激所致,其预后良好。     

5-氟胞嘧啶和5-氟脲嘧啶的免疫抑制作用

经5-氟胞嘧啶(5-Fc)治疗的肾移植患者出现念珠菌病,提出此药可能有免疫抑制作用。作者建议,在选用已知有细胞毒作用的药物治疗真菌类传染病患者时应慎重。作者通过本文所述实验结果,以验证上述设想。实验选用三项指标:(1)BALB/C 小鼠静脉注射羊红血球(SRBC)或经热处理的大肠杆菌055:B_5脂多糖进行免疫,然后取脾脏测定抗体空斑形成细胞(PFc)数,观察体液免疫水平;(2)在BALB/C小鼠脾细胞悬液加入促分裂素植物血凝素(PHA)或刀豆球旦白A(Con A),并在温育过程的不同时间分别加入5-Fc液。氚化胸腺嘧啶核苷(TDR)和碘-2′-去氧尿嘧啶苷(IUDR),从TDR与IUDR掺入的情况了解5-Fc对     

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目的 观察甲酰四氢叶酸钙(CF)联合5-氟尿嘧啶(5-Fu)治疗晚期乳腺癌的疗效和安全性.方法 选择既往经过蒽环类、紫杉类等药物治疗无效的晚期乳腺癌31例,中位年龄48.0岁(27～66岁).采用CF联合5-Fu化疗方案治疗.CF[150 mg/(m2·d)]+ 5-Fu[600 mg/(m2·d)],连用5天,每天静脉滴注不少于12h,每4周为一周期.观察有效率及不良反应.结果 完全缓解2例(6.5％),部分缓解7例(22.6％),病情稳定6例(19.4％),进展16例(51.6％).总有效率为29.0％,临床获益率为48.4％,其中激素受体阴性患者更能获益(P＜0.05).中位有效期为2.3月(95％CI:1.1～4.1),中位生存期为9.5月(95％CI:4.7～14.8).15例(48.4％)生活质量改善,6例(19.4％)稳定,10例(32.3％)下降.不良反应主要是胃肠道反应(11例)、骨髓抑制(4例)和口腔炎(9例).结论 CF+ 5-Fu联合静脉滴注二线治疗晚期乳腺癌疗效确切,不良反应可控,患者易于耐受,可以作为复发转移的晚期难治性乳腺癌的解救治疗.     

CDCA5与肿瘤

姐妹染色单体凝聚发生于DNA复制时期,由黏合素调节,并且依赖于细胞分裂周期相关蛋白5(CDCA5)及黏合素的乙酰化。WAPL可以促进黏合素与DNA解离,CDCA5可以拮抗WAPL的作用,通过稳定黏合素与DNA的结合从而稳定姐妹染色单体凝聚。CDCA5 mRNA在多种肿瘤细胞株中具有较高的转录水平,提示CDCA5可能与肿...     

那可丁对人结肠癌5-Fu耐药细胞株HT-29/5-Fu、LoVo/5-Fu及SW480/5-Fu耐药性的影响

目的 探讨那可丁（Nos）对人结肠癌5-氟尿嘧啶（5-Fu）耐药株耐药性的影响及其机制。方法 构建人结肠癌耐药株HT-29/5-Fu、LoVo/5-Fu及SW480/5-Fu，MTT法筛选出Nos对各组细胞的半数抑制浓度（IC50），观察细胞形态变化，利用流式细胞仪检测细胞周期及凋亡水平；RT-qPCR及Western blot检测细胞P38表达和激活水平，以及耐药相关蛋白的表达。结果 成功构建耐药细胞株HT-29/5-Fu、LoVo/5-Fu和SW480/5-Fu。与对照组比较，Nos干预后的结肠癌耐药细胞株HT-29/5-Fu、LoVo/5-Fu及SW480/5-Fu细胞周期明显阻滞在G₀/G₁期（P<0.01），凋亡率升高，而P38表达及磷酸化受到显著抑制（P<0.01），与耐药相关的多药耐药相关蛋白、肺耐药相关蛋白及P-glycoprotein表达显著降低（P<0.01）。结论 Nos对耐5-Fu的人结肠癌细胞具有一定的毒性作用，降低了耐药细胞耐药性，作用机制可能与抑制P38的表达和磷酸化有关。     

Pharmacokinetic and pharmacodynamic comparison of fluoropyrimidine derivatives, capecitabine and 5′-deoxy-5-fluorouridine (5′-DFUR)

Purpose Capecitabine is a three-step prodrug that was rationally designed to be a more effective and safer alternative to its intermediate metabolite, 5-deoxy-5-fluorouridine (5-DFUR). We compared the pharmacokinetics/pharmacodynamics of these drugs in metastatic breast cancer patients.Methods Six patients received oral capecitabine at 1657 mg/m² twice daily and 17 received 5-DFUR at 400 mg three times daily. Both drugs were administered for 21 days followed by a 7-day rest.Results Median daily 5-DFUR AUC was significantly higher for capecitabine than for 5-DFUR (81.1 vs 32.6 mmol h/l; P=0.01). Following treatment with 5-DFUR, the median AUC and C_max of 5-DFUR tended to be higher in patients with a partial response (3.83 g h/ml and 4.88 g/ml) and stable disease (6.46 g h/ml and 4.96 g/ml) than in those with disease progression (2.53 g h/ml and 1.36 g/ml). The AUC and C_max of 5-DFUR was significantly related to overall survival.Conclusions These results support the superiority of capecitabine over 5-DFUR.     

Effect of uridine coadministration on 5′-deoxy-5-fluorouridine disposition in rats

Summary Uridine (UR) inhibits the metabolic activation of 5-deoxy-5-fluorouridine (dFUR) to 5-fluorouracil (FU) by the intestinal pyrimidine nucleoside phosphorylases and could potentially reduce its intestinal toxicity. This study examined the effect of UR coadministration on the absorption and disposition of an oral dose of dFUR. Rats were given dFUR alone (500 mg kg^-1) and dFUR (300 mg kg^-1) plus UR (4.5 g kg^-1) in a random crossover experiment. Simultaneous injection of a tracer dose of [6-³H]dFUR was used to asses the total body clearance (Cl) of dFUR. The absorption of UR was rapid and variable. The UR dose produced a maximal blood concentration of 80 g/ml for UR and 100 g/ml for its metabolite uracil (U). The absorption of dFUR was slower than UR, as indicated by its later time of maximal concentration. UR did not alter the Cl of dFUR, but reduced the absorption rate of dFUR from the gastrointestinal tract and significantly reduced the absolute oral bioavailability of dFUR from 55.2% to 33.4%. The effects of UR coadministration on the dFUR metabolite FU were opposite to those on dFUR; the FU availability was increased sixfold, and the elimination of FU was reduced. Based on the known competition between pyrimidine bases for their saturable metabolic enzymes, the increase in FU availability by UR coadministration was likely due to a competitive inhibition of FU metabolism by U. This study established the complex pharmacokinetic interactions between dFUR and UR and between their metabolites, which may be important in the modulation of dFUR activity by UR.Supported in part by research grants CA-37110, CA-43365 and P30CA16058-12 from the National Cancer Institute, USPHS     

隐睾恶变5例报告

隐睾症是男性生殖系统最常见的先天性畸形,约86%的正常男性睾丸在出生时下降正常,其余大多数在出生第一年下降。下降不全的睾丸易发展为恶性肿瘤,其恶变率比正常睾丸大39～50倍(1)。有关隐睾恶变之病例已有数篇报道(2、3)。本文报告5例.对其发病因素,诊断等问题结合文献进行讨论。临床病例资料见附表。     

患癌5年的感悟

201 1年3月3日,我到达了不久前还根本不敢期待的生命中的一个里程碑——癌症康复5年整.不过,还不能说自己已经完全走出了困境,治疗留下的瘢痕时时都在提醒我患癌的事实.当你患了进展性、浸润性的癌症时,定期筛查、乳腺X线检查、超声等所有程序都会造成神经毁灭.屏幕上的每一个小点都会立即引起一阵(虽然是暂时的)恐惧,即使当医生说"没什么大不了"时(但是他们仍然会让你一个月以后回来随访).     

恶性肿瘤伴发高钙血症5例

目的及时诊断恶性肿瘤伴发高钙血症的临床意义。方法对经影像学和病理学确诊的５例恶性肿瘤（肺鳞癌３例，乳腺癌１例，肾癌１例）伴发高钙血症进行临床分析。结果４例伴有多发骨转移。５例高钙血症均有不同程度的口渴、多饮、厌食或纳差等胃肠道症状以及疲乏无力、烦燥、表情淡漠或木僵和多尿、便秘、脱水等临床表现，其中２例心电图Ｓ－Ｔ段消失，呈宽大Ｔ波。５例血钙的校正值分别为３．７５ｍｍｏｌ／Ｌ、３．５ｍｍｏｌ／Ｌ、３ｍｍｏｌ／Ｌ、４．４３ｍｍｏｌ／Ｌ、４．５ｍｍｏｌ／Ｌ。经补钠、利尿、骨膦静脉滴注和口服治疗，很快使血钙降至正常。结论对可疑的恶性肿瘤伴发高钙血症患者及时检查，可明确诊断，且经积极治疗后可获好转。