CLINICAL ANALYSIS OF EXTRAMAMMARY PAGET’S DISEASE OF VULVA

Paget'sdiseasewasfirstlydescribedbyJamesPagetin1874asabreastlesion.ItwasalsoseenatotherplacesandgenerallycalledextramammaryPagetsdisease,76%ofwhichwaspredominantlyfoundonthevulva[1].Pagetsdiseaseofthevulvaremainsarareconditionthataccountsforlessthan1%ofvulvarneoplasms[2].Thelesionusuallyappearsaseczemaandmaybemisdiagnosed.However,invasivediseaseoradenocarcinomamaybepresentwithPagetsdisease.Andrecurrenceishighaftertreatment.TheaimofthisstudywastoreviewcasesofPagetsdiseaseinourhospitalandanal…     

Methadone versus morphine as a first-line strong opioid for cancer pain: a randomized, double-blind study.

PURPOSE: To compare the effectiveness and side effects of methadone and morphine as first-line treatment with opioids for cancer pain. PATIENTS AND METHODS: Patients in international palliative care clinics with pain requiring initiation of strong opioids were randomly assigned to receive methadone (7.5 mg orally every 12 hours and 5 mg every 4 hours as needed) or morphine (15 mg sustained release every 12 hours and 5 mg every 4 hours as needed). The study duration was 4 weeks. RESULTS: A total of 103 patients were randomly assigned to treatment (49 in the methadone group and 54 in the morphine group). The groups had similar baseline scores for pain, sedation, nausea, confusion, and constipation. Patients receiving methadone had more opioid-related drop-outs (11 of 49; 22%) than those receiving morphine (three of 54; 6%; P =.019). The opioid escalation index at days 14 and 28 was similar between the two groups. More than three fourths of patients in each group reported a 20% or more reduction in pain intensity by day 8. The proportion of patients with a 20% or more improvement in pain at 4 weeks in the methadone group was 0.49 (95% CI, 0.34 to 0.64) and was similar in the morphine group (0.56; 95% CI, 0.41 to 0.70). The rates of patient-reported global benefit were nearly identical to the pain response rates and did not differ between the treatment groups. CONCLUSION: Methadone did not produce superior analgesic efficiency or overall tolerability at 4 weeks compared with morphine as a first-line strong opioid for the treatment of cancer pain.     

Decreased mtDNA Copy Number of Gastric Cancer： a New Tumor Marker？

Objective To explore the relationship between mtDNA (mitochondnal DNA) and gastric cancer by comparing the difference of mtDNA copy number in gastric cancers and paracancerous tissues. Methods The HV1 (hypervariable region) and HV2 of the mitochondrial D-loop region from 20 cases of gastric cancer and 20 paracancerous tissues were amplified by PCR with βactin serving as a quantitative standard marker. The products were separated by polyacrylamide gel electrophoresis (PAGE) and silver stained in order to compare the difference in mtDNA copy number between gastric cancers and paracancerous tissues. The mtDNA copy number was determined for gastric cancers having various pathological characteristics and the results compared with previous immunohistochemical staining of the tumors. Results There was a significantly quantitative difference in HV1, HV2 (standardized with βactin) between gastric cancers and paracancerous tissues (P<0.01 ). The mtDNA copy number was associated with important enzymes in the nucleus such as AKP, cAMP-PDE and cGMP-PDE (P< 0.05), but not associated with tumor histological type and invasive depth (P> 0.05). Conclusion The occurrence of gastric cancer was closely associated with decreased mtDNA copy number, which may be a new tumor marker. This work was supported by the research grants from the National Natural Science Foundation of China (No. 30371607).     

银环蛇毒素对白血病K562细胞株凋亡诱导作用的研究

目的 探讨银环蛇毒素及其若干组分在体外对白血病K562细胞株的凋亡诱导作用。方法 采用阳离子交换层析法分离纯化银环蛇粗毒，应用MTT法、荧光显微镜和流式细胞术等研究毒素对K562细胞株的凋亡作用。结果 除Ⅳ峰毒素外，银环蛇粗毒及分离的部分组分IV峰、Ⅶ峰和Ⅷ峰等毒素的荧光显微图末见特征性的凋亡小体，DNA含量分布组方图中的二倍体峰前末见Gl细胞群。结论 银环蛇毒对K562细胞具有杀伤作用，但并非是细胞凋亡作用，而是致细胞坏死，而粗毒中的某些组分可能具有促K562细胞凋亡作用。     

大肠癌组织中Survivin表达与血管生成、细胞增殖的关系

目的　探讨大肠癌组织中Survivin表达与血管生成、细胞增殖的关系。方法　采用原位杂交方法和免疫组织化学方法 ,对 46例大肠癌、2 2例大肠腺瘤和 10例大肠正常组织进行SurvivinmRNA和PCNA检测 ,并计数微血管密度 (MVD)。结果　大肠癌组织中SurvivinmRNA、PCNA指数和MVD均显著高于大肠腺瘤和大肠正常组织 (P <0 .0 5 )。SurvivinmRNA表达阳性组中 ,MVD和PCNA指数均明显高于SurvivinmRNA阴性组 (P <0 .0 5 )。结论　Survivin在大肠癌组织中表达上调 ,并与血管生成和细胞增殖关系密切 ,提示Survivin对大肠癌的发生发展起重要作用     

中药糖脉通片治疗糖尿病周围神经病临床研究

应用糖脉通片治疗糖尿病周围神经病中医辨证属气阴两虚、痰瘀阻络证患者103例，并与西药弥可保组99例进行随机对照。结果：糖脉通片在缓解患者肢痛、麻木症状，改善血流变，升高SOD活性，降低MDA含量，改善神经传导速度等方面均有较好作用，部分指标改善情况优于弥可保。     

中医学证候量化诊断研究现状与思考

本文简要分析了中医学证候量化诊断的历史发展与研究现状,对目前用于中医证候量化诊断(如多元统计分析、计算机模式识别、DME/流行病学等)方法作了详述和讨论。认为证候量化研究应该重视中医理论,充分以临床实践为基础,开展多学科、多层次、多途径的交叉协作,使证候研究者具备较好的数学素质,使用较好的数学研究方法,从方法学上为证候量化研究提供正确保证,整体把握运用数学方法研究中医学问题。其次,要重视建立数学模型所用本底资料的科学性、可靠性、准确性,力求从源头上搭建证候量化的操作平台。     

骨重建过程"四环素活体标记"骨组织形态计量学指标在骨质疏松中的应用

扼要结合骨组织形态计量学指标与实验动物数据介绍影响骨质疏松中骨重建过程的动态指标变化及意义,讨论各指标间的关系及变化所代表的实验意义,还介绍了一系列骨计量学观测指标的标准名称,以及利用体视学和图像分析方法进行测量的公式、单位,并扼要介绍一组实验数据与骨计量学指标的相关分析意义,便于今后分析例样的应用查阅。     

肝癌介入治疗方法的回顾与展望

介入治疗被认为是肝癌非手术疗法中的首选方法。肝癌介入治疗方法可分为经皮经血管治疗技术和经皮非血管治疗技术。单纯动脉内灌注抗癌药效果差，各种肝动脉栓塞术尤其是使用同轴导管作超选节段性治疗是介入治疗的主流；一些非血管介入方法如经皮无水乙醇注射治疗、经皮射频消融治疗等以及合理的综合治疗也是治疗肝癌的有效武器。