Clinical analysis of 276 cases of non-palpable TO breast cancer

Objective Discussion of diagnosis, treatment and prognosis of non-palpable TO breast cancer. Methods Between 1978 and 1997, 9,980 female patients with operable breast cancer were treated surgically, of which 276 were determined to have TO breast cancer. Most TO breast cancers could be detected promptly with careful examination of presenting symptoms, such as nipple discharge, local thickening of the breast, nipple erosion, nipple retraction and postmenopausal mastalgia, while 12 cases were detected by routine mammography of the contralateral breast. Results All patients were treated surgically and their tissue subjected to histopathological examination. Most cases (73.0%) were noninvasive or early invasive carcinoma. Axillary lymph nodes metastases were found in 7.69% of 234 mastectomy cases. Conclusion The survival rate was significantly increased if the tumor was in an early stage. The 5-, 10-, 15-years survival rates were 98.1%, 94.6% and 90.3%, respectively.     

TGF-beta-1 gene transfer in joint cartilage cells. Stimulating effect in extracellular matrix synthesis

TGF beta-1 has been shown to upregulate matrix synthesis in articular chondrocytes. TGF beta-gene transfer to chondrocytes has the potential to increase the local production of this key component within regenerating cartilage after trauma and could support the repair process in articular cartilage lesions. Primary rabbit articular chondrocytes were cultured and retrovirally transfected with the experimental TGF beta-1 and the lacZ marker gene for control purposes. After radioactive labeling of new synthesized matrix proteins results were compared with normal primary chondrocytes. After TGF beta-1 gene transfer the endogenous growth factor concentration was doubled compared to normal chondrocytes and decreased in the lacZ control group. The proteoglycan synthesis in TGF beta-1 transfected chondrocytes showed a 96% increase compared to the basal production of normal chondrocytes. The LacZ transfected group revealed the opposite effect by a 44% decrease. The collagen synthesis of TGF beta-1 transfected chondrocytes was 304% compared to normal chondrocytes, predominantly type II collagen. The lacZ group collagen production was reduced by 35%. We conclude that TGF beta-1 gene transfer overcomes the decreasing effect observed by transfection with the LacZ marker gene and increases matrix synthesis in articular chondrocytes. Genetically altered chondrocytes might improve the repair of cartilage lesions by stimulating matrix synthesis and supporting the expression of the hyaline phenotype.     

Tissue engineering and gene therapy of the musculoskeletal system with muscle cells

AIM: Muscle-based somatic gene therapy is a novel way to alleviate a biochemical deficiency. METHOD: Muscle-derived cells are very promising in the field of gene therapy and tissue engineering. First, most muscle tissue is accessible by injection. Second, muscle tissue consists of multinucleated, postmitotic myofibers, which enable a long-term expression of the transduced gene. Third, muscle tissue can be biopsied easily. It is available in abundance and the biopsy does not compromise the health and function of the patient. Finally, muscle tissue is highly vascularized, which makes systemic delivery feasible. RESULTS: Muscle-derived cells can promote muscle healing and bone healing. Implanted cells maintain a long-term transgene expression of therapeutic proteins. Isolated, muscle-derived stem cells can differentiate in osteoblasts. CONCLUSION: Based on these characteristics, we present four possible applications: inherited muscular diseases, muscle injury, bone healing, and intraarticular disorders.     

尼尔雌醇作用下去势雌兔骨组织形态计量学改变

目的：评估尼尔雌醇对绝经后骨质疏松症的疗效，并探讨其机理。方法：将３０只雌性新西兰兔随机分成３组（每组１０只）：治疗组［摘除卵巢＋尼尔雌醇（每月２ｍｇ）］、模型组（摘除卵巢）和正常对照组（假手术），６个月后处死取材，并在处死前行四环素标记，ＶＩＤＡＳ图象分析系统下作骨组织形态计量学测定。结果：治疗组的单位体积骨小梁骨量（ＢＶ／ＴＶ）、相对类骨质量（ＯＶ／ＢＶ）、成骨细胞指数（ＯＢＩ）和组织水平的骨形成速率［ＢＦＲ（Ｔ）］明显高于模型组和（或）正常对照组。结论：尼尔雌醇能增加成骨细胞数量，可能是一种成骨细胞募集和（或）增殖的刺激剂。     

肿瘤内血流检测对卵巢肿瘤定性诊断的研究

目的：评价多普勒血流显象技术检测卵巢肿瘤内血流定性诊断卵巢肿瘤的价值。方法：对疑诊卵巢肿瘤的75例（其中53例卵巢良性肿瘤和22例恶性肿瘤）于术前1w内行C超检查及肿瘤内血流检测，并与术后组织病理学诊断对照。结果：53例卵巢良性肿瘤中的21例（39．62％）及22例卵巢恶性肿瘤中的21例（95．45％）C超均显示其结构鼻常；在21例卵巢良性肿瘤内检测到血流高峰收缩速度（PSV）的均值为14．2±8．1cm／s，阻抗指数（RI）均值为0．478±0．119。当以PSV＝16cm／s为卵巢良、恶性肿瘤的界值时，PSV诊断卵巢恶性肿瘤的敏感性和特异性率分别为90．91％和90．57％；当以RI＝0．72为卵巢良、恶性肿瘤的界值时，RI诊断卵巢恶性肿瘤的敏感性和特异性率分别为86．36％和69．81％；C超诊断卵巢恶性肿瘤的敏感性和特异性率分别为95．45％和71．70％。三者的敏感性差异无显著性，而PSV诊断卵巢恶性肿瘤的特异性率明显高于RI和C超检查者，差异具有显著性（P＜0．05）。结论：用多普勒血流显象技术检测卵巢肿瘤内异常。流的PSV，对预测卵巢肿瘤性质具有一定的临床意义。     

肠外营养在不能手术肝癌治疗中的应用

目的:观察肠外营养在肝癌治疗中的作用.方法:38例体重下降超过10%不能手术的肝癌患者随机分成A、B两组,A组接受肝动脉插管化疗栓塞(TACE)前给予肠外营养(PN)支持;B组单接受TACE.结果:A组有效率及一年存活率均显著高于B组.结论:TACE前给予PN支持可以提高伴有营养不良的不能手术肝癌的治疗效果.     

盐酸恩丹西酮预防化疗所致呕吐Ⅱ期临床研究

观察国产５－ＨＴ３阻滞剂－盐酸恩丹西酮预防化疗所致呕吐的临床疗效。方法：采用随机自身交替对照方法分为两组观察，接受顺铂联合化疗组及非顺铂联合化疗组各２５例。盐酸恩丹西酮８ｍｇ，化疗前１５分钟静注，恩丹西酮８ｍｇ，化疗后８小时口吸口服。对照组：胃复安２０ｍｇ，化疗前１５分钟肌注，胃复安８ｍｇ化疗后８小时口服。     

电针刺激对外伤性脊髓损伤患者功能独立性评定影响的临床研究

目的:通过观察电针刺激疗法对外伤性脊髓损伤患者的生活独立功能的影响,为脊髓损伤患者寻求一条有效的康复治疗途径。方法:62例外伤性脊髓损伤患者被随机分成治疗组32例,接受电针刺激加运动治疗、作业治疗;对照组30例,接受单纯性运动治疗、作业治疗。在治疗前后进行功能独立性评定。结果:治疗组与对照组的功能独立性积分均明显高于治疗前(P<0.01),而治疗组治疗后的分值97.78±19.55明显高于对照组的分值87.53±16.67(P<0.05)。同样,治疗组的住院效率明显高于对照组(P<0.05)。结论:电针刺激加运动与作业治疗的综合康复手段能明显改善外伤性脊髓损伤患者的生活独立能力,且能科学地提高住院效率。