鼻咽癌的病理组织学分类

鼻咽癌是鼻咽黏膜被覆上皮(鳞状、柱状和移形上皮)和小涎腺发生的恶性肿瘤[1-2].有关全人群鼻咽癌病理方面,尤其是有关其流行趋势方面的研究甚少,现有人群中鼻咽癌病理类型构成的研究多是医院内鼻咽癌病理诊断构成[3-6].     

反流性食管炎中医证候分布特点的文献研究

目的:通过文献探讨反流性食管炎中医证候的分布规律,提取证候要素,总结分布特点。方法:检索CBM、CNKI、万方、VIP数据库(截止至2011年9月),收集反流性食管炎的中医证型文献,进行证候要素分析、提取。结果:纳入文献37篇,报告病例3 078例,报道证候类型26种,以肝胃郁热和肝胃不和为主;证候要素16个,主要病位证素为胃、肝、脾,病性证素中实证证素以热、气滞、湿为主,虚证证素以阳虚、阴虚多见。结论:反流性食管炎证候类型以肝胃郁热和肝胃不和为主,主要病位在胃、肝、脾,病性以实证为主。     

Fibroblasts in omentum activated by tumor cells promote ovarian cancer growth, adhesion and invasiveness

Omentum metastasis is a common occurrence in epithelial ovarian cancer (EOC), which is often accompanied by ascites that facilitates the spread of EOC cells. A subpopulation of fibroblasts-the cancer-associated fibroblasts (CAFs) are important promoters of tumor progression. We have shown previously that CAFs exist not only in omentum with EOC metastasis but also in omentum without metastasis. In the present study, using primary human fibroblasts isolated from normal omentum (NFs) and omentum with ovarian cancer metastasis (CAFs), we established in vitro coculture models and a 3D culture model mimicking human omentum structure for investigation of interactions between fibroblasts and cancer cells. We demonstrate that EOC cells activate NFs and promote their proliferation via transforming growth factor-β1 (TGF-β1) signaling, and the activated fibroblasts contribute to the invasion and adhesion of EOC cells. Moreover, EOC cells and NFs coculture led to overexpression of hepatocyte growth factor (HGF) and matrix metalloproteinase-2 (MMP-2) and adhesion and invasion of EOC cells could be partially suppressed by blocking the function of HGF or MMP-2. Additionally, mouse peritoneal dissemination models of EOC confirmed the activation of fibroblasts by cancer cells and the tumor growth- and metastasis-promoting effects of activated fibroblasts in vivo. Our findings indicate that activated fibroblasts in omentum form a congenial environment to promote EOC cells implantation. It is an intriguing concept that targeting the activation of omentum fibroblast through the inhibition of TGF-β1 signaling can be used as a new therapeutic strategy against ovarian cancer omentum metastases, which needs further study.     

细胞因子诱导的杀伤细胞在肿瘤治疗中的作用

 细胞因子诱导的杀伤细胞（CIK）治疗是在手术、化疗和放疗之后的第4大肿瘤治疗手段,是目前肿瘤治疗的发展方向。它是一种新型的免疫活性细胞,该种细胞同时表达CD3和CD56两种膜蛋白分子,因此又将其称之为自然细胞杀伤样T淋巴细胞。CIK在临床应用比较广泛,在血液系统肿瘤、实体瘤的治疗中都取得了较好的临床疗效,是抗肿瘤过继免疫治疗的新希望。     

膝后外侧结构损伤诊断和治疗的探讨

目的探讨膝后外侧结构（posterolateralcomplex,PLC）损伤的诊断和不同的手术方式问的疗效分析。方法2002年6月至2011年3月期间,我院共收治的198例PLC损伤患者,男126例,女72例;年龄15～58岁,平均38．6岁;急性损伤152例,陈旧损伤46例。病程2天至28个月。术前伸直位内翻不稳Ⅲ度134例,II度64例;屈膝30。位内翻不稳Ⅲ度156例,Ⅱ度42例。患侧小腿外旋较健侧增加10°～30°,平均25°。Lachman试验阳性33例,前抽屉试验阳性36例,后抽屉试验阳性98例,前后抽屉试验均阳性者28例。术前行x线片、MRI等影像学检查及关节镜检查关节的松弛程度和前后交叉韧带的断裂程度及半月板损伤类型等。在行合并前后交叉韧带损伤重建及半月板损伤处理等同时,根据后外侧结构损伤的类型和程度对PLC损伤进行骨折内固定术、韧带重建术、PLC股骨止点上移术三种不同的治疗方法。结果198例均获随访,时间为6—30个月,术后6个月检查,伸直受限10°2例,5°4例,屈膝活动度均超过120°。稳定性检查,伸直位无内翻不稳;屈膝30。位I度内翻不稳伴硬性止点3例。患侧小腿外旋较健侧增加者4例,均〈5°。术后Lachman试验、前抽屉试验、后抽屉试验均为阴性。术后1年随访185例,伸直受限10°1例,5°3例,与6个月时比较无明显变化。术后1年随访的185例HSS评分结果为：优165例,良20例,中0例,差0例,优良率100％。最后随访时间为术后30个月,共102例获随访,HSS评分结果为：优90例,良10例,中2例,差0例,优良率98．4％。结论依据具体的损伤的类型、组织撕裂程度和部位采用不同手术方式进行膝后外侧结构修复,恢复膝关节在各方位活动时后外侧的稳定,能够为患者提供更为满意的治疗。     

胸骨后甲状腺肿外科手术治疗体会

目的 总结胸骨后甲状腺外科手术治疗体会。方法 回顾分析50例胸骨后甲状腺肿患者的手术治疗资料,其中48例患者采用胸骨上1cm低位领形切口,2例行颈部低位领形切口+胸骨切开切除胸骨后甲状腺肿。术中常规显露喉返神经。结果 50例患者手术均获成功,结节性甲状腺肿41例,滤泡性甲状腺腺瘤7例,桥本病2例。术后并发症包括4例短暂的低钙血症、甲状腺功能减退症。结论 胸骨后甲状腺肿患者采用颈部低位领形切口是可行的,术中常规显露喉返神经全程对于减少喉返神经损伤具有重要意义。