儿童寰枢椎半脱位的诊断与治疗

目的 探讨儿童寰枢椎半脱位的早期诊断与诒疗。方法 选择1992～2001年期问临床资料完整的32例寰枢椎半脱位患儿进行分析研究。结果 32例小儿经过Glission牵引、抗感染和对症处理，31例患儿症状体征完全消失，随访半年无复发。1例患儿经反复治疗，X线影像无明显改变。结论 寰枢椎半脱位是儿童期突发斜颈最常见的原因，早期诊断早期治疗预后良好。     

高三尖杉酯碱对鼻咽癌CNE-2Z细胞的增殖抑制和凋亡诱导作用

目的　探讨高三尖杉酯碱 (homoharringtonine,HHT)对鼻咽癌细胞CNE 2Z的增殖抑制和凋亡诱导作用。方法　采用MTT法检测增殖抑制率和IC50 ,流式细胞术、琼脂糖凝胶电泳和Hoechst 3 3 2 5 8/PI荧光染色分析细胞凋亡。结果　不同浓度的HHT分别处理CNE 2Z细胞 2 4、48和 72h ,抑制率随浓度的增加和时间的延长而增高 ,其IC50 分别为(0 62 9± 0 0 3 9)、(0 483± 0 0 2 7)、(0 3 89± 0 0 2 7)mg·L-1,各IC50 间差异有统计学意义 (P <0 0 1)。 1、0 5mg·L-1HHT处理细胞 8h ,流式细胞术观察到凋亡峰 ,荧光染色可见凋亡形态学改变 ,流式细胞术和荧光染色检出的凋亡率均高于对照组 (P <0 0 1) ;1mg·L-1HHT处理细胞 8h ,琼脂糖凝胶电泳可见DNA梯带。结论　HHT对CNE 2Z细胞具有增殖抑制作用 ,此抑制作用具有剂量和时间依赖性 ;HHT可诱导CNE 2Z细胞凋亡     

香菇多糖对巨噬细胞一氧化氮和一氧化氮合酶活性的影响

目的研究香菇多糖(LTN)诱导巨噬细胞的一氧化氮(NO)生成和一氧化氮合酶(iNOS)的活性,探讨LTN的免疫调节作用机理.方法采用Griess反应和荧光法测定不同剂量的LTN作用小鼠腹腔巨噬细胞后NO的生成量和iNOS活性.观察mRNA转录抑制剂、蛋白质合成抑制剂和iNOS抑制剂对巨噬细胞NO的生成和iNOS活性的影响.结果LTN能使小鼠腹腔巨噬细胞NO生成增加,iNOS活性增高,并呈作用剂量依赖关系.3种抑制剂均能抑制LTN诱导的小鼠腹腔巨噬细胞N0的生成和iNOS活性.结论LTN能刺激小鼠腹腔巨噬细胞提高iNOS活性和NO的生成.提示LTN的免疫调节作用机制可能与LTN刺激巨噬细胞NO生成有关.     

自体造血干细胞移植治疗晚期恶性实体瘤

目的观察自体造血干细胞 (aulologoushematopoiticstemcelltransplantation ,AHSCT)对晚期恶性实体瘤的疗效及副作用。方法 6例患者中 ,1例行自体骨髓移植 (antologousbonemarrowtranspla tion ,ABMT) ,5例行自体外周血干细胞移植 (autologousperipheralbloodstemcelltransplantationAPBSCT)。预处理方案 :乳腺癌为CEP(CTX ,VP-1 6,DDP) ,恶性淋巴瘤为CEA(CTX ,VP-1 6,Ara-c)方案 ,采集的干细胞 1例 4℃保存 ,72小时内回输 ,其余 5例 - 80℃保存。结果APBSCT动员采集单个核细胞数 7 0 2× 1 0 8 kg ,ABMT和APBSCT后 ,患者中性粒细胞计数恢复到 0 5× 1 0 9/L ,血小板达 50× 1 0 9/L以上的时间平均为 1 0 8天和 1 6 2天。毒副作用主要是骨髓抑制和消化道反应 ,随访至今死亡 2例 ,复发 2例 ,2例无瘤生存。结论AHSCT治疗晚期乳腺癌近期疗效肯定 ,可提高生活质量 ,对恶性淋巴瘤的治疗有效 ,但对反复复发患者需移植后作进一步治疗。     

PXJ-41/M2-1转染人肺腺癌PAa细胞及其稳定表达

目的探讨外源性呼吸道合胞病毒(RSV)M2—1基因在人肺腺癌贴PAa细胞中获得稳定表达的可行性。方法将携有RSVM2—1基因的真核表达载体PxJ41／M2—1，在脂质体介导下，导入人肺腺癌PAa细胞株。通过以18筛选获得阳性克隆，并继续培养，用RT—PCR及免疫组织化学方法检测M2—1在人肺腺癌PAa细胞内的稳定表达情况。结果经RT—PCR方法扩增到M2—1620bP特异性条带。免疫组织化学证实，转染PxJ41／M2—1后的PAa细胞内有M2—1蛋白的表达。     

多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值

目的　研究多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值。方法　用该检测系统测定10 8例肺癌患者、48例肺良性病变患者和 14 5例正常人血清中 12种肿瘤标志物 (CA199,NSE ,CEA ,CA2 42 ,CA12 5 ,CA15 3 ,AFP ,ferritin ,free PSA ,PSA ,β HCG及HGH)的水平。 结果　肺癌组的芯片阳性率为 83 .3 3 %( 90 / 10 8) ,显著高于肺良性病变组 ( 5 2 .0 8% ,2 5 / 48)和健康组 ( 2 8.97% ,42 / 14 5 ) (P <0 .0 0 1) ;肺癌不同分期组间阳性率存在显著性差异 ,以Ⅳ期肺癌组阳性率最高 (P =0 .0 48) ,但不同病理类型肺癌组间无显著性差异(P =0 .5 19) ;不同分期之间CA199、CEA以及CA2 42血清水平存在显著性差异 (P =0 .0 41,P =0 .0 18和P =0 .0 0 2 ) ;CEA阳性率以腺癌组最高 ,与其它组织学类型肺癌比较无显著性差异 (P =0 .0 7) ;NSE阳性率以小细胞肺癌组最高 (P <0 .0 0 1) ;联合检测在提高诊断敏感性的同时 (P <0 .0 0 1) ,特异性有所下降 (P <0 .0 0 1)。结论　运用蛋白芯片联合检测多种血清肿瘤标志物可明显提高肺癌诊断的敏感性 ,同时对于确定其临床分期 ,鉴别病理类型以及监测疗效均有一定的意义。由于该法特异性及阳性预测值偏低 ,更适合于无明显症状的门诊患者和肺癌高危人群的筛查。     

Bicalutamide monotherapy versus leuprolide monotherapy for prostate cancer: effects on bone mineral density and body composition.

PURPOSE: Gonadotropin-releasing hormone agonists decrease bone mineral density, lean mass, and muscle size and increase fat mass in men with prostate cancer. Less is known about the effects of bicalutamide monotherapy on bone mineral density and body composition. PATIENTS AND METHODS: In a 12-month, open-label study, we randomly assigned 52 men with prostate cancer and no bone metastases to receive either leuprolide or bicalutamide (150 mg by mouth daily). Bone mineral density and body composition were measured by dual energy x-ray absorptiometry and quantitative computed tomography. RESULTS: Mean (+/- standard error) bone mineral density of the posterior-anterior lumbar spine decreased by 2.5% +/- 0.5% in the leuprolide group and increased by 2.5 +/- 0.5 in the bicalutamide group from baseline to 12 months (P <.001). Mean changes in bone mineral density of the total body, total hip, femoral neck, and trabecular bone of the lumbar spine also differed significantly between groups (P < or =.003 for each comparison). Fat mass increased by 11.1% +/- 1.3% in the leuprolide group and by 6.4% +/- 1.1% in the bicalutamide group (P =.01). Changes in lean mass, muscle size, and muscle strength were similar between the groups. Breast tenderness and enlargement were more common in the bicalutamide group than in the leuprolide group. Fatigue, loss of sexual interest, and vasomotor flushing were less common in the bicalutamide group than in the leuprolide group. CONCLUSION: In men with prostate cancer, bicalutamide monotherapy increases bone mineral density, lessens fat accumulation, and has fewer bothersome side effects than treatment with a gonadotropin-releasing hormone agonist.     

异丙酚的剂量与镇静和呼吸抑制作用之间的关系

研究不同剂量的异丙酚的量效关系。方法:选择50例甲状腺腺瘤切除病人,随机分为5组,Ⅰ组,0.5mg/kg、Ⅱ组0.75mg/kg、Ⅲ组1.0mg/kg、Ⅳ组1.5mg/kg、V组2.0mg/kg.采用Star呼吸机监测呼吸功能指标,同时观察其神志变化,应用Probit法分析该药量效关系。结果:Ⅱ、IV、V组随着剂量增加,潮气量降低的幅度和呼吸抑制持续时间明显增加,以给药后1～3分钟潮气量减少最为明显(P<0.01),浅睡状态ED_(50)为0.98mg/kg.深睡状态ED_(50)为1.26mg/kg,呼吸抑制ED_(50)为1.1mg/kg。结论:静注0.8～1mg/kg异丙酚可以产生适用于非全麻病人的镇静、催眠作用,而对呼吸抑制的作用较小。     

Direct angioplasty of totally occluded left main coronary artery in acute myocardial infarction complicated by cardiogenic shock: report of two cases and literature review

Acute total occlusion of the left main coronary artery is usually characterized by a rapid course of deterioration that challenges therapeutic intervention. Unlike subtotal occlusion of the left main coronary artery, acute total occlusion of the left main coronary artery is extremely rare and has a grave prognosis. Most patients with this problem die suddenly or go into cardiogenic shock. Direct percutaneous transluminal coronary angioplasty (PTCA) was performed on 2 patients, both suffering from cardiogenic shock due to acute total occlusion of the left main coronary artery. Both patients underwent coronary artery bypass surgery subsequently. One patient, who had substantial intercoronary collaterals, remained asymptomatic at 31 months of follow-up. The other, who had no intercoronary collateral circulation, expired 3 days after coronary artery bypass surgery. We conclude that direct PTCA to the acutely occluded unprotected left main coronary artery in cardiogenic shock patients is a potentially life-saving procedure, and the presence or absence of collaterals from the dominant right coronary artery will influence the clinical outcome.     

Sequential production and activation of matrix-metalloproteinase-9 (MMP-9) with breast cancer progression

The degradation of the basement membrane by matrix-metalloproteinase(MMP) and serine protease is a critical pointin tumor invasion and metastasis. We measured theactivity of MMP-9 from 28 normal, 12 benignand 126 breast cancer tissues using gelatin zymographywith an image analysis system. ProMMP-9 was expressedin 17.5% of the cancer patients compared to2.5% in 40 non-cancerous tissues (p=0.014).The mature form of MMP-9 (82 kD) wasexpressed only in T2–T4 stages. During the earlyphase of breast cancer (DCIS and T1 stage)progression, only production of proMMP-9 increased. However, asthe cancer grew or invaded skin (T2–T4), orwith lymphovascular permeation, both production and activation ofMMP-9 increased. In conclusion, proMMP-9 production was themain cause of increased MMP-9 activity during theearly phase, while both production and activation increasedin the late phase of breast cancer.