香港地区肿瘤放射治疗发展简史

通过回顾香港地区肿瘤放射治疗设备、人员、技术等情况的进展,可为广大读者提供一个简单清晰的脉络,并帮助了解香港地区肿瘤放射治疗学创建与发展过程。此报告是对香港地区肿瘤放射治疗学发展的宣传与肯定,也更是为扩大放射肿瘤学科交流和发展提供契机。     

Systemic interleukin 1 administration suppresses arachidonic acid-induced ear oedema in the mouse

Recombinant human interleukin 1 beta (IL-1 beta), given intraperitoneally to mice as a single injection, significantly suppressed the development of arachidonic acid (AA)-induced ear oedema. This effect was noted 2 h after administration and for at least 5 days afterwards. IL-1 beta was effective in the dose range of 250 ng-20 micrograms/mouse. Injection of IL-1 beta per se resulted in erythema of the ears, and thus, IL-1 beta has the capacity not only to induce and augment but also to suppress inflammatory responses. Indomethacin administered as subcutaneously-implanted pellets did not influence the IL-1 beta induced-ear erythema, but suppressed to some extent the effect of IL-1 beta on the AA-induced ear oedema.     

Oculocutaneous albinism

Oculocutaneous albinism represents a group of inherited skin disorders characterized by a generalized reduction of cutaneous, ocular and pilar pigmentation from the time of birth. Oculocutaneous albinism types 1 and 2 are the most common, but several other types have been described. A defect in the melanin synthesis pathway, resulting in reduced formation of melanin, is responsible for oculocutaneous albinism. Aetiology, clinical manifestations, diagnosis and management are discussed.     

QS Alex 755 nm激光对黑素细胞p16INK4a表达的影响

目的 了解激光对黑素细胞潜在恶变作用的可能性。方法 QS Alex 755nm激光体外照射HTB66、Sk-mel-24和G361 3种黑素瘤细胞株,照射剂量为0．85～2 J／cm^2,24h后收集细胞。应用流式细胞仪和RT-PCR方法分别测定p16INK4a蛋白和p16INK4a mRNA在激光照射前后和不同剂量照射后的表达水平。结果激光照射后,HTB 66细胞株(p16INK4a蛋白阳性株)的p16INK4a蛋白表达明显增加：而低水平表达的Sk-mel-24和G361细胞株无明显变化。在HTB66细胞株中虽然p16INK4a蛋白的表达上调,但对其功能的测定发现它并不能阻止细胞周期从G0/G1向S／G2M转变。HTB66细胞株的p16INK4a mRNA的表达也增加。结论经研究剂量的激光照射后DNA有损伤。具有黑素瘤家族史或个人史的患者可能有p16INK4a基因的突变或丢失,不提倡用激光治疗此类患者的色素性疾病。     

二十碳五烯酸对三种肝癌细胞系作用的实验研究

目的 探讨二十碳五烯酸（eicosapentaenoic acid,EPA)对3种肝癌细胞系作用。方法 EPA作用于HepG2（携带有野生型p53基因）、Huh7（携带有突变型p53基因）和Hep3B(p53基因缺失）这3种肝癌细胞系,通过细胞计数、DNA电泳、流式细胞技术和末端转移酶标记技术等来检测EPA对这3种细胞系的作用和可能的机制。结果 EPA主要是通过诱导HepG2肝癌细胞系的细胞凋亡来抑制其生长,而且这种抑制作用呈现出时间和剂量依赖的关系。而且同时发现EPA对于Huh7和Hep3B这两种肝癌细胞系无明显抑制作用。结论 细胞凋亡的诱导可能是EPA抑制HepG2肝癌细胞系生长的主要机制。而且p53基因可能参与EPA诱导HepG2细胞系细胞凋亡的过程。     

Nitrogen-Containing Bisphosphonates Are Associated With Reduced Risk of Pneumonia in Patients With Hip Fracture

The objective of this work was to study the risk of pneumonia and pneumonia mortality among patients receiving nitrogen-containing bisphosphonates (N-BPs), non-N-BP anti-osteoporosis medications, and no anti-osteoporosis medications after hip fracture. We studied a historical cohort using a population-wide database. Patients with first hip fracture during 2005–2015 were identified and matched by time-dependent propensity score. The cohort was followed until December 31, 2016, to capture any pneumonia and pneumonia mortality. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox-proportional hazards regression. Absolute risk difference (ARD) and number needed to treat (NNT) were calculated. We identified 54,047 patients with hip fracture. Of these, 4041 patients who received N-BPs and 11,802 without anti-osteoporosis medication were propensity score–matched. N-BPs were associated with a significantly lower risk of pneumonia compared with no treatment (6.9 versus 9.0 per 100 person-years; HR 0.76; 95% CI, 0.70 to 0.83), resulting in an ARD of 0.02 and NNT of 46. A similar association was observed with pneumonia mortality (HR 0.65; 95% CI, 0.56 to 0.75). When N-BPs were compared with non-N-BP anti-osteoporosis medications, the association remained significant. N-BPs were associated with lower risks of pneumonia and pneumonia mortality. Randomized controlled trials are now required to determine whether N-BPs, non–vaccine-based medications, can reduce pneumonia incidence in high risk groups. © 2020 American Society for Bone and Mineral Research.     

The Hutson loop and prosthesis: Clinical uses in hepato-biliary intervention

A number of method of making a Roux-en-Y hepaticojejunostomy have been advocated to help the radiologist gain access to the biliary system. We have found markers and rings unsatisfactory and therefore designed and tested our own prosthesis. Reliable rapid access is easily achieved using this device with a much reduced radiation dose to both patient and radiologist. The prosthesis has been used for the past 3 years, and the last 23 patients are reviewed. Seven patients have required repeated interventions via the loop and we present the findings and our results.     

Clinical evaluation of total serum calcium in primary hyperparathyroidism and the risk of death after surgery

Abstract. This study aims to understand the behaviour and clinical value of total serum calcium in untreated primary hyperparathyroidism, to identify the significant relationship between pre-operative total serum calcium and the risk of death after surgery, and to consider the issue of when to operate. The risk of death after surgery was studied as dependent on pre-operative serum calcium levels in a series of 896 patients followed up for mean 12.9 years (SD 6.1) after surgery. The predictive power of pre-operative peak calcium levels was stronger than that of mean calcium levels. It was found that an increase of peak serum calcium from 2.60 mmolL^-1 to 2.90 in one patient meant a death risk increase, with 38% still 5 years after surgery. The marginal risk increase per mmolL^-1 was found to be higher below the peak serum calcium level of 2.90 mmolL^-1 than above that level. The variation of total serum calcium before surgery was found to be substantial and the occurrence of transient high serum calcium levels was not unusual. Therefore, conservative surveillance with yearly total serum calcium estimations seems insufficient. Rather, early surgery, when serum calcium levels are not more than moderately increased, appears to be the most favourable alternative.