612例肾虚相关证型功能性子宫出血患者证型分布规律的临床调查

目的:了解肾虚相关证型功血患者中医证型分布状况,为规范功血辨证诊断标准奠定基础。方法:采用临床流行病学横断面调查方法,对612例肾虚相关证型功血患者进行问卷调查和各证型的频数统计。结果:复合肾虚证型(510,83.33%)较单一证型(102,16.67%)多见。单一证型中,肾阴虚(45,44.12%)、肾气虚(45,41.18%)多见。且肾气虚多兼肝郁(68,11.09%)、血虚(57,9.30%)、血瘀(57,9.30%);肾阴虚证多兼肝郁(113,18.43%)、血瘀(99,16.15%)和血虚证(49,7.99%);肾阳虚证多兼脾气虚证(75,12.23%)。排卵型功血多见肾气虚证(186,57.23%),无排卵型功血多见肾气虚(146,50.69%)、肾阴虚(111,38.54%)。结论:临床肾虚功血多为复合证型,常易相兼的其他证型有肝郁、脾虚、血虚、血瘀。     

转移性肝癌外放射肝动脉化疗栓塞综合治疗

（目的）探讨转移性肝癌的外放射、肝动脉化疗栓塞的综合治疗价值。（方法）回顾性分析转移性肝癌的肝动脉化疗栓塞、外放射综合治疗（28例）及单纯外放射治疗（25例）的治疗效果。〔结果〕综合治疗组的有效率为53．6％，1年、2年、3年生存率分别为60．7％、32．2％、14．3％，单纯放疗组的有效率为32％，1年、2年、3年生存率分别为44．0％、28．0％、12．0％。综合治疗组、单纯放疗组的平均生存期分别为14．6个月、11．8个月。其中III期患者的平均生存期综合治疗组（13．4个月）明显优于单纯放疗组（7．1个月，P＜0．05）。（结论）综合治疗未能提高I、II期转移性肝癌的治疗效果，但能明显延长III期患者的生存期。     

TNF-A基因多态性及其单体型与新疆维、汉民族胃癌的关系

目的:探讨新疆维吾尔族(维族)和汉族胃癌患者肿瘤坏死因子-α基因(TNF-A)rs1800629和rs361525位点多态性及其单体型与胃癌易感性的关系。方法:采用Snapshot技术分析322例胃癌患者(其中维族93例,汉族229例)和作为对照的487例非胃癌患者(其中维族231例,汉族256例)TNF-A基因rs1800629和rs361525位点基因型的分布;利用SHEsis软件分析其构成的单体型在病例组和对照组中的分布频率,比较基因型和单体型在病例组和对照组间的分布差异。结果:在维族人群中,TNF-A基因rs1800629和rs361.525位点不论是等位基因位点、基因型还是单体型在病例组和对照组中的分布频率差异均无统计学意义(P>0.05)。在汉族人群中,TNF-A基因rs361525位点AA+GA基因型在病例组和对照组之间的分布差异有统计学意义(χ=4.56,P=0.03),即携带A等位基因者发生胃癌的风险增加(OR=2.41,95%CI:1.06～5.49);rs1800629位点基因型与胃癌之间未发现明显关联;A-A单体型在病例组及对照组分布频率分别为0.92%和0.86%,差异有统计学意义(χ~2=7.03,P=0.01)。结论:TNF-A基因单核苷酸多态性与汉族人群胃癌发病风险相关,这种相关性具有民族差异。     

分化型甲状腺癌再次手术原因探讨(附82例病例报告)

目的　探讨分化型甲状腺癌的术前正确诊断和合理的手术术式选择。方法　对 82例分化型甲状腺癌再次手术的临床资料进行回顾性分析。结果　术前 69例误诊为甲状腺瘤 ,11例误诊为结节性甲状腺肿。首次手术行单纯性肿瘤切除 5 9例 ,患叶甲状腺次全切除 13例 ,9例行腺叶加峡部切除。术前、术中 80例未做细胞及病理学检查。结论　对甲状腺结节患者 ,应行细针穿吸 (FNAC)及术中冰冻切片 (FS)检查。并重视区域淋巴结的检 (探 )查 ,以确定分化型甲状腺癌诊断 ,根据病期选择手术术式。如无条件行FNAC及FS ,对一叶单发或多发甲状腺结节的可疑病例 ,宜选择甲状腺叶加峡部切除术术式治疗     

Detection and clinical significance of thrombomodulin in both plasma and tissue extracts of cancer patients

Thrombomodulin?is the endothelial cell surface glycoprotein that converts thrombin from a procoagulant protein into the activator for protein C. Thrombin plays an important role in the adhesion of cancer cells to endothelial cells through fibrin formation and platelet activation, and thrombin stimulates tumor cell bindings to endothelial cells[1]. In this article, the changes of TM were studied in both plasma and tissue extracts of cancer patients for evaluating its clinical significance. P…     

Gli1在鼻咽癌组织中的表达及临床意义

目的:探讨神经胶质瘤相关癌基因1(Gli1)在鼻咽癌组织中的表达及其临床意义.方法:免疫组化方法检测89例鼻咽癌组织及21例正常鼻咽组织中Gli1的表达情况,分析Gli1的表达与与鼻咽癌患者临床病理参数及预后之间的关系.结果:Gli1在鼻咽癌组织的表达水平显著高于正常鼻咽组织(P＜0.01),且Gli1的表达水平与鼻咽癌的T分期、淋巴结转移程度及临床分期显著相关(P＜0.05).此外,Gli1蛋白表达越高,患者的生存时间也明显缩短.结论:Gli1在鼻咽癌组织中呈过表达,可能在鼻咽癌的发生、发展中起重要作用,Gli1有可能成为鼻咽癌治疗的新靶点之一.     

Spectrum and immunophenotyping of 653 patients with B‐cell chronic lymphoproliferative disorders in China: A single‐centre analysis

The incidence of B‐cell chronic lymphoproliferative disorders (B‐CLPDs) is significantly lower in China than that in western countries. There have been studies involving small cohorts with conflicting results regarding the spectrum of B‐CLPDs in China, and the types and immunophenotyping of B‐CLPDs in China remain largely unexplored. We conducted a retrospective analysis of 653 cases of B‐CLPDs seen in our centre from 2011 to 2015. Four‐colour flow cytometry was used to determine the expression of each immunological marker, and the diagnostic values of the immunological markers were also investigated. Chronic lymphocytic leukaemia (CLL) was the most common type of B‐CLPD, which was consistent with that in west countries. However, the proportions of CLL (55.9%), follicular lymphoma (2.6%), and hairy cell leukaemia (0.2%) were lower, while the proportion of lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia (5.4%) was higher in China, as compared with western countries. With respect to immunophenotypic characteristics, CD23 (31.7%) was more frequently expressed in mantle cell lymphoma (MCL) in our cohort than that in western countries. Immunophenotyping was useful in differentiating MCL from CLL or B‐cell prolymphocytic leukaemia and lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia from splenic marginal zone lymphoma. CD200 was of better diagnostic performance (accuracy: 94.6%) in differentiating CLL from MCL compared with CD23 (accuracy: 93.3%). Some cases of B‐CPLDs, however, had no definite diagnoses, which were diagnosed as CD5⁺B‐CPLDs unclassified (7.7%) and CD5^?B‐CPLDs unclassified (15.8%). This is the largest study that systematically explores the spectrum and immunophenotyping of B‐CLPDs in Asia, confirming that spectrum of B‐CLPDs in China was different from that in western countries. The immunophenotypic features of B‐CLPDs were similar between China and western countries, although a few disparities exist. Cases with no definite diagnoses warrant further studies in the future.     

平调饮抗肿瘤作用的实验研究

背景与目的:建立H22肝癌腹水瘤荷瘤小鼠模型,通过给予模型鼠平调饮灌胃评价其抗肿瘤作用.材料与方法:用H22腹水肝癌株种植于小鼠右腋皮下,致移植性肿瘤,建立H22肝癌腹水瘤荷瘤小鼠模型.将模型鼠分成阴性对照组,平调饮组,平调饮+5-Fu组和5-Fu组,共4组,各组模型鼠分别灌胃生理盐水、平调饮、平调饮+5-Fu和5-Fu,连续灌胃10 d后,观察瘤体大小、胸腺指数、脾脏指数、抑瘤率、生命延长率和VEGF在肿瘤及肿瘤周围组织中的表达.结果:平调饮组肿瘤平均瘤体、VEGF值减小,胸腺指数、脾脏指数、抑瘤率(48.6%)及生命延长率(168.3%)增高.结论:平调饮可提高胸腺指数,降低5-Fu对免疫功能的毒性作用,显著延长荷瘤小鼠的生存期.平调饮可能通过促进肿瘤细胞分化成熟,抑制肿瘤细胞增殖,降低肿瘤组织和肿瘤周围组织中VEGF表达,而对H22腹水型小鼠肿瘤的发展起抑制作用.     

甲状腺微小癌的外科手术治疗研究

目的 比较甲状腺微小癌全切术与传统手术的疗效.方法 比较82例经甲状腺全切术治疗的甲状腺微小癌患者(观察组)与82例经传统手术治疗的甲状腺微小癌患者(对照组)的疗效、手术指标(手术时间、出血量、切口长度、住院时间)、术后并发症发生情况和术后1年复发率、颈部淋巴结转移率、远处转移率.结果观察组患者治疗的总有效率为95.12%(39/41),高于对照组的78.05%(32/41),差异有统计学意义(P﹤0.05).观察组患者的手术时间、出血量、切口长度和住院时间分别为(41.5±11.4)min、(42.5±12.8)ml、(5.2±1.0)cm、(4.4± 1.2)d,均低于对照组的(68.7±14.6)min、(83.6±10.6)ml、(6.2±1.4)cm、(6.3±1.4)d,差异均有统计学意义(P﹤0.05).治疗后观察组患者的并发症发生率为7.32%(3/41),低于对照组的29.27%(12/41),差异有统计学意义(P﹤0.05).术后1年观察组患者的复发率、颈部淋巴结转移率和远处转移率分别为4.88%(2/41)、4.88%(2/41)、7.32%(3/41),均低于对照组的19.51%(8/41)、21.95%(9/41)、26.83%(11/41),差异均有统计学意义(P﹤0.05).结论 甲状腺全切术治疗甲状腺微小癌的疗效明显,对患者造成的创伤较小;同时可以明显减少术后并发症、复发率和转移率,有利于患者早日康复,值得临床推广应用.     

粒细胞集落刺激因子影响白血病细胞增生的研究

 目的 探讨粒细胞集落刺激因子（G-CSF）对急性白血病（AL）细胞增生的影响。方法 急性髓系白血病（AML）患者30例,急性淋巴细胞白血病（ALL）患者20例,正常对照20例。化疗前留取骨髓5 ml,制备其单个核细胞（MNC）悬液,并分别加入不同浓度G-CSF培养24 h后用流式细胞仪（FCM）检测其DNA倍体的量。同时检测MNC的G-CSF受体（G-CSFR）表达率。结果 骨髓MNC培养24 h后各浓度的DNA倍体量在AML随着G-CSF浓度的增加有线性上升趋势,在ALL和正常对照呈直线。骨髓MNC G-CSFR表达率AML（68.59±13.99）%;ALL（1.90±0.93）%;正常对照（70.50±10.80）%。结论 G-CSF 可促进AML细胞增生,对ALL和正常粒细胞增生无促进作用。G-CSFR于恶性及正常粒细胞表达,淋巴细胞不表达。