MIC-1 serum level and genotype: associations with progress and prognosis of colorectal carcinoma.

PURPOSE: Macrophage inhibitory cytokine-1 (MIC-1) is a divergent member of the tumor growth factor beta (TGF-beta) superfamily. Several observations suggest that it plays a role in colorectal carcinoma (CRC). In particular, MIC-1 is markedly up-regulated in colorectal cancers as well as in premalignant adenomas. This study examines the relationship of serum MIC-1 levels and genotypes to clinical and pathologic features of colonic neoplasia. Experimental Design: We confirmed the presence of MIC-1 in CRC tissue and the cell line CaCo-2. The normal range for serum MIC-1 levels was defined in 260 healthy blood donors, and the differences between normal subjects and 193 patients having adenomatous polyps or CRC were then determined. In a separate cohort of 224 patients, we evaluated the relationship of MIC-1 serum level and genotype to standard tumor parameters and outcome measures. RESULTS: MIC-1 was expressed in CRC tissue and the cancer cell line CaCo-2. There was a progressive increase in serum MIC-1 levels between normal individuals [mean (M) = 495 pg/ml, SD = 210), those with adenomatous polyps (M = 681 pg/ml, SD = 410), and those with CRC (M = 783 pg/ml, SD = 491)]. Serum MIC-1 level was correlated with the extent of disease so that the levels were higher in patients with higher Tumor-Node-Metastasis stage. There were significant differences in time to relapse and overall survival between subjects with different MIC-1 levels and genotypes. CONCLUSIONS: This study identifies a strong association between MIC-1 serum levels and neoplastic progression within the large bowel. We suggest that the measurement of serum MIC-1 levels and determination of MIC-1 genotype may have clinical use in the management of patients with CRC.     

抗抑郁药物在恶性肿瘤疼痛治疗中的应用与疗效观察

目的 研究不同类型的抗抑郁剂作为辅助性干预药物在恶性肿瘤疼痛伴发抑郁治疗中应用及其疗效。方法 将126例患者随机分组,全部患者在不受干扰、继续常规应用止痛药物的同时,进行抗抑郁药物辅助性干预治疗,抗抑郁药物选择5-羟色胺再摄取抑制剂氟西汀20mg/d(氟西汀组)和三环类抗抑郁药物氯丙咪嗪250mg/d(氯丙咪嗪组)口服,分别于服药当日及服药后3周进行相关各项指标的评定比较。观察抗抑郁药物的应用对缓解恶性肿瘤患者临床抑郁症状的作用及疗效;观察抗抑郁药物与止痛药物联合应用对患者疼痛程度、强度的影响;观察抗抑郁药物应用的毒副反应情况。结果 氟西汀组患者抑郁情绪明显缓解,治疗前后比较差异有显著性(P<0.05),氯丙咪嗪组患者治疗前后抑郁情绪也有一定的缓解,但差异无显著性(P>0.05);同时,NRS在两组患者中均明显下降,差异有显著性(P<0.05)。氯丙咪嗪组患者在食欲、睡眠、日常生活三项不但未见改善,反而加重,治疗前后比较差异有显著性(P<0.05);精神状态、情绪、与人交往和生活乐趣四项治疗前后比较略有改善,但差异无显著性(P>0.05)。氟西汀组患者在用药期间未见有明显的不良反应发生。氯丙咪嗪组患者中出现锥体外系反应,较明显的抗胆碱样副反应、药疹和体位性低血压。结论 在恶性肿瘤的疼痛治疗中加     

石蜡包埋组织DNA检测在判断畸形儿病因中的应用

目的：对１９８５～１９９５年在我院尸体检查证实为畸形死亡的３９例围产儿石蜡包埋组织标本，进行有关病原体的检测，以明确围产儿致畸原因。方法：用改良的水浴脱蜡、直接裂解及酶解法，进行石蜡包埋的死亡围产儿肝、脑组织的弓形体、巨细胞病毒及Ⅱ型单纯疱疹病毒的聚合酶链反应（ＰＣＲ）检测。同时对送检胎盘者，取胎盘石蜡包埋组织，分别作上述病原体的检测。结果：３９例中２５例检出病原体，检出率为６４％。其中泌尿生殖系统畸形１３例中９例检出病原体，神经管缺陷１２例中８例检出病原体。此两种畸形中病原体的检出率高达６８％。结论：本组资料证实宫内感染是围产儿致畸的重要原因之一，并对胎盘感染常见的形态学变化及畸形儿胎盘常规送检的重要性进行了讨论。     

输卵管妊娠保留输卵管手术后综合疗法的宫内妊娠探讨

对输卵管妊娠52例有生育要求者，其中28例行切开输卵管壶腹部取胚胎术，10例行输卵管峡部破裂口修补术，7例行输卵管伞部成形术，5例行输卵管峡部端端吻合术，2例行输卵管子宫角部植入术。术后给MTX与中药等综合治疗2～5个月，对其中45例行输卵管通畅检查，双侧输卵管通畅4O例，通畅率为88.9％；有41例宫内妊娠，妊娠率为78.9％，另有1例再次异位妊娠。提示：对有生育要求的输卵管妊娠尽量根据输卵管的不同情况采用相应的手术方法，并应用有效的术后综合措施，对保留患者的生育功能和提高妊娠率有重要意义。     

GLOMUS TUMORS──A REVIEW OF 8 CASES WITH INTRODUCTION OF A MODIFIED COMBINED INTRA-AND EXTRACRANIAL APPROACH

Eight cases of glomus tumors hospitalized in our department from 1982 through 1995 were reviewed. It comprised of five glomus tympanic tumors and three glomus jugular tumors. Discussion was centered on it’s contemporary diagnosis, classification and surgical treatment with introduction of a modified combined intra-and extracranial surgical approach to resect the extensive glomus tumors.     

THE HUMORAL ANTITUMOR RESPONSES INDUCED BY IL-4 GENE-MODIFIED TUMOR VACCINE

ＴＨＥＨＵＭＯＲＡＬＡＮＴＩＴＵＭＯＲＲＥＳＰＯＮＳＥＳＩＮＤＵＣＥＤＢＹＩＬ４ＧＥＮＥＭＯＤＩＦＩＥＤＴＵＭＯＲＶＡＣＣＩＮＥ１ＹｕＹｉｚｈｉ于益芝ＣａｏＸｕｅｔａｏ２曹雪涛ＺｈａｎｇＭｉｎｇｈｕｉ张明徽ＬｅｉＨｏｎｇ雷虹ＴａｏＱｕｎ陶群Ｄｅｐ...     

GM-CSF/IL-4基因修饰的瘤苗不同的免疫途径诱导不同免疫反应的观察

对细胞因子基因修饰瘤苗的研究表明,IL-2、IL-4、IFN-γ、GM-CSF等一系列细胞因子基因以不同载体转入肿瘤细胞制成瘤苗后皮下免疫小鼠,均可增强机体抗肿瘤免疫力,其机制可能是由于瘤苗分泌的细胞因子促进了免疫细胞对肿瘤抗原的识别、提呈及对肿瘤细胞的杀伤能力.有文献报道,逆转录病毒介导的GM-CSF和IL-4共同转染瘤苗可以有效激发机体抗肿瘤免疫力,为探讨不同途径瘤苗免疫后机体的免疫反应,我们采用皮下、腹腔、脾内、静脉四种途径接种GM-CSF、IL-4基因双重转染的小鼠红白血病细胞FBL-3瘤苗,发现免疫途径不同,所激发的免疫应答类型不同,诱导机体生成的免疫力不同,提示某些瘤苗应用时应选择适当的免疫途径.     

小儿咽侧间隙肿瘤4例报告

为探讨小儿咽侧间隙肿瘤的临床特征，报告４例小儿咽侧间隙肿瘤患者儿的诊治体会。结合临床提出诊断本病宜通过ＣＴ扫描，先确定肿瘤的大小和范围，再选择颈侧径路摘除肿瘤．结果治疗的４例患儿均获得了肯定的结果。并且提示手术中应保护重要的血管和神经。     

颅底恶性肿瘤切除术后组织缺损一期修复的探讨──附18例报告

目的：为解决颅底恶性肿瘤的广泛切除或根治性切除术后所致的颅底骨与软组织缺损，预防此缺损所致的颅内感染，脑脊液漏等并发症。方法：在术中应用了斜方肌下部岛状肌皮瓣，胸大肌下部岛状肌皮瓣，颞肌复合组织瓣等各种修复方法分别对18例患者进行了一期修复。结果：修复成功率73．2％（13例），术后并发症27．8％（5例）.结论：根据组织缺损的不同大小、范围、程度、部位和不同的手术入路来选择不同的修复方法，关系到手术成败。