膀胱肿瘤2350例临床病理学特点分析

目的 探讨膀胱肿瘤的发病现状、总体趋势和病理特点.方法 整理1980-2007年2350例膀胱肿瘤病理档案,分为1980-1989、1990-1999和2000-2007年3个时间段.应用SPSS 13.0软件分析3时间段患者性别、年龄及肿瘤组织学类型间的关系.结果 2350例膀胱肿瘤中男1854例,女496例.良性92例,恶性2258例,膀胱恶性肿瘤的发病人数逐年上升.发病高峰年龄从50～69岁推迟到60～79岁.1980-1989、1990-1999和2000-2007年3个时间段中男、女恶性肿瘤病例数分别为524例和113例(4.64:11 00)、589例和164例(3.59:1.00)、675例和193例(3.50:1.00),男性约为女性的3.80倍;3时间段男性发生膀胱尿路上皮癌年龄分别为(57.5±11.7)、(62.6±12.3)、(65.9±11.3)岁,女性分别为(58.7±13.6)、(60.7±12.1)、(65.8±12.0)岁,男女各年龄段分别比较差异有统计学意义(P<0.05).男性发生鳞状细胞癌、尿路上皮癌和腺癌年龄分别为(68.05±9.7)、(59.85±14.1)、(63.4±9.9)岁,差异有统计学意义(P相似文献   

维生素D受体基因多态性与汉族人群慢性牙周炎易感性的关系

目的 探讨维生素D受体(VDR)基因多态性与汉族人群慢性牙周炎(CP)易感性的关系。方法 收集汉族轻、中、重度CP患者共166例及80名无牙周炎对照者的颊黏膜拭子，以Chelex-100法提取DNA，采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法测定VDR BsmI、VDR ApaI和VDR TaqI的基因型，分析组间基因型分布和等位基因频率的差异。结果 轻、中、重度CP患者中VDR ApaI等位基因A携带者明显多于对照组，重度CP与中度CP、重度CP与轻度CP患者间VDR ApaI基因型的分布差异均有统计学意义，中度CP与轻度CP患者间VDR ApaI基因型分布差异无统计学意义，而VDR BsmI、TaqI位点的基因型分布在患者组和对照组间差异无统计学意义。结论 VDR ApaI等位基因A可能与汉族人群CP的易感性有关。     

甲基苯丙胺抗体、疫苗以及检测试纸研究进展

苯丙胺类兴奋剂(amphetamine-type stimulants,ATS)是21世纪主要流行滥用的药物之一,目前社会上流行的"冰毒","摇头丸"等属于此类毒品,主要有甲基苯丙胺(methamphetamine,METH),亚甲基二氧基甲基苯丙胺(MDMA)等.在我国,此类毒品无论是在舞厅、迪吧或其它公共娱乐场所和地下色情场所等都很容易获得,导致滥用人群日益扩大[1],影响社会治安和社会稳定.虽然世界各国在药物滥用防治工作中投入了大量的人力、物力、财力,但收效甚微,对ATS依赖者目前治疗多采用强制戒毒、对症治疗和辅以心理治疗等方法,但治疗时间长,复吸率高[1-4],对于高危人群目前还没有一种有效的预防手段.检测ATS多用高效液相色谱(HPLC)、气相色谱-质谱联用(GC-MS)、薄层色谱(TLC)等[2]方法,其设备昂贵,难以开展现场检测,应用范围受限,并不适合于现场快速便捷检测,因而探索对ATS更有效的预防、治疗方法和更便捷的现场检测方法,极具现实意义.     

电视纵隔镜手术在肺癌分期中的应用价值

背景与目的　随着新辅助治疗方案的提出,以及人们逐渐认识到CT和PET等检查在肺癌分期中的局限性,纵隔镜手术在肺癌分期中的价值日益受到人们的重视。本研究旨在探讨电视纵隔镜手术在肺癌纵隔淋巴结分期中的应用价值。方法　回顾性总结2001年9月至2004年6月60例经电视纵隔镜检查的肺癌患者的临床资料,其中颈部电视纵隔镜手术52例,胸骨旁电视纵隔镜手术2 例,颈部加胸骨旁电视纵隔镜手术6例。术前所有患者胸部CT均发现纵隔淋巴结肿大(直径大于1.0 cm)。结果　本组60 例患者,经电视纵隔镜检查证实纵隔淋巴结转移(阳性)者42例,未见纵隔淋巴结转移(阴性)者18例。纵隔淋巴结阳性者放弃手术,予以化疗;阴性者中转开胸行肺叶切除或肺楔形切除加纵隔淋巴结清扫,术后病理证实17 例纵隔淋巴结未见转移,1例隆凸后淋巴结可见癌转移(电视纵隔镜检查假阴性)。电视纵隔镜手术敏感性、特异性和准确性分别为97.7%、100%和98.3%。本组术中发生无名动脉撕裂1 例,并发症发生率为1.7%(1/60)。无围手术期死亡。结论　电视纵隔镜手术安全、可靠,可作为明确肺癌分期的常规方法。     

螺旋CT三期扫描对肝纤维化诊断价值研究

目的探讨螺旋CT三期扫描对肝纤维化的诊断价值。方法对66例经肝穿刺活检病理证实的慢性乙型肝炎肝纤维化患者组和42例正常对照组进行螺旋CT三期增强扫描。根据纤维化程度分期进行影像资料和相关指标的统计分析。结果肝左叶增大,肝表面形态及肝实质密度的改变,脾脏增大,门静脉增宽和侧枝循环的建立等影像学改变,随着肝纤维化严重程度的加重而有统计学差异。本研究显示57例肝纤维化患者螺旋CT三期扫描诊断肝纤维化52例,敏感性91.2%,特异性77.8%。各期肝纤维化分期准确28例,准确率49.1%;准确判断轻度纤维化(S1、S2)或重度纤维化(S3、S4)44例,准确率77.2%,诊断早期肝硬化16例,准确率84.2%。结论螺旋CT三期扫描能判断肝纤维化的程度,而且是动态观察肝纤维化的病程演进和临床随访的有效手段。     

Pesticide assessment: Protecting public health on the home turf

Pesticide regulation is examined in the context of Health Canada’s Pest Management Regulatory Agency’s assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec’s Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.     

急性冠状动脉综合征患者介入术前后血小板活化及血管内皮功能的变化

目的观察急性冠状动脉综合征患者介入治疗后血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物及内皮功能的改变。方法60例急性冠状动脉综合征患者在冠状动脉介入术前和术后即刻以及次日采用流式细胞仪检测血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物;双抗体夹心固相酶联免疫吸附试验测定血浆假血友病因子的表达水平;放射免疫测定法测定血浆内皮素1表达水平;酶法测定血浆一氧化氮的含量;彩色多谱勒超声诊断仪测量内皮依赖性血管舒张功能。选择健康体检者和稳定型心绞痛患者各30例作对照,观察急性冠状动脉综合征患者冠状动脉介入前后指标的变化并与对照组比较。结果与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物明显增高(P<0.05或0.01);急性冠状动脉综合征患者介入术后即刻CD62p、CD63和糖蛋白Ⅱb/Ⅲa受体复合物与术前相比明显增高(P<0.01),但术后24h较术前无明显变化(P>0.05)。与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组假血友病因子、内皮素1的表达水平明显增高(P<0.01),内皮依赖性血管舒张功能和一氧化氮降低(P<0.05或<0.01);急性冠状动脉综合征患者介入术后即刻血浆假血友病因子和内皮素1水平升高(P<0.05或P<0.01),内皮依赖性血管舒张功能和一氧化氮水平降低(P<0.05),且介入术后24h假血友病因子水平也较术前升高(P<0.05),内皮依赖性血管舒张功能降低(P<0.05),但内皮素1和一氧化氮水平与术前差异无显著性(P>0.05)。结论血小板活化和内皮功能的损伤在急性冠状动脉综合征发生和发展过程中起重要的作用,冠状动脉介入术后血管内皮受到一定损伤,血小板有一定程度的激活。     

Molecular determinants of cetuximab efficacy.

PURPOSE: To investigate whether mRNA expression levels of cyclin D1 (CCND1), cyclooxygenase 2 (Cox-2), epidermal growth factor receptor (EGFR), interleukin 8 (IL-8), and vascular endothelial growth factor (VEGF), all members of the EGFR signaling pathway, are associated with clinical outcome in patients with EGFR-expressing metastatic colorectal cancer (CRC) treated with cetuximab. PATIENTS AND METHODS: Thirty-nine patients with metastatic CRC, refractory to both irinotecan and oxaliplatin, were enrolled on IMCL-0144 and treated with single-agent cetuximab. The intratumoral mRNA levels of CCND1, Cox-2, EGFR, IL-8, and VEGF were assessed from paraffin-embedded tissue samples using laser-capture microdissection and quantitative real-time polymerase chain reaction. RESULTS: There were 21 women and 18 men with a median age of 64 years (range, 35 to 83 years). Higher gene expression levels of VEGF were associated with resistance to cetuximab (P = .038; Kruskal-Wallis test). The combination of low gene expression levels of Cox-2, EGFR, and IL-8 was significantly associated with overall survival (13.5 v 2.3 months; P = .028; log-rank test). Both findings were independent of skin toxicity that was itself significantly correlated to survival. Patients with a lower mRNA amount of EGFR had a longer overall survival compared with patients that had a higher mRNA amount (7.3 v 2.2 months; P = .09; log-rank test). Patients with lower expression of Cox-2 had a significantly higher rate of grade 2 to 3 skin reactions under cetuximab treatment. CONCLUSION: This pilot study suggests that gene expression levels of Cox-2, EGFR, IL-8, and VEGF in patients with metastatic CRC may be useful markers of clinical outcome in single-agent cetuximab treatment.     

白内障超声乳化术后角膜地形图和屈光状态的观察

目的　观察白内障超声乳化人工晶状体植入术后 ,患者角膜地形图和屈光状态的变化。方法　对2 0 0 0年～ 2 0 0 1年行白内障超声乳化的 136例 (15 1只眼 )患者术前、术后随访一年的资料进行回顾性分析。结果　术后 1、3、6、12月术眼的球镜、散光、角膜地形图曲率和散光 sim k值统计结果无明显差异 ;术后 1～ 12月视力和屈光状态稳定 (方差分析 P >0 .0 5 )。术后 6月平均视力为 0 .5 9± 0 .2 3,矫正视力为 0 .82± 0 .19,术后 6月 ,球镜为 (-0 .2 4± 0 .88) D,散光为 (- 0 .5 6± 1.0 1) D,在± 1.0 D之内球镜和散光眼分别为 84.0 %和 6 4.0 % ,≥ 0 .5和≥ 0 .8的视力分别为 70 .0 %和 2 8.0 % ,≥ 0 .5和≥ 0 .8的矫正视力分别为 94.0 %和 72 .0 %。≥ 0 .5和≥ 0 .8裸眼视力和矫正视力的平均百分率分别由 6 1.96 %和 2 3.49%提高到配镜矫正后的 92 .35 %和 6 3.0 9%。结论　超声乳化术后角膜形态和屈光状态保持良好的稳定性 ,患者可以达到良好的视力。由于植入的人工晶状体无调节功能和测量误差 ,目前部分患者需要配戴较低度数的眼镜矫正远或近视力 ,达到更好的视觉效果。