重组人血管内皮抑素联合白介素-2灌注治疗恶性胸/腹腔积液的临床研究

目的:观察重组人血管内皮抑素联合白介素-2(IL-2)治疗恶性胸/腹腔积液的疗效及安全性。方法:回顾性分析我院经病理学及细胞学检查证实为恶性胸/腹腔积液患者(PS评分>2)59例,随机分为2组,试验组应用重组人血管内皮抑素联合IL-2胸/腹腔内灌注,对照组应用IL-2胸/腹腔内灌注,均每周给药1次。评估2组近期疗效、KPS评分和毒副反应及中位总生存时间。结果:试验组有效率为36.7%,对照组为13.8%,差异有统计学意义(P=0.044);试验组临床获益率为60.0%,对照组为31.0%,差异有统计学意义(P=0.026)。试验组生活质量改善16例,稳定10例,下降4例;对照组生活质量改善7例,稳定11例,下降11例,2组差异有统计学意义(P=0.033)。2组毒副反应及总生存时间差异无统计学意义。结论:重组人血管内皮抑素联合IL-2治疗PS>2的晚期恶性胸/腹腔积液疗效好,毒副反应小,值得临床推广。     

肾移植术后恶性肿瘤39例临床分析

目的分析总结肾移植术后恶性肿瘤的发生情况,探讨其诊断方法和治疗措施。方法回顾性分析1978年9月至2009年12月接受免疫抑制治疗的肾移植受者中恶性肿瘤的发生情况。结果1945例（2106例次）肾移植共发生恶性肿瘤39例,发生率为2％。恶性肿瘤于移植术后8～124个月（中位时间57个月）得到明确诊断,其中泌尿系统肿瘤22例,消化系统肿瘤8例,肺癌、淋巴瘤、乳腺癌各2例,硬脑膜小细胞癌、胸膜低分化癌各1例,另有1例转移性肝癌患者人院后3d死亡,原发肿瘤不明。28例获手术治疗,随访至2010年12月,生存16例,其余12例在术后3-96个月（中位时间33个月）死于肿瘤转移;11例未手术者于诊断后3d一36个月（中位时间5个月）死亡。结论肾移植受者中恶性肿瘤的发生以泌尿系统肿瘤最为多见,肿瘤恶性程度高,早期发现、早期治疗是提高生存率的关键,治疗上应尽早采取以手术为主的综合治疗。     

前列爽颗粒对慢性前列腺炎模型大鼠血清中IL-10,TNF-α含量的影响

目的:观察前列爽颗粒对慢性前列腺炎(CAP)模型大鼠血清,白细胞介素-10(IL-10)和肿瘤坏死因子-α(TN F-α)表达的影响,并初步探讨其作用机制.方法:将60只SD大鼠随机分为正常对照组、CAP模型组、前列回春胶囊组(0.18 g·kg-1)、前列爽低剂量组(0.79 g·kg-1)、前列爽中剂量组(1.58 g·kg-1)、前列爽高剂量组(3.15 g·kg-1),每组10只.观察大鼠前列腺病理形态学改变,ELISA法检测IL-10,TNF-α.结果:CAP模型大鼠的组织病理学改变符合CAP的特点,治疗组炎症明显消退.模型组血清中IL-10,TNF-α水平明显高于正常组(P＜0.05),前列回春胶囊组、前列爽颗粒中、高剂量组血清TNF-α水平明显低于模型组(P＜0.05),前列回春胶囊组、前列爽颗粒中、高剂量组,血清中IL-10水平明显升高.结论:前列爽颗粒可通过调节抗炎/促炎因子分泌而发挥治疗CAP的作用.     

Colocalized granular cell tumor and infiltrating ductal carcinoma of the breast

A 57-year-old woman presented with a 2-year history of a palpable mass in the upper inner quadrant of the right breast. A 1.1-cm, poorly circumscribed, firm tumor nodule was noted, consisting of 2 histologically distinct lesions in the same location, with some areas showing purely well-differentiated invasive ductal carcinoma and others composed of granular cell tumor. In 1 area, the 2 tumors collided and infiltrated each other. The invasive ductal carcinoma was admixed with ductal carcinoma in situ of solid and cribriform types. To our knowledge, this is the first case report demonstrating colocalization of these 2 neoplasms, which raises questions regarding causal relationship. We also review the literature on granular cell tumor of the breast.     

BUB1与APC蛋白在不同乳腺组织中的表达及临床意义

背景与目的：乳腺癌的发展涉及多个染色体的改变，且与肿瘤的形态和进展相关。本研究探讨乳腺正常、增生及癌组织中BUB1、APC蛋白的表达及其临床意义。方法：收集辽宁医学院附属第一医院2005年24--2008年2月乳腺存档蜡块87份，其中乳腺癌67例，乳腺增生20例，另收集正常乳腺蜡块15例（取自距癌组织边缘≥5cm处）。所有标本均取自女性患者，年龄30-78岁，平均年龄49岁。用免疫组化方法检测乳腺正常、增生及癌组织中BUB1与APC蛋白的表达。结果：正常乳腺组织BUB1蛋白阳性表达率为86．7％，增生组织中为80．0％，癌组织中为46．O％，三者间差异有显著性（P〈0．01）。BUB1表达与淋巴结转移、远处脏器转移，肿瘤分化程度有关（P〈0．05）。正常乳腺组织APC蛋白阳性表达率为93．3％，增生组织中为75．0％，癌组织中为55．3％，三者间差异有显著性（P〈0．05），APC蛋白表达与乳腺癌的TNM分期、远处脏器转移有关（P〈0．05）。结论：BUB1蛋白和APC蛋白表达异常是乳腺癌产生的机制之一，与乳腺癌的发生发展、转移有关，两者在乳腺癌的发生过程中具有协同性。     

急性硫化氢中毒7例的抢救和心理护理

2007年12月16日，120急救车30min之内送到我院7名急性硫化氢中毒的病人。因抢救及时，护理得当，7名硫化氢中毒患者全都脱离危险。     

进展期结肠癌MSCT分期诊断与病理对照研究

目的评估结肠充气多层螺旋CT(MSCT)扫描在结肠疾病及大肠癌术前分期的诊断价值。方法对37例临床怀疑结肠疾病的患者,进行MSCT检查,并利用工作站进行后处理以获取CT仿真内镜(CTVE)、多平面重建(MPR)、表面阴影成像(SSD)和透明显示(Raysum)图像,并结合横断面图像,分析其图像特征,并与纤维内窥镜、手术病理对照分析,探讨多层螺旋CT在结肠疾病中的应用价值;并对手术病理证实的结肠癌进行术前Dukes分期评价。结果MSCT显示大肠癌部位的敏感性达100%;对大肠癌Duke分期的准确率为92.30%,对浆膜面浸润诊断的灵敏度90.90%,特异度为90%。4种后处理对结肠癌的浆膜面浸润情况及病理对照符合率依次为:MPR(92.3%),CTVE(84.6%),Raysum(69.2%),SSD(50%)。结论MSCT扫描对大肠癌的术前分期很有价值,尤其对判断局部浸润和远处转移的情况更为准确,对评估大肠癌术前分期有较高的临床应用价值。     

异常黑胆质性哮喘与ECP、IgE及FEV1的关系研究

目的探讨异常黑胆质性哮喘与嗜酸细胞阳离子蛋白（ECP）、血清总免疫球蛋白E（T-IgE）、血清特异性免疫球蛋白E（S-IgE）、第1秒用力呼气流量（FEV1）之间的关系。方法对76例支气管哮喘患者按维医体液论进行辨证分型，异常黑胆质性哮喘组30例，非异常黑胆质性哮喘组46例，并与正常对照组89例进行对照，分别测定各组血清ECP、T-IgE、S-IgE、FEV1水平。结果血清ECP、T-IgE、S-IgE变化在3组间有显著差异（P〈0．01），异常黑胆质性哮喘组明显高于正常对照组（P〈0．01），异常黑胆质性哮喘组明显高于非异常黑胆质性哮喘组（P〈0．01），非异常黑胆质性哮喘组明显高于正常对照组（P〈0．01），FEV1水平变化在3组间有显著性差异（P〈0.01），异常黑胆质性哮喘组明显低于非异常黑胆质性哮喘组和对照组（P〈0．01），非异常黑胆质性哮喘组也低于正常对照组（P〈0．01）。结论异常黑胆质性哮喘的气道炎症程度更明显，阻塞情况更严重。     

Association of cysteine-rich secretory protein 3 and beta-microseminoprotein with outcome after radical prostatectomy.

PURPOSE: It has been suggested that cysteine-rich secretory protein 3 (CRISP-3) and beta-microseminoprotein (MSP) are associated with outcome in prostate cancer. We investigated whether these markers are related to biochemical recurrence and whether addition of the markers improves prediction of recurring disease. EXPERIMENTAL DESIGN: Tissue microarrays of radical prostatectomy specimens were analyzed for CRISP-3 and MSP by immunohistochemistry. Associations between marker positivity and postprostatectomy biochemical recurrence [prostate-specific antigen (PSA) >0.2 ng/mL with a confirmatory level] were evaluated by univariate and multivariable Cox proportional hazards regression. Multivariable analyses controlled for preoperative PSA and pathologic stage and grade. RESULTS: Among 945 patients, 224 had recurrence. Median follow-up for survivors was 6.0 years. Patients positive for CRISP-3 had smaller recurrence-free probabilities, whereas MSP-positive patients had larger recurrence-free probabilities. On univariate analysis, the hazard ratio for patients positive versus negative for CRISP-3 was 1.53 (P=0.010) and for MSP was 0.63 (P=0.004). On multivariable analysis, both CRISP-3 (P=0.007) and MSP (P=0.002) were associated with recurrence. The hazard ratio among CRISP-3-positive/MSP-negative patients compared with CRISP-3-negative/MSP-positive patients was 2.38. Adding CRISP-3 to a base model that included PSA and pathologic stage and grade did not enhance the prediction of recurrence, but adding MSP increased the concordance index minimally from 0.778 to 0.781. CONCLUSION: We report evidence that CRISP-3 and MSP are independent predictors of recurrence after radical prostatectomy for localized prostate cancer. However, addition of the markers does not importantly improve the performance of existing predictive models. Further research should aim to elucidate the functions of CRISP-3 and MSP in prostate cancer cells.