中医论治霍乱的寒热之争

霍乱是烈性传染病,自从1821年传入我国出现首次大流行之后,此病在中国危害多年,直到解放后才得到基本控制.百馀年来,中医在治疗霍乱方面积累了不少经验,出现了许多专著.由于各人治疗经验不同,在治疗霍乱方面形成主寒、主热两大派,论争不休.     

RAS mutation is associated with hyperdiploidy and parental characteristics in pediatric acute lymphoblastic leukemia.

We explored the relationship of RAS gene mutations with epidemiologic and cytogenetic factors in a case series of children with leukemia. Diagnostic bone marrow samples from 191 incident leukemia cases from the Northern California Childhood Leukemia Study were typed for NRAS and KRAS codon 12 and 13 mutations. A total of 38 cases (20%) harbored RAS mutations. Among the 142 B-cell acute lymphoblastic leukemia (ALL) cases, RAS mutations were more common among Hispanic children (P=0.11) or children born to mothers <30 years (P=0.007). Those with hyperdiploidy at diagnosis (>50 chromosomes) had the highest rates of RAS mutation (P=0.02). A multivariable model confirmed the significant associations between RAS mutation and both maternal age and hyperdiploidy. Interestingly, smoking of the father in the 3 months prior to pregnancy was reported less frequently among hyperdiploid leukemia patients than among those without hyperdiploidy (P=0.02). The data suggest that RAS and high hyperdiploidy may be cooperative genetic events to produce the leukemia subtype; and furthermore, that maternal age and paternal preconception smoking or other factors associated with these parameters are critical in the etiology of subtypes of childhood leukemia.     

Cigarette smoking and risk of non-Hodgkin lymphoma: a pooled analysis from the International Lymphoma Epidemiology Consortium (interlymph).

BACKGROUND: The International Lymphoma Epidemiology Consortium (InterLymph) provides an opportunity to analyze the relationship between cigarette smoking and non-Hodgkin lymphoma with sufficient statistical power to consider non-Hodgkin lymphoma subtype. The results from previous studies of this relationship have been inconsistent, likely due to the small sample sizes that arose from stratification by disease subtype. To clarify the role of cigarette smoking in the etiology of non-Hodgkin lymphoma, we conducted a pooled analysis of original patient data from nine case-control studies of non-Hodgkin lymphoma conducted in the United States, Europe, and Australia. METHODS: Original data were obtained from each study and uniformly coded. Risk estimates from fixed-effects and two-stage random-effects models were compared to determine the impact of interstudy heterogeneity. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from unconditional logistic regression models, controlling for study center, age, sex, and race. RESULTS: In our pooled study population of 6,594 cases and 8,892 controls, smoking was associated with slightly increased risk estimates (OR, 1.07; 95% CI, 1.00-1.15). Stratification by non-Hodgkin lymphoma subtype revealed that the most consistent association between cigarette smoking and non-Hodgkin lymphoma was observed among follicular lymphomas (n = 1452). Compared with nonsmokers, current smokers had a higher OR for follicular lymphoma (1.31; 95% CI, 1.12-1.52) than former smokers (1.06; 95% CI, 0.93-1.22). Current heavy smoking (> or = 36 pack-years) was associated with a 45% increased OR for follicular lymphoma (1.45; 95% CI, 1.15-1.82) compared with nonsmokers. CONCLUSIONS: Cigarette smoking may increase the risk of developing follicular lymphoma but does not seem to affect risk of the other non-Hodgkin lymphoma subtypes we examined. Future research is needed to determine the biological mechanism responsible for our subtype-specific results.     

The association of XRCC1 haplotypes and chromosomal damage levels in peripheral blood lymphocyte among coke-oven workers.

Theoretically, a haplotype has a higher level of heterozygosity than individual single nucleotide polymorphism (SNP) and the association study based on the haplotype may have an increased power for detecting disease associations compared with SNP-based analysis. In this study, we investigated the effects of four haplotype-tagging SNPs (htSNP) and the inferred haplotype pairs of the X-ray cross-complementing group 1 (XRCC1) gene on chromosome damage detected by the cytokinesis-block micronucleus assay. The study included 141 coke-oven workers with exposure to a high level of polycyclic aromatic hydrocarbons and 66 nonexposed controls. The frequencies of total MN and MNed cells were borderline associated with the Arg(194)Trp polymorphism (P = 0.053 and P = 0.050, respectively) but not associated with the Arg(280)His, Arg(399)Gln and Gln(632)Gln polymorphisms among coke-oven workers. Five haplotypes, including CGGG, TGGG, CAGG, CGAG, and CGGA, were inferred based on the four htSNPs of XRCC1 gene. The haplotype CGGG was associated with the decreased frequencies of total MN and MNed cells, and the haplotypes TGGG and CGAG were associated with the increased frequencies of total MN and MNed cells with adjustment for covariates among coke-oven workers. This study showed that the haplotypes derived from htSNPs in the XRCC1 gene were more likely than single SNPs to correlate with the polycyclic aromatic hydrocarbon-induced chromosome damage among coke-oven workers.     

16例直肠腺瘤的CT影像分析

[目的]探讨直肠腺瘤的CT表现.[方法]对16例经病理证实的直肠腺瘤CT表现进行回顾性分析.[结果]16例腺瘤按病理类型分为绒毛状腺瘤,管状绒毛状腺瘤和管状腺瘤,其中8例恶变.CT征象如下:广基生长有8例,窄基带蒂生长的5例,环壁增厚的有4例;向腔内匍匐式或菜花状生长的有10例;占肠周径比率在1/3以下的9例;病灶与直肠壁相贴时留下通气的间隙7例,可作为直肠腺瘤的特征性表现.[结论]一般直肠腺瘤均具有典型的CT表现,术前明确的腺瘤的CT诊断对于手术方式有重要影响.     

GM-CSF基因重组腺病毒载体的构建及鉴定

目的：构建人粒细胞-巨噬细胞集落刺激因子（GM-CSF）基因的重组腺病毒载体，为进一步研究GM-CSF基因在肿瘤基因治疗中的应用提供实验基础。方法：采用PCR方法，从重组质粒pcDNA3．1-GM-CSF扩增出GM-CSF基因片段，通过穿梭质粒pShuttle，将带有CMV启动子的目的片段克隆入Adeno-X腺病毒DNA中，获得重组腺病毒DNA，通过脂质体转染HEK293细胞，经包装扩增后，获得重组腺病毒Adeno-X-GM-CSF，PCR鉴定，ELISA法检测表达产物。结果：含GM-CSF基因的重组腺病毒Adeno-X-GM-CSF构建成功，经PCR鉴定和DNA测序等证实了其正确性，重组腺病毒上清液中GM-CSF表达量达26ng／mL。结论：含GM-CSF基因的重组腺病毒构建成功。     

白细胞介素-13及其受体与恶性肿瘤的关系

白细胞介素-13（IL-13）是一类由P600 cDNA编码的细胞因子,与哮喘病和肾病的关系甚为紧密.但近年来国外学者发现与肿瘤尤其是恶性肿瘤也有着密切的关系,如IL-13在恶性肿瘤的发生发展过程中起重要作用,其受体在许多恶性肿瘤如肾细胞癌、Kaposi肉瘤、多形性胶质母细胞瘤等细胞表面存在特异性高表达,可以将IL-13及其受体应用于某些恶性肿瘤的诊断和免疫治疗等.     

前纵裂入路切除鞍区巨大肿瘤

背景与目的：鞍区巨大肿瘤手术难度较大，本文探索前纵裂入路切除鞍内、鞍上向单双侧海绵窦、第三脑室、蝶窦及伴颞叶发展的巨大肿瘤的手术适应症、方法与优缺点方法：总结分析2002年1月至2004年5月我科经前纵裂入路切除鞍区各部位发展的肿瘤17例。结果：肿瘤全切14例，近全切2例．部分切除1例；术后视力改善12例，无改变5例，尿崩或电解质紊乱8例，死亡1例，随访时间3～32个月，有1例复发，系巨大侵袭性垂体瘤术后，行γ-刀治疗后肿瘤基本得到控制。结论：前纵裂入路是切除鞍内、鞍上向单双侧海绵安、第三脑室、蝶窦及伴颞叶发展的肿瘤较理想的入路，利用自然脑裂的分离，手术视野、操作角度好、肓区少，有利于显露重要血管、神经及双侧海绵窦内侧壁，肿瘤全切率高。     

Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40～50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40～50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29.8% before radiation as compared to 57.6±22.6% during RT. The difference between these two groups was not significant (P=0.280). The decreased relative lung perfusion post-RT was found in six patients, whereas the increased relative lung perfusion post-RT was observed in 13 patients.CONCLUSION SPECT lung perfusion scaning is a simple, convenient and useful method for assessing regional lung function pre-RT and for monitoring the changes in regional lung function after irradiation.     

Clinical observation on acupuncture treatment of functional dyspepsia

目的:观察针刺治疗功能性消化不良的临床疗效.方法:根据中医经络理论选择以足三里等穴位,用平补平泻手法,辅以电针治疗功能性消化不良,并以常用西药多潘立酮作为对照进行临床观察.结果与结论:针刺组总有效率93.8%,显效率为63.3%,药物组分别为82.3%和43.1%,针刺组治疗非特异型功能性消化不良疗效好于药物组(P＜0.05);治疗动力障碍型者,两者无明显差异(P＞0.05),疗效均较突出.