舌黏膜微囊型淋巴管畸形的平阳霉素局部硬化治疗

目的 探讨舌黏膜微囊型淋巴管畸形的无创治疗方法,评价疗效.方法 采用平阳霉素局部注射治疗舌背黏膜微囊型淋巴管畸形15例,隔周1次,4次为1个疗程.1个疗程不能治愈者,间隔1个月后开始第2疗程治疗.记录不良反应和病变转归进程,追踪随访,评价临床疗效.结果 经过3～6次局部注射,12例患者完全治愈,病变消退,表面黏膜恢复正常,舌体、舌背无畸形.另外3例,舌背黏膜恢复正常,但病变区舌体组织仍有轻度突出.所有病例均无严重全身不良反应,仅1例出现局部溃疡,1周自愈后继续完成后续治疗.随访1～5年,无复发病例,无瘢痕形成.结论 平阳霉素局部注射治疗舌背微囊型淋巴管畸形.疗程短,疗效确切,且可避免手术切除造成局部组织缺损,为无创性治疗手段,值得临床推广应用.     

人源性Jagged1 RNAi慢病毒载体的构建及鉴定

目的构建人源性Jagged1 RNAi慢病毒载体,并观察其对舌癌细胞中Jagged1的敲减作用。方法 GenBank检索人Jagged1信息,设计Jagged1靶点。BLAST比对同源性,合成双链DNAoligo。线性化的RNA干扰载体质粒pAJ-U6-shRNA-CMV-eGFP/PuroR,双酶切,与合成的双链DNAoligo连接,转化感受态细胞,选择阳性克隆进行鉴定。慢病毒三质粒系统共转染293T细胞,包装,纯化,并转染Tca8113以及Cal27细胞,测定转染效率。PCR及Western Blot检测Jagged1基因及蛋白表达变化。结果成功构建靶向Jagged1 RNAi载体质粒,并成功进行慢病毒包装。该系统可有效地感染Tca8113及Cal27细胞。细胞内Jagged1基因及蛋白表达均有明显下调。结论成功构建Jagged1 RNAi慢病毒载体,为下一步研究Jagged1在人舌鳞癌的中的作用机制奠定基础。     

靶向纳米转基因载体在头颈肿瘤中的研究现状

近年来利用纳米载体传递药物和转移基因的报道颇多。本文主要就纳米基因转移载体的分类熏在头颈肿瘤基因治疗中靶向性的获得与提高,以及存在问题与展望等作一综述。     

放射诱导启动子介导双自杀基因治疗舌鳞癌的实验研究

目的探讨放射诱导启动子介导双融合自杀基因CDglyTK靶向治疗人舌鳞癌裸鼠移植瘤的疗效。方法构建人舌鳞癌裸鼠移植瘤模型．以脂质体为载体介导携放射诱导启动子调控双融合自杀基因的真核表达质粒pcDNA3．1（＋）／E-CDglyTK瘤内转染,辅以3Gy放疗,腹腔注射5-氟胞嘧啶和丙氧鸟苷．描绘肿瘤生长曲线,RT—PCR检测CDglyTK的mRNA水平．免疫组化检测细胞核增殖抗原的表达．原位末端标记法检测肿瘤细胞凋亡。结果放射诱导启动子介导的CDglyTK对肿瘤生长有明显抑制作用．RT—PCR可检测到转染后肿瘤细胞CDglyTK的mRNA表达,诱导放疗增强了其表达水平．电泳条带灰度值从0．213±0．023上调至0．279±0．038（P〈0．01）;诱导放疗显著提高疗效,凋亡指数从21．52％上升为32．23％（P〈0．01）,增殖指数由28．36％下降至20．07％fP〈0．01）。结论放射诱导启动子可作为基因治疗分子开关调节CDglyTK基因在人舌鳞癌裸鼠移植瘤中靶向表达．低剂量放射性照射可显著提高其疗效。     

内镜辅助下腮腺浅叶部分切除术与传统腮腺浅叶部分切除术的比较研究

Objective To investigate the feasibility of endoscopy-assisted partial-superficial parotidectomy. Methods 38 cases with benign tumors located in the superficial lobe of the parotid gland were randomly assigned to receive conventional (20 cases) or endoscopic (18 cases) partial-superficial paretidectomy. Two short incisions, which were 2 ～ 2.5 cm in length and located at retromandibular and postauricular area, were adopted for endoscopy-assisted surgery. The facial nerve was dissected through retrograde approach. Results The tumors were successfidly resected with endoscopy in 18 cases. The operation time was not significantly different between the conventional and endoscopy-assisted procedures (P > 0.05). The intraoperative blood loss was markedly lower in endoscopy-assisted group, compared with conventional group(P < 0.01). All the 18 cases with endoscopy-assisted surgery were satisfactory with the postoperative cosmetic results. The great auricular nerve was preserved very well in 12 patients(66.6%). Transcient facial paralysis happened in 1 ease and relieved 1 months later. Salivary fistula occurred in 1 case and recovered after dressing with pressure for 2 weeks. All the patients were followed up for 24 ～ 50 months (mean, 39 months) without relapse. Conclusions Endoscopy-assisted partial-superficial parotidectomy can successfully treat benign tumors located in the superficial lobe of parotid gland with a better postoperative cosmetic result.     

全反式维甲酸对舌癌细胞株抗增殖作用的研究

目的：研究全反式维甲酸（ＡＴＲＡ）对舌癌细胞株的体外抗增殖作用。方法：经不同浓度全反式维甲酸（１０＾－７￣１０＾－５ｍｏｌ／Ｌ）处理舌癌细胞株后,应用流式细胞仪检测舌癌细胞细胞周期变化。结果：舌癌细胞株经１０＾－７￣１０＾－５ｍｏｌ／Ｌ全反式维甲酸处理１￣６ｄ后,Ｇ１／Ｇ０期比率呈上升趋势,Ｓ期和Ｇ２＋Ｍ期比率呈下降趋势,与对照组相比,经全反式到处理３ｄ和６ｄ的细胞,其Ｇ１／Ｇ０期比率明显上升（Ｐ     

内镜辅助下腮腺浅叶部分切除术与传统腮腺浅叶部分切除术的比较研究

Objective To investigate the feasibility of endoscopy-assisted partial-superficial parotidectomy. Methods 38 cases with benign tumors located in the superficial lobe of the parotid gland were randomly assigned to receive conventional (20 cases) or endoscopic (18 cases) partial-superficial paretidectomy. Two short incisions, which were 2 ～ 2.5 cm in length and located at retromandibular and postauricular area, were adopted for endoscopy-assisted surgery. The facial nerve was dissected through retrograde approach. Results The tumors were successfidly resected with endoscopy in 18 cases. The operation time was not significantly different between the conventional and endoscopy-assisted procedures (P > 0.05). The intraoperative blood loss was markedly lower in endoscopy-assisted group, compared with conventional group(P < 0.01). All the 18 cases with endoscopy-assisted surgery were satisfactory with the postoperative cosmetic results. The great auricular nerve was preserved very well in 12 patients(66.6%). Transcient facial paralysis happened in 1 ease and relieved 1 months later. Salivary fistula occurred in 1 case and recovered after dressing with pressure for 2 weeks. All the patients were followed up for 24 ～ 50 months (mean, 39 months) without relapse. Conclusions Endoscopy-assisted partial-superficial parotidectomy can successfully treat benign tumors located in the superficial lobe of parotid gland with a better postoperative cosmetic result.     

Survivin基因在顺铂诱导Tca8113舌鳞癌细胞凋亡中的作用

目的体外观察顺铂（DDP）诱导Tca8113舌鳞癌细胞株凋亡的作用, 同时检测在此过程中凋亡蛋白抑制因子Survivin mRNA表达和蛋白表达的变化。方法将人Tca8113舌鳞癌细胞株进行传代培养,MTT法检测顺铂不同浓度和不同时间对Tca8113舌鳞癌细胞生长的抑制作用,通过RT- PCR检测凋亡过程中Survivin基因mRNA的表达,免疫细胞化学观察Survivin基因的蛋白表达,以及流式细胞术观察顺铂诱导各组Tca8113细胞的凋亡率。结果顺铂可明显抑制Tca8113舌鳞癌细胞的增殖, 其增殖抑制率呈浓度和时间依赖性,细胞凋亡率也呈同样的趋势,最高可达34.1%。1.0 μg/mL DDP处理Tca8113舌鳞癌细胞,Survivin mRNA和蛋白表达水平随时间的增加而降低,在24h达到最低,随后又升高。结论抗凋亡蛋白Survivin在Tca8113舌鳞癌细胞高表达,顺铂可有效诱导Tca8113舌鳞癌细胞凋亡, Survivin mRNA表达在化疗早期随作用时间的延长而降低,Survivin基因的抑制在顺铂诱导的Tca8113舌鳞癌细胞的细胞凋亡中起着重要的作用。     

快速原型技术和腓骨肌皮瓣即刻重建下颌骨成釉细胞瘤术后缺损

目的 探讨即刻重建下颌骨成釉细胞瘤术后缺损解剖外形的理想方法. 方法 对6例需行下颌骨部分切除的成釉细胞瘤患者行术前CT扫描,MIMICS软件重建下颌骨三维数字模型,激光树脂成型机打印下颌骨实体模型,根据影像学检查结果在实体模型上设计截骨范围和重建钛网,数控成型机冲压钛网,腓骨肌皮瓣和钛网植入即刻修复下颌骨缺损. 结果 6例腓骨肌皮瓣全部存活,下颌骨缺损区解剖外形恢复满意,局部面容和余留牙咬合关系保持正常.结论 应用快速原型技术和腓骨肌皮瓣即刻修复下颌骨成釉细胞瘤术后缺损,不仅可以有效恢复下颌骨自然外形和患者容貌,也为局部咬合重建提供了解剖基础.     

用普通X线遥控床射频消融术治疗PSVT

阵发性室上性心动过速(PSVT)是一种常见病。近年公认经支导管射频消融术(RFCA)能安全、有效地根治PSVT。我们自1993年10月至1994年12月用普通遥控X线机开展RFCA治疗PSVT38例,均获成功,现报道如下。