食管癌手术前后血清同型半胱氨酸水平检测的临床意义

 目的　探讨食管癌患者手术前后血清同型半胱氨酸（Hcy）水平变化及临床意义。方法　采用循环酶法检测 168例食管癌患者和50名对照外周血Hcy水平。结果　食管癌组外周血Hcy水平明显高于对照组[（19.6±6.1）μmol／L比（13.0±2.3）μmol／L,P＝0.001];食管癌患者术后第5天、术后1个月以及术后3个月血清Hcy水平显著低于术前[（17.0±8.5）、（15.8±6.4）、（12.8±5.6）μmol／L比（20.6±9.1）μmol／L,均P＜0.05）];术后3个月血清Hcy水平接近于对照组;T4患者血清Hcy水平高于其他T分期组[（29.5±1.7）μmol／L比（18.5±6.9）、（18.8±8.0）、（20.6±8.8）μmol／L,均P＜0.001];肿瘤长度＞5 cm组明显高于＜3 cm、3～5 cm组[（23.6±9.6）μmol／L比（18.1±6.3）、（19.6±6.6）μmol／L,P＝0.036、P＝0.021];淋巴结转移与否食管癌患者的血清Hcy水平差异无统计学意义[（20.2±9.3）μmol／L比（20.3±7.6）μmol／L,P＝0.897],脉管阳性组血清Hcy水平低于阴性组[（16.7±3.4）μmol／L比（21.1±8.9）μmol／L,P＝0.007]。结论　血清Hcy水平与食管癌的进展密切相关。     

pN0期食管鳞癌血液微转移检测的临床意义

Objective To explore the clinical significance and the impact on prognosis of blood micrometastasis in the patients with pN0 esophageal squamous cell carcinoma. Methods Total RNA was extracted with TRIzol and mRNA was transcribed reversely into cDNA. RT-PCR was used to detect MMP-7 mRNA and hTERT mRNA in blood. △△Ct sample values were calculated with post-operative follow-up of 3 month, 6 month, 12 month. Results Statistical results suggested that blood micrometastasis was related to differentiation grade and pTNM staging (P=0.000, P=0.000 respectively), but not to age, sex, length of turnout (P0.05). Follow-up results suggested that the degree of invasion and tumor metastasis (recurrence) was no correlation; follow-up to 6 month and 12 month, tumor metastasis (recurrence) was associated with blood micrometastasis, and follow-up to 12 month, compared with the tumor metastasis (recurrence) probability of blood micrometastasis-positive patients and negative patients, the former was as 6.44 times as the latter. (OR=6.440, 95 % CI 1.547-26.822). Conclusion Blood micrometastasis testing is of great significance to early diagnosis and prognosis judgment in pN0 esophageal squamous cell carcinoma patients.     

食管癌患者外周血γδT细胞对Th1/Th2细胞因子的影响

目的 探讨食管癌患者外周血γδT细胞水平及对Th／Th2细胞因子的影响。方法 用流式细胞仪测定46例食管癌患者、28例本院健康职工外周血γδT细胞在淋巴细胞中的百分率和血浆中Th1／Th2细胞因子的含量。结果 两组比较γδT细胞有显著性意义，Th类因子有显著性意义，Th2类细胞因子无显著性意义。结论 食管癌患者γδT细胞水平显著低于常人群，γδT细胞可以通过分泌细胞因子调节和维护机体Th1／Th2的免疫平衡。     

食管鳞状细胞癌患者γδT细胞研究

 目的 探讨食管癌患者机体γδT细胞水平及与临床的关系，为γδT细胞在食管癌综合治疗中的应用提供依据。方法 采用流式细胞术测定食管癌患者外周血中和癌组织中γδT细胞水平，分析其与临床的关系。结果 癌组织中浸润γδT细胞水平显著高于癌旁组织（P = 0.045）；食管癌患者外周血中γδT细胞水平显著低于正常人（P = 0.011）；食管癌术后患者外周血中γδT细胞水平显著高于术前患者（P = 0.037）。食管癌T分期、N分期、M分期、大体分型、病变部位、病变长度（3 ~ 5 cm组和5 cm组）、组织学分级各组与正常组比较差异有统计学意义（P＜0.05）。食管癌患者外周血中总T细胞，各组与正常组比较差异无统计学意义（P＞0.05）；外周血中γδT细胞年龄、性别、病变长度（＜3 cm），各组与正常组比较差异无统计学意义（P＞0.05）。结论 γδT细胞在机体抗食管癌中发挥重要作用，手术切除肿瘤后可使患者γδT细胞恢复正常水平。     

脑疝伴失血性休克抢救成功1例

休克是一种由于组织灌注不足为特征的综合征,具体说是由于各种致病因素(创伤、感染、低血容量、心源性和过敏等)引起有效循环血量不足的急性微循环障碍,组织和脏器灌注不足,组织与细胞缺血、缺氧、代谢障碍和器官功能受损为特征的综合征,是一序贯性变化,从亚临床变化发展成为多     

pN0期食管鳞癌血液微转移检测的临床意义

Objective To explore the clinical significance and the impact on prognosis of blood micrometastasis in the patients with pN0 esophageal squamous cell carcinoma. Methods Total RNA was extracted with TRIzol and mRNA was transcribed reversely into cDNA. RT-PCR was used to detect MMP-7 mRNA and hTERT mRNA in blood. △△Ct sample values were calculated with post-operative follow-up of 3 month, 6 month, 12 month. Results Statistical results suggested that blood micrometastasis was related to differentiation grade and pTNM staging (P=0.000, P=0.000 respectively), but not to age, sex, length of turnout (P0.05). Follow-up results suggested that the degree of invasion and tumor metastasis (recurrence) was no correlation; follow-up to 6 month and 12 month, tumor metastasis (recurrence) was associated with blood micrometastasis, and follow-up to 12 month, compared with the tumor metastasis (recurrence) probability of blood micrometastasis-positive patients and negative patients, the former was as 6.44 times as the latter. (OR=6.440, 95 % CI 1.547-26.822). Conclusion Blood micrometastasis testing is of great significance to early diagnosis and prognosis judgment in pN0 esophageal squamous cell carcinoma patients.     

坎地沙坦酯对老年2型糖尿病合并高血压患者105例临床疗效分析

目的:探讨坎地沙坦酯(维尔亚)对老年2型糖尿病(T2DM)合并高血压患者的临床疗效。方法:选择老年2型糖尿病合并高血压患者105例,随机分为两组,治疗组65例,给予坎地沙坦酯初始量4 mg/d,常量8 mg/d,疗程为6周;对照组40例给予苯磺酸左旋氨氯地平初始量2.5 mg/d,常量5 mg/d。疗程为6周,观察期间两组均未更换降糖药物,但调整降糖药物用量。结果:治疗组用药效果明显优于对照组,降压幅度平稳,降糖药物剂量减少,改善血糖波动,糖化血红蛋白降低,两组比较,差异有统计学意义(P﹤0.05)。结论:坎地沙坦酯对于老年2型糖尿病合并高血压患者具有综合治疗的效果,既能平稳降低患者血压又能改善胰岛功能,调节血糖水平,降低血糖波动,且不良反应少,能够提高患者的依从性及耐受性。     

肺癌患者外周血γδT细胞的检测及意义

 目的　探讨肺癌患者群体的γδT细胞的功能状态。方法　应用流式细胞术检测124例手术前肺癌患者（肺癌组）和56名健康职工（健康对照组）外周血γδT细胞。结果　γδT细胞健康对照组为（6.54±2.90）%,患者组为（3.76±2.81）%（t＝3.568,P＜0.001）。肺癌患者外周血中γδT细胞水平显著低于健康人（P＝0.000 ）;肺癌组织学分类、T 分期、N分期、M分期、临床分期、大体分型、病变部位各组与健康对照组比较差异有统计学意义（P＜0.05）;肺癌患者中不同年龄、性别各组患者外周血中γδT细胞比较差异无统计学意义（P＞0.05）。结论　γδT细胞减少对肺癌的发生有重要影响。     

pN0期食管鳞癌血液微转移检测的临床意义

目的探讨pN0期食管鳞癌的血液微转移临床意义及其对预后的影响。方法提取血液标本总RNA,将mRNA反转录成cDNA,然后用实时荧光定量RT—PCR技术检测血液标本MMP-7 mRNA和hTERT mRNA表达,计算样本的△△Ct值,对40例N0期食管癌患者分别进行术后3、6、12个月跟踪随访复查。结果血液微转移与年龄、性别、癌肿长度等因素无相关关系,但与组织分化等级和pTNM分期间存在相关关系。随访结果显示单纯观察肿瘤不同侵犯深度与肿瘤术后转移（复发）率无相关性;随访术后6个月及12个月,血液微转移与否与肿瘤转移（复发）率有相关性（P〈0．05）,其中血液微转移阳性患者术后12个月肿瘤转移（复发）概率是阴性患者的6．44倍（OR=6．440,95％CI为1．547～26．822）。结论食管鳞癌患者血液微转移检测对早期诊断及预后判断具有重要意义。     

pN0期食管鳞癌血液微转移检测的临床意义

Objective To explore the clinical significance and the impact on prognosis of blood micrometastasis in the patients with pN0 esophageal squamous cell carcinoma. Methods Total RNA was extracted with TRIzol and mRNA was transcribed reversely into cDNA. RT-PCR was used to detect MMP-7 mRNA and hTERT mRNA in blood. △△Ct sample values were calculated with post-operative follow-up of 3 month, 6 month, 12 month. Results Statistical results suggested that blood micrometastasis was related to differentiation grade and pTNM staging (P=0.000, P=0.000 respectively), but not to age, sex, length of turnout (P0.05). Follow-up results suggested that the degree of invasion and tumor metastasis (recurrence) was no correlation; follow-up to 6 month and 12 month, tumor metastasis (recurrence) was associated with blood micrometastasis, and follow-up to 12 month, compared with the tumor metastasis (recurrence) probability of blood micrometastasis-positive patients and negative patients, the former was as 6.44 times as the latter. (OR=6.440, 95 % CI 1.547-26.822). Conclusion Blood micrometastasis testing is of great significance to early diagnosis and prognosis judgment in pN0 esophageal squamous cell carcinoma patients.