SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

ＳＥＡＲＣＨＦＯＲＨＥＲＰＥＳＳＩＭＰＬＥＸＶＩＲＵＳＴＹＰＥ２（ＨＳＶ－２）ＡＮＤＨＵＭＡＮＰＡＰＩＬＬＯＭＡＶＩＲＵＳ（ＨＰＶ）ＩＮＴＨＥＮＯＲＭＡＬＡＮＤＡＢＮＯＲＭＡＬＣＥＲＶＩＣＡＬＳＡＭＰＬＥＳＺｈａｎｇＷｅｉ;张伟;ＪｉｎＳｈｕｎｑｉａ...     

72例慢性心力衰竭临床分析

目的 分析慢性心力衰竭的病因、诱因及住院和门诊治疗情况,提高临床诊治水平,改善预后.方法 查阅72份慢性心力衰竭住院病历和门诊病历,统计病因、诱因和药物治疗情况.结果 基本病因以冠心病和高血压性心脏病为主,占73.6％,合并两种以上基础心脏病占47.1％.诱因以快速房颤和血压升高为主,占78.5％.72例住院患者药物使用率：氢氯噻嗪75％,卡托普利71％,地高辛44％、参麦41％,螺内酯41％,美托洛尔和呋塞米均是13.7％,毛花苷C 8％,显效18例（25％）,其中：有效22例（30.5％）,无效32例（44.5％）,其中有3例住院1天自动出院.出院治疗后3个月门诊随访：显效44例（81.5％）,有效8例（14.8％）,死亡2例（3.7％）.结论 本组慢性心力衰竭患者多种基础心脏病并存,以冠心病和高血压性心脏病引起的心力衰竭最多见,发病以快速房颤和高血压为主要诱因.基层医院大部分患者住院时间短,治疗不彻底,门诊随访继续给予规范有效的治疗,效果理想,预后好.     

高危型人乳头瘤病毒载量与子宫颈病变的关系

Objective To determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN). Methods Cervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00),low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load 100. 00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression. Results The HR-HPV infection rate of the population was 14. 51% (2515/17 334). 100. 00% (29/29) of SCC,97. 63% (206/211) of CIN 3,93.43% (199/213) of CIN 2,75.04% (421/ 561) of CIN 1 and 10. 17% (1660/16 320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC,CIN 3,CIN 2,CIN I and normal were 320. 85,158. 05, 143. 70,125.34 and 9. 64, respectively. There were significant differences among the distributions of viral loads in each lesion (X2=6190. 40,P<0. 01). The severity of CIN increased with the viral load (X2=5493. 35 ,P<0. 01). Compared with the risks of CINs in HR-HPV negative population,the risks of CINs in low,moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9. 01 (6. 31 -12. 87), 24.96(18.23 -34. 17) and 68.42(51.40 -91.08); CIN 2:26.44(12.07 -57.95),98. 53 (49. 54 -195.98) and 322. 88(168.62 -618. 27) ; CIN 3 + : 72. 89(24.02 -221.18) ; 343. 58(121.81 -969.09) Was 3115.05,2413.95 and 3098.57, respectively. P<0.01) . In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95%CI):<35: 4. 71(1.23-18.09) and 15.06(4.40-51.49); 35-: 4.01 (1.62-9.90) and 14.09(6. 15 -32.28); 40-: 3.06(1.52 -6. 16) and 7.78(4.05 -14.95); ≥45: 3. 50(1.36 -9. 01) and 7. 57 (3. 13 -18. 30)], and there was a positive correlation between the risk of CIN 2 + and the viral load (Xtrend2was 51. 33,66. 28,53. 64 and 51.00,respectively. P<0. 01). The risk of CIN 2 + was highest among the women aged 40 -with high viral load [0R(95% CI):2.02 (1.15 -3. 52)]. Conclusion There is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3,and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively.     

六甲嘧胺治疗卵巢癌的研究进展

本文在阐述六甲嘧胺的化学结构、作用机制及药代动力学的基础上,综述了其单药及联合用药治疗卵巢癌的临床研究结果及其主要的不良反应,显示了六甲嘧胺在治疗卵巢癌中的作用.     

子宫颈癌综合治疗的几个问题

1　综合治疗的必要性　　子宫颈癌综合治疗始于 4 0～ 5 0年代。 10多年来 ,宫颈癌的综合治疗日益受到关注 ,综合治疗已成为现代处理宫颈癌的一个重要策略。　　众所周知 ,手术和放疗是宫颈癌的主要治疗方法 ,早期以手术治疗为主 ,中晚期大多采用放射治疗。然而 ,尽管手术技巧、放疗设备和技术不断改进 ,4 0年来宫颈癌的治疗效果并无根本提高 ,总 5年生存率在 5 0 %左右徘徊。而具有预后不良因素的宫颈癌患者预后差 ,5年生存率低 ,如不少作者报道早期宫颈癌ⅠB1期 (局部肿瘤 <4cm直径 )的 5年生存率为 80 %～ 90 % ,ⅠB2期 (局部肿瘤≥ 4cm…     

THE INFECTION OF EBV FOR CERVICAL EPITHELIUM-A NEW CAUSITIVE AGENT IN THE DEVELOPMENT OF CERVICAL CARCINOMAS?

Epstein-Barr virus was considered as a caustive agent for Burrkitt' s lymphoma and non-malignant B lymphocytes proliferation. The recent studies revealed the striking association of the Infection of EBV with the development of human epithelial tumors. 43 specimens of normal exfoliated cervical epithelial cells, 47 biopsies of chronic cervlcitis and 80 tissue samples of cervical carcinomas were tested for the presences of EBV W fragments by using dot blot hybridization method. The results showed that the detectable rates of EBV DNA sequences In the normal exfoliated epithelium, the chronic cervlcitis and cervical carcinomas were 44.16%, 12.77% and 13.75%, respectively. Eleven EBV positive DNA samples from cervical cancers were also examined for the presence of HPV DNA. The result showed 9 out of 11 were HPV DNA positive, the cultanious infectious rate of both viruses was about 81.81%.In this paper, the EBV genomes existed In the part of biopsies of cervical carcinomas were first reported. The results Imp     

子宫恶性中胚叶混合瘤

37 patients with malignant mesodermal mixed tumor of the uterus treated from 1958 to 1987 were reviewed. It accounted for 38.5% of all uterine sarcomas during the same period. Six were homologous and 31 were heterologous in origin. The mean age was 56.8 years. 75.5% of the patients were postmenopausal. Nine (24.3%) patients had previous pelvic irradiation. There were 13 Stage I, 4 Stage II, 5 Stage III, 2 Stage IV and 13 unstaged (including 11 misdiagnosed and 2 operated in other hospital) lesions as classified according to the FIGO Staging System for malignant tumors of the Endometrium and Cervix. Twenty-six patients were treated by combined surgery and radiotherapy or chemotherapy and radiotherapy, 5 by radiotherapy alone and 6 by surgery alone. The overall 2-year survival rate was 35.1%. Twenty-two (59.5%) patients developed recurrence and/or metastasis and 86.4% (19/22) did so within 2 years after treatment. The most significant prognostic factors were: the depth of myometrial invasion, extent of lesion and method of treatment. The best 2-year survival rate (83.3%) was seen in patients treated by the combined use of surgery, radiotherapy and chemotherapy which is considered the treatment of choice for this malignancy.     

Notch信号通路与肿瘤

Notch信号通路存在于多种动物体内,脊椎动物中有4个Notch同源体Notch1、Notch2、Notch3、Notch4,其中Notch1在肿瘤形成中起重要作用,至于其是癌基因还是抑癌基因,目前尚存争议.Notch通路是许多重要细胞信号转导通路的交汇点,对Notch1的研究可进一步阐明肿瘤发生的机制,为肿瘤基因治疗及新药开发提供一个新的有希望的靶点.