Ⅰb2宫颈癌术前化疗效果研究

背景与目的：Ⅰb2宫颈癌肿瘤最大径线大于4cm直接手术出血多，手术比较困难。本文探讨新辅助化疗吉西他滨联合顺铂对Ⅰb2宫颈癌术前应用的临床效果。方法：h组Ⅰb2宫颈癌患者23例，用吉西他滨（1．5g／m^2第一天）联合顺铂（50mg／m^2第二天）治疗，2周后重复，至少治疗2个疗程；B组Ⅰb2宫颈癌患者19例，用长春新碱（1．5g／m^2第一天）、顺铂（20mg／m^2第一天至第三天）和博来霉素（10mg／m^2）治疗，肌内注射，第一天至第三天，3周后重复。至少治疗2个疗程。对药物的临床疗效和毒性进行评价，并对患者进行随访。结果：与B组相比，A组肿瘤最大径线缩小，差异有显著性（P=0．004）。化疗的毒副反应以骨髓抑制常见。术后病理显示：淋巴结转移及脉管内转移在A组明显少于B组，差异有显著性（P〈0．05）。结论：吉西他滨联合顺铂对Ⅰb2宫颈癌术前应用有较好的效果，可以较快的缩小肿瘤体积，缩短发现肿瘤与可以手术的时间，毒副作用可以耐受。并且能减少淋巴结转移及脉管内转移。     

胎盘部位滋养细胞肿瘤的病例分析

胎盘部位滋养细胞肿瘤的病例分析上海医科大学妇产科医院（２０００１１）朱关珍陆惠娟胎盘部位滋养细胞肿瘤（ｐｌａｃｅｎｔａｌｓｉｔｅｔｒｏ－ｐｈｏｂｌａｓｔｉｃｔｕｍｏｒ，ＰＳＴＴ）是一种少见而独特的子宫肿瘤。按Ｖａｒｄａｒ［１］报道在英文文献迄今共有７...     

卵巢转移性印戒细胞型粘液腺癌——62例临床病理分析

本文对62例卵巢转移性印戒细胞型粘液腺癌的临床和病理资料进行了分析。临床表现以腹块、腹水最常见,伴消化道症状。根据病理大体特征将肿瘤分为三种类型,并提出对肿瘤命名的看法和讨论了鉴别诊断。     

机用ProTaper两步法预备根管的器械折断情况的体外研究

【摘要】 目的 评价分析机用镍钛器械在两步预备根管时的器械折断情况。方法 采集600颗离体磨牙,分成对照组与实验组,各300颗,对照组用常规机用ProTaper一步预备到位(S1-Sx-S2-F1-F2),实验组分两步预备根管(第一次:S1-G Grill-S2;第二次:F1-F2),最后统计分析每组器械折断情况,使用SPSS18.0软件包对结果进行卡方检验。结果 2种方法预备根管过程中发生器械折断率和器械折断长度显著性差异（p<0.05）,但在不同根管长度里预备器械折断率实验组虽然比对照组少但差别无统计意义,下颌磨牙器械折断36个(76.6%) 较上颌磨牙多, 且上下颌磨牙多发生在近中根管;器械折断的位置多位于根管弯曲的中段28个(59.6%);器械折断多发生于弯曲度大于30°的复杂根管41个(87.2%),两组之间无统计学差异。结论 根管治疗中机用Protaper使用两步法预备可以降低器械折断率。     

肾功能正常的2型糖尿病患者血肌酐与乳酸水平相关

目的 探讨肾功能正常的2型糖尿病患者的血肌酐与血乳酸水平的关系以及应用二甲双胍后对血乳酸的影响.方法 选择肾功能正常的住院2型糖尿病患者723例,其中应用二甲双胍者(用药组)275例,未用双胍类者(对照组)448例.用酶电极法测定血乳酸水平,同时榆测空腹血糖、胰岛素、HbA1C尿素氮、肌酐和丙氨酸转氨酶(ALT)等水平.结果 (1)用药组的平均血乳酸水平高于对照组[(1.33±0.57 vs 1.17±0.47)mmol/L,P<0.01];高乳酸血症的发生率显著高于对照组(9.45% vs 4.91%,P<0.01),但均末达到酸中毒的水平.(2)相关性分析结果显示,血乳酸水平与血肌酐、尿素氮、ALT、体重指数(BMI)呈明显正相关.在校正ALT和BMI后,肌酐仍与血乳酸呈正相关(r=0.345,P<0.01).(3)按肌酐水平进行分层后,血乳酸水平随着血肌酐水平升高而增加,肌酐>90 μmol/L后显著增高;受试者工作特征(ROC)曲线分析表明预测血乳酸水平增高的肌酐截点是95.35 μmol/L.结论 肾功能正常的2型糖尿病患者应用二甲双胍虽具有较好的安全性,但仍有极少数患者可出现乳酸水平的轻度升高.血肌酐>95.35μmol/L者发生高乳酸血症的风险增加.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

线粒体tRNALeu(UUR)基因nt3243A→G突变糖尿病临床特点分析

目的 了解线粒体tRNALeu(UUR)基因nt3243A→G突变在上海及江浙地区家族性糖尿病人群中的发生率及其临床特点.方法 应用聚合酶链反应-限制性片段长度多态结合直接测序方法对随机抽取的无亲缘关系的770个糖尿病家系的先证者进行线粒体tRNA<'Leu(UUR)>基因nt3243A→G突变的筛查,并进一步对阳性先证者家系进行家系遗传学及临床特点分析.结果 在770个糖尿病先证者中发现13例(1.69%)nt3243A→G突变.13个先证者家系的一级亲属中共检出32例3243突变携带者,其中24例为糖尿病,8例糖耐量正常,17例伴不同程度听力减退.24例糖尿病患者多呈消瘦体型,有18例呈典型母系遗传,13例伴胰岛素抵抗,15例伴听力障碍,14例应用胰岛素治疗.结论 上海及江浙地区家族性糖尿病人群线粒体3243点突变检出率是1.69%,线粒体糖尿病患者的临床特点是:(1)多数呈母系遗传,少数可为散发;(2)多于45岁以前发病;(3)体型多偏瘦;(4)胰岛β细胞分泌功能明显降低,部分患者同时伴有胰岛素抵抗;(5)多数患者伴神经性听力障碍或神经性耳聋.     

Relationship of LDLR gene polymorphism and NIDDM in Chinese.

Genomic DNA was extracted from peripheral blood lymphocytes of 105 healthy and 75 NIDDM Chinese subjects. The fragment located in exon 13 of the low density lipoprotein receptor (LDLR) gene was amplified by polymerase chain reaction (PCR), and digested with restriction enzyme Hincll. LDL, TC and TG levels were measured in all subjects. Investigations were conducted to explore the correlation between the Hincll RFLP of LDLR gene aned NIDDM in the Chinese population. The results showed that no significant correlation existed between this RFLP locus and NIDDM. Marked differences were found, however, between the genotype distribution of low LDL level subgroups of NIDDM patients and normal controls. It was inferred that the H1 allele might be associated with high blood cholesterol levels, and the H2 allele with low cholesterol levels. Disturbances of lipid metabolism occur frequently in diabetes mellitus. This study suggested that differences in LDLR genotypes may affect the phenotypes of lipid metabolism.     

上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.