Ⅲb期宫颈癌的放射治疗并化疗疗效观察

目的:观察放射治疗并同期化疗Ⅲb期宫颈癌的疗效及不良反应.方法:对59例Ⅲb期宫颈癌患者随机分为放射治疗 化疗组(放、化组)和单纯放射治疗组(单放组).两组放疗方案相同,化疗与放疗同时进行.结果:近期有效率放、化组为100%,单放组为92.3%,两组无明显差异(P＞0.05);5年生存率放、化组为69.7%,单放组为42.3%,两组有显著差异(P＜0.05);恶心、呕吐消化道反应和白细胞降低率放、化组较单放组明显高(P＜0.01 P＜0.05),放射性直肠炎、膀胱炎两组无差异(P＞0.05);远处转移率单放组明显高(P＜0.05).结论:放射治疗同时化疗可提高局部控制率及5年生存率,减少远处转移率.不良反应经对症治疗后,症状减轻或消失.     

胃肠道交界性病变/肿瘤和相关病变的临床病理特点及其治疗原则

交界性病变／交界性肿瘤是目前诊断病理面临的最大难题之一。病理和临床医师应正确认识胃肠道的一些交界性病变／交界性肿瘤及相关病变如胃肠道间质瘤、胃肠道淋巴组织增生和粘膜相关淋巴组织淋巴瘤、免疫增生性小肠病、胃肠道腺瘤和阑尾类癌。     

18例大肠癌肝转移高强度聚焦超声治疗的临床观察

目的:研究高强度聚焦超声(HIFU)治疗大肠癌肝转移病灶的安全性和有效性.方法:18例大肠癌术后肝转移患者31个病灶行HIFU治疗,观察患者生命体征、主要脏器功能、影像学检查(CT或MRI等)、并发症和肿瘤转归的情况.结果:所有患者生命体征平稳,肝、肾功能正常,平均随访16.1个月(6～38个月),失访2例,生存13例,12、18个月生存率分别为83.3%和66.7%,中位生存期16个月;随访25个病灶中,17个肿瘤块缩小超过50%,有5例出现新的转移灶,8例出现皮肤浅Ⅱ度烧伤.结论:HIFU治疗是一种安全、有效和非侵入性治疗大肠癌肝转移病灶的手段.     

Genetic polymorphisms in GSTM1, GSTP1, and GSTT1 and the risk for breast cancer: results from the Shanghai Breast Cancer Study and meta-analysis.

PURPOSE: We studied the relation of breast cancer to common deletion mutations in GSTM1 and GSTT1 and the functional Ile(105)Val polymorphism in GSTP1 in a large, population-based case-control study conducted in China and performed a meta-analysis to summarize the literature. EXPERIMENTAL DESIGN: In the case-control study, a total of 1144 breast cancer cases and 1221 community controls were genotyped for GSTM1, GSTP1, and GSTT1 using PCR-based methods. Associations of genotypes and breast cancer were evaluated in logistic regression models. Meta-analysis odds ratios (ORs) were estimated using a fixed effects model. RESULTS: In the case-control study, associations were null for GSTM1 [age-adjusted OR 0.97, 95% confidence interval (CI): 0.82-1.14] and GSTT1 (OR 0.97, 95% CI: 0.83-1.15). A significant increase in risk was observed among homozygotes for the variant Ile(105)Val polymorphism (OR 1.92, 95% CI: 1.21-3.04). No combined effects of GSTM1, GSTP1, and GSTT1 genotypes or interactions with potential effect modifiers were detected. All results were similar in pre- and postmenopausal women and for early versus advanced stage breast cancer. The meta-analysis, based predominantly on Caucasian women, supported null results for the homozygous deletion variant in GSTM1 (summary OR 1.05; combining 19 studies) and GSTT1 (summary OR 1.11; 15 studies). Meta-analysis results for the homozygous GSTP1 variant indicated no overall association (summary OR 1.04; 10 studies), although results varied significantly across studies (P = 0.009). CONCLUSIONS: This large case-control study provides strong support for earlier studies showing no overall association of the GSTM1 and GSTT1 deletion polymorphisms with breast cancer risk. The GSTP1 variant may be relevant to breast cancer risk in Asian populations.     

DIAGNOSTIC IMPLICATIONS OF IMMUNOHISTOCHEMICAL MARKERS IN UTERINE SMOOTH MUSCLE TUMORS

Objective: To evaluate the diagnostic implications of immunohistochemieal markers in uterine smooth muscle tumors. Methods: Formalin-fixed paraffin-embedded tissue blocks were selected from 17 uterine leiomyosarcomas, 40 uterine unusual leiomyomas and 25 uterine usual leiomyomas. Utilizing immunohistochemical techniques with antigen retrieval, serial sections of each tumor for immunoreactivity with myogenic markers, ovarian steroid receptors, CD44v3, proliferating cell nuclear antigen and mast cells were assessed. Results: Although the myogenic markers and CD44v3 showed less frequent positivity in uterine leiomyosarcomas than those in unusual leiomyomas,they were not reliable markers for differentiating leiomyosarcoma from leiomyoma. Uterine leiomyosarcoma tended to have lower ovarian steroid receptors immunoreactivity rates than leiomyoma. Leiomyoma tended to have a higher quantity of intratumoral mast cells than leiomyosarcoma, while the expression of proliferating cell nuclear antigen was lower in them. Conclusion: Because the estimation of mitotic count was subject to significant variation, the immunohistochemical expression of ovarian steroid receptors, mast cells and proliferating cell nuclear antigen seemed to be helpful for the discrimination of unusual leiomyoma from leiomyosarcoma.     

ICAM-1 deficiency suppresses host allosensitization and rejection of MHC-disparate corneal transplants

BACKGROUND: We used a murine model of orthotopic corneal transplantation to determine whether host deficiency in ICAM-1 promotes survival of corneal grafts with different degrees of allodisparity. METHODS: ICAM-1-/- and wild-type C57BL/6 (ICAM-1+/+) received corneal grafts from the following strains of mice: BALB/c (fully mismatched), BALB.b (mismatched at multiple minor H only), or B10.D2 [including major histocompatibility complex (MHC) mismatch]. Graft rejection, induction of allospecific delayed-type hypersensitivity (DTH) responses, and leukocytic infiltration of grafts were measured. RESULTS: There were no differences in long-term survival of allografts that were either fully mismatched or had only minor H disparity in ICAM-1+/+ vs. ICAM-1-/-hosts. However, whereas B10.D2 grafts were accepted in only 58% of the ICAM-1+/+ hosts, graft survival in ICAM-1-/- recipients was 100% (P=0.006). Moreover, none of the ICAM-1-/- mice receiving B10.D2 grafts developed allospecific DTH. CONCLUSIONS: Prolonged survival seen in MHC-mismatched grafts in ICAM-1-/- mice, along with a suppressed DTH response to donor alloantigens after transplantation, suggest that ICAM-1 is associated with recipient sensitization to MHC alloantigens.     

嗜铬细胞瘤临床诊治

目的 提高嗜铬细胞瘤的诊治水平。方法 总结１９５８年至１９９８年间经手术和病理证实的嗜铬细胞瘤２８６例。结果 本组２２０例患者肿瘤位于肾上腺,６６例位于肾上腺外。在２９例恶性嗜铬细胞瘤中,７例位于肾上腺,２２例位于肾上腺外。１９例为静止型嗜铬细胞瘤。手术切除肿瘤２８１例。结论 对潜在的儿茶酚胺性心肌病的防治可降低手术死亡率。恶性嗜铬细胞瘤的诊断要靠长期严密的随访。     

心外管道全腔肺动脉吻合术的临床应用

目的 评价心外管道全腔肺动脉吻合术的临床应用价值。方法 １９９８年６月～１９９９年８月,１０例先天性心脏复杂畸形的患者接受了心外管道全腔肺动脉吻合术。包括单心室８例,均伴有完全性大动脉转位;右心室发育不良２例。均在全麻低温体外循环下手术。结果 患者全部治愈出院。术后随访６～１８个月,无晚期死亡。所有患者症状消失,无静脉压明显升高现象,超声检查显示心外管道血流通畅,无血栓形成;心电图检查显示无严重心     

Clinical observation of 82 cases of enuresis treated by ginger-partitioned moxibustion plus cupping therapy

Purpose: To observe the clinical therapeutic effect in the treatment of enuresis by ginger-partitioned moxibustion plus cupping therapy.Methods: Ginger-partitioned moxibustion was applied on Guanyuan (CV 4) and bilateral Zusanli (ST 36) and cupping therapy was applied on Shenque (CV 8) in the treatment of 82 cases of enuresis, in comparison with 76 cases treated by Chinese herbal medicine.Results: The effective rate was 84.1% in the treatment by ginger-partitioned moxibustion plus cupping therapy and was 64.5% in the treatment by Chinese herbal medicine.Conclusion: Ginger-partitioned moxibustion plus cupping therapy was better than Chinese herbal medicine in the treatment of enuresis (P<0.05). Translator: HUANG Guo-qi