Krebsbekämpfung,allgemeine und operative herapie

Ohne Zusammenfassung     

毛子草化学成分的研究

目的：对民间常用草药毛子草进行化学成分的研究。方法：利用硅胶柱色谱，制备薄层色谱和葡萄糖凝胶SephadexLH-20柱层析纯化，利用各种光谱方法鉴定化合物的结构。结果：从毛子草中分离得到3个单帖生物碱，鉴定为毛子草碱甲（argutineA, Ⅰ），毛子草碱乙（argutineB,Ⅱ），和boschniakinic acid（Ⅲ），结论：其中化合物Ⅰ和Ⅱ为新化合物，化合物Ⅲ为首次从角蒿属植物中分离得到。     

Divergent roles of growth factors in the GnRH regulation of puberty in mice

Pubertal onset, initiated by pulsatile gonadotropin-releasing hormone (GnRH), only occurs in a favorable, anabolic hormonal milieu. Anabolic factors that may signal nutritional status to the hypothalamus include the growth factors insulin and IGF-1. It is unclear which hypothalamic neuronal subpopulation these factors affect to ultimately regulate GnRH neuron function in puberty and reproduction. We examined the direct role of the GnRH neuron in growth factor regulation of reproduction using the Cre/lox system. Mice with the IR or IGF-1R deleted specifically in GnRH neurons were generated. Male and female mice with the IR deleted in GnRH neurons displayed normal pubertal timing and fertility, but male and female mice with the IGF-1R deleted in GnRH neurons experienced delayed pubertal development with normal fertility. With IGF-1 administration, puberty was advanced in control females, but not in females with the IGF-1R deleted in GnRH neurons, in control males, or in knockout males. These mice exhibited developmental differences in GnRH neuronal morphology but normal number and distribution of neurons. These studies define the role of IGF-1R signaling in the coordination of somatic development with reproductive maturation and provide insight into the mechanisms regulating pubertal timing in anabolic states.     

Correlations between reduced expression of the metastasis suppressor gene KAI-1 and accumulation of p53 in uterine carcinomas and sarcomas

Kangai (KAI)-1 (CD82) is a metastasis suppressor gene, which belongs to the family of tetraspanin proteins. A loss of KAI-1 expression is associated with the advanced stages of many human malignancies. The present study was designed to investigate the expression pattern of KAI-1 in the normal endometrium and uterine tumors and to correlate it with the expression of tumor suppressor protein p53. KAI-1 could be found in the normal endometrium throughout the menstrual cycle. Thirteen of 42 endometrial carcinomas demonstrated moderate KAI-1 expression, but low expression of p53. Twenty-nine of 42 endometrial carcinomas showed reduced or absent KAI-1 expression, which correlated with strong expression of p53 (p < 0.001). There were significant correlations between KAI-1 expression and histological type, e.g., 93% of endometrioid carcinomas displayed a low or moderate immunostaining for KAI-1, whereas nearly all of the serous/clear cell carcinomas were KAI-1 negative (p < 0.001); tumor grading, e.g., 73% of high grade tumors showed no KAI-1 expression (p < 0.001). Most of the investigated uterine sarcomas were negative for KAI-1, whereas they displayed a strong immunostaining for p53. In conclusion, KAI-1 and p53 show inverse expression. The reduced KAI-1 expression may be the result of dysregulated p53 function and could be an important step in the endometrial carcinogenesis.     

婴幼儿期背部烫伤致青少年瘢痕挛缩性脊柱侧弯

目的 探讨婴幼儿期背部烫伤所致青少年瘢痕挛缩性脊柱侧弯的发病机制、临床表现和治疗方法。方法 1997年8月～2003年6月共诊治各类儿童及青少年脊柱侧弯7000余例，其中仅有2例为瘢痕挛缩性脊柱侧弯，均伴有不同程度的骨盆倾斜。1例先行皮肤扩张、背部瘢痕切除、皮瓣转移术，再行脊柱侧弯前路TSRH矫形内固定术。另1例先行背部瘢痕切除、脊柱侧弯前路松解手术，Halo-股骨牵引50d后再行后路TSRH矫形内固定加胸廓成形术。结果 2例患儿术后外观畸形明显改善，侧弯矫正率分别为91．0％和55．0％，躯干变直，骨盆水平，伤口愈合良好。经3～4个月随访，无明显矫正丢失。结论 婴幼儿期烫伤所致背部严重瘢痕，可在青少年生长发育期诱发瘢痕挛缩性脊柱侧弯，其发病机制、临床表现均与典型青少年特发性脊柱侧弯有所不同。这一类型脊柱侧弯手术方案的制定必须遵循个体化、特异性的治疗原则。     

女性肾上腺性征异常症

目的 探讨女性假两性畸形的诊断和治疗的时机及方法。方法 回顾性分析近23年来收治的31例患儿的诊疗资料。1～6岁19例，7～14岁12例。性染色体均为46，XX。腕骨骨龄大于实际年龄的18例。出生后均见阴蒂肥大，27例为尿生殖窦单一开口，4例分别见到尿道和阴道口，半数已长出阴毛、声粗、痤疮，最小者2岁，3例14岁患儿身高不足150cm。行B超检查及尿生殖窦造影的病例均有正常女性生殖道。失盐型3例，在新生儿期出现危象而确诊。结果 剖腹探查的9例有正常卵巢及内生殖道。26例作了阴蒂缩短成形或肥大阴蒂切除，小阴唇成形。除1例外，其余30例均在确诊后接受内科药物治疗。结论 典型的女性肾上腺性征异常诊断虽不难，但就诊年龄多较晚，药物治疗滞后，对患儿的生理和心理有严重的负面影响。典型患儿不必作剖腹探查。失盐型患儿多在新生儿期出现危象，应尽早诊疗。     

Bedeutung molekular-zytogenetischer Befunde bei Speicheldrüsentumoren am Beispiel des Mukoepidermoidkarzinoms

Chromosomentranslokationen in Tumoren führen nicht selten zur Ausbildung von Fusionsgenen, die für Proteine mit onkogenen Eigenschaften codieren können. Mukoepidermoidkarzinome sind charakterisiert durch eine Translokation t(11;19), die in 60% der untersuchten Tumoren vorkommt. Diese chromosomale Umlagerung führt zu einem Fusionsgen, das aus dem Exon 1 des MECT 1-Gens und den Exons 2–5 des MAML 2-Gens zusammengesetzt ist. In der Folge bildet sich ein Fusionstranskript, wodurch unabhängig von Notch-Liganden eine Aktivierung der Transkription von HES 1, einem Notch-Zielgen, erfolgt. Durch die veränderte Funktion von MAML 2 kommt es zur Unterbrechung des NOTCH-Signaltransduktionsweges, was einen neuen Mechanismus in der Tumorgenese vermuten lässt. Der Nachweis der Translokation mittels FISH und/oder RT-PCR könnte von erheblichem diagnostischem und möglicherweise auch prognostischem Interesse sein. Zuvor müssen allerdings die molekularen Ereignisse, die einem scheinbar identischen chromosomalen Rearrangement in Warthin-Tumoren zugrunde liegen, geklärt werden. Warthin-Tumoren sind gutartige Speicheldrüsentumoren mit einer vom Mukoepidermoidkarzinom abweichenden Histomorphologie und Histogenese.     

Agouti-related peptide-expressing neurons are mandatory for feeding

Multiple hormones controlling energy homeostasis regulate the expression of neuropeptide Y (NPY) and agouti-related peptide (AgRP) in the arcuate nucleus of the hypothalamus. Nevertheless, inactivation of the genes encoding NPY and/or AgRP has no impact on food intake in mice. Here we demonstrate that induced selective ablation of AgRP-expressing neurons in adult mice results in acute reduction of feeding, demonstrating direct evidence for a critical role of these neurons in the regulation of energy homeostasis.     

Myoepitheliale Tumoren der Kopfspeicheldrüsen

This tutorial focuses on myoepithelial tumors of salivary glands, an entity with heterogeneous cytomorphology and inconsistent immunophenotype. Moreover, the clinical course cannot be predicted reliably from cytomorphological and immunophenotypic analysis. This heterogeneity causes problems in routine diagnostic, so that diagnosis ultimately rests on conventional histology. In a representative series of myoepitheliomas and malignant myoepitheliomas, antibodies against cytokeratins 5/6, S 100 protein and vimentin produced the most consistent reactivity profile. Staining for cytokeratins 5/6 is a useful addition to the established immunohistologic marker panel in the work-up of myoepitheliomas, because of its reliable expression in most cases and because it may underline the epithelial nature of the lesion. Comparative genomic hybridisation (CGH) profiles of myoepitheliomas and myoepithelial carcinomas showed no chromosomal aberration in less than 50% of myoepithelial carcinomas, so that CGH is of limited help in a given case. In a case that was represented in three separately localized manifestations of the disease that differed in their CGH profiles, gross genetic aberrations suggest to be acquired during tumor progression and should raise the suspicion of malignancy. Thus, diagnosis of myoepithelial tumors of salivary glands has to rest on morphological grounds with support of a restricted panel of immunohistologic markers.     

AO加压空心钉治疗股骨颈骨折79例报告

目的 探讨AO加压空心钉治疗股骨颈骨折的临床疗设。方法 对79例股骨颈骨折患者均采用AO加压空心钉治疗。结果 所有病人都获得随访，随防时间6个月～4年，按马元障功能恢复分级．优45例．良26例，差8例．总优良率88.7%。结论 AO加压空心钉治疗股骨颈骨折方法简单．疗效确切，值得提倡。