食管癌根治术后生存质量评价

目的评价食管癌根治术后患者生存质量.方法采用EORTC QLQ-C30以问卷形式采集食管癌根治术后患者生存质量情况,根据术后时间分组(1年组、1～3年组和3年以上组),与术前患者资料相比较.结果患者体能、社会能力于手术后出现下降,1年后明显恢复;情感能力3年后较前有提高;术后呼吸困难加重,1年后开始减轻,3年后接近术前;术后食欲丧失加重,1年后开始减轻;便秘症状术后改善.结论食管切除食管胃吻合术降低食管癌患者的生存质量,但多数生存质量评分在1年后开始恢复,3年后明显改善.     

青年人肺癌化疗加放射治疗的临床研究

目的　探讨化疗 放射治疗 (化放疗 ) <4 0岁青年人肺癌的临床病理及预后。方法　对化放疗的 70例肺癌患者 (<4 0岁 ,研究组 )进行回顾性研究 ,对照组是 82例随机选择同期患者 (≥4 0岁 )。比较两组临床病理特征和生存期。结果　研究组中位年龄 36 .5岁 ,对照组 6 2 .0岁。与对照组相比 ,研究组中女性多 (P =0 .0 39) ,中位症状持续时间长 (4个月 ,P <0 .0 0 1) ,误诊率高 (70 % ,P <0 .0 0 1)及中位误诊时间长 (4个月 ,P <0 .0 0 1) ,腺癌为主要病理类型 (6 4 .3% ,P <0 .0 0 1) ,诊断时晚期多 (90 % ,P <0 .0 0 1) ,放射治疗剂量高 (Ⅰ～Ⅲb期 ,中位剂量 6 2Gy ,P =0 .0 4 8;Ⅳ期 ,中位剂量 5 6Gy,P =0 .0 0 3) ,同期化放疗和早期放射治疗比例高 (77.1% ,P <0 .0 0 1和 5 5 .6 % ,P =0 .0 2 3) ,顺铂剂量高(90mg/m2 ,P <0 .0 0 1)以及化疗周期多 (6个周期 ,P <0 .0 0 1) ;两组在体重减轻、KPS、肿瘤家族史及吸烟史方面无差异。两个组总的中位生存时间及生存率比较差异无显著性意义 (χ2 =2 .88,P =0 .0 90 )。结论　化放疗的青年人肺癌临床病理特征明显不同于≥ 4 0岁人的肺癌 ,但生存情况一致。将青年人肺癌定义为”青年型肺癌”有一定临床实际意义。     

IL-12协同B7-1诱导机体抗肿瘤免疫的实验研究

目的研究白细胞介素-12(Interleukin-12,IL-12)协同共刺激分子B7-1,联合诱导机体抗肿瘤免疫对大鼠卵巢上皮癌的治疗作用并探讨其机理.方法用携带有小鼠IL-12和B7-1的逆转录病毒表达载体感染大鼠卵巢癌细胞株NuTu-19,建立高表达细胞株NuTu-19/IL-12、NuTu-19/B7-1及双基因共表达细胞株NuTu-19/IL-12-B7-1,并以转染空载体pLXSN的细胞NuTu-19/Neo为对照.用经丝裂霉素C处理的各种基因修饰的肿瘤细胞免疫动物,观察卵巢癌腹腔转移模型动物生存期,及其诱导细胞毒性T淋巴细胞(cytotoxic lymphocyte,CTL)杀伤活性的作用.结果经各种基因修饰的肿瘤细胞免疫后,大鼠脾淋巴细胞增殖能力有不同程度的提高,CTL杀伤同源肿瘤细胞的活性明显增强,IL-12和B7-1基因联合修饰的肿瘤细胞免疫动物对模型动物生存期的延长具有显著意义(P＜0.05).结论IL-12和B7-1基因联合修饰的肿瘤细胞可以刺激机体CTL增殖、成熟,增强CTL对肿瘤细胞的识别和杀伤活性等,两者联合具有明显的协同效应.联合免疫基因治疗作为一种新的卵巢癌治疗方法,值得深入研究.     

The trouble with kidneys derived from the non heart-beating donor: a single center 10-year experience

BACKGROUND: The demand for renal transplantation has increasingly outstripped the supply of donor organs especially over the past 10 years. Although related and unrelated live donation is being promoted as one option for increasing the donor pool, it is unlikely that this will in itself be able to bridge the gap. Non-heart beating donors (NHBD) can provide an alternative supply of organs, which should substantially increase the donor pool. METHODS: In Newcastle, NHBD kidneys have been used for transplantation for a period of 10 years. In the early period (1988-1993) excellent results were obtained (90.5% success); however, these donors were controlled NHBD, Maastricht category III. In the second phase (1994-1998) increasing numbers of donors were obtained from the Accident and Emergency Department unit. These were failed resuscitation for cardiac arrest (category II). The rates of success in this period were poor (45.5% success) and the program was halted. The third phase of the program used machine perfusion of the kidneys and glutathione S transferase enzyme analysis to assess viability. RESULTS: Using such approaches renal transplants from largely category II donors produced a success rate of 92.3% which was significantly better than the phase II period of the program (P=0.023, Fisher two-tail test). CONCLUSION: Machine perfusion and viability assessment of NHB kidneys in phase III of the program has increased our donor pool as well as improved the graft survival. This is particularly relevant for the use of the category II NHB donor where the incidence of primary nonfunction was high, illustrated by phase II where machine perfusion/viability assessment was not used.     

Overexpression of oncogenic STK15/BTAK/Aurora A kinase in human pancreatic cancer.

PURPOSE: Multiple chromosome abnormalities, including gain of chromosome20q, have been detected frequently in human pancreatic cancers. Overexpression of the STK15/BTAK/Aurora A gene located on chromosome 20q13, which encodes a centrosome-associated serine/threonine kinase, has been shown to induce chromosomal instability, leading to aneuploidy and cell transformation in multiple in vitro experimental systems. The purpose of this study was to investigate the expression and copy number alteration of STK15 in pancreatic cancer. EXPERIMENTAL DESIGN: STK15 expression at both the mRNA and protein levels together with the copy number of STK15 gene was measured in nine pancreatic carcinoma cell lines: (a) HPAF-II; (b) Aspc-1; (c) Panc-1; (d) Panc-3; (e) Panc-28; (f) Panc-48; (g) HS766T; (h) MIAPaCa-2; and (i) BxPc3. STK15 protein expression was also examined in normal pancreatic tissues and tumors by Western blotting and immunohistochemistry. RESULTS: STK15 was overexpressed in all of the nine cell lines examined, but gene amplification was infrequent. Western Blot analysis of primary tumor tissues revealed 2-10 times overexpression of STK15 protein compared with normal adjacent tissues from pancreatic cancer patients. Concurrent overexpression of cdc20, an STK15-associated protein, and reduced expression of cdc25, a mitosis-activating protein phosphatase, were detected in the same tumor samples. Elevated STK15 protein expression was detected in 22 of 38 tumor sections (58%) from pancreatic cancer patients. The extent of STK15 expression was not significantly correlated with the size, degree of differentiation, and metastasis status of the tumors. CONCLUSIONS: These results show that STK15 is overexpressed in pancreatic tumors and carcinoma cell lines and suggest that overexpression of STK15 may play a role in pancreatic carcinogenesis.     

有机化学中的学习障碍及教学策略

通过对学生在有机化学学习过程中的障碍分析，实施相应的教学策略，以提高有机化学的教学质量和学生的学习水平。     

粘附分子CD_(44)剪接变异体在宫颈癌中的表达及其意义

目的：探讨细胞表面粘附分子CD44的表达在宫颈癌浸润和转移中的作用。方法：应用敏感的RT-PCR法检测62例行广泛根治术的宫颈癌组织及痛分组织CD44剪接变异体的表达情况，结合相应的临床病理资料探讨其与宫颈癌侵袭转移的关系。结果：62例宫颈癌CD44VmRNA总阳性率为90.3％，其中有淋巴结转移的宫颈癌CD44表达率显著高于无淋巴结转移者（P＜0.05），并且癌旁组织表达高于癌组织本身的占54.8％结论：CD44剪接变异体可能赋予宫颈癌更强的侵袭转移潜能，并且痛分组织CD44VmRNA的表达可能较单纯癌组织的表达更有意义。     

芪丹煎对动脉粥样硬化家兔载脂蛋白的影响

目的观察益气活血中药复方芪丹煎对实验性动脉粥样硬化(AS)家兔的影响,探讨该方防治AS导致心肌缺血的机制。方法采用酶法测定血清三酰甘油(TG)、总胆固醇(TC)、载脂蛋白AI(ApoAI)和载脂蛋白B(ApoB),电镜观察胸主动脉的病理改变。结果与模型组比较,芪丹煎可以明显降低血清TG(P<0.05)、TC和ApoB(P<0.01)水平,增加ApoAI含量(P<0.01)。结论降低血脂、调节载脂蛋白含量可能是芪丹煎抑制AS的机制。     

艾迪注射液配合放射治疗鼻咽癌的临床观察

目的比较艾迪注射液加放疗与单纯放疗对鼻咽癌的疗效、毒副反应及免疫功能的影响.方法将71例鼻咽癌患者随机分为两组.治疗组（A组）放疗同时加用艾迪注射液50～80ml静脉滴入,1次/d,连用30d.对照组（B组）单用放疗.结果 A组有效率为83.3%,B组为80%,差异无统计学意义,P〉0.05.A组白细胞减少、贫血、口腔溃疡发生率明显低于B组,差异有统计学意义,P〈0.05.A组治疗后NK细胞活性、CD4/CD8比值明显升高,P〈0.01.A组治疗后的生存质量评分高于B组,P〈0.05.结论艾迪注射液配合放射治疗鼻咽癌,可减轻毒副反应,增强机体免疫功能,改善患者的生存质量.     

18F-FDG PET用于头颈部肿瘤疗效评价和预后分析的研究进展

正电子发射型计算机断层显像(positron emission tomograph,PET)通过探测肿瘤标准摄取值(standard uptake value,SUV)的大小来判断肿瘤的良恶性、生物学行为、监测放化疗的疗效和早期发现肿瘤的复发等.18F-脱氧葡萄糖(18F-FDG)是目前最常用的PET显像药物,主要反映细胞的葡萄糖代谢情况,18F-FDG的吸收与肿瘤生物学行为、代谢特征、病理学类型及分化程度的相关性为临床判断肿瘤的恶性程度提供了一定的依据,进而为反映肿瘤的预后提供了分子基础.综述了18F-FDG PET在头颈部肿瘤疗效评价和预后分析的研究进展.