Nasopharyngeal and nasal malignant lymphoma: a clinicopathological study of 54 cases

Forty-one cases of nasopharyngeal and 13 cases of nasal malignant lymphoma have been examined histologically and immunohistochemically. All of the cases were non-Hodgkin's lymphoma; one case was of follicular type and the remaining 53 were of diffuse type. Large cell lymphoma comprised 48% of cases and most of the immunoblastic lymphomas showing pleomorphism occurred in the nose. Twenty-seven cases were of T-cell and 21 of B-cell phenotype. The predominance of T-cell lymphoma was due to an increased incidence of these in the nose, the T:B ratio of 3.33:1 contrasting with a 1:1.05 ratio in the nasopharynx. Nasopharyngeal lymphomas seem to show an intermediate incidence between the T-cell predominance in the nose and a B-cell predominance in the oropharynx. Since the large cell type of lymphoma was predominant, the differential diagnosis from undifferentiated carcinoma is important and is facilitated by the use of immunostaining methods.     

应用激光显微分离技术在骨肉瘤组织原位筛选噬菌体肽库

目的将激光显微分离(laser capture microdissection, LCM) 技术应用于噬菌体表面呈现肽库的筛选过程,建立一种可以直接在天然组织中筛选肽库的方法。方法将新鲜人骨肉瘤组织块在噬菌体肽库溶液振荡孵育后制成组织冰冻切片,免疫组化染色检测噬菌体在组织中的浸润扩散。改进常规LCM切片处理方法,以冻干法替代酒精/二甲苯法脱水,以期在LCM操作过程中提高切片上噬菌体的存活率。LCM法分离摄取骨肉瘤切片上的肿瘤靶细胞,转染回收这些细胞上特异结合的噬菌体。滴定法检测所筛选的噬菌体对特异性细胞的亲和力。结果利用LCM技术,可以由肿瘤冰冻切片上收集到足够的与特异性噬菌体短肽,应用于噬菌体表面呈现肽库筛选。经过3轮筛选后所获得的噬菌体与人骨肉瘤组织的特异性亲和力提高16倍。结论本研究首次将LCM技术应用于噬菌体表面呈现肽库的筛选,可以使我们直接在新鲜人肿瘤组织中筛选与特定细胞群甚至单个细胞亲合的短肽;同时又避免了天然组织中其他杂质细胞的污染,为研制细胞特异性导向载体提供了一个新的途径。     

异丙酚无痛人工流产时静脉注射缩宫素可致血液循环严重波动

目的　观察异丙酚无痛人工流产时静脉注射缩宫素对血压和心率的影响。　方法　将 90例Ⅰ级 (美国麻醉协会麻醉术前分级 )早期宫内妊娠的患者随机分为 3组 :A组 30例 ,应用 2～ 3mg/kg异丙酚和 1μg/kg枸橼酸芬太尼进行无痛人工流产术 ,手术后期注射缩宫素 1ml,于注射后的 3min内观察收缩压、舒张压和心率变化 ;B组 30例 ,用相同麻醉方法进行无痛人工流产 ,术中不用缩宫素 ,观察指标与方法同于A组 ;C组 30例 ,不用任何麻醉药物进行人工流产 ,在与A组相同的时间注射缩宫素 ,观察指标与方法同于A组。　结果　A组在注射缩宫素后 0 5min ,血压显著下降 ,心率显著增加 ,注射后 2 .5min时 ,血压和心率基本恢复到注射前水平。B组和C组无明显血压下降。　结论　异丙酚无痛人工流产时注射常规剂量缩宫素后可致血液循环短暂严重波动 ,应引起临床妇产科医师高度重视 ,特别是对心功能储备较差的患者更应关注。     

全雄激素阻断治疗晚期前列腺癌

为了评价全雄激素阻断治疗晚期前列腺癌的疗效，采用双侧睾丸切除、Ｆｌｕｔａｍｉｄｅ和Ｆｉｎａｓｔｅｒｉｄ联合治疗Ｄ２期前列腺癌病人５例。随访１５～２０个月，结果ＰＳＡ均正常，前列腺体积缩小６１．２％～６９．３％，有显著性差异（Ｐ＜０．０１），骨转移灶缩小、部分消失，积水肾脏完全恢复正常，所有病人治疗后全部有效。表明全雄激素阻断对晚期前列腺癌有良好的治疗效果。提出在三个层次上阻断雄激素治疗晚期前列腺癌的策略。     

肝门胆管癌的外科治疗60例临床分析

肝门胆管癌近年有增多趋势,本文报告我院1975年～1985年间肝门胆管癌60例,占全部肝外胆管癌82例之73.1％,占同期全部胆道手术3626例之1.65％。临床表现主要有三型:1)阻塞性黄疸29例,其中25例曾误诊为肝炎;2)急性胆管炎12例;3)长期胆道疾病14例,其他5例。本组行B超检查19例,ERCP10例,PTC39例。最后诊断根据PTC和/或ERCP,剖腹术及病理检查结果。 56例施行了手术治疗,仅6例施行肿瘤连同半肝切除,姑息性肝胆管内引流15例,外引流23例,其他方法12例。平均存活时间:6例切除组24.5月,48例姑息手术组8.7月,未手术的4例为5月。文中强调早期诊断,凡40岁以上出现阻塞性黄疸或“传染性肝炎”均须警惕胆管癌,进行B超,CT,ERCP或PTC检查,文中强调PTC是诊断本病重要手段,可选择进行右左肝管PTC。本病应争取手术切除,不能切除者行肝胆管内引流或外引流,二者疗效无明显差别。     

消化道肿瘤血浆胃动素测定及其意义

作者报告经病理诊断消化道恶性肿瘤患者30例及手术切除肿瘤患者15例的血浆胃动素水平,并以健康成人31例作为对照。消化道恶性肿瘤的胃动素水平373.4±123.7ng/L,显著高于正常对照组(162.3±52.3ng/L,P<0.001),而消化道恶性肿瘤患者术前及术后胃动素水平无显著差异。消化道恶性肿瘤患者胃动素水平增高的原因可能是肿瘤刺激神经所致。胃癌和结肠癌细胞可产生胃泌素样物质,它可刺激胃动素的释放。     

肠梗阻的临床进展

将近5年来有关肠梗阻的新诊治方法作一综述，结论如下：①B超、CT和76％泛影葡胺口服造影等对肠梗阻诊断有重要临床价值。②腹腔镜小肠梗阻手术是最能体现微创技术优越性的手术之一。③EPII应以非手术疗法为主。     

加温合并药物治疗Lewis肺癌的实验研究

本实验以荷 Lewis 肺癌的 NIH 小鼠为模型,以肿瘤平均直径倍增时间(MDDT)为终点,进行加温合并抗癌药物的研究。结果表明:①43℃加温25分钟,对 Lewis 肺癌有明显的治疗效果(P<0.05);②喜树碱16mg/kg合并加温25分钟,对 Lewis 肺癌的抑制作用随加热温度升高而加强,在43℃时出现相加作用(P<0.001);③斑蝥素0.45mg/kg,高三尖杉酯碱1.2mg/kg 或消瘤芥0.75mg/kg 合并加温25分钟,对Lewis 肺癌的抑制作用随加热温度升高而增强,其中斑蝥素和消瘤芥在43℃时出现协同作用(P<0.001);①去甲斑蝥酸钠3mg/kg 对 Lewis 肺癌无治疗作用,但合并43℃加温25分钟时有协同作用;⑤鸦胆子油口服乳液8ml/kg,间隔27小时合并43℃加温25分钟,对 Lewis 肺癌的治疗有相加作用,并明显延长了荷瘤动物的生存时间。     

Study on lymphocyte activation and proliferation induced by anti-CD3 McAb

Summary T cell activation and proliferation via CD₃-TCR complex were investigated by lymphocyte DNA synthesis in vitro. Several interfering factors were also discussed. The result indicated that lymphocyte activation and proliferation are calciumdependent. A rise of cytoplasmic free Ca²⁺ quickly following activation with CD₃ McAb is mainly due to intracellular mobilization of Ca²⁺, while lymphocyte proliferation needs both intracellular mobilization of Ca²⁺ as well as influx of extracellular Ca²⁺. It was confirmed that CTX sensitive G protein plays a role in regulating T cell proliferation by pretreatment with CTX suppressing lymphocyte³H-TdR incorporation obviously. PLC and PKC inhibitor neomycin and P. S. S could also decrease T cell proliferation.     

The role of nuclear medicine in oncology

Nuclear Medicine offers screening methods for oncology such as bone and bone marrow scintigraphy. During the last two decades, special procedures have gained widespread application. This paper is centered around the “tumor-specific” radiopharmaceuticals. In patients with thyroid cancer, I-131 still plays a significant role. Ga-67 still has its indications in lymphoma, while in other diseases Tl-201 cloride is now the agent of choice. Especially in thyroid cancer, Tl-201 has proved to be a reliable tumor imaging radiopharmaceutical. More recently, Tc-99m MIBI was introduced for tumor imaging. Tc-99m HMPAO may also be used for tumor scintigraphy, especially in brain lesions. In addition, I-123 IMP has successfully been used for imaging malignant melanoma. Another promising field of tumor diagnosis is receptor imaging. In neuroblastoma and malignant pheochromocytoma, I-131/123 mIBG is the radiopharmaceutical of choice and may be considered as a receptor imaging agent also. First clinical results with In-111 octreotide show potentials as somatostatine-receptor radiopharmaceutical in insulinoma, islet cell carcinoma, medullary and lung cancer, while I-123 estradiol needs some improvement until it may be recommended as diagnostic tool in breast cancer. Since 1978, radiolabeled poly- or monoclonal tumor antibodies and their fragments have gained widespread application. Especially the Tc-99m 225.28S melanoma antibody, I-131 or Tc-99m CEA and In-111/I-131 labeled OC-125 antibodies have proven to be of clinical significance in melanoma, colorectal and ovarian cancer.