亚硒酸钠对实验性自身免疫性甲状腺炎大鼠甲状腺细胞凋亡的影响

目的 探讨亚硒酸钠对实验性自身免疫性甲状腺炎(EAT)大鼠甲状腺细胞凋亡的影响.方法 Wistar大鼠分为正常对照组、自身免疫性甲状腺炎(EAT)组和硒干预EAT组.制备EAT大鼠模型,硒干预EAT组给予亚硒酸钠灌胃.用放射免疫法(RIA)测定各组大鼠自身抗体水平,HE染色观察甲状腺组织病理改变及TUNEL法标记甲状腺组织中凋亡细胞,观察甲状腺细胞凋亡情况.结果 正常对照组、EAT组、硒干预EAT组的TgAb分别(6.94±1.13)%、(36.24±3.64)%、(17.23±2.90)%,TmAb分别为(5.96±1.40)%、(27.12±5.06)%、(15.98±2.45)%.硒干预EAT组TgAb、TmAb水平较EAT组明显下降(P<0.05).各组大鼠甲状腺组织炎症程度及凋亡程度评分结果比较显示,不同组别的甲状腺组织病变程度间差别有显著性(P<0.001),硒干预EAT组的甲状腺滤泡破坏程度较EAT组减轻,淋巴细胞浸润减少(P<0.05),甲状腺细胞的凋亡数量较EAT组明显减少(P<0.05).结论 亚硒酸钠可能通过抑制甲状腺细胞的凋亡来减轻或抑制自身免疫性甲状腺炎的免疫损伤.     

智能纳米材料在细胞水平治疗疾病时的应用

摘要：恶性肿瘤的常规治疗方法在临床应用中存在着或多或少的缺陷。为了实现靶向治疗及提高药物利用度等目的,一类具有智能效应(如热敏感、pH敏感、磁敏感以及光敏感等)的纳米材料已被应用到细胞水平治疗疾病的领域中。它们是通过药物靶向缓释、热效应和可控机械力等方式,杀死靶组织内的病理细胞,进而实现疾病的治愈。文章综合讨论了应用该类材料在细胞水平治疗疾病的最新进展,同时展望了其存在的问题以及发展前景。     

Epilepsy surgery in the first 3 years of life: A Canadian survey

Objective:   To determine the clinical characteristics, surgical challenges, and outcome in children younger than 3 years of age undergoing epilepsy surgery in Canada.
Methods:   Retrospective data on patients younger than age 3 years who underwent epilepsy surgery at multiple centers across Canada from January 1987 to September 2005 were collected and analyzed.
Results:   There were 116 patients from eight centers. Seizure onset was in the first year of life in 82%, and mean age at first surgery was 15.8 months (1–35 months). Second surgeries were done in 27 patients, and a third surgery in 6. Etiologies were malformations of cortical development (57), tumor (22), Sturge-Weber syndrome (19), infarct (8), and other (10). Surgeries comprised 40 hemispheric operations, 33 cortical resections, 35 lesionectomies, 7 temporal lobectomies, and one callosotomy. There was one surgical mortality. The most common surgical complications (151 operations in 116 patients) were infection (17) and aseptic meningitis in 13. Of 107 patients with seizure outcome assessed more than one year postoperatively, 72 (67.3%) were seizure free (Engel I), 15(14%) had >90% improvement (Engel II), 12 had >50% improvement (Engel III), and 8 did not benefit from surgery (Engel IV). Development improved in 55.3% after surgery.
Conclusion:   Epilepsy surgery in children younger than 3 years of age is relatively safe and is effective in controlling seizures. Very young age is not a contraindication to surgery in children with refractory epilepsy, and early surgery may impact development positively.     

Relationship between gene expression of 5-fluorouracil metabolic enzymes and 5-fluorouracil sensitivity in primary cancer cells isolated from malignant ascites

This study was designed to investigate the predictive role of 5-FU metabolic enzymes in malignant ascites. Forty-three malignant ascites were collected and primary cancer cells were isolated. Gene expression was detected by quantitative RT-PCR. We found that DPD mRNA was higher in patients with pancreatic cancers than those with gastric cancers, colon cancers, and liver cancers. Significant correlations were found between expression of DPD and TP, and between TS and OPRT. mRNA levels of TS and OPRT correlated significantly with the chemosensitivity of 5-FU. Assessing gene expression would be useful in predicting 5-FU sensitivity for patients with malignant ascites.     

卵巢透明细胞癌脾脏转移并文献回顾

目的:探讨卵巢透明细胞癌脾脏转移的临床特点和治疗策略。方法:报告1例卵巢透明细胞癌脾脏转移的详细临床资料,并进行系统文献回顾。结果:卵巢癌出现脾脏转移以浆液性乳头状囊腺癌多见,卵巢透明细胞癌发生脾脏转移极为罕见。卵巢癌出现脾脏转移时间多在卵巢癌术后,少数出现于首次就诊时,多数表现为同时多发性的大网膜及盆腔转移,个别患者可表现为孤立性脾转移病灶。结论:卵巢癌脾脏转移诊断的确立需要结合肿瘤标志、影像学资料和组织病理;治疗方面需采取综合手段,应在准确评估病情的前提下,及时行减瘤术和脾切除术,以提高患者生存质量。     

直肠癌放射治疗方案剂量学比较

目的:研究直肠癌不同放射治疗计划的剂量学差异。方法:对18例直肠癌患者分别设计三维适形(3DCRT)和调强放射治疗计划(IMRT),利用剂量体积直方图来比较2种计划中靶区、危机器官的剂量学差异。结果:IMRT与3DCRT相比,靶区适合度指数(CI)、靶区剂量不均匀性指数(HI)均更接近1,Dmean也更接近处方剂量,差异有统计学意义(P<0.05);与3 DCRT相比,IMRT中小肠的D30%、Dmean、Dmax,膀胱的D30%、D50%、Dmean更低;IMRT中小肠的D50%,股骨头的D5%、Dmean比3DCRT高,但仍远低于剂量限值。结论:IMRT技术对直肠癌进行治疗时,靶区适合度和靶区剂量均匀性更好,危及器官受量能够得到很好的控制。     

药师参与外科抗菌药物合理应用的持续改进

目的:记录并分析药师在促进我院外科抗菌药物合理应用的工作,探讨药师参与临床的工作模式。方法:2009年10月-2010年6月,由药剂科和感染科组成检查组,对外科在架病历抗菌药物应用进行专项检查和督促,并比较合理用药改进情况。结果:观察期内,抗菌药物应用率由84.1%降低至78.4%,不合格率由57.2%降低至42.3%,临床不合理用药现象得到较大改善。结论:在药师参与下,推动我院住院抗菌药物合理应用的工作取得了较好成绩,值得进一步深入开展。     

Grandilodines A-C, biologically active indole alkaloids from Kopsia grandifolia

Three new indole alkaloids (1-3), named grandilodines A-C, and five known ones were obtained from the Malayan Kopsia grandifolia. The structures were established using NMR and MS analyses and, in the case of 1 and 2, were confirmed by X-ray diffraction analyses. Alkaloids 1, 3, and lapidilectine B (8) were found to reverse multidrug resistance in vincristine-resistant KB cells.     

Laparoscopic radical correction combined with extensive lymphadenectomy and pelvic autonomic nerve preservation for mid-to-low rectal cancer

Objective

The purposes of this study were to confirm the definite metastasis and micrometastasis rate of upward and lateral lymph nodes of mid-to-low rectal cancer at stage II and stage III, and to evaluate the feasibility and safety of laparoscopic radical correction combined with extensive lymphadenectomy and pelvic autonomic nerve preservation (PANP).

Methods

The study was performed in 68 patients who were diagnosed with mid-to-low rectal cancer at stage II or stage III and received laparoscopic radical correction combined with extensive lymphadenectomy and PANP from June 2006 to June 2008 in the General Surgery Department of Southwest Hospital. All lymph nodes resected in the surgeries were examined by hematoxylin and eosin (H & E) stain and immunohistochemistry with an antibody against cytokeratin 20 (CK20) to confirm the conditions of metastasis and micrometastasis. We compared the postoperative complications with those of traditional surgeries.

Results

In 1571 lymph nodes, 16 lymph nodes were found to have definite metastasis in 6 patients (8.8%) and in 41 lymph nodes we found micrometastasis in 12 patients (17.6%). The total metastasis rate of upward and lateral lymph nodes was 19.1%. Compared with traditional surgeries, the new surgery had less blood loss and short convalescence and postoperative complications were not increased.

Conclusion

The total metastasis rate of upward and lateral lymph nodes is 19.1%. The laparoscopic radical correction combined with extensive lymphadenectomy and PANP is feasible and safe.     

CD133+细胞在乳腺良恶性病变中的分布特点及其临床病理意义

研究CD133+细胞在乳腺普通型增生、乳腺不典型增生、乳腺原位癌、浸润性乳腺癌中的分布特点及其与乳腺癌临床病理特征的关系。方法:采用免疫组织化学方法对45例正常乳腺组织、41例普通型增生乳腺组织、39例不典型增生乳腺组织、51例乳腺原位癌组织、121例乳腺癌组织中CD133+的表达进行检测,分析CD133+细胞在乳腺良恶性病变中的分布特点。结果:CD133+在正常乳腺组织中不表达,在乳腺普通型增生、不典型增生、原位癌、浸润性癌的表达率逐渐增高,分别为31.7%（13/41）、48.7%（19/39）、64.7%（33/51）、74.4%（90/121）,有显著性差异（P<0.01）。CD133+的表达率随乳腺癌组织学分级［Ⅰ级63.6%（21/33）、Ⅱ级72.2%（26/36）、Ⅲ级82.7%（43/52）,P<0.05］和TNM分期［Ⅰ期57.1%（12/21）、Ⅱ期69.4%（34/49）、Ⅲ期68.7%（11/16）、Ⅳ期94.3%（33/35）,P<0.001］的增高而增高;有淋巴结转移或远处转移者分别高于无转移者、无远处转移者（P<0.05）;有复发者高于无复发者（P<0.05）;与患者年龄、月经状态、肿瘤的组织学类型、肿瘤大小、ER、PR、Her-2的表达无显著相关（P>0.05）。结论:CD133+细胞可能在乳腺增生与癌变过程中起重要作用;CD133+的乳腺癌细胞与乳腺癌的侵袭、转移和复发密切相关,CD133+是提示乳腺癌恶性程度和预后的指标之一。