谷胱甘肽硫转移酶M1与T1基因缺失增加鼻咽癌易感性(英文)

目的在中国西南的广西壮族自治区的鼻咽癌高发区内研究谷胱甘肽硫转移酶 M1与 T1遗传多态性与鼻咽癌易感的相关性。方法病例与对照研究这些酶的遗传多态性(GSTM1和 GSTT1零基因型),鼻咽癌总数为127例,对照207例。结果 GSTM1和 GSqT1零基因型的频数在 NPC 患者中较高,差异达统计学意义(P<0.001)。结论鼻咽癌是广西最常见癌症,GST 酶与多种环境致癌物的解毒相关,同合子缺失 GSTM1和 GSTT1与数种癌相关,生鼻咽癌危险性已知与环境因素如吸烟和 EB病毒感染相关联,我们的结果提示 GSTM1和 GSTF1缺失多态性与增加鼻咽癌易感性相关,若两种解毒酶基因同时缺失对鼻咽癌易感受性意义更重要。     

肝囊腺癌的诊治(附18例报告)

目的探讨肝囊腺癌的诊治方法,提高对肝囊腺癌的认识。方法对18例在2000年1月至2004年12月在我院进行手术治疗并经病理证实为肝囊腺癌的病例进行回顾性分析,收集其临床表现、影像学及病理等资料。结果肝囊腺癌在男女发病比例为9/9,平均年龄51岁。单结节病变占94.44%(17/18),病灶平均直径约10.08cm(3-17cm),1例病灶为多发。AFP及CEA均为阴性,61.11?19.9阴性(11/18)。超声检查示病灶呈囊实性块状回声伴液化,边缘呈菜花样突起。平扫CT示:肝内低密度占位,边缘结节状突起。增强CT示:病灶结节状突起,周边强化,延迟期消失。66.67%的病灶大于10cm(12/18)。所有病例在术后均得到病理证实。其中12例位于肝左叶,3例位于肝右叶,1例位于中肝叶,1例位于尾状叶,1例肝左右叶内均有病灶。18例中6例行囊腺癌切除;2例行剖腹探察术;1例行TAE 活检;9例行肝叶切除 胆囊切除及T管引流术。其中1例行左肝叶切除 胆囊切除 胃癌根治术 淋巴结清扫。1例于术后20个月复发再次手术行胆肠吻合术,6个月后再次复发仅行PMCT,此病人死于术后胆瘘。7例患者死于复发转移。10例患者目前健在无复发和转移(平均随访时间20个月)。结论肝囊腺癌是一种少见的肿瘤,生长缓慢。该肿瘤临床特征明显。临床医师对其病理及临床特征的认识将有助于该疾病的诊治。根治性手术切除是延长患者生存期的有效方法。     

前外侧或外侧硬脑膜外入路切除海绵窦区肿瘤：附9例临床经验

背景与目的：目前对海绵窦区肿瘤的手术治疗仍是神经外科的难题之一。本文旨在提高海绵窦区肿瘤的全切率，降低神经功能的残障率。方法：针对海绵窦外侧壁的显微解剖特点，结合典型病例分析，回顾性总结了9例海绵窦内肿瘤，经前外侧或外侧硬膜外入路，通过显微神经外科技术切开海绵窦外侧壁夹层，按神经走行方向切开，辨认肿瘤生长和颅神经的关系分块切除肿瘤。结果：9例海绵窦内肿瘤中，海绵状血管瘤1例，神经鞘瘤6例，脑膜瘤2例。全切除5例，3例次全切除，1例大部分切除。3例出现新的颅神经功能障碍症状，6个月后新出现的颅神经功能障碍症状减轻2例．完全恢复1例。结论：明确的海绵窦区显微外科解剖概念．娴熟的显微神经外科技术以及选择适当的手术入路是提高海绵窦区肿瘤的全切率，降低术中出血、术后残障率的关键因素。     

Clinical observation on acupuncture treatment of 36 cases of chronic atrophic gastritis

目的:观察针灸结合治疗慢性萎缩性胃炎的临床疗效.方法:慢性萎缩性胃炎患者36例,按中医辩证,分型施以针灸治疗.治疗前及治疗后均进行胃镜、体表胃电图、胃酸和胃蛋白酶、血中胃泌素、血中前列腺素E及胃粘膜胃泌素细胞等理化指标检查.结果:针灸治疗本病有较好的效果,显效好转率达97.2%,临床症状消失率达97.0%.治疗后可使患者血中前列腺素E等防御性因子增强,使患者从胃内低酸转向正常状态,胃动力功能增强,胃电图幅值回升,并可促使胃泌素释放,有利于胃酸的分泌.结论:针灸治疗萎缩性胃炎简便经济,无副作用,见效快,疗效肯定,可重复性强,具有一定的临床意义.     

冠状动脉造影及支架植入术后的处理

冠状动脉造影是判断冠状动脉病变范围和严重程度的最准确的方法，也是确诊冠心病的主要方法。而冠状动脉内支架植入术是目前治疗冠心病的有效措施之一，具有创伤小、安全、成功率高等优点。但由于这项技术需要通过穿刺动脉来完成，加上对这类患者术后的护理非常重要，现将这类患者的术后护理总结如下：     

丹地剂对去卵巢高脂雌鼠雌激素受体α、βmRNA表达的影响

目的：观察丹地剂对去卵巢高脂雌鼠ER（α、β）mRNA表达的影响。方法：采用8周龄雌性大鼠建立去卵巢高脂模型，将24只大鼠随机分为三组：去卵巢＋丹地剂组（丹地组），去卵巢＋苯甲酸雌二醇组（雌二醇组），去卵巢＋生理盐水组（对照组），每组8只，丹地组每天每只大鼠灌饲丹地剂，含生药量6g，共6周；雌二醇组用苯甲酸雌二醇注射液按每鼠每3天1次皮下注射0．2mg，共12次；对照组给予生理盐水，早晚各一次灌胃，共6周。RT-PCR法分析ERα、ERβmRNA表达，应用全自动生化仪测血脂、放免法测FSH、E2，硝酸还原酶法测NO。结果：与对照组比较，丹地组能明显降低TC、TG，差异有显著性（P〈0．01），升高HDL—C（P〈0．05），E2上升（P〈0．05），NO明显上升（P〈0．01），ERα、ERβmRNA表达均明显高于对照组（P〈0．01）。结论：丹地剂具有调高去卵巢高脂大鼠主动脉ERα、ERβmRNA的表达及升高血清NO的作用，并可改善血脂，该作用为其在绝经女性防治动脉粥样硬化和冠心病等应用提供了依据。     

康复新液保留灌肠治疗慢性非特异性溃疡性结肠炎疗效观察

为探讨慢性非特异性溃疡性结肠炎的治疗方法，本文对30例采用康复新液保留灌肠治疗的观察组与30例采用庆大霉素加10％腐植酸钠液保留灌肠治疗的对照组治疗效果相比较，结果发现，观察组疗效明显优于对照组（P〈0．05）。结论：康复新液保留灌肠治疗慢性非特异性溃疡性结肠炎疗效可靠，方法简便，值得推广。     

STAT1对人肾透明细胞癌放射敏感性的影响

目的 研究人肾透明细胞癌信号传递和转录活化因子1(STAT1)表达情况及抑制STAT1对该肿瘤细胞放射敏感性的影响.方法 采用免疫组织化学染色技术对比检测34例人肾透明细胞癌标本和12例正常肾组织标本的STAT1表达.用Western blotting法检测离体培养人肾透明细胞癌细胞(CRL-1932)、纤维母细胞(CCL-116)和wilm's瘤细胞(CRL-1441)的STAT1表达.用氟达拉滨和siRNA抑制CRL-1932细胞STAT1表达,并通过成克隆法和台盼蓝染色计数法研究抑制STAT1对CRL-1932细胞放射敏感性的影响.结果 人肾透明细胞癌标本的总STAT1和磷酸化STAT1表达均明显高于正常肾组织.Western blotting法显示CRL-1932细胞STAT1表达比CRL-1441、CCL-116细胞明显增高;药物氟达拉滨能显著抑制CRL-1932细胞磷酸化STAT1的表达,并显著增加CRL-1932细胞的放射敏感性,且放射增敏程度与药物浓度呈正相关.经STAT1 siRNA处理后CRL-1932细胞总STAT1和磷酸化STAT1的表达均被有效抑制,且细胞在照射后的存活分数显著下降.结论 肾透明细胞癌STAT1呈高表达,抑制STAT1对该细胞有放射增敏作用.     

Interpreting the improved outcome of patients with central nervous system metastases managed in clinical trials compared with standard hospital practice*

The aims were to determine the median survival and prognostic factors of patients with central nervous system (CNS) metastases managed with whole‐brain radiation therapy (WBRT), and to explore selection criteria in recently published clinical trials using aggressive interventions in CNS metastases. A retrospective audit was performed on patients managed with WBRT for CNS metastases. Potential prognostic factors were recorded and analysed for their association with survival duration. The proportion of patients with these factors was also compared with those of patients managed under three recently reported studies investigating aggressive interventions, such as radiosurgery and chemotherapy for CNS metastases. Seventy‐three patients were treated with WBRT for cerebral metastases over a 12‐month period. The median survival of the population was 3.4 months (95% confidence interval: 2.7–4.1), with 6‐ and 12‐month survival rates of 30 and 18%, respectively. Significant prognostic factors for prolonged median survival were Eastern Cooperative Oncology Group status 0–2 (P = 0.015), Medical Research Council neurological functional status 0–1 (P = 0.006), and Recursive Partitioning Analysis Class 2 versus Class 3 (P = 0.020). On multivariate analysis, younger patient age (P = 0.02) and better performance status (P < 0.01) were associated with improved outcome. When comparing these characteristics with selected published studies, our study cohort demonstrated a higher proportion of patients with poor performance status, a greater number of metastases per patient and a higher incidence of extracranial disease. This reflects the selected nature of patients in these published studies. Central nervous system metastases confer a poor prognosis and, for the majority of patients, aggressive interventions are unlikely to improve survival. The use of potentially toxic and expensive treatments should be reserved for those few in whom these studies have shown a potential benefit.     

p53 Codon 72 polymorphism predicts the pathologic response to neoadjuvant chemotherapy in patients with breast cancer.

PURPOSE: Recent studies have highlighted that the p53 codon 72 polymorphism plays a crucial role in modulating wild-type p53 apoptotic capacity, and as such may influence the response to chemotherapy. Thus, the purpose of this study was to investigate whether the p53 codon 72 polymorphism might influence pathologic response to neoadjuvant chemotherapy in primary breast cancer. EXPERIMENTAL DESIGN: One hundred and ten operable breast cancer patients received anthracycline-based neoadjuvant chemotherapy and p53 codon 72 polymorphism status was analyzed by PCR-RFLP. RESULTS: The distribution of initial clinical stage, tumor size, estrogen receptor or progesterone receptor status, menopausal status, or erbB2 expression was not significantly different among the polymorphic variants. However, we found that only 13% (3 of 23) of patients with the Pro/Pro variant had a good pathologic response, defined as a complete pathologic response or minimal residual disease. In comparison, 40% (22 of 55) or 37.5% (12 of 32) of patients with the Pro/Arg or Arg/Arg variant had a good pathologic response (P = 0.019). Moreover, patients with the Pro/Pro variant were more likely to have a positive axillary lymph node status than those with the Pro/Arg or Arg/Arg variant (P = 0.007). Furthermore, in multivariate analysis, p53 codon 72 polymorphism was found to be a strong predictor of pathologic response (odds ratio 6.7, 95% confidence interval, 1.4-31.2; P = 0.016). CONCLUSION: Our study indicates that breast cancer patients with the Pro/Pro variant may be less sensitive to anthracycline-based treatment than those with the Pro/Arg or Arg/Arg variant and suggests that analysis of p53 codon 72 polymorphism may provide a simple predictive marker for selecting the right breast cancer patients to anthracycline-based neoadjuvant chemotherapy in clinical setting.