经食管床高位食管胃机械吻合在食管癌手术中的应用

目的：探索用新术式治疗食管中、下段癌和部分上段癌的可行性。方法：本组全部经左胸第五肋间后外侧切口剖胸。用国产弯管形吻合器经食管床作食管胃端侧吻合。吻合部位在主动脉弓上、胸顶或颈根部(超胸顶)。在主动脉弓下折叠缝合胸胃小弯侧，使成直径4cm～5cm的管状。结果：本组共103例，有102例一次吻合成功。96例作主动脉弓上或胸顶吻合，7例作颈根部吻合。全组切缘均阴性，无吻合口瘘、狭窄及胃梗阻，无手术死亡。胸胃经食管床距离短，可最大限度的切除有癌灶的食管；吻合口和幽门区张力小，可减少吻合口瘘和幽门痉挛。胸胃在食管床内，可减少创面渗出，减轻对心肺压迫，减轻返流。由胸内游离颈根部食管，可减少喉返神经损伤的机会，不作颈部切口。结论：此术式融合了食管胃机械吻合、经食管床、缩小胸胃，经胸作颈根部吻合多个术式的优点，提高了患者生活质量，适用于大部分食管中、下段癌及部分胸上段癌患者。     

鼻腔鼻窦鳞状细胞癌组织中PCNA和EGFR的表达

目的　探讨增殖细胞核抗原 (PCNA )和表皮生长因子受体 (EGFR )在鼻腔鼻窦鳞状细胞癌组织中的表达 ,并分析其与临床病理特征的关系。方法　采用免疫组化方法 ,对 45例鼻腔鼻窦鳞癌组织进行PCNA和EGFR检测 ,并用 15例正常鼻黏膜作对照。结果　PCNA和EGFR在各级鼻腔鼻窦鳞癌组织中均有表达 ,与正常鼻黏膜比较有显著性差异 ,均有随鳞癌分级的升高而表达增强的趋势。PCNA、EGFR在鼻腔鼻窦鳞癌中的表达有显著的相关性。结论　PCNA和EGFR的表达均能反映鼻腔鼻窦鳞癌的增殖活性 ,表达强度可反映鳞癌细胞增殖活性的高低     

表皮生长因子受体和细胞外信号调节激酶的表达与舌鳞状细胞癌转移关系的观察

目的　了解表皮生长因子受体 (EGFR )和细胞外信号调节激酶 (ERK )在舌鳞状细胞癌中的表达 ,探讨EGFR和ERK与肿瘤增殖、转移的关系。方法　应用免疫组织化学SABC方法 ,分别对 90例舌鳞状细胞癌术后组织标本的EGFR、活化ERK 1/2和Ki 67进行检测 ,并对各因子间的表达关系进行统计分析。结果　在 90例舌鳞状细胞癌组织中 ,2 6例证实有颈部淋巴结转移 ,EGFR、活化ERK 1/2及Ki 67的阳性表达率分别为 93 .3 3 % ( 84/90 )、10 0 .0 0 % ( 90 /90 )和 10 0 .0 0 % ( 90 /90 ) ,阳性细胞分布和反应强度均以肿瘤深部边界区域最为明显 ,统计分析显示EGFR、活化ERK 1/2与肿瘤细胞增殖和肿瘤转移之间呈明显的正相关 (P <0 .0 1)。结论　EGFR、活化ERK 1/2在舌鳞状细胞癌细胞中多呈现过度表达与肿瘤的增殖、转移密切相关     

胰腺癌组织p57kip2和cyclin E蛋白表达及其临床意义

目的:探讨p57kip2蛋白和cyclin E(周期蛋白E)在胰腺癌发生发展中的作用.方法:采用免疫组化SP法,检测p57kip2和cyclin E蛋白在32例胰腺癌和癌旁胰腺组织中的表达.结果:p57kip2蛋白阳性表达率在胰腺癌组织中为46.9%,显著低于癌旁胰腺组织(x2=5.317,P＜0.05),并与胰腺癌组织分化程度有关(x2=4.979,P＜0.05),而与淋巴结转移无关(x2=3.698,P＞0.05);cyclin E蛋白阳性表达率在胰腺癌组织中为68.8%,显著高于癌旁胰腺组织(x2=4.036,P＜0.05),并与胰腺癌组织分化程度和淋巴结转移均有关(x2=5.128,x2=4.693,P＜0.05);p57kip2蛋白阳性表达组cyclinE蛋白阳性表达率低于p57kip2蛋白阴性表达组,但两者之间无相关性(γ=-0.112 11,P＞0.05).结论:p57kip2蛋白的低表达和/或cyclin E的高表达可能在胰腺癌发生发展中发挥重要作用.     

胃肠癌肝转移经肝动脉栓塞及皮下药盒持续灌注化疗的疗效初探

目的本研究观察经肝动脉栓塞化疗和(或)肝动脉插管持续灌注化疗治疗晚期胃肠癌肝转移的临床疗效.方法 22例无外科手术指征的晚期胃肠癌肝转移患者经肝动脉介入治疗共72次,单采取Seldinger法肝动脉内插管皮下埋置药盒持续灌注化疗48次,或先用吡柔比星(THP)60 mg/m2和DDP 50 mg/m2加入超液化碘油10～30 ml进行肝动脉栓塞化疗再联合肝动脉持续灌注化疗共24次.肝动脉插管灌注的方案:CF 200 mg/m2,d1,d14,静脉滴入;顺铂(DDP)50 mg/m2,d1,或用奥沙利铂100～130 mg/m2,d1,从皮下药盒处缓慢推入;5-Fu 2 000～2 500 mg/m2,d1,d14,装入美国百特公司的便携式输液泵持续动脉灌注48 h.结果总有效率(完全缓解 部分缓解)为59.0%.肿瘤负荷＜30%者的有效率为77.8%,明显高于肿瘤负荷＞30%者(46.2%,P＜0.005).本组患者主要不良反应为肝功能损害、发热及胃肠道反应等,经相应对症处理可缓解.结论经肝动脉栓塞及插管持续化疗是治疗胃肠癌肝转移的安全有效方法,值得临床推广.     

上皮性卵巢癌患者血清sICAM-1检测的意义

 目的　探讨血清可溶性细胞间粘着分子 1(sICAM 1)在上皮性卵巢癌中的临床意义。方法　利用ELISA法检测血清sICAM 1浓度。结果　卵巢上皮癌患者血清sICAM 1平均浓度和阳性率与良性卵巢瘤组和正常对照组相比有显著性差异 (P <0 .0 0 1) ;II～Ⅳ期显著高于临床Ⅰ期的患者 ;淋巴结转移阳性显著高于淋巴结转移阴性的患者 ;组织分化程度Ⅲ级者高于Ⅰ、Ⅱ级 (P <0 .0 1)。结论　血清sICAM 1检测可能有助于监测上皮性卵巢癌患者的病情和判断预后     

MAP2K4/MKK4 expression in pancreatic cancer: genetic validation of immunohistochemistry and relationship to disease course.

MKK4 (MAP2K4/SEK1) is a member of the mitogen-activated protein kinase family, originally identified as a kinase involved in the stress-activated protein kinase pathway by directly phosphorylating c-Jun NH2-terminal kinase. MKK4 genetic inactivation has been observed in a subset of pancreatic carcinomas, implicating deregulation of the stress-activated protein kinase pathway in pancreatic carcinogenesis. We evaluated Mkk4 protein expression patterns by immunohistochemical labeling in a series of 60 resected primary infiltrating pancreatic adenocarcinomas (24 cases with known MKK4 genetic status), and 14 different tissue arrays representing the primary carcinoma and all of the gross metastases from 26 patients that died of metastatic pancreatic cancer. Among the surgically resected carcinomas, focal or diffuse-positive immunolabeling for Mkk4 protein was found in 52 of 60 cases (86.7%). Among the eight carcinomas with negative Mkk4 immunolabeling, three harbored a homozygous deletion or intragenic mutation of the MKK4 gene, in contrast to none of the 52 cases with positive Mkk4 immunolabeling (P < 0.01). Loss of Mkk4 immunolabeling showed a trend toward shorter survival, with Mkk4-positive carcinomas having half the risk of death than Mkk4-negative carcinomas (P = 0.09). Mkk4 immunolabeling patterns were also evaluated among unresectable primary and metastatic cancer tissues from autopsy specimens, indicating intact Mkk4 immunolabeling in 88.8% of the unresectable primary carcinomas as compared with 63.3% of distant metastases (P < 0.001). Our data indicate that the loss of Mkk4 protein expression in pancreatic carcinomas may be more frequent than suggested by the rates of genetic inactivation alone and that MKK4 loss may contribute to disease progression. The correlation of MKK4 genetic status with immunolabeling patterns validate this approach for the evaluation of MKK4 status in routine histologic sections and may provide useful information regarding patient prognosis.     

抗膀胱癌免疫毒素BDI-1-PEA特异杀伤肿瘤细胞的研究

新近利用抗原处理细胞(APC细胞)处理制备瘤疫效疗较为肯定,认为天然免疫细胞DC细胞瘤疫更有其应用价值.红细胞也是天然免疫细胞.能否用红细胞处理补体调理过的肿瘤细胞制备瘤苗是值得探讨的.有的学者认为红细胞是T细胞活性的调节器,我们的实验有可能为此提供的依据[Arosa FA, Currpharm Des, 2004, 10(27): 191].     

Prostatosis treated with acupuncture and herbal medicine

According to differentiation of symptoms and signs, prostatosis was divided into pattern of dampness and heat in the lower energizer, pattern of qi stagnation and blood stasis, pattern of deficiency and cold in the lower abdomen, and pattern of qi deficiency and kidney deficiency. Prostatosis were treated mainly by acupuncture, plus moxibustion and Chinese medicine, and the effect was good. Author: Zhao Chang-quan (1949-), male, junior consultant doctor Translator: Huang Guo-qi     

Clinical observation of vascular dementia treated by surrounding-acupuncture of the CT-located area

Purpose To observe the clinical effect of “Surrounding Needling Technigue through CT Location” in treating vascular dementia.Method Fifty cases of vascular dementia were randomly divided into surrounding Needling Technigue through CT location and routine acupuncture groups, 25 cases in each group, and were given surrounding Needling Technigue through CT location and routine acupuncture respectively.Results The effective rates in surrounding Needling Technigue through CT location and routine acupuncture groups were 88% and 60% respectively, and there was significant difference between the two groups,P<0.01.Conclusion Therapeutic effect of surrounding Needling Technigue through CT location in treating vascular dementia was satisfactory, and better than that of routine acupuncture. Foundation Item: Scientific Fundation of Guangdong TCM Bureau Author: Lun Xin(1964-), male, associate professor