CT引导放射性~(125)Ⅰ粒子组织间植入治疗复发直肠癌的疗效观察

目的探讨CT引导下放射性~(125)Ⅰ粒子组织间植入治疗复发直肠癌的技术可行性、疗效和副反应。方法23例直肠癌术后复发患者行CT引导下~(125)Ⅰ粒子植入术,其中3例行2次粒子植入。20例手术采用硬膜外麻醉,3例局部麻醉。20例腹卧位,3例仰卧位。术前通过治疗计划系统行三维治疗计划,确定粒子数目、空间分布和粒子针数目。既往放疗者肿瘤匹配周边剂量为90～120 Gy,未行放疗者为140～160 Gy。治疗PTV为CTV外加1 cm。粒子活度18．5～25．9MBq(0．5～0．7mCi)。植入粒子33～137颗,术后即刻行CT扫描进行质量验证。术后1周3例患者加三维适形放疗,2～3 Gy/次,总剂量45～50 Gy。每3个月复查1次CT。结果随访3～28个月。术后平均7 d疼痛缓解,其中完全缓解12/15,部分缓解2/15,无变化1/15,总有效率为93%。肿瘤局部控制率为87%。中位生存时间14个月,1、2年生存率分别为93%和50%。4例全身合并全身转移,2例8个月和12个月时死于肺转移。无治疗相关严重并发症发生。结论CT引导放射性~(125)Ⅰ粒子植入治疗复发直肠癌具有安全、微创、并发症率低和疗效肯定等优势,疗后配合外放疗和全身化疗有望进一步提高疗效。     

氧化新喹对O_S-732细胞系的杀伤作用及超微结构的电镜观察

本文介绍氧化新喹对O_s-732细胞系的体外实脸结果,并以扫描及透射电镜的细胞计量学测算超微结构变化及意义的探讨。当药物浓度达30μg/ml时,对细胞毒性显著,细胞在48小时相继死亡。扫描电镜观察,药物达0.5μg/ml时肿瘤细胞微绒毛大部消失,5～20μg/ml则细胞皱缩碎裂成不规则团块。透射电镜见到核质溶解、线粒体水肿、嵴消失,脆质溶解成空泡、溶酶体增多自溶灭亡。细胞计量学测算溶酶体增大3.3倍导致自溶为本品抑瘤杀伤机理。     

卵巢恶性肿瘤DNA倍体及其异质性的临床预后意义

目的 探讨卵巢恶性肿瘤DNA倍体、异倍体和异质性与临床预后的关系。方法 应用FCM流式细胞术，对20例卵巢恶性肿瘤、20例卵巢良性肿瘤、10例正常卵巢组织进行了DNA倍体、异倍体和异质性的检测，并分析其与临床预后的关系。结果 卵巢恶性肿瘤DNA异倍体、异质性的患者术后肿瘤复发率、死亡率明显高于卵巢恶性肿瘤DNA二倍体、同质性患者（P＜0．01）。卵巢恶性肿瘤DNA二倍体、同质性患者术后无瘤生存期明显长于卵巢恶性肿瘤DNA异倍体、异质性的患者（P＜0．01）。结论 卵巢恶性肿瘤DNA倍体、异倍体和异质性的测定是判断患者预后的良好指标。     

银染RNA AP-PCR差示法克隆人胃癌转移相关基因

目的:以改进的银染RNAAP-PCR法分析原发性及转移性胃癌标本,鉴定和克隆胃癌转移相关基因。方法:以原发及转移灶胃癌标本总RNA为研究对象,首先以T12MN“锚定”引物进行逆转录合成cDNA第一链,再以10核苷酸任意引物进行PCR扩增,5%非变性聚丙烯酰胺凝胶电泳分离扩增产物后银染显示并回收差异条带,经RNA点杂交验证、克隆测序后进入GenBank数据库检验同源性。结果:经银染RNAAP-PCR法分析,获得系列差异表达片段。对其中MGA1(662bp)和PGA1(589bp)两个片段进行验证和测序,结果显示,MGA1与胃癌转移相关,并与编码人巨噬细胞集落刺激因子受体(macrophagecolony-stimulatingfactorreceptor,CSF-1R)的原癌基因c-fms100%同源;而PGA1则属胃癌转移抑制基因,与编码肿瘤转移抑制基因KAI-1完全同源。结论:银染RNAAP-PCR法适用于分析和克隆差异表达基因,具有快速、直观、假阳性率低等优点;提示CSF-1R及KAI-1与胃癌转移表型相关,为进一步研究CSF-1R功能提供了新的线索。     

转染LCRG1基因的喉癌细胞差异蛋白质分析

背景与目的:LCRG1基因是我室利用mRNA差异显示技术克隆的一个喉癌相关抑癌基因。先前的研究显示将LCRG1转染喉癌细胞系Hep-2,发现其具有抑制细胞增殖、软琼脂集落形成及裸鼠成瘤能力的作用。本研究旨在利用比较蛋白质组学的方法筛选LCRG1抑瘤作用相关的蛋白质。方法:抽提稳定高表达LCRG1基因的Hep-2/LCRG1和载体对照组Hep-2/pcDNA3.1( )的细胞总蛋白,采用双向凝胶电泳技术分别分离其总蛋白。考马斯亮蓝染色显色,PDQuest图像分析系统分析获取的2-D胶图像,从胶中选取差异表达的蛋白质点,进行基质辅助激光解吸电离飞行时间质谱或电喷雾-四极杆-飞行时间串联质谱分析,最后Mascot软件搜索数据库初步鉴定蛋白质。结果:获得了重复性和分辨率较好的Hep-2/LCRG1和Hep-2/pcDNA3.1( )细胞系的双向凝胶电泳图谱,总蛋白质点数分别为1075±43和1027±23,平均匹配率为91%。图像分析差异蛋白质点,质谱鉴定了20个差异表达的蛋白质点,其中MALDI-TOF-MS鉴定了16个,ESI-Q-TOFMS/MS鉴定了4个。对这些初步鉴定的差异蛋白质进行功能分析,发现一些与细胞代谢、转录调控相关的蛋白质。结论:建立了稳定高表达LCRG1基因的Hep-2/LCRG1和载体对照组Hep-2/pcDNA3.1( )细胞系的双向凝胶电泳图谱,应用质谱技术识别并鉴定出一些与LCRG1抑瘤作用相关的差异表达蛋白质,为进一步研究LCRG1作用的分子机制提供新的线索。     

HBV/HCV相关性肝细胞癌抗病毒治疗专家建议

乙型肝炎病毒(hepatitis B virus,HBV)和丙型肝炎病毒(hepatitis C virus,HCV)感染在肝细胞癌(hepatocellular carcinoma,HCC)的发生和发展中起着重要作用.中国近年发布的《慢性乙型肝炎防治指南(2010版)》和《原发性肝癌诊疗规范(2011版)》都强调了肝癌患者抗病毒治疗的重要性,但未对此作深入而具体的阐述.《丙型肝炎防治指南(2004版)》也注意到抗病毒治疗可延缓HCC的发生.有鉴于此,中华医学会肝病学分会肝癌学组召开了3次专题讨论会,系统收集并分析了现有的关于HCC综合治疗中抗病毒治疗的临床研究文献,回顾了HCC治疗中抗病毒药物临床应用的进展,依据现有的病毒相关性HCC抗病毒治疗的循证医学临床资料,综合部分专家的意见,按照循证医学证据分级GRADE系统(表1)进行细化和补充,针对这些患者抗病毒治疗的应用,最终提出《HBV/HCV相关性肝细胞癌抗病毒治疗专家建议》(表     

Exposure to power frequency electric fields and the risk of childhood cancer in the UK

The United Kingdom Childhood Cancer Study, a population-based case-control study covering the whole of Great Britain, incorporated a pilot study measuring electric fields. Measurements were made in the homes of 473 children who were diagnosed with a malignant neoplasm between 1992 and 1996 and who were aged 0-14 at diagnosis, together with 453 controls matched on age, sex and geographical location. Exposure assessments comprised resultant spot measurements in the child's bedroom and the family living-room. Temporal stability of bedroom fields was investigated through continuous logging of the 48-h vertical component at the child's bedside supported by repeat spot measurements. The principal exposure metric used was the mean of the pillow and bed centre measurements. For the 273 cases and 276 controls with fully validated measures, comparing those with a measured electric field exposure >/=20 V m(-1) to those in a reference category of exposure <10 V m(-1), odds ratios of 1.31 (95% confidence interval 0.68-2.54) for acute lymphoblastic leukaemia, 1.32 (95% confidence interval 0.73-2.39) for total leukaemia, 2.12 (95% confidence interval 0.78-5.78) for central nervous system cancers and 1.26 (95% confidence interval 0.77-2.07) for all malignancies were obtained. When considering the 426 cases and 419 controls with no invalid measures, the corresponding odds ratios were 0.86 (95% confidence interval 0.49-1.51) for acute lymphoblastic leukaemia, 0.93 (95% confidence interval 0.56-1.54) for total leukaemia, 1.43 (95% confidence interval 0.68-3.02) for central nervous system cancers and 0.90 (95% confidence interval 0.59-1.35) for all malignancies. With exposure modelled as a continuous variable, odds ratios for an increase in the principal metric of 10 V m(-1) were close to unity for all disease categories, never differing significantly from one.     

Knowledge and Practices of Digestive Surgeons concerning Specialized Nutritional Support in Cancer Patients: A Survey Study

A survey study based on a 21-item questionnaire was conducted to assess knowledge and practices of digestive surgeons focused on nutritional support in gastrointestinal cancer patients. At least 5 staff digestive surgeons from 25 tertiary care hospitals throughout Spain were invited to participate and 116 accepted. Malnutrition was correctly defined by 81.9% of participants. In patients undergoing major abdominal surgery, 55.2% considered that preoperative nutritional support is indicated in all patients with malnutrition for a period of 7–14 days. For the diagnosis of malnutrition, only 18.1% of participants selected unintentional weight loss together with a fasting or semi-fasting period of more than one week. Regarding the advantages of enteral infusion, 93.7% of participants considered preservation of the integrity of the intestinal mucosa and barrier function, and in relation to peripheral parenteral nutrition, 86.2% selected the definition of nutrient infusion through a peripheral vein and 81.9% its indication for less than 7 days. Digestive surgeons had a limited knowledge of basic aspects of clinical nutrition in cancer patients, but there was some variability regarding clinical practice in individual cases. These findings indicate the need to develop standardized clinical protocols as well as a national consensus on nutrition support in cancer patients.     

HPLC法测定阿归养血颗粒中芍药苷含量

目的:建立阿归养血颗粒中芍药苷的含量测定方法。方法:采用高效液相法测定阿归养血颗粒中芍药苷含量,色谱柱:Diamonsil C1(8 4.6 mm×250 mm,5μm);流动相:乙腈-0.05%磷酸(16∶84);检测波长:230 nm;流速:1 mL/min。结果:芍药苷在92.5-740 ng范围内线性关系良好,平均回收率为99.32%。结论:该方法简便可行、重复性好,可作为阿归养血颗粒质量评价的依据。     

银杏叶聚戊烯醇抗癌作用的初步研究

目的 :研究银杏叶 (FoliumGinkgo)提取物—聚戊烯醇 (PolyprenolsGP 1 )的抗肿瘤作用。方法 :采用动物抗移植性肿瘤实验方法。结果 :1 0 0mg/kg的聚戊烯醇对移植性肝癌Heps和肉瘤S1 80 的实验抑制率分别为 49 1 3 %和 46 53% ,40 0mg/kg的聚戊烯醇对艾氏癌EC抑制率为 49 65 % (P <0 0 1 )。银杏叶聚戊烯醇对艾氏腹水癌EAC小鼠无明显延长寿命作用。结论 :银杏叶聚戊烯醇有良好的抗肿瘤作用 ,应进行深入研究