多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值

目的　研究多种肿瘤标志物蛋白芯片检测系统对肺癌的诊断价值。方法　用该检测系统测定10 8例肺癌患者、48例肺良性病变患者和 14 5例正常人血清中 12种肿瘤标志物 (CA199,NSE ,CEA ,CA2 42 ,CA12 5 ,CA15 3 ,AFP ,ferritin ,free PSA ,PSA ,β HCG及HGH)的水平。 结果　肺癌组的芯片阳性率为 83 .3 3 %( 90 / 10 8) ,显著高于肺良性病变组 ( 5 2 .0 8% ,2 5 / 48)和健康组 ( 2 8.97% ,42 / 14 5 ) (P <0 .0 0 1) ;肺癌不同分期组间阳性率存在显著性差异 ,以Ⅳ期肺癌组阳性率最高 (P =0 .0 48) ,但不同病理类型肺癌组间无显著性差异(P =0 .5 19) ;不同分期之间CA199、CEA以及CA2 42血清水平存在显著性差异 (P =0 .0 41,P =0 .0 18和P =0 .0 0 2 ) ;CEA阳性率以腺癌组最高 ,与其它组织学类型肺癌比较无显著性差异 (P =0 .0 7) ;NSE阳性率以小细胞肺癌组最高 (P <0 .0 0 1) ;联合检测在提高诊断敏感性的同时 (P <0 .0 0 1) ,特异性有所下降 (P <0 .0 0 1)。结论　运用蛋白芯片联合检测多种血清肿瘤标志物可明显提高肺癌诊断的敏感性 ,同时对于确定其临床分期 ,鉴别病理类型以及监测疗效均有一定的意义。由于该法特异性及阳性预测值偏低 ,更适合于无明显症状的门诊患者和肺癌高危人群的筛查。     

Bicalutamide monotherapy versus leuprolide monotherapy for prostate cancer: effects on bone mineral density and body composition.

PURPOSE: Gonadotropin-releasing hormone agonists decrease bone mineral density, lean mass, and muscle size and increase fat mass in men with prostate cancer. Less is known about the effects of bicalutamide monotherapy on bone mineral density and body composition. PATIENTS AND METHODS: In a 12-month, open-label study, we randomly assigned 52 men with prostate cancer and no bone metastases to receive either leuprolide or bicalutamide (150 mg by mouth daily). Bone mineral density and body composition were measured by dual energy x-ray absorptiometry and quantitative computed tomography. RESULTS: Mean (+/- standard error) bone mineral density of the posterior-anterior lumbar spine decreased by 2.5% +/- 0.5% in the leuprolide group and increased by 2.5 +/- 0.5 in the bicalutamide group from baseline to 12 months (P <.001). Mean changes in bone mineral density of the total body, total hip, femoral neck, and trabecular bone of the lumbar spine also differed significantly between groups (P < or =.003 for each comparison). Fat mass increased by 11.1% +/- 1.3% in the leuprolide group and by 6.4% +/- 1.1% in the bicalutamide group (P =.01). Changes in lean mass, muscle size, and muscle strength were similar between the groups. Breast tenderness and enlargement were more common in the bicalutamide group than in the leuprolide group. Fatigue, loss of sexual interest, and vasomotor flushing were less common in the bicalutamide group than in the leuprolide group. CONCLUSION: In men with prostate cancer, bicalutamide monotherapy increases bone mineral density, lessens fat accumulation, and has fewer bothersome side effects than treatment with a gonadotropin-releasing hormone agonist.     

异丙酚的剂量与镇静和呼吸抑制作用之间的关系

研究不同剂量的异丙酚的量效关系。方法:选择50例甲状腺腺瘤切除病人,随机分为5组,Ⅰ组,0.5mg/kg、Ⅱ组0.75mg/kg、Ⅲ组1.0mg/kg、Ⅳ组1.5mg/kg、V组2.0mg/kg.采用Star呼吸机监测呼吸功能指标,同时观察其神志变化,应用Probit法分析该药量效关系。结果:Ⅱ、IV、V组随着剂量增加,潮气量降低的幅度和呼吸抑制持续时间明显增加,以给药后1～3分钟潮气量减少最为明显(P<0.01),浅睡状态ED_(50)为0.98mg/kg.深睡状态ED_(50)为1.26mg/kg,呼吸抑制ED_(50)为1.1mg/kg。结论:静注0.8～1mg/kg异丙酚可以产生适用于非全麻病人的镇静、催眠作用,而对呼吸抑制的作用较小。     

Direct angioplasty of totally occluded left main coronary artery in acute myocardial infarction complicated by cardiogenic shock: report of two cases and literature review

Acute total occlusion of the left main coronary artery is usually characterized by a rapid course of deterioration that challenges therapeutic intervention. Unlike subtotal occlusion of the left main coronary artery, acute total occlusion of the left main coronary artery is extremely rare and has a grave prognosis. Most patients with this problem die suddenly or go into cardiogenic shock. Direct percutaneous transluminal coronary angioplasty (PTCA) was performed on 2 patients, both suffering from cardiogenic shock due to acute total occlusion of the left main coronary artery. Both patients underwent coronary artery bypass surgery subsequently. One patient, who had substantial intercoronary collaterals, remained asymptomatic at 31 months of follow-up. The other, who had no intercoronary collateral circulation, expired 3 days after coronary artery bypass surgery. We conclude that direct PTCA to the acutely occluded unprotected left main coronary artery in cardiogenic shock patients is a potentially life-saving procedure, and the presence or absence of collaterals from the dominant right coronary artery will influence the clinical outcome.     

Sequential production and activation of matrix-metalloproteinase-9 (MMP-9) with breast cancer progression

The degradation of the basement membrane by matrix-metalloproteinase(MMP) and serine protease is a critical pointin tumor invasion and metastasis. We measured theactivity of MMP-9 from 28 normal, 12 benignand 126 breast cancer tissues using gelatin zymographywith an image analysis system. ProMMP-9 was expressedin 17.5% of the cancer patients compared to2.5% in 40 non-cancerous tissues (p=0.014).The mature form of MMP-9 (82 kD) wasexpressed only in T2–T4 stages. During the earlyphase of breast cancer (DCIS and T1 stage)progression, only production of proMMP-9 increased. However, asthe cancer grew or invaded skin (T2–T4), orwith lymphovascular permeation, both production and activation ofMMP-9 increased. In conclusion, proMMP-9 production was themain cause of increased MMP-9 activity during theearly phase, while both production and activation increasedin the late phase of breast cancer.     

CA19-9在胃肠肿瘤组织中的测定及其意义

采用固相放射免疫分析法在２４例胃癌和１２例结直肠癌患者的肿瘤组织抽提液中测定糖链抗原ＣＡ１９－９含量。结果显示癌组织中ＣＡ１９－９的平均水平显著高于正常组织（Ｐ＜０．０１）；３６例肿瘤患者有３１例（８６％）癌组织中的ＣＡ１９－９含量明显高于对应的正常组织；瘤体较大的癌组织中ＣＡ１９－９水平与瘤体小的相比差别具有统计学意义（Ｐ＜０．０１）；ＣＡ１９－９水平与淋巴结转移状况和组织学类型无相关性，提示胃肠肿瘤细胞合成ＣＡ１９－９增加，该指标对判断胃肠恶性组织可能具有一定的价值。     

卡培他滨联合沙利度胺治疗晚期结直肠癌39例

[目的]观察卡培他滨(希罗达)联合沙利度胺对晚期结直肠癌的作用.[方法]对我院39例晚期结直肠癌采用希罗达联合沙利度胺应用治疗.希罗达1250mg/m2,每天2次,口服1～14天;沙利度胺100mg,口服1～21天.28天为一个化疗周期,4个周期为一个疗程,完成一个疗程后30天评价疗效,按照WHO实体瘤近期客观疗效评定标准进行评价.[结果]39例病例中3例因药物不良反应未服完1个疗程即中断治疗.36例可评价病例中,CR 3例(8.33%),PR 14例(38.88%),NC¨例(30.56%),PD8例(22.22%),总有效率47.22%.毒性反应主要为神经毒性、便秘和手足综合征.[结论]希罗达联合沙利度胺治疗晚期结直肠癌疗效肯定,安全性较好.     

中医药院校信息技术课程教学改革的思考

自20世纪70年代末,我国就开展了高校计算机教育.近几年,由于计算机和网络应用知识普及速度的加快,加之中小学均已开设了相应的信息技术课程,因而新一代大学生的信息技术掌握程度起点逐渐提高,原有的为非计算机专业设置的"计算机应用基础"课程已不能适应形势的发展.为此,有必要对高校的计算机基础教育进行改革.     

人谷胱甘肽硫转移酶A1原核表达系统的构建及高效表达

目的　对人谷胱甘肽硫转移酶A1(GSTA1)原核表达系统的构建及高效表达。方法　采用RT -PCR方法将肝组织中提取总RNA扩增人GSTA1基因的cDNA序列 ,将其插入到原核表达载体pET30a多克隆位点中 ,构建重组表达质粒 ,并用PCR扩增、酶切分析及序列测定等方法对重组质粒进行鉴定 ,并进行了高效表达。结果　人GSTA1克隆到原核表达载体pET30a多克隆位点中 ,测序结果同GenbankGSTA1(GI:2 2 0 914 5 3)cDNA序列相比较 ,在 5 12位点T→C ,氨基酸由Met→Thr,同源性为 99% ,基因登陆号为AY5 32 92 8。通过IPTG诱导表达 ,在 34.4KDa处 1、2、3、4小时的表达量分别为 4 1.8%、6 8%、6 8.3%、83%。结论　经Westernblot分析 ,证实GSTA1基因在原核表达系统中有蛋白质表达     

性病艾滋病恐惧症110例心理咨询情况

目的:了解性病艾滋病恐惧症形成原因,寻找预防控制的措施.方法:对110例性病艾滋病恐惧症患者的临床症状和全身不适进行分析.结果:绝大多数患者都有不洁性交史,占82%,发病与患者的文化程度、心理因素和医学误导有关.结论:目前应加强对性病艾滋病恐惧症的预防、加强对性病艾滋病知识的宣传教育和心理疏导.