肺鳞状细胞癌p53 过度表达与肿瘤生物学行为及预后的关系

目的：探讨肺鳞状细胞癌组织ｐ５３ 蛋白的过度表达与肿瘤生物学行为及预后的关系。方法：应用单克隆抗 ｐ５３ 抗体对石蜡包埋的肺癌组织标本进行免疫组织化学染色。结果：６８ 例获随访的肺鳞状细胞癌病例中有 ４４ 例 ｐ５３ 表达阳性,总阳性率为 ６４７％ ,且其阳性率随肿瘤病理分级、临床分期的增高而增加（ Ｐ＜ ００５）;与术后５ 年存活情况有关（ Ｐ＜ ００５）。结论：提示ｐ５３ 基因的异常表达在肺鳞状细胞癌的发展过程中起重要作用,对肺鳞状细胞癌病人的预后判定有一定意义。     

镍钛合金支架治疗食管良、恶性狭窄(附10例报道)

目的;研究镍钛合金支架在食管良,恶性狭窄治疗中的应用,方法;本组１０例患者,食管癌９例,贲门失弛缓症１例,均采用镍钛合金支架,在Ｘ线监视下,经口腔进行置入术。结果：全组支架均一次置入成功,支架入后,患者吞咽困难明显改善,总有效率为１００％,追踪观察,有３例食管癌患者,肿瘤分别突向支架腔内及支架上,下端生长,再次引起狭窄,其中１例又加置一个支架,使食管狭窄再次开通。结论：采用镍钛合金支架治疗食管良,     

Side effects during continuous epidural infusion of morphine and fentanyl

Respiratory effects, nausea, somnolence, and pruritus were compared during a 48-hr period of continuous epidural morphine (n = 34) and fentanyl (n = 32) infusion in 66 patients following elective total replacement of the hip or knee joint. Respiratory effects were assessed by PaCO2. Side effects were assessed by visual analogue scale and considered to be present when the score was above 30. Assessment was made at preoperative visits then 3, 6, 12, 24, 36, and 48 hr after the epidural injection. The bolus dose and subsequent infusion rate were 3,900 +/- 1,300 micrograms and 427 +/- 213 micrograms.hr-1 for morphine, and 85 +/- 46 micrograms and 56 +/- 27 micrograms.hr-1 for fentanyl. Pain relief was similar in both groups. In the morphine group, PaCO2 elevation and nausea occurred over a period of more than 12 hr (P less than 0.05). In the fentanyl group, there was no PaCO2 change, and nausea was confined to the first few hours. Nausea was more severe (P less than 0.01 at six hours and more frequent (24 hr cumulative incidence, 53 vs 28%, P less than 0.05) in the morphine group. Somnolence was prominent within several hours in two-thirds of patients in both groups. Somnolence continued to decline thereafter in the morphine group, but it was demonstrable in approximately half of the patients throughout the second day in the fentanyl group. The incidence was higher in the fentanyl group at the 48th hr (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

传染性非典型肺炎31例胸部X线影像表现

目的研究传染性非典型肺炎影像特点。为今后该病的诊断提供X线诊断依据。方法回顾性分析研究31例临床诊断为传染性非典型肺炎患者胸部X线检查结果。结果从发热到出现胸部X线异常影像平均为4.2d,从出现异常影像到极期(X线影像最重的1d)平均为6.4d,从极期到大部或基本吸收消散平均为8d。有28例双侧中、下肺野出现不同程度的阴影,占90.3%;有16例早期表现为雾状、磨砂玻璃样浅淡阴影,占51.6%;全部病例均为多叶、多节段受损,占100%;有12例遗留条索状、网格状、蜂窝状阴影,占38.7%。结论传染性非典型肺炎发病后数天内胸片可无异常改变;大多数患者肺损害为多叶,多节段;胸片影像表现四不象,呈多种肺部炎性疾病影像表现;胸片阴影多发部位在中下2/3肺野;一部分患者遗留肺纤维化;胸部CT检查可早期发现病灶。     

GPBB、cTnI、CK、CKMB在急性心肌梗死伴糖尿病早期诊断中的临床应用价值

分析心肌梗死伴糖尿病患者血清中糖原磷酸化酶同工酶BB(GPBB)、肌钙蛋白I (cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)水平的变化。结果显示糖尿病组、单纯急性心肌梗死组及急性心肌梗死伴糖尿病组患者血清中GPBB、cTnI、CK、CKMB、BNP及超敏C反应蛋白(Hs-CRP)水平明显升高(P<0.05),且急性心肌梗死伴糖尿病组患者与其他组相比差异均有显著性(P<0.05);与GPBB、cTnI、CK、CKMB单独检测相比,各项目联合检测急性心肌梗死伴糖尿病敏感度和特异性均明显升高(P<0.05)。因此, GPBB、cTnI、CK、CKMB联合检测在急性心肌梗死伴糖尿病早期诊断中具有重要的参考价值。     

Hepatic epithelioid hemangioendothelioma: Update on diagnosis and therapy

With an estimated incidence of only 1-2 cases in every 1 million people, hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and histiocyte-like vascular endothelial cells in mucus or a fibrotic matrix. HEHE is characterized as a low-to-moderate grade malignant tumor and is classified into three types: solitary, multiple, and diffuse. Both the etiology and characteristic clinical manifestations of HEHE are unclear. However, HEHE has a characteristic appearance on imaging including ultrasound, magnetic resonance imaging, and positron emission tomography/computerized tomography. Still, its diagnosis depends mainly on pathological findings, with immunohistochemical detection of endothelial markers cluster of differentiation 31 (CD31), CD34, CD10, vimentin, and factor VIII antigen as the basis of diagnosis. Hepatectomy and/or liver transplantation are the first choice for treatment, but various chemotherapeutic drugs are reportedly effective, providing a promising treatment option. In this review, we summarize the literature related to the diagnosis and treatment of HEHE, which provides future perspectives for the clinical management of HEHE.