椎管内海绵状血管瘤的显微外科治疗——26例临床分析

背景与目的：随着MRI检查的普及，椎管内海绵状血管瘤的诊断变得相对简单。因椎管内海绵状血管瘤以髓内型最多见．显微外科治疗甚为关键。本研究旨在探讨椎管内海绵状血管瘤的临床特点和显微手术治疗效果。方法：2000年1月至2005年4月间北京天坛医院神经外科治疗椎管内海绵状血管瘤26例，均行MRI检查，全组均经后正中直入路显微手术治疗。结果：26例病灶均为单发，均经手术切除。其中23例全部切除，2例近全切除，1例大部切除。所有病例术后均经病理证实为海绵状血管瘤。术后神经功能状况改善20例，无变化5例．恶化变差1例。全组无手术死亡。结论：显微手术切除椎管内海绵状血管瘤是本病的首选治疗方法，全切除病灶可避免病变复发和再出血。术中精细的显微操作是手术成功的关键，术前症状轻和病灶处理及时与术后恢复良好相关。     

核转录因子-κB在胰腺癌中的表达及其与上皮细胞间质转化的关系

 Objective　To investigate the expression of NF-κB and epithelial-mesenchymal transition(EMT) related markers E-cadherin and Vimentin proteins in human pancreatic cancer tissues and its relation with the malignant features． Methods　The expression of NF-κB、E-cadherin and Vimentin proteins in 62 cases of pancreatic cancer tissues were detected by using immunohistochemistry and compared with the clinicopathological data of pancreatic cancer. Results　The positive expression rate of NF-κB was 81 ％ (50/62), Vimentin protein increased of expression was 61 ％ (38/62), and E-cadherin protein loss of expression was 55 ％ (34/62) in pancreatic cancer. The positive expression rate of NF-κB was significantly related with the lymph node metastasis (χ2=11.761, P ＜0.05), distant metastasis(χ2＝9.225, P ＜0.05), the absent expression of epithelial marker E-cadherin protein (r =0．352, P <0．05) and the positive expression of mesenchymal marker Vimentin protein (r =0．343, P <0．05), but there was no relation with the patients gender, age, tumor location, tumor type and tumor differentiation (P ＞0．05)． In addition, the significant correlation of E-cadherin expression loss and Vimentin expression with tumor lymph node metastasis and distant metastasis was found (χ2＝6.914, 4.984, 7.753, 5.144, P <0.05). Conclusion　The overexpression of NF-κB in pancreatic cancer may accelerate invasion and metastasis of pancreatic cancer through inducing EMT．     

甲基丙烯酸环氧丙酯致人支气管上皮细胞恶性转化相关DNA修复基因表达改变的研究

目的：检测甲基丙烯酸环氧丙酯（glycidyl methacrylate,GMA）致人支气管上皮细胞（16HBE）恶性转化相关DNA修复基因表达改变的情况,以探讨GMA致细胞癌变的机制。方法：采用＂基因组稳定和DNA修复基因芯片＂分析检测GMA诱导16HBE细胞恶性转化过程中,经鉴定具备恶性细胞表型特征的第30代转化细胞DNA修复基因表达的改变。结果：GMA转化第30代细胞与同代龄对照细胞比较,在113个基因中有8个基因的表达有显著差异,其中7个基因表达上调（ratio〉2）,分别是NBN、RAD50、RAD51、OGG1、XAB2、TOP3A、TNKS;NEIL2基因表达下调（0〈ratio〈0.5）。结论：GMA致16HBE细胞恶性转化是一个多基因参与涉及多通路的复杂过程,DNA修复基因表达的改变可能是该过程中重要的分子事件。     

基于Hilbert曲线的数字图像置乱方法研究

研究了基于Hilbert曲线的数字图像置乱方法 ,引入二个概念 :“重合度”和“Hilbert曲线的平移” ,利用Hilbert曲线平移 ,获得了更多新的置乱路径 ,并根据重合度变化图探讨了置乱变换的规律 ,以测试置乱变换的周期和拟周期。然后把基于Hilbert曲线的置乱方法推广到任意大小的图像。实验结果表明 :利用Hilbert路径进行置乱不仅具有非常大的置乱路径选择空间 ,而且具有很好的置乱效果和极大的置乱周期 ,具有较大的实用性。     

颅内肿瘤术前颈外动脉栓塞术

报告2例颅内巨大型脑膜瘤和1例海绵状血管瘤,因肿瘤血供丰富,并有明显的颈外动脉供血,使手术切除困难。术前采用经股动脉插管颈外动脉栓塞术,有效的减少了肿瘤切除手术中出血,使肿瘤得以彻底切除。对栓塞适应症、栓塞技术和方法、并发症预防做了探讨。     

四甲基偶氮唑盐比色法测定白细胞介素-2活性及淋巴细胞增殖反应

用改良MTT(四甲基偶氮唑盐)比色法检测白细胞介素-2(IL-2)活性和淋巴细胞转化反应,并与~3H-dT掺入法相比较。结果表明,改良MTT比色法具有简单、快速、敏感的优点,不仅适用于检测IL-2,同时也可用于淋巴细胞转换试验。在与~3H-dT掺入法平行试验时发现,两者平行相关(相关系数均>0.90)。本法无需接触同位素,便于推广应用。     

1023中药合剂对口腔癌前病变的治疗和阻癌作用的临床研究

目的：探讨1023对口腔白班（OLK）、口腔扁平苔藓（OLP）和盘状红斑狼疮（DLE）等癌前病变的治疗作用和阻断癌变的作用。方法：将1023合剂用于48例OLK、139例OLP和38例DLE，并设对照组，实验组和对照组均接受相同的常规治疗。结果：1023对OLK和OLP治疗有明显的效果，其有效率明显高于对照组（P＜0．05），而OLK的癌变率明显低于对照组（P＜0．05）。结论：1023合剂对OLK和OKP均有治疗作用，对OLK有阻止癌变的作用。     

MYD88 wild‐type Waldenstrom Macroglobulinaemia: differential diagnosis,risk of histological transformation,and overall survival

MYD88 mutations are present in 95% of Waldenstrom Macroglobulinaemia (WM) patients, and support diagnostic discrimination from other IgM‐secreting B‐cell malignancies. Diagnostic discrimination can be difficult among suspected wild‐type MYD88 (MYD88^WT) WM cases. We systematically reviewed the clinical, pathological and laboratory studies for 64 suspected MYD88^WT WM patients. World Health Organization and WM consensus guidelines were used to establish clinicopathological diagnosis. Up to 30% of suspected MYD88^WT WM cases had an alternative clinicopathological diagnosis, including IgM multiple myeloma. The estimated 10‐year survival was 73% (95% confidence interval [CI] 52–86%) for MYD88^WT versus 90% (95% CI 82–95%) for mutated (MYD88^MUT) WM patients (Log‐rank P < 0·001). Multivariate analysis only showed MYD88 mutation status (P < 0·001) as a significant determinant for overall survival. Diffuse large B‐cell lymphoma (DLBCL) was diagnosed in 7 (15·2%) and 2 (0·76%) of MYD88^WT and MYD88^MUT patients, respectively (Odds ratio 23·3; 95% CI 4·2–233·8; P < 0·001). Overall survival was shorter among MYD88^WT patients with an associated DLBCL event (Log‐rank P = 0·08). The findings show that among suspected MYD88^WT WM cases, an alternative clinicopathological diagnosis is common and can impact clinical care. WM patients with MYD88^WT disease have a high incidence of associated DLBCL events and significantly shorter survival versus those with MYD88^MUT disease.