前列腺体积与前列腺特异抗原及抗原密度关系的多元回归研究

对１００例前列腺增生患者的前列腺体积，年龄，血清前列腺特异抗原，抗原密度进行多元回归与相关分析。结果；年龄和前列腺体积与血清ＰＳＡ浓度显著相关，其中，体积与ＰＳＡ之间的年龄与体积之间具有相关性、而年龄与ＰＳＡ之间无相关性，体积每增加１０ｃｍ＾３，ＰＳＡ增高０．９μｇ／Ｌ。     

HBV DNA及HBxDNA亚片段在肝癌细胞内的整合及作用

为探讨ＨＢＶＤＮＡ及其亚基因片段ＨＢｘＤＮ在肝细胞肝癌（ＨＣＣ）中整合特点用机制，制备了地高辛标记的３．２ｋｂＨＢＶＤＮＡ全基因及０．５９ｋｂＨＢＶＤＮＡ／ＢａｍＨＩ，ＢｇｌⅡＢＨｘＤＮＡ亚基因探针。点杂交、原位杂交及Ｓｏｕｔｈｅｒｎ杂交检测ＨＢＶＤＮＡ的存在情况，筛选ＨＢＶＤＮＡ纯整合标本，以ＨＢｘＤＮＡ探针检测ＨＢｘＤＮＡ在ＨＣＣ染色体的整合。结果显示ＨＢＶＤＮＡ在肝细胞内以核型为主（７０％）     

乌苯美司的药物动力学及对实验性肿瘤转移的治疗作用

目的：探讨乌苯美司对小鼠药物动力学及与实验性肿瘤转移治疗活性间的关系。方法：用放射免疫法测定小鼠在不同给药途径下的乌苯美司血清药物动力学及观察乌苯美司对黑色素瘤肺转移模型的治疗活性。结果：乌苯美司ｉｖ的Ｔ１２较短，初始血药浓度较高。ｉｖ和ｉｍ给药后的曲线下面积较大；ｐｏ及ｉｐ则较小。不同给药途径对实验性肿瘤转移均有治疗作用。结论：乌苯美司的血清Ｔ１２较短，其治疗活性取决于冲击和高剂量的给药方式。     

Solitary necrotic nodule of the liver: A riddle that is difficult to answer

Solitary necrotic nodule of the liver is an unusual lesion that is often an incidental finding on abdominal imaging, intraoperative examination, or post mortem. Most reported cases of solitary necrotic nodule have been in males, and over three quarters of these lesions have occurred in the right lobe of the liver. Pathologically, solitary necrotic nodule is a benign lesion characterized by a completely necrotic core that is often partly calcified, surrounded by a dense hyalinized fibrous capsule containing elastin fibres. The ultrasound appearance of solitary necrotic nodule is usually of a “target” lesion with a hyperechoic center, while on CT scan they appear as non-enhancing hypodense lesions that are typical of metastatic adenocarcinoma or peripheral cholangiocarcinoma. The impression of malignancy is further enforced with the finding of necrotic cellular material on biopsy and the macroscopically hard and “gritty” nature of the nodules. Currently, permanent histopathology of solitary necrotic nodules is the only accurate method of diagnosis. However, solitary necrotic nodules are usually of a bilobed or lobulated shape that is unusual for malignant liver lesions, and they often lie in close proximity to hepatic inflow structures. Solitary necrotic nodule should be suspected in liver lesions with this configuration, location, and on a biopsy showing a large amount of necrosis.     

原发性食管癌中胸苷磷酸化酶表达和血管生成的临床意义

目的　观察原发性食管癌中胸苷磷酸化酶 (thymidinephosphorylase,TP)的表达情况 ,探讨肿瘤组织中胸苷磷酸化酶表达、肿瘤微血管密度 (microvesseldensity ,MVD)和临床病理特征之间的关系 ,分析TP表达和肿瘤MVD的预后意义。方法　应用单克隆抗体对 6 5例食管癌标本进行免疫组化染色 ,测定TP表达及MVD。结果　TP在食管癌中的表达 (4 5 / 6 5 ,6 9.2 % )明显 (P <0 .0 0 1)高于正常食管粘膜 (4 / 2 4 ,16 .7% )。食管癌的MVD(4 5 .0 9± 8.76 )与正常食管粘膜的MVD(2 7.4 8± 8.4 4 )的差别显著 (P <0 .0 0 1)。食管癌TP阳性的MVD的均值是 (4 6 .5 3± 7.18) ,TP阴性的MVD的均值是 (4 1.85± 11.0 8) ,前者明显 (P =0 .0 4 6 ) 高于后者。食管癌的TP表达与临床病理特征无相关性 ,MVD却与肿瘤的浸润深度(P =0 .0 35 ) 及分期(P =0 .0 18) 有关 ,而且只有MVD才是食管癌的一个预后指标(P <0 .0 0 1)。结论　食管癌的TP表达与MVD密切相关。TP表达与食管癌的临床病理特征无关。MVD与肿瘤的浸润发展有关 ,同时只有MVD才是食管癌的一个预后指标     

One-year follow-up after laparoscopic Heller-Dor operation for esophageal achalasia

Background: The Heller-Dor operation has recently been proposed for the treatment of esophageal achalasia even via a laparoscopic approach. Methods: To measure the medium-term effectiveness of this new minimally invasive technique, an evaluation of pre- and postoperative symptoms, esophagogram, endoscopic findings, esophageal manometry, and pH monitoring was prospectively designed in 43 patients with primary esophageal achalasia. The mean clinical follow-up for all the patients is 12 months (range 3–43), while the mean radiological follow-up is 11 months (range 1–23). Endoscopic data 1 year after surgery are currently available for 27 patients (63%), whereas a 12-month (range 1–26) functional follow-up (including manometric and pH-monitoring studies of the esophagus) is currently available for 35 patients (81.4%). Results: No dysphagia was reported in 38 cases (88.4%); two (4.6%) complained of occasional swallowing discomfort which regressed spontaneously; two (4.6%) had persistent dysphagia which regressed with pneumatic dilatation. One patient (2.8%) reported mild occasional dysphagia after a 1-year asymptomatic period. Preoperatively, esophagograms showed an average maximum diameter of 40.6 ± 9.1 mm which decreased to 24.1 ± 6.0 mm after operation. Mean lower esophageal sphincter (LES) resting and residual pressures decreased significantly from 28.6 ± 10.7 mmHg to 8.8 ± 4.1 mmHg and from 17.0 ± 9.7 mmHg to 4.7 ± 4.0 mmHg, respectively (p < 0.0001). These effects on esophageal diameter and LES function seem to persist over time. The complete absence of any peristaltic contractions recorded preoperatively in all cases remained unchanged after surgery in all but four patients. However, this rare recovery of peristalsis proved to be transient, and patients revealed a manometric impairment of their esophageal body function, but without complaining of dysphagia. Twenty-four-hour pH monitoring showed abnormal gastroesophageal reflux episodes in two (5.7%) of the 35 patients who were monitored: one was asymptomatic; the other had heartburn and endoscopically demonstrated grade II esophagitis. Conclusions: Laparoscopic Heller-Dor operation achieves excellent medium-term results which, together with the already-demonstrated advantages of a minimal surgical trauma and rapid convalescence, validate the use of such a minimally invasive approach to treat patients with primary achalasia of the esophagus. Received: 19 March 1996/Accepted: 15 May 1996     

PTEN基因在喉鳞癌中的表达及意义

目的:探讨蛋白酪氨酸磷酸酶基因(PTEN)在喉鳞癌中的表达及其临床意义.方法:应用半定量RTPCR方法检测喉癌组织中PTEN mRNA的表达.结果:淋巴结转移组喉癌较正常喉组织PTEN mRNA表达下降有统计学意义(P＜0.05).病理低分化与高分化相比,PTEN mRNA表达差异有统计学意义(P＜0.05).结论:PTEN基因表达下降在喉鳞癌演进中起重要作用.     

Ninety-one Cases of Breast Cancer and Chronic Lymphoproliferative Neoplasm: A Retrospective Review of a Population at High Risk for Multiple Malignancies

Abstract: We performed a retrospective analysis of clinical course of 91 patients who developed both breast cancer and a chronic lymphoproliferative neoplasm and were seen at the M. D. Anderson Cancer Center between January 1, 1970 and December 30, 1991. The sample included 24 individuals who developed lymphoproliferative neoplasm first (Group A), 22 individuals with concurrent diagnosis of both malignancies (Group B), and 45 individuals who developed breast cancer first (Group C). The median time to diagnosis of secondary breast cancer and lymphoproliferative neoplasm was 66 months (range, 7–459) and 65 months (range, 0–334), respectively. A higher proportion of Group B lymphomas were low-grade (77% vs. 47% [Group A] vs. 37% [Group C] p = 0.009). Prior occurrence of either one of these malignancies did not affect the disease-specific survival from the second malignancy. However, continuing mortality from the first malignancy appeared to contribute to a poor overall survival following second malignancy. Group A included 8 patients who developed breast cancer following radiation therapy for Hodgkin's disease after a mean interval of 18 (± 4.3) years. Three of these individuals had coexisting ductal and lobular histology (vs. none of the individuals in Groups B and C, p = 0.02). Another interesting finding was the high incidence of multiple additional malignancies in this patient population. A total of 29 additional neoplasms occurred in 21 (23%) of the 91 study subjects. These malignancies involved a wide variety of organ sites and could not be attributed to the therapy for either the breast cancer or the lymphoma in most cases. The data suggest that individuals who develop both breast cancer and a lymphoproliferative neoplasm are at a high risk for multiple malignancies. Close surveillance of such individuals for additional malignancies and further studies to understand the molecular basis of this predisposition are warranted.?     

Diagnosis and therapy for primary hepatic carcinoma: Transcatheter inferior phrenic arteriography and chemoembolization

Summary Transcatheter inferior phrenic arterial (IPA) and hepatic arteriography was performed on 38 patients with advanced primary hepatic carcinoma (PHC) with blood supplied by IPA and hepatic artery. 18 patients received single treatment with hepatic arterial infusion (HAI) or embolization (HAE) 20 received double treatment with IPA and hepatic arterial infusion or embolization. The results show that the double treatment is superior to the single one. The angiographic features and mechanism of parasitization of inferior phrenic arterial supply to PHC were also discussed.     

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目的　探讨腹腔镜食道裂孔疝修补术的可行性及安全性。方法　回顾性分析 2 0 0 1年 3月至 2 0 0 3年12月天津南开医院行腹腔镜食道裂孔疝修补术 11例病人的临床资料。结果　 10例行裂孔疝修补后同时行胃底折叠术 ,其中 7例行Nissen胃底折叠术 ,3例行Toupet胃底折叠术 ,1例仅行裂孔修补术。术后症状完全缓解。食道下段压力由 (8 6± 2 4 )mmHg(1mmHg =0 133kPa)提高到 (18 2 0± 3 4 3)mmHg(P <0 0 1) ,2 4hpH值监测评分由 5 3 4± 39 7降低到 8 0 4± 2 12 (P <0 0 1) ,较手术前有明显改善 ,并达到正常范围。无手术并发症 ,无中转开腹及死亡病例。结论　对于食道裂孔疝 ,腹腔镜食道裂孔疝修补术是一种安全、有效的治疗方法