Treatment of malignant dysphagia with nitinol stents

Self-expanding nitinol stents were used in 22 patients for palliative treatment of malignant esophagogastric strictures. All patients but 5 were men (age range 47–75 years). The strictures were caused by squamous cell carcinoma (n = 12), adenocarcinoma (n = 8), and recurrent anastomotic carcinoma (n = 2). No technical failure or procedural complications occurred. After the procedure, the severity of dysphagia decreased at least one grade in all patients. Tumor ingrowth into the stent was seen in 7 patients of 22 (32%). Four of these patients were treated with additional stents, and in 3 patients, due to refusal, only balloon dilations were performed, which caused temporary relief. Tumor ingrowth into the stent was noted from 10 days to 7 months (mean 3 months). This seems to be a disadvantage of nitinol stents. At the end of the study 10 patients had died dead with a mean survival of 3 months (range 1 week to 6 months) and 12 patients were still alive with a mean follow-up of 4 months (range 1–8 months). It is concluded that nitinol stents provide satisfactory palliation in patients with malignant dysphagia with neglectable procedural morbidity and mortality rates.     

前列腺癌穿刺活检组织中端粒酶活性检测及意义

目的;探讨前列腺穿刺活检标本中端粒酶（TE）活性检测在前列腺癌（PCA）诊断、鉴别诊断及评估PCA生物学行为中的意义。方法：应用端粒重复片段扩增法（TRAP法）检测疑为前列腺癌患者的前列腺穿刺活检标本的TE活性,并比较TE活性水平与PCA病理分化程度及转移情况的关系。结果：PCA组织中TE活性明显高于前列腺增生（BPH）组织。PCA组织中TE活性水平与其病理分化程度及转移情况相关。结论：PCA患者的前列有朱穿刺活检组织中的TE活性显著高于BPH者,且与其病理分化程度及转移情况相关。提示TE可能成为PCA早期诊断及鉴别诊断的一项新的分子瘤标,并可能与PCA的生物学行为相关。     

PIK3C3与SMAD4在胰腺癌中的表达及作用

背景与目的 III型磷脂酰肌醇3-激酶（PIK3C3）及SMAD家族成员4（SMAD4）参与的信号通路与胰腺癌（PAAD）关系密切,但两者与PAAD发生及预后是否有关尚不十分清楚。本研究初步探究两者在PAAD中的表达及其对患者预后的影响。方法 利用UALCAN在线网站分析PIK3C3 mRNA和SMAD4 mRNA在PAAD中的表达及两者各自对PAAD患者预后的影响;从TCGA数据库下载PAAD患者PIK3C3 mRNA和SMAD4 mRNA的表达数据和相应临床病理资料,基于PIK3C3和SMAD4联合的mRNA表达水平,用一致性聚类分析将PAAD患者分为两个聚类,用Kolmogorov-Smirnov检验及Kaplan-Meier法分析两个聚类患者PIK3C3与SMAD4的mRNA表达模式、临床病理因素和总体生存率的差异;用免疫组化的方法检测PAAD和癌旁组织组织芯片中PIK3C3及SMAD4蛋白表达水平,并用独立样本t检验及ROC曲线下面积（AUC）评估两个蛋白在癌和癌旁组织中的差异;采用Kaplan-Meier的方法分析PIK3C3和SMAD4的蛋白水平单独及联合对PAAD患者生存的影响。结果 分析结果表明,PIK3C3 mRNA或SMAD4 mRNA水平在PAAD中均无明显变化,并且两者单独均不影响PAAD患者的预后（均P>0.05）。PAAD中与PIK3C3 mRNA与SMAD4 mRNA具有较高的共表达相关性。两个聚类的PAAD患者之间,两基因的mRNA水平及年龄有明显差异（均P<0.05）,其中,PIK3C3 mRNA及SMAD4 mRNA均高表达聚类的PAAD患者预后较好（P=0.006）。PAAD组织中PIK3C3和SMAD4的蛋白表达水平均明显低于癌旁组织（均P<0.001）,AUC分别为0.7417及0.7991。PIK3C3和SMAD4蛋白之一阳性患者比两蛋白均阴性的患者预后更好（P=0.0359）。结论 PIK3C3和SMAD4蛋白可作为PAAD潜在的诊断标志物,PIK3C3和SMAD4联合分析可成为PAAD患者预后评估的新指标。     

Spinal metastases treated with bipolar radiofrequency ablation with increased (> 70 °C) target temperature: Pain management and local tumor control

PurposeTo investigate the safety and clinical efficacy of bipolar radiofrequency ablation (b-RFA) with increased (> 70 °C) target temperature for the treatment of spine metastases with the intent of achieving pain relief or local tumor control.Materials and methodsThirty-one patients with a total of 37 metastases who were treated with b-RFA with increased temperature and vertebroplasty from January 2016 to May 2019 were retrospectively included. There were 20 women and 11 men with a mean age of 62.4 ± 10.5 (SD) years (range: 40–78 years). Patients and metastases characteristics, procedure details and clinical outcomes were analyzed.ResultsMetastases were predominantly located in lumbar (22/37; 59.5%) or thoracic spine (13/37; 35.1%). Mean target temperature was 88.4 ± 3.5 (SD) °C (range: 70–90 °C). Technical success was 100% (37/37 metastases). One (1/37; 2.7%) major complication unrelated to b-RFA was reported. One (1/37; 2.7%) metastasis was lost to follow-up. Favorable outcome was noted in patients receiving b-RFA for pain management (16/20 metastases; 80%; mean follow-up, 3.4 ± 2.9 [SD] months) or with oligometastatic/oligoprogressive disease (6/6 metastases; 100%; mean follow-up, 5.0 ± 4.6 [SD] months). In patients receiving b-RFA to prevent complications, favorable outcome was noted in 6/10 metastases (60%; mean follow-up, 3.8 ± 4.8 [SD] months).ConclusionsB-RFA with increased target temperature has an excellent safety profile and results in high rates of pain relief and local metastasis control in patients with oligometastatic/oligoprogressive disease. Suboptimal results are achieved in patients receiving b-RFA to prevent complications related to the growth of the index tumor.     

桥粒斑蛋白II在肿瘤组织中的表达

桥粒斑蛋白ＩＩ（ＤＰＩＩ）是一种新的上皮和上皮性肿瘤标记物。我们应用针对石蜡切片的抗ＤＰＩＩ单抗和抗细胞角蛋白（ＣＫ）单抗对２ｌ７例肿瘤作了免疫组织化学ＡＢＣ法染色的研究，结果：在１６３例上皮性肿瘤和双向分化的肿瘤中，１４７例表达ＤＰＩＩ，占９０．７％，９２例表达ＣＫ，占５６．４％。ＣＫ阳性染色全部位于细胞浆内，ＤＰＩＩ阳性染色则同时分布在细胞交界面上和细胞浆中。其他５４例不含桥粒的肿瘤均无ＤＰＩＩ和ＣＫ表达。结果表明，ＤＰＩＩ单抗是有用的含桥粒肿瘤的免疫组化探针。因ＤＰＩＩ不存在于一切含桥粒肿瘤，故在鉴别上皮性肿瘤时，ＤＰＩＩ单抗尚需与其他上皮标记物的抗体合并使用。     

富集CD34~ 细胞作干细胞移植的临床初步探索

目的　观察富集CD34 的造血干 /祖细胞做肿瘤患者同种异基因造血干细胞移植 (Allo HSCT)和自体移植的临床疗效。观察输注纯化CD34 细胞患者的预后情况。方法　采用磁分选临床型细胞富集仪将表面包被有CD34单抗的磁性微球体系与细胞共同培养 ,特异性结合CD34 细胞。在磁场作用下分别收集CD34 和CD34-组分。完成 2 0例患者CD34 细胞体外纯化富集。其中HLA半相合移植 5例 ,自体移植 15例。结果　纯化后CD34 细胞纯度达 97%以上 ,移植CD34 细胞中位数 5 .72 (0 .15～ 12 .0 )× 10 6,CD34 细胞中位数 3.73(2 .6～ 6 .8)× 10 4 ;CD34-细胞 (CD3、CD4、CD8、CD19)对数去除率 (Log,下同 )为 1.99～ 5 .0。 19例患者移植后随访 11个月 (中位数 ,1～ 2 0 ) ,总体生存13/ 19(例 )。本院 11例中 ,总体生存为 8/ 11(例 ) ,其中HLA半相合 1/ 3(例 ) ,自体移植 7/ 8(例 )。移植后造血重建迅速 ,随访 18个月以上无病生存者 3例中 1例为同种异基因HLA半相合亲属移植 ,2例为肿瘤自体移植。 1例父子间HLA半相合移植 ,白细胞恢复 >1× 10 9/L ,血小板 >2 0× 10 9/L(均为移植后第 13天 )。仅有短暂的I度移植物抗宿主疾病。 2例自体移植病例白细胞恢复 >1× 10 9/L(8～ 2 6d) ,血小板恢复 >2 0× 10 9/L(2 2～ 35d)。结论     

乳腺及甲状腺病变针吸细胞学AgNOR诊断价值的研究

目的 探讨核仁组成区嗜银颗粒的计数对于区别乳腺及甲状腺良恶性病变的诊断价值。方法 采用针吸细胞技术对乳腺及甲状腺病变穿刺标本进行核心仁组成区嗜银颗粒定量分析研究。结果 ４３例不同类型乳腺癌,嗜银颗粒平均值４．４０（Ｐ〈０．０１）,１２例乳腺上皮良性增生,平均值２．９０,４５例不同类型甲状腺癌,嗜银颗粒平均值３．５０（Ｐ〈０．０１）,１０例甲状腺上皮良性增生,平均值１．７７,良,恶性肿瘤细嗜银颗粒的     

The effect of TGFβ1 on murine tumor growth following direct intratumoral injection of plasmid DNA

In order to investigate TGFβ1 gene expression and its effect on murine tumor growth following direct intratumoral injection of naked plasmid DNA encoding human TGFβ1, LM₃ murine lung adenocarcinoma cells were inoculated subcutaneously to T₇₃₉ mice and grew to tumor nodules in 2 weeks. Multiple direct intratumoral injection of plasmid DNA, PMAMneo- TGFβ1, were given and compared with saline or vector plasmid administration groups. The growth of tumor was observed till the 8th week when the mice were killed for Northern blot analysis and histopathological study of tumoral tissue. The results showed that the growth of tumor was boosted in the TGFβ1 gene treated mice as compared with the control groups, whereas there was no significant difference in the metastatic behavior. Northern blot showed efficient expression of TGFβ1 mRNA in the treated group. The present study indicated that TGFβ1 may stimulate tumor growthin vivo through certain mechanisms. And direct intra-tumoral injection of nude plasmid DNA may be a promising gene transfer strategyin vivo. This work was supported by the National Natural Science Foundation of China (No. 39370761).     

Human leukocyte interferon-α in cream,for the treatment of genital warts in asian women a placebo-controlled,double-blind study

The purpose of this double-blind, placebo-controlled study was to determine and compare the clinical efficacy and tolerance of human leukocyte -interferon (incorporated 2 × 10⁶ IU/g) in hydrophilic cream to cure genital warts. Preselected Asian female patients (n=150) aged 18–40 years (mean 22.5), with the clinical and biopsy-confirmed diagnosis of genital warts (mean 2.64), predominantly flat vaginal condylomas, were randomly allocated to 3 parallel groups. Each patient was given a coded tube containing 80 g placebo/active preparation with a graduated applicator. Patients were instructed to inject 6 g of the either alloted placebo/active cream deep into the vagina thrice a day for 3 consecutive days (group A) or 4 consecutive days (group B) per week, and if not cured the same treatment was extended to 3 more weeks (maximum 4 weeks active treatment). To assess the clinical efficacy patients were examined on a week-to-week basis. A total clearance of warts (biopsy-confirmed) was evaluated as a complete cure. Patients cured during the treatment were spared further treatment and were requested to visit us after 16 weeks for relapse control. As for the remaining patients, empty tubes were collected, and similarly coded replacement tubes were given for further treatment (in total 588 tubes were used). By the end of the treatment 57.2% lesions (227/397) were eliminated in all the groups: 48% patients in group A, 90% patients in group B, and 10% patients in placebo groups taken as completely cured. Of the 150 patients 128 (85.3%) did not complain of any drug-related adverse symptoms. Transitory increase in body temperature (mean 38.4°C), accompanied by headache (14.6%) and generalized itching (6.6%) were the most frequently reported side effects; however, treatment was well tolerated by all the patients, and there were no dropouts. Our findings indicate that clinical efficacy is dose dependent, that is, the results of group B were significantly superior to that of group A (P < 0.05). Of the 49.3% cured patients (74/150) followed up for 6 months (monthly basis) seven had a relapse, and none had reinfection. It is concluded that clinical efficacy of leukocyte interferon-a to cure genital warts is dose dependent. These results further support the view that leukocyte interferon-a incorporated in hydrophilic cream can be considered a reliable, safe, and home-based treatment to cure vulvar and vaginal warts.Abbreviation HPV human papillomavirus     

乳腺良恶性病变中纤维连接蛋白的分布

目的观察乳腺良恶性病变中纤维连接蛋白（ＦＮ）的分布,探讨它与乳腺癌分化、浸润、转移的关系。方法应用免疫组织化学方法,对乳腺良恶性病变纤维连接蛋白进行半定量研究。结果乳腺癌及淋巴结转移细胞ＦＮ呈强阳性表达,而基膜ＦＮ及间质ＦＮ普遍减少甚至缺乏。结论细胞ＦＮ可能是乳腺癌的一个标记物,间质ＦＮ及基膜ＦＮ减少有利于乳腺癌浸润、转移。