外阴汗腺癌七例临床分析

目的：总结外阴汗腺癌的临床特点及治疗方法。方法：对７例外阴汗腺癌病例进行回顾性分析。结果：外阴汗腺癌的发病年龄为４０～５８岁。７例患者的治疗为局部扩大切除或根治性外阴广泛切除，２例辅以术后放疗。７例中５例存活５年以上，其中１例曾在首次治疗后第７年、１１年２次复发并于第１７年死于肿瘤。２例存活＜５年，１例在术后２年半死于脑出血，１例因脊椎广泛转移在术后１年零９个月死亡。结论：外阴汗腺癌的预后较好，局部扩大切除或根治性外阴切除，是首选治疗方法。     

Effect of distension on adrenergic innervation of the rat urinary bladder

Summary The effect of distension on adrenergic innervation was investigated in the rat urinary bladder. Bladders were distended for 3 h by forced diuresis and ballon obstruction, and specimens were taken from the bladder dome, body and neck for the demonstration of glyoxylic acid-induced fluorescence of catecholamines. Depletion of catecholamines started after 10 h and was almost complete after 2 days. The fluorescence had recovered part way after 5–7 days and was practically normal after 21 days. Small, intensely fluorescent (SIF) cells in the ganglia continued to leak catecholamines throughout the 21-day study period. The primary clinical success of distension therapy for the treatment of unstable bladder may be at least partly due to a reversible disturbance in the function of the adrenergic nerves, which have an excitatory alpha-adrenergic dominance in such cases, but the persistent leakage from SIF cells raises the question of whether distension causes prolonged disturbances in bladder function.     

Image-directed color Doppler ultrasonography in the evaluation of superficial solid tumors

Image-directed color Doppler ultrasonography (ICDUS) studies of 86 patients with superficial solid masses yielded significantly lower resistive index (RI) values in acute inflammatory lesions, but no significant difference between the maximum systolic flow velocities (S) of the patient groups with malignant, benign, and acute inflammatory lesions. When analyzed separately, the malignant soft-tissue tumor subgroup was shown to have significantly higher mean RI compared to that of the malignant node subgroup. We conclude that RI may be useful in the differentiation of acute inflammatory masses from other pathological entities. Malignant soft-tissue tumors, especially sarcomas, may have different Doppler features from those of carcinomatous tumors. © 1995 John Wiley & Sons, Inc.     

异环磷酰胺为主的联合方案治疗晚期复发鼻咽癌

[目的]观察比较异环磷酰胺(IFO)、顺铂(DDP)、5-氟尿嘧啶(5-Fu)联合方案(IPF方案)与DDP,5-Fu(PF方案)治疗晚期复发鼻咽癌(Ⅲ-Ⅳ期)的近期疗效及毒副反应。[方法]136例均经病理证实为晚期复发鼻咽癌患者,随机分为IPF组69例,PF组67例(对照组)[结果]IPF组和PF组有效率分别为69.56％(48/69)和43.3％(29/67),两组间差异有显著性(X2=8.519,P<0.01)。中位生存期:IPF组16个月(8-34个月),PF组为6.5个月(4-21个月),两组间差异有显著性(X2=22.36,P<0.05)。毒副作用主要为骨髓抑制,Ⅲ-Ⅳ度白细胞下降率IPF组为49.4％,PF组为5.97％,两组差异有显著性(X2=29.54,P<0.01)。Ⅲ-Ⅳ度血小板下降率IPF组为29.18％,PF组为0％(X2=30.29,P<0.01);Ⅲ-Ⅳ度消化道反应两组的发生率分别为15.94％和11.94％(x2=0.234,P>0.01).且以Ⅲ度为主。[结论]以IFO为主的方案联合治疗晚期复发鼻咽癌疗效好,毒副反应能耐受,可作为一线方案。     

Papilliferous keratoameloblastoma

A case of papilliferous keratoameloblastoma is reported which is only the second ever documented. The patient was a 76-yr-old black woman with a large expansile multilocular radiolucency of the body, angle and ramus of the mandible. Histologically the lesion consisted of sheets of cystic follicles filled with necrotic debris and sometimes parakeratin. The vast majority of the follicles were lined by a papilliferous epithelium consisting of large rounded cells with centrally placed nuclei. True papillary projections with cores of connective tissue were also present. The remainder of the follicles were lined by a thin parakeratinising stratified squamous epithelium. Histological features characteristic of ameloblastoma were absent. Final classification of these lesions will have to await the reporting of further cases.     

Trigone sensitivity testing is a measure of exteroceptive function

The trigone sensitivity test, a complementary test to cystometry, has been proposed as a method for distinguishing certain clinical disorders. Pressure is applied to the trigone region of the bladder by pulling upon a Foley catheter with the balloon inflated and the amount of force needed to induce an urge to void is recorded. Although the trigone sensitivity test has been proposed as a test of exteroceptive function, it is possible that deeper receptors, perhaps proprioceptors, are actually responsible for the awareness of the urge to void during the study. The present investigation compared the trigone sensitivity test with provoked detrusor contraction in 107 patients. The findings indicate that variations in the two responses occur independently of each other. It is concluded that different neural pathways are responsible for the two functions. The hypothesis that exteroceptive and not proprioceptive nerves are being measured during trigone sensitivity testing is supported by these findings.     

胃癌和胃癌前病变Cx43、PCNA的表达及意义

目的　通过观察间隙连接蛋白 Cx4 3和增殖细胞核抗原 (PCNA )在正常胃粘膜、胃癌前病变和胃癌中的表达和分布情况 ,探讨 Cx基因表达与胃癌发生的关系。　方法　运用 SP免疫组织化学方法检测 Cx4 3、PCNA在 70例原发性胃癌 ,6 2例中、重度不典型增生和 16例正常胃粘膜中表达规律。　结果　 Cx4 3在正常胃粘膜 ,中、重度不典型增生和胃癌中表达的阳性率分别为 10 0 % ,83.9%和 17.1% ,三者比较差异有显著性 (P<0 .0 5 )。 Cx4 3表达与胃癌的分化程度相关 (P<0 .0 1)。胃癌前病变、胃癌组中的 PCNA较正常胃粘膜组增高 (P<0 .0 1)。 Cx4 3表达与 PCNA呈负相关 (P<0 .0 1)。　结论　 Cx4 3表达降低在胃癌发生发展中起重要作用 ,Cx4 3可做为胃癌早期诊断的指标     

全去带乙状结肠原位可控膀胱术25例随访报告

目的：探讨全去带乙状结肠原位可控膀胱术的临床效果。方法：对25例施行该术式术后患者的可控性、尿动力、血清电解质、肾功能、生活质量等进行随访观察。结果：25例随访2－15个月，平均11．3个月。白天完全自控排尿25例（100％）；夜间完全自控排尿24例（96．0％），1例偶有遗尿；贮尿囊容量220－370ml，平均320ml；贮尿囊内压力1．86－3．92kPa，平均2.44kPa。IVU及贮尿囊造影示单侧贮尿囊输尿管反流2例（8．0％），无肾积水；膀胱镜检查2例（8．0％）贮尿囊内出现细沙样结石，1例（4．0％）贮尿囊后尿道吻合口狭窄，经尿道直视内切开术治愈。15例（60．0％）男性患者保留性功能，肾功能正常，1例（4．0％）出现一过性高氯血症。结论：全去带乙状结肠原位可控膀胱术手术成功率高，疗效可靠，患者生活质量高，是一种较理想的尿路分流术，值得推广。     

胃癌组织端粒酶活性与催化亚基hTERT表达的关系

研究胃癌、胃黏膜肠化生及正常黏膜组织端粒酶活性与人端粒酶催化亚基(hTERT)表达的相关性及端粒酶激活在胃癌发生中的作用.方法:通过端粒重复序列扩增(TRAP)和逆转录聚合酶链反应(RT -PCR)方法测定3种胃癌细胞株、26例胃癌、10例胃黏膜肠化生和36例正常胃黏膜组织标本端粒酶活性和hTERT表达.结果:3种胃癌细胞株、24例胃癌组织有端粒酶活性;4例肠化生端粒酶活性较弱;36例正常胃黏膜标本未测到端粒酶活性.hTERT在26例胃癌组织、5例肠化胃黏膜中表达;正常胃黏膜无表达.端粒酶活性、hTERT表达与肿瘤的分期和病理分级无关.结论:hTERT在肿瘤形成的早期阶段表达,端粒酶的激活是胃癌形成的关键步骤.     

47例原发性乳腺癌多药耐药MDR1基因表达及其临床意义

[目的]探讨原发性乳腺癌多药耐药MDR1基因的表达及其临床意义.[方法]采用荧光定量RT-PCR法检测47例乳腺癌组织及15例正常对照(包括5例乳腺纤维腺瘤、10例癌旁组织)MDR1基因的表达.[结果]乳腺癌MDR1基因表达阳性率为46.8%,与病人年龄、肿瘤大小、淋巴结转移与否、ER、PR状况、绝经与否无关.对照组中无MDR1基因表达.[结论]乳腺癌MDR1基因的表达可作为乳腺癌化疗耐药的评价指标,能否作为判断预后的独立指标尚需进一步研究.