游离和前列腺特异性抗原相互关系及临床应用

目的　评价总前列腺特异性抗原 (tPSA)、游离前列腺特异性抗原 (fPSA)及百分率 (f/tPSA % )检测前列腺癌 (PCa)的相关性及临床价值。方法　用酶免法测定 35例PCa及 73例良性前列腺增生 (BPH)患者血清tPSA水平 ,4tPSA <10ng/ml患者另测其fPSA ,计算f/tPSA(% )。 结果　血清tPSA <4、4～ 10、>10ng/ml者发现PCa的比例组间相比均有统计学意义。 4～ 10ng/ml组 ,PCa和BPH者f/tPSA(% )分别是 9.1± 4.8、16 .4± 6 .1,差别有显著意义 (P <0 .0 1)。结论　tPSA仍是PCa筛查的有效瘤标 ,tPSA低水平时 ,f/tPSA(% )检测PCa则更为灵敏精确。     

胃癌组织中P16、Cyclin D1、Rb表达及其生物学行为的研究

目的研究P16、Cyclin、D1Rb基因在胃癌中的表达及其与胃癌生物学行为的关系.方法采用免疫组化方法检测10例正常胃黏膜、30例胃癌组织中P16、Cyclin D1、Rb蛋白的表达,并结合其临床资料进行分析.结果P16、Cyclin D1、Rb蛋白阳性表达,正常胃粘膜分别为90%、10%、90%;胃癌分别为36.67%、53.33%、50%,胃癌纽与正常对照组间差异均有显著性(P＜0.05),P16、Cyclin D1蛋白与胃癌分化程度、淋巴结转移与否、远处转移与否呈一定的相关性.结论P16、Cyclin D1、Rb基因与胃癌发生有关,P16、Cyclinp蛋白检测有助于胃癌预后的判断.     

正常小鼠胃肠运动昼夜节律及药物作用的影响

目的：观察小鼠胃肠运动昼夜节律及药物对节律的影响。方法：小鼠不同时间点灌胃给予蒸馏水及实验药物，同步测定胃排空及小肠推进运动情况。结果：小鼠胃排空及小肠推进运动存在昼夜节律；普瑞博思促进胃肠运动存在时间效应，但对节律无明显影响；阿托品抑制胃肠运动可使原有昼夜节律消失。结论：小鼠胃肠运动功能存在昼夜节律，药物对胃肠运动功能的作用存在时间效应，可使节律发生不同变化。     

胃液乳酸定量测定对中晚期胃癌的意义

用比色法测定148例胃癌和非胃癌患者胃液乳酸含量,包括正常对照36例。胃癌患者胃液乳酸含量明显增高,与胃良性疾病及正常人比较,差异非常显著(p<0.001),重叠甚少,有助于初步鉴别胃良性和恶性疾病。     

18F-FDG符合线路显像与异机CT图像融合诊断非小细胞肺癌复发转移的价值

目的 评价18F-脱氧葡萄糖(FDG)符合线路显像与异机CT图像融合诊断非小细胞肺癌(NSCLC)术后放化疗后复发转移的价值.方法 对可疑复发转移的40例NSCLC患者行18F-FDG符合线路显像,并于显像前后1周内行CT扫描.用三维(3D)图像融合软件进行图像融合.结果 在18F-FDG符合线路显像与CT扫描相同的范围内,40例患者共检出病灶58处,其中恶性52处,良性6处.融合图像诊断NSCLC复发转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比及阴性似然比分别为94.23%(49/52),5/6,93.10%(54/58),98.00%(49/50),5/8,5.65及0.07.图像融合灵敏度、准确性明显高于CT.单纯18F-FDG符合线路显像诊断效能与图像融合无差别,但与CT图像融合可明显提高对病灶的定位诊断(提高44.83%).结论 18F-FDG符合线路与CT图像融合诊断NSCLC术后放化疗后复发转移灵敏度高,定位准确,值得推广应用.     

p21WAF1与p27KIP1真核双表达载体的构建鉴定及在胃癌细胞中的表达

目的 构建p21WAF1与p27KIP1真核双表达载体,体外转染胃癌7901细胞,观察其在胃癌细胞中的表达及相关特性.方法 提取人全血总RNA,利用逆转录-聚合酶链反应(RT-PCR)扩增p21WAF1和p27WAF1基因并将其分别克隆到真核双表达载体pIRES中构建重组质粒pIPES-p27KIP1-p21WAF1,经酶切和测序鉴定重组质粒.脂质体介导重组质粒plRES-p27KIP1.p21WAF1"转染胃癌7901细胞,收集并提取转染后12、24、48、72 h和5 d各细胞的总RNA,逆转录成cDNA,荧光定量聚合酶链反应(FQ-PCR)检测各细胞中p21WAF1和p27KIP1在RNA水平的表达.带有绿色荧光蛋白的pIRES-EGFP作为对照.结果 RT-PCR扩增分别获得约500和600 bp大小的产物,重组质粒pIRES-p27KIP1.p21WAF1经酶切和测序鉴定证实为p21WAF1和p27KIP1基因.转染胃癌7901细胞48 h时转染率为68%.与空质粒对照组比较,重组质粒转染胃癌7901细胞12、24、48、72 h和5 d后FQ-PCR证实p27KIP1的Ct值(cycle threshold,Ct)分别减少8.2、10、10、7.4和6.7,p21WAF1的Ct值分别减少7.4、8.2、8.2、6.3和5.70其中24 h和48 h的Ct值减少最大.结论 真核双表达载体pIRES-p27KIP1.p21WAF1构建成功并能在胃癌7901细胞内高效表达.     

A nationally representative survey of hospital malnutrition: the Italian PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Aim and methods  Nutrition, unhealthy lifestyles and cancer appear to be strictly related, but few authors have analysed the interest in dietary information of cancer patients and their families. This survey was conducted in the Veneto area (Italy) to investigate the concern of cancer patients and their family members about diet as a health tool before and after diagnosis of cancer. Results  Seven hundred and four questionnaires were collected: 380 from cancer patients and 324 from family members of cancer subjects. Breast cancer (BC) was the most frequent disease for patients (61.8%) as well as families (26.5%). Generally, the importance of having precise diet information after diagnosis is recognised by 40.3% of patients, with significant differences between the various types of cancer: gastric and colon/rectum cancer (GCC) patients were more concerned than BC women about precise information concerning a diet to follow immediately after diagnosis (p = 0.000, ODs = 3.10, CI 1.68–5.71) or during treatments (p = 0.001, ODs = 2.67, CI 1.46–4.89). The nutritional information is supplied to patients in 34% of cases and to relatives in 30.3%, often from non-medical sources. In total healthcare workers (family doctor, oncologist, surgeon, dietician) represented the exclusive source of dietary information for 24.9% of patients and 22.9% of family members. Diet after diagnosis changes in 69.1% of GCC patients and in 39.2% of BC women. Relatives, particularly women, report difficulties preparing patients’ meals in 30.7% of cases, changes in the eating habits of the entire family in 29.9% and discontent connected with patients diet in 13.9%. The concern about proper nutrition after diagnosis increases more in GCC subjects (p < 0.025) when compared to BC subjects and in patients with more recent diagnosis (p < 0.041) when compared with patients with diagnosis >5 years ago, while in family members the interest in diet after diagnosis increases more in women than in men (p < 0.030) without other differences regarding the degree of relationship, type of cancer or diagnosis time. Relatives (92.7%) have more interest in nutritional education than patients (74.9%). Cancer patients <65 years were more interested in educational initiatives concerning nutrition (p = 0.000, ODs = 4.46, CI 2.6–7.4) than older patients (>65 years) and female subjects were more concerned than male patients (p = 0.008, ODs = 2.11, CI 1.2–3.6). Conclusions  The interest in the dietary knowledge and in educational initiatives concerning nutrition is high in cancer patients and their relatives, although it decreases with the age. The poor attention paid to nutrition of cancer patients by various healthcare workers deserves consideration, since the psychophysical wellbeing and perhaps also survival of cancer patients can be improved by correct dietary management, as well as, naturally, by the principal treatments themselves.     

环氧合酶-2反义核酸对膀胱癌细胞恶性表型的抑制作用

目的探讨环氧合酶-2(COX-2)反义核酸对膀胱癌细胞恶性表型的抑制作用。方法采用脂质体介导方法,分别构建转染COX-2反义真核表达载体和空载体的膀胱癌细胞系5637-AS细胞和5637-P细胞,RT-PCR及W estern b lot分析转染细胞COX-2 mRNA及蛋白表达水平。MTT比色实验、Boyden侵袭小室法和裸鼠成瘤实验分别检测转染细胞体外增殖速度、体外侵袭力和体内成瘤性。结果RT-PCR结果显示,5637-AS细胞COX-2/磷酸甘油醛脱氢酶(GAPDH)mRNA比值(0.65)明显低于5637(0.92)和5637-P细胞(0.90);W estern b lot提示5637-AS细胞COX-2/β-actin比值(0.29)明显低于5637细胞(0.46)和5637-P细胞(0.44)。MTT比色实验显示5637-AS细胞较5637-P、5637细胞生长速度减慢,三者倍增时间分别为3.6 d、2.9 d和2.9 d。体外侵袭实验结果表明,5637-AS侵袭细胞数显著低于5637细胞及5637-P细胞(18.20±5.97比45.40±8.12,18.20±5.97比44.10±6.47,P<0.01)。裸鼠成瘤实验中,5637-P、5637细胞接种裸鼠后第5天肿瘤长出,而5637-AS细胞第7天肿瘤长出;30 d后5637-AS细胞接种组瘤体重量(392.15 mg±33.58 mg)明显小于5637细胞(738.26 mg±66.32 mg),和5637-P细胞接种组(698.53 mg±88.76 mg),P<0.01。结论膀胱癌细胞中COX-2过表达与细胞的恶性表型相关,反义技术抑制COX-2表达可以逆转膀胱癌细胞的恶性表型。     

肝癌多药耐药产生与低糖环境的关系

目的探讨局部微环境低糖与肝细胞癌多药耐药性(MDR)产生的关系及影响机制。方法低糖培养HepG2细胞,应用流式细胞术Annexin V/PI法检测低糖培养的细胞在化疗药物5-氟脲嘧啶(5-Fu)作用后的凋亡情况,分别应用荧光定量聚合酶链反应(PCR)技术和Western blot技术检测低糖培养后HepG2细胞内多药耐药相关基因mdr1、MRP1、LRP的mRNA和蛋白水平的表达。结果在低糖环境下生长时间越长的HepG2细胞对5-Fu的抵抗越强,而且随着低糖培养时间的增加,5-Fu诱导的HepG2细胞的凋亡高峰延迟。低糖培养的HepG2细胞内多药耐药相关基因mdr1、MRP1、LRP在mRNA和蛋白水平的表达随低糖培养时间的延长而升高,以LRP的改变最为显著。结论肝癌生长微环境葡萄糖耐量不足也是肝癌产生MDR的原因之一。低糖可通过上调一组多药耐药相关基因的表达而诱导肝癌的多药耐药性。     

Gastrogastric fistula: a possible complication of Roux-en-Y gastric bypass.

BACKGROUND: Gastrogastric fistula is a communication between the proximal gastric pouch and the distal gastric remnant, rarely described in the realm of bariatric procedures. The aim of this study was to review the existing literature about this topic and to demonstrate its laparoscopic treatment. METHODS: An extensive literature review found several articles reporting this complication. However, no citation was found describing the steps of the laparoscopic management of this situation. RESULTS: Gastrogastric fistula occurs in up to 6% of Roux-en-Y gastric bypasses. Two theories exist for fistula formation: (1) it is a technical complication derived from the incomplete division of the stomach during the creation of the pouch, and (2) it occurs after a staple-line failure, developing a leak with an abscess, which then drains into the distal stomach forming the fistula. Early symptoms include fever, tachycardia, and abdominal pain. Failure in weight loss is a late clinical sign observed in these patients. Diagnosis is based on radiologic study, upper endoscopy and computed tomography. When identified in the acute postoperative course, laparoscopic treatment is easy. Chronic fistulas are difficult to manage, and the laparoscopic approach is an alternative to open surgery. CONCLUSIONS: Gastrogastric fistula is a possible complication of Roux-en-Y gastric bypass and its laparoscopic treatment is feasible.