白细胞介素—2胸腔灌注治疗恶性胸水24例临床分析

恶性胸腔积液能严重影响病人的呼吸循环功能,加速病人死亡。本文对24例恶性胸腔积液病人给予白细胞介素—2(IL-2)胸腔灌注治疗,取得了明显效果。其总有效率(完全缓解率 部分缓解率)较对照组有显著性差异(P<0.05),该作者认为该疗法治疗效果肯定,副作用轻,具有推广应用价值。     

以华明产阿霉素为主联合化疗9425例恶性肿瘤临床疗效综合分析

本文综合了全国26个省、自治区、直辖市内180家医院应用鮀滨-华明产阿霉素单剂或联合方案治疗42种癌症患者9425例的近期疗效和毒副反应资料,在可评价的8314例各类恶性肿瘤患者中,完全缓解者1502例,部分缓解者2928例,总有效率为53.3％。其中以恶性淋巴瘤的缓解率最高,达83.8％;小细胞肺癌次之,达73.9％。毒副反应以骨髓抑制、胃肠反应、脱发为多见。相当一部分资料将华明产品与进口同类产品进行了比较,结论为:疗效肯定,毒副反应与进口品相似,价格低廉,值得大力推广应用。     

Dedifferentiated chondrosarcoma

We reviewed 74 cases of dedifferentiated central and peripheral chondrosarcoma. Histologically these tumours consist of an underlying cartilaginous component (either benign or malignant) juxtaposed to a highgrade non-cartilaginous component, with a typically abrupt transition between the two tissue types. The noncartilaginous component may constitute a very small or a very large proportion of the tumour, so diagnosis often requires histological evaluation of the entire tumour. The diagnosis is often suspected on the basis of the clinical course and careful evaluation of the radiographie characteristics. Central dedifferentiated chondrosarcoma can be classified radiographically into three types. In type 1 (36 cases in our review) the radiographie features are the same as those of a central chondrosarcoma, with the addition of a region with very aggressive radiographie features. Type 2 lesions (20 cases) resemble the underlying benign enchondroma but also have destructive changes and/or a large soft tissue mass. Type 3 lesions (8 cases) are not distinctive radiographically and present as a very high grade destructive lesion of bone. These cases are diagnosed following biopsy or tumour resection. The prognosis of these tumours is extremely poor, with 13% overall 5-year survival in this series. Improved survival was found in those cases where diagnosis was prompt and surgical treatment with a wide or radical margin was attained. No benefit was found from the use of adjuvant chemotherapy or radiotherapy. Thus, early recognition of the characteristic radiographie features, adequate histological sampling, and wide or radical surgical margins are necessary for satisfactory management of this highly malignant variant of chondrosarcoma.     

106Ru/106Rh plaque radiotherapy for malignant melanomas of the choroid

Therapeutic results are presented with follow-up examinations of at least 5 years (min. 5 years, max. 22 years) after ¹⁰⁶Ru/¹⁰⁶Rh plaque radiotherapy of posterior uveal melanomas. Out of 227 patients 146 (= 64.3%) could be treated successfully, 37 (= 16.3%) had to be enucleated and are alive, 44 (= 19.4%) died from metastases and 40 (17.6%) from other causes. 75.0% of all small melanomas (T1a) showed an excellent regression pattern to flat scars. Five years after treatment the survival rate was 83.7% (deaths from any causes) respectively 88.2% (deaths from metastases only) and 64.8% (deaths from any causes) respectively 79.7% (deaths from metastases only) ten years after irradiation. ¹⁰⁶Ru/¹⁰⁶Rh plaque radiotherapy can be recommended for small (Tla, b) and medium sized (T2) choroidal melanomas.     

全身热疗法治疗晚期肝脏恶性肿瘤39例报告

目的 探讨全身热疗法（whole body hyperthermia，WBH）治疗肝脏恶性肿瘤的疗效及其对肝功能的影响。方法 采用WBH治疗肝脏恶性肿瘤患者39例，并对治疗前、后患者肝功能指标进行动态观察，分析该疗法对肝脏功能的影响，并通过分析治疗效果，初步评估该疗法的疗效。结果 ①WBH治疗不能手术切除的晚期肝脏恶性肿瘤患者的有效率为61．5％（24／39），60．0％（9／15）的患者AFP有不同程度下降，肿瘤疼痛缓解率达100％；存活期〉2年者占12．8％（5／39），〉1年者占59．0％（23／39），〉6个月者占76．9％（30／39）。②谷丙转氨酶于治疗后1～3d出现明显升高（P〈0．05），7d后下降并接近治疗前水平；谷草转氨酶于治疗后1d明显升高（P〈0．05），3～7d则下降并接近治疗前水平；白蛋白于治疗后1d出现下降（P〈0．05），但3d即已恢复；肝功能正常组总胆红素于治疗后第1～3d出现升高（P〈0．05），而肝功能异常组未观察到同样变化；转肽酶则无明显变化。结论 WBH能改善晚期肝脏恶性肿瘤患者的预后，提高生存质量，延长生存时间，但同时可造成患者肝功能一定程度的可逆性损害。     

脉络膜黑色素瘤脱色素处理后Caspase-3的免疫组化研究

目的 观察凋亡基因Caspase-3在脉络膜黑色素瘤(choroidal melanoma)中的表达及分型与细胞凋亡的关系。方法 收集20例脉络膜黑色素瘤标本，对其进行Caspase-3免疫组织化学染色，观察表达情况及染色强度。结果 Caspase-3在脉络膜黑色素瘤有较好的表达，在梭形细胞型中5例／6例呈阳性表达，在混合型中6例／8例呈阳性表达，在上皮样瘤细胞型中3例／4例呈阳性表达，在坏死型中1例／2例呈阳性表达，且在各型之间没有显著性差异(P＞0．05)。结论 凋亡在脉络膜黑色素瘤中存在；Caspase-3在脉络膜黑色素瘤的发生发展中起重要作用。     

Analysis on Mental Features and Nursing Countermeasures for Malignant Ovarian Tumor Patients

Objective To inquire into the mental features of malignant ovarian tumor patients and advance the way to appease the mental state. Methods The mental health status of 168 malignant ovarian tumor patients was evaluated using Symptom Checklist 90 （SCL-90）, and compared with that of normal crowd and other gynecologic malignant tumor patients. Results The scores of suppression, anxiety, fear, somatization, constrain, hostility, interpersonal relationship of the ovary malignant tumor patients were higher than those of the normal model, and the scores of suppression, anxiety, interpersonal relationship higher than those of other gynecologic malignant tumor patients. Conclusions To strengthen the nursing teaching, understand the mental state on time, use moral support therapy, and help the patients to change their inadequate attitude and behavior, can strengthen the therapy confidence and promote the health rehabilitation.     

免疫组化在恶性间皮瘤鉴别诊断中的应用价值

目的 对恶性间皮瘤进行免疫组化的对比性研究,以进一步评价它们在恶性间皮瘤鉴别诊断中的价值。方法 采用免疫组织化学染色(LSAB)法对22例恶性间皮瘤和20例对照组腺癌组织进行EMA、CEA、CK、vimentin、间皮细胞(M-cell)等5种单克隆抗体的标记。结果 恶性间皮瘤的阳性率分别为 M-cell 91％,CEA 9％,vimentin 73％,CK82％,EMA64％;而腺癌的阳性率为分别为M-cell5％,CEA 85％,vimentin 15％,CK100％,EMA 100％。结论 在恶性间皮瘤和腺癌的鉴别诊断中,M-cell和CEA是较理想的标记物,尤其是M-cell,CEA和vimentin三种抗体联合应用更具有价值。而在恶性间皮瘤和其他梭形细胞肿瘤的鉴别诊断中,还应联合使用CK和EMA。     

Inward rectifying potassium channels in human malignant glioma cells

Human glioma cells obtained from established cell lines (Tp-276MG, Tp-301MG, Tp-378MG, Tp-483MG and U-251MG) were analyzed for the presence of ion channels with the tight-seal voltage clamp technique. The current-voltage relation revealed a marked inward rectification at hyperpolarizing voltages, due to the presence of inward rectifying K-channels in cells from all studied cell lines. These channels were conducting when the membrane potential was more negative than the K-equilibrium potential. The slope conductance for the inward K-currents (g_Ki) was affected both by [K⁺]_i and [K⁺]₀. g_Ki was proportional to [K⁺]₀ raised to 0.35 or 0.50, of which the larger value was measured in the presence of low [K⁺]_i (25mM). The rectification was not significantly different in cells perfused with Mg-free EDTA-buffered internal solution. Tl⁺ was 3.5 times more permaant than K⁺. g_ki was blocked by Cs⁺ (1 mM) in a voltage-dependent way (more effective in the hyperpolarized membrane), and by Na⁺ (154 mM) depending on voltage and time. From measurements of unitary current events in membrane patches (outside out or cell attached) the conductance of the single inward rectifying channel was estimated to be 27 ± 7 pS. This type of ion channel may be important for K-uptake by glial cells and hence for the K-homeostasis in the brain.     

Desmoplastic malignant melanoma: An aggressive tumor

Summary The clinical features and histological appearance of desmoplastic malignant melanoma are presented. Aggressive surgical management and close follow-up are mandatory if this highly aggressive tumor is to be controlled. Despite this, the prognosis is poor.