Prognostic potential of flow cytometric S-phase and ploidy prospectively determined in primary breast carcinomas

In a prospective study of a consecutive breast cancer series accumulated in the period 1978–82, the S-phase fraction (SPF) and ploidy status were determined by flow cytometry performed on cell nuclei derived from samples of 580 primary tumors. Sixty percent of the tumors were non-diploid. After correction for debris the median SPF values were 7.3% overall, 12% for non-diploid tumors, and 2.9% for diploid tumors (2.6% when nodal subsets N2 and N3 and cases with metastases at presentation were excluded). The SPF values correlated both to tumor size (p=0.008) and to the number of positive axillary lymph nodes (p=0.03).At clinical follow-up in 1986, 467 unilateral breast cancer patients who had undergone radical treatment for cure could be evaluated with respect to the prognostic value of both the SPF value and ploidy status. The median duration of follow-up was then 59 months (range 2–90), and the median time-to-recurrence 24 months (range 2–69, n=137).At follow-up in 1991, 201/467 of the patients had died, the median duration of follow-up being 50 months (range 2–126) for the deceased, and 119 (range 6–148) for the survivors. In multivariate analysis (Cox's proportional hazards models), the strongest independent predictors of distant recurrence-free survival (DRFS) were the number of positive axillary lymph nodes (p<0.0001), the debris-corrected SPF value alone (p=0.003,versus p=0.05 for uncorrected value), and ploidy status combined with the corrected SPF value (p=0.0002). When age was taken into account, both the corrected SPF value and the ploidy-SPF combination were predictors of crude survival (p=0.006 and p=0.002, respectively).In univariate life-table analysis, the 5-year DRFS rate was 93% in node-negative (N0) cases with an SPF<7.3%, as compared to 80% in those with an SPF7.3% (p=0.005). Among node-positive cases, the prognostic value of the SPF was confined to those with 1–3 positive nodes, the 5-year DRFS rate being 68% in cases with an SPF<7.3%, as compared to 40% in cases with an SPF7.3% (p=0.01).Ploidy status and SPF were combined to form four groups: diploid & SPF<2.6% (DL), diploid & SPF2.6% (DH), non-diploid & SPF<12% (NDL), and non-diploid & SPF12% (NDH). Among node-negative patients, the DRFS rate fell from 95% in the DL group to 87% in the NDL group, with the DH group at an intermediate level, as compared with 74% (p=0.03) for the NDH group which accounted for the bulk of the early distant recurrences. Among patients with 1–3 positive lymph nodes, the 5-year DRFS rate was 68% in both the groups with low SPF values (DL and NDL), as compared with 45% in the DH group (p=0.03), and 37% in the NDH group (p=0.006).In this study, the flow cytometry SPF value, alone or in combination with ploidy status, yielded the most profound additional prognostic information, enabling both node-negative patients with a high probability of cure and patients at risk of early relapse to be identified. Among node-positive patients, the prognostic value of the SPF value was confined to those with 1–3 positive axillary lymph nodes (the predominant node-positive subgroup), enabling a high and a low DRFS rate subgroup to be distinguished – a useful distinction where selection for adjuvant drug treatment is concerned. As the predictive strength of the SPF value was enhanced when correction was made for debris, we would recommend that the effect of such factors as debris be minimized as far as possible when flow cytometry-derived SPF values are to be used for prognostic purposes.     

板蓝根抑菌抗炎活性部位的评价

目的：评价和比较板蓝根5个化学部位抑菌、抗炎活性的强弱。方法：采用管碟法测定板蓝根不同化学部位对于金黄色葡萄球菌、铜绿假单胞菌的敏感性，观察对二甲苯所致小鼠耳廓肿胀的抑制作用。结果：板蓝根Ⅴ部位体外抑菌活性最强，Ⅴ部位具有显著的抗炎活性。结论：板蓝根中高极性成分具有很强的药理活性，是其发挥清热解毒功效的物质基础。     

大青叶抗内毒素活性部位筛选

目的 评价和比较大青叶5个化学部位的抗内毒素作用。方法 采用动态浊度法测定细菌内毒素浓度，观察大青叶不同化学部位对放线菌素D敏化小鼠内毒素致死攻击的保护作用。并以内毒素制备家兔发热模型，测定其肛温变化。结果 大青叶Ⅳ部位能直接中和降解内毒素，显著降低内毒素的致热性和致死性。结论 大青叶Ⅳ部位具有显著的体内外抗内毒素活性。     

桂枝汤有效部位A对体温双向调节作用及其机理研究————对下丘脑NE、DA、5-HT含量的影响

在酵母诱导的发热大鼠中，桂枝汤有效部位Ａ（Ｆｒ．Ａ）能降低下丘脑５－ＨＴ、ＮＥ、ＤＡ含量；在安痛定诱导的低体温大鼠中，能升高５－ＨＴ含量。结果提示，Ｆｒ．Ａ为桂枝汤体温双向调节作用的一种物质基础，影响中枢神经递质５－ＨＴ的水平是其机理之一；其解热作用与影响中枢神经递质ＮＥ和ＤＡ的含量有关     

结核病临床分离株及痰标本中embB基因型的快速测定

目的建立快速测定结核病耐乙胺丁醇(EMB)分离株和痰标本中结核分枝杆菌EMB耐药基因型的方法，以期为患者提供及时、有效地化验结果。方法应用16S rDNA聚合酶链反应(PCR)-单链构象多态性(SSCP)和PCR-限制性片段长度多态性(RFLP)对11株耐EMB分离株和46例结核病痰标本进行分子菌种鉴定和embB基因突变的部位与性质分析。结果以结核分枝杆菌H37Rv标准株为对照，11株耐EMB分离株和46例临床痰标本经16S rDNA PCR-SSCP分析电泳图谱均与结核分枝杆菌标准株相同；限制性内切酶NlaⅢ消化embB基因扩增产物显示，11株耐EMB分离株中4株(36．4％)不被NlaⅡ消化；46例结核病痰标本中10例(21．7％)不被NlaⅡ消化。结论部分结核分枝杆菌耐EMB是由于embB基因突变所致。采用PCR-SSCP和PCR-RFLP方法可直接快速测定结核病耐EMB分离株和痰标本中结核分枝杆菌耐EMB基因型。     

单纯性肥胖儿童心电图QT离散度与左心室射血分数的关系研究

【目的】　分析单纯性肥胖儿童是否存在心电图QT离散度 (QTD ,QTcD)的改变及其可能的临床应用价值。　【方法】　测量单纯性肥胖组和对照组儿童 12导联心电图RR间期、QT间期并计算QTc、QTD、QTcD ,彩色多普勒测量受试者左室射血分数 (LEF)。　【结果】　肥胖组RR、LEF明显低于对照组 (P <0 .0 1,P <0 .0 0 1) ,QTcD明显高于对照组 (P <0 .0 5 ) ,QTD虽然比对照组大 ,但无统计学意义 (P >0 .0 5 ) ;肥胖组QTD、QTcD与LEF成负相关关系 (r = 0 .485 ,P <0 .0 5 ;r = 0 .5 12 ,P <0 .0 5 ) ,与RR成正相关关系 (r =0 .5 2 0 ,P <0 .0 2 ;r =0 .613 ,P <0 .0 0 5 )。　【结论】　肥胖儿童LEF降低 ,心率增快 ,QTcD显著延长 ;QTD、QTcD的变化可能是肥胖儿童心室肥厚、心肌脂肪浸润等某一或某几项病理改变及心率变化的综合反映 ,也是LEF变化的反映     

卡介菌多糖核酸对尖锐湿疣患者外周血T细胞受体表达的影响

目的：研究卡介菌多糖核酸(BCG PSN)对尖锐湿疣患者外周血T细胞受体(TCR)表达的影响，探讨BCG PSN对尖锐湿疣可能的免疫调节机制。方法：尖锐湿疣患者18例给予BCG PSN 0.5 mg，im，隔天1次，36 d为1个疗程。治疗前后采用双色荧光抗体染色技术经流式细胞仪检测外周血CD＋3及TCRαβ＋T细胞、TCRγδ＋T细胞百分率。结果：在BCG PSN治疗前，尖锐湿疣患者CD＋3 T细胞百分率明显低于正常对照组(P＜0.01)，TCRγδ＋T细胞百分率较正常对照组明显下降(P＜0.01)，TCRαβ＋T细胞百分率与正常对照组差异无显著性(P＞0.05)；而治疗后尖锐湿疣患者CD＋3T细胞百分率高于治疗前(P＜0.01)；TCRαβ＋T细胞、TCRγδ＋T细胞百分率较治疗前升高(P＜0.01)。结论：BCG PSN可能通过调节尖锐湿疣患者外周血TCR的表达，起到治疗尖锐湿疣的作用。     

卡介苗多糖核酸微乳的研究

目的制备卡介苗多糖核酸(BCG-PSN)微乳。方法采用磷脂为乳化剂,乙醇为助乳化剂,油酸乙酯为油相,用改良三角相图法确定微乳区域,优化BCG-PSN微乳处方组成。结果与结论所制得BCG-PSN微乳澄清透明,性质稳定。     

子宫内膜癌DNA倍体、SPF的检测及其临床意义的研究

目的通过检测子宫内膜癌及其癌前病变中的DNA倍体、S期细胞率、DI值在不同临床分期和病理分期中的变化并评价其临床意义。方法采用流式细胞术(FCM)检测30例子宫内膜癌CA及10例子宫内膜复合性增生,10例不典型增生过长中的DNA倍体、S期细胞比率、DI值的表现。结果子宫内膜癌组与不典型增生组和子宫内膜复杂型增生组的异倍体率,DI值,SPF有显著差异(P<0.05);而且子宫内膜癌的DNA含量,与SPF癌灶的组织学分级,病理分期及肌层浸润程度,临床分期呈正相关。结论癌前病变出现DNA非整倍体及细胞增殖水平增高对预测和诊断癌变是一个重要而有价值的指标,且早于临床病理诊断。DNA含量与SPF与肿瘤预后密切相关,二者是判断子宫内膜癌预后的非常有意义的指标。     

慢性心房颤动患者心室率变化意义的探讨

目的分析探讨慢性心房颤动患者心室率变化的意义,为临床如何预防心房颤动患者出现脑栓塞、心功能降低等并发症提供理论依据。方法将入院或门诊就诊病程超过1年的慢性心房颤动患者分为脑栓塞组和非脑栓塞组,各30例,观察比较两组患者临床特征,动态心电图计数比较两组患者最大心室率、平均心室率及最小心室率变化,超声心动图测定两组患者左房内径大小、左室射血分数变化,血浆凝血酶原时间凝固法测定两组患者血浆凝血酶原时间国际标准化比值(I NR)变化。结果两组患者一般临床特征、左房内径大小、I NR值比较,差异无统计学意义。脑栓塞组最大心室率、平均心室率及最小心室率均明显快于非脑栓塞组,左室射血分数明显低于非脑栓塞组。结论慢性心房颤动患者降低心室率对预防脑栓塞、左心功能降低有重要意义。