三种光疗法治疗寻常性痤疮疗效观察

目的：评价光动力学疗法（PDT）,强脉冲光（IPL）和红蓝光（LED）治疗中、重度寻常性痤疮的疗效。方法：将90例中、重度痤疮患者随机分为三组：PDT治疗组,IPL治疗组和LED红蓝光治疗组。分别于治疗前、治疗中期（治疗1个月）和末次治疗结束后评价疗效。结果：治疗中期评价时,PDT、IPL、LED治疗组总有效率分别为93.3%、60.0%和36.7%,平均皮损减少率分别为90.4%、69.0%和39.8%。要达到炎症性皮损痊愈,PDT组平均需要（3±1.52）个治疗周期,IPL组（6±2.15）个治疗周期,LED组（9±3.34）个治疗周期。结论：光疗法治疗中、重度痤疮疗效显著,PDT组疗法效果优于IPL和LED组,副作用少,有很好应用前景,而长期疗效有待进一步观察。     

新辅助治疗在直肠癌脉管癌栓中的临床意义

目的 研究新辅助治疗后直肠癌脉管癌栓在中低位直肠癌组织中的分布规律,探讨脉管癌栓对直肠癌预后评价的意义.方法 按照入选标准收集2002年8月至2005年8月北京大学临床肿瘤学院连续收治的接受根治性切除的中低位直肠癌患者297例,根据是否接受术前辅助治疗将患者分成新辅助治疗组和对照组,观察两组患者术后病理标本中的脉管癌栓并根据术后随访资料研究脉管癌栓与预后的关系.采用x2检验分析其相关性,Kaplan-Meier生存法分析无病生存率和总生存率.结果 脉管癌栓总体阳性率为23.9%(71/297),新辅助治疗组阳性率为21.5%(31/144),对照组阳性率为26.1%(40/153),两组比较,差异无统计学意义(x2=0.872,P＞0.05).新辅助治疗组和对照组的脉管癌栓均与病理T、N分期及组织学分化程度有关(x2=13.490,27.401,7.323;16.188,21.623,16.534,P<0.05).新辅助治疗组脉管癌栓与局部复发无关(x2=0.000,P＞0.05),对照组的脉管癌栓与局部复发有关(x2=4.010,P<0.05).两组的脉管癌栓均与远处转移有关(x2=4.950,14.332,P<0.05).脉管癌栓阳性者比阴性者的无病生存率和总体生率低,分别为46.4%(26/56)和75.1%(148/197)、56.7%(34/60)和79.4%(166/209),两者比较,差异有统计学意义(x2=16.720,12.660,P<0.05).结论 新辅助治疗并未使脉管癌栓减少,但脉管癌栓在生物学行为上已经发生了变化,且脉管癌栓阳性的患者有可能从新辅助治疗中获益.     

Protaper器械治疗不可复性牙髓炎中残髓与IAE关系的临床研究

目的：探讨Protaper镍钛器械根管预备不可复性牙髓炎后残髓与IAE的关系。方法：按Crown-down预备技术进行根管预备,约诊时记录初次预备后是否疼痛和发生时间、程度并做再次清理预备,仔细观察是否存在残髓和预备过程疼痛与否,必要时行多次清理和预备。结果：第1次预备后疼痛者往往在第2次预备时发现残髓。结论：残髓的存在是导致根管治疗期间疼痛应足够重视的原因之一,约诊期间最好行二次或以上次数的根管清理和预备。     

The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer： a 3-year pilot study

To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy （ADT） was used. We compared biochemical responses between primary cryosurgical ablation of the prostate （CSAP） combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy （3D-CRT） with the same protocol for ADT. Biochemical recurrence （BCR） was assessed by the American Society for Therapeutic Radiation Oncology （ASTRO） definition, the Phoenix definition and a prostate-specific antigen （PSA） cutoff of 0.5 ng mL^-1. Median follow-up was 61.0 ± 11.9 months for the CSAP ＋ ADT group and 86.0±15.8 months for the 3D-CRT ＋ ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP ＋ ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL^-1. In the 3D-CRT ＋ ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP ＋ ADT group, the BCR-free survival （BRFS） was 54 ± 10 months using the ASTRO definition, 65 ± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL-1. In the 3D-CRT ＋ ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.     

Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection

BACKGROUND AND OBJECTIVE: To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. STUDY DESIGN/MATERIALS AND METHODS: Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. RESULTS: Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. CONCLUSIONS: Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy.     

胃肠道间质瘤71例预后影响因素分析

目的探讨胃肠道间质瘤的诊断和治疗方式及影响术后复发的因素。方法对我院2001年1月～2007年6月收治并获随访的71例胃肠道间质瘤的临床资料进行回顾性分析。分别采用单因素和多因素两种方式对影响复发的因素进行分析。结果单因素分析显示,肿瘤大小、有无浸润、坏死和手术方式均对术后复发有影响(P<0.05);多因素分析显示,肿瘤大小、有无浸润和手术方式对术后复发有影响(P<0.05)。结论适当扩大切除范围,术后服用依马替尼可降低胃肠道间质瘤的术后复发率,改善病人预后。     

贲门癌近端胃切除术后残胃排空障碍的诊断和治疗

目的探讨贲门癌术后胃瘫的临床诊治方法。方法对我院2001年1月～2006年12月收治的贲门癌术后胃瘫18例的临床资料进行回顾性分析。结果本组经胃肠减压,营养支持,维持水、电解质代谢平衡及促进胃肠动力药物等治疗后均得以缓解。结论贲门癌术后胃瘫的诊断主要依据临床表现;胃镜检查有其重要价值;排除机械性梗阻后应积极采取非手术治疗,不应盲目再次手术。     

开放手术和内窥镜手术治疗男性尿道狭窄83例报告

目的:总结83例男性尿道狭窄患者的手术治疗体会.方法:对54例≤1.5 cm尿道狭窄者采用内窥镜技术治疗;对29例＞1.5 cm尿道狭窄中的21例行开放手术治疗,其中4例长段尿道狭窄者利用包皮瓣或阴茎皮瓣做尿道成形术,另8例行内窥镜手术治疗,其中5例采用自体包皮片移植术.结果:经6～36个月随访,开放手术排尿通畅者占85.7%,内窥镜手术排尿通畅者为88.7%.结论:临床上应根据尿道狭窄范围及长短选择手术方式,尿道狭窄段≤1.5 cm者适合内窥镜手术,而＞1.5 cm者适合开放手术.而包皮皮片、包皮、阴茎皮瓣是非常好的长段尿道狭窄的替代物.     

携带Fas基因重组腺病毒治疗瘢痕疙瘩的体内实验研究

目的 研究携带人Fas基因的两种重组腺病毒对瘢痕疙瘩的体内治疗效果。方法 构建瘢痕疙瘩裸鼠模型,应用携带Fas基因的常规腺病毒Ad—Fas（T）和细菌内重组腺病毒Ad—Fas（B）注射及Fas单克隆抗体（FasMcab）辅助对植入裸鼠皮下的瘢痕疙瘩组织进行治疗。通过大体观察、常规病理及电镜观察检测瘢痕疙瘩组织的变化。结果 单纯使用腺病毒注射的瘢痕疙瘩组织块体积仅轻度缩小。前期注射Ad—Fas（B）或Ad—Fas（T）后,应用FasMcab作为后续治疗,瘢痕疙瘩组织块均明显缩小,HE染色证实瘢痕疙瘩组织结构遭到破坏,电镜观察发现细胞凋亡证据。结论 重组腺病毒Ad—Fas（B）及Ad—Fas（T）的瘢痕疙瘩基因治疗效果令人满意。为瘢痕疙瘩的治疗提供了新途径。     

多药耐药相关基因及其蛋白在介导胰腺癌细胞原发性耐药中的作用及调控

目的 检测多药耐药相关基因（MDR1）及其蛋白（P-gP）在胰腺癌细胞株的表达,初步探讨胰腺癌发生先天性耐药的机理。方法 选择8株人胰腺癌细胞株,采用RT-PCR方法检测MDR1mRNA在胰腺癌细胞中的表达;通过免疫细胞化学方法检测P-gP的表达;以流式细胞仪检测胰腺癌细胞对罗丹明的外排情况,评价P-gP泵功能;最后通过P-gP抑制物维拉帕米与化疗药物联合应用,检测其对胰腺癌细胞的杀伤作用。结果 MDR1mRNA在胰腺癌细胞株SW1990中的表达最高,除PCT-2未检测到MDR1的表达外,其余6株细胞均有MDR1的微弱表达;免疫细胞化学染色结果证实P-gP在SW1990中的表达明显高于其他细胞株。57．9％±5．4％的SW1990细胞内有罗丹明蓄积,而在P-gP阴性对照细胞中,99．5％±3．3％的细胞内存在罗丹明的积聚,两者差异有统计学意义（P〈0．05）。P-gP抑制物维拉帕米与阿霉素或表阿霉素联合应用时可以部分逆转肿瘤细胞对化疗药物的耐药性。结论 MDR1及P-gP在人胰腺癌细胞中存在一定量的表达;维拉帕米联合阿霉素可以明显抑制P-gP阳性细胞的生长。