大肠癌巨─微血管构筑的临床研究

为了探讨大肠癌和其间质血管的关系，我们研究了48例大肠癌标本不同部位的巨─-微血管构筑。方法：用癌瘤标本造影摄X线片、立体显微镜和微机图象定量分析。结果显示：癌中心血管稀疏或为无血管的坏死区及血管破坏；癌远近端瘤组织内血管增多增粗，畸形及紊乱；其血管定量参数与癌中心和癌远近端肠粘膜相比有显著差异（P＜O．05，P＜0．01）。结论：①大肠癌的发生发展依赖于血管形成和细胞增殖。②在理论上解释了大肠癌的临床病理过程。③大肠癌的恶性程度与其血管密度间似有负相关的趋势。④探讨了其临床应用价值。     

原发性输尿管肿瘤22例诊断与治疗体会

目的提高原发性输尿管肿瘤的诊断与治疗水平。方法对原发性输尿管恶性肿瘤22例进行回顾性分析,比较各种检查手段。结果随访20例(90.9%),随访时间6个月到7年,死亡8例。结论静脉尿路造影、膀胱镜和逆行肾盂输尿管造影是原发性输尿管恶性肿瘤的基本检查手段;大剂量静脉滴注尿路造影效果更好。肾输尿管全长及膀胱部分切除仍是其主要术式。     

乙肝病毒外膜大蛋白检测在阿德福韦抗病毒治疗中的应用

目的 通过检测抗病毒治疗患者血清中乙肝病毒外膜大蛋白(HBV-LP)和病毒载量(HBV-DNA),探讨阿德福韦抗病毒治疗过程中HBV-LP与HBV-DNA的关系,观察HBV-LP用于评估抗病毒治疗效果的应用价值.方法 采用酶联免疫吸附试验(ELISA)方法对HBV-LP进行检测;采用荧光定量PCR方法对HBV-DNA进行检测.结果 抗病毒治疗有效组患者HBV-DNA和HBV-LP下降趋势一致;抗病毒治疗无效组患者HBV-DNA始终没有出现阴转,HBV-LP的含量维持在较高水平;抗病毒治疗效果反复组患者HBV-LP的含量维持较高水平或变化不明显,HBV-DNA则出现暂时阴转.结论 动态监测HBV-LP的含量可用于阿德福韦抗病毒治疗效果的评估.     

三羟异黄酮对失血性休克大鼠肠系膜上动脉收缩反应性的影响

目的研究三羟异黄酮(genistein,GST)对失血性休克大鼠肠系膜上动脉收缩反应性的影响及其可能机制。方法建立大鼠失血性休克(3.9kPa,2h)模型。采用离体血管环张力测定实验,观察三羟异黄酮及酪氨酸蛋白磷酸酶抑制剂钒酸钠(sodiumorthovannadate,Na3VO4)对休克大鼠肠系膜上动脉血管收缩反应性的影响;采用细胞贴附式膜片钳记录技术,观察三羟异黄酮及钒酸钠对休克大鼠肠系膜上动脉平滑肌细胞大电导钙激活钾通道(largeconductancecalciumactivatedpotassiumchannel,BKCa)活动的影响。结果失血性休克导致大鼠肠系膜上动脉对去甲肾上腺素(noradrenine,NE)的收缩反应性降低,三羟异黄酮可在一定的剂量范围内明显改善失血性休克引起的血管低反应性;钒酸钠则可引起休克血管收缩反应性的进一步降低,且该作用可被0.1mmol·L-1TEA部分阻断;进一步的研究显示,失血性休克可引起大鼠肠系膜上动脉血管平滑肌细胞BKCa通道活动的增强,三羟异黄酮可抑制休克血管平滑肌细胞BKCa通道活动,且该作用可被钒酸钠逆转。结论三羟异黄酮可通过干预由PTK介导的酪氨酸蛋白磷酸化,防止失血性休克血管平滑肌细胞BKCa通道活动的增强,从而有效恢复失血性休克大鼠肠系膜上动脉对NE的收缩反应性。     

Constructing Large Scale Cohort for Clinical Study on Heart Failure with Electronic Health Record in Regional Healthcare Platform: Challenges and Strategies in Data Reuse

Regional healthcare platforms collect clinical data from hospitals in specific areas for the purpose of healthcare management. It is a common requirement to reuse the data for clinical research. However, we have to face challenges like the inconsistence of terminology in electronic health records (EHR) and the complexities in data quality and data formats in regional healthcare platform. In this paper, we propose methodology and process on constructing large scale cohorts which forms the basis of causality and comparative effectiveness relationship in epidemiology. We firstly constructed a Chinese terminology knowledge graph to deal with the diversity of vocabularies on regional platform. Secondly, we built special disease case repositories (i.e., heart failure repository) that utilize the graph to search the related patients and to normalize the data. Based on the requirements of the clinical research which aimed to explore the effectiveness of taking statin on 180-days readmission in patients with heart failure, we built a large-scale retrospective cohort with 29647 cases of heart failure patients from the heart failure repository. After the propensity score matching, the study group (n=6346) and the control group (n=6346) with parallel clinical characteristics were acquired. Logistic regression analysis showed that taking statins had a negative correlation with 180-days readmission in heart failure patients. This paper presents the workflow and application example of big data mining based on regional EHR data.     

Blimp-1 protein and Hans classification on prognosis of diffuse large B-cell lymphoma and their interrelation

Background and Objective:Diffuse large B-cell lymphoma (DLBCL), the most common type of non-Hodgkin's lymphoma (NHL), is heterogeneous on molecular and clinical levels, therefore, its prognosis is difficult to predict.This study aimed to evaluate the value of Blimp-1 protein and Hans classification in predicting the prognosis of DLBCL and their interrelation.Methods:The clinical records of 136 patients with DLBCL were reviewed.The patients were followed up for 5-80 months (median, 39 months).Immunohistochem...     

CD10,Bcl-6,CD138,Bcl-2,MUM1在136例弥漫大B细胞淋巴瘤中的表达及预后意义

Objective  

We evaluated the value of using a panel of GC B-cell (CD10 and Bcl-6) and activation (MUM1, CD138 and Bcl-2) markers by immunohistochemistry to define prognosis in patients with diffuse large B-cell lymphoma (DLBCL).     

大肠癌术后腹腔化疗的临床价值

目的　为防止大肠癌术后腹腔内复发和肝转移 ,探讨切实有效的辅助治疗措施。方法　对 3 4例大肠癌根治术后行DDP、5 -Fu腹腔内灌注 ,与 3 7例根治术后静脉化疗相比较。结果　腹腔组 5年复发率 ( 3 2 % )明显低于静脉组 ( 70 % ) ,5年生存率 ( 74% )明显高于静脉化疗组 ( 3 8% )。腹腔组全身毒性反应明显低于静脉组。结论　腹腔灌注化疗对预防大肠癌术后复发及肝脏转移颇有意义。     

巨大甲状腺肿合并胸骨后病变或气管软化的外科处理

目的:探讨巨大甲状腺肿合并胸骨后病变或气管软化的外科处理,以及开胸和气管悬吊的手术适应症。方法:回顾性分析1992年-2010年本院收治的66例巨大甲状腺肿患者的临床资料。其中24例为胸骨后甲状腺肿,42例合并气管软化,所有病例均在术前行米瓦试验摄片,以及颈部-上胸部CT。结果:胸骨后甲状腺肿常规做好开胸准备,24例中23例经颈部切口切除,1例术中冰冻证实为淋巴瘤仅行姑息性大部切除后续化疗;42例米瓦试验阳性患者,术中探查见局部受压处气管软骨环消失6例,气管软骨环变细、变薄、变软36例。36例甲状腺切除术后行单一气管悬吊患者获得临床治愈,6例气管悬吊加气管切开患者抢救成功,无手术死亡。52例获随访,随访时间3个月至18年,48例均无呼吸道梗阻症状,2例死于癌症复发转移,2例死于其他疾病。结论:绝大多数的胸骨后甲状腺肿可经颈部切口切除。术中探查有助于气管软化的确诊,气管悬吊是治疗巨大甲状腺肿合并气管软化的有效方法。     

ALK 与儿童恶性肿瘤关系的研究进展*

近年来儿童恶性肿瘤的发病率有逐年增高的趋势,高危患儿预后差,且手术及放化疗等主要治疗手段的疗效已经达到平台期。靶向治疗以其可靠的疗效和轻微的毒副反应成为目前最受关注和最有前景的治疗手段之一。间变性淋巴瘤激酶（anaplastic lymphoma kinase,ALK ）是一种受体型酪氨酸激酶,近年的研究成果表明其异常与多种儿童肿瘤的发生发展密切相关。ALK 的异常形式主要包括基因融合、基因突变、基因扩增和蛋白表达增加。随着ALK 抑制剂在临床抗肿瘤治疗中的应用,针对ALK 异常的靶向治疗获得越来越多的关注。本研究主要针对ALK 在儿童恶性肿瘤中的异常以及与其发生发展关系的研究进展进行综述。