肺癌患者FLK-1、LRP和MDR1的表达与临床研究

目的:探讨血管内皮生长因子受体 (Flk 1),肺耐药蛋白 (LRP)基因以及多药耐药基因 (MDR1)蛋白与肺癌患者临床及病理指标的关系。方法:用免疫组化技术(ABC法)对原发性肺癌组织中三种基因的表达进行检测。结果: 70例肺癌中,非小细胞肺癌MDR1阳性率 49. 2% (29 /59),明显高于小细胞肺癌 (SCLC) 18. 2% (2 /11)(P<0. 05);非小细胞肺癌LRP阳性率 69. 5% (41 /59),明显高于小细胞肺癌 27. 3% (3 /11) (P<0. 05)。腺癌中MDR1与LRP的表达明显高于鳞癌(P<0. 05)。LRP与Flk 1在NSCLCs中共同表达 49. 2% (29 /59),LRP的表达与肺癌的组织学分级相关,MDR1和LRP的表达与肺癌的组织学类型有关,Flk 1与TNM分期相关,均有统计学意义(P<0. 05)。Flk 1 LRP均阳性、FLK 1 LRP MDR1均阳性、中药治疗、复发与患者的生存率有关(P<0. 05)。结论:FLK 1、LRP和MDR1基因蛋白产物的检测对肺癌患者的诊治和预后评估有积极意义。     

QT离散度对急危重病人预后的评估

目的　研究QT离散度对急危重病人预后的预测价值。方法　死亡组 4 7例、疾病组 4 0例和正常组 4 3例。记录 12导联心电图 ,人工测量各导联R -R间期和QT间期 ,计算R -R、QTc、QTd和QTcd。结果　死亡组的R -R、QTc、QTd和QTcd分别为 0 5 6 2± 0 2 2 0ms、0 35 6± 0 0 6 9ms、0 0 5 6± 0 0 33ms和 0 0 79± 0 0 4 6ms ;疾病组的R -R、QTc、QTd和QTcd分别为0 80± 0 134ms、0 4 16± 0 0 3ms、0 0 34± 0 0 14ms和 0 0 39± 0 0 16ms;正常组的R -R、QTc、QTd和QTcd分别为 0 82 5± 0 0 88ms、0 4 0 2± 0 0 3ms、0 0 2 7± 0 0 15ms和 0 0 31± 0 0 15ms。比较死亡组、疾病组和正常组发现 ,死亡组和疾病组的R -R、QTc、QTd和QTcd存在显著差异 (P分别 <0 0 0 1、<0 0 0 2 5、<0 0 0 1和 <0 0 0 1)。死亡组和正常组的R -R、QTc、QTd和QTcd存在显著差异 (P分别 <0 0 0 1、<0 0 0 2 5、<0 0 0 1和 <0 0 0 1)。结论　QTd对急危重病人的预后有一定的预测价值 ;但其它临床应用价值存在局限性 ,有待进一步探索。     

Predictive value of clinical characteristics for 'benign' multiple sclerosis

We studied a cohort of 496 patients who had multiple sclerosis (MS) for at least 10 years. Ten years after disease onset, 151 had benign MS defined as an Extended Disability Status Scale (EDSS) ≤3. Between benign and non-benign patients we compared gender, age at clinical onset, relapsing–remitting or primary progressive, symptoms at onset, recovery from first relapse, time between first and second relapse, number of relapses in the first 5 years, use of immunomodulatory drugs, and EDSS scores at 2, 5 and 10 years. A multivariate regression analysis showed that a relapsing–remitting course, a low EDSS score at 5 years, and a low number of relapses in the first 5 years were predictive for benign MS at 10 years. Other factors had no additional value. Thirty-five of the 51 patients (69%) with benign MS at 10 years were still benign at 20 years. A low 10-year EDSS score was the only clinical variable associated with a benign course at 20 years. Our results suggest that within the first 5 years from onset it is not possible to predict a benign course. Disease course, EDSS score and relapse rate at 5 years are predictors for benign MS at 10 years.     

Pathological variables determining the prognosis of non-Hodgkin''s lymphomas

The aim of the study was to assess the role of pathological grade, cell proliferation, ploidy, immunophenotype and site in determining the prognosis of non-Hodgkin's lymphomas. Of particular interest was the relative value of grades derived from the Kiel classification as opposed to the National Cancer Institute (NCI) working formulation. The study consisted of 181 cases, treated in a relatively uniform way over an 18-month period spanning 1986. Using life table analysis, both NCI working formulation grade and Kiel grade correlated strongly with survival. However, the differences between grades were entirely due to an excess of early deaths in the high-grade and intermediate-grade categories. In patients surviving greater than 0.1 years (37 days), phenotype, site, ploidy and cell proliferation had no effect on survival. There was no evidence that intermediate-grade tumours, when subdivided into Kiel low- and high-grade types, differed in survival from tumours graded as low- or high-grade by both methods. However, NCI working, formulation high-grade tumours, especially those with a high proliferation rate, formed a group with a very high likelihood of death within 0.1 years.     

高血压脑出血微创外科治疗的预后因素分析

目的探讨影响高血压脑出血（HICH）微创外科治疗预后的相关因素。方法回顾性分析经微创手术治疗的HICH病人106例,总结其临床特点和疗效,并采用单因素和Logistic多因素回归分析,总结影响预后的有关因素。结果单因素分析显示：平均动脉压（MAP）、术前意识状态、血肿形态、出血部位、血肿量、血肿与脑室关系、血肿再发及术后并发症等因素与HICH微创外科治疗临床预后有关（P〈0.05）。多因素回归分析显示：术前意识状态、术后并发症及出血部位与HICH微创外科治疗预后密切相关（P〈0.01）。结论微创外科手术治疗HICH具有简单、安全、疗效好等优点;术前意识状态、术后并发症、出血部位是影响其预后的重要因素。     

Dipyridamole technetium 99m sestamibi myocardial tomography as an independent predictor of cardiac event-free survival after acute ischemic events

Background  

A total of 137 consecutive patients with recent uncomplicated myocardial infarction (n=31) or unstable angina (n=106) were studied to determine the relative prognostic value of predischarge clinical risk stratification and intravenous dipyridamole stress sestamibi (MIBI) myocardial tomography in patients unable to exercise maximally after an acute ischemic coronary event.     

Peripheral Blood Lymphocyte Surface Antigen Expression and Prognosis in Myeloma: Australian Leukaemia Study Group Study

The Australian Leukaemia Study Group myeloma study (MM1) aimed to determine the prognostic significance of clinical and immunophenotypic markers in patients with multiple myeloma. All patients were treated with standard dose melphalan and prednisone. Seventy-four patients were entered and the median survival was 27 months. Serum beta 2-microglobulin (βM) and albumin levels were the only significant clinical factors influencing survival (p = 0.007 and p = 0.008, respectively). Patients with raised levels of CD38+ lymphocytes at presentation had a significantly shorter survival than patients with normal levels (p = 0.01, logrank test, median 19 months vs 33 months). CD38 antigen expression was independent of β2M but patients with raised levels of CD38 had significantly lower levels of albumin than patients with normal levels (p = 0.001) which may explain their poorer survival. Salmon and Durie stage was not associated with antigen expression. No other B-cell antigens (CD10, CD19, CD20, CD21, CD22, CD23, FMC1 or FMC7) or plasma cell antigens tested (PCA-1) were found to be associated with prognosis. Patients who achieved plateau phase had a better prognosis than those who did not (p = 0.04 in a landmark analysis). Patients who achieved plateau phase following an objective response appeared to have a better prognosis than those who were in plateau phase at presentation (p = 0.09 in a landmark analysis). Light chain isotype suppression (LCIS) was not associated with a significant survival advantage and did not correlate with any known prognostic indicator. We conclude that phenotypic analysis of peripheral blood lymphocytes for CD38 antigen at diagnosis may be useful as a prognostic indicator in patients with myeloma.     

Comparison of the treadmill exercise score and single-photon emission computed tomographic thallium imaging in risk assessment

Background  

This study compared the prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging with that of treadmill exercise score in medically treated patients with coronary artery disease (CAD)     

Pronounced bronchial hyper-responsiveness and asthma severity

Summary. Fifty-six asthmatics from an asthma ward or from an asthma out-patient clinic were challenged with two low concentrations (0–03 and 0–012 mg) of metacholine chloride in order to assess the relationship between pronounced hyper-responsiveness and asthma severity in a clinical setting. Only inhaled bronchodilators were stopped before challenge. Asthma severity was assessed retrospectively and prospectively on the basis of treatment, number of days in hospital, intensive care, number of emergency visits and days on sick-leave. The results show that pronounced hyper-responsiveness (n= 28) is not associated with asthma severity. It is concluded that a single simplified test of pronounced bronchial hyper-responsiveness, performed without taking into consideration the actual state of the disease and without stopping all medication, is of no help in identifying the patients with the clinically most severe asthma and worst prognosis.,