46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

一种朊蛋白错误折叠循环扩增方法的建立

目的建立一种类似于PCR的蛋白质扩增方法-蛋白错误折叠循环扩增技术(PMCA),用于朊病毒病脑组织中PrPSc的检测。方法将不同浓度的羊瘙痒因子263K毒株原液与正常仓鼠脑组织匀浆混合,经反复孵育/超声,共10~15个循环。WesternBlot检测扩增产物中蛋白酶K抗性PrPSc信号。结果在本研究试验体系下,263K毒株可以利用仓鼠脑组织为基质在体外迅速复制。所建立的PrPSc-PMCA技术可检测到10-5稀释的毒株原液中的PrPSc。与常规的脑组织免疫印记方法相比,敏感度提高了105~106倍。研究还显示PrPSc还可利用小脑和脑干为基质进行体外扩增复制。结论成功建立了PrPSc-PMCA技术,为朊病毒病的早期诊断和朊病毒生物学特性的研究提供了一种新的手段。     

46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

美国癌症研究联合会第七版肿瘤分期对鼻咽癌放疗预后的影响

目的 观察美国癌症研究联合会( AJCC)第7版肿瘤分期标准对鼻咽癌常规放疗(CRT)和凋强放疗(IMRT)预后的影响.方法 用AJCC第7版肿瘤TNM分期标准对本院2004-2006年接受CRT和IMRT的鼻咽癌患者重新分期和分析预后.共1138例患者入组,CRT 790例,IMRT 348例.CRT和IMRT患者中位年龄分别为47岁和45岁(x2 =1.49,P=0.222),男女比例分别为580∶210和266∶82(x2=1.15,P=0.303),Ⅰ、Ⅱ、Ⅲ、Ⅳ期例数分别为0、41、488、261和5、65、176、102例(x2 =64.78,P=0.001).比较两种放疗的3年疗效,Kaplan-Meier法计算生存率并Logrank法检验.结果 3年随访率为96.0％.常规、IMRT患者中位随访时间分别为32、33个月,死亡例数分别为113、35例.N分期是影响常规、IMRT总生存和无远处转移生存的因素(x2 =6.50、13.60,P=0.038、0.004和X2=7.78、15.30,P=0.009、0.002),临床分期对CRT总生存有影响(x2=6.70,P=0.035)、对IMRT无远处转移生存有影响(x2=9.12,P=0.028).结论 第7版AJCCT分期仍不能满足准确判断鼻咽癌预后的需要,N分期是影响鼻咽癌总生存和无远处转移生存的重要预后因素.     

儿童鼻咽癌50例预后分析

目的 分析儿童鼻咽癌的疗效及预后因素。方法 回顾性分析50例经病理组织学确诊,年龄10-18岁的鼻咽癌患者资料。鼻咽部放疗采用60Co或60MV光子线常规分割照射,照射剂量为54.4-74 Gy,平均剂量（67.8±4.0） Gy;颈部采取切线野照射至45-50Gy后,转移淋巴结补充剂量至56-66 Gy。其中37例患者接受不同方式的化疗。结果 全组1、3、5年生存率分别为85.4%、69.7%及67.4%。单因素分析结果显示N分期（P=0.038）、临床分期（P=0.035）及是否化疗（P=0.043）对预后有影响。多因素分析仅N分期影响预后。结论 N分期是影响儿童鼻咽癌的重要预后因素,N2以上患者建议选择放疗加化疗的综合治疗。     

单枚空心钉治疗未成年MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折

目的 探讨在关节镜辅助下用单枚空心螺钉治疗未成年人MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折的疗效.方法 选出我科2010年1月至2017年3月间收治的具有手术指征的10～18岁MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折的未成年人21例,在关节镜辅助下复位骨折块,并用单枚空心螺钉在导针指引下行内固定治疗,通过测...     

单心室患者辅助循环设备的研究与应用进展

单心室由于其特殊的病理生理特点,一直是心脏外科治疗的难点之一,其术后低心排血量引起的心力衰竭是影响其生存率的重要问题之一。机械辅助支持(mechanical circulatory support,MCS)是治疗心力衰竭的有效手段,可以帮助患者渡过单心室术后短期低心排血量恢复,也可以进行长期辅助循环治疗慢性心力衰竭或过渡到心脏移植,有效挽救患者生命,但单心室辅助循环的成功率明显低于双心室的心力衰竭患者。我们总结了现在可用于单心室辅助循环支持的MCS装置和其单心室辅助的临床效果,并介绍针对功能性单心室特点正在研发或实验阶段的各种单心室辅助循环设备。     

保留桡骨茎突带桡动脉茎突支桡骨骨瓣移植治疗腕舟骨骨折不愈合

腕舟骨骨折是常见的骨折,由于其特殊的血供特点及解剖位置,骨不愈合的发生率为5％～10％,治疗较困难[1-2].2007年2月至2010年8月,我院采用带桡动脉茎突支桡骨骨瓣移植治疗腕舟骨骨折不愈合19例,疗效满意.资料与方法本组男12例,女7例.年龄21 ～ 45岁.病程8个月～12年.骨折部位:舟骨腰部骨折17例、近侧t/3骨折2例,其中3例近端缺血性坏死.临床表现:腕关节酸疼,持物时明显,握力下降,鼻烟窝区压痛.X线片显示:骨折线清晰,骨折断端硬化,断端骨吸收.近折端呈囊性变3例.     

将人工智能引入网络药理学学科建设北大核心CSCD

网络药理学的提出是药理学的一大进步,它标志着药理学的研究从传统的一药一靶,一钥匙一锁的研究思想走向了系统化的研究模式[1]。在过去十年的网络药理学研究中,网络及网络科学中的多种度量指标成为了药理研究中的描述和研究工具,为药物新用途发现及药物治疗理论的完善提供了全新视角。