胆汁CEA和CA72-4联合检测对胆管癌的诊断价值

胆管癌术前的定性诊断十分困难。检测胆汁肿瘤标志物是一条可研究的途径。本文探讨胆汁癌胚抗原(CEA)和糖类抗原72-4(CA_(72-4))联合检测对胆管癌的诊断价值。 1.材料和方法:研究对象来自本院自1999年1月至2002年4月收治的66位病人,胆管癌32例(男20例,女12例),胆管良性病变34例(男15例,女19例)。术前经ENBD或PTCD、术中直接穿刺胆管收集胆汁。经超速离心15 min后,取上清液5 ml,—20℃存放。     

The pathogenesis of diabetic retinopathy

Diabetic retinopathy remains a major cause of loss of vision. The Diabetes Control and Complications Trial (DCCT) has implicated hyperglycaemia as a probable major direct causative factor in the pathogenesis of diabetic retinopathy. There are several plausible mechanisms by which high glucose concentrations could lead to the functional and later structural changes characterising diabetic retinopathy. These include increased activity of the aldose reductase pathway, increase de novo synthesis of diacylglycerol from glucose, causing protein kinase C activation, increased non-enzymatic glycation and increased oxidative damage. The demonstration of the potential roles of these pathways and the subsequent effects of growth factors in enhancing angiogenesis provide potential new approaches to the prevention and treatment of diabetic retinopathy.     

The Effect of C4 on C1 Binding and Activation

Cell-bound human C4 enhances the uptake of C1 by immunoglobulin-carrying cells. The effect is more pronounced with small amounts of IgG than with large amounts. Furthermore, the presence of C4 on the cell surface dramatically promotes the enzymatic effect of C1 on C2. The C1 binding is efficiently blocked, and the C1 activation is almost abolished by pretreating IgG-bearing cells with protein A from Staphylococcus aureus. In contrast, protein A has no effect on cells carrying C4 in addition to IgG. Protein A added in small amounts to IgG-coated sheep erythrocytes inhibits the haemolysis by subsequently added human serum, whereas even larger amounts of protein A has no effect when added to cells carrying C4 as well. Cells with and without C4 take up protein A equally well.     

Effects of smoking and aging on oxidative DNA damage of human lymphocytes

The effects of H2O2-induced oxidative DNA damage in 80 healthy individuals with relation to age (20-25 and 55-60 years old) and smoking has been investigated with the comet assay technique. Both factors have shown a significant effect upon basal DNA damage with smoking appearing to have the most impact. A differentiation of the four groups response to induced oxidative damage was also observed. A distinctly separate behavior of the younger non-smokers group, when compared with the rest of the categories, was found. This is attributed to the lower degree of initial basal damage that occurs in their lymphocytes.      

影像学检查技术在壶腹周围癌诊断上的合理应用

目的：探讨影像学检查技术在壶腹周围诊断上的合理应用。方法：对我院185例壶腹周围癌（包括胰头癌119例、十二指肠乳头癌41例、Vater壶腹癌13例、胆总管下段癌12例）的临床特点和各种影像学检查资料进行回顾性分析。结果：本组CT诊断胰头癌的准确率为90．9％；ERCP对十二指肠乳头癌的确诊率为100％；ERCP和MRCP对壶腹癌和胆总管下段癌的诊断价值优于其他检查。78％的病人上腹饱胀／隐痛出现时间早于黄疸1－3月。血清CA19－9值在3／4以上的胰头癌、壶腹癌和胆总管下段癌病人超过正常值。结论：凡有中上腹部饱胀、隐痛、血清CA19－9值升高、胆总管和（或）胰管扩张的病人应有步骤地进行各种影像学检查。超声检查发现胰头部有肿块，宜行CT检查。如未发现肿块，则行ERCP。凡ERCP检查时观察到有肿瘤征象的病人，不宜作胰胆管造影而仅作活检。MRCP可用于胰胆管造影失败的壶腹癌和胆总管下段癌。超声内镜对壶腹周围癌的诊断和鉴别诊断也起重要作用。     

检测胆汁和胆管刷取物中K-ras基因突变诊断胆管癌

目的　探讨检测胆汁和胆管刷取物中K ras基因突变对胆管癌的诊断价值。方法　采用聚合酶链反应 单链构象多态性 (PCR SSCP)和DNA测序检测K ras基因突变 ,胆汁标本 2 3例 ,胆管刷取物 14例 ,胆管癌组织 10例。结果　经PCR SSCP银染分析 ,胆管癌胆汁、胆管刷取物和胆管癌组织中K ras基因突变率分别为 5 4.6% (6/ 11)、60 .0 % (6/ 10 )和 60 .0 % (6/ 10 ) ,胆管良性病变均无突变。经DNA测序分析发现 ,6例胆管癌中 2例为点突变 ,4例为插入突变。同一病例的胆汁、胆管刷取物和癌组织中的K ras基因突变及突变类型相一致。结论　检测胆汁和胆管刷取物中K ras基因突变对胆管癌的术前定性诊断有一定的实用价值。     

Pulmonary function at peak exercise in patients with chronic heart failure

BackgroundVarious respiratory abnormalities are associated with chronic heart failure (CHF). However, changes in inspiratory capacity (IC) and breathing pattern from rest to exercise in patients with CHF have not been thoroughly investigated in these patients.Materials and methodsSeventy seven (66 male/11 female) patients with clinical stable CHF (age: 52 ± 11 years) were studied. All the patients underwent pulmonary function tests, including measurements of IC and maximal inspiratory pressure (Pimax) at rest and then a maximal cardiopulmonary exercise testing (CPET) on a treadmill. During the CPET, IC was measured every 2 min. Pimax was measured again after the end of CPET.ResultsPercent predicted forced expiratory volume in 1 s (FEV₁) was 91 ± 12, %predicted forced vital capacity (FVC) was 92 ± 13, %FEV₁/FVC was 81 ± 4, and %predicted IC was 85 ± 18. Peak exercise IC was lower than resting (2.4 ± 0.6 vs. 2.6 ± 0.6 l, p < 0.001). Analysis of variance between Weber's groups revealed statistically significant differences in peak exercise IC (p < 0.001), V_E/V_CO2slope (p < 0.001), resting Pimax (p = 0.005) and post-exercise Pimax(p < 0.001). At rest, there was a statistically significant difference in end-tidal CO₂ (P_etco2) (p = 0.002), in breathing frequency (p = 0.004), in inspiratory time (Ti) (p = 0.04) and in total respiratory time (T_Tot) (p = 0.004) among Weber's groups. At peak exercise there was a statistically significant decrease in minute ventilation (V_E) (p < 0.001), tidal volume (V_T) (p < 0.001), respiratory cycle (V_T/T_I) (p < 0.001) and P_etco2(p < 0.001).Peak IC was correlated with peak V_O2 (r = 0.72, p < 0.001), anaerobic threshold (r = 0.71, p < 0.001), V_O2/t slope (r = 0.54, p < 0.0001), and post-exercise Pimax (r = 0.62, p < 0.001).ConclusionsIn patients with CHF, peak exercise IC is reduced in parallel with disease severity, which is probably due to respiratory muscle dysfunction.