Confounded association between proton pump inhibitor use and risk of biliary tract cancer: Result from three cohorts

Recent epidemiological studies suggested that proton pump inhibitor (PPI) use was associated with an increased risk of biliary tract cancer (BTC), however, confounders were not adequately controlled. Our study aimed to evaluate PPI use and subsequent risk of BTC and its subtypes in three well-established cohorts. We conducted a pooled analysis of the subjects free of cancers in UK Biobank (n = 463 643), Nurses' Health Study (NHS, n = 80 235) and NHS II (n = 95 869). Propensity score weighted Cox models were used to estimate marginal HRs of PPIs use on BTC risk, accounting for potential confounders. We documented 284 BTC cases in UK Biobank (median follow-up: 7.6 years), and 91 cases in NHS and NHS II cohorts (median follow-up: 15.8 years). In UK biobank, PPI users had a 96% higher risk of BTC compared to nonusers in crude model (HR 1.96, 95% CI 1.44-2.66), but the effect was attenuated to null after adjusting for potential confounders (HR 0.95, 95% CI 0.60-1.49). PPI use was not associated with risk of BTC in the pooled analysis of three cohorts (HR 0.93, 95% CI 0.60-1.43). We also observed no associations between PPI use with risk of intrahepatic (HR 1.00, 95% CI 0.49-2.04), extrahepatic bile duct (HR 1.09, 95% CI 0.52-2.27) and gallbladder cancers (HR 0.66, 95% CI 0.26-1.66) in UK Biobank. In summary, regular use of PPIs was not associated with the risk of BTC and its subtypes.     

Iliopsoas Abscess Due to Brenner Tumor Malignancy: A Case Report

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甲状腺癌根治术中不同途径显露喉返神经的应用效果评价

目的 探讨甲状腺癌根治术中不同途径显露喉返神经的应用情况.方法 根据随机数字表法将92例进行甲状腺癌根治术的患者随机分为对照组和观察组,每组46例.对照组采用甲状腺下动脉途径法显露喉返神经,观察组采用甲状腺最下动脉途径法显露喉返神经.比较两组患者寻找喉返神经的时间、术中出血量、手术时间、术后声音嘶哑和喉返神经损伤的发生率.结果 观察组患者寻找喉返神经的时间和手术时间均明显短于对照组患者,差异均有统计学意义(P﹤0.01).观察组患者的术中出血量明显少于对照组患者,差异有统计学意义(P﹤0.01).观察组患者术后声音嘶哑和喉返神经损伤的发生率均低于对照组患者,差异均有统计学意义(P﹤0.05).结论 甲状腺癌根治术中应用不同途径显露喉返神经,其效果存在差异.与甲状腺下动脉途径法相比,甲状腺最下动脉途径法能够明显缩短寻找喉返神经的时间和手术时间,减少术中出血量,降低术后声音嘶哑和喉返神经损伤的发生率,值得临床推广应用.     

脂质体介导人β-神经生长因子基因转染培养肌母细胞的表达研究

目的　了解含 β-神经生长因子 (β- NGF)基因的表达质粒 PSVCEP NGF- CAT在培养肌母细胞中的表达及 L ipofect AMINE阳离子脂质体介导的转染效率。方法　将表达质粒 PSVCEP NGF- CAT经 L ipofectAMINE转染至培养成的肌母细胞中 ,用免疫细胞化学方法检测基因在肌母细胞内的表达。结果　培养肌母细胞在转染 6小时吞噬脂质体最显著 ,转染 48小时后约 40 %的肌母细胞胞质内有β- NGF基因表达。结论　含β- NGF基因的表达质粒 PSVCEP NGF- CAT可以在培养肌母细胞中表达 ,脂质体转染的方法简便、有效     

Quantitative observation by enzyme cytochemistry of human rectal adenocarcinoma cells killed by LAK cells

Activity of succinic dehydrogenase(SDH)and acid phosphatase(AcPase)of effector-target cells during the process of LAK cells killing HR8348 cells was estimated by enzyme cyto-chemistry technique.SHD positive granules and AePase gray level were assayed with MIAS-300image analyser.The results showed:(1)After cocultivation of effector and target cells for vari-ous times,the activity of AcPase of HR8348 cells was apparently higher than that of the controlgroup,and it increased following prolonged coincubation.SDH activity of target cells increasedmarkedly within 30 and 60 rain cocultivation,but became low after 90 min treatment.(2)Ac-Pase content within LAK cells at 60,90,120,180 and 240 rain cocultivation was significantlyhigher than that of control group(P<0.01).The phenomenon of high AcPase and SDH activitywithin effector-target cells indicates that the function of the two types of cells was in an activestate.At the early stage of effector-target combining,the increase of SDH with HR8348 cellsmay be related to defensive function of the target cells.Higher AcPase activity of target cells in-dicates the activation of lysosomal enzyme which serves as the material basis for autolysis of thecells.     

JX-1对雄性小鼠生殖细胞致突变作用的研究

本文采用小鼠精子试验和小鼠睾丸DNA合成抑制试验,检测了JX-1对雄性生殖细胞的致突变作用。实验结果表明JX-1对小鼠精子总数、精子活动率及精子畸形率均无统计学意义的增加,与小鼠睾丸DNA合成抑制试验阴性反应一致。作者认为JX-1对雄性生殖细胞为一种非诱变剂。     

放射性125I粒子组织间植入或联合放化疗治疗复发直肠癌

目的探讨超声或CT引导下放射性125I粒子组织间植入治疗复发直肠癌的技术可行性、近期疗效和副反应.方法 15例直肠癌术后盆腔复发患者,女4例,男11例.硬膜外麻醉,2例经阴道超声引导,13例CT引导,行放射性125I粒子植入术.肿瘤匹配周边剂量为90～110 Gy,每颗粒子活度为0.50～0.70 mCi,植入33～70颗.术后24～48 h拍胸、盆腔X线片了解粒子是否发生移位.术后6例加三维适形放疗,4～6野/次,200～300 cGy/次,5次/周,总剂量为4 500～5 000 cGy,间隔4周.2例粒子治疗后加草酸铂、5-氟尿嘧啶和四氢叶酸化疗1个周期,随访3～15个月,根据CT扫描结果判断肿瘤大小. 结果术后平均7天疼痛缓解,其中12例完全缓解,2例部分缓解,1例无变化,有效率93%(14/15).9例肿瘤完全缓解,2例部分缓解,4例局部进展,局部控制率73%(11/15).2例术后6个月和12个月时死于肺转移.1例1颗粒子移位至盆壁,随访12个月无症状.无治疗相关并发症和副作用发生. 结论经超声或CT引导放射性125I粒子植入治疗复发直肠癌具有安全、微创、并发症发生率低和疗效肯定等优势,粒子治疗后应配合外放疗和全身化疗,有望进一步提高疗效.     

跖跗关节骨折脱位手术治疗21例报告

我院自 1993年 5月 - 2 0 0 1年 5月采用闭合复位或切开复位克氏针内固定治疗跖跗关节骨折脱位2 1例 ,取得满意疗效 ,现报告如下。1　临床资料　　本组 2 1例 ;男 14例 ,女 7例 ;左侧 12例 ,右侧 8例 ,双侧 1例 ;年龄 2 1～ 6 8岁 ,平均 4 0 5岁 ;闭合性骨折脱位 16例 ,开放性骨折脱位 5例 ;按照Kuss分类法 :同向性脱位 15例 ,分离性脱位 6例 ;伤因 :车祸伤 12例 ,高处坠落伤 5例 ,重物压伤 3例 ,扭伤 1例。同时伴肢体骨折 6例 ,胸腹伤 3例。2　治疗方法本组 16例闭合性损伤均采用闭合复位克氏针内固定。一般在硬麻下进行 ,取平卧位 ,膝关…     

正常人与重症肌无力患者胸腺提取液免疫活性比较

用~３Ｈ－ＴｄＲ掺入法观察不同稀释度的正常人与重症肌无力患者胸腺提取液对健康成人外周血淋巴细胞增殖的影响。实验证实了正常儿童的胸腺功能下降（高浓度Ｐ＜０．０２，余浓度Ｐ＞０．０５），成人胸腺无功能（Ｐ＞０．０５）；并且得出增生型重症肌无力胸腺提取液对ＰＨＡ诱导的人外周血淋巴细胞增殖有促进和抑制双向作用。提示重症肌无力患者的胸腺免疫活性与正常人比较有差异。解释并肯定了手术切除胸腺治疗增生型重症肌无力的作用。     

普鲁卡因静脉复合麻醉对肝脏血流和氧耗影响的实验研究

采用电磁血流仪和血气分析等技术，研究普鲁卡因静脉复合麻醉对犬体循环血流动力学及肝脏血流和氧耗影响。 １％普鲁卡因复合液以 １．０ｍｇ· ｋｇ－１／ｍｉｎ速度静滴时，随麻醉时间延长，血浆普鲁卡因浓度逐渐升高，６０分钟达５６．９±８．７ｍｇ／Ｌ。体循环各项血流动力学参数趋于稳定，仅在６０分钟产生明显的体循环抑制效应。心率和平均动脉压分别降低２７％、２５％，心指数由３．５２±０．２１Ｌ·ｍｉｎ－１／ｍ２降至 ３． ０８±０．１２Ｌ· ｍｉｎ－１／ｍ２。肝总血流量和氧耗与体循环动力学呈一致性变化。因此，肝脏疾患及肝手术的患者，只要控制血中普鲁卡因浓度不过高，仍可安全实施普鲁卡因静脉复合麻醉。