183例老年人骨密度检测分析

目的 :研究老年人不同疾病时骨密度 (BMD)的分布情况。方法 :用DXADAS 6 0 0EX型骨密度仪对183例老年患者进行左侧远程桡骨加尺骨BMD检测。结果 :内分泌疾病组、消化道疾病组和其它疾病组的患病率分别为 72 7% ,2 0 6 %和 31 4 %。T值比较 :三组差异明显 (P <0 0 0 1)。累积骨丢失率 (ABLR)比较 :前一组明显高于后两组病人 (P <0 0 1)。BMD比较中 ,内分泌和其它疾病组明显低于消化道疾病组 (P <0 0 0 1)。相关分析显示 ,内分泌和消化道疾病组的年龄变化与BMD呈正相关 (r =0 5 19P <0 0 0 1和r =0 5 89P <0 0 0 1) ,内分泌疾病组和其它疾病组的体重变化与BMD呈正相关 (r=0 918P <0 0 0 1和r =0 338P <0 0 0 1)。结论 :老年人骨质疏松 (OP)患病率以内分泌疾病组最高 ,消化道疾病组较低 ;随年龄和体重增加 ,BMD降低加重。     

Toxic epidermal necrolysis; 15 years'' experience in a Dutch burns centre

BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe and potentially fatal drug reaction characterized by an extensive skin rash with blisters and exfoliation, frequently accompanied by mucositis. The wounds caused by TEN are similar to second-degree burns and severe cases may involve large areas of skin loss. OBJECTIVES: Analysis of our results in patients with TEN and evaluation of the variety of therapeutic interventions that has been studied and suggested in TEN. PATIENTS/METHODS: Retrospective analysis of 19 consecutive patients with TEN treated in our burns centre between 1989 and 2004. RESULTS: Immediate withdrawal of any potentially fatal drug, maximum supportive care, and a restricted and tailored antibiotic, medical and surgical treatment regimen confined mortality to 21%, whereas prognosis scores like APACHE II and SCORTEN predicted mortality of 22 and 30%, respectively. A positive contribution of selective digestive decontamination is suggested but has yet to be established. CONCLUSIONS: Because of a potentially fatal outcome, fast referral of a patient suspected of TEN to a specialized centre (mostly a burns unit or specialized dermatology centre) for expert wound management and tailored comprehensive care is strongly advised and contributes to survival.     

Extracellular Enzyme Activities by Basidiobolus and Conidiobolus Isolates on Solid Media./Extrazelluläre Enzymaktivitäten bei Basidiobolus- und Condiobolus-Isólaten auf festen Medien

Summary: Fifty-seven isolates of Basidiobolus from reptiles and amphibians, and 7 other obtained from the American Type Culture Collection (ATCC) in Maryland were studied for their extracellular enzyme activities on solid media. The Conidiobolus isolates studied included 4 recovered from Nigerian soil and additional 4 obtained from the ATCC All these isolates produced active extracellular lipase and protease and failed to exhibit amylase, deoxyribonuclease and ribonuclease activities. The significance of the findings is discussed.
Zusammenfassung: Fünfundsiebzig Basidiobolus-Isolate aus Reptilien und Amphibien und sieben weitere aus der American Type Culture Collection (ATCC) in Maryland wurden auf Aktivtäten extrazellulärer Enzyme auf festen Medien untersucht Die untersuchten Conidiobolus-Isolate schlossen vier aus nigerianischen Böden und vier weitere aus der ATCC ein. Alle Isolate zeigten extrazellulär Lipase- und Proteaseaktivität Amylase-, Desoxyribonuclease- und Ribonucleaseaktivität war jedoch nicht nachzuweisen. Die Bedeutung dieser Befunde wird diskutiert.     

端粒酶活性检测在乳腺癌诊断中的意义

[目的 ]探讨细针穿刺乳腺肿瘤组织的端粒酶活性检测在乳腺癌诊断中的意义 .[方法 ]用聚合酶链反应 酶联免疫吸附测定法检测 79例术前乳腺肿瘤细针穿刺活检标本和大体标本的端粒酶活性 ,并与病理诊断进行比较 .[结果 ]乳腺癌 6 5例中穿刺组织端粒酶呈阳性的为 5 7例 ,阳性率为 88% ;大体组织端粒酶呈阳性的为 5 4例 ,阳性率为 83% .淋巴结转移者端粒酶活性高于无淋巴结转移者 .乳腺良性疾病 14例中端粒酶呈阳性的为 2例 ,阳性率为 14 % .[结论 ]术前乳腺肿瘤穿刺组织的端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断 .     

消化道肿瘤血浆胃动素测定及其意义

作者报告经病理诊断消化道恶性肿瘤患者30例及手术切除肿瘤患者15例的血浆胃动素水平,并以健康成人31例作为对照。消化道恶性肿瘤的胃动素水平373.4±123.7ng/L,显著高于正常对照组(162.3±52.3ng/L,P<0.001),而消化道恶性肿瘤患者术前及术后胃动素水平无显著差异。消化道恶性肿瘤患者胃动素水平增高的原因可能是肿瘤刺激神经所致。胃癌和结肠癌细胞可产生胃泌素样物质,它可刺激胃动素的释放。     

全肠外营养对老年晚期消化系统恶性肿瘤病人生存期的影响

目的:评估全肠外营养(TPN)对老年晚期消化系统恶性肿瘤病人生存期的影响。方法:回顾性分析121例老年晚期消化系统恶性肿瘤病人TPN治疗后的生存期。结果:TPN治疗后,患者生存期不同程度延长,为9～126天,平均68.1天,多数在两月左右。结论:TPN可延长老年晚期消化系统恶性肿瘤病人的生存期。     

Effect of dietary protein on Masheri-induced drug metabolising enzymes

The modulation of drug metabolising enzymes by Masheri extract (ME) and Benzo(a)Pyrene [B(a)P] was studied in male Sprague Dawley rats fed different dietary protein levels. Two groups of 21 days old male Sprague Dawley rats were put on a high protein diet (SHP) with 20% Casein, and a low protein diet (SLP) with 3% Casein semisynthetic based diets for 12 weeks. The SLP fed animals showed lower basal levels of the Phase I activating enzymes viz. Cytochrome P450, Benzo(a)Pyrene hydroxylase, Benzphetamine demethylase and Phase II glutathione detoxification system viz. Glutathione (GSH) and Glutathione-S-transferase. ME and B(a)P treatment significantly depleted the glutathione detoxification system in the SLP group whereas an opposite effect was observed in the SHP group. Interstingly, ME and B(a)P treated rats in the SLP group showed a higher percent increase in the hepatic and pulmonary Phase I enzyme activities than those observed in the treated ME/B(a)P treated SHP rats. Furthermore, both ME and B(a)P significantly decreased the hepatic pool of vitamin A while a concomittant increase in that of vitamin C was observed.     

血清TPS浓度在消化道肿瘤中价值的研究

共选择３０例消化道肿瘤病人，其中食管癌，胃癌，大肠癌各１０例，设健康献血者３０例，对两组血清特异型组织多肽抗原浓度进行了检测，结果肿瘤组血清ＴＰＳ浓度明显高于健康人。消化道肿瘤阳性检出经达７０％，其中食管癌８０％，胃癌６０％，大肠癌７０％。消化道肿瘤合并淋巴转移阳性检出率达７６．９％，其中食管癌１００％，胃癌６６．７％，大肠癌７０．０％。随着病程发展，血清ＴＰＳ浓度呈现升高趋势。     

Human lymphoblastoid cells produce extracellular matrix-degrading enzymes and induce endothelial cell proliferation, migration, morphogenesis, and angiogenesis

Human lymphoproliferative diseases can be hypothesized to invade locally and to metastatize via mechanisms similar to those developed by a variety of solid tumors, i.e., the secretion of extracellular matrix-degrading enzymes and stimulation of angiogenesis. To assess this hypothesis, Namalwa, Raji, and Daudi cell lines (Burkitt’s lymphoma), LIK and SB cell lines (B-cell lymphoblastic leukemia), CEM and Jurkat cell lines (T-cell lymphoblastic leukemia), and U266 cell line (multiple myeloma) were evaluated for their capacity to produce matrix metalloproteinase-2 and -9, and urokinase-type plasminogen activator. These cell lines were also assessed for their ability: (1) to produce the angiogenic basic fibroblast growth factor and vascular endothelial growth factor; (2) to induce an angiogenic phenotype in cultured endothelial cells, represented by cell proliferation, chemotaxis, and morphogensis; (3) to stimulate angiogenesis in different in vivo experimental models. All cell lines expressed the mRNA for one or both metalloproteinases. Namalwa, Raji, LIK, SB, and U266 cells secreted the active form of both metalloproteinases, while Daudi, CEM, and Jurkat cells produced metalloproteinase-2 but not -9. In contrast, urokinase-type plasminogen activator was secreted only by SB cells. While Raji, LIK, SB, CEM, and Jurkat cells secreted both basic fibroblast growth factor and vascular endothelial growth factor, Daudi and U266 cells produced only the former, and Namalwa cells only the latter. Accordingly, the conditioned medium of all cell lines stimulated cell proliferation and/or chemotaxis in cultured endothelial cells, with the exception of that of Namalwa cells which was ineffective. The conditioned medium of CEM and Jurkat cells induced morphogenesis in cultured endothelial cells grown on a reconstituted basement membrane (Matrigel). Lastly, Namalwa, Raji, LIK, SB, U266, CEM, and Jurkat cells induced angiogenesis and mononuclear cell recruitment in the murine Matrigel sponge model and in a chick embryo chorioallantoic membrane assay. The extent of angiogenesis in both models was strictly correlated with the density of the mononuclear cell infiltrate. The results indicate that human lymphoproliferative disease cells possess both local and remote invasive ability via the secretion of matrix-degrading enzymes and the induction of angiogenesis which is fostered by host inflammatory cells and by an intervening ensemble of angiogenic factors.     

ELFP方案治疗晚期鼻咽癌及上消化道癌疗效分析

目的探索ELFP方案治疗转移复发的晚期鼻咽癌、食管癌、胃癌的临床疗效和毒性.方法选择病理证实的64例晚期鼻咽癌、食管癌、胃癌采用Vp-16 0.1 g静滴,d1-3;CF 0.1 g静滴,d1-3 5-FU 0.5 g静滴,d1-3;DDP 50 mg静滴,d1-2;21 d为1周期.治疗2～6个周期.结果鼻咽癌,食管癌、胃癌有效率(CR PR)分别为75%、70%、43.8%,其中胃癌与鼻咽癌及食管癌分别比较有差异;单病灶与多病灶之间疗效无差异.全组病例总生存期为3～41月,中位生存期分别为11.5、10、7.5个月.主要毒性为骨髓抑制,其中Ⅲ、Ⅳ度白细胞下降占21.9%;Ⅲ、Ⅳ度血红蛋白下降占15.6%;Ⅲ、Ⅳ度血小板下降占3.1%.Ⅲ、Ⅳ度恶心、呕吐发生率为7.8%.结论ELFP对晚期鼻咽癌及食管癌有较好的疗效,其毒性可以耐受,是临床治疗鼻咽癌,食管癌切实可行的方案.