肝癌患者外周血树突状细胞的体外扩增、鉴定及内吞能力观察

目的　从肝癌患者外周血培养扩增树突状细胞，观察其形态、表型、内吞及递呈抗原能力，为树突状细胞在肝癌生物治疗中的应用奠定基础。方法　从肝癌患者外周血中分离单个核细胞，在 Ｇ Ｍ Ｃ Ｓ Ｆ、 Ｉ Ｌ４ 的诱导下培养扩增树突状细胞。光学显微镜下观察其体外培养过程中的形态特征及变化，电镜观察其超微结构， Ｆ Ａ Ｃ Ｓ观察其表型特征， Ｍ Ｌ Ｒ检测其抗原递呈能力， Ｈ Ｒ Ｐ内吞实验检测其群体内吞能力。结果　肝癌患者外周血树突状细胞具典型的形态及表型特征，较巨噬细胞更强的激发同种混合淋巴细胞反应的能力。其群体的内吞能力约在培养第 ５ 天达高峰，之后有明显下降。结论　从肝癌患者外周血中可获取较大量的、高纯度的、具较强抗原递呈能力的树突状细胞，在其具有活跃的内吞能力时，以合适的肿瘤抗原致敏可望成为肝癌生物治疗的崭新手段。     

胆管癌的分子生物学特性

胆管癌是危害人类健康的恶性肿瘤，其发生发展是多因素、多步骤的病理过程，涉及癌基因的激活、抑癌基因的失活、细胞凋亡和细胞周期调控失常等多方面。但作为胆道的恶性肿瘤，其具有独特的生物学特性，如神经浸润与转移、与肝炎病毒感染有关等。现综述其分子生物学特性，旨在进一步探讨胆管癌的发病机制，提高胆管癌诊治水平。     

一九九二年度卫生部医药卫生科学技术进步三等奖——胃癌特殊结构五种标志物的基础与实验应用研究

本项成果是采用先进的现代生物工程技术——单克隆抗体和酶化学检测技术，针对我国最高发的胃癌，系统地研究与其相关的五种生物标志。其意义在于，探索其生物学本质，为其早诊、早治提供新途径。该项成果分为两方面，其一采用单抗技术，分析和鉴定了与胃癌相关的4种特殊结构标志物，     

颈部肿块的诊断和鉴别诊断及活检时应注意事项

颈部肿块在任何年龄组都可以发生，涉及到内、外、肿瘤、眼耳鼻喉、口腔、小儿等科，临床较为多见。由于颈部解剖和组织结构比较复杂，颈部肿块种类繁多，表现各异，其预后差别甚大，因而其诊断和鉴别诊断就显得格外重要。颈部肿块的活检是必要的，活检时有些事项需要注意。     

橙皮苷生物活性作用及机制研究进展

陈皮始载于《神农本草经》，为芸香科植物橘及其栽培变种的干燥成熟果皮，别名橘皮。陈皮味苦辛，性温；归肺、脾经，具有“理气健脾，燥湿化痰”的功效。橙皮苷是陈皮黄酮类的主要活性成分之一，其化学结构具有双氢黄酮氧苷结构， 颜色为白色针状晶体，主要存在于芸香科植物橘及其栽培变种的成熟果皮中，其生物活性一直受到人们的广泛关注。近年来随着对橙皮苷的深入研究，其许多药理活性为研究所证实并被广泛应用于医药、食品等科学领域。橙皮苷具有抗炎，抗氧化，抗辐射，抗癌，保护心血管系统，改善血糖、脂质代谢，保护神经系统等生物活性作用。本文结合国内外研究现状，总结前人研究成果，综述了橙皮苷部分生物功效及其活性的机制和最新研究进展，分析和展望其未来发展趋势，以期填补橙皮苷生物活性空白领域，为更好地开发、利用橙皮和橙皮苷，结合其生物活性进行动物实验、临床研究、创新开发药物提供依据和思路。     

肺癌脑转移的临床诊断

总结我院经病理确诊的28例肺癌脑转移的病例，回顾其病史病例资料及CT、MRI表现，分析其机制，总结诊断要点。     

诱导细胞焦亡抑制恶性肿瘤的新策略研究进展

细胞焦亡是一种非典型的细胞程序性死亡方式，其主要表现为各种外界刺激后细胞膜产生孔隙，随后细胞膨胀、胞液外流、分泌炎性因子引起炎性反应，最终导致细胞崩解。焦亡起初发现于感染性疾病，但后来在神经系统、心血管系统中均有所发现，近期研究也发现了其在肿瘤中也存在，探究其对肿瘤的作用成为研究热点之一。目前已有研究提出抗肿瘤药物、中药单体等可以诱导肿瘤细胞焦亡，故本文从此入手，探究肿瘤细胞焦亡相关影响分子，并总结归纳其作用方向，提出阻止化疗耐药与调节代谢分子两条可能的抗肿瘤新策略。     

癌痛治疗新概念——细胞镇痛、基因治疗

目前癌性疼痛的治疗多遵循WHO三阶梯治疗原则，其常用方法为药物治疗和神经阻滞治疗，但神经阻滞疗法的疗效有限且不能持久，而阿片类制剂虽有良好的镇痛作用，但其较多的副作用如药物依赖成瘾、呼吸抑制、消化道副反应等，限制了其临床应用。寻求更有效、安全的镇痛方法和药物成为人们的共识。近年来，国内外在细胞基因水平镇痛的研究取得了很大的进展，兹综述如下。     

CGAP:构建肿瘤研究领域的生物信息技术平台

美国癌症研究所在1996年发起了癌肿基因组解剖计划（CGAP），其目的在于创建一系列工具以获知与肿瘤相炎的基因、蛋白质及其它生物标记物。近年来，生物信息技术的发展为其计划的实施提供了丰富的生物信息资源。常用的生物信息技术有：表达序列标签（EST）、Unigene、基因表达系列分析（SAGE）和数字化差异表达（DDD），四种方法各有其优势，共同成为生物信息技术的组成部分。本文综述了上述生物信息技术在CGAP中的应用，并预测了其未来的发展趋势。     

直肠类癌的治疗现状

直肠类癌是一种良性肿瘤，但其具有潜在恶性的生物学行为，约15％的患者可能发生远处转移。直肠类癌的治疗以外科手术为主．如何判断其侵袭性是选择手术方式的关键，综合文献分析显示，肿瘤大小、浸润深度和病理学类型等是其主要判断指标。而放疗、化疗在直肠类癌治疗上的作用有限，目前尚无一致结论。     

结直肠癌NCCN、NICE及ESMO指南的对比分析和解读

结直肠癌的规范化治疗是患者得到正确合理治疗的一个重要保障。国外有很多重要诊断治疗指南指导结直肠癌的规范化治疗,其中影响力最大的指南分别是结直肠癌NCCN指南、ESMO指南和NICE指南。NCCN指南是由美国牵头制定的极具影响力的规范化治疗指南,ESMO指南是由欧洲肿瘤内科学会颁布,NICE指南是由英国国家卫生与临床优化研究所发布的成人结直肠癌诊断和管理临床实践指南。这三个指南在结直肠癌的诊断和治疗上存在着一些共同和不同之处,拟就其中的一些关注点进行分析解读,希望对我国的结直肠癌规范化治疗能起到一些参考借鉴作用。     

Classification of Fungi in modern view

Fungi are a heterogeneous jumble coming together from three kingdoms of organisms. The True Fungi represent a kingdom of its own and are positioned closer to the Animalia than to the Plantae. At present the Fungi are divided into five Divisions. Species pathogenic for humans are found in the Divisions Zygomycota, Ascomycota and Basidiomycota. The Pneumocystidales are now classified in the Ascomycota. The Malasseziales are included in the Class Ustilaginomycetes. Essential characteristics for the classification of Fungi are derived from ultrastructure, chemistry, and more recently also from molecular biology of these organisms. None of these methods can stand for its own, all characteristics must be included.     

Fatal reactivation of hepatitis B post-chemotherapy for lymphoma in a hepatitis B surface antigen-negative, hepatitis B core antibody-positive patient: potential implications for future prophylaxis recommendations

In the absence of prophylaxis, the reactivation of hepatitis B in oncology patients who are hepatitis B carriers is a well-known and often fatal complication of chemotherapy. The current recommendations in Canada and the USA are that patients who are positive for hepatitis B surface antigen (HBsAg) receive antiviral prophylaxis prior to chemotherapy. We report a 67-year-old man with B-cell lymphoma who developed hepatitis B reactivation following chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone and rituximab. Pre-chemotherapy, the patient was negative for HBsAg, positive for hepatitis B core antibody (anti-HBc) and weakly positive for hepatitis B surface antibody. Despite treatment with lamivudine, the patient died of fulminant hepatic failure. Our experience indicates that patients who are negative for HBsAg but positive for anti-HBc are still at risk for reactivation of latent hepatitis B during and after chemotherapy and may be considered for prophylaxis.     

Cardiac Catheterization: II. Detection and Assessment of Common Cardio-vascular Abnormalities

The haemodynamic parameters used in detecting and assessing each of several common cardio-vascular abnormalities are presented, and the pertinent catheterization techniques are described. Methods for studying patients with the more common congenital cardiac malformations are for the most part well standardized, and when adequate data are obtained, these are usually easily interpreted. Acquired valvular lesions, especially stenotic ones, can also be evaluated by standard techniques and the severity of such lesions accurately determined. In contrast, methods for studying myocardial function are less satisfactory. The parameters usually employed in assessing myocardial performance are also influenced by extra-myocardial factors, and some of the more meaningful methods of studying myocardial contractility are still too complex and time-consuming for routine use. Except for selective angiocardiography, cardiac catheterization techniques are likewise of only limited help in evaluating patients with ischaemic heart disease.     

Issues in experimental design and endpoint analysis in the study of experimental cytotoxic agents in vivo in breast cancer and other models

Considerable effort has been placed into the identification of new antineoplastic agents to treat breast cancer and other malignant diseases. The basic approaches, in terms of model selection, endpoints, and data analysis, have changed in the previous few decades. This article deals with many of the issues associated with designing in vivo studies to investigate the activity of experimental and established compounds and their potential interactions. Endpoints for both in situ and excision assays are described, including approaches for determining cell kill, tumor growth delay, survival, and other estimates of activity. Suggestions for approaches that may limit the number of animals also are included, as are possible alternatives for death as an experimental endpoint. Other concerns, such routes for drug administration, drug dosage, and preliminary assessments of toxicity also are addressed. Statistical considerations are only briefly discussed, since these are addressed in detail in the accompanying article by Hanfelt (Hanfelt JJ, Breast Cancer Res Treat 46:279-302, 1997). The approaches suggested within this article are presented to draw attention to many of the key issues in experimental design and are not intended to exclude other approaches.     

Current status of 10B-neutron capture therapy: enhancement of tumor dose via beam filtration and dose rate, and the effects of these parameters on minimum boron content: a theoretical evaluation

At least 8 classes of compounds are being evaluated in various laboratories around the world as possible vehicles for the transport of boron to tumor for neutron capture therapy (NCT). A parameter of major importance is the minimum concentration of boron needed in tumor in order to produce improved results in cancer therapy. Calculations are made here of the minimum boron content in tumor necessary for NCT. These estimations are obtained for various neutron beams, on the basis of therapeutic gain produced by the effective dose (absorbed dose X relative biological effect). The effects of repair are considered, in anticipation of having boronated bio-molecules with selective and long-term binding to tumor cells, thus allowing protracted irradiations. Pure epithermal neutron beams (free of significant fast neutron and gamma contamination) are found to offer major advantages, particularly when the effects of repair are included. The various boron compounds being investigated for NCT are evaluated on the basis of necessary minimum boron content in tumor.     

Is there a role for a specialized follow-up clinic for survivors of pediatric cancer?

Due to advances in chemotherapy and supportive care, greater than 70% of patients with childhood cancer will survive 5 years. However, there are long-term physiological and psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. Various studies done in the long-term pediatric survivors have noted that they are at increased risk for poor health and for chronic health problems. One complicating factor in treating these patients for their health problems is that many childhood cancer survivors are unaware of their past medical history and what their past cancer treatment entailed. There are also a number of barriers to medical care in survivors of childhood cancer which include inadequate insurance coverage for many and lack of knowledge of long-term effects physicians. As pediatric cancer survivors age they usually transition to community physicians. This paper proposes different models for follow-up clinics for survivors of pediatric cancers so childhood cancer survivors are not be subjected to cost ineffective or excessive evaluations but rather medical screening tests that are risk and guidelines that are set forth by experts.     

Late injury of cancer therapy on the female reproductive tract

The purpose of this article is to review the late effects of cancer therapy on the female reproductive tract. The anatomic sites detailed are the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The available pathophysiology is discussed. Clinical syndromes are presented. Tolerance doses of irradiation for late effects are rarely presented in the literature and are reviewed where available. Management strategies for surgical, radiotherapeutic, and chemotherapeutic late effects are discussed. Endpoints for evaluation of therapeutic late effects have been formulated utilizing the symptons, objective, management, and analytic (SOMA) format. Late effects on the female reproductive tract from cancer therapy should be recognized and managed appropriately. A grading system for these effects is presented. Endpoints for late effects and tolls for the evaluation need to be further developed.     

Safety profiles of aromatase inhibitors and selective estrogen-receptor modulators in the treatment of early breast cancer

For the medical treatment of early breast cancer, aromatase inhibitors (AIs) such as anastrozole, letrozole, and exemestane are more effective than selective estrogen-receptor modulators (SERMs) such as tamoxifen (TAM). However, the adverse events associated with AIs are different from those associated with SERMs. Hot flushes, gynecological disorders, and thrombosis are more frequent in patients treated with TAM than in those treated with AIs. Conversely, osteoporosis, fractures, joint symptoms, and myalgia are more common in patients receiving AIs. Osteoporosis and bone fractures resulting from osteoporosis are important issues for patients treated with AIs. The precise management of bone health, in strict accordance with clinical guidelines, is vital in patients receiving AIs. AI-related joint symptoms are also one of the most important considerations for patients taking AIs. AI-related joint symptoms are the most common reason for the discontinuation of AIs. Confirmed management strategies for AI-related joint symptoms are unavailable at present. In patients receiving AIs, long-term adverse events (for example, those occurring as a result of changing lipid metabolism) remain unclear. There is a clear need to elucidate AI-related adverse events over the long term and to establish management strategies for AI-related adverse events, such that AIs can be used safely in patients with breast cancer over long periods of time.     

Second malignancies among elderly survivors of cancer

The U.S. population is aging, life expectancy is increasing, and cancer is a disease associated with aging. Advances in screening and therapeutics have led to a growing number of cancer survivors who are at risk for the development of secondary malignancies. Although the risks for the development of second malignancies following a first diagnosis of cancer are well described for survivors of childhood malignancies, there are fewer data for malignancies common in older adults. With the aging of the U.S. population, and with improving survival statistics in many adult malignancies, there is an increasing need to identify those second malignancies that might develop in the older adult survivor of cancer. In this paper, we describe the types and rates of second malignancies following cancers commonly seen in older adults and review the literature on these malignancies. Comparisons are made between older and younger adults with regard to the risks for developing treatment-related cancers with different modalities. Recommendations for early detection of second malignancies are summarized, though there remains an unmet need for evidence-based guidelines for screening for second malignancies in the older adult in particular.