前列腺癌根治术后生化复发的诊治进展

前列腺癌根治性治疗（根治性手术或根治性放疗）是治愈局限性前列腺癌最有效的方法之一,但是20%的患者在术后5年内发生了生化复发,术后10年内仍有27%-53%的患者发生肿瘤局部复发或远处转移。因此生化复发患者的早期发现、正确评估和规范化治疗,对前列腺癌患者的总体治疗水平尤为重要。     

早期前列腺癌不同治疗模式的疗效及生化复发的危险因素分析

目的 探讨早期（T1~2N0M0）前列腺癌患者根治性手术或根治性放疗疗效对比及影响生化复发的相关因素。方法 回顾性分析新疆医科大学附属第一临床学院2004年4月至2012年4月间收治的269例早期前列腺癌根治术后患者的临床资料,采用多因素Logistic回归模型分析前列腺癌生化复发的危险因素。结果 269例前列腺癌患者中有97例经随访检测发生前列腺特异性抗原PSA（prostatespecific antigen）升高。单因素分析显示,肿瘤分期、Gleason评分、治疗前PSA水平、治疗前血红蛋白（hemoglobin,HGB）、肥胖与前列腺癌生化复发有关（P均＜0.05）;多因素分析显示,肿瘤分期、Gleason评分、治疗前PSA水平、肥胖是前列腺癌患者生化复发的独立高危因素（P均＜0.05）。两种不同的根治性治疗方式的生化复发率比较,总体累积生化复发率为36.0%,其中根治术组累积生化复发率为36.5%（23/63）,根治放疗组为36.0%（74/206）,两组生化复发的趋势较为一致。两种根治性治疗方式,治疗后第2年及第5年生化复发机率会增高。结论 T分期≥T2a、Gleason评分≥7 分、治疗前PSA≥10 ng/ml、肥胖的前列腺癌患者治疗后生化复发风险较高。对早期前列腺癌行根治性手术或根治性放疗可以达到相似的治疗效果,故可以根据患者的身体状况和意愿进行选择。     

前列腺癌根治术后复发的诊断和治疗

临床局限型前列腺癌患者在接受根治术后有一部分会发生生化复发，生化复发是肿瘤继续进展并发生临床复发或转移的前兆。术后随访中检出生化复发患者，进行恰当的评估，可以筛选出高危患者接受进一步治疗。挽救性放疗和内分泌治疗对前列腺癌根治术后复发或转移的患者有一定的疗效。本文综述了前列腺癌根治术后复发和转移的诊断方法和治疗选择的进展。     

前列腺癌包膜外侵犯对根治性前列腺切除术中性神经保留决策的影响

保留性神经（NS）的根治性前列腺切除术（RP）能够促进术后性功能的恢复，但可能增加术后切缘阳性率与生化复发的风险，尤其是对于存在前列腺癌包膜外侵犯（EPE）的患者。预测EPE是根治性前列腺切除术制定手术方式的关键。文章就术前预测EPE的手段做一综述，以期为临床RP提供依据。     

前列腺癌组织TGF-β1/Rac1通路蛋白表达与根治术后生化复发的相关性

目的:探讨前列腺癌组织转化生长因子-β1（TGF-β1）/Ras相关C3肉毒素底物1（Rac1）通路蛋白表达与根治术后生化复发的关系。方法:回顾性分析2015年02月至2018年02月在本院行前列腺癌根治性切除术的200例患者的临床资料，均于手术时留存前列腺癌组织与癌旁组织标本。采用免疫组织化学法检测前列腺癌组织与癌旁组织中TGF-β1、Rac1、波形蛋白（Vimentin）、E-钙黏蛋白（E-cadherin）蛋白表达情况并比较阳性表达率。另统计根治术后随访3年期间患者生化复发情况并据此将其归为生化复发组与未生化复发组，对比生化复发组与未生化复发组前列腺癌组织中TGF-β1、Rac1、Vimentin、E-cadherin蛋白阳性表达率，采用Cox回归模型分析前列腺癌组织中TGF-β1、Rac1、Vimentin、E-cadherin蛋白表达情况与患者根治术后生化复发的关系。结果:前列腺癌组织中TGF-β1、Rac1、Vimentin蛋白阳性表达率明显高于癌旁组织，E-cadherin蛋白阳性表达率明显低于癌旁组织，差异均有统计学意义（P＜0.05）；根治术后随访3年，生化复发率为14.50%（29/200），生化复发组前列腺癌组织中TGF-β1、Rac1、Vimentin蛋白阳性表达率高于未生化复发组（P＜0.05），E-cadherin蛋白阳性表达率低于未生化复发组（P＜0.05）；经Cox回归模型分析显示，术前PSA水平、标本Gleason评分、包膜侵犯、精囊侵犯、神经周围侵犯、血管侵犯、手术切缘阳性、TGF-β1蛋白阳性、Rac1蛋白阳性、Vimentin蛋白阳性均是前列腺癌患者根治术后生化复发的危险因素（HR=3.350、3.117、4.702、5.618、6.328、5.114、6.007、3.019、3.077、2.740，P＜0.05），E-cadherin蛋白阳性是其保护因素（HR=0.471，P＜0.05）。结论:前列腺癌组织中TGF-β1、Rac1、Vimentin蛋白均高表达，而E-cadherin蛋白低表达，其表达情况均与患者根治术后生化复发存在一定的关系，TGF-β1、Rac1、Vimentin蛋白阳性表达可增加术后生化复发的概率，而E-cadherin蛋白阳性表达可降低术后生化复发的风险，此对临床具有一定的指导作用。     

高危局限性前列腺癌治疗进展

摘 要：前列腺癌是男性泌尿生殖系统常见恶性肿瘤之一,大部分局限性前列腺癌依靠根治性前列腺切除术或根治性放疗可获得良好的疗效,而侵袭性更强的高危前列腺癌,其最佳治疗方案仍存在争议。随着微创外科和放疗技术的不断发展进步,高危前列腺癌患者有了更多的治疗选择。全文就高危局限性前列腺癌的治疗进展进行综述,探讨高危局限性前列腺癌的治疗策略。     

根治性外放射治疗与根治性前列腺切除术治疗局限性高危前列腺癌的疗效比较

目的 比较根治性外放射治疗（ExRT）与根治性前列腺切除术（RP）治疗局限性高危前列腺癌患者的疗效。方法 回顾性分析诊断为高危前列腺癌（T2b-T4N0M0）并接受ExRT或RP的150例患者。高危前列腺癌的入选标准为PSA≥20 ng/ml或cT3以上或GS≥8。主要研究终点为无生化复发生存期,次要研究终点为无远处转移生存期、癌症特异性生存期及总生存期。结果 88例患者接受了ExRT及雄激素剥夺治疗（ADT）,其余62例患者接受了RP及盆腔淋巴结清扫术（PLND）。两组患者的中位年龄（68.9±5.2 vs. 64.3±6.5岁, P=0.012）及中位随访时间（60.2±32.3 vs. 45.8±25.5月,P=0.005）差异有统计学意义。ExRT组患者生化复发率显著低于RP组患者（23.9% vs. 58.1%, P<0.001）,而无生化复发患者生存期显著延长（96.2±7.4 vs. 38.7±4.6月, P<0.001）。两组无远处转移生存期、癌症特异性生存期及总生存期差异均无统计学意义。结论 与RP相比,接受ExRT治疗的局限性高危前列腺癌患者生化复发率低,无生化复发生存期显著延长。     

前列腺癌机器人辅助手术的现状与展望北大核心CSCD

根治性前列腺切除术是局限性前列腺癌的主要治疗方法。手术后早期肿瘤控制效果、术后尿控和勃起功能恢复三个方面是该手术面临的重要问题。关于前列腺癌根治性手术发展有3个关键节点,包括1982年Walsh PC首次提出解剖性根治性前列腺切除术;1992年Schuessler等完成首例腹腔镜下根治性前列腺切除术以及2001年Binder和Kramer首次报道机器人辅助腹腔镜根治性前列腺切除术。本文详细介绍了前列腺癌治疗采用机器人辅助手术的应用现状、进展及发展前景。     

高强度聚焦超声在前列腺癌治疗中的临床应用进展

高强度聚焦超声(HIUF)通过提供高强度聚焦超声能量以局部加热的方式破坏病变或者受伤组织.作为一种临床治疗的补充手段,对于那些不选择根治性前列腺癌切除术的患者来说是一种可选的微创治疗方法.同时,HIUF也是前列腺癌根治术及放射治疗之后残留或者复发的前列腺癌患者的一种重要抢救治疗方法.本文将围绕HIUF的临床应用进展进行综述.     

结直肠癌术后复发49例临床分析

 目的　分析结直肠癌术后复发的原因及治疗方法。方法　回顾性分析1995年3月至2011年6月49例结直肠癌术后复发患者的临床资料。结果　49例患者中,吻合口复发24例,手术区域局部复发10例,会阴部复发15例。非手术治疗13例,手术治疗36例,其中根治性切除22例,姑息性手术14例。根治性切除和非根治性切除患者的中位生存时间分别为28个月和9个月。结论　对结直肠癌患者应重视首次治疗的合理性,术后密切随访。根据病期、复发部位选择以手术为主的综合治疗,能提高患者生存率和生存质量。     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.