低铁与低热量饮食延缓糖尿病肾病的进展

目的探讨低铁与低热量饮食是否能延缓糖尿病肾病的进展。方法以168例Ⅱ型糖尿病肾病患者为研究对象,随机分为两组,对照组予以常规治疗,治疗组在进行同样常规治疗的同时,予低铁、低热量饮食。结果平均随访37±22个月,治疗组患者血清铁水平显著降低,与对照组比较,有显著差异(P<0.01);治疗组血清肌酐189±78μmmol/L,对照组257±115μmmol/L,两组比较,有显著差异(P<0.01)。治疗组有6例患者达到终止随访目标,血红蛋白低于80g/L和或红细胞压积<33%,需进行促红素治疗,占17.6%;对照组有10例达到终止目标,占35.7%,两组比较,有显著差异(P<0.01)。结论低铁饮食治疗能显著降低糖尿病肾病患者铁负荷,配合低热量饮食治疗,能明显延缓糖尿病肾病的进展。     

慢性乙型肝炎中医药治疗中的有关问题

经长期临床观察研究,对慢性乙型肝炎(CHB)的中医药治疗论述了以下有关问题CHB自然病程和中西医治疗策略;介绍治疗CHB中药基本方“二黄双虎汤”;CHB的降酶治疗;CHB“正复胜邪现象”;对HBV携带者的用药经验。     

Screening for SNCA and LRRK2 mutations in Greek sporadic and autosomal dominant Parkinson's disease: identification of two novel LRRK2 variants

Mutations in SNCA and LRRK2 genes, encoding alpha-synuclein and leucine-rich repeat kinase 2, respectively, cause autosomal dominant Parkinson's disease (AdPD). The LRRK2 G2019S (c.6055G > A) and R1441G (c.4321C > G) mutations have also been identified in sporadic PD (sPD). We studied 55 unrelated patients with AdPD, 235 patients with sPD, and 235 healthy age- and gender-matched controls all of Greek origin. Patients with AdPD were screened for SNCA and LRRK2 mutations by direct sequencing. SNCA gene dosage analysis was also performed for AdPD using quantitative duplex polymerase chain reaction of genomic DNA. In addition, we investigated the frequency of the LRRK2 G2019S mutation in sPD. We found no missense mutations or multiplications in the SNCA gene. Here we report two novel variants, A211V (c.632C > T) and K544E (c.1630A > G) in LRRK2 gene in two patients with AdPD that was not present in controls. We identified only one patient with sPD (1/235; 0.4%) carrying the G2019S mutation. LRRK2 mutations are present in AdPD and sPD patients of Greek origin.     

肺鳞状细胞癌81例临床分析

目的 分析81例肺鳞状细胞癌（鳞癌）临床特征，提高早期诊治率。方法 回顾性分析81例肺鳞癌诊断、手术、治疗及随访资料。结果 患者平均年龄62岁，男：女为2．2：1，有吸烟史76例（93．8％），平均26年，全组均有呼吸道症状，合并全身症状14．8％（12例）。确诊时间2～7个月。手术切除病肺63例（77．8％），术后放、化疗。未能切除18例中10例放、化疗。随访中位数5年以上。80例得到随访，1、3、5年生存率为90％（72例）、65％（52例）、47．5％（38例）。结论 肺鳞癌以老年男性多见，易误诊，手术切除率低，早期手术5年生存率高。     

神经调节素1基因SNPrs2954041多态性与精神分裂症及其认知功能的关联研究

目的探讨昆明地区汉族人群神经调节素1(NRG-1)基因SNPrs2954041多态性与精神分裂症及认知功能的关系。方法采用聚合酶链反应限制性片段长度多态性(PCR-RFLP)的方法检测141例精神分裂症患者和84名正常对照的NRG-1基因SNPrs2954041多态性;采用韦氏记忆量表(WMS)和威斯康辛卡片分类测验(WCST)评估两组人群的记忆功能和执行功能,并用PANSS量表评定患者的临床症状。结果两组NRG-1基因SNPrs2954041多态性的基因型和等位基因频率差异有统计学意义(2=34.01,P<0.05;2=30.201,P<0.05)。按性别分组后比较,结果仍同前。患者组中各基因型组间认知功能比较结果示:①各基因型组间韦氏记忆量表的理解记忆得分差异有统计学意义(P<0.05),两两比较显示G/G与T/T基因型患者间差异有统计学意义(P<0.05)。②G/G与T/T基因型患者比较,威斯康辛卡片分类测验中的错误数、持续错误数和分类个数差异有统计学意义(P<0.05)。结论NRG1基因SNPrs2954041多态性与精神分裂症存在关联,他也与精神分裂症患者的认知功能相关。     

Survivin反义核酸诱导乳腺癌细胞凋亡的实验研究

目的探讨Survivin反义核酸技术诱导乳腺癌细胞凋亡的作用及效果。方法本实验共分6组，分为以脂质体介导反义寡核苷酸组（ASODN／Lip）、无义寡核苷酸组（NODN／Lip）及RPMI 1640培养液的空白对照组（Lip），转染人乳腺癌MCF-7细胞系，应用Hoechst 33258／PI双重染色观察MCF-7细胞的形态学改变，透射电镜观察细胞超微结构，流式细胞仪检测细胞周期和细胞凋亡的变化，DNA凝胶电泳观察凋亡情况，研究Survivin反义寡核苷酸对MCF-7乳腺癌细胞的生长抑制作用。结果Hoechst 33258／PI染色及透射电镜观察可见转染后的细胞结构呈凋亡样改变；流式细胞仪检测见转染后细胞凋亡显著增加，并出现G2／M期阻滞现象；DNA凝胶电泳在600ng／ml，800ng／ml ASODN／Lip组的电泳图谱上呈现出明显的“梯状”现象。结论凋亡抑制基因Survivin表达下涧对乳腺癌细胞的生长抑制作用主要是通过诱导细胞发生凋亡以及阻止有丝分裂发生在G2／M阻滞期来实现，Survivin靶向反义核酸技术可能成为乳腺癌基因治疗的一种有效方法。     

Optimising Hormone Therapy in Advanced Disease

Although most prostate cancer (PCa) patients nowadays are diagnosed at an early stage of disease, unfortunately still a significant number of patients will develop advanced PCa or will be diagnosed at an advanced (or metastatic) stage of disease. The group of patients showing the highest increase in incidence are those with rising prostate specific antigen (PSA) after radical therapy.In the last quarter of 2004, a Medline search has been performed targeting publications on patients diagnosed with advanced PCa, as well as with PSA relapse after previous radical therapy. This review aims at providing guidance to optimise hormone therapy in those selected groups of patients by addressing three pivotal questions; (i) who should receive hormonal treatment, (ii) what type of hormonal therapy should the patient be offered and (iii) what is the best timing of starting hormonal treatment.In patients relapsing after radical therapy, the PSA doubling time (PSA DT) has become a critical instrument to distinguish patients to have innocuous PSA evolution from patients at high risk for disease progression. A PSA DT of 3 months seems to be the cut-off point for identifying patients at risk. Therefore patients with a PSA DT of less than 3 months should be advised to initiate hormonal therapy. Antiandrogen monotherapy may be considered in this setting as it has been shown to delay progression; however, significant survival data are not yet available. Whether luteinising hormone releasing hormone (LHRH) agonists should be given continuously or intermittently (IHT) remains subject of debate.Surgical castration has been the standard of care in patients diagnosed with advanced PCa. Currently, LHRH agonists have become the preferred way of suppressing testosterone.Combination of an antiandrogen and a LHRH agonist (CAB) shows a modest benefit over LHRH agonist monotherapy. As CAB leads to increased side effects and costs, LHRH agonist monotherapy is preferred in the majority of patients.Conflicting data have been published concerning the optimal timing of LHRH agonist therapy. So it is not clear whether LHRH agonist therapy should be started immediately or deferred until appearance of symptoms. When initiating continuous hormone therapy, patients should be carefully monitored for the risk of long term androgen deprivation (anaemia, osteopenia and osteoporosis).     

肝动脉解剖变异在中晚期肝癌介入治疗中的意义

目的 探讨放射学肝动脉解剖变异及其在中晚期肝癌介入导管治疗中的临床意义。方法 回顾性分析125例中晚期肝癌肝动脉造影表现及其介入治疗资料。结果 125例中107例(85．6％)有典型肝动脉分布。肝动脉变异18例(14．4％)，其中肝右动脉变异10例(8％)，而又以肝右动脉始于肠系膜上动脉者最多，占6．4％。副肝左动脉变异1例(0．8％)。肝左动脉和肝右动脉同时变异2例(1．6％)。肝总动脉变异3例(2．4％)。胃十二指肠动脉起自肝右动脉和腹腔动脉各1例(1．6％)。对123例成功进行了肝动脉化疗栓塞，2例肝右动脉变异因角度关系超选插管未成功。结论 认识肝动脉解剖变异有助于提高插管的成功率和中晚期肝癌的介入治疗疗效。     

肿瘤物理治疗技术及设备

简要介绍了肿瘤的放射治疗和热治疗的技术及设备，介绍了各种技术及设备的特点。     

中医药治疗宫环出血临床疗效的Meta分析

目的:观察中医药治疗宫环出血的临床疗效。方法:应用Meta分析方法的随机效应模型,对国内1989~2006年采用中医药治疗宫环出血,并以西医治疗作对照的研究文献进行定量合并分析。结果:对中医治疗组与西医对照组临床有效率进行分析后表明,在临床疗效方面,中医治疗组427例患者中376例临床治疗有效,西医对照组347例患者中217例临床治疗有效。中医治疗组稳定率总优势比(OR)=4.65,95%置信区间(CL)为(3.20~6.75)。两者间差异有统计学意义(P<0.05)。结论:据目前掌握的资料证明中医药治疗宫环出血的临床疗效确切。