脑胶质瘤端粒酶活性表达的研究

目的：探讨端粒酶在脑胶质瘤发生、发展中的作用，并研究端粒酶活性是否与其恶性程度相关。方法：应用端粒重复序列扩增技术(TRAP)对48例胶质瘤标本和8例正常脑组织的端粒酶活性进行检测。结果：8例正常脑组织端粒酶活性均为阴性表达，48例胶质瘤标本中23例为表达阳性(47．92％)，低度恶性组与高度恶性组胶质瘤之间端粒酶活性阳性率有明显差异(P=0．001)。结论：端粒酶活性与胶质瘤恶性程度明显相关，端粒酶在胶质瘤发生发展过程中可能具有重要作用。     

替莫唑胺治疗脑原发性恶性胶质瘤患者的护理

目的总结应用替莫唑胺（TMZ）治疗恶性胶质瘤患者的护理要点。方法2005年1月～2006年9月选择符合TMZ治疗适应症的脑原发性恶性胶质瘤患者，给予口服TMZ进行化疗，并配合做好护理工作。结果胶质瘤患者最短无进展生存期（PFS）Ⅲ级者9—15个月，Ⅳ级4～9个月，平均生存时间为12个月。药物治疗后有18例患者出现恶心、呕吐症状，23例患者出现口腔溃疡，18例患者出现白细胞下降，9例患者出现血小板减少症。结论做好化疗前患者心理护理、化疗知识的教育、掌握给药时间契机及密切观察患者病情及药物毒副作用。可早期预测与发现治疗后患者可能出现的并发症，从而提高TMZ治疗胶质瘤患者成功率及生活质量。     

荧光引导下行脑恶性胶质瘤切除术患者的护理

目的探讨荧光引导下行脑恶性胶质瘤切除术患者的护理方法。方法回顾性分析2006-2010年在哈尔滨医科大学附属第一医院神经外科治疗的46例恶性脑胶质瘤患者的临床资料和护理方法。所有患者均在荧光引导下行脑恶性胶质瘤切除术。结果经治疗和护理,46例行荧光引导下脑恶性胶质瘤切除术患者,均好转出院。结论术前充分的准备,术后密切观察病情、精细的术后护理,是手术顺利进行、减少术后并发症、提高手术成功率,促进患者康复的关键。     

替莫唑胺联合放射治疗复发性恶性脑胶质瘤的研究进展

随着科学技术的快速发展,复发性恶性脑胶质瘤的治疗也取得了显著的提升,随着人们对于医疗技术发展的信心,对于其治疗效果也提出了更高的要求。如何使用现有的治疗方法来提高治疗效果就成了迫切需要解决的问题,替莫唑胺联合放射治疗就是其中的一种治疗思路,本文将探讨替莫唑胺联合放射治疗复发性恶性脑胶质瘤的研究进展,为在复发性恶性脑胶质瘤治疗一线和相关的研究人员提供一些参考。     

胶质瘤术后假性进展的临床特点及治疗

随着对术后胶质瘤复发的不断研究,逐渐发现胶质瘤术后补充放疗和／或化疗等综合治疗的患者行MRI检查后出现类似肿瘤复发的强化影像,经病检证实为一种治疗相关反应,称之为“假性进展（pseu-doprogression,psPD）”。胶质瘤术后患者psPD与肿瘤复发有不同的病理生理机制及治疗方案,随着对psPD及胶质瘤复发认识的日臻完善,使得临床医生在判断复发胶质瘤及制定其治疗策略的过程中更为准确、有效。     

小儿恶性脑胶质瘤患者术后放化疗的观察护理

恶性脑胶质瘤约占原发性中枢神经系统肿瘤的43％～50％,可发生于中枢神经系统的任何部位和任何年龄,其中髓母细胞瘤多发于10岁以下的小儿,占儿童肿瘤15％～20％,是颅内恶性度最高的胶质瘤之一。手术切除是首选的治疗方案,但由于其特殊的病理特性,以及浸润性的生长方式,很难做到完全切除,术后局部复发率高。     

16例恶性脑胶质瘤术后替莫唑胺联合放疗临床分析

目的观察口服替莫唑胺(Temozolomide,TMZ)联合头部伽玛刀治疗颅内恶性胶质瘤的疗效及生存质量。方法 16例经病理证实为Ⅲ、Ⅳ级星形胶质细胞瘤与多形性胶质母细胞瘤患者,术后常规行头部伽玛刀治疗;放疗前1~2小时口服首剂TMZ。TMZ 100~150 mg/(m2.d),连服5天,28天为一个治疗周期,连续治疗2~3个周期。结果经TMZ联合放疗治疗后,本组完全缓解4例,部分缓解5例,稳定4例,恶化3例;临床改善6例,临床稳定8例,临床恶化2例;服药后常见的不良反应轻微。结论恶性胶质瘤患者术后联合TMZ化疗与同期伽玛刀治疗效果好,安全性高,患者耐受性良好,能够提高部分患者的生存质量,可以在严密观察下应用于临床。     

99mTc-MET、18F-FDG及1H-MRS多模式分子显像在恶性脑胶质瘤放化疗后假性进展诊断中的应用研究

选取本院28例患有恶性脑胶质瘤与18例良性脑病患者作为研究对象。分别采用99m Tc-MET、18F-FDG1H-MRS多模式分子显像,对比鉴别结果。结果 99mTc-MET较18F-FDG及1H-MRS鉴别准确性更好,对比TER,观察组67.86%,对照组为83.33%。psPD患者在观察组中为42.86%,TP患者为57.14%。在半年后,psPD患者复发率为16.67%,一年后为0.00%,而TP患者复发率分别为50.00%、12.50%,差异明显,(P0.05)。临床上出现ps PD的患者鉴别非常重要,应用99m Tc-MET、18F-FDG及1H-MRS多模式分子显像在脑胶质瘤临床诊疗中有较高价值。     

The ‘PRESTON Profile’ — the first disease-specific tool for assessing quality of life in patients with malignant glioma

This study seeks to assess the quality of life in patients with malignant glioma, using as its measuring tool the disease-specific ‘PRESTON Profile’ designed by the author. Twenty patients took part in the project. Following completion of the questionnaire, semi-structured interviews were conducted with each subject to further explore issues raised by their responses to the ‘PRESTON Profile’. Results showed that the ‘PRESTON Profile’ was perceived as a most pertinent tool for ascertaining quality of life in patients with malignant glioma. However, it was apparent that a questionnaire alone is not the ideal way of assessing quality of life in these patients, as the concentration required to reach each statement, and then to make a considered decision, sometimes proved too demanding. Interviewing patients (alone or with their spouse/carer) -utilizing information gained from their responses to the ‘PRESTON Profile’ elicited considerably more information. Thus the ‘PRESTON Profile’ can be used successfully as both an assessment of quality of life, and as a ‘launching pad’ for more in-depth counselling, for patients with malignant glioma.     

The role of thrombin in gliomas

BACKGROUND: In a previous study we found that intracerebral infusion of argatroban, a specific thrombin inhibitor, reduces brain edema and neurologic deficits in a C6 glioma model. OBJECTIVES: To examine the role of thrombin in gliomas and whether systemic argatroban administration can reduce glioma mass and neurologic deficits and extend survival time in C6 and F98 gliomas. METHODS: The presence of thrombin in human glioblastoma samples and rat C6 glioma cells (in vitro and in vivo) was assessed using immunohistochemistry. The effect of thrombin on C6 cell proliferation in vitro was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay. The role of thrombin in vivo was assessed in rat C6 and F98 glioma cell models using argatroban, a thrombin inhibitor. The effects of argatroban on tumor mass, neurologic deficits and survival time were investigated. RESULTS: Thrombin immunoreactivity was found in cultured rat C6 glioma cells and human glioblastomas. Thrombin induced C6 cell proliferation in vitro. In C6 glioma, argatroban reduced glioma mass (P < 0.05) and neurologic deficits (P < 0.05) at day 9. In F98 glioma, argatroban prolonged survival time (P < 0.05). CONCLUSION: These results suggest that thrombin plays an important role in glioma growth. Thrombin may be a new therapeutic target for gliomas.     

Aberrant expression of five miRNAs in papillary thyroid carcinomas

BackgroundThe miRNAs play critical roles in the progression of various tumors. Our study aimed to screen and identify miRNAs to investigate their diagnostic and prognostic value for papillary thyroid carcinoma (PTC).MethodsmiRNAs were evaluated in PTC (n = 30) tissues, A‐PTC (n = 30), benign nodules (n = 35) and A‐benign nodules (n = 35). The expression levels of five miRNAs were quantified using real‐time, quantitative PCR. ROC analysis was used to evaluate the miRNA diagnostic value.ResultsThe expression of miR‐1296‐5p, miR‐1301‐3p, and miR‐532‐5p was significantly downregulated (p = 0.0001, p = 0.0006, p = 0.0024, respectively), while miR‐551b‐3p and miR‐455‐3p were significantly upregulated in PTC tissues compared to A‐PTC tissues (p = 0.0005, p = 0.0046, respectively). Interestingly, the expression of miR‐1296‐5p was downregulated, while miR‐551b‐3p and miR‐455‐3p were upregulated in the A‐PTC group compared to the A‐benign group. Moreover, the miR‐1296‐5p expression level was associated with tumor size, the number of foci and the TNM stage; the miR‐455‐3p expression level was correlated with patient age, tumor size, and TNM stage; and the miR‐532‐5p expression level was correlated with patient age, lymph node metastasis and TNM stage correspondingly. ROC analysis revealed that the AUCs for miR‐1301‐3p, miR‐1296‐5p, miR‐455‐3p, miR‐532‐5p, and miR‐551b‐3p were 0.773, 0.790, 0.783, 0.744, and 0.650, respectively.ConclusionsOur results indicated that miR‐1296‐5p, miR‐1301‐3p, miR‐532‐5p, miR‐551b‐3p, and miR‐455‐3p are aberrantly expressed in papillary thyroid carcinomas and correlated with clinicopathological features. ROC curve analysis indicated that these five miRNAs have a potential diagnostic value. Consequently, we speculate that the five altered miRNAs may serve as potential diagnostic and prognostic biomarkers for PTC.     

5种血清miRNA的检测在前列腺癌诊断中的价值评估

目的 检测miR-141,miR-16,miR-103,miR-574,miR-34b等五种前列腺癌相关的miRNA在前列腺癌患者血清中的含量,评价其在前列腺癌诊断中的价值.方法 收集临床血清样本,将其分为前列腺癌、前列腺增生、PSA升高等三组,提取血清中miRNA.应用荧光定量PCR方法检测相应miRNA的含量,用GraphPad Prism软件进行统计学分析.结果 miRNA-103和miR-34b在前列腺癌患者、前列腺增生患者和PSA增高人群血清中的含量普遍较正常人增高,其中miRNA-34b平均增高2.2×104倍,在所有PSA升高的样本中均增高.其余3种miRNA的水平相对于正常人未呈现显著差异.结论 miR-34b的诊断价值与PSA相当,是一个潜在的前列腺癌诊断性血清标志物.     

pSiRNA-Shh逆转录病毒载体的构建及对恶性脑胶质瘤细胞作用的离体实验研究

目的建立逆转录病毒介导的人Shh基因RNA干扰体外表达体系并观察对恶性脑胶质瘤细胞的作用。方法将人Shh基因RNA干扰双链转录DNA片段重组到逆转录病毒质粒Psilencer 5.1-H1 Retro中,构建成携带人Shh基因RNA干扰逆转录病毒载体pSiRNA-Shh,经PT67细胞包装后,产生的重组逆转录病毒感染恶性脑胶质瘤细胞株U251和CHG-5细胞,用WST-8、RT-PCR和Western Blotting分别检测对转染细胞活性、人Shh mRNA和蛋白表达的影响。结果重组pSiRNA-Shh质粒经测序鉴定正确。重组逆转录病毒滴度可达210×104CFU/ml,感染U251和CHG-5恶性脑胶质瘤细胞株后3 d能明显抑制细胞生长,RT-PCR和Western Blotting检测人Shh mRNA和蛋白表达水平明显低于阴性对照组和未干扰组。结论携带人Shh基因RNA干扰双链转录DNA片段的逆转录病毒体现出明显的抑制恶性脑胶质瘤细胞生长作用,为下一步开展基因治疗恶性脑胶质瘤奠定了基础。     

脑恶性胶质瘤化疗患者生存质量及应对方式的调查

目的探讨脑恶性胶质瘤化疗患者生存质量及应对方式,提出相应的护理对策。方法采用生存质量核心量表(European organization for research and treatment of cancer quality of Life,core 30,EORTC QLQ-C30)和医学应对问卷(medical coping modes questionnaire,MC-MQ)对45例脑恶性胶质瘤化疗患者进行调查。结果患者生存质量的情绪功能和角色功能较低,得分分别为(7.80±2.52)分和(16.26±5.35)分。患者多采取回避应对方式,回避因子得分为(16.26±5.35)分与常模得分(14.44±2.97)分比较,差异有统计学意义(P0.05)。结论护理人员应充分评估脑恶性胶质瘤化疗患者所采取的应对方式和生存质量情况,有针对性制订干预措施,鼓励患者采用正性的应对方式来解决问题,使患者保持乐观的态度,以提高患者生存质量。     

白细胞介素6对卵巢癌恶性演进的影响

现代肿瘤学认为,肿瘤相关性炎症是肿瘤微环境形成的显著特点之一。卵巢癌的发生和发展与微环境中的炎症因子的影响密不可分,白细胞介素6(interleukin 6,IL-6)就是调节肿瘤细胞生长的一种重要的促炎因子。研究发现,在卵巢癌患者中可检测到IL-6及其受体异常高表达,且IL-6升高与临床预后不良密切相关,IL-6对卵巢癌恶性演进的作用机制成为肿瘤微环境领域的研究热点。我们结合课题组近年来的研究成果,主要从IL-6与卵巢癌的增殖、侵袭和转移、血液系统的紊乱、耐药性,IL-6靶向治疗卵巢癌的研究现状和应用前景几方面进行综述。     

p57kip2在脑胶质瘤组织中的表达和肿瘤级别的关系探讨

目的 检测人脑胶质瘤组织中p57kip2的表达水平，探讨它和肿瘤级别的关系和临床意义。方法 采用荧光实时定量聚合酶链式反应（RT—PCR）法检测p57kip2mRNA在47例脑胶质瘤组织和25例正常脑组织中的表达水平，统计分析表达水平和肿瘤级别之间的关系。结果 p57kip2在Ⅰ-Ⅱ级胶质瘤及Ⅲ-Ⅳ级胶质瘤中的表达均明显低于正常脑组织（P〈0．01），而且随着肿瘤级别的升高，p57kip2的表达降低：Ⅲ-Ⅳ级胶质瘤中的表达量显著低于Ⅰ-Ⅱ级胶质瘤（P〈0．01）。结论 p57kip2在胶质瘤组织中低表达，而且表达水平和恶性程度有负相关。p57kip2的检测可作为胶质瘤恶性程度判断的参考，为从基因水平上探讨胶质瘤的生物学行为、预后及治疗提供新的思路。     

MR弥散加权成像在脑胶质瘤中的应用价值

目的：探讨磁共振弥散加权成像（DWI）及表观弥散系数（ADC）图在鉴别胶质瘤实质部分、瘤周水肿及正常组织中的应用，及其在胶质瘤良、恶性分级诊断中的价值。方法：采用Philips 1.5T Intera超导型磁共振成像系统，对39例胶质瘤患者均行常规MRI及弥散加权成像。在x，y，z轴3个方向施加弥散梯度。弥散系数（b值）：b=0s/mm2及b=1000s/mm2，测量了肿瘤实质部分、瘤周水肿及正常组织的ADC值。结果：脑肿瘤实质部分的DWI和ADC图信号分别高于和低于正常脑组织。肿瘤实质部分的ADC值（1.72±0.78）×10-3（mm2/ｓ）及瘤周水肿的ADC值（1.44±0.31）×10-3（mm2/ｓ）与正常组织的ADC值（0.93±0.59）×10-3（mm2/ｓ）相比均有显著差异（P<0.01），肿瘤组织与瘤周水肿之间无显著差异（P>0.05）；1~2级低度胶质瘤的平均ADC值高于3~4级恶性胶质瘤的平均ADC值（P<0.05）。结论：DWI、ADC图及ADC值的测量能够用于胶质瘤的肿瘤实质及瘤周水肿与正常脑组织的区分，但不能可靠地鉴别肿瘤组织及瘤周水肿。ADC值能够反映肿瘤的细胞构成，MR弥散加权成像对于良、恶性胶质瘤的分级有较高的预测价值。