骨肉瘤细胞核因子кB免疫组化研究

细胞核因子ＮＦ－кＢ在肿瘤血管生成中可能具有核心调节作用,本文选择８０例有随访结果的骨肉瘤,应用免疫组化方法检测 ＮＦ－кＢ ｐ６５亚单位以及血管内皮细胞生长因子（ＶＥＧＦ）的表达,同时观察肿瘤内微血管密度（ＭＶＤ）,旨在探讨 ＮＦ－кＢ表达与骨肉瘤血管生成的关系。结果：８０例骨肉瘤中 ４８例 ＮＦ－кＢ ｐ６５阳性,阳性产物主要定位于肿瘤细胞浆。ＮＦ－кＢ表达与ＶＥＧＦ表达和ＭＶＤ呈显著正相关,而且ＮＦ－кＢ阳性组病人存活时间显著低于阴性组。该结果表明：①ＮＦ－кＢ ｐ６５是骨肉瘤相关的一种癌蛋白,在骨肉瘤的发生和发展中发挥重要的作用;②ＮＦ－кＢ对ＶＥＧＦ可能有正向调节作用,进而影响骨肉瘤血管生成;③ＮＦ－кＢ　对肿瘤血管生成的作用,可能是影响骨肉瘤预后的主要原因之一。     

应用CD3AK细胞预防肝癌术后复发的初步观察

目的 观察ＣＤ３ＡＫ细胞治疗对肝癌术后复发的影响。方法 ６２例肝癌切除术按序列单双数的原则分为两组,研究组３２例术后１周开始应用ＣＤ３ＡＫ细胞治疗,每隔２～３个月施行一疗程,共２～６个疗程;对照组３０例术后不用ＣＤ３ＡＫ细胞治疗,仅作一般护治疗。结果 ①研究组术后１年复发率６．３％（２／３２）明显低于对照组２６．７％（８／３０）（Ｐ〈０．０５）;②研究组和对照组术后４周免疫功能有明显差异（Ｐ〈０．     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

Periodontitis, a risk factor for cardiovascular diseases?

Exist a statistically significant association between a diagnosis of coronary heart disease and certain oral health parameters. These parameters are independent and more strongly associated with coronary heart disease than were recognized risk factors, such as serum cholesterol levels, body mass index, diabetes and smoking status. The correlation between serum and salivary cholesterol concentration and the role of salivary lipids in oral health have been poorly characterized. Lipids in saliva are mostly glandular in origin, through some may diffuse diffuse directly from the serum. The surface of the enamel (in case of dietary fat which have an cariostatic effect) is protected against demineralization by a mixture of salivary lipids and proteins. Salivary lipids may have anucleating role in the early mineralization of the dental plaque. The prevalence of periodontal disease may be increased in patients with atherosclerosis, and dental and periodontal infections have been shown to be associated with occurrence of acute and chronic coronary heart disease. Among the known risk factors of atherosclerosis, high serum lipid levels, especially cholesterol may be important with regard to periodontal health.     

犬失血性休克早期血浆3种酶活性值的变化

用１０只犬复制失血性休克模型,观察休克前、休克３０ｍｉｎ及回输血后３０ｍｉｎ时,血浆中心肌相关酶—肌酸激酶（ＣＫ）、谷草转氨酶（ＧＯＴ）、α－羟丁酸脱氢酶（ＨＢＤ）活性值的变化。结果发现：失血性休克３０ｍｉｎ时,ＣＫ、ＧＯＴ较休克前显著下降（Ｐ＜０．０５,Ｐ＜０．０１）;ＨＢＤ值也下降,但无统计学意义（Ｐ＞０．０５）。输血后３０ｍｉｎ时,ＣＫ、ＧＯＴ、ＨＢＤ值回升,与休克３０ｍｉｎ时比显著升高（Ｐ＜０．０５）,与休克前比无显著性差别（Ｐ＞０．０５）。提示：失血性休克早期心肌细胞可能存在有一种保护性反应,心肌细胞没有发生明显损伤。     

我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。     

小分割分次立体定向放射治疗脑转移瘤近期疗效观察

目的观察小分割分次立体定向放射治疗(fractionated stereotatic radiation therapy,FSRT)脑转移瘤的近期疗效.方法15例病人单纯全脑外照射(WBRT组),中间平面剂量20～40Gy/10～20次/2～4周.17例病人接受FSRT(FSRT组),每次分次剂量为2.5～3.0Gy.其中11病人行单纯FSRT,中心总剂量为30～60Gy/1 0～20次/2～4周;6例病人先行WBRT,然后行FSRT,中心总剂量为46～60Gy/5～6周.结果KSP评分增加10分以上者,WBRT组为5 3.3%,FSRT组为82.4%.(P＜0.05).WBRT组有效率(CR PR)为50.0%;FSRT组有效率(CR PR)为80.0%.中位生存率:WBRT组为3.5月,FSRT组为10.0月.结论FSRT能有效地控制脑转移瘤,减轻神经系统症状,提高生存质量,延长病人生存期,而没有增加副作用,值得临床推广应用.     

妊娠合并肺动脉高压23例分析

目的 探讨合并肺动脉高压(PH)妇女能否妊娠及妊娠的适宜时间。方法 回顾性分析1997～2002年在我院诊治的23例合并有PH的孕妇，分析PH的分类，妊娠结局。结果 3例合并原发性肺动脉高压(PPH)孕妇，2例在剖宫产术中死亡，1例在孕早期终止妊娠后存活。14例因合并风湿性心脏病(风心病)致PH的孕妇，妊娠至足月行剖宫产者10例，1例早产，3例引产，无一例孕妇死亡。6例因合并先天性心脏病(先心痛)致PH的孕妇，轻度PH孕妇3例，均妊娠至足月；重度PH孕妇3例，2例死亡，1例存活。结论 PPH患者应避免妊娠。风心病致PH的孕妇，依心功能、PH高低及血氧饱和度决定是否终止妊娠。对先心病致PH者，最好在手术或药物治疗后妊娠；患Eisenrnenger’s综合征妇女禁止妊娠。     

Lymphangioma of the spermatic cord

We report a new case of spermatic cord lymphangioma in a infant 2 years old. The initial diagnosis was funicular hydrocele. The treatment was the local excision of tumor and the diagnostic was histological. Postoperative course was excellent. Must be explored the transillumination of the mass which would have led us to think other the diagnosis different from that of the cord hydrocele before the operation since it would have given negative. During the operation, must the assured that the cystic anomaly is limited to spermatic cord, to evite recurrences in the postoperative course.     

Randomized parallel study of doxorubicin plus paclitaxel and doxorubicin plus cyclophosphamide as neoadjuvant treatment of patients with breast cancer.

PURPOSE: This randomized, noncomparative, parallel-group study was designed to evaluate the pathologic complete response (pCR) rate of combined doxorubicin plus paclitaxel (AP) and doxorubicin plus cyclophosphamide (AC) as neoadjuvant chemotherapy in patients with previously untreated breast cancer who were unsuitable for conservative surgery. PATIENTS AND METHODS: A total of 200 patients with T2-3, N0-1, M0 disease were randomly assigned in a 2:1 ratio to receive preoperative chemotherapy with either doxorubicin 60 mg/m(2) plus paclitaxel 200 mg/m(2) as a 3-hour infusion (AP) or doxorubicin 60 mg/m(2) plus cyclophosphamide 600 mg/m(2) (AC) every 3 weeks for 4 courses followed by surgery. RESULTS: A pCR (eradication of invasive carcinoma in tumor and in axillary lymph nodes) was found in 16% and 10% of patients in the AP and AC arms, respectively, by study center pathologists, and in 8% and 6% of patients, respectively, by independent pathologists. Patients with pCRs tended to have unifocal disease, tumors with negative hormonal receptor status, and less differentiation (Scarff, Bloom, and Richardson scale grade 3). Breast-conserving surgery was performed in 58% and 45% of patients in the AP and AC arms, respectively. An objective clinical response was achieved in 89% of patients in the AP arm and 70% in the AC arm. At a median follow-up of 31 months, disease-free survival (DFS) was higher in patients who reached pCR versus those without pCR (91% v 70%). CONCLUSION: The encouraging pathologic and clinical responses of patients with breast cancer after neoadjuvant chemotherapy with doxorubicin plus paclitaxel warrant additional investigation of paclitaxel in the neoadjuvant setting of breast cancer management.