32例老人慢性硬膜下血肿诊疗分析

我院自 1989年 - 1998年共收治 60岁以上慢性硬膜下血肿病人 32例 ,全部行手术治疗 ,疗效满意 ,现报告如下 :1　临床资料1.1　一般资料 :本组男 2 9例 ,女 3例 ,年龄 61～ 84岁 ,平均 69岁 ,有明确外伤史者 2 6例 ,占 81% ,其中车祸致伤者 11例 ,跌伤 5例 ,另有 10例仅有轻微头部外伤而无昏迷史。从发病至确诊时间均在 3周以上 ,最长者 2年 ,平均 152天。1.2　临床表现 :头痛头晕 2 4例 ,不同程度偏瘫 18例 ,精神症状记忆力下降 ,反应迟钝 ,智力障碍 2 2例 ,有明显意识障碍者 10例 ,其中深昏迷 2例 ,癫痫发作 8例。眼底检查 32例中正常者 15…     

CT引导下~(125)I粒子植入治疗恶性肿瘤的临床应用

目的：探讨CT引导下125I粒子治疗恶性肿瘤的临床应用价值。方法：搜集本院48例恶性肿瘤患者资料（男35例,女13例,年龄37-82岁）,其中肺癌20例,肝癌4例,胰腺癌4例,肝、肺、肾、脊柱、骨骼、软组织及颈胸腹部淋巴结等部位转移性肿瘤共20例。全部患者经过放射粒子植入计划系统（TPS）计划,CT引导下植入125I粒子对肿瘤进行治疗,观察其疗效及相关并发症。结果：全部患者125I粒子均植入成功,其中43例患者追踪复查1-13个月,疗效评价：完全缓解（CR）10例,部分缓解（PR）21例,无变化（NC）5例,进展（PD）7例,临床总有效率（CR＋PR）为72%。125I粒子植入过程中出现气胸5例,针道渗血4例,咯血3例,肝包膜下出血1例,粒子游走2例,无1例严重并发症。结论：CT导向下125I粒子植入治疗多种恶性肿瘤微创安全,疗效肯定。     

双重室性逸搏致特殊心电现象3例

完全性房室传导阻滞时,心室通常由1个起搏点所控制,而同时起源于心室不同部位或左右心室两个部位组成的双源性室性逸搏心律较为少见,其心电图表现较多变,现将我们遇到的3例报告如下.     

基于生物信息学对NK细胞抑制肝细胞癌发生发展潜在关键基因的筛选和鉴定

目的 基于生物信息学探讨和筛选自然杀伤(NK)细胞抑制肝细胞癌(HCC)发生发展过程中的关键基因及相关的信号通路.方法 在美国国立生物技术信息中心公共数据平台基因表达组学数据库(GEO)下载基因芯片数据GSE120123,从中选取4个关于NK细胞的样本,其中2个样本来自正常肝组织,2个来自HCC组织.分析其差异表达基因...     

食管贲门双源癌患者癌组织中mdm2,CyclinD1和p16蛋白的表达

目的:探讨食管贲门双源癌组织中mdm2、CyclinD1和p16蛋白的表达.方法:采用免疫组化ABC法,对河南食管癌高发区30例双源癌患者食管鳞癌(SCC)和贲门腺癌(GCA)组织中mdm2、CyclinD1和p16蛋白的表达进行检测.结果:30例双源癌患者SCC组织中mdm2、CyclinD1和p16蛋白阳性率分别为57%(17/30)、45%(13/29)和24%(7/29),CCA组织中分别为73%(22/30)、33%(10/30)和17%(5/30),SCC和GCA组织中3种蛋白的阳性率差异均无统计学意义(P均＞0.05).SCC和GCA组织中mdm2、CyclinD1和p16蛋白表达的一致性差异无统计学意义(P均＞0.05).结论:食管和贲门双源癌存在较高的mdm2、CyclinD1和p16蛋白表达一致性改变,提示河南食管癌高发区食管贲门双源癌可能具有相似的发病因素和分子机制.     

肝动脉介入热灌注化疗栓塞联合GT引导下射频消融治疗肝脏恶性肿瘤

[目的]探讨肝动脉介入热灌注化疗栓塞联合CT引导下射频消融（RFA）治疗肝脏恶性肿瘤的临床应用价值。[方法]48例肝脏恶性肿瘤随机分为联合组（24例）和对照组（24例）,联合组采取肝动脉介入热灌注化疗栓塞联合RFA治疗,对照组仅行肝动脉介入热灌注化疗栓塞治疗。治疗后通过影像学及相关肿瘤标志物等进行疗效评价。[结果]联合组和对照组临床治疗有效率分别为70.8%和41.6%;两组患者甲胎蛋白（AFP）下降率和转阴率分别为66.7%、33.3%和30.7%、0。[结论]肝动脉介入热灌注化疗栓塞联合RFA是肝脏恶性肿瘤的一种有效治疗方法。     

消炎痛抑制肝细胞肝癌生长转移的研究

Objective To study the effects of indomethacin on proliferation and invasion of hepatocellular carcinoma (HCC) cell line MHCC97L with metastatic potential and the effect of indomethacin on the growth and metastasis of HCC. Methods (1) In vitro; Proliferation, Transwell invasion assay, cell motility assay, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) protein activity were evaluated after cells were treated with 0. 2 mmol/L indomethacin. (2)In vivo: Mice bearing xenografts in the liver were randomly divided into control and indomethacin groups. At the end of sixth week, the mice were killed and tumor volume, inhibitory rate, immunohistochemistry assay (IHA) and metastasis were evaluated. Results (1)In vitro; 0. 2 mmol/L indomethacin could inhibit the proliferation of MHCC97L cells markedly (P ＜0. 01). The average amount of invading cells per field in cell invasion assay and motility assay was 2. 2 ± 1. 3 and 4.4 ± 1. 1 respectively in indomethacin group, significantly less than in control group ( 11. 4 ± 1. 9 and 12. 8 ± 1. 8 respectively, P ＜0. 01). The expression of VEGF and MMP-2 in cells treated with indomethacin was significantly lower than in control group (P ＜0. 01). (2)In vivo; Tumor volume, incidence and number of lung metastases in control and indomethacin groups were (1700 ±422) mm3 and (1170 ± 585) mm3 (P ＜ 0. 05), 75% and 50% ( P ＞ 0.05), 2. 92 ± 2. 07 and 1.33 ±1.56 (P＜0. 05) , respectively. Inhibition rate in indomethacin group was 31.2%. IHA showed that the expression of VEGF, MMP-2, and cyclooxygenase-2 ( COX-2) was down-regulated in indomethacin group (P ＜0.01). Conclusion Indomethacin could inhibit the growth and metastasis of HCC, which was in part mediated by down-regulation of VEGF and MMP-2.     

伊立替康联合草酸铂、5-氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床疗效

目的:比较伊立替康联合奥沙利铂和5-氟尿嘧啶、亚叶酸钙(FOLFOXIRI)与奥沙利铂联合CF,5-FU(FOLFOX4)治疗进展期或转移性胃癌的疗效和毒副反应。方法:经病理确诊的进展期或转移性胃癌患者78人,随机分为两组,FOLFOXIRI组36人,FOLFOX6组42人。FOLFOX4方案:L-OHP 85 mg/m2,第1天静滴,CF 200 mg/m2,5-FU 400 mg/m2,静冲,5-FU 600mg/m2,第1,2天,持续静点22h。FOLFOXIRI方案用法:CPT-11 165 mg/m2,L-OHP,CF,5-FU用法同FOLFOX4。结果:FOL-FOXIRI方案与FOLFOX4方案一线治疗进展期或转移性胃癌的缓解率分别为53.07%和28.57%(P=0.028),中位生存期分别为11.8月和9.4月(P=0.321),中位疾病进展时间为6.0月和4.8月(P=0.036)。FOLFOXIRI方案的骨髓毒性和腹泻发生率高于FOLFOX4方案。结论:本研究结果显示FOLFOXIRI方案治疗胃癌近期缓解率高于FOLFOX4方案,不良反应可以耐受,值得更深入系统地进行临床研究。     

绿脓杆菌制剂对人肝癌MHCC97L细胞增殖和侵袭能力的影响

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.     

交界区逸搏心律伴右束支直接显示性双向文氏现象

患者男,76岁,临床诊断:陈旧性前间壁心肌梗塞。,心电图(V_(1—a)～V_(1—c)系连续记录)示:P—P略有不整,含QRS的P—P间距小于不含QRS的P—P间距(相差大于0.02s),频率约86次/min,但频率较慢,为35次/min,P与QRS无关。QRS波群起始部有q波。QRS波群形态呈系列性变化,R_(1～6)呈RBBB图形,R波振幅逐渐增高,畸形逐搏明显,时限从0.12s至0.16s;R_(7、12)图形固定不变(中行),R_(13～18)(下行)与R_(1～6)(上行)呈相反的改变,从CRBBB型演变成IRBBB型。从