EMA/CO化疗方案治疗恶性滋养细胞肿瘤的临床疗效观察

目的:恶性滋养细胞肿瘤(Malignant trophoblastic tumor)是胚胎滋养细胞发生病变而产生的恶性肿瘤,严重威胁女性患者的身体健康及生活质量。本研究对EMA/CO(etoposide,methotrexate,actinomycin D,cyclophosphamide and vincristine)化疗方案治疗恶性滋养细胞肿瘤的临床效果及毒副反应情况进行探讨,旨在为该病的临床治疗积累经验。方法:选取我院2010年8月-2012年12月收治的恶性滋养细胞肿瘤患者58例,随机分为研究组和对照组,每组各29例。对照组采用5-Fu+KSM方案进行治疗,研究组采用EMA/CO方案治疗。观察并比较两组患者的治疗总有效率及毒副反应的发生情况。结果:对照组治疗总有效率为75.9%,研究组治疗总有效率为79.3%,两组患者的临床疗效无显著差异(P0.05)。研究组白细胞减少、呕吐及口腔溃疡程度均比对照组轻,差异具有统计学意义(P0.05)。结论:应用EMA/CO化疗方案治疗恶性滋养细胞肿瘤具有积极的作用,不但可以获得较好的近期疗效,且毒副反应较轻,值得临床应用推广。     

CXCL10和MMP-13在妊娠滋养细胞疾病滋养细胞中的表达及其临床意义

目的检测妊娠滋养细胞疾病滋养细胞中CXCL10和MMP-13表达情况,探讨其在滋养细胞疾病浸润和转移中的作用。方法采用免疫组织化学Powervision法检测40例早孕绒毛,30例葡萄胎,18例葡萄胎恶变(随访发生恶变),35例滋养细胞肿瘤(28例绒癌,7例胎盘部位滋养细胞肿瘤)中CXCL10和MMP-13的表达。结果CXCL10和MMP-13在滋养细胞肿瘤中表达阳性率和免疫反应性强度最高;在葡萄胎恶变组中表达阳性率和免疫反应性强度较高,但是低于在滋养细胞肿瘤中的表达阳性率和免疫反应性强度;在葡萄胎组和早孕绒毛组中表达阳性率和免疫强度较低。CXCL10和MMP-13在滋养细胞肿瘤中的表达,年龄<40岁组中表达低于年龄>40岁组;在临床分期分组(Ⅰ、Ⅱ)中表达低于临床分期分组(Ⅲ、Ⅳ);在FIGO预后评分分组低危组中表达低于高危组。结论CXCL10和MMP-13在早孕绒毛组织中低表达,而在滋养细胞肿瘤中高表达,提示其可能参与滋养细胞疾病的浸润和转移过程,因此联合检测CXCL10和MMP-13的表达可能对葡萄胎恶变的早期诊断以及对滋养细胞肿瘤的预后评估提供依据。     

Rockall危险性积分对急性上消化道出血患者临床预后的预测价值

目的:探讨Rockall危险性积分对急性上消化道出血(AUGIH)患者临床预后的预测价值。方法:选择2012年1月至2014年1月我院收治的120例AUGIH患者,依据Rockall评分标准对患者相关临床资料进行收集,并计算其Rockall危险性积分评分,记录患者再出血率及死亡率。结果:120例AUGIH患者中,低危组39例(32.5%)、中危组72例(60.0%)、高危组9例(7.5%)。高危组患者再出血率及死亡率分别为33.3%和22.2%,均明显高于中危组16.7%和15.3%,比较差异具有统计学意义(P0.05)。结论:Rockall评分系统可作为AUGIH患者预后预测的重要指标,对急诊AUGIH预后的判断具有重要临床意义。     

滋养细胞肿瘤糖原PAS整块显色及图像定量分析

应用图像分析仪,对经过ＰＡＳ整块染色的４４例滋养细胞肿瘤标本进行糖原定量测定和分析。结果表明：滋养细胞肿瘤细胞的糖原含量和细胞增生程度成正比。恶性葡萄胎（ＨＭ）（未化疗）和绒毛膜癌（未化疗）的糖原含量明显高于良性葡萄胎和正常绒毛,有极显著性差异（Ｐ＜０．０１）。恶性葡萄胎和绒毛膜癌经化疗后,糖原含量明显降低。结果提示：滋养细胞肿瘤糖原含量的图像分析,在该肿瘤的诊断、预测预后,指导临床治疗方面,有一定的意义     

Glasgow-Blatchford和Rockall评分系统对上消化道出血患者治疗的指导作用比较

目的:比较Glasgow-Blatchford和Rockall评分系统对上消化道出血患者治疗的指导作用。方法:回顾分析我院收治的上消化道出血病人共366例,详细记录每一位入组患者的临床表现、生命体征、实验室检查结果,根据Glasgow-Blatchford和Rockall评分系统的规则计算每一位患者的危险分值,并依据其分值将其分为低危组和高危组(Glasgow-Blatchford≥1分,Rockall≥1分)。结果:366例上消化道出血患者有243位(66.4%)经过补液、抑酸等保守治疗后出血停止,并按照临床实际将其定义为低危患者,Glasgow-Blatchford评分为0的低危患者有63位(17.2%),Rockall评分为0的低危患者有99人(27.0%),参照临床治疗中实际的高低危患者,计算得到Rockall评分系统对高危患者诊断的敏感性为87.0%,而Glasgow-Blatchford评分系统对高危患者诊断的敏感性为100%。Glasgow-Blatchford评分系统对上消化道出血高危患者诊断的敏感性明显高于临床Rockall评分系统。结论:基于实验室检查和临床表现的Glasgow-Blatchford评分,是一种简单、有效的判断上消化道出血严重程度的评分系统,有助于临床医师选择正确的治疗方案。     

非小细胞肺癌的治疗方案及影响预后的重要因素

目的:回顾分析各种非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗方案及影响其治疗预后的因素,为合理制定个体化的综合治疗方案提供参考。方法:回顾分析近年来NSCLC治疗的研究报道,分析如病理分期、实验室检查结果(VEGF、WBC、Hg等)影响治疗预后的因素,建议相应的治疗对策。结果:1.Ⅰ期、Ⅱ期及部分Ⅲa期NSCLC的患者治疗措施首先以手术治疗为主,同步放化疗比单纯放、化疗及序贯放化疗更能有效改善晚期NSCLC的预后;2.个体相关因素、肿瘤相关因素和治疗相关因素影响NSCLC治疗预后。结论:同步放化疗在晚期NSCLC的治疗中有重要作用,肿瘤的病理分期、血浆VEGF浓度是影响NSCLC预后的独立因素。     

短暂性脑缺血发作患者血脂水平与ABCD2 评分的相关性研究

目的:探讨短暂性脑缺血发作(transient ischemia attach,TIA)患者血脂水平对预后的影响及其临床意义。方法:回顾性分析以2009年最新定义为诊断标准的我院TIA患者62例,根据ABCD2评分进行危险分级。其中,低危组(0～3分)患者16例、中危组(4～5分)患者20例,高危组(6～7分)患者26例,比较三组患者血脂水平的差异及其预后效果的影响。结果:三组患者中血脂水平从高到低依次为:高危组、中危组与低危组,其中高危组血脂水平与其它两组患者血脂水平的差异均有统计学意义(P<0.05),但中危组与低危组间差异无统计学意义(P>0.05)。低、中危组患者血脂平均水平随ABCD2分值增高呈轻度上升趋势,高危组患者血脂平均水平随ABCD2分值明显增高。血脂水平越高其预后效果相对越差。结论:血脂水平与TIA患者ABCD2评分呈正相关的趋势,而与预后效果呈负相关的趋势。     

Glasgow-Blatchford和Rockall评分系统对上消化道出血患者治疗的指导作用比较

目的：比较Glasgow-Blatchford和Rockall评分系统对上消化道出血患者治疗的指导作用。方法：回顾分析我院收治的上消化道出血病人共366例,详细记录每一位入组患者的临床表现、生命体征、实验室检查结果,根据Glasgow-Blatchford和Rockall评分系统的规则计算每一位患者的危险分值,并依据其分值将其分为低危组和高危组（Glasgow-Blatchford≥1分,Rockall≥1分）。结果：366例上消化道出血患者有243位（66.4%）经过补液、抑酸等保守治疗后出血停止,并按照临床实际将其定义为低危患者,Glasgow-Blatchford评分为0的低危患者有63位（17.2%）,Rockall评分为0的低危患者有99人（27.0%）,参照临床治疗中实际的高低危患者,计算得到Rockall评分系统对高危患者诊断的敏感性为87.0%,而Glasgow-Blatchford评分系统对高危患者诊断的敏感性为100%。Glasgow-Blatchford评分系统对上消化道出血高危患者诊断的敏感性明显高于临床Rockall评分系统。结论：基于实验室检查和临床表现的Glasgow-Blatchford评分,是一种简单、有效的判断上消化道出血严重程度的评分系统,有助于临床医师选择正确的治疗方案。     

前列腺癌根治术治疗不同分级前列腺癌患者的临床研究

目的:探究前列腺癌根治术在不同危险度前列腺癌患者中治疗的临床效果,为临床前列腺癌患者的治疗提供依据。方法:选择2008年1月~2015年12月期间我院94例前列腺癌患者为研究对象,根据D'Amico评分将其分为高危、中危及低危三组,收集患者基线资料、术后随访资料,并比较三组手术并发症;采用Kaplan-Meier分析法计算三组患者生存率,并采用Log-rank检验比较不同危险组的生存率。结果:高危组患者进行开放性手术人数多于中危组和低危组,且中危组多于低危组,差异具有统计学意义(P0.05);高危组患者术前Gleason评分和PAS水平高于中危组和低危组,且中危组高于低危组,差异具有统计学意义(P0.05);术后5年高危组患者完全控尿率显著低于中危组和低危组(P0.05);三组患者间5年无生化复发率比较无统计学意义(P0.05)。结论:前列腺癌根治术治疗高危前列腺患者较中、低危患者疗效较差,但仍可达到较好的疗效,可在临床推广使用。     

老年广泛期小细胞肺癌患者化疗与预后的分析

目的:在老年人群中,小细胞肺癌的治疗难度大,缺乏有临床指导意义的研究数据,本文旨在通过对老年广泛期小细胞肺癌患者预后因素的分析寻找适合老年患者的化疗策略.方法:回顾性分析106例老年广泛期小细胞肺癌患者资料,应用SPSS13.0统计软件对数据进行单因素及COX回归多因素分析,探讨年龄、PS评分、化疗周期、化疗方案、血液学毒性等因素对生存的影响.结果:①单因素分析显示PS评分、化疗与否、化疗周期数、血液学毒性等因素对预后有影响,单药化疗与联合用药预后无明显差别.②COX回归多因素分析显示PS评分(P＜0.001)、化疗周期数(P=0.002)是影响预后的因素.③单药化疗的血液学毒性明显低于联合用药,化疗周期数更多.结论:老年广泛期小细胞肺癌患者可从化疗中受益,四周期以上的化疗可明显延长生存时间,对于PS评分较差的患者,单药化疗可能是一个好的选择.     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

Physiological characteristics of various species of strains of carboxydobacteria

Seven strains of aerobic carbon monoxide-oxidizing bacteria (carboxydebacteria) when growing on CO as sole source of carbon and energy had doubling times which ranged from 12–42 h. The activity profiles obtained after discontinuous sucrose density gradient centrifugation indicated that the CO-oxidizing enzymes are soluble and the hydrogenases are membrane-bound in all strains examined. The CO-oxidizing enzymes of Pseudomonas carboxydohydrogena, Pseudomonas carboxydoflava, Comamonas compransoris, and the so far unidentified strains OM2, OM3, and OM4 had a molecular weight of 230,000; that of Achromobacter carboxydus amounted to 170,000. The molecular weights of the CO-oxidizing and H₂-oxidizing enzymes turned out to be identical. The cell sonicates were shown to catalyze the oxidation of both CO and H₂ with methylene blue, thionine, phenazine methosulfate, toluylene blue, dichlorophenolindophenol, cytochrome c or ferricyanide as electron acceptors. Methyl viologen, benzyl viologen, FAD⁺, FMN⁺, and NAD(P)⁺ were not reduced. The spectrum of electron acceptors was identical for all strains tested. Neither free formate, hydrogen nor oxygen gas were involved in the CO-oxidation reaction. Methylene blue was reduced by CO at a 1:1 molar ratio. The results indicate that CO-oxidation by carboxydobacteria is catalyzed by identical or similar enzymes and that the reaction obeys the equation CO+H₂OCO₂+2H⁺+2e^- as previously shown for Pseudomonas carboxydovorans.Dedicated to Otto Kandler remembering almost three decades of enjoyable cooperation     

Modulation of allostery of pyruvate kinase by shifting of an ensemble of microstates

Since the introduction of the concepts of allostery about four decades ago, much advancement has been made in elucidating the structure-function correlation in allostery. However, there are still a number of issues that remain unresolved. In this review we used mammalian pyruvate kinase (PK) as a model system to understand the role of protein dynamics in modulating cooperativity. PK has a triosephosphate isomerase (TIM)(α/β)₈ barrel structural motif. PK is an ideal system to address basic questions regarding regulatory mechanisms about this common (α/β)₈ structural motif. The simplest model accounting for all of the solution thermodynamic and kinetic data on ligand-enzyme interactions involves two conformational states, inactive E^T and active E^R. These conformational states are represented by domain movements. Further studies provide the first evidence for a differential effect of ligand binding on the dynamics of the structural elements, not major secondary structural changes. These data are consistent with our model that allosteric regulation of PK is the consequence of perturbation of the distribution of an ensemble of states in which the inactive E^T and active E^R represent the two extreme end states. Sequence differences and ligands can modulate the distribution of states leading to alterations of functions. The future work includes: defining the network of functionally connected residues; elucidating the chemical principles governing the sequence differences which affect functions; and probing the nature of mutations on the stability of the secondary structural elements, which in turn modulate allostery.