经支气管针吸活检术对肺癌伴纵隔淋巴结转移的临床诊断价值

目的评价经支气管针吸活检术（transbronchial needle aspiration,TBNA）对伴有纵膈淋巴结转移的肺癌临床诊断价值。方法对肺部CT检查疑诊为伴有淋巴结转移的肺癌53例患者,在常规支气管镜行刷检和活检后,对转移肿大的纵隔淋巴结行经支气管针吸活检术（TBNA）,对获取的标本实行相应的病理学检查。结果 53例患者经三种结合的纤支镜检查明确诊断46例,其中组织活检、刷检和TBNA的阳性率分别是64.2%、60.4%、58.5%,常规组织刷检及活检的阳性率为69.8%,结合TBNA术的阳性率增加至86.8%。参检者术中及术后均未发现严重的并发症。结论 TBNA术对于伴有纵膈淋巴结转移的肺癌患者具有较高的临床诊断价值。     

放疗联合食管支架对晚期食道癌患者预后影响的COX分析

目的:分析放疗联合食管支架对晚期食道癌患者预后影响。方法:选取我院收治晚期食道癌患者90例,经西医诊断标准经病理学及CT检查确诊为晚期食道癌,根据治疗方法不同分为实验组(放疗联合食管支架术)与对照组(食管支架术)。比较患者肝、肾功能,及生存率。采用Cox分析法对患者预后与放疗的相关性分析。结果:两组患者半年、1年、3年、5年生存率相比较,实验组与对照组相比较,生存率升高,差异具有统计学意义(P0.05);经COX分析,食管癌患者的生存率与患者的淋巴结转移书、TNM分期以及是否放疗有关(P0.05);经COX分析后可见,是否有食管瘘、是否根治术、病理分型、TNM分期、是否放疗为影响食管癌患者生存的独立影响因素(P0.05)。结论:是否有食管瘘、是否根治术、病理分型、TNM分期、是否放疗是食管癌患者生存的独立影响因素。术后的放疗治疗对患者的生存有积极意义。     

脑转移瘤CT诊断(附68例分析)

脑转移瘤是指身体其它部位的恶性肿瘤经血行、淋巴或直接侵入颅内者,亦可经脑脊液循环种植、转移。其很常见,约占颅内肿瘤的4%~10%。现将我院近四年的68例脑转移瘤CT资料进行报道,并结和国内外资料分析探讨。材料及方法原发病灶为肺癌者37例,肾癌和黑色素瘤各3例,乳腺癌2例,其他如肝癌、卵巢癌、食道癌、鼻咽癌、腮腺癌各一例;原发灶不明者18例。症状以头痛者居多,41例;恶心呕吐者20例;一侧肢体偏瘫、麻木者33例,部分有视物模糊。37例肺癌脑转移者中34例有明确原发灶并手术证实;3例肺部有肿块,临床确诊但未手术证实。原发灶不明18例中8例经…     

早期肺癌诊断中PET/CT的应用价值

目的:探讨PET/CT在早期肺癌诊断中的应用价值.方法:应用PET/CT对16例肺部孤立性病灶进行PET/CT检查,手术切除病灶组织送病理检查,以判断诊断符合率与细胞类型.结果:16例肺病灶患者PET/CT检查与手术切除组织病理结果相比较,诊断符合率为87.5%,其中腺癌13例(包括细支气管肺泡细胞癌6例),鳞癌2例,肺粘膜相关B细胞淋巴瘤1例.结论:结合临床症状,PET/CT检查能够准确的对肺癌做出早期诊断,及早治疗,改善患者预后     

CT联合DR对早期周围型肺癌的诊断价值

目的:分析数字X线摄片(DR)、CT及其联合应用对周围型肺癌的诊断价值。方法:选择该院2012年2月~2016年3月收治早期周围型肺癌患者90例为研究对象,分别进行数字化X线摄影和CT检查,以手术切除或病理结果为最终诊断的金标准,计算两种检查方法及其联合对早期诊断周围型肺癌的敏感度、特异度和准确率阳性预测值以及阴性预测值。结果:胸部DR检出空泡征者7例(7.8%),分叶征47例(52.2%),边缘有细小毛刺征36例(40%),胸膜凹陷征9例(10%);CT见病变边缘分叶征71例(78.8%),长短毛刺征57例(63.3%),空洞征27例(30%),胸膜凹陷征32例(35.6%)。DR诊断周围型肺癌的敏感性、特异性及准确性分别为85%、81%、85.6%,而CT则为90%,87.6%,90.5%,均高于DR。DR与CT两者联合诊断周围型肺癌的敏感性为98.4%,显著高于DR(85%)和CT(90%)。结论:在早期周围型肺癌的影像学诊断中,CT的临床价值显著优于DR,而两者联合诊断的临床价值明显优于单独检测。     

应用双向热循环消减SELEX技术筛选肺癌血清核酸适配体

肺癌是发病率和死亡率较高的恶性肿瘤。现阶段,用于肺癌早期诊断的血清肿瘤标志物因其特异性与敏感性均较低,严重影响肺癌的临床诊断和治疗。本文用双向热循环消减指数富集的配基进化(systematic evolution of ligands by exponential enrichment, SELEX)技术,筛选肺癌和非癌血清标志物的核酸适配体,建立肺癌的检测方法,提高诊断和治疗效率。实验用环氧基琼脂磁珠为筛选介质,以非癌混合血清、肺癌混合血清作为双向靶标。应用热循环消减SELEX技术,经19轮筛选分别获得非癌和肺癌血清的特异性核酸适配体。通过高通量测序,得到 40条非癌核酸适配体序列和 41条肺癌核酸适配体序列。从肺癌与非癌血清特异性核酸适配体序列中分别挑选出高丰度的 4条序列,合成后制成检测试剂,经临床血清验证,阳性率为 90%。该检测方法检测灵敏度高,为肺癌的早期诊断和治疗提供了新的分子识别元件。     

动态浊度法检测血浆内毒素在发热查因诊断中的应用

目的:探讨动态浊度法检测血浆内毒素含量对发热查因患者诊断的临床价值.方法:采用动态浊度法检测80名发热查因患者及50名健康人血浆中内毒素含量水平,并对发热查因患者的白细胞计数、血培养结果、用药及治疗手段、出院诊断进行回顾性调查分析.结果:发热查因中诊断为G-细菌感染者血浆内毒素含量明显高于G+细菌感染者、病毒感染者、非感染性发热者及健康人(P＜0.05).G+细菌感染者血浆内毒素水平明显高于非感染性发热者和健康人(P＜0.05).病毒性肝炎患者血浆内毒素水平明显高于健康对照(P＜0.05).内毒素水平和白细胞计数没有显著相关性(P＞0.05).5例G-菌败血症患者治疗5天后血浆内毒素含量明显低于治疗前(P＜0.01).结论:动态浊度法检测血浆内毒素水平对G-菌感染所致发热具有早期诊断价值,有助于判断感染的严重程度和治疗效果的检测,有利于临床合理应用抗菌药物和及时对症处理.     

纤维支气管镜在肺不张诊断与治疗中的意义

目的:探讨纤维支气管镜(纤支镜)在肺不张的诊断及治疗中的意义.方法:对经X线、CT诊断为肺不张的67例患者行纤支镜检查和治疗.结果:纤支镜病因诊断符合率为98.5%.其中肺癌38例(56.7%),炎症19例(28.4%),结核9例(13.4%),异物阻塞1例(1.5%).病变部位以右上叶16例最多(23.9%),接着依次为右肺下叶(19.4%),右肺中叶(17.9%).对肺不张患者经纤支镜吸痰、灌洗、局部给药、取出异物等治疗后,患者症状均有不同程度的改善,且炎症、结核、异物所致的肺不张肺叶均有不同程度复张,呼吸功能改善.结论:纤支镜对肺不张的诊断及治疗具有重要意义,且经纤支镜辅助治疗可促进肺复张.     

肺癌发病及骨转移相关因素分析

目的:探讨肺癌发病的可能相关因素。方法:选择87例确诊为肺癌的患者,收集患者的一般资料,临床信息以及诊断和治疗信息,其中伴骨转移者39例。结果:发病年龄平均67.8岁;6例(35.3%)女性患者为吸烟者,58例(97.7%)男性患者有吸烟史。女性吸烟人数及吸烟量增多;咳嗽为最常见的症状;病理组织学男性患者多为鳞癌,女性腺癌多见;Ⅲ和Ⅳ期明显多于Ⅰ期和Ⅱ期。虽然外科手术治疗后可以提高患者生存时间,接受外科手术患者仍较少。骨转移与性别、年龄和放化疗与否无关,与病理类型有关。结论:年龄、吸烟与肺癌发病密切相关,多数患者就诊时为中晚期,多只能接受姑息治疗,早期诊断及其重要。腺癌患者需警惕骨转移。     

P53抗体联合CYFRA21-1和CEA在非小细胞肺癌中的应用

目的:研究血清P53抗体在非小细胞肺癌临床病理特征之间的关系,并结合血清中的癌胚抗原、角质蛋白21-1以指导对临床上肺癌复发和转移的分析,用来选择合理的治疗方案。方法:正常组30例,肺良性疾病组10例,肺癌组45例,肺癌全组分别于手术前1天、术后10、30、60和90天时抽取清晨空腹静脉血2ml,23例肺癌病例于手术后120天,15例病例于手术后180天抽取清晨空腹静脉血2ml,肺良性疾病组分别于手术前1天、抽取清晨空腹静脉血2ml。正常组清晨空腹采集静脉血2ml。采用酶联免疫吸附法(ELISA)检测血清P53抗体和角质蛋白21-1,采用荧光酶标免疫法检测血清癌胚抗原。结果:血清P53抗体、CYFRA21-1和CEA在正常人组、良性疾病组、肺癌组术前阳性率的比较三种肿瘤标志物阳性率经X2检验,在肺癌组分别与正常人组和良性病例组有显著性差异(P<0.05),良性病例组和正常人组之间无显著行差异(P>0.05)。并与手术后复发与转移相关。结论:联合检测癌胚抗原、角质蛋白21-1及血清P53抗体水平有助于肺部良恶性疾病的诊断;手术前后动态测定肺癌患者血清P53抗体和角质蛋白21-1的变化规律,有助于判断疗效,监测预后和指导肺癌术后的综合治疗。     

紫茎泽兰的光合作用特征及其生态学意义

本文研究了紫茎泽兰(Eupatorium adenophorum Spreng)光合作用强度的变化规律及其与环境主要生态因子的关系,比较了它与某些农作物叶片净光合速率的差异,得到如下结果: 1.紫茎泽兰是一种阳性偏阴的C_3类草本植物,其光合作用的光饱和点约为40000 lx,光补偿点约为700 lx,且具有80 ppm左右的CO_2补偿点。 2.紫茎泽兰的最大净光合速率能达到23毫克CO_2/平方分米·时左右,叶片净光合速率的日变化规律呈双峰曲线型(主峰在10时左右,次峰在16时左右)。在一年中有较长的时间,它的光合速率保持着较高的水平。 3.生长在一般菜园土上的紫茎泽兰,当土壤含水量降至17％左右时,叶片光合速率接近0:而且,受过干旱处理的紫茎泽兰植株,在恢复供水后的第三天,其光合速率只达到原来的53％。 根据以上结果,结合受紫茎泽兰危害地区干湿季分明的特点,提出干季是防除紫茎泽兰的最佳季节。     

Cardio-pulmonary function of cyclists competing on an ascending mountain course between altitudes of 1400 m and 2800 m

Physiological changes were investigated in the cardio-respiratory function of competitors in a bicycle race which involved not a flat course but ascending a mountain, from 1400m to 2800m. Heart rate throughout the race, arterial oxygen saturation and pulmonary function before and after the race of well trained competitors were measured. The individual's maximal heart rate during the race was designated as HRmax for the calculations. (1) There were significant correlations between the age and the mean %HRmax during the race, between mean %HRmax and time, and between age and time (n=15); the mean %HRmax had a 3.90 times greater effect on time than did age. (2) The individuals who performed best had lower values of oxygen saturation just after finishing the race (n=51). (3) At 1 min after reaching the finishing line, oxygen saturation levels had recovered to the value of 20 min after finishing the race, whereas the heart rate was still in the process of recovery (n=18). (4) Maximum expiratory flow at 50% vital capacity measured 30 min after reaching the finishing line was significantly higher than at the starting point. The intensity of the load on the cardiac system produced by completion of this course was estimated to be almost the same as that of a full marathon on a flat course. The time depended on both the youth of the cyclist and on his ability to maintain a high value of %HRmax during the race.     

Age-dependent methylation of ESR1 gene in prostate cancer

The incidence of prostate cancer increases dramatically with age and the mechanism underlying this association is unclear. Age-dependent methylation of estrogen receptor alpha (ESR1) gene has been previously implicated in other cancerous and benign diseases. We evaluated the age-dependent methylation of ESR1 in prostate cancer. The methylation status of ESR1 in 83 prostate cancer samples from patients aged 49 to 77 years (mean age at 67.4 years) was examined using the bisulfite genomic sequencing technique. The samples were divided into three age groups: men aged 60 years and under (n = 14), men aged 61-70 years (n = 40), and men aged over 70 years (n = 29). Overall, ESR1 promoter methylation was detected in 54 out of 83 (65.1%) prostate samples. The methylation rate of ESR1 increased dramatically with age from 50.0% in patients aged 60 years and under to 89.7% for patients aged 70 years and over. Logistic regression analyses revealed that age and Gleason score were the only variables that affect incidence of ESR1 methylation; other clinical factors such as prostate-specific antigen level and clinical stage did not. We also calculated ESR1 methylation density (the percentage of methylated CpGs among all CpGs within the analyzed region) and severity (the percentage of methylated CpG alleles) for each sample analyzed. Multiple regression analyses showed a positive correlation between age and methylation density (beta, 0.35; P, 0.012; 95% CI, 0.26-2.01); while Gleason score was positively associated with methylation severity (beta, 0.45; P, 0.018; 95% CI, 1.04-4.26). These findings suggest that methylation of ESR1 is both age-dependent and tumor differentiation-dependent and age-dependent methylation of ESR1 may represent a mechanism linking aging and prostate cancer.     

不同声功率聚焦超声治疗不同时期胰腺癌疗效分析

目的:对不同声功率聚焦超声治疗不同时期胰腺癌疗效进行分析。方法:以胰腺癌患者为研究对象,分为低功率组和高功率组,其中低功率组治疗功率为100249 W,高功率组治疗功率为250350 W,以疼痛缓解效果、肿瘤坏死体积和体积消融率、血管内皮生长因子(vascular endothelial growth facto,VEGF)和肝细胞生长因子(hepatocyte growth factor,HGF)水平、并发症和生存时间为指标,评价治疗效果。结果:低功率疼痛缓解总有效率为97.5%,高功率组总有效率为92.5%,两组比较无显著差异(P>0.05);所有患者的胰腺癌肿瘤均呈现不同程度的坏死,且坏死区域体积在13个月内逐渐缩小,表现为增强扫描无强化,肿瘤周围存在环形强化带;高功率组IIIIV期患者的肿瘤体积消融率显著高于低功率组(P<0.05);与治疗前相比,低功率组和高功率组IIIIV分期患者的VEGF和HGF水平均显著下降,与低功率组相比,高功率组各时期VEGF和HGF水平降低更显著(P<0.05);高功率组和低功率组并发症发生率分别为12.5%和15.0%,经比较无统计学差异(P>0.05);治疗后低功率组患者中位生存期为6.37±1.13个月,高功率组患者中位生存期为6.72±1.34个月,经比较无显著差异(P>0.05)。结论:不同声功率聚焦超声消融治疗不同时期胰腺癌均有较好疗效,减轻患者疼痛,延长中位生存期,安全性较好。     

美常安干预肠易激综合征伴小肠细菌过度生长的研究

目的通过美常安干预肠易激综合征(IBS)伴小肠细菌过度生长(SIBO)患者,探讨IBS与SIBO之间的关系。方法选取40例IBS患者为IBS组,40例健康志愿者为对照组,两组患者治疗前均进行乳果糖氢呼气试验(LHBT)明确SIBO情况。IBS组中SIBO阳性者予美常安干预,观察其治疗前后的症状变化,疗程结束后复查LHBT。结果 IBS组患者SIBO发病率为55.0%,对照组为10.0%,两组患者SIBO发病率比较差异有统计学意义(P0.05);IBS组中SIBO阳性患者治疗后显效1例,有效12例,无效6例,脱落3例,有效率为68.0%,SIBO转阴率为57.9%。IBS组中SIBO阳性患者治疗前后腹胀程度、排便频率异常时间、排便时腹痛率及总积分比较差异有统计学意义(P0.05)。结论 IBS患者SIBO发病率远高于健康者,美常安能改善IBS伴SIBO患者部分症状及SIBO发病率,IBS的发生与SIBO之间存在一定关系,但对于IBS患者单纯补充益生菌制剂疗效并不理想,仍需结合其他手段进行干预。     

金桔秋季光合特性初步研究

采用Li-6400型便携式光合测定系统对多年生金桔的光合特性进行研究。结果表明,金桔净光合速率日变化呈双峰曲线,存在光合"午休"现象,最高峰出现在11:00左右,次峰出现在14:00,日最大净光合速率为3.4467 μmol/m²·s。净光合速率与蒸腾速率、气孔导度之间呈正相关,与胞间CO₂浓度呈负相关;在400 μmol/mol CO₂浓度下,光补偿点为67 μmol/m²·s,光饱和点为672 μmol/m²·s。金桔的光合特性表现为典型的阳性耐荫植物,对光照的适应性较强。     

Flow cytometric sperm sorting: effects of varying laser power on embryo development in swine.

This study was conducted to determine fertilization rate and embryo development using the Beltsville Sperm Sexing Technology with two different laser power outputs, 25 and 125 milliwatts (mW). Freshly ejaculated boar semen was diluted; one aliquot was not stained or sorted (nonsort) and a second aliquot was stained with Hoechst 33342 and sorted as a complete population, not separated into X and Y populations (all-sort). Ovulation controlled gilts were surgically inseminated with 2 x 10(5) spermatozoa (44-46 hr after human chorionic gonadotropin (hCG)) into the isthmus of each oviduct, one oviduct receiving nonsort and the other all-sort at 25 or 125 mW. A total of 426 embryos were flushed from oviducts at slaughter 43 hr after laparotomy and prepared for determination of fertilization and cleavage rates using confocal laser microscopy for analysis of actin cytoskeleton and chromatin configuration. The percentage of fertilized eggs and embryos was less for the 25 mW all-sort compared to nonsort or the 125 mW all-sort (77.9 vs. 96.3 and 96.2%, P < 0.05). The percentage of fragmented embryos was greater for the 25 mW all-sort than the nonsort (15.2 vs. 4.5%, P < 0.05), but did not differ significantly from 125 mW all-sort mean (7.2%). The percentage of normal embryos (80.4% overall) did not differ (P > 0.05) among treatments. However, the rate of embryo development was slower (P < 0.05) after insemination with the 25 mW all-sort spermatozoa compared to nonsort spermatozoa. Embryos in the 3-4 and 5-9 cell stages for the 25-mW all-sort and nonsort were 78 and 20% vs. 49 and 50%, respectively. The embryo percentages for the 125 mW (3-4 and 5-9 cell stages, 59 and 35%) did not differ significantly (P > 0.05) from the nonsort or 25 mW all-sort. We conclude that the use of 125 mW laser power for sorting boar spermatozoa is advantageous to maintain high resolution separation and has no detrimental effect on embryo development compared to 25 mW.     

青梅树叶片某些光合性能的研究

六月上旬检测青梅树叶片光合作用对光照强度的反应、光合速率的日变化及其影响因素,表明青梅树叶片光合作用的光补偿点和光饱和点分别为2-3千勒克斯和35-40千勒克斯。在新梢旺盛生长期的晴天。叶片的光合速率于10时和15时出现两次高峰。叶片的光合生产能力直接受光照强度的制约,同时还受气温和空气相对湿度的影响。     

TK1在肺癌患者血清中的表达水平及其与肿瘤临床病理特征及预后的关系

目的:探讨肺癌患者血清胸腺嘧啶核苷激酶1(TK1)与肿瘤临床病理特征及预后的关系。方法:选择2012年1月-2014年1月在我院接受治疗的肺癌患者79例作为研究对象,另选择同期在我院接受健康体检的志愿者53例作为对照组。采用化学发光法检测两组研究对象血清中TK1的表达情况,并分析TK1表达与肿瘤临床病理特征及预后的关系。结果:TK1在肺癌患者血清中的阳性表达率(56.96%)显著高于健康对照组(16.98%),差异具有统计学意义(P0.05)。肿瘤分期为晚期的患者血清中TK1的阳性表达率高于肿瘤分期为早期的肺癌患者,差异具有统计学意义(P0.05);肿瘤远处转移的患者血清中TK1的阳性表达率高于未发生远处转移的患者,差异具有统计学意义(P0.05)。TK1在性别、抽烟史、淋巴结转移及病理类型不同患者血清中的阳性表达率比较,差异无统计学意义(P0.05)。TK1阳性患者两年生存率(42.22%)低于TK1阴性患者(64.71%),差异具有统计学意义(P0.05)。结论:肺癌患者血清中TK1呈高表达,其表达水平与肿瘤远处转移、TMN分期及预后有关。     

P53抗体联合CYFRA21-1和CEA在非小细胞肺癌中的应用

目的：研究血清P53抗体在非小细胞肺癌临床病理特征之间的关系,并结合血清中的癌胚抗原、角质蛋白21-1以指导对临床上肺癌复发和转移的分析,用来选择合理的治疗方案。方法：正常组30例,肺良性疾病组10例,肺癌组45例,肺癌全组分别于手术前1天、术后10、30、60和90天时抽取清晨空腹静脉血2ml,23例肺癌病例于手术后120天,15例病例于手术后180天抽取清晨空腹静脉血2ml,肺良性疾病组分别于手术前1天、抽取清晨空腹静脉血2ml。正常组清晨空腹采集静脉血2ml。采用酶联免疫吸附法（ELISA）检测血清P53抗体和角质蛋白21-1,采用荧光酶标免疫法检测血清癌胚抗原。结果：血清P53抗体、CYFRA21-1和CEA在正常人组、良性疾病组、肺癌组术前阳性率的比较三种肿瘤标志物阳性率经X2检验,在肺癌组分别与正常人组和良性病例组有显著性差异（P〈0.05）,良性病例组和正常人组之间无显著行差异（P〉0.05）。并与手术后复发与转移相关。结论：联合检测癌胚抗原、角质蛋白21-1及血清P53抗体水平有助于肺部良恶性疾病的诊断;手术前后动态测定肺癌患者血清P53抗体和角质蛋白21-1的变化规律,有助于判断疗效,监测预后和指导肺癌术后的综合治疗。