胃癌肝转移术中射频消融治疗的临床意义

目的：评估胃癌根治术同时性射频消融治疗在治疗胃癌肝转移的临床意义。方法：收集2008年1月至2010年12月19例胃癌肝转移患者,合计转移灶33个,转移灶小于4厘米,且合计不超过4个转移灶。射频消融治疗在术中超声引导下完成。Kap-lan—Meier法分析无病生存期,无肝转移生存期及总生存期。对临床病理学因子及肝转移相关因子采用Log-rank法Cox风险比例模型解析。结果：中位无病生存、无肝转移生存及总生存期为355,394及488天。有3例患者获得长期的无复发生存。单因素分析显示,较早的T分期、N分期,较少的转移灶数量,较小的转移灶直径与良好的预后相关。多因素分析提示,病灶数量与病灶直径为独立预后因子。结论：肝转移射频消融治疗安全性好,对单发的小于4cm转移灶,以及多发病灶合计直径小于4cm者射频消融治疗较为适用,可有显著生存获益。部分患者可迭临床治愈。对于胃癌肝转移的合适病例,射频消融治疗值得推广。     

直肠癌术后肺转移72例的临床分析

目的：探讨直肠癌根治术后肺转移的治疗效果和影响预后的因素。方法：回顾性分析1978～2008年间的直肠癌根治术后发生单纯性肺转移的72例病例资料。结果：自原发灶切除术后全组病例中位生存时间34个月,行转移灶的切除手术23例,中位生存49个月;其余49例行非手术治疗,中位生存33个月;其中转移瘤大于3个组中位生存时间28个月,转移瘤小于等于3个组中位生存时间41个月。手术患者和转移灶个数少的患者的总生存率较大,总生存率可能和是否手术、转移灶的个数有关,但尚未发现年龄、性别、原发灶病理类型、分期、转移灶大小对生存率有明显影响。结论：直肠癌肺转移灶的手术治疗是安全、有效的。手术及转移灶个数可影响患者生存率。     

胃癌肝转移术前经肝动脉化疗栓塞联合术中射频消融治疗的临床意义

目的:研究胃癌肝转移经肝动脉化疗栓塞联合射频消融治疗的临床意义。方法:选择胃癌肝转移灶小于4处,最大直径不超过4cm的患者23名。全组患者接受胃癌D2根治性切除及超声引导下射频消融治疗,其中15名患者术前接受了肝动脉化疗栓塞治疗。术后化疗采用以氟尿嘧啶及奥沙利铂为基础的方案。结果:本研究组未发生严重并发症,无病复发生存时间和总生存时间分别为366天和505天,5例患者获得无复发长期生存。多因素分析表明,N分期、转移癌的分布及是否接受肝动脉化疗栓塞治疗为独立预后因子。分层分析提示,术前肝动脉化疗栓塞治疗对多叶肝转移组疗效为优。结论:胃癌肝转移孤立或少数较小转移灶病例通过根治性手术、射频消融、肝动脉化疗栓塞术及术后化疗联合方案能够提高疗效,对部分患者可能获得长期生存的治疗成绩。     

TLR4 基因启动子单核苷酸多态性与结直肠癌临床预后的关系

目的:探讨Toll样受体(TLR)基因启动子单核苷酸多态性(SNP)与结直肠癌临床预后的关系。方法:收集我院2006年1月到2010年1月收治的结直肠癌患者200例,通过PCR扩增外周血DNA,经过查找数据库发现TLR4基因启动子区域有rs137853920、ss77136219多态位点,对所有患者随访5年,比较不同手术方式、美国癌症联合委员会(AJCC)分期、分化程度患者的总生存时间(OS)率和疾病无进展时间(PFT)率,分析基因型频率以及单倍体频率对患者生存影响。结果:200例患者生存时间在4~60个月,中位生存时间为54个月,OS率和PFT率在不同手术方式、癌症AJCC分期、分化程度患者间差异均具有统计学意义(P0.05);对生存资料进行多因素的Cox回归分析,结果显示rs137853920基因多态位点基因型AA、AG、GG具有较好的预后(P0.05),而ss77136219基因多态位点基因型GG、GA、AA具有较差预后(P0.05)。rs137853920、ss77136219多态位点共有四个单倍体型分别为AA、AG、GA、GG,频率分别为26.3%、21.7%、38.5%、21.6%,经过Cox多因素分析AG型患者具有较好预后(P0.05),而GG型患者具有较差预后(P0.05)。结论:TLR4基因启动子SNP可以作为结直肠癌临床预后的特异指标。     

外泌体在结直肠癌肝转移中的研究进展

肝脏是结直肠癌最常见的转移部位之一,肝转移灶的发生和发展会直接导致结直肠癌患者生存期明显缩短,且现有的治疗策略总体效果欠佳,因此,寻找更为有效的诊断和预后的生物标志物及可干预的靶点成为改善结直肠癌患者预后的一项重要任务。外泌体在结直肠癌肝转移过程中起重要作用,可介导化疗耐药的产生,同时作为生物标志物在结直肠癌肝转移的诊断和预后方面也具有一定价值。外泌体研究为结直肠癌靶向治疗提供了分子基础。本文就外泌体在影响结直肠癌肝转移、促进治疗耐药以及为结直肠癌肝转移提供诊断及预后价值的研究进展进行综述。     

胃癌肝转移治疗方法的探讨

目的:探讨胃癌肝转移的外科治疗效果.方法:对本院1998年1月～2008年1月收治的原发性胃癌269例中伴肝转移的53例的临床资料进行回顾性分析.对其中施行同时性胃癌肝转移灶切除术(切除组)的18例和仅行胃癌切除术而未行肝转移灶切除术(未切除组)的35例的术后生存时间进行对比.结果:全组有50例获得随访.胃癌肝转移灶切除术后1年、3年和5年生存率分别为58.8%、17.6%和0;未切除组术后1年、3年和5年生存率分别为为57.6%、15.2%和0.两组术后生存时间差异无统计学意义(P>0.05).结论:胃癌肝转移施行同时胃癌肝转移病灶切除术并不能有效改善病人的预后.     

89例喉鳞癌患者术后生存的COX模型多因素分析

目的:探讨影响喉癌手术后生存的相关危险因素。方法:回顾1997年1月-2006年12月在我科行喉癌手术治疗的89例患者,分析肿瘤因素、宿主因素及辅助治疗因素对术后生存的影响。结果:全组术后5年生存率70.7%(63/89),肿瘤T分期、颈部淋巴结是否转移及手术切缘状态是影响喉癌手术预后的独立危险因素。对于进展期喉癌,如适应症选择合理,行全喉切除及根治性喉部分切除预后无统计学差异。结论:早期诊断并选择合理的术式,尤其一些保留或重建喉功能的术式加合理的颈淋巴结清扫,同时确保手术安全切缘是提高喉癌术后肿瘤和喉功能效果的关键。     

结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A水平及其危险因素分析

目的:检测结直肠癌肝转移患者血清骨桥蛋白(Osteopontin,OPN)、人类软骨糖蛋白-39(Human cartilage gp-39,YKL-40)、肝细胞生长因子(Hepatocyte growth factor,HGF)和血管内皮生长因子A(Vascular endothelial growth factor A,VEGF-A)水平,并分析直肠癌患者发生肝转移的危险因素。方法:收集56例发生肝转移的直结肠癌患者和50例未发生肝转移的直结肠癌患者,采用酶联免疫法检测两组患者血清OPN、YKL-40、HGF和VEGF-A的水平。收集所有患者的临床资料,分析直肠癌患者发生肝转移的危险因素。结果:结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A水平均显著高于未发生肝转移的直结肠癌患者(P0.05);糖尿病、肿瘤最大直径、病理类型、分化程度、浸润深度、淋巴结转移、盆腹膜种植、肝外转移、吸烟史均与结直肠癌发生肝转移相关(P0.05);而HGF、VEGF-A、糖尿病、肿瘤最大直径≥5 cm、淋巴结转移、盆腹膜种植、肝外转移是直肠癌发生肝转移的独立危险因素(P0.05)。结论:结直肠癌肝转移患者血清OPN、YKL-40、HGF和VEGF-A明显升高,HGF、VEGF-A、糖尿病、肿瘤最大直径≥5 cm、淋巴结转移、盆腹膜种植、肝外转移是直肠癌发生肝转移的独立危险因素。     

结直肠癌术后并发腹腔感染患者的病原学特点、危险因素分析及对患者预后的影响

目的:分析结直肠癌患者术后并发腹腔感染的常见病原菌及其耐药性,探讨其危险因素及对患者预后的影响。方法:回顾性纳入2012年1月至2015年1月于我院行结直肠癌根治手术治疗的225例患者为研究对象,根据术后是否出现腹腔感染,将患者分为感染组(31例)和未感染组(194例),疑似感染患者进行病原菌培养鉴定以及药敏试验,分析影响结直肠癌根治术后腹腔感染的危险因素,对比两组病死率、无进展生存期(PFS)以及复发率。结果:结直肠癌根治术后腹腔感染发生率为13.77%,共检出菌株67株,革兰阴性菌检出率最高,其次是革兰阳性菌、真菌。大肠埃希菌对亚胺培南敏感,耐药率为0.00%。克雷伯菌对亚胺培南、阿米卡星、妥布霉素敏感,耐药率均为0.00%。铜绿假单胞菌对妥布霉素较为敏感,耐药率为11.11%。表皮葡萄球菌对左氧氟沙星、妥布霉素、环丙沙星、亚胺培南较为敏感,耐药率分别为0.00%、0.00%、12.50%、12.50%。单因素分析显示:结直肠癌根治术后并发腹腔感染与术前血红蛋白水平、术前血清白蛋白水平、是否合并糖尿病、TNM分期、Dukes分期、手术类型、手术时间、术中出血量、是否联合脏器切除、是否术后造口、有无吻合口瘘、术后引流管留置时间有关(P0.05)。多因素Logistic回归分析显示:合并糖尿病、联合脏器切除、术前血清白蛋白水平35 g/L、手术时间≥160 min、术后造口、吻合口瘘、术后引流管留置时间≥11d是结直肠癌根治术后并发腹腔感染的独立危险因素(P0.05)。与未感染组相比,感染组3年病死率、复发率升高,PFS显著缩短(P0.05)。结论:结直肠癌根治术后并发腹腔感染受多种因素影响,感染率较高,预后较差。感染病原菌以革兰阴性菌为主,并对抗生素有一定耐药性。临床应对合并糖尿病、术前血清白蛋白水平过低、术中联合脏器切除、手术时间过长、术后造口、吻合口瘘、术后引流管留置时间过长患者做好预防术后感染工作,亚胺培南、妥布霉素可用于防治结直肠癌根治术后耐药菌引起的腹腔感染。     

肝细胞癌根治性切除术后预后因素分析

目的:探讨影响肝细胞癌患者根治性术后预后相关因素。方法:回顾性分析2004年1月1日至2009年12月31日245例我院行根治性切除术的肝细胞癌患者,采用Kaplan-Meier法和Cox比例风险模型分析临床资料、手术过程、病理特征与预后的关系。结果:多因素分析结果显示术前AFP水平、术中出血量、TNM分期是影响无进展生存时间和总生存时间的独立风险因素。术前AFP水平越高、术中出血量越大、TNM分期越晚则患者无进展生存时间及总生存时间明显缩短。此外,患者出现肿瘤组织局部坏死、门静脉癌栓,则总生存时间明显缩短。结论:术前AFP水平、术中出血量、TNM分期是外科根治性切除术后肝细胞癌患者复发及死亡的相关因素,对于临床医师判断预后及延长术后生存时间具有重要的临床意义。     

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.     

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.     

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.     

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.     

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。     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

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.