卵巢交界性肿瘤及Ⅰ期上皮性卵巢癌143例临床分析

目的:比较卵巢交界性肿瘤及1期上皮性卵巢癌的临床病理特征,探讨鉴别于交界性肿瘤的早期上皮性卵巢癌的高危因素.方法:回顾性分析2002年11月至2010年5月于北京大学人民医院妇科诊治的143例卵巢交界性肿瘤(91例,borderline ovarian tumor,BOT组)和Ⅰ期上皮性卵巢癌患者(52例,epithelial ovarian carcinoma,EOC组),比较两组患者的临床病理特征.结果:BOT组患者发病年龄显著低于Ⅰ期卵巢癌患者[(41.16±14.95)岁vs.(50.90±14.37)岁,P<0.01],Ⅰ期卵巢癌患者中绝经患者占42.3%(22/52),有恶性肿瘤家族史患者占26.9%(14/52),均显著高于BOT组患者的23.1%(21/91,P=0.016)和13.2%(12/91,P=0.04).术前阴道彩色超声检查提示两组间肿物大小差异无统计学意义,但卵巢癌组患者肿物实性部分明显大于BOT组(P<0.01).两组间血清学肿瘤标记物(CA125,CA199,CP2,CEA)阳性率差异无统计学意义,但在CP2升高的患者中,Ⅰ期卵巢癌患者CP2值升高幅度显著高于BOT组(256.99 kU/L vs.116.59 kU/L,P=0.028).两组间肿物组织病理类型有显著不同,交界性肿瘤中以浆液性和黏液性肿瘤为主(90.1%,82/91),而Ⅰ期卵巢癌患者中浆液性和黏液性肿瘤仅占44.2%(23/52),但其他病理类型(如子宫内膜样癌、透明细胞癌和混合性上皮癌)比例明显增高(P<0.01).结论:早期上皮性卵巢癌与卵巢交界性肿瘤虽临床表现相似,但早期卵巢癌患者的发病年龄、绝经与否、恶性肿瘤家族史、超声检查提示的卵巢肿物实性部分大小、血清学肿瘤标记物的升高幅度(特别是CP2的升高程度)以及组织病理类型均有别于交界性肿瘤,这些临床病理特征可能有助于临床医师在术前对两种疾病进行鉴别诊断.     

联合检测Syk及nm23H1在大肠癌中的表达及其意义

目的:探讨候选抑癌基因脾酪氨酸激酶(spleen tyosine kinase,Syk)及转移抑制基因(metastasis suppressorgene,mn23H1)在大肠癌组织中的表达及其生物学行为之间的关系.方法:采用免疫组织化学SP法,分别检测60例大肠癌组织及30例癌旁正常组织中Syk及nm23H1蛋白的表达情况;并分析其与大肠癌病理特征及生物学行为之间的关系.结果:Syk及nm23H1蛋自在大肠癌组织中的阳性表达率分别为31.7%、53.3%,在癌旁组织中的阳性表达率分别为96.7%、93.3%,癌组织中的阳性表达率均较癌旁组织明显降低(p<0.05).单因素分析显示Syk及nm23H1蛋白分别与淋巴结转移、浸润深度、Dukes分期密切相关(p<0.05),但与患者的年龄、性别、肿瘤大小、发生部位和肿瘤分化程度无明显关系(p>0.05).结论:大肠癌组织中Syk和nm23H1蛋白表达均明显低于癌旁正常组织,可能与大肠癌的发生发展及恶性程度相关.联合检测syk及nm23H1的表达对大肠癌的临床治疗和预后判断有一定价值.     

系统型间变性大细胞淋巴瘤30例临床分析

目的 探讨系统型间变性大细胞淋巴瘤(S-ALCL)的临床特征和预后相关因素.方法 回顾性分析30例S-ALCL患者的临床资料.30例患者均以联合化疗为主,配合局部病灶野放疗8例.化疗方案主要为CHOP、EPOCH、Hyper-CVAD,以CHOP方案为主.结果 30例S-ALCL患者中位年龄36岁,男女比例为1.5∶1,有B症状、Ⅲ～Ⅳ期和结外侵犯者分别占60.0%(18/30)、73.3%(22/30)和60.O%(18/30);乳酸脱氢酶(LDH)升高者占46.7%(14/30);间变性大细胞淋巴瘤激酶(ALK)+18例(60.0%),其发病年龄小于ALK-者(u=3.92,P=0.001).单因素分析显示ALKˉ及LDH升高是重要的预后不良因素.结论 S-ALCL患者发病年龄较轻,预后较好.但ALK-、LDH升高者预后不良.治疗以联合化疗为主,对于有不良预后因素的患者,大剂量治疗可能获益.     

血液病相关颅内出血的临床和影像学特点分析

目的 分析血液病相关颅内出血(ICH)的临床和影像学特点,提高临床医师的认识.方法 1998年1月至2010年5月发生的与原发血液病相关的ICH病例31例,回顾性分析其基础疾病、临床和影像学表现以及导致死亡的危险因素.结果 发生ICH的血液病以急性髓细胞白血病(AML)、特发性血小板减少性紫癜(ITP)多见,分别为13例和6例,多表现为头痛、烦躁、恶性呕吐和意识障碍,缺乏定位体征,影像学表现以渗血为主,CT与MRI诊断的符合率为60%(3/5),头颅MRI的ICH检出率高于CT.总病死率为71%(22/31),发热、白细胞＞5×109/L、血小板＜50×109/L、免疫球蛋白增高、凝血功能异常、全身多部位出血等是ICH的危险因素,具备≥2个危险因素者病死率为86.4%(19/22),显著高于有≤1个危险因素的患者病死率[33.3%(3/9)](x2=8.718,P=0.003).结论 血液病相关ICH是威胁患者生命的严重并发症,头颅MRI有助于提高血液病相关ICH诊断率,发热、白细胞＞5×109/L、血小板＜50×109/L、免疫球蛋白增高、凝血功能异常等多种危险因素并存可导致血液病ICH患者死亡率增加.     

重组人白细胞介素-11治疗恶性血液病化疗相关性血小板减少30例

目的 观察重组人白细胞介素-11(rhIL-11,商品名:巨和粒)治疗恶性血液病化疗相关性血小板减少的疗效及安全性方法随机选取确诊的常规化疗的恶性血液病30例,化疗后加用rhIL-11作为治疗组,并随机选取同期化疗的恶性血液病患者35例作为对照组,分析比较两组病例血小板减少程度、血小板≤100×109/L的持续天数、血小板输注次数及其不良反应结果治疗组在化疗结束时血小板计数为(41.22±23.67)×109/L,化疗后1周及2 周时血小板计数分别为(82.22±46.72)×109/L及(119.67±34.12)×109/L;治疗组化疗期间输注血小板例数7例;治疗组在化疗结束后第7天及第14天时,血小板计数恢复正常(≥100×109/L)分别为12例(40.00%)和26例(86.67%),与对照组比较差异有统计学意义(P＜0.05).且治疗组治疗过程中不良反应轻微,有良好的耐受性和安全性.结论 rhIL-11治疗细胞毒药物化疗所致血小板减少安全、有效,值得在恶性血液病的治疗中推广使用.     

社区老年高血压患者危险因素的调查及干预

目的:探讨社区老年高血压患者危险因素状况及干预情况.方法:调查社区400名老年人,患高血压病148例(37.0%),统计合并高脂血症、肥胖、吸烟、糖尿病、缺乏体力活动、早发心血管病家族史以及冠心病、卒中或短暂性脑缺血发作的比例.结果:老年高血压患者合并其他心血管危险因素的比例较高,尤以高盐饮食(55.4%)和高脂血症(54.1%)最明显,且普遍存在多重危险因素.结论:社区老年高血压患者多存在多重危险因素和较高比例的心脑血管并发症如高脂血症尤为突出,是社区防治的重点目标.     

中剂量依托泊苷联合粒细胞集落刺激因子动员恶性淋巴瘤的外周血造血干/祖细胞

目的 观察中剂量依托泊苷(VP16)和粒细胞集落刺激因子(G-CSF)在恶性淋巴瘤患者动员采集自体外周血造血干/祖细胞的有效性和安全性.方法 31例恶性淋巴瘤患者(非霍奇金淋巴瘤30例,霍奇金淋巴瘤1例),VP16 1.2 g/m2分3 d静脉滴注,外周血白细胞降至最低点时给予G-CSF每天5μg/kg,分2次,皮下注射,直至采集结束.结果 VP16应用后12 d(10～15 d)开始采集外周血造血干/祖细胞,获得单个核细胞(MNC)7.8×108/kg[(5.2～11.3)×108/kg],CD+34细胞7.2×106/kg[(5.3～13.1)×106/kg] 18例患者采集1次,13例采集2次.所有患者移植后均恢复造血,外周血粒细胞＞0.5×109/L的中位时间为12 d(9～18 d),血小板＞20×109/L的中位时间为14d(10～21 d).患者无严重不良反应结论中剂量VP16和G-CSF动员恶性淋巴瘤患者外周血干/祖细胞有效、安全,可获得满意的动员采集效果.     

影响移植肾长期存活的相关免疫学及非免疫学研究探析

目的:探讨影响移植肾长期存活的相关免疫学及非免疫学因素.方法:通过对2000年1月至2008年1月期间进行肾移植的154例患者的资料进行分析,分别分析存活7年以上的病例和移植肾失功及死亡的病例,分析影响移植肾长期存活的相关免疫学因素及非免疫学因素.结果:154例患者移植肾存活7年以上者115例(74.68%),移植肾失功23例(14.94%),死亡16例(10.39%),长期存活率在74.68%.结论:影响移植肾长期存活的相关免疫学因素包括组织相容性、急性排斥反应、亚临床型排斥反应、免疫抑制剂的使用等;影响移植肾长期存活的非免疫学因素有供受者的年龄、供受者在年龄体形等方面的匹配、原发性肾疾病及高血压等对肾功能有影响的疾病及移植前透析治疗.为提高移植肾的长期存活率,应尽量避免上述因素.     

金属冶炼中产品产量预测的数学建模方法

传统的金属冶炼产品产量预测方法主要通过对历史数据的统计处理,总结数据之间的规律实现产量预测.在预测时考虑的因素过少,导致预测结果误差较大、预测耗时长.针对上述问题,研究金属冶炼中产品产量预测的数学建模方法.使用聚类算法识别金属冶炼过程中的不同工况后,使用灰色预测模型根据不同工况下影响产品产量的指标进行预测.将预测值作为...     

表观弥散系数值在脑胶质瘤术前分级诊断中的应用价值

目的:通过分析表观弥散系数(ADC)值在低级别胶质瘤及高级别胶质瘤的差别,探讨ADC值在胶质瘤分级诊断中的价值.方法:经手术病理证实的14例低级别胶质瘤(Ⅰ、Ⅱ级)和20例高级别胶质瘤(Ⅲ、Ⅳ级)患者术前常规MRI检查、增强扫描检查及磁共振弥散加权成像(DWI)扫描.在工作站构建ADC图,分别测量肿瘤实质部分、瘤周水肿区和囊变坏死区以及相应对侧正常脑白质的ADC值,分析各测量区的ADC值与胶质瘤病理分级的关系.结果:低级别胶质瘤肿瘤实质部分ADC值[(1.47±0.18) ×10-3 mm2·s-1]明显高于高级别胶质瘤 [(0.97±0.18) ×10-3 mm2·s-1](P<0.01),相应对侧脑白质ADC值分别为(0.76±0.06)×10-3 mm2·s-1和(0.75±0.06) ×10-3 mm2·s-1;低级别胶质瘤肿瘤周围水肿区ADC值[(1.61±0.19) ×10-3 mm2·s-1]明显高于高级别胶质瘤 [(1.26±0.14) ×10-3 mm2·s-1](P<0.01),相应对侧脑白质ADC值分别为(0.74±0.04)×10-3 mm2·s-1和(0.77±0.06)×10-3 mm2·s-1;低级别胶质瘤囊变坏死区ADC值[(1.88±0.11) ×10-3 mm2·s-1]明显高于高级别胶质瘤[(1.31±0.14) ×10-3 mm2·s-1](P<0.01),相应对侧脑白质ADC值分别为(0.75±0.08) ×10-3 mm2·s-1和(0.73±0.06) ×10-3 mm2·s-1.脑胶质瘤肿瘤实质部分、瘤周水肿区、囊变坏死区的ADC值与肿瘤的恶性度呈负相关关系(r值分别为-0.821、-0.726和-0.919,P<0.01).结论:低级别胶质瘤与高级别胶质瘤瘤体实质区、瘤周水肿区、瘤体囊变坏死区ADC值有明显差异,ADC值测量可作为脑胶质瘤术前分级诊断的指标之一.     

转炉炉壳热应力分析

根据实际转炉建立实体模型。以有限元为手段,考虑了炉衬和炉壳材料的物性参数随温度变化的特点和炉衬与炉壳之间膨胀间隙,计算了转炉炉壳在温度载荷和炉衬膨胀压力同时作用下的热应力。所得结果可为转炉炉壳设计提供依据。     

焦炭热性能指标意义浅析

通过对焦炭在高炉内的历程及其变化规律的剖析,阐述焦炭热性能指标的意义,形象地把焦炭在高炉内的损耗分为三部分(M1,M2,M3)。指出M2对焦比及焦炭价格有一定的指导作用。     

Results of treatment of cancer of the cardia

Cancer of the cardia is traditionally discussed with cardiac cancer of the lower portion of the esophagus and upper gastric cancer invading the esophagus, and the specific characteristics of cancer of the cardia have never been clearly defined. We reviewed the outcome of 172 patients with adenocarcinoma of the cardia who had undergone radical surgery between 1949 and 1994 in the Division of Gastrointestinal Surgery of the Cancer Institute Hospital. The centers of the tumors were located within 2 cm above and below the boundary between the esophagus and the stomach, and their longitudinal diameter was less than 8 cm. We divided the patients into an early period (1949-1979; n = 79) and a late period (1980-1994; n = 93), and focused on the historical transition. There were no differences in patient gender or histology between the two periods. However, the late period was associated with fewer cases of esophageal invasion and shorter longitudinal diameter, as the age of the population advanced. The number of advanced cancers such as the localized and infiltrative type had decreased, and early cancer and early clinical stage had become more common, but despite the fact that the number of early cancers had increased, extended dissection, such as thoracic and paraaortic lymph node dissection, was performed more frequently. By clinical stage, the long-term outcome markedly improved in Stage I patient in the late period, and tended to improve in Stage II and III patients. This appears to have been attributable to the prevention of micrometastasis by extended dissection, although the number of early cancers is another major potential cause. There were no differences in the outcome of Stage IV patients between the two periods, and further advances in multimodality therapy must be awaited. The range of resection is basically proximal gastrectomy, and if there are adequate indications, the prognosis is favorable. In view of the status of lymphatic flow and lymph node metastasis, and long-term results, lateroaortic lymph node dissection is important. Since the number of early cancer patients has been increasing, if intraabdominal recurrence is prevented, intrathoracic lymph node dissection will contribute greatly to the outcome of such patients.     

The effect of amount of possession of the trait of hostility on accuracy of perception of hostility in others.

Some theories of personality hold that an individual's perception of others is influenced by his own personality characteristics; more specifically, that a trait of low social value will be projected more into others, and that insight into the possession of these characteristics reduces this distortion. These 2 hypotheses were tested by having a group of college students rate each other (including themselves) on degree of friendliness or hostility. Agreement with group rating about self yielded the insight score. In general, the hypotheses were supported; the "friendly" Ss were most accurate in their perception of others, and insight was positively associated with accurate perception. From Psyc Abstracts 36:04:4HL16M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of rates of infection of two methods of emergency ventricular drainage

The rates of infection of two methods of external ventricular drainage in use at Atkinson Morley's Hospital--namely, (a) percutaneous drainage with Rickham reservoirs and (b) tunnelled ventriculostomies--were compared in this retrospective review. Percutaneous drainage of CSF with Rickham reservoirs was associated with a 27% rate of infection as identified by positive microbiological cultures; tunnelled ventriculostomy catheters had a 10% infection rate. The difference in the infection rate between the two methods was statistically significant (P < 0.015). Other variables examined, including the age and sex of the patients and the reasons for ventricular drainage, were not associated with an increased rate of infection. Most infections from either method were caused by a coagulase negative staphylococcus. The average duration of ventricular drainage before identification of positive cultures was 5.7 days for Rickham reservoirs and 6.0 days for ventriculostomies.     

浅析《野草》的版画特征

鲁迅先生一生热爱美术作品,对版画中木刻兴趣尤甚.<野草>作为其"写心之作",亦呈现出一些与木刻版画一致的审美特征:一是具有木刻版画的色彩特征,多对比、多冷色,有阴郁的美感;二是具有木刻版画的力度特征,环境描写、人物刻画处处刀锋毕现,遒劲有力,有一种"力之美".     

四辊破碎机车刀架的改造

针对四辊破碎机车刀架车削中存在的几个问题,详细介绍了电动车刀架的结构和工作原理,建立主要设计参数的数学表达式,并进行适当的分析。改造后,这种电动车刀架运行平稳、可靠、方便、省力,取得了预期的效果。     

Effect of antibiotics of chemotaxis of human leukocytes

The effect of 20 different antibiotics on chemotaxis by human neutrophils was studied. Human leukocytes incubated with chloramphenicol, rifampin, sodium fusidate, and tetracyclines in vitro showed markedly depressed migration. The mechanisms by which these antibiotics affect leukotaxis are discussed.