从卡介苗成功治疗膀胱癌论肿瘤的免疫治疗

卡介苗(BCG)膀胱内灌注是治疗浅表性膀胱癌一种最有效的方法。通过对治疗后的监测发现,卡介苗灌注后可引发肿瘤部位显著的固有免疫和适应性免疫细胞反应,体内大多数的抗肿瘤免疫效应细胞参与这一反应过程。这一结果表明,有效的肿瘤免疫治疗必须由固有免疫和适应性免疫细胞协同作用才能完成。     

ICU患者低磷血症临床观察与思考

回顾性分析41例低磷血症患者血磷水平与同期血气分析、血浆白蛋白(ALB)、尿素氮(BUN)等因素间关系及治疗前后急性生理和慢性健康评分(APACHE)Ⅱ的变化.结果显示脓毒症组血磷降低程度最明显,该组APACHEⅡ评分及纠正低磷血症所需时间显著高于其他基础疾病组.治疗前重度低磷血症组患者血pH、BUN显著高于轻中度低磷血症组,而PaCO2及ALB则明显低于轻中度低磷血症组;治疗前重度低磷血症组与轻中度低磷血症组间APACHE Ⅱ评分有显著差异,而治疗后两组间差异消失.病因治疗辅以适当补磷治疗可有效纠正低磷血症.由此得出结论,脓毒症患者易继发低磷血症.危重症患者重度低磷血症的发生与机体内酸碱环境改变及感染、高分解代谢等因素有关.低磷血症程度与疾病严重程度有关,但尚不足以成为独立的预后指标.     

Accuracy of Self-Reported Personal History of Cancer in an Outpatient Breast Center

The self-reporting of cancer history is becoming increasingly important, as it frequently guides medical decision-making. We studied the accuracy of personal cancer history using a self-administered questionnaire, comparing the results with the Tumor Registry at our institution. Among 39,662 records, we identified 3614 women with a single cancer in the Tumor Registry who reported none or one cancer on their questionnaire. The sensitivity in self-reporting cancers was 85.7%, ranging from 92.1% for breast cancer to 42.9% for leukemia. The accuracy for breast cancer and Hodgkin's Lymphoma was significantly better than other cancers (p=0.00027, CI: 1.4–3.88). Analysis of patient's characteristics showed that Caucasians reported breast cancer more accurately than Asian/Pacific Islanders (p=0.008), and those with Jewish ancestry more accurately than non-Jewish (p=0.0435). These results will help us to improve data collection and thus improve medical decision-making.     

经肛直肠癌切除术的应用现状

在严格选择适应证的条件下,经肛直肠癌切除术是治疗早期低位直肠癌的可选术式之一。相比于直肠癌前切除术和经腹会阴切除术,经肛切除术具有创伤小,并发症少等特点。关于经肛切除术后的局部复发率以及综合治疗对经肛切除术治愈能力的影响尚存在争议。本文将对经肛切除术做一系统的回顾。     

告知患者癌症诊断的利弊分析及有效告知的方法

告知患者癌症诊断是肿瘤科的核心问题。法律和医学伦理原则要求医务人员应掌握肿瘤患者的心理和其他方面的特殊性,及时、充分地与患者及家属进行沟通,严格履行肿瘤患者的知情同意原则。本文旨在对告知患者癌症诊断的利弊及有效告知癌症诊断的方法进行分析,以期为临床肿瘤医疗、护理工作提供指导。     

5-氨基酮戊酸光动力疗法对人卵巢癌细胞的杀伤作用及对HSP70和HIF～1α表达的影响

探讨5-氨基酮戊酸（5-aminolevulinicacid,5～ALA）光动力疗法（photodynamictherapy,PDT）对SKOV3细胞的杀伤作用及对HSP70和HIF-1α表达的影响。CCK-8法检测5～ALA—PDT对SKOV3细胞增殖的影响;荧光Real～timePCR法检测HSP70和HIF—1α...     

Illness representations and distress in women undergoing screening for familial ovarian cancer

Women with a familial or genetic predisposition to ovarian cancer are at significantly increased risk of developing the disease, and this warrants effective risk management strategies. A clinical trial of ovarian cancer screening (OCS) is being conducted to establish the effectiveness of this risk management strategy. This article reports data from its psychological partner study which aims to evaluate the psychological effects of OCS. Leventhal's Self-Regulatory Model provided the theoretical framework for understanding emotional responses to OCS. The revised Illness Perceptions Questionnaire (IPQ-R) is based on this model and the IPQ-R, adapted to the risk of ovarian cancer, was completed by women (N?=?1999) prior to screening. The original IPQ-R factor structure was not replicated but IPQ-R variables explained 14.70% of the variance in women's ovarian cancer-specific distress after controlling for age, general anxiety and depression. Negative emotional representations of ovarian cancer risk and general anxiety were moderately associated with greater ovarian cancer-specific distress whereas cognitive illness representations were weakly related to ovarian cancer-specific distress. Further analyses of data from the ongoing psychological evaluation are needed to determine the predictive utility of IPQ-R variables in explaining distress during OCS.     

循证医学与卵巢癌的治疗

循证医学(EBM)是在临床实践中通过科学的方法获得最充分的证据,并对病人做出最佳诊治决策的一门科学。目前卵巢癌的治疗还存在很多不规范的问题,利用循证医学观点来指导卵巢癌治疗方案的选择,对保留患者的生育功能、生理功能、提高生活质量有着重要的指导意义。     

结直肠转移癌临床表现与治疗

为了探讨结直肠癌转移的临床特点,对我院于2000年1月-2007年12月收治的12例结肠转移癌患者的诊疗及预后进行了回顾性分析。结果显示,12例结肠转移癌患者,原发肿瘤分别来源于胃癌5例,肺癌3例,乳腺癌2例,胰腺癌1例,胆囊癌1例,提示结肠转移癌在临床上并不多见,提示患者已经出现广泛转移且预后不良。