目的 探讨雄激素受体(AR)和核因子(NF)-κB在乳腺癌组织中的表达及其与临床病理特征的关系.方法 200例乳腺癌患者中三阴型乳腺癌98例及非三阴型乳腺癌102例.免疫组化法检测两组AR、NF-κB的表达情况并收集患者临床病理资料,分析两指标与临床特征的关系.结果 三阴乳腺癌组AR表达阳性率低于非三阴乳腺癌组,NF-κB表达阳性率高于例非三阴乳腺癌组(P<0.05);三阴乳腺癌患者AR表达阳性与乳腺癌肿瘤坏死和组织浸润呈负相关(P<0.05),非三阴乳腺癌患者AR表达阳性与乳腺癌瘤体大小、肿瘤坏死和组织浸润呈负相关(P<0.05);三阴乳腺癌组织NF-κB表达阳性与乳腺癌肿瘤大小、肿瘤坏死和组织浸润呈负相关但与组织分级呈正相关(P<0.05),而在非三阴乳腺癌中,NF-κB表达阳性仅与乳腺癌肿瘤大小、肿瘤坏死和组织浸润呈负相关(P<0.05).结论 乳腺癌组织中AR、NF-κB异常表达,可能参与乳腺癌的发生、发展及转移,可能成为理想的乳腺癌预测标志物.

目的 评价喉罩或单腔气管内插管在胸腔镜下胸交感神经链切断术的应用效果.方法 选择80例行胸腔镜下胸交感神经链切断术的手汗症患者,采用计算机随机法将患者分为A、B两组,每组各40例.其中A组男20例、女20例,平均年龄24岁;B组男21例、女19例,平均年龄23岁.A组使用喉罩通气,B组使用单腔气管内导管,均应用小潮气量较快频率正压通气及间歇人工气胸.观察两组麻醉期间各时点心率(HR)、平均动脉压(MAP)、呼气末二氧化碳分压(PetCO2)、动脉血氧饱和度(SpO2)、心电图(ECG)的变化.同时记录喉罩/单腔导管置入时间、CO2充气时间、手术时间、术中术后不良反应和并发症.结果 两组患者手术顺利,无并发症.A组喉罩/插管置入时间和喉罩/单腔管呛咳、术后咽喉疼痛发生率低于B组,差异有统计学意义(P＜0.05).B组MAP、HR水平在T2(喉罩/单腔管置入后)和T7(苏醒后拨喉罩/单腔管时)明显高于T1(麻醉诱导完成),差异有统计学意义(P＜0.05);A组MAP、HR水平在T2和T7时亦明显低于B组,差异有统计学意义(P＜0.05).所有患者术中ECG、SpO2和PetCO2无明显变化.结论 喉罩或单腔气管内插管结合间歇的人工气胸都能满足胸交感神经切断术的操作需要,喉罩具有更稳定的血流动力学状态和更高的安全性.

Matrine, as a member of Sophora family, is an alkaloid found in plants, and produces plethora pharmacological effects, including anti-cancer effects. However, the mechanism involved remains largely unknown. This study is conducted to investigate the anti-cancer mechanisms of matrine in human esophageal cancer in vitro and in vivo. In human esophageal cancer cell Eca-109, matrine significantly decreased the cell viability in a dose-dependent manner, and induced apoptosis as well as cell cycle arrest in G0/G1 phase by up-regulation of P53 and P21. The expression of several apoptosis-related proteins in cells and tumor tissues were evaluated by Western blot analysis. We found that matrine induced cell apoptosis by down-regulation of the ratio of BCL-2/BID and increasing activation of caspase-9. Further studies indicated that matrine induced apoptosis of Eca-109 was through the mitochondria-mediated internal pathway, but not by death receptor-mediated extrinsic apoptotic pathway, which was confirmed by the fact that Bid translocated from the nucleus to mitochondria during the process of the apoptosis induced by matrine. In vivo study found that matrine effectively inhibited the tumor formation of Eca-109 cells in nude mice. Our study suggests that matrine could serve as a potential novel agent from natural products to treat esophageal cancer.

乳腺大汗腺癌临床非常少见,合并原发性多汗症更少见,国内外还没有报道.本文就1例乳腺大汗腺癌并原发性手足多汗症患者的临床特点、病理特征和免疫表型作一简述,认为原发性手足多汗症患者合并乳腺癌以大汗腺癌为主,且GCDFP-15蛋白表达上调.

原发性手汗症是指无明显器质性病因，手掌部汗腺分泌亢进的状态，是外分泌腺过度分泌的功能性疾病，常合并足底及腋窝多汗。胸腔镜下胸交感神经干切断术是治疗手汗症的有效方法［1］。如何在保证疗效的同时尽可能减少术后并发症，是目前研究手汗症治疗的热点。笔者医院于2011年12月－2013年4月行胸腔镜下双侧 T 4交感神经干切断术治疗手汗症80例，取得满意效果，现报道如下。

β-elemene (β-ELE) is a new anticancer drug extracted from Curcuma zedoaria Roscoe and has been widely used to treat malignant tumors. Recent studies have demonstrated that β-ELE reverses the drug resistance of tumor cells. To explore the possible mechanisms of action of β-ELE, we investigated its effects on cisplatin-resistant human lung adenocarcinoma A549/DDP cells. The effects of β-ELE on the growth of A549/DDP cells in vitro were determined by MTT assay. Apoptosis was assessed by fluorescence microscopy with Hoechst 33258 staining and flow cytometry with Annexin V-FITC/PI double staining. Mitochondrial membrane potential was assessed using JC-1 fluorescence probe and laser confocal scanning microscopy, and intracellular reactive oxygen species levels were measured by 2',7'-dichlorofluorescein-diacetate staining and flow cytometry. Cytosolic glutathione content was determined using GSH kits. The expression of cytochrome c, caspase-3, procaspase-3 and the Bcl-2 family proteins was assessed by western blotting. The results demonstrated that β-ELE inhibited the proliferation of A549/DDP cells in a time- and dose-dependent manner. Furthermore, β-ELE enhanced the sensitivity of A549/DDP cells to cisplatin and reversed the drug resistance of A549/DDP cells. Consistent with a role in activating apoptosis, β-ELE decreased mitochondrial membrane potential, increased intracellular reactive oxygen species concentration and decreased the cytoplasmic glutathione levels in a time- and dose-dependent manner. The combination of β-ELE and cisplatin enhanced the protein expression of cytochrome c, caspase-3 and Bad, and reduced protein levels of Bcl-2 and procaspase-3 in the A549/DDP lung cancer cells. These results define a pathway of procaspase‑3-β-ELE function that involves decreased mitochondrial membrane potential, leading to apoptosis triggered by the release of cytochrome c into the cytoplasm and the modulation of apoptosis-related genes. The reversal of drug resistance of the A549/DDP cell line by β-ELE may be derived from its effect in inducing apoptosis.

目的 通过使用中药小柴胡汤作用于人食管癌细胞株Eca-109,研究其抗肿瘤的作用机制;方法 分别采用四甲基偶氮唑蓝(MTT)比色法、Hoechst33342染色法以及流式细胞仪检测法,观察小柴胡汤对Eca-109细胞株的增殖抑制和诱导凋亡作用.结果 经不同溶度小柴胡汤处理后Eca-109细胞株,其生长明显受到抑制.MTT比色法结果说明小柴胡汤对Eca-109细胞株的增殖能起到明显抑制,流式细胞仪检测方法所检测出结果说明Eca-109细胞株的细胞周期G0/G1期细胞明显增多,S期细胞显著减少.结论 本研究证实小柴胡汤在体外具有抗肿瘤作用,与其阻断细胞周期、增殖抑制和凋亡诱导有关.

To assess the feasibility of totally implantable access port(TIAP)for long - term transfusion in patients with chest cancer. Methods:From December 2009 to May 2012,we used TIAP for long term transfusion in 50 cases of chest cancer. Under local anesthesia or general anesthesia,with subclavian vein or internal jugular vein puncture,we inserted TIAP with over the wire(OTW)technique. Peri - operation and long term complications were observed. Results:TIAP was inserted successfully at a rate of 98% in all cases. All cases had no serious complica-tion. Among the patients,the tip point of the wire reaching internal jugular vein occurred in two cases,puncture insert-ed subclavian artery improperly in one case. All of them had to receive inserted again and successful. Two patients had the catheter occlusion:Both of them were cured by arm exercise or moving the port. One patient got out the TIAP be-cause the access port leaked. 35 cases had been removed TIAP in plan. Conclusion:TIAP is effective and safe for pa-tients of chest cancer. Operation can achieve success safely with design formulas of catheter depth and OTW tech-nique.

Background: beta-elemene (beta-ELE) injection is a new anticancer drug extracted from Curcuma zedoaria Roscoe that has been widely used to treat malignant tumors. Recent studies show that beta-ELE reverses the drug resistance of tumor cells. To explore the possible mechanisms of beta-ELE, we investigated its effects on cisplatin (DDP)-resistant human lung adenocarcinoma A549/DDP cells.Methods: The effects of beta-ELE on the growth of A549/DDP cells in vitro were determined by MTT assay. Apoptosis was assessed by fluorescence microscopy with Hoechst 33258 staining, flow cytometry with Annexin V-FITC/propium iodide double staining; mitochondrial membrane potential using JC-1 fluorescence probe and laser confocal scanning microscopy, and intracellular reactive oxygen species levels were measured by 2',7'-dichlorfluorescein-diacetate staining and flow cytometry; and contents of cytosolic glutathione were determined by glutathione assay kits. Intracellular Rhodamine-123 fluorescence intensity was detected by flow cytometry, and the expression of P-glycoprotein (P-gp) was detected by Western blotting.Results: beta-ELE inhibited the proliferation of A549/DDP cells in a time-and dosedependent manner. Furthermore, beta-ELE enhanced the sensitivity of A549/DDP cells to cisplatin and reversed the drug resistance of A549/DDP cells. Consistent with a role in activating apoptosis, beta-ELE decreased mitochondrial membrane potential, increased intracellular reactive oxygen species concentration and intracellular accumulation of Rhodamine-123, decreased the cytoplasmic glutathione levels and the expression of P-gp in a time-and dose-dependent manner.Conclusions: These results define a pathway of beta-ELE function that involves decreased mitochondrial membrane potential and P-gp expression activated intracellular redox system, and induced apoptosis leading to reverse drug resistance.

磷脂酰肌醇-3激酶/蛋白激酶B(PI3K/Akt)信号转导通路与肿瘤的发生、发展密切相关。研究表明,PI3K/Akt信号通路的活化具有促进乳腺癌细胞增殖及减少细胞凋亡、分化的作用。基底细胞样(Basal-like)乳腺癌是乳腺癌的一种亚型,因其分子表型独特无明确的治疗靶点且恶性程度高、预后差。随着对PI3K/Akt信号转导通路及基底细胞样型乳腺癌发生、发展的研究不断深入,开发应用PI3K/Akt信号通路抑制剂可能为Basal-like型乳腺癌提供有效的分子治疗药物。

Objective:To investigate the inhibitory effect of Radix Bupleuri on human esophageal cancer cell Eca-109.Methods:In vitro culture of human esophageal cancer cell (Eca-109),were treated with different concentration of Radix Bupleurum solution on Eca-109 in vitro intervention.Inhibition of proliferation was measured Radix with MTT colorimetric method,to calculate the cell proliferation,survival rate.Results:MTT showed Bupleurum solution can significantly inhibit the proliferation of Eca-109 cells.After the proliferation of Eca-109 cell survival rate decreased with the dose of positive.Conclusion:Radix Bupleuri has antitum or effect in vitro,the mechanism is to inhibit the proliferation of tumor cells,and inhibited cell differentiati on and achieve the purpose of anti tumor.

乳腺浸润性筛状癌(invasive cribriform carcinoma,ICC)是一种罕见的乳腺浸润性癌,占所有乳腺癌的0.8％ ～3.5％.2003年,世界卫生组织(WHO)乳腺肿瘤组织学分类在上皮性肿瘤中将其列为一种新的肿瘤亚型[1].现就福建中医药大学附属厦门市中医院外二科1例乳腺混合型ICC,结合文献分析如下.

目的:探讨榄香烯乳(elemene,ELE)逆转人肺腺癌A549/DDP细胞株耐药性及其机制.方法:采用MTT法检测榄香烯乳单用的细胞毒作用及与顺铂(cisplatin,DDP)合用时耐药逆转作用;采用流式细胞术检测榄香烯乳对A549/DDP细胞内罗丹明-123(rhodamine-123,Rh123)蓄积的影响;采用Western blot检测榄香烯乳对耐药细胞A549/DDP细胞膜上P-gp蛋白表达的影响.结果:不同浓度榄香烯对A549/DDP细胞均有一定的抑制作用,呈时间-剂量依赖性效应.单用DDP的IC50为15.46μg/ml,合用20μg/ml榄香烯24h,IC50为4.15μg/ml,逆转耐药倍数为3.63.同时,榄香烯增加A549/DDP细胞内Rh123的蓄集,降低细胞膜上p-gP的表达,且呈剂量依赖性,表明榄香烯能减少A549/DDP细胞对药物的外排和抑制P-gp蛋白的表达.结论:榄香烯在体外逆转肿瘤细胞耐药性可能与其抑制P-gp的功能和表达有关.

<正>随着诊断技术的发展和医疗水平的提高,乳腺癌发病率呈逐年上升趋势。化疗是乳腺癌综合治疗中不可或缺的重要环节,乳腺癌手术后的辅助化疗可以减少复发转移,提高生存率[1]。但目前化疗药物毒副作用多,在抑制肿瘤细胞生长的同时,也会杀伤正常的细胞,对机体免疫功能起到抑制作

报告1例刀刺伤致患者心、左肺、肝、右侧膈肌破裂的成功诊治经验,讨论心脏刀刺伤合并其他脏器损伤的诊断、救治方法及注意事项。

Objective To investigate the effects of matrine on the proliferation and apoptosis of human esophageal carcinoma Eca-109 cell line.Methods Different concentrations of matrine were used in the culture of esophageal carcinoma cells.Proliferation,apoptosis,and cell cycle arrest of esophagus carcinoma Eca-109 cells line were observed by MTT assay,Hoechst33342 staining,and flow cytometry quantitative analysis.Results showes that matrine significantly induced apoptosis of the Eca-109 cell line;The cell cycles measurement by flow cytometry quantitative analysis showed an increase in G2 phase cells,and S phase cells were significantly reduced.Conclusions Matrine can inhibit proliferation and promote apoptosis of the Eca-109 cell line,and the mechanism may be correlated to the cell cycle arrest at G2 phase.

目的 观察常规肠外营养联合力肽对食管癌根治术后颈部吻合口瘘的疗效.方法 将20例食管癌根治术后并发颈部吻合口瘘患者随机分为常规肠外营养组和常规肠外营养联合力肽组,每组10例,观察颈部吻合口瘘愈合时间、营养指标、免疫指标、肝功能的变化.结果 20例吻合口瘘全部愈合.两组平均愈合时间、肝功能受损差异无统计学意义.两种方法均能改善患者营养,提高免疫力,纠正负氮平衡；但联合力肽较单纯常规肠外营养改善患者营养、提高免疫力、纠正负氮平衡效果更好(P＜0.01).结论 常规肠外营养联合力肽对食管癌根治术后颈部吻合口瘘患者是一种更为合理的肠外营养方式,值得临床推广使用.

目的评价手汗症患者临床路径实施的实际效果及应用价值。方法随机选择40例手汗症患者为实验组,实施临床路径;另外选择40例手汗症患者为对照组,比较2组住院时间、住院费用、满意度等指标。结果 2组患者的住院时间、住院费用和患者满意度比较均有显著性差异(P<0.05)。结论临床路径在保证医疗质量的同时,为手汗症患者提供了优质服务,可以缩短住院时间,降低住院费用,提高患者的满意度。

目的:研究分化诱导剂黄芪(Astragalus)在体外对人肺腺癌SPC-A-1细胞生长抑制的影响.方法:用不同浓度的黄芪分别处理肺腺癌SPC-A-1细胞后,镜下观察癌细胞的生长情况;测定软琼脂克隆形成率;MTT(噻唑蓝)法测定生长抑制率.结果:不同浓度黄芪处理后细胞的生长明显受到抑制,细胞生长抑制率随黄芪的浓度增加而增加.结论:黄芪对肺腺癌SPC-A-1细胞的生长有明显的抑制作用.

食管良性间质瘤(esophageal stromal tumor,EST)与食管平滑肌瘤(esophageal stromal tumor,EMT)都是常见的食管良性肿瘤,术前多常误诊.最近我科收治误诊1例,现报告如下. 1 病历摘要 男,44岁."嗳气、返酸并胃部不适2个月余"行上消化道造影:食管中段一充盈缺损,钡剂通过呈分流现象,食管黏膜正常.被建议手术治疗.入院查体:生命征平稳,一般情况可,心、肺、腹体检无异常.辅助检查:胸CT:食管中段管腔狭窄,食管左侧壁均匀增厚,肺门、纵隔未见肿大淋巴结,双侧胸腔无积液.