目的:探讨菊池病的发病规律、临床表现、病理学特征和诊疗方法,提高对该病的认识及早期诊治.方法:回顾性分析2例菊池病患者的临床资料,并对以往文献进行回顾.结果:2例患者中1例无症状患者发病后3个月随访阳性体征(颈部淋巴结肿大)消失,3个月内未复发;1例患者有发热、颈部肿大淋巴结疼痛症状,经泼尼松等对症治疗后体温正常,肿大淋巴结缩小,泼尼松逐渐减量并随访5个月无复发.结论:菊池病为临床少见病,患者多以浅表淋巴结肿大为首发症状,部分伴有发热,临床表现缺乏特异性,容易造成误诊误治,确诊需要依靠淋巴结活检联合病理检查,确诊后根据有无症状分别给予相应治疗,糖皮质激素为目前首选治疗药物.

目的 研发并探讨新型半密闭式细胸膜腔引流管的作用效果.方法 使用胸膜腔密闭模拟系统模拟穿刺漏气实验,实验组使用新型半密闭式细胸膜腔引流管,对照组使用同管径的猪尾巴管.记录置管过程的漏气量,每组各20次.使用巴马小型猪模拟操作性能和安全性实验,胸腔镜下选定20个观察良好的穿刺部位,每个穿刺部位按照从下向上的顺序依次编号3个置管点,对照组(1号)使用12F猪尾巴管组;实验组(2号)使用A型尖端穿刺引导针的新型细型半密闭式胸膜腔引流管;实验组(3号)使用B型尖端穿刺引导针的新型细型半密闭式胸膜腔引流管.胸腔镜下观察每组引流管置入的操作性能及对肺脏的损伤率,每组各20次.结果 实验组平均漏气量明显低于对照组,差异有统计学意义(P＜0.05).三组均能顺利穿刺置管到巴马小型猪胸膜腔内,且实验组(2号)和实验组(3号)引流管置入后壁层胸膜的破口与对照组(1号)的壁层胸膜的破口直径相当.进针深度为10 mm时,实验组的损伤率低于对照组,差异无统计学意义(P＞0.05);进针深度为20 mm时,实验组的损伤率低于对照组,差异有统计学意义(P＜0.05).结论 新型半密闭式细胸膜腔引流管具有结构简单、精准提示的特点,可有效降低医源性气胸和内脏损伤的发生风险;同时一步法置管操作简单,安全性高,具有良好的临床应用价值.

胸腔闭式引流术是指将引流管一端置于胸膜腔内,另一端连接密闭式引流装置,使气、液、血、脓等病理成分自胸膜腔内沿着引流管排出的一种治疗手段[1].中大量气胸、胸腔积液、血胸、开胸术后为其适应证.临床上昏迷、体质虚弱或开胸术后疼痛等原因常常导致患者不能主动咳嗽或咳嗽无力,使患侧肺组织不能有效复张促进胸膜腔内的气体或液体排出,从而影响患者康复并增加住院时间和费用.

Purpose: MicroRNA-622 has been proven down-regulated in many human malignancies and correlated with tumor progression. However, its role in esophageal squamous cell carcinoma (ESCC) is still unclear. The aim of this study was to explore the expression and function of miR-622 in ESCC.Methods: Using quantitative RT-PCR, we detected miR-622 expression in ESCC cell lines and primary tumor tissues. The association of miR-622 expression with clinicopathological factors and prognosis was also analyzed. Then, the effects of miR-622 on the biological behavior of ESCC cells were investigated. At last, the potential regulatory function of miR-622 on E2F1 expression was confirmed.Results: miR-622 was found to be down-regulated in ESCC tissues and cell lines. Decreased miR-622 expression was closely correlated with aggressive clinicopathological features and poor overall survival. Multivariate regression analysis corroborated that low level of miR-622 expression was an independent unfavourable prognostic factor for patients with ESCC. Up-regulation of miR-622 could significantly reduce ESCC cell proliferation, enhance cell apoptosis, and impair cell invasion and migration in vitro, while down-regulation of miR-622 showed opposite effects. Further, E2F1 was confirmed as a direct target of miR-622 by using Luciferase Reporter Assay.Conclusions: These findings indicate that miR-622 may act as a tumor suppressor in ESCC and would serve as a potential therapy target for this disease. (C) 2016 Elsevier Masson SAS. All rights reserved.

Objective: To investigate the effects of dihydromyricetin on proliferation and apoptosis of human lung adenocarcinoma cell line NCI-H1975 in vitro, and to explore its molecular mechanism.Methods: After treatment with different concentrations of dihydromyricetin (10, 25, 50, 75 and 100 μmol/L) for different time (12, 24 and 48 h), the proliferation of human lung adenocarcinoma NCI-H1975 cells was detected by CCK-8 assay. The cell cycle and apoptosis rate of NCI-H1975 cells treated with different concentrations of dihydromyricetin (25, 50 and 100 μmol/L) for 24 h were determined by flow cytometry, and the change of cell morphology was observed by inverted phase contrast microscopy. Real-time fluorescent quantitative-PCR and Western blotting were used to analyze the expression levels of Bcl-2, Bax and Bad genes in NCI-H1975 cells treated with 25, 50 or 100 μmol/L dihydromyricetin for 24 h.Results: Dihydromyricetin significantly inhibited the proliferation of human lung adenocarcinoma NCI-H1975 cells in a dose- and time-dependent manner (P 0.05). Furthermore, dihydromyricetin significantly decreased the expression levels of Bcl-2 mRNA and protein in NCI-H1975 cells (both P 0.05).Conclusion: Dihydromyricetin can suppress the growth of human lung adenocarcinoma cells through regulating the expression of Bcl-2 protein family in mitochondrial apoptotic pathway. Dihydromyricetin may be a potential drug for the treatment of lung carcinoma. DOI:10.3781/j.issn.1000-7431.2015.11.455

胰岛素生长因子-1受体(IGF-1R)是胰岛素生长因子家族主要成员之一,I GF-1R在人类大多数肿瘤中呈过表达,也在肺癌的转化与恶性进展中起重要作用,与肺癌的发生、发展有密切关联.本文就IGF-1R在信号转导通路、与肺癌形成和发展的关系及其在靶向药物治疗方面的研究进展进行综述.

Insulin-like growth factor 1 receptor (IGF1R) is a tyrosine kinase receptor implicated in tumourigenesis that may be an attractive target for anti-cancer treatment. In this study, the expression and clinical significance of IGF1R were investigated in serum and lung cancer tissues from small cell lung cancinoma (SCLC). We also compared the effect of IGF1R up-regulation and IGF1R inhibition on viability and apoptosis of NCI-H446 cells. We found the concentration of IGF1R in blood serum was significantly increased and positive IGF1R protein in cancer tissue was more prevalent in SCLC. A statistically significant correlation among IGF1R-positve tumors, lymph node metastasis and local invasion was discussed. Furthermore, IGF1R overexpression lead to an increase of cell survival and suppressed cell apoptosis, IGF1R silencing mediated by RNAi abrogate this response of NCI-H446 cells. Our results further demonstrated that the effects of these treatments may be assigned to the effective inhibition of lung cancer cells from Akt/P27(Kip1) pathway in IGF-1R signaling. These features may have important implications for future anti-IGF1R therapeutic approaches.

The expression and clinical significance of insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), and insulin-like growth factor binding protein 7 (IGFBP-7) were investigated in serum and lung cancer tissues from 57 patients with non-small cell lung cancer (NSCLC). Lung cancer tissues at different pathologic stages (27 patients at stages I-II and 30 patients at stages III-IV), normal lung tissues from 17 patients with benign pulmonary disease, and serum samples from both lung cancer and benign pulmonary disease patients were collected during surgery. Enzyme-linked immunosorbent assay and avidin-biotin-peroxidase complex immunohistochemical staining were used to detect IGF-1, IGFBP-3, and IGFBP-7 expression in serum and tissues, respectively. The results show that expression of IGF-1 in lung cancer tissues and serum from NSCLC patients were significantly higher than in the control (P < 0.05). However, expression of IGFBP-3 and IGFBP-7 in cancer tissues and serum from NSCLC patients was significantly lower than in the control (P < 0.05). These results suggest that upregulation of IGF-1 and downregulation of IGFBP-3 and IGFBP-7 may be potential diagnostic biomarkers for NSCLC.

目的检测胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）在非小细胞肺癌（non-small cell lung cancer,NSCLC）患者外周血清中的含量和肺癌组织局部的表达情况,探讨IGF-1和IGFBP-3与NSCLC发生发展的关系及其在NSCLC辅助诊断、危险性预测和治疗中的临床意义。方法运用酶联免疫吸附法（ELISA）检测肺癌组和对照组患者外周血血清中IGF-1、IGFBP-3的水平;运用免疫组化方法检测肺癌组和对照组患者肺组织标本的IGF-1与IGFBP-3表达情况。结果肺癌组血清中IGF-1表达高于对照组（P＜0.05）,肺癌组血清中IGFBP-3的表达显著低于对照组（P＜0.05）,IGF-1在肺癌组织中的表达强于对照组（P＜0.05）,IGFBP-3在肺癌组织中的表达弱于对照组（P＜0.05）。结论 NSCLC患者血清IGF-1、IGFBP-3表达在非小细胞肺癌的发生、发展及远处转移中有重要作用,检测其水平变化对肺癌的诊断、判断预后有重要意义。

<正>患者女,38岁。因反复咯血3年,再发1周入院。患者于3年前无明显诱因开始咯血,量不多,多为痰中带血,偶有轻咳,无咳黄色脓痰、发热、心悸、气促、消瘦和乏力。曾于外院多次住院,诊断为"支气管扩张",给予抗感染、化痰和止血等处理,效果不佳。3年来咯血反复发作,近1周来咯血加重,每天约2次,每天总量约200 ml,色鲜红。入院查体:呼吸

世界卫生组织国际癌症研究署2010年6月发布的GLOBOCAN2008癌症报告显示:2008年全球的肺癌新发病例大约为161万例,死亡约138万例,居恶性肿瘤第一位[1].

目的探讨高龄食管癌的外科手术治疗效果及影响其预后的因素。方法回顾性分析76例70岁以上高龄食管癌患者的临床资料。全组患者均经手术治疗,其中根治术67例,姑息术9例。结果总的1、3年生存率分别为44.7%和21.1%。单因素分析显示术前合并症、肿瘤病理分期、淋巴结转移状况、肿瘤最大径、手术方式、术后放化疗为影响预后的主要因素;而多因素分析显示手术方式、肿瘤病理分期、淋巴结转移、术后放化疗是影响预后的重要的独立因素。结论高龄食管癌临床分期较早,根治性手术切除率较高,应加强早诊治意识,在患者能耐受手术的情况下,应积极手术治疗;手术方式、肿瘤病理分期、淋巴结转移、术后放化疗是影响预后的重要因素。