目的 探讨结直肠癌肿瘤组织中跨膜丝氨酸蛋白酶4(TMPRSS4)、间质表皮转化因子(c-Met)、驱动蛋白家族成员18A(KIF18A)表达水平与其病理特性和生存状态的关系.方法 选取该院于2015年3月至2017年6月确诊的102例结直肠癌患者作为研究对象,比较癌变组织和癌旁组织TMPRSS4、c-Met阳性率及KIF18A水平的差异,不同病理状态及生存状态患者的TMPRSS4、c-Met阳性率及KIF18A水平的差异,分析患者的病理状态及生存状态与TMPRSS4、c-Met阳性率和KIF18A水平的相关性.结果 癌变组织TM-PRSS4、c-Met阳性率及KIF18A水平明显高于癌旁组织(P<0.05);不同性别、年龄患者TMPRSS4、c-Met阳性率及KIF18A水平比较差异均无统计学意义(P>0.05),而不同病程、TNM分期、临床分型患者之间比较差异有统计学意义(P<0.05);通过对患者的随访,生存患者61例,死亡患者41例,生存组TMPRSS4、c-Met阳性率及KIF18A水平明显低于死亡组(P<0.05);患者的TNM分期、临床分型、病程及生存状态与TM-PRSS4、c-Met阳性率及KIF18A的水平呈正相关(r=0.165～0.998,P<0.05).结论 结直肠癌肿瘤组织中TMPRSS4、c-Met阳性率及KIF18A水平与其病理特性和生存状态存在一定的相关性,可作为结直肠癌患者诊断辅助参考之一.

Objective:To explore the clinicopathological characteristics and prognosis of colorectal cancer with liver and lung metastases according to different T stage.Methods:The information of 2 602 patients with colorectal cancer with liver and lung metastases registered in the surveillance, epidemiology and end results (SEER) database from 2010 to 2015 was collected. All the patients were divided into three groups according to T stage: T0/T1 group ( n=545), T2/T3 group ( n=1 138), and T4 group ( n=919). The clinicopathological characteristics (including age, sex, race, primary tumor site, histology, differential stage, T/N stage, distant metastatic site, carcinoembryonic antigen, surgery, and overall survival) were compared across the three groups and the impact of T stage on the overall survival was detected by Kaplan-Meier method and COX logistical analysis. Results:The proportion of N2 in T0/T1 group was significantly lower than those in T2/T3 group and T4 group [3.5% (19/545) vs. 29.3% (333/1 138), χ2=379.911, P<0.05; 3.5% (19/545) vs. 32.4% (298/919), χ2=379.911, P<0.05]. The proportion of rectum location in T4 group was significantly lower than those in T0/T1 group and T2/T3 group [18.6% (167/899) vs. 32.8% (165/503), χ2=64.569, P<0.05; 18.6% (167/899) vs. 33.9% (382/1 127), χ2=64.569, P<0.05]. Among the three groups, the proportion of grade Ⅳ in T0/T1 group was the lowest, and the proportion of grade Ⅲ and Ⅳ in T4 group was the highest. COX logistical analysis indicated that T0/T1 group [hazard ratio ( HR)=1.130, 95% confidence interval ( CI): 1.001-1.275, P<0.05] and T4 group [ HR=1.190, 95% CI: 1.085-1.305, P<0.01] showed a significantly poorer prognosis compared with T2/T3 group. Conclusion:Patients with colorectal cancer with liver and lung metastases in the different T stage presented significantly different clinicopathological characteristics and prognosis, especially for T0/T1 stage that has lower proportion of N2 and poorer prognosis.

目的 对在右半结肠癌手术中完整结肠系膜切除术的临床效果进行分析和探讨.方法 方便选择2012年6月—2014年6月期间由于右半结肠癌而在该院治疗的60例患者作为研究对象,通过随机的方式对这些患者进行划分,其中30例为对照组,30例为观察组.采用传统根治术治疗对照组患者,采用完整结肠癌系膜切除术治疗观察组患者,对两组患者的相关手术指标、并发症发生率等进行比较,同时对其进行为期2年的随访,对两组患者的复发率和死亡率等进行统计和比较.结果 观察组的术中出血量为(178.27±12.43)mL、术后引流量为(58.43±2.49)mL、淋巴结清扫总数目为(21.03±1.29)个,对照组的术中出血量为(231.42±13.61)mL、术后引流量为(84.21±1.74)mL、淋巴结清扫总数目为(12.97±1.58)个;观察组的残端肿瘤残余率为3.3%、术后吻合口漏率为0.0%、并发症发生率6.7%、死亡率0.0%、复发率为3.3%,对照组的残端肿瘤残余率为6.7%、术后吻合口漏率为3.3%、并发症发生率20.0%、死亡率10.0%、复发率为13.3%.在上述指标方面,观察组与对照组相比差异有统计学意义(P<0.05).结论 在右半结肠癌的临床治疗中采用完整结肠系膜切除的方式具有十分显著的效果,能够将患者的肿瘤有效清除,并且具有较低的复发率和死亡率.

Objective To compare with the effect of improved small incision and traditional thyroidectomy surgery treatment of thyroid adenoma. Methods 76 cases of thyroid adenoma patients treated in our hospital in July 2013- August 2014 were randomly divided into two groups, each of 38 cases. Observation group were given small incision surgery, control group were given traditional thyroidectomy surgery, hospital time, operation time, incision length, blood loss and postoperative compli-cations of two groups were compared. Results Hospitalization time, operation time, incision length blood loss intraoperative of observation group compared with control group significantly reduced (P﹤0.01);Postoperative complication rate of observa-tion group was 15.79%, compared with control group was significantly lower (P﹤0.05) . Conclusion Effect of small incision surgery in the treatment of thyroid adenoma is significant, with few complications,worthy of application.

目的:观察卡培他滨联合奥沙利铂治疗晚期结肠癌的疗效.方法:将我院2013年3月~2014年3月收治的42例晚期结肠癌患者,采用双色球分组法分为对照组和观察组.对照组单纯采用卡培他滨治疗,观察组在此基础上使用奥沙利铂治疗.对比两组治疗效果,并对所有患者随访两年,对比两组治疗后1年、2年的生存率.结果:观察组治疗有效率明显高于对照组,存在显著差异(P<0.05);治疗后随访2年,发现观察组1年、2年生存率均明显高于对照组,差异显著(P<0.05).结论:卡培他滨联合奥沙利铂治疗晚期结肠癌具有良好的效果,两年期生存率比单一使用卡培他滨治疗高,值得在临床推广.

目的总结乳腺癌的病理检查特点并分析在乳腺癌的治疗中应用保乳手术的临床效果。方法在我院2010年3月至2011年12月收治的乳腺癌病患中随机抽取53例,对其病理检查资料进行总结以归纳病理特点,并实施保乳手术,分析美容效果。结果跟踪随访中未有病患出现癌细胞转移,53例均无复发现象。美容效果符合要求的合格百分比为100%,其中69.8%(37/53)达到优秀标准,24.5%(13/53)达到良好标准,其余的5.3%(3/53)达到合格标准。结论通过为乳腺癌病患实施病理检查可证实诊断,在乳腺癌的治疗中应用保乳手术能够提升美容效果,增加术后的合格占比。

目的总结胃癌术后复发患者的临床特点和治疗经验。方法对20例胃癌术后复发患者的临床资料进行总结分析。结果行再次手术治疗后生存1年以内占80.0%,生存2年以内占55.0%,生存3年以内占40.0%,生存4年以内占20.0%。结论对证实为术后复发的胃癌者只要符合手术适应症,均应采取积极的态度争取早期再手术,尽力延长患者的生存时间,提高患者的生存质量。

Objective To investigate the effect of Aidi injection on cellular immune function in postoperative patients with gastric cancer.Methods Totally 40 gastric cancer patients receiving radical operation were randomly divided as A and B groups,with 20 in each;and 40 healthy physical examinees were enrolled as the controls.After operation,the patients in B group received only conventional anti-inflammatory treatment,and those in A group received additional Aidi injection.The immune functions(Changes of CD3+,CD4+,CD8+ T cells,and CD4+ T cells /CD8+T cells in peripheral blood)between the patients before operation and the controls,and between the patients in A and B groups before and after operation were compared.Results In percentages of CD3+,CD4+,and CD8+ T cells,as well as CD4+ T cells /CD8+T cells,the comparisons between the patients with gastric cancer and the controls all showed a significant difference(P<0.01),so the comparisons did between the patients in the A and B groups post-operationally(P<0.01);but the comparisons in patients of B group between pre-operation and post-operation showed no significant difference(P>0.05).Conclusion The immune functions of patients with gastric cancer are in a suppressive stage,which can not be improved by operation,but by Aidi injection.

目的 观察药物联合足三里穴位注射治疗高龄胃瘫综合征的疗效.方法 将25例高龄胃瘫患者(≥70岁)随机分为药物联合穴位注射治疗组(n=12)和药物治疗组(n=13),观察治疗前、后第3、7、11天胃引流量及胃肠动力恢复时间.结果 药物联合穴位注射治疗能明显减少胃引流量(P<0.05)及缩短胃肠动力恢复时间,与药物治疗组比较,胃肠动力恢复时间显著缩短(P<0.01),胃引流量显著减少(P<0.05).结论 药物联合足三里穴位注射治疗组对高龄胃瘫治疗有较好疗效,优于药物治疗组.

腮腺手术是头颈部常见手术,其中80%为良性肿瘤手术,80%位于浅叶.传统的手术方法,易出现面神经麻痹,味觉出汗综合征(Frey综合征),涎漏等并发症.我们自1999年1月～2001年12月,采用保留腮腺筋膜的腮腺浅叶部分切除术治疗腮腺浅叶良性肿瘤60例,取得了较好的疗效,现报告如下.推广.

目的前瞻性研究足三里穴位注射防治肿瘤化疗所致白细胞减少症的临床疗效。方法将化疗所致白细胞减少的患者39例随机分为A、B两组,A组给予654—2加地塞米松足三里注射,B组予利血生及沙肝醇口服,两组于治疗前和治疗后7天检查血常规。将需化疗、白细胞正常的肿瘤患者58例随机分为C、D两组,C组给予化疗,D组于化疗结束后第二天给予654—2加地塞米松足三里注射,两组化疗后7天检查血常规。结果A组治疗后白细胞高于B组(P<0．05);以WHO的骨髓抑制毒性标准评价,D组的血液毒性低于C组(P<0．05)。结论足三里穴位注射用于治疗及预防化疗引起的白细胞减少症安全有效。

目的前瞻性研究足三里穴位注射防治肿瘤化疗所致白细胞减少症的临床疗效.方法将化疗所致白细胞减少的患者39例随机分为A、B两组,A组给予654-2加地塞米松足三里注射,B组予利血生及沙肝醇口服,两组于治疗前和治疗后7天检查血常规.将需化疗、白细胞正常的肿瘤患者58例随机分为C、D两组,C组给予化疗,D组于化疗结束后第二天给予654-2加地塞米松足三里注射,两组化疗后7天检查血常规.结果A组治疗后白细胞高于B组(P＜0.05);以WHO的骨髓抑制毒性标准评价,D组的血液毒性低于C组(P＜0.05).结论足三里穴位注射用于治疗及预防化疗引起的白细胞减少症安全有效.

结、直肠癌是临床上常见的恶性肿瘤,手术治疗是最佳治疗方法\.但临床上见到多为中晚期病例,术后出现腹腔内转移、复发和肝转移的比例较高, 5年生存率低,约25%～35%[1],如何降低结、直肠癌术后腹腔及肝转移发生率、提高患者的5年生存率成为目前研究的热点之一.笔者自1992年3月～1997年5月共收治结、直肠癌患者156例,术后采用静脉路单纯化疗和静脉路加腹腔化疗的综合化疗,现进行回顾性对照研究.