目的 探讨T3期喉癌采用支撑喉镜下CO2激光切除术和部分喉切除术两种手术治疗方式的临床治疗效果。 方法 将2003年8月－2010年7月收治的31例患者按所接受手术方式分为A、B两组（非随机分组），A组16例中男15例，女1例，年龄38～72岁，中位年龄51岁；B组15例，均为男性，年龄46～68岁，中位年龄58岁。病变均累及前联合，A组10例和B组11例累及对侧声带约1/3。A组选择支撑喉镜下CO2激光切除术，B组选择气管切开＋部分喉切除术。两组患者首次术后均未接受放射（放疗）或化学治疗（化疗）。术后第1、3、6、12、24个月门诊纤维喉镜复查。随访时间14～78个月。 结果 A组5例复发或颈部淋巴结转移，复发率31.3%；5例患者均行再次手术、颈清扫及放、化疗。B组4例复发，复发率26.7%；4例均行全喉切除双侧选择性颈清扫术，其中3例术后辅以放、化疗。两组复发率比较差异无统计学意义（P＞0.05）。 结论 采用支撑喉镜下CO2激光切除治疗T3期喉癌，有望得到类似部分喉切除的临床治疗效果。
目的：本文观察了三只做了泪道激光手术的狗泪小管组织，目的是为了解激光术后是否泪道会遗留瘢痕或狭窄。方法：三只成年狗用激光分别点击了泪小点，泪小管，泪囊。30天内取材。结果：泪道上皮及管道未见损害。结论：泪道YAG激光只要掌握能量和点击次数，术后不会遗留瘢痕。
目的：为了进一步了解YAG激光在临床对泪道病的治疗情况,预后的观察随访的结果,我们对所做的患者进行分析、总结。材料和方法:我院4月中做了96例泪道激光成形术,本文从临床,随访等方面,通过写信,电话,回诊等进行随访、总结。结果:86例中单一部位的堵塞占67%，术后随访58%通畅。结论:泪道YAG激光对泪小管、泪总管堵塞治疗有一定疗效,能解决部分病人的流泪问题。
Objective To detect the serum protein fingerprint in gastric cancer patients by using the surface-enhanced laser desorption-ionization time-of-flight mass spectrometry (SELDI-TOF-MS) and protein chip array technology, screen biomarker candites, build diagnostic models and evaluate its clinical significance. Methods The serum proteomic patterns were detected in 40 patients with gastric cancer, 20 patients with gastric ulcer and 20 healthy blood donors. The diagnostic models were developed and valited by discriminant analysis. Results The peak intensity of differential expression proteins was not found in healthy blood donors, and 1 case was found in patient with gastric ulcer (m/z: 5 910,4 095). The peak intensity of 5 329, 4 095, 5 910, 8 691 and 3 300 (m/z) proteins were significantly higher in 40 gastric cancer patients than those in 20 gastric ulcer patients and 20 healthy blood donors ( P ＜0.05）. Three differential expression proteins were set up a diagnostic model together to diagnose gastric cancer. The diagnostic model made up of the differential expression proteins of 4 095, 5 910 and 8 691 had a sensitivity of 92.5% and a specificity of 97.5% . Conclusion Using SELDI-TOF-MS shows great potential to detect, and screen novel and better biomarkers for gastric cancer.
目的 探讨经胆道镜联合钬激光碎石治疗肝内外胆管难取性结石的价值。方法 纤维胆道镜窥视下用钬激光碎石治疗肝内外胆管难取性结石29例，观察临床效果。结果 经1～3次胆道镜下钬激光碎石治疗，28例患者结石全部取尽，1例未完全取净，成功率为96.55%（28/29）； 近期无胆道出血、漏胆、黄疸等并发症发生。26例获得随访，随访时间6～20个月，平均13个月，未发现结石复发及胆管狭窄。结论 经胆道镜钬激光碎石是一种治疗肝内外胆管难取性结石简便、安全及有效的方法。
Objective To study the effect of substance P ( SP) on int racellular f ree calcium concent ration in human poorly-differentiated gast ric cancer cell in vitro. Methods Human gast ric cancer cell line MKN45 was cultured in RPMI 1640. Then the cells were loaded with specific calcium fluorescent probe Furu23/ AM. ASN21377642 (NK21 receptor antagonist) , Nicardipine (calcium channel blocker) and different concent rations of SP were used to treat gast ric cancer cells. The concent ration changes of int racellular free calcium were detected by laser scanning confocal microscope. Results It was found that 10 , 50 and 100 nmol/ L SP could significantly increase the int racellular free calcium concent ration of gast ric cancer cells in Hanks solutions , which contain ext racellular calcium ( P lt;0. 05) , and the change was in a dose-dependent manner ( P lt; 0. 05) . When there was ext racellular calcium existed ,the increasing amplitude of intracellular f ree calcium concent ration was significantly higher than that when there was no extracellular calcium ( Plt; 0. 05) . And when Hanks solutions were pretreated with ASN21377642 and Nicardipine , the effects of 100 nmol/ L SP were partly inhibited , and the concent rations of int racellular f ree calcium were significantly lower than those in group s without pret reatment s ( P lt; 0. 05) . Conclusion SP can significantly increase free calcium concent ration in the gastric cancer cells. Releasing of stored calcium in the cells and influx of extracelluar calcium may contribute to the elevation of int racellular free calcium concentration.
ObjectiveTo evaluate the effect of low power red laser illumination on the intimal proliferative response in vein graft models.MethodsAutogenous vein graft models were established in 80 rats by transplanting jugular vein to carotid artery by end to end anastomosis, and were randomized into two groups: control group (graft nonilluminated), laser illumination group (0.9 J/cm2).The grafted veins were harvested at 3,7,14 or 28 day respectively after operation. IH (intimal hyperplasia) and SMC (smooth muscle cell) proliferations were pathologically and immunohistochemically observed and analyzed by computer digitizing system. ResultsThere were no significant differences in the intimal average thickness and the areas of lumen between two groups for 3 day. Laser group was significantly lower than the control in both the intimal average thickness and the stenosis of lumen at 7 day,14 day and 28 day (P＜0.05).Immunohistochemical analysis of PCNA indicate the decreased positive cell in laser group compared with the control group (P＜0.01).ConclusionThese preliminary results demonstrate that a certain density of low power red laser illumination in vein graft inhibits SMC proliferation and neointimal hyperplasia in rat.
Objective To study the characteristics of endothelin(ET) and hemodynamics parameters in patients with coronary artery disease (CAD) in perioperative period and aim to find out some rules and useful suggestions for clinical trial. Methods Fortyseven patients were divided into 5 groups: patients undergoing coronary artery bypass grafting (CABG) and resection of left ventricular aneurysm(CABG+LVAN group),patients undergoing classical CABG(CABG group), patients undergoing offpump coronary artery bypass grafting (OPCAB group), patients undergoing transmyocardial laser revascularization (TMLR group), and group control, patients undergoing mitral valve replacement because of rheumatic heart disease(RHD). The ET was measured in the following time: before operation, before aortic clamping(or before revascularization or before TMLR), aortic declamping(or just after revascularization or just TMLR), 3 h, 6 h, 24 h after reperfusion. CI was measured before operation, 3 h, 6 h and 24 h after reperfusion, respectively. Results ET Compared in each group: in CABG+LVAN group, it significantly increased when aortic declamping (69.93±7.20 pg/ml),at 3 h (89.99±5.76 pg/ml),6 h (60.94±8.69 pg/ml) and, 24 h (6899±10.30 pg/ml) after reperfusion than that beforeoperation (40.17±13.37 pg/ml，Plt;0.05); in CABG group, ET significantly increased when reperfusion(66.59±4.86 pg/ml), at 3 h (95.97±10.72 pg/ml), 6 h (61.51±765 pg/ml) and, 24 h (57.85±6.34 pg/ml) after reperfusion than that beforeoperation(43.22±9.13 pg/ml，Plt;0.05); in OPCAB group, ET increased significantly when reperfusion(66.47±5.90 pg/ml) than that beforeoperation(44.80±6.51 pg/ml，Plt;0.05), and then returned to normal level; in TMLR group,there is no difference before and after operation; in control group, ET increased significantly after operation. ET compared between different groups: ET level was higher in CABG group than that in OPCAB group at 3 h after reperfusion(95.97±10.72 pg/ml vs.59.72±4.81 pg/ml,Plt;0.05). Although CI significantly increased after myocardial reperfusion in all groups, the CI was significantly higher in OPCAB group than that in CABG group at 3 h after reperfusion(3.25±0.05 pg/ml vs. 2.17±0.46 L/min·m2,Plt;0.05). Conclusions In patients with CAD, the ET increases after operation, but the increasing levels are different among the different groups. In patients with OPCAB, the changes of ET and hemodynamics are mild, and heart function recovers quickly, so OPCAB is a very good choice for CAD surgical therapy if the indications are suitable; In patients with classical CABG, the changes of ET are obvious, and the heart function recovers a little bit slowly, but they all can return to normal level at 24 h after operation; TMLR is a good supplement for CAD therapy.
Objective To select relatively specific biomarkers in serum from lung adenocarcinoma patients using surface-enhanced laser desorption ionization time of flight mass spectrometry （SELDI-TOF-MS） Protein Chip technology, and study the follow-up results of postoperative serum proteomic patterns. Methods Serum samples from 71 lung adenocarcinoma patients. 71 healthy volunteers with matched gender, age and history of smoking were analyzed by using weak cation exchange 2（WCX2） Protein Chip to select potentially biomarkers. Seventy-one patients were followed-up till 9 months after surgery. Compare the serum proteomic patterns 3,6 and 9 months after surgery. Results Five highly expressed potential biomarkers were identified with the relative molecular weights of 4 047.79, 4 203. 99, 4 959. 81, 5 329. 30 and 7 760. 12 Da. The postoperative serum proteomic patterns changed among individuals, and correlated with patients＇ clinical stage. Conclusions SELDI-TOF-MS Protein Chip technology is a quick, easy, convenient, and high-throughout analyzing method capable of selecting relatively specific, potential biomarkers from the serum of lung adenocarcinoma patients and may have attractive clinical value.