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甲状腺癌术后乳糜瘘的观察与护理

【摘要】　目的　总结甲状腺癌行颈廓清术并发乳糜瘘的治疗及护理方法。　方法　2008年8月-2009年10月，对8例甲状腺癌行颈廓清术发生乳糜瘘患者，采用局部加压包扎，引流管接负压器充分引流或手术缝扎乳糜管等治疗，并进行心理护理、营养指导、引流管监护、并发症的预防等专科护理和基础护理。　结果　4例患者经保守治疗、4例患者采用手术缝扎乳糜管，治愈出院。　结论　对甲状腺癌颈廓清术后并发乳糜瘘患者，采取适当的治疗方法及正确的护理措施，能促进患者尽快早日康复出院，缩短住院时间和减少经济负担。

A STUDY ON THE GENOMIC VARIANT IN MATCHED ADENOCINOMA AND NON-TUMOR GASTRIC TISSUE BY ARBITRARILY PRIMER POLYMERASE CHAIN REACTION

Objective To identify and isolate the variant gene associated with gastric adenocarcinoma and clone the fragment of variant gene.Methods By arbitrarily primer polymerase chain reaction (AP-PCR), DNA samples from 5 matched gastric adenocarcinoma and non-tumor gastric tissues were analysed. Results The produced AP-PCR profiles were different in each matched gastric adenocarcinoma and non-tumor gastric tissue. One differentiated amplified DNA fragments PW2.2 from a matched gastric adenocarcinoma were cloned. The result of Southern blot hybridization with PW2.2 as a probe showing that this fragment was also found in some other gastric adenocarcinoma samples. Conclusion AP-PCR fingerprinting assay can be used to identify and clone the variant genes associated with gastric adenocarcinoma.

C-erb B-2基因蛋白和增殖细胞核抗原抗体在乳腺癌中的表达

Initial Approach of Applying Intraoperative Radiotherapy with Electrons after Conservative Surgery for Patients with Early Breast Cancer

【摘要】目的探讨早期乳腺癌保乳术中电子线放射治疗(intraoperative radiotherapy with electron,ELIOT)的可行性,评价术后并发症和术后乳房外观。方法2007年6月2009年6月期间,共有26例早期乳腺癌(肿瘤直径不超过25 cm)患者接受乳腺癌保乳手术及ELIOT,放疗剂量为21 Gy(分割照射58～60 Gy)。术后1年内第1、2、3个月,第6、9、12个月,1年后每6个月评估一次,主要评估切口愈合状况、并发症、乳房外观及肿瘤复发情况。结果术后切口愈合时间14～22 d,平均17 d。随访2～25个月,平均12个月,有2例切口脂肪液化,11例切口水肿伴引流液较多,全组无切口感染或血肿。随访期间内,未发现局部复发、远处转移或对侧乳腺癌。手术切口愈合后、术后6个月,1、2年对乳房外观评价结果:优秀者分别依次为577%、667%、727%及100%;好者分别依次为346%、222%、182%及0;一般者分别依次为77%、111%、91%及0。结论乳腺癌保乳术后行ELIOT 疗效确切、安全,对早期乳腺癌患者是一种方法简便,疗效确切、安全的选择。

EXPRESSION AND ROLE OF METALLOPROTEINASES IN BREAST CANCER

Objective To study the relationship between metalloproteinases (MMPs) and breast cancer. Methods The literature in recent years on the relationship between the expression of MMPs and breast cancer was reviewed. Results The balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs) is keeping normally kept in human body. Many of the studies showed that the expression of MMPs is increased in breast cancer. Conclusion The growth, invasion and metastasis of breast cancer is closely related with the increased expression of MMPs. This suggests that MMPs is a valuable prognostic marker and TIMPs would be a novel drug against cancer.

The Application of Serum CA153 and BAKP Measurements in Bone Scanning for Metastasis in Patients with mammary Cancer Diagnostic

摘要:目的:探讨血清CA153和BAKP在乳腺癌骨转移显像诊断中的应用。方法:对92例乳腺癌患者的核素骨显像结果、血清CA153和BAKP结果进行回顾性研究。结果:①血清CA15-3和B-AKP的值随着骨转移分期的增高而逐步升高,且差异显著(Plt;0. 01);②血清CA15-3和B-AKP与骨转移的数目呈正相关;③血清CA15-3gt;25 U/mL时,骨转移的阳性率为63.3%,血清CA15-3lt;25 U/mL时,骨转移的阴性预测值为94. 5%;血清B-AKPgt;20 U/L时,骨转移的阳性率为59. 6%时,骨转移的阴性预测值为73.5%;当血清CA15-3lt;25 U/mL同时B-AKPlt;20 U/L时,骨转移的阴性预测值为100%。结论:血清CA15-3和BAKP测定在乳腺癌骨显像诊断中具有重要的应用价值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.

Upper Limb Edema in the Shortterm Clinical Observation of Fitness Ball Exercise Treatment of Breast Cancer after Radical Surgery

目的:初步评价健身钢球锻炼法治疗乳腺癌根治性手术后上肢水肿的疗效。方法:收集乳腺癌改良根治术后并发上肢水肿患者60例,按照就诊顺序随机配对分为实验组和对照组,每组各30例。实验组术后采用健身钢球锻炼患侧上肢的方法;对照组采用抬高患肢、向心性按摩和热敷的传统方法。结果:两组患侧上肢各部位术后1天均存在不同程度水肿(Plt;0.05),实验组随着时间的推移,其水肿程度不断减轻(Plt;0.05),而对照组则在术后1周内变化不明显(Pgt;0.05),并且其各部位肿胀率均高于实验组,二者差异均有统计学意义(Plt;0.05)。结论:健身钢球锻炼法对乳腺癌根治性手术后上肢水肿具有一定的短期疗效。

STUDY ON THE EXPRESSION OF p16 AND Rb IN THYROID CARCINOMA

【Abstract】Objective To demonstrate the role of p16 protein and Rb protein in the formation and progression and their relationship in thyroid carcinoma. Methods p16 and Rb from 46 patients with thyroid cancer were detected by SP immunohistochemistry. Results In thyroid carcinoma,the p16 positive rate was decreased with the decline of differentiation. There was an inverse correlation between the rates of p16 positive expression and involvement of lymph node,clinical stage and prognosis index.The Rb protein was not present in any cases as a nucleus staining. Conclusion The p16 gene is likely to play an important role in the genesis and malignant progression of thyroid carcinoma,while the Rb gene is not .

乳腺癌患者围手术期心理问题及护理干预

目的探讨乳腺癌患者的心理问题及有效的心理干预措施。 方法选择2010年1月-2012年5月65例确诊为乳腺癌并行根治性手术患者，对其围手术期的心理问题进行评估，并通过有效沟通、鼓励与支持、提供科学方法、充分调动家庭和社会支持系统等手段给予相应的心理干预。 结果经干预，患者的心理问题得到了疏导，能主动配合治疗，健康指导依从率高，患侧肢体淋巴水肿发生率1.54%，以积极乐观的生活态度重返社会。 结论重视乳腺癌患者的心理问题，提供有效的心理干预，对于完善护理人文关怀，促进患者全面康复、重返社会有着积极的意义。

CORRELATION BETWEEN METALLOTHIONEIN AND PROGNOSIS IN BREAST CANCER

To investigate the relationship between metallothionein (MT) and prognosis in breast cancer MT expression was determined with immunohistochemical method (SABC). Results: There was a statistically significant association between expression of MT in breast benign and malignant disease (Ｐ＜0.005). The positive rate was 73.8%(62/84) and 15.0%(3/20) in breast cancer and mastofibroma respectively. The positivity of MT was ber in advanced clinical stages than in early clinical stages. There was no association between MT expression and lymph node metastasis. The mortality of the cancer cases with lymph node metastasis having positive MT expression was higher than those with negative MT expression. Conclusion: MT can be taken as a prognostic index of breast cancer.