【摘要】目的 探讨低磁场MRI诊断胰腺癌的价值。方法 回顾性分析我院78例经手术和病理证实的胰腺癌的MRI表现。结果 肿瘤的低磁场MRI主要表现为胰腺出现局部软组织肿块或全部肿大，轮廓、信号异常，T1加权像呈等或低信号，信号不均匀，T2加权像信号不均匀增高； 肝内外胆管、胰管扩张，邻近组织及器官受累。结论 低磁场MRI能较好地显示胰腺癌的大小、形态和继发的胆、胰管梗阻、扩张以及肿瘤转移、侵袭范围，有利于肿瘤的诊断。
ObjectiveTo establish multidrugresistance cell substrain of human hepatocellular carcinoma and to investigate its characteristics.MethodsSMMC7721 cell strain was cultured in Adriamycin(ADM). The multidrugresistance cell substrain SMMC7721/ADM was harvested after a long period of culture by gradually increasing the concentration of ADM and its characteristics were investigated. Results①The drug resistance of SMMC7721/ADM to ADM increased by 33.3 times, to Vincristine 16.8 times, to Diamminedichloroplatinum 2.8 times. ②The drug resistance cell substrain had almost the same growth velocity as its parental generation. The doubling time was 32.0 hours and 30.5 hours respectively. They had the analogous growth curves. ③The obvious difference between the drug resistance cell substrain and its parental generation was that the former’s microvilli became thick, short and scattered by scanning and transmitting electron microscopy. ④The multidrug resistance cell substrain kept the characteristics of hepatocellular carcinoma, it could be transplanted into the subcutaneous tissue of nude mice. ⑤The drug resistance of the cell substrain reduced to 28.0% and 9.2%after removal of the drug for 1 month and 2 months respectively, its drug resistance could remain stable (35.4 times) after 2 months of culture in ADM (0.04 μg/ml).ConclusionThe SMMC7721/ADM cell substrain has the stable fundamental characteristics of a drug resistance cell strain.
Objective To explore the feasibility of recombinant adeno-associated virus (rAAV) as a vector for the gene therapy of liver cancer. Methods The rAAV/enhance green fluorescein protein (EGFP) recombinant was prepared by the routine method of two plasmids cotransfection.Results The experiment showed that one 10cm plate could produce 107-108 infection unit recombinant by the method of two plasmids cotransfection, and the transduction of HepG2 cell was increased with the increase of infection dosage of rAAV. About 100 multiplicity of infection (MOI) AAV vector could make all the tumor cell light. Conclusion Liver cancer cell can be efficiently transduced by rAAV, and AAV vector may be a valuable vector for the gene therapy of liver cancer.
目的:探讨活体右半肝移植供体术后并发症及其处理。方法:回顾性分析了我院肝移植中心的120例活体肝移植供体术后并发症发生的类型和临床处理方法。结果:120例活体肝移植供体术后都出现肝功能实验室指标的短期变化,其中114例术后1周内恢复正常;6例恢复时间大于1周。术后并发症总发生率9.16%,其中严重并发症发生率4.16%,轻微并发症发生率5.00%。所有术后并发症得到及时的发现和处理,恢复良好。结论:经过严密的术前检查和评估、充分的术前准备、细致的术中操作和全面的术后监护与治疗,活体右半肝移植供体的手术安全性较高,近期预后较好。
Objective To investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide （ASODN） on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P＜0.05）. Tumor size in group ASODN was marked smaller than that of other 3 groups after the 5th day (P＜0.05)，while tumor size of group control 1,2 and group SODN in different phase showed no significant difference (Pgt;0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth. Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.
目的探讨肝结核病的临床诊断及误诊原因。方法对我院普外科1996~2001年收治的8例肝结核病患者的临床资料进行回顾性分析。结果本组病例中发热5例，A/G倒置6例，甲胎蛋白均阴性； OT或PPD皮试5例，4例阴性，1例可疑； CT发现腹主动脉旁淋巴结肿大3例。入院诊断肝结核1例，原发性肝癌或转移性肝癌3例，肝血管瘤1例，肝脓肿2例，肝包虫病1例。剖腹探查、肝部分切除、活检6例，肝脓肿引流2例，术中冰冻切片检查证实均为结核。结论对于肝功能大致正常、甲胎蛋白阴性的中、青年患者，如CT或B超发现肝区有多发性占位病变并伴午后发热、A/G倒置、有肝外结核病史或表现者，应高度怀疑本病。经皮肝穿刺或腹腔镜下行肝活检是确诊本病的首选方式； 如无法与肝恶性肿瘤鉴别，应尽早行剖腹探查术，术中常规作冰冻检查，术后行正规抗痨治疗，可治愈该病。
Objective To study the expression and significance of multidrug resistance-associated protein (MRP) gene in hepatocellular carcinoma (HCC). Methods Reverse transcription polymerase chain reaction (RT-PCR) assay was used to detect the expression of MRP mRNA in 25 fresh specimens of the primary HCC and its surrounding liver tissues. Immunohistochemistry LSAB technique was adopted to test MRP in 60 HCC specimens. The drug sensitivity was also tested by flow cytometry.Results The positive expression rates of MRP mRNA and MRP protein in primary HCC were 44.00%(11/25) and 45.00%(27/60) respectively. All the intensity of expression was low, but significant higer than its surrouding liver tissues (P＜0.05). The intensity and expression rate of MRP protein in 5 recurrent HCC had a tendency to increase. There was a correlation between the expression of MRP mRNA and MRP protein in 25 patients using RT-PCR and immunohistochemistry assay (Plt;0.05). Detected by flow cytometry, the average sensitivity of drugs in vitro of 60 HCC sp-cimens were 5-FU （15.80±7.63）%，DDP（18.45±9.59）%，ADM（17.95±7.99）%，MMC（16.60±8.69）% and CTX（17.40±10.14）%. Only 5FU and ADM were significantly affected by the expression of MRP protein (Plt;0.05).Conclusion The expression of MRP in primary HCC may be one of the important mechanisms of the intrinsic and acquired drug resistance in HCC. To study the expression of MRP could give a predictive value in HCC chemotherapy.
目的总结原发性甲状腺鳞癌的诊治经验。方法回顾分析我院1996～2001年收治的12例原发性甲状腺鳞癌患者的临床资料。结果单纯性鳞癌4例，合并甲状腺其它疾病8例。主要临床表现为颈部包块和声嘶。单纯性鳞癌免疫组化甲状腺球蛋白染色阳性3例，阴性1例。12例患者中10例行姑息性切除者于术后1年内死亡，2例行根治性切除者存活时间超过3年。结论原发性甲状腺鳞癌呈高度恶性，可与甲状腺其它良、恶性疾病并存； 要重视对该病的诊断和鉴别诊断，免疫组化甲状腺球蛋白染色可提高确诊率； 根治性手术切除加综合治疗是提高其生存率的关键。
ObjectiveTo explore the relationship between liver transplantation procedure with or without preservation of retrohepatic vena cava and postoperative reinfection of hepatitis B virus.MethodsHepatitis B virus makers of 15 retrohepatic vena cava samples from hepatitis B virus active replicating recipients was detected using immunohistochemistry stain LSAB and HBV DNA hybridization in situ. Hepatitis B virus reinfection rate and survival rate after transplantation in classic group (20 cases) and piggyback group (7 cases) was analyzed retrospectively. ResultsHepatitis B virus makers including HBsAg and HBcAg and HBV DNA of all 15 retrohepatic vena cava samples, 10 from classic group and 5 from piggyback group, was negative. In classic group, 20 recipients were followedup 6-30 months, mean 18 months, only one case of hepatitis B recurrence was confirmed 22 months after operation; In piggyback group,7 recipients were followedup 5-12 months, mean 8 months, none of hepatitis B virus reinfection was encountered. Recurrence rate in classic group and piggyback group was 5.0%(1/20) and 0(0/7), respectively.ConclusionThis preliminary study indicated that the retrohepatic vena cava of hepatitis B virus active replicating recipients don’t have the residence and replication of hepatitis B virus particle. Orthotopic liver transplantation procedure with preservation of retrohepatic vena cava appears not to increase the hepatitis B virus reinfection rate in hepatitis B virus active replicating recipients after transplantation.