目的 探讨二氢丹参酮Ⅰ在胃癌细胞中的抗癌作用。方法 采用 3-(4,5-二甲基噻唑-2)-2,5-二苯基四氮唑溴盐法(MTT法)测定细胞活力。流式细胞术检测细胞内活性氧(ROS)水平。荧光法测定Caspase活性。裸鼠胃癌模型验证DHTS的抗癌活性。结果 MTT实验结果表明,DHTS对HCG27和AGS细胞活力具有明显的剂量依赖性和时间依赖性。在DHTS处理的HCG27和AGS细胞中,细胞内ROS水平升高,凋亡细胞增多。 在DHTS处理的HCG27和AGS细胞中发现caspase-3和caspase-8活性增高,caspase-9活性不变。用N -乙酰半胱氨酸阻断ROS生成可显著逆转DHTS诱导的细胞凋亡。DHTS显著抑制小鼠肿瘤瘤体体积的增加。结论 所有的研究结果都有力的说明,DHTS可以在HCG27和AGS人胃癌细胞中启动活性氧生成,诱导氧化应激和细胞凋亡,值得作为抗癌药物进一步开发。

Objective To evaluate the anticancer actions of dihydrotanshinone Ⅰ(DHTS)in gastric cancer cells. Methods Cell viability was determined using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay. Intracellular reactive oxygen species (ROS)levels were determined using flow cytometry. Caspase activities were measured with fluorometric assay. The anticancer activity of DHTS in nude mouse gastric cancer model was verified. Results MTT assay showed that DHTS greatly inhibited HCG27 or AGS cell viability in dose- and time-dependent manners. Elevated intracellular ROS levels and increased apoptotic cells were observed in DHTS-treated HCG27 or AGS cells. In addition, activation of caspase-3 and caspase-8, rather than caspase-9, were noticed in DHTS-treated HCG27 or AGS cells. Furthermore, blocking ROS generation with N-acetylcysteine markedly reversed DHTS-induced cell apoptosis. DHTS inhibited the increase of tumor volume in mice. Conclusion All the findings strongly suggest that DHTS may initiate ROS generation and induce oxidative stress and cell apoptosis in HCG27 or AGS human gastric cancer cells, which deserves to be further developed as an anticancer agent.

目的 观察重组人血管内皮抑素注射液（恩度） 联合化疗治非小细胞肺癌（NSCLC）的近期疗效和安全性。方法 对2015年3月—2017年10月经病理组织学或细胞学检查确诊的Ⅲ-Ⅳ期NSCLC74例患者,采用随机数字法把受试者随机分为联合治疗组（n=35）和对照组（n=39）,联合治疗组接受恩度联合化疗的方案治疗;对照组单纯行常规化疗治疗。近期疗效评价采用RECIST标准,生活质量（QOL）采用Karnofsky评分（KPS）,抗癌药物急性与亚急性毒性反应分度标准分0~Ⅳ度。比较两组患者的近期疗效指标（疾病完全缓解（CR）、疾病稳定（ SD）、疾病进展（ PD）、客观有效率（RR）、疾病控制率（DCR ）;QOL评分及毒副反应情况。结果 联合治疗组近期疗效指标RR及DCR高于对照组（P < 0.05）;联合治疗组KPS评分高于对照组（P < 0.05）;两组间的毒副作用包括恶心/呕吐、腹泻、疲乏、脱发、血小板下降及白细胞下降等,两组间毒副反应出现数量比较,差异无统计学意义（P > 0.05）。结论 恩度与化疗药物联合使用可以提高NSCLC疗效和改善患者生活质量,未增加患者不良反应发生率。

Objective To observe the curative effect and the side effects of recombinant human vascular endostatin （Endostar） combined with the chemotherapy on nonsmall cell lung cancer（NSCLC）. Methods Seventy-four NSCLC patients confirmed by histopathology or cytopathology were randomly distributed to combined therapy group （n=35, with Endostar combined with chemotherapy） and control group （n=39, with conventional chemotherapy）. The recent efficacy of drug was evaluated according to the RECIST criteria. The quality of life （QOL） was assessed by usingto the Karnofsky scores, and the safety of drug was evaluated according to WHO side effects criteria. Results The therapeutic effectiveness was better in the combined therapy group than that in the control group（P<0.01）. The KPS was better in co-therapy group than that in the control group（P<0.05）. The common adverse reactions in both groups included neutropenia, thrombocytopenia, nausea/vomiting, diarrhea, lassitude, alopecia, thrombocytopenia and leukocytopenia. However, the incidence rates of adverse reactions between the two group was not significant （P>0.05）. Conclusion Endostar combined with the related chemotherapy may improve the curative effect and QOL of NSCLC.

目的 探讨结直肠癌肝转移瘤的CT 成像特点及规律分析。方法 回顾性分析我院2016 年3 月—2018年3 月的84 例结直肠癌肝转移瘤患者的CT 动态增强图像及临床资料记录并统计其不同血流汇入情况下、不同增强时期的CT 成像结果,根据原发灶部位,将患者分为左半结肠组和右半结肠组,左半结肠组再按照血管重建情况分组。结果 原发灶在左半结肠时,转移瘤的左、右叶分布无差异（P>0.05）,而原发灶在右半结肠时,转移瘤的右叶优势分布多于左叶优势（P<0.001）;左半结肠组内比较,甲组转移瘤的左叶优势分布多于右叶,分布差异有统计学意义（P<0.001）,其左右叶构成比约为4∶1;乙组转移瘤的左、右叶分布差异不具有统计学意义（P>0.05）;丙组转移瘤的右叶优势分布多于左叶优势（P<0.001）;84 例患者中,共发现338 个肝转移灶。平扫中,低密度灶多于高密度灶,最少是等密度灶;动态CT 增强扫描中,环状强化灶多于结节状强化灶,其他不典型强化灶最少,且门脉期时强化灶显示最为清晰。结论 结直肠癌肝转移患者的CT 肝扫描图像特点有一定规律,可以为诊断结直肠癌原发灶及结直肠癌的早期转移提供一定理论依据。

Objective To investigate the characteristics and regularity of CT imaging of colorectal cancer liver metas tases. Methods A retrospective analysis of 84 cases of colorectal cancer liver metastases from March 2016 to March 2018 in our hospital. CT dynamic imaging images and clinical data were recorded and statistically analyzed for different blood flow in flows and different enhancement periods. For the CT imaging results, the patients were divided into the left colon group and the right colon group according to the primary tumor site, and the left colon group was grouped according to the blood vessel reconstruction. Results There was no statistic difference in the distribution of left and right lobe between the primary tumor and the left colon in the left colon （P>0.05） . However, in the right colon, the dominant distribution of the right lobe in the metastatic tumor was more than that in the left lobe. The advantage （P=0.00） in the left colon group, the left leaf dom inant distribution of the metastatic tumor of group A was more than that of the right lobe, and the difference was statistically significant （P=0.00）, and the ratio of left and right lobe was about 4∶1;There was no statistic difference in the distribu tion of left and right leaves between group B metastases （P>0.05） . The right leaf dominant distribution of group C metasta ses was more than that of left lobe （P=0.00） . Among 84 patients, a total of 338 liver metastases were found. In the plain scan, the low-density foci were more than the high-density foci, and at least the iso-density foci;in the dynamic CT-en-hanced scan, the annular intensified foci were more than the nodular intensive foci, and the other atypical intensive foci were the least, and the portal vein period enhanced stove display is the clearest. Conclusion The characteristics of CT liver scan in patients with liver metastases from colorectal cancer do have certain regularity, which may provide a theoretical basis for the diagnosis of primary colorectal cancer and early metastasis of colorectal cancer.

目的 分析促红细胞生成素（EPO）及促红细胞生成素受体（EPOR）在肝细胞癌（NCC）以及正常组织中的表达规律,以及它们和肝细胞癌微血管密度（MVD）之间的关系。方法 选取我院手术切除的肝细胞肝癌的标本30例,取肿瘤边缘2.0 cm的肝组织作为对照,同时取正常肝脏组织10例做为阴性对照。利用酶联免疫吸附实验（ELISA）检测各组织中EPO及EPOR表达水平,利用免疫组织化学方法染色检测微血管密度（MVD）。对比癌组织和癌旁组织EPO、EPOR及MVD差异,分析NCC中EPO、EPOR、MVD与肿瘤病理特征的关系,分析EPO、EPOR表达水平与MVD之间的关系。结果 HCC组织中,EPR、EPOR、MVD均高于癌旁组织和正常组织,差异有统计学意义（P<0.001）,EPR、EPOR、MVD在癌旁组织和正常组织中,差异无统计学意义（P>0.05）。肿瘤大小>5 cm、存在包膜侵犯、存在远处转移以及高中分化的HCC中,EPR、EPOR、MVD水平高于肿瘤大小≤5 cm、无包膜侵犯、无远处转移以及低分化的水平,差异有统计学意义（P<0.05）。Person相关分析结果显示,EPO表达水平与MVD的相关系数r=0.651（P<0.001）,EPOR表达水平与MVD的相关系数r=0.620（P<0.001）。结论 EPO、EPOR、MVD在HCC中呈现高水平,且与肿瘤大小、局部侵犯、远处转移及分化程度有关,其机制可能与EPO、EPOR增加MVD有关。

Objective To analyze the expression of erythropoietin （EPO） and erythropoietin receptor （EPOR） in hepatocellular carcinoma （NCC） and normal tissues,and their relationship with hepatocyte microvessel density （MVD）. Methods Thirty specimens of hepatocellular carcinoma hepatectomy were selected from our hospital. The liver tissue at the edge of the tumor was taken as a control,and 10 cases of normal liver tissue were used as a negative control. The expression levels of EPO and EPOR in each tissues were detected by enzyme-linked immunosorbent assay （ELISA）,and microvessel density （MVD） was detected by immunohistochemistry. The differences of EPO,EPOR and MVD between each tissues were compared. The relationship between EPO,EPOR,MVD and tumor pathological features in NCC was analyzed. The relationship between EPO and EPOR expression levels and MVD was analyzed. Results In HCC tissues,EPR,EPOR and MVD were higher than those in adjacent tissues and normal tissues. The difference was statistical difference （P<0.001）. EPR,EPOR and MVD were not statistically significant in adjacent tissues and normal tissues. P>0.05）. The levels of EPR,EPOR,and MVD in tumors with tumor size >5 cm,invasion of the capsule,distant metastasis,and high-differentiation were higher than those of tumor size ≤ 5 cm,no capsule invasion,no distant metastasis,and poor differentiation. The difference was statistical difference （P < 0.05）. Person correlation analysis showed that the correlation coefficient between EPO expression level and MVD was r=0.651 （P<0.001）,and the correlation coefficient between EPOR expression level and MVD was r=0.620 （P<0.001）. Conclusion EPO,EPOR and MVD are highly expressed in HCC,and are related to tumor size,local invasion,distant metastasis and differentiation. The mechanism may be related to EPO and EPOR increasing MVD.

目的 筛选结直肠癌（CRC）差异性表达的长链非编码RNA（lncRNA）,并进行临床标本验证,研究其对结肠癌细胞HCT116功能的作用。方法 利用lncRNA PCR芯片对3对CRC组织和癌旁对照组织筛选差异性表达的lncRNA,确定候选研究lncRNA GAPLINC,RT-qPCR对21例临床样本进行验证其表达的差异性;同时构建GAPLINC表达质粒及其沉默体siRNA转染HCT116细胞,研究其对细胞凋亡、迁移及侵袭能力的影响。结果 lncRNA芯片实验结果提示CRC组织中存在大量的差异性表达的lncRNA,其中GAPLINC在CRC组织表达稳定增加,21例临床样本进一步验证了其在肿瘤组织中表达增加（P<0.05）;转染GAPLINC表达质粒后,HCT116细胞凋亡被抑制,同时其迁移及侵袭能力增强,转染siRNA抑制GAPLINC的表达后,则出现相反的结果。结论 利用lncRNA芯片可对CRC差异性表达lncRNA进行批量筛选,GAPLINC在CRC组织中表达稳定增加,具有促癌作用,在CRC发生发展中可能起着重要作用。

Objective To screen the differentiational expression of lncRNA in CRC tissue,confirm it in large simple of clinical specimens,and study its effects on human colorectal cells HCT116 cell line. Methods We screened the lncRNA which expressed differently in 3 CRC tissues and their pair-non carcinour tissues by lncRNA arrays;chose the over expressed lncRNA which played the potential role of oncogene for further researching,and tested the difference in 21 clinical specimens by RT-qPCR. We cultured the HCT166 cells,and then constructed expressed plasmids pcCDNA3.1-GAPLINC and synthesized GAPLINC siRNA,transfected the plasmids and siRNA into HCT116 cells;to study the changes of HCT116 cells behavior,the transwell assays were carried on;the changes of apoptosis of HCT116 cells were tested by flow cytometry. Results There existed many lncRNA which expressed differently between CRC tissues and normal control tissues by lncRNA arrays,there were 21 lncRNA down expressed,and 3 lncRNA up expressed;among these lncRNA,GAPLINC over expressed stably,and its high level of expression was approved in 21 clinical specimens by the test of RT-qPCR. We constructed the expressed plasmids pcCDNA3.1-GAPLINC and synthesizing GAPLINC siRNA successfully;after transfecting pcCDNA3.1-GAPLINC into HCT116 cells,the over expression of GAPLINC increased the migration and invasion of the HCT166 cells （P<0.05）,decreased the proportion of cell apoptosis （P <0.05）;by contraries,knocked down the expression of GAPLINC inhibited invasion and migration of HCT116 cells （P<0.05）,and promoted the apoptosis of the HCT116 cells （P <0.05）. Conclusion It could screen the different expression of lncRNA in large quantities by lncRNA arrays,and GAPLINC expressed highly and stably in CRC tissues. GAPLINC played a role of oncogene,which promoted the proliferation and invasion of CRC cells,and inhibited the apoptosis of CRC cells,which meant playing an important role in the carcinoma and development of CRC.

目的 观察小剂量阿帕替尼联合经肝动脉化疗栓塞术(TACE)对晚期肝癌的疗效。方法 选择2016年1月1日—2017年12月31日在我院住院治疗的晚期肝癌患者38例,将其随机分为对照组和观察组,每组19例,对照组给予TACE治疗,观察组在TACE治疗的基础上联合口服阿帕替尼(250 mg/d)。随访两组患者的存活状态,Kaplan-Meier 法计算中位生存期,并绘制生存曲线,采用log-rank法比较两组患者生存曲线的差异。结果 对照组和观察组中位生存期分别为4.3月、5.8月,两组生存曲线比较有差异(χ²=4.691,P=0.043)。结论 相比于单纯TACE治疗,小剂量阿帕替尼联合TACE方案可以延长晚期肝癌患者的生存期。

目的 研究罗哌卡因阻滞用于胸腹腔镜联合食管癌根治术后镇痛的临床效果。方法 胸腹腔镜联合食管癌根治术患者60例,分为: 观察组(n=30),缝合切口时用0.25%盐酸罗哌卡因10 mL于切口局部浸润;对照组(n=30) 不做局部浸润麻醉处理;记录二组术后2 h、6 h、12 h、24 h、48 h的疼痛视觉模拟评分(VAS)及血浆皮质醇浓度。结果 观察组术后2 h、6 h、12 h VAS评分优于对照组,术后12 h观察组血浆皮质醇浓度低于对照组。结论 罗哌卡因术终阻滞术后12 h内镇痛效果明显。

Objective To evaluate the efficiency of postoperative analgesia with ropivacaine block after thoracoscopic-lapacoscopic esophagectomy (TLE). Methods Totally 60 patients with esophageal cancer underwent TLE were divided into two groups: observation group(n=30)with 0.25% ropivacaine hydrochloride solution 10 mL injection around incision before end of the operation; control group(n=30)without the treatment. The VAS and the plasma Cortisol concentration at 2 h、6 h、12 h、24 h、48 h after surgery were recorded. Results The VAS at 2 h、6 h、12 h after surgery in observation group was higher than that of the control group,but not at 24 h、48 h after surgery. The plasma Cortisol concentration in the observation group was higher than that of in the control at 12 hours postoperatively. Conclusion Ropivacaine block of incision is helpful to have analgesic effect within 12 hours after TLE.

目的 分析乳腺恶性肿瘤患者的诊断和治疗方法的动态变化,了解该疾病的患者诊治相关行为方式的变化。方法 抽取我院1999年—2014年收治的所有乳腺恶性肿瘤患者,比较不同初诊时间和初诊年龄分组间,患病部位、肿瘤大小、手术方式、治疗方式的差异。结果 比较1999年—2004年组、2005—2009年组,近年诊断的肿瘤最大直径有所下降,经过卡方比较,构成比有差异(χ²=14.2,P=0.007)。近年诊断的患者更愿意选择积极的改良根治术作为手术治疗方式(χ²=38.8,P<0.001)。就不同年龄而言,年轻的患者选择改良根治术和化疗的比例也较年老的患者高,而年龄大的患者则选择姑息治疗的比例较高(χ²=154.9,P<0.001)和(χ²=129.8,P<0.001)。结论 乳腺恶性肿瘤的认知的加强,诊治技术的提高,乳腺恶性肿瘤能够更早的被发现诊断,治疗方式的选择也更加积极。

Objective To analyze the dynamic changes of breast cancer diagnosis and treatment. and to understand the changes of related behaviors of the patients. Methods From 1999 to 2014, breast cancer patients were chosen, the differences of tumor size, operation and treatment were not compared. Results The results were compared within different groups of diagnosis years, such as 1999-2004,2005-2009, and 2010-2015. The maximum diameter of the tumor diagnosed in recent years was decreased, χ²=14.2,P= 0.007. At the same time, patients that were diagnosed in recent years were more likely to choose radical surgery as surgical treatment, χ²=38.8,P<0.001. Comparing within groups of different ages, more patients chose radical surgery and chemotherapy in younger patients than older ones, we found that the older patients chose a higher proportion of palliative care, χ²=154.9,P<0.001 and χ²=129.8,P<0.001. Conclusion Understan-ding of breast cancer malignancies was enhanced. Breast cancer may be diagnosed earlier and the choice of treatment is more positive with the development of technology.

目的 观察⁹⁹锝-亚甲基二膦酸盐对前列腺癌骨转移患者骨痛、骨质疏松的治疗效果。方法 对76例前列腺癌骨转移患者给予⁹⁹锝-亚甲基二膦酸盐治疗1年(每疗程15 d,每天静滴22 mg,15 d为一个疗程,共12个疗程),比较治疗前及治疗1年后患者骨密度(BMD)值及血清钙、磷、碱性磷酸酶、骨钙素、I型胶原交联羧基末端肽、1,25二羟维生素D3等指标的变化。结果 云克治疗后腰椎(L1-4)及左股骨颈、大转子及小转子骨密度(BMD)值均较治疗前增加(P＜0.05);云克治疗后AKP、ICTP均较治疗前明显下降(P＜0.01)。OC云克治疗后较治疗前增加(P＜0.05)。血钙、血磷、1,25-二羟维生素D3云克治疗后与云克治疗前相比无明显变化,P<0.05。前列腺癌骨转移轻度骨痛组及中度骨痛组治疗1年后骨痛VAS评分明显降低,差异有统计学意义,P＜0.05。重度骨痛组云克治疗前、治疗后VAS评分比较,差异无统计学意义,P<0.05。结论 ⁹⁹锝-亚甲基二膦酸盐在治疗前列腺癌骨转移的骨痛、骨质疏松方面,具有缓解骨痛,促进骨增殖,抑制骨吸收,提高骨密度,防治骨质疏松的作用。

目的 探讨我院17年间前列腺癌患者的临床特征如发病年龄、前列腺特异性抗原(PSA)、Gleason评分、分期及穿刺阳性率等的变化。方法 采用回顾性分析,对广州市第一人民医院2000—2016年泌尿外科1 231例穿刺活检的患者及564例前列腺癌患者资料进行分析,按患者的诊断时间分为A组(2000—2005年)、B组(2006—2009年)、C组(2010—2012年)、D组(2013—2014年)、E组(2015—2016年),对各组的年龄、PSA、Gleason评分、分期及穿刺活检阳性率进行统计学分析,看各组间的各项指标差异是否有统计学意义。结果 5组年龄均值(73.36,73.74,72.05,73.40,72.96岁)、PSA均值(208.95,190.25,173.19,283.54,148.69 μg/L)及穿刺活检阳性率均值(48%,43%,37%,44%,39%)差异均无统计学意义(P均>0.05)。5组Gleason均值为6.80,6.73,7.12,6.93,7.32,A、B组和E组Gleason评分差异有统计学意义(P均<0.05),其余各组Gleason评分差异均无统计学意义(P均>0.05)。TNM分期转化得分5组均值为5.96,6.80,7.05,7.31,6.83, A和C组、D组、E组差异均有统计学意义(P均<0.05),其余各组TNM分期转化得分差异均无统计学意义(P均>0.05)。结论 17年间前列腺癌患者诊断时的年龄、PSA水平及穿刺活检阳性率没有显著变化。

Objective To investigate changes of inpatients with prostate cancer in the last 17 years such as age of onset, prostate specific antigen (PSA), Gleason score, prostate cancer staging and positive rate of prostate biopsy. Methods A retrospective analysis was conducted in 1 231 cases of biopsy patients of urology and 564 patients with prostate cancer who were hospitalized in the First People's Hospital of Guangzhou from 2000 to 2016. According to the time of diagnose. All the patients were divided into five groups: group A(2000-2005),group B(2006-2009),group C(2010-2012), group D(2013-2014)and group E(2015-2016). The age, PSA, Gleason score, staging and positive rate of prostate biopsy were compared to realize whether the indicators of the differences between groups was statistically significant. Results In five groups, means of age, PSA, Gleason score and prostate biopsy positive rate are respectively 73.36,73.74,72.05,73.40,72.96 years; 208.95,190.25,173.19,283.54,148.69 μg/L;6.80,6.73,7.12,6.93,7.32; 5.96,6.80,7.05,7.31,6.83 and 48%,43%,37%,44%,39%. There was no significant difference in age, PSA and positive rate of prostate biopsy (P>0.05). The Gleason scores of group A and group E, group B and group E were statistically significant (P<0.05), while the other groups had no significant differences in Gleason score (P>0.05). There werestatistical significancein TNM staging score between group A and group C,group D, group E(P <0.05),while the other groups had nostatistical significance (P>0.05). Conclusion There are no change of prostate cancer patients in diagnosis of age, PSA levels and positive rate of prostate biopsy in the past 17 years.