超声引导间质性激光动力学疗法治疗肝癌新方法

超声引导间质性激光动力学疗法治疗肝癌新方法福建医学院附属二院邮政编码362000吕国荣，陈骥厦门大学抗癌研究中心曾超英，杨栋，黄萍有关超声引导间质性激光动力学疗法治疗肝癌国内外尚未见报道。本文报道11例采用该技术临床应用的经验并探讨其临床应用价值。原...福建省85攻关项

Long-term Follow-up Results of 70 Liver Cancer Cases Received Ultrasound Guided Percutaneous PDT

目的　分析光动力治疗肝癌的临床表现和远期疗效 ,探讨疗效影响因素和治疗适应证 ,为临床推广应用提供参考数据。方法　肝癌患者 70例 ,其中小肝癌 2例 ,大肝癌 6 8例。均经B超、CT定位 ,甲胎蛋白 (AFP)定量 ,病理组织学确诊。治疗前 48h ,患者行血卟啉衍生物 (HpD)皮试 ,阴性者按每公斤体重 5mg静脉给药。治疗时 ,在B超引导下 ,用 18G肝穿针经皮穿刺将石英光纤引导入肝肿瘤内进行光辐照。激光器为氩离子激光泵浦染料激光器系统 ,激光波长 6 30nm ,光纤末端为 1cm长柱状弥散头 ,输出功率 30 0～ 35 0mW ,每一照射点能量累积约 2 2 0J,肿瘤内实行多点照射。治疗后 1周 ,检查血常规、肝功能、AFP及B超 ,一个月后 ,行肝穿活检。多次治疗间歇时间为 1个月。结果　 70例肝癌行 170次治疗 ,其中接受 1次治疗 30例 ,多次治疗 40例。 1次治疗组 1年生存率 10 % ,无生存 2年者 ;2次治疗组 1年生存率 5 0 % ,2年以上生存率 8% ;3次以上治疗组 1年生存率 82 % ,2年生存率 5 0 % ,3年生存率 32 % ,其中 3例存活5年以上。全组只有 18%的患者出现治疗后短期内一过性ALT、AST轻度升高 (<5 0U)和TBIL轻度升高 ,余未见明显异常。随访患者 1～ 5年 ,未见肝功能远期受损。病人接受治疗后 ,只有 17%出现低热 3～ 4天 ,30 %的Objective To investigate the long-term follow-up results of ultrasound-guided percutaneous PDT for liver cancer and to evaluate the efficacy and safety of this technique. Methods 70 patients with liver cancers, including 2 small tumors and 68 large tumors, were examined by ultrasound, CT, AFP assay, and diagnosed by histopatholopy of needle biopsy. The patients received injection of hematoporphyrin derivative(HPD) i.v. in a dose of 5 mg/kg body weight 48 h prior to laser irradiation. An argon laser pumped dye laser system was used to give a CW laser beam at 630 nm. The light beam was split and coupled into three optical fibers. An ultrasound-guided percutaneous liver puncture was performed and optical fibers were inserted into the tumors via 18G needles. Efforts were made to ensure that irradiation points were distributed in entire tumor volume and a light output of 300～350 mW for 12 minutes per point was used. The patients were examined with routine blood test, liver functions, AFP assay and USG at one week after treatment. A month later they were reexamined by needle biopsy and received next PDT treatment. Results Total 170 treatments were performed in the 70 patients. Among them 30 cases were treated for only once, 12 cases twice, 12 cases 3 times, and 16 cases 4 times or more. All 70 cases were followed up for 1-5 years. The results showed that multiple treatment is more effective than single treatment. The 1-, 2-and 3-years survival rate was 10%, 0, 0 in the group by single treatment, respectively, 50%, 8% and 8% in the group treated twice, and 82%, 50% and 30% in the group treated by 3 or more time, respectively. Three patients from the last group have already been surviving for longer than 5 years. Slight increase of ALT, AST and total bilirubin occurred in only 18%, and mild fever occurred in 17% of the 70 cases for 3-4 days shortly after PDT treatment. No severe complications due to PDT such as severe hemorrhage after liver puncture, hepatic failure, biliary peritonitis or long-lasting liver dysfunctions were observed in our group. Conclusions Photodynamic therapy is effective and safe for the treatment of liver cancers including those following hepatic resection or those failed after embolic chemotherapy by hepatic artery infusion. However, we would suggest that single PDT treatment is not enough and repeated PDT treatments are recommended in order to obtain a significant therapeutic effect to patients with large liver cancers.福建省“95”重点科技项

Ultrasound Guided Percutaneous PDT For Advanced Liver Cancer A Report of 30 Cases

为探讨治疗中晚期肝癌的理想方法，扩大和发展光动力疗法，自1994年6月起，我们应用光动力疗法（PdT）治疗中晚期肝癌30例，其中肝细胞癌28例、腺癌2例。肿瘤直径7~10CM的13例、10CM以上至16CM的17例。伴肺转移5例、骨转移5例、门静脉或腔静脉浸润4例。首次治疗19例、其他方法治疗无效或复发者11例。本研究采用氩激光泵浦染料激光器系统，获得630nM波长的连续波治疗光。光敏剂选用血卟啉衍生物（HPd）。治疗时通过b超引导经皮肝穿，将光纤导入肿瘤组织中布点照射。治疗后未见肝功能明显损伤，未出现肝穿出血、腹膜炎等严重并发症，没有一个月内病情恶化者。有14例患者只作一次治疗，其中5例出院后失访；另9例肿瘤部分缓解率为22%。16例患者接受二、三次治疗，肿瘤部分缓解率达到62%。随访病例中有8例已存活1年以上。patients with advanced liver cancer were treated by interstitial photodynamic therapy (PDT).These included 28 hepatocellular carcinoma and two adenocarcinoma, 19 primary tumors and 11 recurred Following other treatments.The diameter of tumors were 7 10 cm in 13 cases and 10 16 cm in 17 cases.In this study, an argon laser pumped dye laser system was used to give a CW laser beam at 630 nm which was split and coupled into three optical Fibers.The patients received injection of photosensitizer of hematoporphyrin derivative (HpD) i.v.at a dose of 5 mg/kg body weight 48 h prior to laser irradiation.Then the Fibers were inserted into tumor by ultrasonic visualization guided percutaneous liver puncture.The inserted irradiation points were spaced in entire tumor volume and the tumor was irradiated with a light output power of 300 mW For 12 minuts per point.Totally 52 treatments were perFormed in 30 patients.Among them, 14 cases were treated by only one time and 16 cases 2 or 3 times.The Follow up were carried out in 25 cases For 3 18 months.The results show that signiFicant remission was 22% (2/9) in those patients by only one treatment and 62% (10/16) in those by 2 or 3 treatments.The reduction rate of tumor size was over 90% in Five out of six cases aFter 3 treatments.8 patients have been surviving over one year.No obvious change was Found in all patients examined by liver Function test, renal Function test and blood routine examination.The level of AFP depicted a descending tendency aFter PDT.Our Findings indicate that PDT is eFFective and saFe For the treatment of large liver cancers including those recurred Following hepatic resection and those Failed in hepatic artery inFusion embolic chemotherapy.福建省“八五”攻关资

原位多聚酶链式反应（InSituPCR）技术的应用和发展

原位PCR 是一项新的分子技术, 它结合了原位杂交技术和PCR 技术的优点, 具有高度的 敏感性、特异性, 并能进行精确的定位, 在研究工作和临床诊断上有广阔的应用前景。本文论述了 原位PCR 的原理、方法、应用、技术要点及常见错误的赝象的排除, 以期对原位PCR 的应用提供一 点参考

CO_2硬化水玻璃改性新方法的研究

针对目前水玻璃砂应用中存在的缺陷，本交通过大量实验，找到了一种新型的复合改性剂．该改性方法不仅工艺简单，而且可使水玻璃加入量降到3．5％，此时，即=0．52MPa、24h=2．39MPa，比未改性的提高117％，残＜0．40MPa．具有优良的工艺性能

Prokaryotic Expression and mRNA Expression Analysis of Epidermal Growth Factor Receptor During Attachment and Metamorphosis from Crassostrea gigas angulata

扩增僧帽牡蛎(CrASSOSTrEA gIgAS AngulATA)的表皮生长因子受体(EPIdErMAl grOWTH fACTOr rECEPTOr,Egfr)基因,并与PET32A(+)载体连接,构建PET32A(+)/Egfr重组质粒.将重组质粒导入大肠杆菌(ESCHErICHIA COlI)bl21(dE3),成功地表达并纯化了一个50ku的重组蛋白.采用rT-PCr技术,检测了僧帽牡蛎幼体附着变态前后Egfr基因表达量的变化,结果表明,Egfr基因在附着变态前的浮游幼体阶段和附着变态24H后的稚贝阶段低表达,附着后1~6H强烈表达,这预示着Egfr基因在僧帽牡蛎幼体附着变态这一生物学过程中具有重要作用.Most benthic marine invertebrates have pelagic larvae that develop to competent stage and then settle on the bottom in response to physical,biological and chemical factors.Many previous investigators focused on exploring the inductive effects of chemical cues on larval settlement and metamorphosis.In this study,a ORF of epidermal growth factor receptor(EGFR) was amplified from sengmao oyster,Crassostrea gigas angulata and the target gene was cloned into prokaryotic expressing vector,pET-32a.After transformation,a soluble protein fused with a hexahistidine affinity ligand was expressed in E.coli BL21(DE3).The 50 ku recombinant protein was highly purified using affinity chromatography.As demonstrated by RT-PCR,EGFR was strongly expressed after 1 to 6 h of attachment of sengmao oyster larvae and weekly expressed before attachment and after 24 h of metamorphosis.And the result of RT-PCR indicated that EGFR played an important role during attachment and metamorphosis of sengmao oyster larvae.国家重点基础研究发展计划(973)项目(2010CB126403