脉冲电磁场对卵巢切除大鼠骨组织活化T细胞核因子2和空泡型V-ATP酶mRNA表达的影响

目的:探讨脉冲电磁场(pulsed electromagnetic fileds,PEMF)对卵巢切除(ovariectomized,OVX)大鼠骨组织细胞核因子κB受体活化因子(receptor activator of NF-κB,RANK),活化T细胞核因子2(nuclear factor of activated T2,NFAT2)和空泡型V-ATP酶(vavcuolar H+-ATPase,V-ATP)表达的影响。方法:将48只SD大鼠随机分为假手术组(SHAM),卵巢切除组(OVX),卵巢切除+脉冲电磁场治疗组(OVX+PEMF)。OVX+PEMF组大鼠在频率8Hz,磁场强度3.8m T的PEMF下每天干预40min,干预8周和16周后检测大鼠骨密度和骨组织RANK,NFAT2和V-ATP的mRNA表达水平。结果:OVX组BMD在第8周(P0.05,而SHAM组NFAT2与V-ATP表达均低于OVX组(P0.05;16周时OVX+PEMF组RANK和NFAT2表达均高于SHAM组(均P0.05。OVX组与OVX+PEMF组相比,8周时两组RANK和V-ATP表达均P>0.05,OVX+PEMF组NFAT2表达低于OVX组(P0.05,NFAT2和V-ATP在OVX+PEMF组的表达均下降(P<0.01,P<0.05)。结论:PEMF可通过下调OVX大鼠骨组织中NFAT2和V-ATPmRNA的表达从而抑制破骨细胞的骨吸收,进而延缓OVX大鼠的骨丢失。国家自然科学基金(81272168);;福建省自然科学基金(2016J01623,2017J01375);;福建省卫生计生委青年科研课题(2015-2-45

Research on T Lymphocyte Subsets and NK Cells Activity in Peripheral Blood of Hypopharyngeal Squamous Cell Carcinoma

目的:分析下咽鳞状细胞癌患者外周血T淋巴细胞亚群和NK细胞活性情况,旨在为相关研究工作提供参考资料。方法:择取2011年6月-2016年5月本院收治的95例下咽鳞状细胞癌病患为病例组,另取此期间内来本院接受健康检查的72例志愿者为正常组。使用流式细胞仪对病患开展相关检查,分析病例组与正常组的淋巴细胞亚群、NK活性情况以及不同临床分期的下咽癌病患外周血T淋巴细胞亚群以及NK细胞活性之间的关系。结果:与正常组相比,病例组的NK细胞、总B淋巴细胞、总T淋巴细胞、辅助/抑制T细胞、辅助T细胞偏低(P0.05)。Ⅰ~Ⅱ期病患辅助T淋巴细胞比Ⅲ~Ⅳ期者略高(P>0.05)。Ⅰ~Ⅱ期病患抑制T淋巴细胞值比Ⅲ~Ⅳ期者低(P0.05)。Ⅰ~Ⅱ期病患外周血NK细胞数比Ⅲ~Ⅳ期者略高(P>0.05)。结论:下咽鳞状细胞癌病患的免疫功能异常,且随着疾病的进展,细胞免疫和体液免疫均有所降低,证实免疫功能紊乱在疾病进展中发挥了一定作用。经流式细胞设备对外周静脉血淋巴细胞亚群以及NK细胞活性情况检测,可实现动态化检测癌症病患某阶段细胞免疫功能变化详情,此法方便简单,在指导治疗方案制定以及监测疾病预后方面,均体现出了一定效果,值得进一步推广

Sarcomatoid Carcinoma of Hypopharynx： A Report of 5 Cases

目的探讨下咽肉瘤样癌的临床及病理学特点,为下咽肉瘤样癌的诊治提供参考依据,提高对肉瘤样癌的诊断、治疗及其预后的认识。方法分析2010年1月—2014年9月我院治疗的5例下咽肉瘤样癌患者的临床资料,包括诊疗过程、病理特征等。结果 5例患者均经过不同的手术方式,其中咽后壁扩大切除1例,梨状窝扩大切除2例,全后、全下咽、全食管切除2例;肉瘤样癌肉瘤样成分与癌成分共存,且之间有一定的移行,CK、vimentin均表达阳性,P63阳性4例。5例患者均定期随访。结论下咽肉瘤样癌有其特殊的生物学行为及病理学特点,是一种不同于其他类型的恶性肿瘤,具有自身病理特征,预后情况各不相同,外科手术仍是首选治疗方法,术后辅助放化疗。Objective To explore the biological behavior and clinical features of the sarcomatoid carcinoma（SC） of hypopharynx for improving the diagnosis,treatment and judgment of prognosis of the tumor.Methods Clinical data,including treatment process and pathology features of the 5 cases of SC underwent operation in our department from January 2010 to September 2014 was analyzed retrospectively.Results All the five patients underwent different surgical procedures and all survived,one case received pharyngeal extended resection,tow cases received pyriform extended resection and tow cases received total throat、swallow、esophagectomy resection.The biological of sarcomatoid carcinoma of head and neck performed components and cancer components coexisted,and has a certain shift between them,CK and vimentin expressed was positive in all cases,P63 was positive in 4 cases.All patients were followed up regularly.Conclusion Sarcomatoid carcinoma of hypopharynx has its special biological behavior and pathology characteristics,it is different from other types of malignant tumors,and has its own pathological features,surgeryis is still the preferred method,postoperative assistance chemotherapy is needed

术前嗓音训练在声带息肉显微手术患者嗓音恢复中的效果观察

目的:探索术前嗓音训练对声带息肉显微手术患者嗓音恢复的作用。方法:将26例频闪喉镜下诊断为声带息肉,需行支撑喉镜下声带病损切除术的患者随机分为对照组与实验组,每组13例。对照组行手术治疗,实验组除了手术治疗外,在术前1周进行嗓音训练强化课程,对照组和实验组均采用同组人员同种方法进行手术。同时进行术前术后的频闪喉镜评估。采用Ling WAVES声学设备收集、分析同一患者术前24~48h与术后14d的声学参数值(包括不规则度、气息音、总体严重程度、频率微扰、振幅微扰)。使用SPSS 19.0软件进行分析。结果:术前实验组与对照组5项嗓音参数的组间差异无统计学意义,术后实验组气息音与频率微扰明显低于对照组,组间差异具有统计学意义;不规则度、总体严重程度、振幅微扰的组间差异无统计学意义。对照组组内术前与术后比较,患者的总体严重程度与频率微扰在术后明显好于术前,差异有统计学意义;不规则度、气息音、振幅微扰的组间差异无统计学意义。实验组组内术前与术后比较,5项嗓音参数,患者术后都明显好于术前,均差异有统计学意义。实验组和对照组术后的频闪喉镜检查均显示声带息肉切除干净,未见残留。结论:术前嗓音训练有助于显微手术后的嗓音恢复,术前嗓音训练与手术的联合干预是治疗声带息肉的有效方式。国家自然科学基金(No:81371080

One stage surgical treatment of multiple primary carcinoma of hypopharynx and esophagus

目的探讨下咽、颈胸段食管多原发癌(multiple primary carcinoma,; MPC)在胸腔镜辅助下行全喉、下咽、食管切除并管状胃重建一期手术的应用及疗效。方法胸科组行胸腔镜辅助下分离食管及纵膈淋巴结清扫后开腹行管状胃成形; ,头颈组行颈部淋巴结清扫、全喉下咽切除、咽胃吻合术。术后常规补充放化疗。结果本组全部病例均一期完成手术,肺部感染3例,胸腔积液2例、气管撕裂1例; ;无吻合口瘘及围手术期死亡病例;3年生存率63.6%,5年生存率50.0%。结论下咽癌应常规行胃镜检查以免MPC的漏诊;胸腔镜辅助下全喉、下咽、; 食管切除并管状胃重建术可一期完成以往分次手术难以完成的手术治疗,有效提高下咽颈胸段食管多重癌的治疗效果。OBJECTIVE To discuss the therapeutic effect of one stage surgical; treatment in the multiple primary hypopharyngeal and cervical thoracic; esophageal carcinoma. METHODS The thoracoscopy group: dissecting the; esophagus and mediastinal lymph node assisted with thoracoscope, and; then opened abdominal cavity to make gastric tube. Head and neck group:; doing the cervical lymph node dissection, total laryngectomy, total; hypopharyngectomy and total esophagectomy, and then anastomosis of the; pharynx with gastric tube. All cases were received conventional; radiotherapy and chemotherapy after operation. RESULTS All the cases in; this group were successfully underwent the one stage operation. The; postoperative complications were pulmonary infection in 3 cases, pleural; effusion in 2 cases and tracheal tear in one case. No anastomotic; fistula or postoperative deaths occurred. The 3 and 5 year survival; rates were 63.6% and 50.0% respectively. CONCLUSION It should take; necessary examinations of cervical thoracic esophagus to prevent missing; the multiple primary carcinoma of the hypopharyngeal carcinoma. The; total laryngectomy, total hypopharyngectomy and total esophagectomy, and; anastomosis of the pharynx with gastric tube for multiple primary; hypopharyngeal and cervical thoracic esophageal carcinoma is a feasible; and active treatment method