乳癌根治术后血清瘤的防治

目的 探讨乳癌根治术后血清瘤的防治措施。方法 将近 5年改进方法乳癌根治术 1 0 0例 ,与过去 1 5年乳癌根治术 2 36例术后发生的血清瘤进行对比研究。结果 乳癌根治术后血清瘤的发生率由1 7.0 %下降至 3 .0 % (P <0 .0 5)。 43例血清瘤均发生在胸壁凹陷区 (腋窝、胸骨旁、锁骨下、肋间 ) ;液体成分检验与血液淋巴液成分基本一致 ,未见恶性细胞。发生原因主要为引流不当或不畅 ,包扎不当或过早松动者。经 1～ 3次穿刺抽液加压包扎治愈者占 95 .4 % ,仅 2 .3 %需切开引流治愈。结论 乳癌根治术后血清瘤的发生与胸壁凹陷、皮瓣张力高、血液及淋巴液渗漏、引流不当或不畅、包扎不当或过早松动有关 ,术中仔细止血 ,结扎相关淋巴管 ,多根多部位负压引流 ,凹陷区纱垫加压包扎是关键性预防措施 ;反复多次穿刺抽液加压包扎 ,必要时切开引流是主要治疗方法。

105例非霍奇金淋巴瘤患者血清乳酸脱氢酶的变化及临床意义

目的 探讨血清乳酸脱氢酶 (L DH)与非霍奇金淋巴瘤 (NHL )分期、组织学分型、治疗及预后的关系。方法 检测 10 5例非霍奇金淋巴瘤患者血清 L DH水平。结果 治疗前早期患者血清 L DH增高为 32 .5 % (14/ 43) ,中、晚期患者 L DH增高为 6 4.5 % (40 / 6 2 ) ,以中、晚期患者 L DH增高较为普遍 (P<0 .0 5 )。低度恶性与中度恶性NHL的 L DH水平差异不明显 (P>0 .0 5 ) ,而高度恶性与中度恶性及高度恶性与低度恶性 NHL的 L DH值差异有显著性 (P<0 .0 5 )。结论 血清 L DH水平与 NHL分期、组织学分型及生存期有关 ,与治疗无关 ,病情越晚 ,L DH越高 ,肝、脾受侵的可能性越大 ,生存期越短。提示 L DH可作为预测 NHL分期及生存期的指标。

血清抑瘤素M、腱糖蛋白-C水平与2型糖尿病合并急性冠脉综合征的关系研究

目的探讨血清抑瘤素M(OSM)、腱糖蛋白-C(TN-C)水平与2型糖尿病(T2DM)合并急性冠脉综合征(ACS)的关系。方法选取该院2018年6月至2020年6月收治的80例T2DM合并ACS患者作为合并组,纳入同期收治的单纯T2DM、ACS患者各60例作为T2DM组、ACS组。比较3组血清OSM、TN-C水平及空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)水平,分析T2DM合并ACS患者血清OSM、TN-C水平与其他检测指标的相关性,经Logistic多元回归模型分析T2DM患者发生ACS的危险因素。结果合并组血清OSM、TN-C水平及TC、LDL-C、CK、CK-MB、cTnI高于T2DM组、ACS组,合并组FPG、HbA1c、FINS、HOMA-IR、Gensini积分高于ACS组,差异有统计学意义(P<0.05)。合并组血清OSM、TN-C水平与TC、LDL-C、CK、CK-MB、cTnI、Gensini积分呈正相关(P<0.05)。Logistic多因素回归分析显示,高血压病史、TC≥3.55 mmol/L、LDL-C≥2.21 mmol/L、CK≥179.88 U/L、CK-MB≥47.12 U/L、cTnI≥1.25μg/L、OSM≥26.52 pg/mL、TN-C≥10.92 ng/mL是T2DM患者发生ACS的危险因素(P<0.05)。结论T2DM合并ACS患者的血清OSM、TN-C水平明显升高,二者是T2DM发生ACS的独立危险因素,OSM、TN-C可作为评估T2DM合并ACS病情进展的辅助指标。

脑出血患者血清B淋巴细胞瘤-2水平与功能预后的相关性

目的探讨脑出血患者血清B淋巴细胞瘤-2(Bcl-2)水平与功能预后的相关性。方法选取2018年10月至2021年3月四川省广元市中心医院收治的脑出血患者216例,随访3个月,观察患者功能预后情况,根据改良版Rankin量表(mRS)评分分为预后良好组(mRS<2分)和预后不良组(mRS≥2分)。收集两组一般资料、实验室指标、血清Bcl-2水平等,采用多因素Logistic回归分析影响脑出血患者功能预后的相关因素,采用限制性立方条图拟合血清Bcl-2水平与脑出血患者功能预后间的非线性关系。结果截止2021年6月1日,预后不良组78例(36.11%),预后良好组138例(63.89%)。两组入院时收缩压、中线移位、超敏C-反应蛋白(hs-CRP)、超敏心肌肌钙蛋白(hs-cTn)、美国国立卫生研究院卒中量表(NIHSS)、Bcl-2水平对比差异具有统计学意义(t=2.048、12.282、5.971、6.120、5.183、4.837,P<0.05);多因素Logistic回归分析显示:中线移位、hs-cTn、NIHSS评分、hs-CRP、Bcl-2水平为脑出血患者功能预后的危险因素[OR(95%CI)=31.846(11.913~85.134)、1.149(1.038~1.270)、1.160(1.026~1.312)、1.156(1.028~1.299)、1.160(1.065~1.265),P<0.05];限制性立方条图显示,血清Bcl-2水平与脑出血患者功能预后风险呈显著非线性关系(χ^(2)=11.950,P<0.05)。结论血清Bcl-2水平与脑出血患者功能预后相关。

消瘤汤含药血清干扰细胞生长作用浓度的实验研究

目的:从细胞和分子水平探讨消瘤汤抑瘤机理并选择最佳含药血清浓度。方法:借鉴西药单体加药浓度梯度方法来确定用于干扰细胞生长的含药血清浓度梯度,消瘤汤高、中、低剂量含药血清12.5%、25%、50%浓度,作用于培养的人肝癌细胞Bel-7402 48h、96h。通过MTT法检测消瘤汤含药血清对人肝癌细胞Bel-7402增殖的影响,用于最佳含药血清浓度的筛选。结果:从不同含药血清浓度、不同作用时间下细胞生长OD值来分析:25%含药血清干扰96h对细胞生长抑制效果最好。结论:25%含药血清干扰96h可作为后期药物实验的含药血清加药浓度及观察时间筛选的实验依据。

血清microRNA在多形性胶质母细胞瘤术预后评估中的研究

目的:筛选多形性胶质母细胞瘤(glioblastoma multiform,GBM)患者术前、术后血清中差异表达的micro RNAs(miRNAs),并探讨差异表达的miRNAs与患者术后预后的相关性。方法:收集2006年1月至2009年6月48例北京天坛医院经临床病理诊断为GBM患者的术前术后血清样本。采用Solexa测序的方法初步筛选出术前术后表达量有差异的miRNA,用实时荧光定量PCR(quantitative real-time PCR,RT-q PCR)的方法对每个样本进行逐一验证,应用t检验的方法筛选出满足条件的miRNA(两组之间的平均值差异在2倍以上,且P<0.05),对48例患者进行随访,统计生存时间,根据48例患者中位生存时间494 d,将所有标本分为长生存期组和短生存期组,应用Kaplan-Meier法和Log-rank检验,研究患者术后血清miRNAs的表达量与患者生存时间之间是否存在统计学意义的相关性。结果:Solexa结果显示,有63个miRNA表达量存在差异,基于本研究先前的研究成果和其他文献的报道,从中选出4个miRNA(miR-26b,miR-30e,miR-129-3p,miR-206)进行逐一验证并进行统计学分析,结果只有1个miRNAs(miR-30e)在术后患者血清中的表达水平有明显上调现象(术前与术后表达水平平均值差异≥2倍且P<0.05),随访结果显示,生存时间>494 d,患者术后血清miR-30e的表达水平有降低的趋势(P<0.05),但生存分析显示,患者术后血清中miR-30e的表达量与患者总生存时间之间差异无统计学意义(P=0.101)。结论:GBM患者术前术后血清中差异表达的miRNA只有miR-30e,且术后患者血清中的miR-30e水平与肿瘤负荷成负相关关系。生存分析结果显示,术后患者血清miR-30e的表达水平与患者的预后没有明显的相关性。

莪芪抗瘤方剂对白血病HL-60细胞的凋亡作用及对细胞内Ca^(2+)水平的影响

目的:研究中药复方莪芪抗瘤方剂在体外对白血病HL-60细胞凋亡作用,并探讨凋亡发生与细胞内Ca2+浓度变化的关系。方法:通过血清药理学方法,选择10%浓度的含药血清与白血病HL-60细胞共同培育24,48,72,96 h后,应用荧光显微镜观察细胞形态,流式细胞仪检测凋亡峰(亚二倍体峰),用Fura-2/AM荧光负载方法测定细胞内Ca2+浓度的变化。结果:10%浓度的含药血清处理组,细胞体积缩小,细胞核固缩,膜起泡,核断裂及形成凋亡小体等,以72 h最为明显;可见DNA含量低于G1期的凋亡细胞群,其凋亡百分率随时间的递增而增加;10%浓度的含药血清处理组的细胞内Ca2+浓度也明显高于对照组(P<0.01)。结论:莪芪抗瘤方剂含药血清诱导白血病HL-60细胞发生凋亡的作用可能与细胞内Ca2+水平上调有关。

肺瘤平膏含药血清对巨噬细胞共培养条件下A549细胞EMT相关mRNA及蛋白表达的影响

目的观察肺瘤平膏含药血清对A549细胞与巨噬细胞共培养条件下上皮间质转化(epithelialmesenchymal transition,EMT)相关mRNA及蛋白表达的影响。方法制备肺瘤平膏含药血清,建立A549细胞与巨噬细胞的共培养体系,将细胞分为A549加空白血清组(A549+NRS组)、共培养加空白血清组(共培养+NRS组)及共培养加肺瘤平膏含药血清组(共培养+FLP组)。采用荧光定量PCR、免疫荧光法比较各组A549细胞EMT相关基因(SNAIL1、SNAIL2、ZEB1、CDH1、CDH2、VIM、TJP1、CLDN1、CTNNB1、FLRT1)及E-cadherin、N-cadherin、ZO-1、Vimentin蛋白表达水平的影响。结果共培养条件下,A549细胞变为间充质细胞样。加入肺瘤平膏含药血清后,部分A549细胞形态恢复为上皮细胞样。与A549+NRS组比较,共培养+NRS组A549细胞SNAIL1、ZEB1、CTNNB1、FLRT1、CDH2、VIM mRNA表达上调,TJP1 mRNA表达下调(均P<0.05);与共培养+NRS组比较,共培养+FLP组SNAIL2、TJP1、CLDN1、CDH1、VIM mRNA表达上调,CTNNB1、FLRT1及CDH2 mRNA表达下调(均P<0.05)。免疫荧光结果显示,E-cadherin表达于细胞膜和胞浆内,以细胞膜为主;N-cadherin表达于细胞膜和胞浆内,以细胞浆为主;Vimentin表达于胞浆内;ZO-1表达于细胞连接处为主,部分细胞膜染色亦呈阳性。与A549+NRS组比较,共培养+NRS组A549细胞E-cadherin蛋白表达下调,N-cadherin及Vimentin蛋白表达上调(P<0.05);肺瘤平膏含药血清可上调E-cadherin表达,下调N-cadherin及Vimentin蛋白表达(均P<0.05)。结论肺瘤平膏可抑制共培养条件下A549细胞EMT的形成。

Serum tumor markers for detection of hepatocellular carcinoma

Hepatocellular carcinoma （HCC） is one of the most frequent malignant tumors and is the second most common cause of cancer death in China. Therefore, it is very important to detect this disease and the recurrence at its earlier period. Serum tumor markers, as the effective method for detecting hepatocellular carcinoma for a long time, could be divided into 4 categories： oncofetal antigens and glycoprotein antigens; enzymes and isoenzymes; genes; and cytokines. Serum alpha fetoprotein （AFP） is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis. However, it has been indicated that AFP-L3 and DCP excel AFP in differentiating hepatocellular carcinoma from nonmalignant hepatopathy and detecting small hepatocellular carcinoma. Some tumor markers, such as human cervical cancer oncogene and human telomerase reverse transcriptase mRNA, have also been indicated to have higher accuracies than AFP. Furthermore, some other tumor markers, such as glypican-3, gamma-glutamyl transferase Ⅱ, alpha-Ifucosidase, transforming growth factor-beta1, tumorspecific growth factor, have been indicated to be available supplementaries to AFP in the detection. AFP mRNA has been shown to correlate with the metastasis and recurrence of HCC, and it may be the most useful marker to prefigure the prognosis. Some other markers, such as gamma-glutamyl transferase mRNA, vascular endothelial growth factor, and interleukin-8, could also be used as available prognostic indicators, and the simultaneous determination of AFP and these markers may detect the recurrence of HCC at its earlier period.

参芪抑瘤方含药血清对BGC-823胃癌细胞增殖和周期的影响

目的：探讨参芪抑瘤方含药血清对胃癌细胞BGC-823增殖和周期的影响,并探讨其作用机制。方法：以参芪抑瘤方3%,5%,10%含药血清干预BGC-823细胞后,采用3-（4,5-二甲基噻唑-2）-2,5-二苯基四氮唑溴盐法检测其对细胞增殖的影响;采用流式细胞仪检测细胞周期变化;采用实时荧光定量PCR（Real-time PCR）检测细胞周期蛋白依赖性激酶（cyclindependent kinase inhibitor,CDKN）1B,CDKN1C mRNA表达;蛋白免疫印迹法（Western blot）检测p27,p57蛋白表达情况。结果：不同浓度含药血清作用于BGC-823细胞24,48,72 h后,细胞存活率显著降低（P〈0.01）,且与时间和浓度呈依赖关系;不同浓度含药血清作用于BGC-823细胞24 h后,G0/G1期细胞增多,S期细胞减少;Real-time PCR结果表明,与溶剂组和空白血清组比较,参芪抑瘤方各组CDKN1B,CDKN1C mRNA表达上调（P〈0.05,P〈0.01）;Western blot结果显示,与溶剂组比较,参芪抑瘤方各组p27,p57蛋白表达上调（P〈0.05,P〈0.01）。结论：参芪抑瘤方含药血清可以抑制胃癌BGC-823细胞的增殖,其机制可能通过调节CDKN1B,CDKN1C mRNA及p27,p57蛋白表达,进而干预细胞周期有关。

Effects of“Moxibustion Serum”on Proliferation and Phenotypes of Tumor Infiltrating Lymphocytes

Tumor infiltrating lymphocytes (TIL) were cultured with “moxibustion serum”(MS), and the results were examined by flow cytometry. The results indicated that MS could enhance the proliferation of TIL,accelerate it to reach the exponential growth phase, and assist recombinant interleukin 2 (rIL-2) to enhance successively the percentage of CD3^+ positive cells, maintain the number of CD4^+ positive T cells, promote greatly the percentage of CD8^+ positive T cells among TILs, and reverse the CD4^+/CD8^+ ratio. Such cooperative effects rely on relative specificity of acupoints. It is suggested that MS is beneficial to the growth of TIL both in the aspects of proliferation and phenotypes.

Measurement of Serum Total and Free Prostate-Specific Antigen for Breast Cancer Diagnosis in Women

Objective: To investigate the diagnostic value and the relationship between the clinicopathological features and the levels of total and free prostate-specific antigen (PSA) in women with breast cancer.Methods: Using the microparticle enzyme immunoassay system, we measured the concentrations of these markers in the sera of 85 women with breast cancer and in 30 healthy women.Rseults: The lowest detection level for both markers was 0.01 ng/ml. Free PSA levels were significantly higher in women with breast cancer than that in healthy women (P<0.05). The percentage of free PSA predominant subjects was 37.6% in breast cancer patients and 3.3% in healthy women. Cut-off values were 0.36 ng/ml for total PSA and 0.02 ng/ml for free PSA. In women with breast cancer, total PSA positivity was 23.5% and free PSA positivity was 27.1%. Compared to negatives, total PSA positive patients had a higher percentage of lymph node involvement tumours (P>0.05). However, patients with predominant free PSA had a higher percentage of early stage than patients with predominant PSA-ACT.Conclusion: Although the sensitivity of free PSA predominance is low (37.6%) in distinguishing women with breast cancer from healthy women, its specificity is high (97.0%).Free PSA predominance tends to be present in early stage tumours. These findings may indicate clinical significance of preoperative measurement of serum total and free PSA in women with breast cancer.

CORRELATION BETWEEN SERUM HER-2 ONCOPROTEIN AND PATIENTS WITH BREAST CANCER

To detect serum HER-2 oncoprotein levels in patients with operable and metastatic breast cancers, and to study the correlations between serum HER-2 level and lymph node status as well as other clinical parameters. Methods A total of 120 women were studied consisting of 10 healthy volunteers, 31 benign breast disease, 53 operable breast cancer, and 26 metastatic breast cancer patients. The levels of serum HER-2 were measured using an enzyme-liked im-munosorbent assay (ELISA). Results The mean serum HER-2 levels were 9.6 ± 1.5 ng/mL in healthy volunteers, 11.9 ± 1.6 ng/mL in benign breast disease, 13.2 ± 4.2 ng/mL in operable breast cancer, and 30.5 ± 30.8 ng/mL in metastatic breast cancer patients. The former is much lower than the latter three (P = 0.02, 0.001, 0.03, respectively). If using 15 ng/mL as a normal baseline, elevated serum HER-2 levels were observed in none of the healthy volunteers as well as patients with benign disease, but in 18.9% (10/53) operable breast cancer patients and 61.5% (16/26) metastatic patients. In patients with operable breast cancer, there was a positive correlation between serum concentrations of HER-2 and the size of primary tumor (P < 0.05), whereas there was no correlation between serum concentration and axillary lymph node or estrogen receptor status. In patients with metastatic dise-ase, there was no correlation with site of metastases (P > 0.05). Conclusion Serum HER-2 level was strongly correlated with tumor loads and clinical stages, thus acting as a promising predictor of cancer recurrence in breast cancer patients.

Clinical significance of serum levels of vascular endothelial growth factor and its receptor in biliary disease and carcinoma

AIM: To investigate the clinical significance of serum vascular endothelial growth factor (VEGF) and soluble VEGF receptor-1 (VEGFRl/Flt-1) (sVEGFR1) levels in biliary diseases. METHODS: We analyzed the serum levels of these proteins in patients with acute cholangitis (group 1), biliary malignancies (group 2), and primary biliary cirrhosis or primary sclerosing cholangitis (group 3), and in healthy donors (group 4). The influence of inflammation was also analyzed. Serum VEGF levels were expressed as VEGF per platelet (VEGF/PLT, pg/106) in order to exclude the influence of platelet counts. RESULTS: sVEGFRl levels were significantly higher in groups 1 and 2 than in the control group, but did not correlate with inflammatory markers. VEGF/PLT levels were generally higher in patients with active inflammation than in those with carcinoma. C-reactive protein strongly correlated with the levels of serum VEGF independently of platelet and leukocyte counts, even in cancer patients. In cancer patients, VEGF/PLT and sVEGFRl levels might be indicators for evaluating the effect of medical treatment or the disease progression. CONCLUSION: Serum VEGF and VEGFR1 might be useful markers for gauging the clinical effect of various treatments on patients.

Gender difference in clinicopathologic features and survival of patients with hepatocellular carcinoma

AIM: To determine the influence of gender on the clinicopathologic characteristics and survival of patients with hepatocellular carcinoma (HCC). METHODS: A retrospective analysis of medical records was performed in 299 patients with HCC and their clinicopathologic features and survival were compared in relation to gender. RESULTS: There were 260 male (87%) and 39 female patients (13%),with a male-to-female ratio of 6.7:1.Female patients had lower mean serum bilirubin levels (P=0.03), lower proportion of alcohol abuse (P=0.002),smaller mean tumor size (P=0.02),more frequent nodular type but less frequent massive and diffuse types of HCC (P=0.01),were less advanced in Okuda's staging (P=0.04),and less frequently associated with venous invasion (P=0.03).The median survivals in females (14 too) were significantly longer than that of male patients (4 mo) (P=0.004,log-rank test). Multivariate analysis demonstrated that high serum alpha- fetoprotein levels,venous invasion,extrahepatic metastasis and lack of therapy were independent factors related to unfavorable prognosis.However,gender did not constitute a predictive variable associated with patient survival. CONCLUSION: Female patients tend to have higher survival rates than males.These differences were probably due to more favorable pathologic features of HCC at initial diagnosis and greater likelihood to undergo curative therapy in female patients.

Helicobacter pyloriseroprevalence in patients with lung cancer

AIM:To assess Helicobacter pylori(Hpylon)seroprevalence in a cohort of Greek patients with lung cancer. METHODS:Seventy-two lung cancer patients(55 males and 17 females,aged 58.2±11.7 years)and 68,age and gender-matched,control subjects were enrolled.All subjects underwent an enzyme-linked immunosorbent assay IgG serologic test for Hpylori diagnosis. RESULTS:A correlation between age and HpyloriIgG level was detected for both lung cancer patients(r=0.42, P=0.004)and controls(r=0.44,P=0.004).Seropositivity for Hpyloridid not differ significantly between patients with lung cancer and controls(61.1% vs 55.9%,P>0.05). Concerning the mean serum concentration of IgG antibodies against Hpylori,no significant difference between the two groups was detected(32.6±19.1 vs 27.4±18.3 U/mL, P>0.05). CONCLUSION:No significant association between Hpylori infection and lung cancer was found.

Science Letters:Serum protein fingerprinting coupled with artificial neural network distinguishes glioma from healthy population or brain benign tumor

To screen and evaluate protein biomarkers for the detection of gliomas (Astrocytoma grade Ⅰ-Ⅳ) from healthy individuals and gliomas from brain benign tumors by using surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) coupled with an artificial neural network (ANN) algorithm. SELDI-TOF-MS protein fingerprinting of serum from 105 brain tumor patients and healthy individuals, included 28 patients with glioma (Astrocytoma Ⅰ-Ⅳ), 37 patients with brain benign tumor, and 40 age-matched healthy individuals. Two thirds of the total samples of every compared pair as training set were used to set up discriminating patterns, and one third of total samples of every compared pair as test set were used to cross-validate; simultaneously, discriminate-cluster analysis derived SPSS 10.0 software was used to compare Astrocytoma grade Ⅰ-Ⅱ with grade Ⅲ-Ⅳ ones. An accuracy of 95.7%, sensitivity of 88.9%, specificity of 100%, positive predictive value of 90% and negative predictive value of 100% were obtained in a blinded test set comparing gliomas patients with healthy individuals; an accuracy of 86.4%, sensitivity of 88.9%, specificity of 84.6%, positive predictive value of 90% and negative predictive value of 85.7% were obtained when patient's gliomas was compared with benign brain tumor. Total accuracy of 85.7%, accuracy of grade Ⅰ-Ⅱ Astrocytoma was 86.7%, accuracy ofⅢ-Ⅳ Astrocytoma was 84.6% were obtained when grade Ⅰ-Ⅱ Astrocytoma was compared with grade Ⅲ-Ⅳ ones (discriminant analysis). SELDI-TOF-MS combined with bioinformatics tools, could greatly facilitate the discovery of better biomarkers. The high sensitivity and specificity achieved by the use of selected biomarkers showed great potential application for the discrimination of gliomas patients from healthy individuals and glioma from brain benign tumors.

The curative effect of zoledronic acid and pamidronic acid on treating ostealgia in malignant tumor with bone metastases and its side effects on serum calcium and phosphorus

Objective： Bisphosphonates were widely used with the rate of malignant tumor with bone metastases increasing rapidly. The aim of this study was to evaluate zoledronic acid and pamidronic acid on treating ostealgia of malignant tumor with bone metastases and serum calcium, phosphorus and alkaline phosphorus movement. Methods： One Hundred cancer patients with bone metastases were diagnosed according to pathological and imaging methods. After zoledronic acid or pamidronic acid intravenous infusion one and two months, ostealgia degree, serum calcium, serum phosphorus and alkaline phosphorus were observed before bisphosphonates treatment, one and two months after treatment, respectively. Results： Ostealgia degree did not change significantly after diphosphonates treatment from one to two months （P 〉 0.05）. The linear correlation between serum calcium and serum phosphorus on bone metastases cancer patients before therapy was dismissed after bisphosphonates treatment one month and did not recover in two months. The incidence of hypo-calcium after diphosphonate treatment one month （54%） and two months （56%） were significantly increased than that before treatment （36%） （X2 = 6.55, P = 0.011; X2 = 8.05, P = 0.005）. Serum calcium and serum phosphorus were both decreased after treatment one month （t = 4.39, P = 0.000; t = 2.50, P = 0.014） and two months （t = 4.32, P = 0.000; t = 2.49, P = 0.010）. There had no difference between zoledronic acid and pamidronic acid on treating of ostealgia and serum calcium and phosphorus changing. Conclusion： Zoledronic acid and pamidronic acid can relief ostealgia of cancer patients with bone metastases and induce hypo-calcium, break the linear relationship between calcium and phosphorus. There have no difference between zoledronic acid and pamidronic acid on treating ostealgia and inducing hypo-calcium and hypo-phosphorus.

Ecologic study of serum selenium and upper gastrointestinal cancers in Iran

AIM:Both observational and experimental studies have shown that higher selenium status reduces the risk of upper gastrointestinal cancers in selenium deficient populations. Recent cancer registry data have shown very different rates of esophageal cancer(EC)and gastric cancer(GC)in four Provinces of Iran,namely Ardabil,Mazandaran,Golestan, and Kerman.The aim of this study was to have a preliminary assessment of the hypothesis that high rates of EC in Golestan and high rates of GC in Ardabil may be partly attributable to selenium deficiency. METHODS:We measured serum selenium in 300 healthy adults from An:labil(n=100),Mazandaran(n=50),Golestan (n=100),and Kerman(n=50),using inductively coupled plasma,with dynamic reaction cell,mass spectrometry(ICP- DRC-MS)at the US Centers for Disease Control(Atlanta, Georgia). RESULTS:The median serum selenium concentrations were very different in the four Provinces.The medians(IQR)for selenium in Ardabil,Mazandarn,Golestan,and Kerman were 82(75-94),123(111-132),155(141-173),and 119 (110-128)μg/L,respectively(P<0.001).The results of linear regression showed that the Province variable,by itself, explained 76% of the variance in log selenium(r^2=0.76). The proportion of the populations with a serum selenium more than 90 μg/L(the concentration at which serum selenoproteins are saturated)was 100% in Golestan, Kerman,and Mazandaran but only 29% in Ardabil. CONCLUSION:Our findings suggest that selenium defidency is not a major contributor to the high incidence of EC seen in northeastern Iran,but it may play a role in the high incidence of GC in Ardabil Province. Nouarie M,Pourshams A,Kamangar F,Sotoudeh M,Derakhshan MH,Akbari MR,Fakheri H,Zahedi MJ,Caldwell K,Abner CC, Taylor PR,Malekzadeh R,Dawsey SM.Ecologic study of serum