磁共振弥散加权成像在直肠癌淋巴结转移评估中的价值综述

随着生活水平的提高,直肠癌在我国的发病率明显提高[1],随之而来的是对诊疗水平要求的提升。据国内外多项研究表明,直肠癌患者是否伴淋巴结转移,是否进行术前辅助放化疗、手术方式及范围的选择,是否进行术后放疗,局部复发率以及远端转移率等密切相关,是一项重要的影响预后的因素[2]。而常规的成像方式对淋巴结状态的评估差强人意[3]。目前磁共振成像在直肠癌的淋巴结状态判断方面日益受到重视。本文就其在直肠癌淋巴结转移中应用及展望进行综述。     

权力的空间意象——《癌症楼》的新文化地理解读

近年来,新文化地理学逐渐被中国人文地理学者所关注,空间与权力的关系受到关注,并产生跨学科效应。国内对此的研究多集中于现实空间层面,尚未重视文本的空间意象。从地理学的空间尺度入手,运用文本解构法,从宏观和微观拆解经典文本《癌症楼》中的空间-权力互动机制。宏观尺度的不同空间有其权力象征,集中反映出中心与边缘的对立,并形成时空交错的社会关系;微观尺度空间既以显性和隐性的方式彰显强大的权力对社会空间的控制,也存在对应的反抗空间以及微渺的自由与希望空间。《癌症楼》透射出对以所谓崇高目的为外表的强权的批判,空间既是这种权力生发的工具,同时也驱动了规训与反抗的过程。     

国医大师潘敏求治疗胃癌用药规律分析

目的：探讨国医大师潘敏求教授治疗胃癌的用药规律。方法：收集整理潘教授治疗胃癌的医案,采用古今医案云平台（V2.3.5）进行证型、证素、药物及组方规律等数据挖掘,归纳总结其辨治规律。结果：纳入的123则病案共涉及13种证型,拆分后得到实性病机证素6个,虚性病机证素4个,病位证素 4个,病机证素以气郁、气虚为主,病位证素以胃脘、脾为主。200首方剂中,共包含中药142味,多药性平、温,药味甘、苦、辛,归脾、肺、肝经;通过药物关联分析得到17对关联药物,通过聚类分析得到4类核心药物组合,通过复杂网络分析得到由甘草、白术、茯苓、黄芪等12味药物组成的治疗胃癌核心药物网络。结论：潘敏求教授认为胃癌病机为脾胃虚弱,临证组方注重健脾益气、疏肝理气、清热解毒等药物的运用,擅长攻补兼施,在临床上取得较好的疗效。     

BOOK REVIEWS

Book Reviewed in this article: Geography and the Third World. International Seminar, 14–18 May 1980, Kuala Lumpur, Malaysia . Ishmail Ahmad and Jamaluddin Md Jahi, eds. The Growth Dilemma: Residents' Views and Local Population Change in the United States . Mark Baldassare. Sport and Place: A Geography of Sport in England, Scotland & Wales . John Bale. The Deindustrialization of America: Plant Closings, Community Abandonment, and the Dismantling of Basic Industry . Barry Bluestone and Bennett Harrison. Selected Essays 1963–1975: Carl O. Sauer . Bob Callahen, ed. Housing and Planning in the Countryside . G. Clark. Conflict, Politics and the Urban Scene . Kevin R. Cox and R. J. Johnston, eds. Thematic Maps: Their Design and Production . David J. Cuff and Mark T. Mattson. Wine: A Geographic Appreciation . Harm Jan de Blij. USSR in Maps . J. C. Dewdney. Political Geography: A Contemporary Perspective . Ramesh D. Dikshit. Rethinking Human Adaptation . Rada Dyson-Hudson and Michael A. Little, eds. Sacred Sands: The Struggle for Community in the indiana Dunes . J. Ronald Engel. Geography of the Biosphere . A. Furley and Walter W. Newey. Disaster and Reconstruction . Robert Geipel. Glasgow: The Making of a City . Andrew Gibb. Design for Arid Regions . Giden S. Golany, ed. Urbanization and Cancer Mortality: The United States Experience, 1950–1975 . Michael R. Greenberg. Geology in the Nineteenth Century: Changing Views of a Changing World . Mott T. Greene. Colonización y Destrucción de Bosques en Panamá . Stanley Heckadon Moreno and Alberto McKay, eds. Urban Geography: A First Approach . David T. Herbert and Colin J. Thomas. The Visual and Spatial Structure of Landscapes . Tadahiko Higuchi. Climate from Tree Rings . M. K. Hughes, P. M. Kelly, J. R. Pilcher, and V. C. LaMarche, Jr., eds. The structure of Nineteenth Century Cities . James H. Johnson and Colin G. Pooley, eds. The American Planner: Biographies and Recollections . Donald A. Krueckeberg, ed. Urban Land Policy For the 1980s, the Message for State and Local Government . George Lefcoe, ed. Regional Planning: Evolution, Crisis and Prospects . Gill C. Lim, ed. Relevance and Ethics In Geography . Bruce Mitchell and Dianne Draper. China: The Geography of Development and Modernization . Clifton W. Pannell and Laurence J. C. MA. The Urban Retailing System . Robert B. Potter. Hants. Nonconventional Energy Resources . Philip R. Pryde. Caribbean Migrants: Environment and Human Survival on St. Kitts and Nevis . Bonham C. Richardson. Population and Resources . Harry Robinson. East Los Angeles: History of A Barrio . Ricardo Romo. Integrated Impact Assessment . Frederick A. Rossini and Alan L. Porter, eds. Environmental Aesthetics: Essays in Interpretation . Barry Sadler and Allen Carlson, eds. Earthwatch . Charles Sheffield. Field Techniques and Research Methods in Geography . Robert H. Stoddard. Haiti: Land of Poverty . Robert J. Tata. Weathering and Erosion: Sources and Methods in Geography . Stephen T. Trudgill. Once Beneath the Forest. Prehistoric Terracing in the Río Bec Region of the Maya Lowlands . B. L. Turner, II. The Historical Geography of Scotland since 1707 . David Turnock.     

海洋生物提取物“KEMH”研究──对57例体外培养不同人癌细胞的杀伤作用

报导一种海洋生物提取物“ＫＥＭＨ”对５７例体外培养的不同人癌细胞杀伤作用的实验。结果表明：“ＫＥＭＨ”对体外培养的人癌细胞有很强的杀伤作用,癌细胞对“ＫＥＭＨ”的敏感度总有效率达５５．４％。本文以１０例以上者按不同癌细胞对“ＫＥＭＨ”的敏感度进行分组统计,指出“ＫＥＭＨ”对肺癌细胞的杀伤率最高,为９４％;对乳癌细胞为６８％;对胃癌细胞为５３．１％．与对照组比较,Ｐ值差异性显著。与常规较有效的抗癌药环磷酰胺,盐酸阿霉素等五种药物比较,“ＫＥＭＨ”比这五种药物对癌细胞具较高的杀伤作用。     

四川省盐亭县食管癌高发与环境地球化学关系

四川省盐亭县是中国著名的食管癌高发区。临床医学对癌变组织、血液等人体组织的研究发现Mn、Mo、Se和Zn 4种元素的缺乏与食管癌关系最为密切。为了探讨食管癌与饮食等环境因素的关系,选择发病率有明显差异的盐亭县高发村和低发村,分别采集分析蔬菜、粮食、土壤等环境介质中微量元素含量,并估算了盐亭县居民Mn、Mo、Se和Zn的日摄入量。结果表明:盐亭县居民Mn和Mo的日摄入量适宜,Se和Zn的日摄入量偏低。但由于食管癌高发村、低发村居民日摄入量没有显著差别,因此,造成研究区食管癌高发的确切原因还有待于进一步研究。     

两种卵巢肿瘤中砂粒体的矿物学研究

砂粒体是病理诊断中常见的钙化形式,与肿瘤关系密切。选取具有砂粒体矿化物的6例卵巢浆液癌和2例成熟性囊性畸胎瘤样品,采用POM、ESEM、EDX、TEM、μ SRXRD和μ SRXRF等研究方法,对原位和分离处理后的砂粒体进行了观察测试。结果表明,两种卵巢肿瘤中的砂粒体由粒状和短柱状矿物分层集合而成,其形成与胶原纤维关系密切。卵巢浆液癌和畸胎瘤中的砂粒体最大直径分别为35 μm、70 μm,主要矿物成分分别为碳羟磷灰石Ca5［PO4,CO3］3(OH)、羟基磷灰石Ca5(PO4)3(OH)。砂粒体中还含有Na、Mg、Zn、Fe、Sr、Cu等微量元素,Zn可替代Ca进入矿物晶格。     

基于网络药理学探讨益气复元汤治疗肺癌的作用机制

目的：基于网络药理学方法探讨益气复元汤治疗肺癌的作用机制。方法：通过TCMSP平台筛选出益气复元汤的主要药物成分,通过GeneCard、OMIM、TTD数据库检索肺癌疾病靶点,使用软件Cytoscape 3.8.2建立蛋白质-蛋白质相互作用（PPI）网络,基于DAVID数据库对核心靶点进行基因本体（GO）功能与京都基因与基因组百科全书（KEGG）通路富集分析。结果：共获得益气复元汤主要活性成分131种,潜在靶点273个,肺癌相关疾病靶点13215个,药物-疾病靶点256个。PPI网络显示主要靶点有雌激素受体1、丝氨酸/苏氨酸蛋白激酶1、肿瘤坏死因子、白细胞介素6、丝裂原活化蛋白激酶1、肿瘤相关蛋白53、丝裂原活化蛋白激酶3等。GO功能主要包括药物反应、细胞缺氧反应、细胞外空隙、细胞溶质、酶结合、药物结合、蛋白结合等。KEGG通路主要有信号转导、肿瘤及癌症的特定类型、病毒相关通路等。预测丝裂原活化蛋白激酶3为益气复元汤治疗肺癌的主要靶点。结论：益气复元汤治疗肺癌具有多成分、多靶点、多通路的作用机制,其主要作用成分可能为槲皮素,作用机制可能与信号转导、肿瘤及癌症的特定类型、缺氧诱导因子-1信号通路、肿瘤坏死因子信号通路密切相关。     

Evaluating the uncertainty caused by Post Office Box addresses in environmental health studies: A restricted Monte Carlo approach

A Monte Carlo approach is used to evaluate the uncertainty caused by incorporating Post Office Box (PO Box) addresses in point‐cluster detection for an environmental‐health study. Placing PO Box addresses at the centroids of postcode polygons in conventional geocoding can introduce significant error into a cluster analysis of the point data generated from them. In the restricted Monte Carlo method I presented in this paper, an address that cannot be matched to a precise location is assigned a random location within the smallest polygon believed to contain that address. These random locations are then combined with the locations of precisely matched addresses, and the resulting dataset is used for performing cluster analysis. After repeating this randomization‐and‐analysis process many times, one can use the variance in the calculated cluster evaluation statistics to estimate the uncertainty caused by the addresses that cannot be precisely matched. This method maximizes the use of the available spatial information, while also providing a quantitative estimate of the uncertainty in that utilization. The method is applied to lung‐cancer data from Grafton County, New Hampshire, USA, in which the PO Box addresses account for more than half of the address dataset. The results show that less than 50% of the detected cluster area can be considered to have high certainty.     

应用地理信息系统探测消化道癌症死亡率空间聚集性

根据研究区分村4种消化道癌症死亡监测数据和人口数据,描述癌症死亡率的空间分布规律,探测病例在空间上存在的聚集性热点,为进一步开展环境和人群监测提供参考依据。本研究采用基本的图层Voronoi处理技术以及全局空间自相关和空间热点探测的方法,通过绘制空间自相关系数图,描述不同空间尺度与消化道癌症死亡率自相关系数之间的关系。结合空间探测技术和癌症死亡率分布特点,确定空间探测的合理参数,应用地理信息系统,对消化道癌症在研究区的空间聚集热点进行探测。结果发现,研究区在4300m尺度存在有意义的显著空间正自相关,探测到3个消化道癌症高值聚集区,共58个村,每个聚集区平均人口在3万左右。3个聚集区癌症粗死亡率明显高于非聚集区和该县平均粗死亡率。空间热点的探测与分析,引入空间权重矩阵的概念,弥补传统统计学缺乏空间信息和空间关联的缺陷,为引起消化道癌症高发的危险因素探寻提供线索,是传统统计学的必要补充。