published_or_final_version / Pathology / Master / Master of Medical Sciences

Thesis (M. Sc.)--York University, 2003. Graduate Programme in Biology. / Typescript. Includes bibliographical references (leaves 91-105). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ82926.

研究目的：結腸癌是現今最常見的惡性腫瘤之一。在西方國家， 其發病率甚至居惡性腫瘤的第二位，在我國發病率居第四位，並且發病率在不斷攀升。在長江中下游，江淅地區，福建，香港等較為發達地區發病率較高，研究提示可能與經濟發達、生活習慣以及飲食習慣有密切關係。隨著醫療技術的進步，西醫針對結腸癌已有多種治療手段。其中，于術治療、放化療綜合治療是主要的治療手段。但在一定程度上對患者機體有一定的毒副作用，嚴重影響生活品質，並且復發和轉移率較高。研究者發現一些中藥對結腸癌細胞有抑制細胞生長、影響腫瘤細胞相關資訊表達、抑制腫瘤細胞血管生成、誘導腫瘤細胞凋亡、對信號轉導通路的影響等作用。中草藥毒副作用小，成本低廉，提高患者生活品質，降低復發和轉移率。因此，中藥對結腸癌的抑制作用有較高的研究價值。 研究方法：選取人結腸癌HCTl 16 細胞用McCoys 5A 的細胞培養液放置於37 ℃、C02 體積分數為5%的培養箱中靜置培養。研究藥物選擇首先對結腸癌進行中醫辨證，分析每種證型用藥特點。其次在中國期刊全文資料庫進行關於結腸癌文獻檢索，在檢索結果中找出辨證分析中藥物出現頻率較高的。最後，查找相關碩士、博士論文以及有關結腸癌書籍資料篩選出以下幾種進行考證對結腸癌細胞是否有抑制作用的中草藥。（土茯苓、白花蛇古草、馬齒莧、藤梨根、敗醬草、白頭翁） 。分別用DCM 以及MEOH 提取土茯苓、白花蛇古草、馬齒莧、藤梨根、敗醬草、白頭翁，將培養好的細胞種植在96 孔板上，分別加入上述藥物提取物。用SRB 法檢測細胞的增殖情況。 研究結果： 根據實驗所得數據發現， 其中茯夜苓、和敗醬草的DCM 提取液均對HCT116細胞有較強的抑制作用，白花蛇古草對此種結腸癌細胞雖有抑制細胞增殖的作用，但結果並不明顯，實驗所得結果還有待反復實驗，以及進一步探究作用機制。然而藤梨根、馬齒莧、白頭翁的DCM 提取液以及用MEOH 提取的上述藥物均對細胞HCT116 無明顯抑制作用， 考慮實驗僅對單一細胞進行，檢測藥物提取物作用於HCT116 細胞的抑制性 。因此， 本實驗僅為六種中草藥提純物對HCT l 16 細胞的抑制作用初步探究，還有待進一步深入研究。

[Truncated abstract] Clinical and pathological predictors of survival for stage II and III colon cancer patients treated with or without chemotherapy: a population-based study. Aim: Using a population-based cohort of colorectal cancer (CRC), the major aims of this study were to: 1. Identify clinico-pathological markers that can be used to define a subset of stage II colon cancer patients with excellent prognosis and who therefore do not require referral for adjuvant chemotherapy; 2. Investigate whether there is a survival benefit from the use of adjuvant chemotherapy in a population-based cohort of stage II colon cancer; 3. Investigate stage III colon cancer patients for evidence of predictive markers for response to 5FU chemotherapy; 4. Investigate CRC for age-related differences in clinico-pathological and molecular features. Hypotheses to be tested: 1. A subset of good prognosis stage II colon cancers can be defined using routine pathological markers; 2. Females colon cancer patients gain more survival advantage from 5FU chemotherapy than males; 3. Tumours from young CRC patients have different molecular characteristics to those from older patients; 4. The underlying molecular characteristics of tumour can impact upon the response to 5FU chemotherapy. Methods: The study cohort consisted of 5,971 cases diagnosed between 1993 and 2003 representing over 90% of the CRCs diagnosed in the state of Western Australia. Results: The major findings of this translational research into colon cancer can be summarized as follows: The morphological features of serosal and vascular invasion allow for prognostic stratification of stage II colon cancer into

published_or_final_version / abstract / Pharmacology / Doctoral / Doctor of Philosophy

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Biological Sciences / Doctoral / Doctor of Philosophy

University of Macau / Institute of Chinese Medical Sciences

published_or_final_version / Chinese Medicine / Doctoral / Doctor of Philosophy

In Hong Kong, the number of colon cancer patients has increased over the years. But at the same time, early detection of colon cancer has also become more readily available due to the recent technological advancement and increased accessibility to medical care. In recent years, more patients have become eligible for having curative sphincter saving operation and one of the objectives of this operation is to preserve continence function without stoma formation. However, colon cancer patients’ journeys do not finish after their operation. For instance, they may have bowel disorder after the operation, namely ‘Anterior Resection Syndrome’. This debilitating condition may not be amenable by surgical technique or medical therapy and it affects the bio-psycho-social wellbeing of the patient. One of the responsibilities of nurses is to promote the general wellbeing of the clients. Therefore, in this study, the possible methods of alleviating the condition of Anterior Resection Syndrome among colon cancer patients were inspected. By using strategic search of current evidences, this study found that several primary studies support the use of biofeedback to alleviate the condition. After conducting a comprehensive review of the selected studies, the biofeedback treatment was considered as an appropriate recommendation for the current clinical setting. After assessing the implementation potential of the current practice, an evidence-based protocol with considerations of local factors was established. In addition, in order to minimize resistance on the change of current practice, plans on communicating with stakeholders, pilot study and evaluation were carefully established. The purpose of this study is to provide professional nursing care by using evidence based practice for those in need. / published_or_final_version / Nursing Studies / Master / Master of Nursing