醋酸甲羟孕酮抑制卵巢癌患者术后 盆腔病理血管生成的临床研究

［摘要］目的探讨卵巢癌手术后化疗联合醋酸甲羟孕酮（MPA）抑制盆腔病理血管生成作用及其对预后的评价。方法治疗组53例，Ⅰ/Ⅱ期30例（56.6%），Ⅲ/Ⅳ期23例（43.4%）。化疗方案：1998年以后采用PAC（顺铂+多柔比星+环磷酰胺）或PC（顺铂+环磷酰胺）方案；2001年以后为PT方案（紫杉醇+卡铂）静脉化疗6个疗程；第7个疗程行髂内动脉化疗栓塞，同时数字减影观察盆腔病理血管。术后1 a时，再增加一次髂内动脉化疗栓塞造影。术后进食开始服用MPA 250 mg•d-1，6～30个月。每次化疗前测定CA125。对照组37例，Ⅰ/Ⅱ期20例（54.1%），Ⅲ/Ⅳ期17例（45.9%），除不用MPA外，卵巢癌手术后化疗方案及检查方法与治疗组均相同。随访两组3，5 a生存率。结果①CA125水平治疗组在第7疗程结束后和术后1 a时，Ⅰ/Ⅱ期和Ⅲ/Ⅳ期与对照组比较下降明显（均P＜0.05或P＜0.01）。②治疗组髂内动脉分支血管走形迂曲、紊乱及火焰状病理血管者明显少于对照组（P＜0.05）；第7个疗程后盆腔病理血管改变与血CA125水平呈明显正相关（r＝0.95，P＜0.01），即盆腔造影有病理血管者，血CA125升高。③Ⅰ/Ⅱ期3和5 a生存率治疗组分别为88.33%，41.23%；对照组分别为79.59%，34.31%，两组比较治疗组高于对照组（P＜0.01或P＜0.05）；Ⅲ/Ⅳ期3和5 a生存率治疗组分别为17.52%，1.34%；对照组分别为12.49%，0.00%，治疗组高于对照组（P＜0.05，P＜0.01）。结论MPA对卵巢癌盆腔病理血管生成有明显抑制作用。MPA联合化疗可延长卵巢癌患者的生存时间。髂内动脉造影显示盆腔病理血管，可作为评价治疗效果及预后的指标。连续服用MPA是安全的。     

胸腺素α1辅助治疗急性白血病并发肺部感染21例

目的观察胸腺素α1对急性白血病并发肺部感染的疗效。方法将38例急性白血病并发肺部感染患者随机分为治疗组21例和对照组17例。两组均给予抗生素（第3代头孢菌素、碳青酶烯类或万古霉素）治疗。治疗组同时给予胸腺素α1 1.6 mg皮下注射，qd。共2周。直接免疫荧光技术检测治疗前后外周血T淋巴细胞亚群（CD+3、CD+4、CD+8）百分率，酶联免疫吸附法测定白细胞介素2(IL 2)、IL 6和α干扰素(INF α)，观察临床疗效。结果治疗组治疗后IL 2升高，CD+3、CD+4、CD+4/CD+8百分率均显著提高（P＜0.05或P＜0.01）, INF α降低（P＜0.01）；对照组治疗后INF α降低（P＜0.05），CD+4明显提高（P＜0.01）。治疗组治疗后CD+4百分率和CD+4/CD+8明显高于对照组（P＜0.01，P＜0.05）。治疗组总有效率（90.48%）明显高于对照组（70.59%）（P＜0.05）。结论胸腺素α1可提高白血病患者机体免疫功能,促进机体产生淋巴因子，改善感染患者细胞因子和细胞免疫失衡，有助于控制白血病并发肺部感染。     

结肠灌洗联合中药结肠透析治疗慢性重型肝炎对患者血清内毒素与肿瘤坏死因子α等的影响

目的观察中药结肠透析疗法对慢性重型肝炎患者血清内毒素（ET）、肿瘤坏死因子α（TNF α）、白细胞介素2（IL 2）、白细胞介素6（IL 6）水平的影响,探讨中药结肠透析疗法在重型肝炎治疗中的意义。方法将60例慢性重型肝炎患者随机分为治疗组和对照组各30例,对照组给予常规护肝支持治疗,治疗组在支持治疗的基础上加用中药结肠透析治疗,4周为1个疗程。观察患者的临床症状改善情况,同时检测治疗前后肝功能等指标,并对治疗前后血清ET、TNF α、IL 2、IL 6等细胞因子水平进行检测。结果治疗后治疗组肝功能、PT等指标均较对照组改善明显（均P＜0.01）。治疗组ET、TNF α、IL 6水平较对照组下降(均P＜0.05)。两组IL 2水平差异无显著性。结论中药结肠透析结合支持疗法治疗慢性重型肝炎能显著改善患者的肝功能,并且对ET、TNF α、IL 6等炎性细胞因子均有不同程度的清除作用,对IL 2的水平无明显影响。     

醋酸甲羟孕酮对卵巢上皮癌患者FSH与LH的影响

目的观察醋酸甲羟孕酮（MPA）对卵巢上皮癌患者化学治疗（化疗）前后血清卵泡刺激素（FSH）和黄体生成素（LH）的影响。 方法将卵巢上皮癌患者60例分为治疗组和对照组各30例,治疗组术后给予MPA片250 mg,qd,po,于第1次化疗第1天开始服用,连续服用至术后6个月。对照组行常规化疗。对比两组患者每次化疗前后血FSH、LH及糖链多肽抗原（CA125）变化。 结果与对照组比较,治疗组手术后血FSH、LH、雌激素（E2）及CA125无明显差异,化疗3次后及化疗6次后血FSH、LH、E2水平下降,差异有统计学意义（P＜0.01,P＜0.05）,化疗6次后血CA125水平较对照组低,差异有统计学意义（P＜0.05）。结论MPA联合化疗可降低卵巢上皮癌患者血中FSH、LH水平,增加化疗效果,改善预后。     

清开灵注射液辅助治疗化疗药物致口腔溃疡30例

目的观察清开灵注射液辅助治疗化疗药物所致口腔溃疡的临床效果。方法将58例使用化疗药物导致口腔溃疡的患者随机分为两组，均予抗生素、补液和提高白细胞等常规方案治疗，治疗组30例在此基础上给予清开灵注射液静脉滴注，1次／d，30．40mL／次，连用7d；观察并记录两组的退热时间和口腔溃疡愈合时间。结果治疗组的退热时间及口腔溃疡愈合时间明显短于对照组（P〈0.01），治愈率也高于对照组（P〈0．05）。结论清开灵注射液辅助治疗化疗药物所致口腔溃疡安全有效。     

复方苦参注射液在胆管癌术后化疗中的评价

目的 评价复方苦参注射液在胆管癌术后化疗中的作用.方法 治疗组应用常规化疗方案加复方苦参注射液静脉滴注,对照组行常规化疗方案,均4周为1个疗程,计6个疗程.结果 治疗组恶心、呕吐、口腔炎、腹痛发生率明显低于对照组,差异有统计学意义（P＜0.05）.治疗组化疗前后白细胞变化差异无统计学意义（P＞0.05）,对照组化疗后白细胞下降明显,差异有统计学意义（P＜0.05）.治疗组化疗后Karnofsky评分有不同程度上升,但差异无统计学意义.对照组化疗后Karnofsky评分降低,差异有统计学意义（P＜0.05）.两组术后1年复发率相比较差异无统计学意义（P＞0.05）.结论 复方苦参注射液虽不能明显提高胆管癌术后化疗的疗效,但能显著减轻胆管癌术后化疗的毒副反应,提高患者生活质量。     

蟾蜍灵对体外培养的大鼠肾小球系膜细胞分泌 肿瘤坏死因子-α与白细胞介素-1β的影响

［摘要］目的观察蟾蜍灵对脂多糖（LPS）诱导的大鼠肾系膜细胞分泌肿瘤坏死因子 α（TNF α）及白细胞介素 1β（IL 1β）的影响。方法体外培养大鼠肾小球系膜细胞,分为对照组、LPS刺激组和蟾蜍灵组;采用逆转录 聚合酶链反应（RT PCR）和凝胶图像吸光度分析系统检测蟾蜍灵刺激前后大鼠肾系膜细胞表达的TNF α及IL 1β的mRNA量;用ELISA试剂盒测定各组TNF α及IL 1β的含量。结果①LPS刺激组TNF α mRNA相对表达量（0.59±0.09）显著高于对照组（0.28±0.13）（P＜0.01）;蟾蜍灵组TNF α mRNA相对表达量（0.25±0.03）显著低于LPS刺激组（P＜0.01）。②LPS刺激组IL 1β mRNA相对表达量（0.57±0.16）显著高于对照组（0.26±0.08）（P＜0.01）;蟾蜍灵组IL 1β mRNA相对表达量（0.30±0.04）显著低于LPS刺激组（P＜0.01）。③LPS刺激组TNF α细胞因子表达量［（195.40±6.09 ） pg•mL 1］显著高于对照组［（97.93±8.44） pg•mL 1］（P＜0.01）;蟾蜍灵组的TNF α细胞因子表达量［（108.39±8.81） pg•mL 1］显著低于LPS刺激组（P＜0.01）。④LPS刺激组IL 1β细胞因子表达量［（168.65±12.80） pg•mL 1］显著高于对照组［（79.77±10.14） pg•mL 1］（P＜0.01）;蟾蜍灵组的IL 1β细胞因子表达量［（98.75±6.95） pg•mL 1］显著低于LPS刺激组（P＜0.01）。结论蟾蜍灵能显著抑制LPS刺激后的体外培养的大鼠肾系膜细胞分泌TNF α及IL 1β。     

痰热清注射液对病毒性肝炎高胆红素血症患者细胞因子的影响

目的探讨痰热清注射液治疗病毒性肝炎高胆红素血症的可能机制。方法病毒性肝炎高胆红素血症患者50例，随机分为治疗组和对照组，每组各25例。对照组给予甘草酸二铵、门冬氨酸钾镁注射液、前列地尔（凯时）、腺苷蛋氨酸（思美泰）、促肝细胞生长素、清蛋白、血浆等综合治疗。治疗组在综合治疗的基础上，加用痰热清注射液20 mL，加入5%葡萄糖注射液中静脉滴注，qd，4周为一个疗程。观察两组治疗前后肝功能、凝血酶原时间(PT)以及血清肿瘤坏死因子α（TNF α）、白细胞介素（IL）-4、IL-18的变化。结果两组患者治疗前后血清总胆红素（T-BiL）、丙氨酸氨基转移酶（ALT）、PT、TNF α、IL-18等指标均显著下降(P＜0.01)，IL-4显著上升（P＜0.01)；治疗后两组比较，治疗组T-BiL、PT、TNF α、IL-18的下降较对照组更明显(P＜0.01)，而ALT水平差异无显著性(P＞0.05)。结论痰热清注射液能显著降低病毒性肝炎高胆红素血症患者血清细胞因子TNF α、IL-4、IL-18水平，是治疗高胆红素血症的重要作用机制。     

痰热清注射液对急性呼吸窘迫综合征患者细胞因子的影响

目的 观察痰热清注射液对急性呼吸窘迫综合征（ARDS）患者细胞因子的影响. 方法 将50例ARDS患者,随机分为治疗组和对照组,每组25例. 对照组给予常规治疗：原发病治疗、去除病因、机械通气、限制输液量、早期应用糖皮质激素、合理选用抗菌药物、充分引流感染灶、营养和代谢支持、维持内环境平衡、防治并发症等. 治疗组在常规治疗的基础上给予痰热清注射液20 mL,加入5%葡萄糖注射液250 mL中静脉滴注,qd,疗程5 d. 结果 治疗组在疗程结束后细胞因子肿瘤坏死因子（TNF－α）、白细胞介素（IL）－6、IL－8水平显著低于对照组（P＜0.05）,并且治疗组的机械通气时间和病死率均明显低于对照组（P＜0.05）. 结论 痰热清注射液能显著降低ARDS患者细胞因子TNF－α、IL－6、IL－8水平,提高治疗效果.     

过敏性紫癜患儿免疫功能变化与静注丙球疗效观察

目的：探讨过敏性紫癜（HSP）患儿的体液免疫，细胞免疫和细胞因子与发病机制的关系。方法：对124例混合型HSP患儿及125例健康儿童，应用单克隆抗体免疫荧光法测定T细胞亚群（CD3^ 、CD4^ 、CD8^ 、CD4^ \CD8^ ），琼脂单相免疫扩散法测定血清免疫球蛋白（IgG,IgA,IgM,IgD)，夹心法ELISA检测白介素IL（IL－1、IL－6、IL－8）及肿瘤坏死因子α（INF－α），用双盲随机法把混合型HSP患儿分成两组：Ⅰ组应用静注丙球（IVIG）300－400MG/KG.D，UBTK3－5D；Ⅱ组应用地塞米松0.3-0.5mg/kg.d，疗程5－7d，并进行疗效比较，结果：（1）HSP患儿，CD4^ 、CD4^ \CD8^ 明显高于对照组（P＜0．01），CD3^ 、CD8^ ，明显低于对照组（P＜0．01）；IgA,IgM,IgD明显高于对照组（P＜0．01）,IgG明显低于对照组（P＜0．01）；IL－1、IL－6、IL－8、TNF－α均明显高于对照组（P＜0．01）。（2）应用IVIG治疗的HSP患儿在皮疹消失时间，关节肿瘤缓解时间，腹痛缓解时间，便血消失时间等均明显短于应用激素治疗（P＜0．01）。结果：HSP患儿存在严重的免疫功能紊乱，IVIG治疗HSP患儿临床疗效明显优于激素治疗。     

Chlordiazepoxide antinociception: Cross-tolerance with opiates and with stress

Chlordiazepoxide (CDP) has been previously shown to possess antinociceptive properties that are resistant, except at high doses, to the opiate antagonist naloxone. The present study evaluated whether CDP's antinociceptive effects were subject to tolerance following repeated injections and whether cross-tolerance might develop between the antinociceptive action of CDP and that of either morphine or cold water swims. CDP increased flinch-jump thresholds following acute administration and exhibited tolerance following repeated injections. Neither morphine-tolerant nor cold water swim-adapted rats displayed an antinociceptive effect when tested with CDP. On the other hand, chronic pretreatment with CDP attenuated the antinociceptive effects of cold water swims, but did not produce any clear effect upon morphine analgesia.     

氯吡格雷和沙格雷酯联用致血小板减少

1例74岁女性患者行人工血管旁路移植术,术后给予肝素,约8．33U·Kg^-1·min^-1静脉泵入;氯吡格雷50mg,1次／d口服;沙格雷酯100mg,3次／d口服;华法林3mg／d口服。手术次日停用肝素,改为达肝素钠0．4ml,1次／12h皮下注射。术后第7天血小板301×10^9／L,停用达肝素钠,同时加用辛伐他汀20mg／d,氯吡格雷、沙格雷酯及华法林按原剂量口服。术后6个月停用华法林,继续口服其他3种药物,此时复查血小板计数为240×10^9／L。术后9个月复查,血小板计数降至1×10^9／L,白细胞及血红蛋白水平正常。立即停用氯吡格雷和沙格雷酯,继续口服辛伐他汀。停药4周,血小板计数恢复至156×10^9／L。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

他巴唑(MMI)与丙基硫氧嘧啶(PTU)治疗甲亢的比较和选择

目的 他巴唑(MMI)与丙基硫氧嘧啶(PTU)治疗甲亢的比较和选择.方法 选择我院2008年至2010年收治的甲亢患者52例,随机分为MMⅠ组和PTU组,治疗6月观察症状缓解,甲亢恢复情况、副作用等.结果 任何一个选择抗甲状腺药物(ATD)治疗甲亢的患者,均可使用MMI,但妊娠早期,甲亢危象,对.MMI治疗不敏感者都除外.     

Interaction of streptonigrin with metals and with DNA.

The antitumor antibiotic, streptonigrin, interacted with zinc, copper, and manganese but not with calcium or magnesium, as indicated by spectral shifts and difference spectra. The titration data showed the formation of 1:1 complexes, and further titration continued to show spectral shifts until a molar ratio for zinc to streptonigrin of 5-10 to 1 was reached. Streptonigrin interacted with DNA only in the presence of a metal ion such as zinc. Streptonigrin titration with DNA at varying zinc molar equivalents revealed that one antibiotic molecule required 5-7 moles of zinc and 20-25 moles of DNA-phosphorus for complexation. Similar values were obtained from gel permeation chromatography.     

Comparative efficacy and tolerance of ibuprofen syrup and acetaminophen syrup in children with pyrexia associated with infectious diseases and treated with antibiotics

A double-blind, randomised, parallel group study has been done comparing the efficacy and tolerability of 7.5 mg/kg ibuprofen syrup (n=77) and 10 mg·kg^–1 acetaminophen syrup (n=77) in 154 children (6 months to 5 years) with fever (38°C) associated with infectious diseases and treated with antibiotic therapy.The area under the percentage reduction in temperature curve captured the net effect of each drug and provided the best estimate for comparison of efficacy during a defined period. Temperature evolution over time was not significantly different between the two groups. Nevertheless, the temperature reduction over the first 4 h of treatment (H0–H4) was significantly higher after ibuprofen (60%) than acetaminophen (45%). Both ibuprofen and acetaminophen were well tolerated.In conclusion, significant antipyretic activity, good tolerability and its availability as a syrup make ibuprofen an effective means of fever control in children.     

Thinking with pleasure: Experimenting with drugs and drug research

Within the field of drug and alcohol studies, researchers think about pleasure or against it; we analyse, consider, investigate, invoke or ignore it. The philosophically inclined may think of pleasure or write on it, but in each of these scenarios pleasure is kept at an arm’s length while the researcher appears to remain unmoved – detached observers, objective scientists, conceptual experts, program directors, sharp critics, policy advocates – sober judges whose sovereignty is secured by the formal conventions of positivist research, established theory, institutional authority and/or disciplinary knowledge. This paper asks what happens when pleasure is allowed to emerge as a constitutive element in the relations of drug and alcohol research. What happens when we conceive our work as thinking with pleasure, rather than simply researching pleasure or thinking about it? I return to the later work of Foucault, reading it alongside conceptions of the experiment drawn from Science and Technology Studies, arguing that both the pleasures of drug consumption and drug research might be conceived more generatively as mutually implicated in events.