血清CA125水平与肝硬化Child-pugh分级及腹水量的关系

目的探讨肝硬化患者血清肿瘤抗原125(CA125)水平与肝功能Child-pugh分级及腹水量的关系.方法肝硬化患者91例,Child-pugh A级32例,B级36例,C级23例;腹水阳性者50例,腹水阴性者41例;正常对照32例.均采用ELISA法检测血清CA125水平.结果肝硬化患者血清CA125水平显著高于对照组(P＜0.01),肝硬化患者血清CA125水平Child-pugh C级＞B级＞A级,随着肝损害程度加重而进行性升高(P＜0.01);肝硬化腹水组及少量腹水组血清CA125水平均显著高于肝硬化无腹水组(P＜0.01),中量腹水组血清CA125水平显著高于少量腹水组(P＜0.01),大量腹水组与中量腹水组的血清CA125水平比无统计学意义.结论肝硬化患者血清CA125水平与肝功能损害及腹水程度密切相关,可以被认为是反映肝硬化程度及监测腹水情况的一项敏感指标,对肝硬化腹水的早期诊断及估计预后具有较高的参考价值.     

肝硬化CA125及CA199水平变化临床观察

目的:探讨肝硬化患者CA125、CA199变化及其与腹水的关系。方法:肝硬化组210例,140例伴有腹水,70例无腹水,正常对照组50例,均采用ELISA法检测血清CA125、CA199水平。分析CA125及CA199水平与肝功能分级(Child-Pugh积分法)及腹水的关系。结果:肝硬化患者血清CA125水平较对照组显著升高(t=10.004,P<0.01),血清CA125水平随着肝功能损害程度的加重呈进行性升高,B级较A级及C级较B级均显著升高,差异有显著性(q=5.9906、2.0800,P<0.05或0.01);血清CA125水平与Child-Pugh肝功能积分呈正相关(r=0.332,P<0.01),伴有腹水患者血清CA125水平明显提高,与同一Child分级的无腹水患者相比有统计学意义。经过常规保肝治疗后,Child-Pugh肝功能A、B级血清CA125水平显著下降(t=3.312、2.802,P<0.01或0.05),而C级治疗前后差异无显著性(t=1.171,P>0.05);而随着腹水量的增多,其血清CA125水平也呈逐渐升高趋势。CA199在肝硬化患者中轻度升高,但与肝硬化程度、腹水量无明显相关性。结论:血清CA125是反映肝硬化患者肝功能损害程度的指标之一,对衡量肝硬化患者的预后、腹水量有一定的参考价值。CA199在肝硬化患者中轻度升高,但与腹水量无明显相关。     

紫杉醇静脉化疗联合卡铂腹腔化疗在卵巢癌术后早期治疗中的应用

目的 探讨上皮性卵巢癌患者术后早期应用紫杉醇静脉化疗联合卡铂腹腔化疗同步双途径化疗的有效性及安全性.方法 2007年3月至2009年6月住院初次治疗为手术治疗的37例上皮性卵巢癌患者在术后l周即开始早期化疗,21例(A组)静脉滴注紫杉醇175 mg/m2,同时腹腔内应用卡铂400 mg,每2周为1个疗程,术后1个月内共完成2个疗程;16例(B组)应用紫杉醇90mg+卡铂200 mg行腹腔化疗,每周1个疗程,术后1个月内共完成3个疗程.结果 37例患者均未出现明显的外周血白细胞下降和肝功能异常.比较化疗后CA125下降情况,A组的总有效率为90.5％( 19/21),B组的总有效率为62.5％( 10/16),差异有统计学意义(P＜0.05).以CA125半衰期＞3周者与CA125半衰期≤3周者比较,A组的化疗有效率为85.7％( 18/21),B组的化疗有效率为56.3％(9/16),差异有统计学意义(P＜0.05).CA125半衰期＞3周者2年复发率为40.0％ (4/10),明显高于CA125半衰期≤3周者[11.1％ (3/27),P＜0.05].结论 紫杉醇静脉化疗联合卡铂腹腔化疗用于上皮性卵巢癌患者术后早期治疗安全有效,可改善患者的预后.     

血清人附睾蛋白4水平在上皮卵巢癌预测中的应用

目的评估和比较人附睾蛋白4(HE4)与常用的标记物糖类抗原125(CA125)在预测上皮性卵巢癌(EOC)中的应用。方法应用化学发光微粒子免疫分析(CMIA)法检测32例EOC、390例卵巢良性肿瘤、36例卵巢交界性肿瘤及50名健康对照组者血清HE4;观察组手术前后血清HE4水平变化;比较血清HE4和CA125水平在EOC诊断中的作用。结果恶性EOC患者血清HE4与CA125水平明显高于交界性上皮卵巢肿瘤、卵巢良性肿瘤组和健康对照组,差异有统计学意义(P<0.01),且卵巢良性肿瘤组HE4水平与健康对照组比较,差异无统计学意义(P>0.05);血清HE4单项检测特异度91.0%,高于CA125特异度59.5%,差异有统计学意义(χ2=6.082,P=0.015)。在交界性上皮卵巢肿瘤患者中ROMA值≥5.6%时,可能存在EOC发病的高风险。结论血清HE4水平在EOC预测中具有重要意义,尤其在早期EOC的诊断中灵敏度及特异性均优于CA125,值得临床广泛推广和应用。     

血清CA 125测定在卵巢上皮癌治疗中的作用

目的:探讨卵巢上皮癌血清CA125在临床治疗中动态变化及其作用.方法:采用放免法对46例卵巢上皮癌患者定期测定CA125值.结果:46例患者中诊断阳性率为89.1%,其中浆液性上皮癌阳性率为94.7%,粘液性及其他占81.5%,两者比较有差异;期别愈晚,则水平愈高;术后比术前CA125值均明显下降;CA125水平平均转阴时间为术后10周,最短为4周,最长为24周.其中达60周前降为正常.同时观察到期别较早者其转阴时间明显短于期别晚者.结论:血清CA125在治疗过程中可以监测治疗效果及早发现复发,并对预后亦有一定的评价.     

血清CA125水平与先兆流产预后的关系

目的 探讨血清CA125水平在预测早期先兆流产妊娠预后的价值.方法 对78例早期先兆流产(保胎失败组和保胎成功组)及40例正常早孕妇女治疗前及治疗后1～4周的血清CA125进行测定并比较.结果 保胎失败组妇女血清CA125水平为(28.52±19.12)×103U/L,显著高于保胎成功组的(28.52±19.12)×103 U/L、正常孕妇组的(20.45±9.55)×103 U/L(t=- 1.28,-1.24,均P＜0.05),且随着时间的推移而递增,检测敏感性为93.10％,特异性为87.85％.结论 血清CA125水平的监测对早孕先兆流产的预后判断具有较高的临床应用价值.     

卵巢上皮癌中MDR1与CA125表达预测化疗效果的价值

目的 研究MDR1在卵巢上皮癌中的表达及其在卵巢上皮癌诊疗方面的价值.方法 采用荧光定量RT-PCR技术检测卵巢组织中MDR1基因的mRNA含量,化学发光法检测术前及术后每次化疗前血清CA125水平,分析MDR1与CA125及其半衰期的相关性.结果 MDR1基因在卵巢上皮癌、良性肿瘤、正常卵巢组织中的表达差异有统计学意义(P＜0.01).34例卵巢上皮癌中,24例CA125升高.MDR1表达与CA125相关关系较弱.在34例卵巢上皮癌患者中,CA125半衰期长的MDRI的表达高于CA125半衰期短者(＞25d vs.＜16d)(P＜0.05).结论 检测MDR1表达可用以预测卵巢上皮癌患者对化疗的近期疗效.     

联合检测血清HE4、CEA、CA125在卵巢癌诊断及治疗中的意义

目的探讨联合检测血清HE4、CEA、CA125对卵巢癌诊断及治疗效果评估的临床意义。方法选择2015年1月～2017年1月收治的80例卵巢癌患者作为研究对象,均采用手术治疗,随访12个月,统计复发情况,同期入组80例健康体检人员作为健康对照,采用ELISA方法检测血清HE4,采用电化学发光免疫法检测CEA、CA125,比较卵巢癌组术前和健康组、卵巢癌手术前和术后、复发组和未复发组HE4、CEA、CA125水平差异,分析HE4、CEA、CA125、联合检测诊断卵巢癌的灵敏度、特异度及准确度。结果卵巢组的HE4、CEA、CA125均明显高于健康组,差异有统计学意义(t=32.863、18.643、22.227,P 0.01);联合HE4、CEA、CA125检测诊断卵巢癌的灵敏度、准确度均明显高于单一HE4、CEA、CA125的灵敏度、准确度,差异有统计学意义(P 0.05);卵巢癌患者手术治疗后1个月的HE4、CEA、CA125均明显低于术前,差异有统计学意义(t=21.344、16.866、20.129,P 0.01);复发组与HE4、CEA、CA125均明显高于未复发组,差异有统计学意义(t=19.853、14.654、19.132,P 0.05)。结论联合检测血清HE4、CEA、CA125有助于提高卵巢癌临床诊断能力,且可为临床治疗效果及疾病复发评估提供参考,具有较高应用价值。     

曲美他嗪对慢性心力衰竭患者血清CA125、IL-6及BNP的作用

目的 观察曲美他嗪对慢性心力衰竭(CHF)患者血清CA125、IL-6及BNP的影响,探讨曲美他嗪治疗CHF的临床疗效.方法 选取本院2012年9月至2015年9月收治的CHF患者160例,随机分为对照组及观察组,各80例.对照组予以标准的CHF药物治疗,观察组在标准CHF药物治疗基础上联合曲美他嗪治疗,疗程3个月.观察治疗前后症状的改善情况,根据纽约心功能(NYHA)分级进行疗效评价,并检测血清糖类抗原125(CA125)、白介素-6(IL-6)及B型钠尿肽(BNP)的表达变化.结果 治疗前两组患者年龄、性别及心功能分级,差异无统计学意义(t=-0.272,P=0.786;x2=0.223,P=0.633;x 2=0.503,P=0.778).观察组临床疗效总有效率90.0％,明显优于对照组的81.3％(x 2=7.047,P=0.030).两组治疗后血清CA125、IL-6及BNP的表达均下调(P＜0.001),观察组血清CA125、IL-6及BNP表达较对照组明显下降(t=5.270、8.960、10.523,P＜0.001).结论 曲美他嗪治疗CHF疗效显著,可显著改善患者NYHA分级,并能降低血清CA125、IL-6及BNP的表达.     

肝硬化患者血清内毒素和糖类抗原125水平相关性分析

目的探讨肝硬化患者血清内毒素和糖类抗原125水平的变化,观察两者的相关性与血清肝纤维化指标的关系。方法采用黨试验酶联法和化学发光法分别测定40例肝硬化患者血清内毒素、CA125和HA、PⅢP水平,并与40名正常健康人作比较。结果肝硬化患者血清内毒素、CA125和HA、PⅢP水平均非常显著地高于正常人组(P值均﹤0.01),血清内毒素水平与CA125、HA、PⅢP水平呈显著正相关(r=0.5813,0.6021,0.6233,P值均﹤0.01)。结论检测肝硬化患者血清内毒素、CA125水平的变化可以作为肝硬化严重程度Child-Pugh分级法的辅助指标,对正确评估病情和预后具有重要的临床意义。     

Role of the liver in the disposition of intravenous nitroglycerin in the rat

Previous studies have indicated that the liver is the main site of nitroglycerin (NTG) elimination when the drug is systematically infused. To examine this hypothesis, we measured the apparent systemic clearance (Cls) of nitroglycerin in anesthesized rats receiving a constant intravenous infusion at a dose of 100 micrograms per kg per min. Animals were divided into shunt and sham groups; the former had undergone a portal vein ligation 10 days prior to the study, while the latter was subjected to a sham operation. On the study day, half of the animals of each group also received probenecid at 200 mg/kg, i.v., a drug previously reported to inhibit organic nitrate ester reductase (ONER) activity in rat liver. Arterial NTG samples were obtained at 41, 43 and 45 min of infusion in all four experimental groups; Cls was 439 +/- 32 ml per kg per min (mean +/- S.E.) in sham, 460 +/- 44 in sham and probenecid, 477 +/- 39 in shunt, and 461 +/- 34 in shunt and probenecid animals. During NTG infusion, hepatic blood flow (measured with a constant infusion of indocyanine green) was decreased markedly in shunted rats as was liver/body weight, indicating hepatic atrophy. The specific activity of hepatic ONER was similar in all four groups. In spite of marked differences in hepatic blood flow and hepatic mass, the Cls was similar in all four groups. The liver does not appear to be a major site for the elimination of systemic nitroglycerin as hitherto assumed.     

HACCP在学校集体食堂卫生管理中的应用研究

目的 通过HACCP在学校集体食堂管理中的应用,提高食品卫生水平,保障学生的身体健康。方法 HACCP原则。结果 食品卫生达到较高水平,极大地减少了食物中毒的发生。结论 提示HACCP原则可在学校集体食堂的卫生管理中发挥有效作用。     

半导体激光治疗老年人压疮疗效观察

目的探讨半导体激光局部照射治疗老年人压疮疗效.方法:收集2012年1月-2015年6月48例压疮患者,分为半导体组和常规组各24例.常规组采用常规治疗,半导体组采用半导体激光加常规治疗,10 d为1个疗程,不超过3个疗程.疗程结束后比较两组疗效.结果:半导体组压疮愈显率为83.33％,创面愈合时间为(12.75±5.51)d,常规组分别为54.17％和(19.63±8.65)d,组间差异有统计学意义(P＜0.05),两组均未见不良反应.结论:半导体激光加常规治疗压疮效果肯定,无明显不良反应,且操作简便.     

脑卒中恢复期患者社区综合康复的疗效观察

目的：探讨社区开展康复活动对于脑卒中患者肢体功能康复的影响。方法：选取2014年4至10月参与社区“陈睿健康工作室”康复活动的脑卒中恢复期患者50例作为观察组,选取同期延吉社区卫生服务中心门诊的50例脑卒中恢复期患者作为对照组（进行门诊随访、服药、自我康复）。采用知识、信念、行为（KAP）量表对观察组患者进行问卷调查。采用简化Fugl-Meyer肢体运动功能评分表（Fugl-Meyer assessment of motor function,FAM）比较两组患者入组时和入组6个月时的肢体功能恢复情况及对家庭医生（门诊医师）的满意度。结果：入组6个月时,两组患者的FAM均有所改善,观察组FAM得分[上肢（50.92±7.05）分,下肢（33.01±1.37）分]较对照组[上肢（34.85±6.55）分,下肢（25.20±4.88）分]更高,差异有统计学意义（t上肢=11.8215,t下肢=10.8595,P均＜0.01）。观察组患者的满意率为92%（46/50）,明显高于对照组的30%（15/50,P＜0.05）。结论：在社区开展康复活动可以促进脑卒中患者肢体功能的康复,提高患者的满意度。     

Evaluation of the safety of enalapril in the treatment of heart failure in the very old

Summary We have introduced enalapril, in doses equal to or less than the 2.5 mg currently recommended, as an adjuvant to digoxin and diuretics in 17 patients of mean (SD) age 83 (5) years with severe heart failure. Only eleven patients tolerated its introduction. Unlike those reported in younger patients, all but one of the adverse drug reactions occurred 8 h or more after the first dose. Aged patients started on ACE inhibitors should be observed in hospital until stabilized on a maintenance dose. Three patients had an adverse reaction which differed in nature from those previously reported: acute confusional state, ataxia and mesenteric ischaemia.Ten patients were discharged on 5 mg or 10 mg maintenance doses of enalapril. In nine of them improvement on triple therapy was sustained for a minimum of three months. ACE inhibition was lost in the other patient when her compliance with enalapril therapy fell to around 75%: monitoring compliance is essential when ACE inhibitors are used in low dosages.Enalapril was withdrawn during follow up in three patients because of symptoms of mesenteric ischaemia and in four because of dramatic deterioration of renal function. One of the latter was found subsequently to have severe bilateral atheromatous renal artery stenosis. When isosorbide dinitrate was substituted for enalapril, symptoms of mesenteric ischaemia resolved and renal function returned to baseline. Continuing surveillance for adverse effects is essential in patients of this age group with severe heart failure, and the risk of occult renal artery stenosis requires regular biochemical screening during follow up.The benefit to cost ratio of ACE inhibitors might be improved in aged patients by their use at an earlier stage in the natural history of heart failure, when perfusion of essential organs is not grossly impaired, but carefully monitored trials would be necessary to establish this.     

替普瑞酮治疗老年慢性浅表性胃炎的疗效分析

目的分析替普瑞酮治疗老年慢性浅表性胃炎的疗效。方法100例老年慢性浅表性胃炎患者,通过计算机随机表数字法分为对照组和实验组,每组50例。对照组患者选择西咪替丁作为本次治疗药物,实验组患者选择替普瑞酮作为本次治疗药物。比较两组患者临床疗效、不良反应发生情况以及生活质量。结果实验组治疗总有效率92.00%高于对照组的76.00%,差异具有统计学意义(P<0.05)。实验组不良反应发生率6.00%低于对照组的20.00%,差异具有统计学意义(χ^2=4.332,P=0.037<0.05)。实验组患者治疗后的生活质量评分(68.68±4.11)分高于对照组的(57.73±3.48)分,差异具有统计学意义(t=14.377,P=0.000<0.05)。结论对于老年慢性浅表性胃炎疾病患者,选择替普瑞酮进行治疗不仅疗效更为理想,而且还不易增加患者的用药不良反应,有利于提高患者的生活质量,建议进一步推广。     

Nifedipine in the treatment of hypertension in the elderly

The effect of nifedipine monotherapy, retard tablets, 20 mg bid, was evaluated in 23 hypertensive patients, mean age, 79 +/- 2 years. Twenty-one patients completed an eight-week study. Blood pressure (BP) decreased to 160/90 mm Hg in 15 patients; in four additional patients diastolic BP dropped by 15% to 28%. In a subset of five patients with isolated systolic hypertension, a significant reduction in systolic BP was noted. Side effects were relatively mild and only two patients discontinued the study. The results suggest that nifedipine monotherapy offers an alternative, logic, therapeutic approach to hypertension in the elderly.     

Interactions among the cannabinoids in the antagonism of the abdominal constriction response in the mouse

The ability of ⁹-tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD), 11-OH THC and 8,11-diOH THC to antagonise the abdominal constriction response in the mouse induced by formic acid, phenylquinone, 5-hydroxytryptamine, prostaglandin E₁ (PGE₁) and bradykinin was tested. THC was an effective antagonist against all nociceptive agents with an ED₅₀ in all cases between 1.0 and 2.6 mg/kg. CBN, while also effective against all nociceptive agents, was less potent than THC, with an ED₅₀ range between 46.2 and 112.5 mg/kg. CBD in doses as high as 200 mg/kg was without effect. Using PGE₁ as the nociceptive agent, 11-OH THC was equipotent to THC while 8,11-diOH THC was inactive. Naloxone, while able to antagonise the antinociceptive effect of morphine against formic acid-induced writhing, did not reverse the antinociceptive effects of THC. There were no pharmacological interactions between THC, CBD and CBN.     

Problems in the evaluation of hypnosis in the treatment of alcoholism

Although hypnotherapy has been applied to alcoholism for over a century and is accepted by the AMA as a medically valid technique, the effectiveness of hypnosis in treating alcoholics remains controversial. Systematic evaluation has been hampered by the unique role of hypnosis as a cultural artifact, by problems in defining and verifying hypnotic intervention, by individual and situational variation in hypnotizability, and by difficulty in separating hypnosis from the therapies to which it is applied. Clinicians using hypnosis are likely to continue to base their claims for its effectiveness on intuition, especially since no study has demonstrated that hypnotherapy is contraindicated for patients requesting its use.