重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液疗效观察

目的观察重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液的疗效和安全性,及其对T淋巴细胞亚群的影响。方法消化道肿瘤并恶性腹腔积液患者64例,随机分为观察组33例和对照组31例,2组化疗均给予卡培他滨口服,第1~14天,21d为1个周期,共2个周期;化疗第1个周期第1、5天,对照组给予奈达铂腹腔热灌注化疗,观察组给予重组人血管内皮抑素~+奈达铂腹腔热灌注化疗。治疗2个周期后评定2组疗效,并应用流式细胞仪检测2组治疗前和治疗2周期后CD4~+、CD8~+T细胞阳性率,计算CD4~+/CD8~+。结果观察组总有效率(87.88%)高于对照组(64.52%)(P0.05);对照组治疗后CD4~+、CD8~+T细胞阳性率及CD4~+/CD8~+与治疗前比较差异无统计学意义(P0.05);观察组治疗后CD4~+T细胞阳性率[(55.23±7.36)%]、CD4~+/CD8~+(1.59±0.19)较治疗前[(45.78±5.12)%、1.05±0.26]增高且高于对照组治疗后[(46.79±9.22)%、1.08±0.23],CD8~+T细胞阳性率[(34.89±5.32)%]较治疗前[(43.66±3.94)%]下降且低于对照组治疗后[(43.15±9.31)%],差异均有统计学意义(P0.05);2组不良反应均为Ⅰ~Ⅱ级。结论在化疗基础上应用重组人血管内皮抑素联合奈达铂腹腔热灌注治疗消化道肿瘤并恶性腹腔积液疗效满意,可改善患者免疫功能,安全性好。     

重组人血管内皮抑素联合奈达铂治疗非小细胞肺癌合并恶性胸腔积液的临床疗效分析

目的分析重组人血管内皮抑素联合奈达铂治疗非小细胞肺癌(NSCLC)合并恶性胸腔积液的临床疗效。方法选取NSCLC合并恶性胸腔积液患者92例,随机分为对照组与实验组,每组46例。对照组患者给予奈达铂胸腔内灌注,实验组在对照组的基础上给予重组人血管内皮抑素静脉滴注。连续治疗4个周期后,比较2组患者胸腔积液的控制率、临床总有效率、胸水中血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)水平、血清癌胚抗原(CEA)水平、鳞状上皮细胞癌抗原(SCCAg)水平。结果实验组临床总有效率为82. 60%,显著高于对照组的58. 69%(P 0. 05)。2组患者积液控制率比较,差异有统计学意义(P 0. 05)。2组患者VEGF、NSE、CEA、SCCAg比较,差异有统计学意义(P 0. 05)。结论重组人血管内皮抑素联合奈达铂治疗NSCLC合并恶性胸腔积液的临床疗效肯定,能够提高患者生活质量。     

重组人血管内皮抑制素联合洛铂治疗肺癌恶性胸腔积液的疗效观察

目的 研究重组人血管内皮抑制素联合洛铂治疗肺癌恶性胸腔积液的疗效。方法 回顾性选取2018年1月至2020年12月武汉科技大学附属武昌医院收治的120例肺癌恶性胸腔积液患者为研究对象。根据治疗方法不同将患者分为LBP组(n=60)与LBP+END组(n=60)。LBP组给予单独洛铂胸膜腔内灌注治疗,LBP+END组给予重组人血管内皮抑制素联合洛铂胸膜腔内灌注化疗。观察两组患者疗效,比较两组患者治疗前、治疗后1个月、血管内皮生长因子(VEGF)、基质金属蛋白酶2(MMP-2)、炎症因子[白细胞介素(IL)-6、肿瘤坏死因子α(TNF-α)、γ干扰素(IFN-γ)]、T淋巴细胞水平,并记录不良反应及生存期。结果 LBP+END组肺癌恶性胸腔积液患者治疗后有效率为91.67%,均显著高于LBP组(75.00%),差异均有统计学意义(P<0.05)。治疗前,LBP组和LBP+END组患者VEGF、MMP-2、IL-6、TNF-α、IFN-γ、CD3⁺、CD4⁺及CD8⁺比较,差异均无统计学意义(P>0.05);治疗后...     

重组人血管内皮抑素联合TACE对原发性肝癌血清VEGF表达的影响

目的观察重组人血管内皮抑素联合肝动脉化疗栓塞术(TACE)对原发性肝癌血清血管内皮细胞生长因子(VEGF)表达的影响。方法 60例原发性肝癌患者分为两组,对照组(n=30)仅采用TACE治疗,观察组(n=30)在对照组治疗基础上加用重组人血管内皮抑素肝动脉栓塞治疗。观察和比较两组临床疗效,治疗前和治疗后第7、15、30 d血清VEGF表达水平。结果观察组治疗总有效率(60.0%)明显高于对照组(43.3%)(P<0.05);观察组术后VEGF表达水平逐渐下降(P<0.05),而对照组术后VEGF表达水平逐渐上升(P<0.05)。结论重组人血管内皮抑素可影响原发性肝癌血清VEGF表达水平,推测其对肿瘤血管生成具有一定的抑制作用。     

重组人血管内皮抑制素联合顺铂治疗晚期胃癌合并恶性腹腔积液的疗效及安全性分析

目的探讨重组人血管内皮抑制素联合顺铂治疗晚期胃癌合并恶性腹腔积液的疗效及安全性。方法前瞻性研究选取48例晚期胃癌合并恶性腹腔积液患者,采用经皮穿刺置管彻底引腹腔腔积液。随机将其分成两组,观察组24例,重组人血管内皮抑制素45 mg联合顺铂40 mg腹腔内注入;对照组24例为单纯顺铂40 mg腹腔内注入。2次/周灌注,疗程为3周。定期复查,比较两组的临床疗效及不良反应发生率。结果观察组腹腔积液疾病控制总有效率95.8%优于对照组70.8%,差异有统计学意义(P0.05);体能改善情况明显优于对照组,体力活动状况改善情况优于对照组,差异具有统计学意义(P0.05);不良反应发生率差异无明显统计学意义(P0.05)。结论重组人血管内皮抑制素联合顺铂治疗晚期胃癌合并恶性腹腔积液临床效果优于顺铂单用,且不增加不良反应的发生率,值得临床推广应用。     

老年肝癌患者行重组人血管内皮抑素介入栓塞治疗的效果观察

研究并探讨重组人血管内皮抑素介入栓塞治疗在老年肝癌患者中的临床疗效。于2012年1月~2015年12月,选取我院收治的60例老年肝癌患者随机分为两组(各30例),对照组实施肝动脉化疗栓塞治疗,观察组在实施肝动脉化疗栓塞治疗的同时加用重组人血管内皮抑素,比较两组患者的临床疗效、血清VEGF水平。观察组的临床总有效率与对照组相比,差异具有统计学意义(P<0.05)。治疗后,观察组的血清VEGF水平较治疗前降低(P<0.05),且低于治疗后的对照组(P<0.05)。采用重组人血管内皮抑素与肝动脉化疗栓塞术治疗老年肝癌患者的疗效显著,可有效抑制血清VEGF水平。     

重组人血管内皮抑制素联合热疗治疗恶性胸腹腔积液的临床观察

目的观察重组人血管内皮抑制素(恩度)联合热疗治疗恶性胸腹腔积液的近期疗效,评价恩度局部应用的安全性和耐受性。方法对45例伴有恶性胸腹腔积液的恶性肿瘤患者,随机分为恩度单药组23例、恩度联合化疗组22例,两组均联合局部射频热疗。恩度单药组注入恩度;联合化疗组同时接受顺铂胸腹腔局部灌注治疗。评价近期疗效、生活质量以及毒副反应。结果 45例患者均可进行客观疗效评价及安全性评价,恩度单药组CR 3例,PR 11例,SD 5例,PD 4例,客观有效率(RR)为60.9%,疾病控制率(DCR)为82.6%。联合组客观有效率高于单药组,但无统计学差异。药物相关性毒副反应不明显。结论恩度胸腹腔灌注给药联合热疗能较好地控制恶性胸腹水,减轻临床症状。恩度与化疗药物联合局部热疗可能具有一定的协同作用,安全性较好,化疗药物的不良反应无明显增加。     

热灌注化疗联合射频热疗治疗恶性腹腔积液34例疗效与护理

目的:探讨热灌注化疗联合射频热疗治疗恶性腹腔积液的效果及护理方法。方法:将68例恶性腹腔积液患者随机分为实验组和对照组各34例,对照组采用腹腔内注入化疗药物治疗,实验组采用热灌注化疗联合射频热疗治疗,治疗前后,两组均给予护理干预。比较两组疗效、不良反应及患者满意度。结果:实验组有效率、患者满意度均高于对照组(P0.05)。结果:热灌注化疗联合射频热疗治疗恶性腹腔积液可明显提高效果及患者满意度,是一种安全有效的治疗方法。     

重组人血管内皮抑制素联合顺铂对恶性胸腔积液患者VEGF、EGFR及肿瘤标志物的影响

目的观察重组人血管内皮抑制素(恩度)联合顺铂腔内灌注治疗恶性胸腔积液的疗效,并探讨其对血清血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)及肿瘤标志物水平的影响。方法 92例合并恶性胸腔积液的晚期非小细胞肺癌(NSCLC)患者随机分为观察组和对照组,各46例。2组均在B超定位下行胸腔穿刺充分引流后给药,对照组给予顺铂40 mg腔内灌注,第1、4、7天;观察组在此基础上增加恩度45 mg腔内灌注。3次灌注为1个疗程,最多可连续治疗2个疗程。1个疗程结束后评估临床疗效并记录不良反应发生率,对比治疗前后胸腔积液VEGF、EGFR水平及血清肿瘤标志物水平变化,包括癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC)、神经元特异性烯醇化酶(NSE)。结果观察组总有效率为86.96%,显著高于对照组的69.57%(P0.05);治疗后2组各指标均下降,且观察组各指标均低于对照组,差异有统计学意义(P0.05或P0.01);2组不良反应发生率无显著差异(P0.05)。结论与顺铂单药相比,恩度联合顺铂腔内灌注治疗可有效提高恶性胸腔积液患者的临床疗效,降低积液内VEGF、EGFR及血清肿瘤标志物的水平,且不增加不良反应。     

重组人血管内皮抑素腹腔内给药治疗恶性腹腔积液的实验研究

目的初步探讨血管内皮抑素(ES)腹腔内给药治疗恶性腹腔积液的治疗机制。方法健康BABL/C小鼠,应用S180细胞建立腹腔积液模型。ES分为5.00mg/kg、2.50mg/kg及1.25mg/kg三组;阴性对照组为生理盐水组;阳性对照组为60.00mg/kg顺铂组。S180细胞腹腔注射接种5d后,实验药物隔日腹腔注射。记录小鼠体重作为腹水计量变化指标。计数小鼠存活只数计算存活率。结果 ES治疗癌性腹水的实验结果显示实验各组间小鼠体重具有统计学差异,高剂量组具有明显的优势,并且与顺铂对照组相当,组间比较具有统计学差异(P<0.05)。ES对恶性腹水小鼠存活率的影响提示,除低剂量组与中剂量组之间无统计学差异外,其余各组间均有统计学差异(P<0.05);不同时间存活率各组间比较均有统计学差异(P<0.01)。综合分析结果显示:在各实验组中,低剂量治疗组小鼠存活率显著高于其他各治疗组,低剂量组小鼠,存活时间长。结论重组人ES具有较好的抗肿瘤性腔内积液效果,并可延长腹水小鼠的生存时间,提高生存率。     

Interaction of peptidoglycans with anti-IgGs and with complement.

This report describes the interaction of peptidoglycan (Streptococcus group A, Staphylococcus epidermidis and Micrococcus lysodeikticus) with 2 serum mediator systems, namely with the anti-IgG system and with complement. The observation that the majority of rabbits hyperimmunized with A-variant streptococcal vaccine produced anti-group carbohydrate antisera containing anti-IgGs and antibodies directed to peptidoglycan suggested that the production of these 2 latter antibodies was related. This view was supported by the finding of a monoclonal 7S anti-IgG with antibody specificity for the pentapeptide of peptidoglycan as evidenced by inhibition of the coprecipitation of 7S anti-IgG with antigen-antibody complexes by the pentapeptide. Inhibition of the anti-idiotype reaction by the pentapeptide provided further evidence for the antibody specificity of 7S anti-IgG for peptidoglycan. When added to normal human sera all peptidoglycan preparations inhibited the hemolytic activity of the sera. Consumption of C3 in C2 deficient serum and consumption of C2 in normal serum indicated the activation of both known complement pathways. Activation of the classical pathway of complement was more efficient since 50 mug of peptidoglycan consumed approximately 70% of C2 per ml normal serum whereas more than 2 mg of the same preparations was required to inactivate 17-24% of C3 in C2 deficient sera. Each of the different peptidoglycan preparations consumed similar amounts of complement in all 20 sera tested. This finding suggested that activation of the classical complement pathway by peptidoglycan was not mediated by anti-peptidoglycan antibodies present in only 20-40% of normal human sera.     

异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较

Toreleasetheseverewithdrawalsymptomsoftheheroinad-dicts,weinjecttheNaloxineinthegeneralanesthesia.160volun-teersreceivedRODwereperformedunderthecombinedanesthesiawithpropofol,midazolamandketamine.1Subjectsandmethods1.1Subjects160volunteerswhoaccordingwiththediagnosticstandardoftheICD-10abouttheopiate-addiction,male:145,fe-male15.Age:(30±6),theeldestwas45yearsold.Themeanbodyweightwasabout(58±8)kg.Educationalbackground:pri-maryschool118cases,juniorhighschool:24casesandseniorhighschool/seco…     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识。方法分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法。结果本组患者治愈5例,好转13例,死亡8例。存活患者随访6～30个月均未复发。结论三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义。     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的 通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识.方法 分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法.结果 本组患者治愈5例,好转13例,死亡8例.存活患者随访6～30个月均未复发.结论 三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义.     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。     

An electroencephalographic comparison of alfentanil with other narcotics and with thiopental

Using aperiodic analysis, we compared the EEC produced by alfentanil with the EEGs produced by two other opiates—fentanyl and sufentanil—on the one hand and with the EEG produced by a barbiturate—thiopental—on the other hand. Alfentanil and thiopental were injected over 1 minute: fentanyl and sufentanil were injected over 10 to 15 minutes. From the aperiodic analysis we derived up to seven single-number variables computed over 30- or 60-second epochs. All the opiates induced EEGs that were qualitatively similar to each other, although the maximum or minimum values tended to be greater and the time course more rapid with alfentanil than with the other two opiates. This finding may have been related to the fact that we injected relatively more alfentanil and administered it more rapidly. The EEGs produced by alfentanil and thiopental differed markedly, both qualitatively and quantitatively. The total power at 1 Hz and cumulative power at 3 Hz went to higher peak values with alfentanil, the latter tending to decrease with thiopental. The total number ot waves per epoch went to lower peak values with alfentanil; there was little change with thiopental. The frequency below which 90% ot the power resides went to considerably lower peak values with alfentanil than with thiopental. Finally, total power at 10 to 12 Hz (alpha waves; and average power at 17 to 19 Hz (beta waves) went to very high peak values with thiopental, but decreased with alfentanil. In spite ot differences in the opiate studies in the timing ot injection and the relative amount ot drug injected, the variables that proved useful in their response to fentanyl and sutentanil also proved useful with altentanil. In contrast, almost all variables showed a difference in response between alfentanil and thiopental. Supported in part by Janssen Pharmaceutics, Inc. Pisacataway, NJ, and by Diatek Corporation, and the Veterans Administration Medical Center, San Diego, CA.     

肿瘤血液透析患者的心理分析及护理

目的评价为肿瘤血液透析患者实施心理护理的效果。方法肿瘤血液透析患者38例实施自身对照,观察心理护理前后其心理状态的变化。结果经过心理护理,患者心态变得平稳,依从性增强,能更好地配合治疗。结论有针对性的心理护理能帮助患者以积极的心态面对困难,增强战胜疾病的信心,更好地配合治疗,并有助于血液透析治疗的顺利进行。     

913例住院患者满意度调查分析

目的:通过住院患者满意度调查分析,提高护理质量,促进和谐护患关系的发展。方法:选择2009年1～6月入住本院妇科的913例患者,主要针对护士的服务态度、操作技术、与患者沟通情况、护士对患者的关怀及健康教育5个方面,在患者出院时进行满意度调查。结果:患者对护士服务的总体满意度为92.94%,对护士的服务态度、操作技术的满意度最高,对护士操作时尊重患者隐私及护士所作的药物指导满意度最低,不同文化程度、不同职业、不同住院次数的患者满意度有一定的差距。结论:医疗机构应科学配备护理人员,培养护士的人文关怀精神,进一步拓宽健康教育的深度及广度,努力构建和谐护患关系。     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.