2001~2011年石河子地区COPD住院患者合并高血压和糖/脂代谢紊乱情况调查

目的探讨慢性阻塞性肺疾病(COPD)患者合并高血压和糖/脂代谢紊乱的发病状况及其影响因素。方法选取2001年4月至2011年7月就诊于石河子大学医学院第一附属医院住院的1 376例COPD患者,回顾性分析COPD合并高血压和糖/脂代谢紊乱的发病状况,同时对导致COPD合并高血压和糖/脂代谢紊乱发生的影响因素进行分析。结果 (1)COPD患者中合并高血压、糖尿病/糖耐量异常、高脂血症/脂蛋白代谢紊乱的发病率分别为41.1%、17.2%、9.2%。(2)就合并高血压、糖尿病/糖耐量发病率而言,3个不同年龄段比较,差异均有统计学意义(P<0.01);60~<80岁患者高脂血症/脂蛋白代谢紊乱发病率较40~<60岁患者更高,差异有统计学意义(P<0.05)。(3)男性患者中COPD合并高血压、糖尿病/糖耐量异常、高脂血症/脂蛋白代谢紊乱的发病率为36.0%、16.5%、4.8%,女性患者中该比率分别为47.6%、22.3%、10.8%,两组比较,差异均有统计学意义(P<0.01)。(4)50~<60岁、60~<70岁女性患者的高血压患病率较男性高,差异均有统计学意义(P<0.05),其中以60~<70岁阶段差异最为显著。随着年龄的增大,女性患者高脂血症/脂蛋白代谢紊乱发病率较男性高,在70~<80岁阶段最为明显,差异有统计学意义(P<0.05)。结论 年龄和性别均能影响COPD合并高血压和糖/脂代谢紊乱的发生,为临床上预防和治疗COPD合并症提供理论指导。     

不同病理类型Ⅰ期肺腺癌患者的生存状况研究

目的探讨不同病理类型Ⅰ期肺腺癌患者的生存状况的预测价值。方法 146例Ⅰ期肺腺癌患者按照IASLC/ATS/ERS新分类进行重新分型,分析生存状况及影响患者生存时间的危险因素。结果 146例患者主要为腺泡为主型、乳头为主型、实体为主型,分别占65.1%、15.1%、8.9%;5年总生存率为84.9%,5年无进展生存率为73.3%,有微乳头成分患者的5年无进展生存率显著低于无微乳头成分患者(P0.05);贴壁型患者的5年无进展生存率与5年总体生存率均为100%,而微乳头为主型与实体为主型患者的5年无进展生存率为50.0%与61.5%;Cox多因素分析结果显示,肿瘤大小是影响患者死亡与复发转移的独立危险因素。结论 IASLC/ATS/ERS新分类对于Ⅰ期肺腺癌患者的生存状况具有一定预测价值,微乳头成分会对患者的预后造成一定影响。     

200例肺癌患者的流行病学调查研究

目的:对肺癌患者的流行病学特征及病理类型分布特点进行调查和分析,从而为防治肺癌提供科学依据,降低肺癌的发病率和死亡率。方法:选取2015年至2017年在我院住院治疗的200例肺癌患者作为研究对象。所有患者均经病理组织细胞检查确诊为肺癌。对患者的临床资料进行回顾性分析。结果:性别分布情况:男性患者占比明显高于女性。年龄分布情况:患者年龄40-82岁,其中,40-49岁年龄组31例,50-59岁年龄组78例,60-69岁年龄组61例,70-79岁年龄组27例,80-89岁年龄组3例;50-59岁年龄组患者数量最多。地域分布情况:农村人口所占比例逐年上升,而城镇人口所占比例逐年下降。不良生活习惯及病史:有不良生活习惯者的男性患者比例明显高于女性患者,有呼吸系统疾病病史者占比29.00%,有恶性肿瘤家族史者占比0.50%。病理类型分布:鳞状细胞癌35例,腺癌患者115例,其他类型50例。结论:肺癌是一种发病率较高的肿瘤疾病,男性发病率高于女性,患者中老年人比例较高,危险因素主要为吸烟、嗜酒等不良生活习惯,病理类型主要为腺癌。     

肺腺癌外科治疗疗效观察

肺癌发病率迅速增长,其中肺腺癌发病率的增加尤为突出。为探讨其特有的临床表现与外科疗效,现对我们1995-01～2001-10经手术病理证实的34例肺腺癌治疗体会总结如下。1临床资料本院34例肺腺癌中,男23例,女11例。年龄33～76岁,平均54.5岁。术前有症状者26例,其中咳嗽、血痰、胸痛;体检发现8例。19例有长期吸烟史,其中吸烟指数>400支/年者15例。出现症状至确诊时间<3个月者17例,>6个月者11例。14例曾误诊,其中误诊为肺炎3例,肺结核病4例,肺良性肿瘤3例,肋间神经痛1例;以肺外表现为首发症状而误诊3例,其中2例头痛、右上肢麻木、感觉异常疼痛;突…     

周围型肺腺癌的CT表现

<正>肺癌是最常见的恶性肿瘤之一,近年来发病率呈逐渐上升趋势,是现今癌症中病死率最高的一种,肺癌的早期诊断较为困难,5年生存率为10%~15%。肺腺癌居肺癌第三位且又以周围型肺腺癌最常     

YTH结构域家族蛋白 2和叉头蛋白转录因子 3在肺腺癌中的表达关系研究

目的分析 YTH结构域家族蛋白 2(YTHDF2)及叉头蛋白转录因子 3(FOXO3)在肺腺癌病人中的表达及与预后的关系。方法收集 2020年 1月至 2021年 5月在郑州大学第一附属医院行手术治疗的肺腺癌病人癌组织及对应的癌旁组织(距离癌组织 5 cm以上) 80对,收集病人临床病理资料;利用癌症基因组图谱( TCGA)数据库查询 YTHDF2、FOXO3基因在肺腺癌中的表达水平;采用免疫组织化学法检测 YTHDF2、FOXO3蛋白在肺腺癌组织中的表达情况;分析 YTHDF2、FOXO3蛋白水平与肺腺癌病人临床病理资料的关系;分析肺腺癌中 YTHDF2与 FOXO3基因表达水平的相关性;对病人进行为期 3年的随访,分析病人 3年累积生存率。结果 YTHDF2、FOXO3蛋白在肺腺癌组织中的高表达率分别为 34.00%、26.00%,明显低于癌旁正常组织中 79.48%、61.54%(P<0.05)。 YTHDF2蛋白表达情况与肺腺癌病人年龄、淋巴结转移和分化程度相关( P<0.05);与 TNM分期、性别无关( P>0.05); FOXO3蛋白表达情况与肺腺癌病人性别和分化程度相关(P<0.05);肺腺癌组织中 YTHDF2蛋白高表达组和低表达组病人 3年累积生存率分别为 53.30%、14.00%,经 log-rank比较,差异有统计学意义( P<0.05); FOXO3蛋白高表达组和低表达组病人 3年累积生存率分别为 64.50%、12.20%,经 Log-Rank比较,差异有统计学意义( P<0.05)。结论 YTHDF2、 FOXO3在肺腺癌组织中均低表达,与病人肿瘤分化程度及 3年累积生存率有关,有望成为评估肺腺癌病人预后的生物标志物。     

24例恶性肿瘤合并结核的治疗观察

近年来,恶性肿瘤的发病率逐年上升,而经积极治疗后生存率提高,生存期延长,但合并肺结核的病例有增多趋势,诊治有一定的困难。我院回顾性分析2000年1月~2003年2月共24例恶性肿瘤合并结核的临床资料。1临床资料1.1一般资料:24例病例均有恶性肿瘤病理、细胞学诊断、痰菌阳性或典型的影像学诊断或病理活检证实。男性17例,女性7例;年龄35~64岁,中位年龄52.2岁。食管癌7例,均为鳞癌;肺癌15例,鳞癌12例,腺癌2例,小细胞癌1例;大肠癌2例,均为腺癌。肺结核21例,其中痰菌阳性18例;淋巴结核2例,肠结核1例。肿瘤治疗后陈旧性结核复发15例,食管癌5例,肺癌1…     

弹力纤维在肺腺癌组织中的分布量与患者临床特征和预后的关系

目的 探讨弹力纤维在肺腺癌组织中的分布量与患者临床特征和预后的相关性。方法 收集安徽医科大学第一附属医院2012年1月至2014年8月术后病理诊断为肺腺癌的标本123例。所有病理标本行苏木精-伊红、弹力纤维染色,观察弹力纤维在肺腺癌中的分布量,同时依据弹力纤维在癌组织中量的多少,将弹力纤维量的表达分为I级、Ⅱ级、Ⅲ级3个等级,术后随访5～66个月,分析弹力纤维3个等级与肺腺癌的临床特征和预后的关系。结果 123例肺腺癌中,弹力纤维I级60例（48.78%）,Ⅱ级23例（18.70%）,Ⅲ级40例（32.52%）;单因素分析显示,3组弹力纤维分级患者一般资料比较显示,年龄、性别,差异无统计学意义（P均> 0.05）,肿瘤直径、淋巴结分期和病理类型,差异有统计学意义（P均< 0.05）。随访结果显示,123例肺腺癌中,弹力纤维I级、Ⅱ级、Ⅲ级患者的总生存率分别为60.00%、79.30%、95.00%,弹力纤维Ⅲ级患者的总生存率高于I级、Ⅱ级,差异有统计学意义（P < 0.05）。COX多因素分析显示,肿瘤直径、淋巴结分期是影响肺腺癌预后的独立危险因素（P均< 0.05）,弹力纤维分级与患者预后无关（P > 0.05）。结论 弹力纤维明显增生的肺腺癌患者预后较好,但弹力纤维增生不是影响肺腺癌预后的独立危险因素。     

心包内肺切除术9例报告

经心包内肺血管处理行肺切除术可用于全肺切除或肺叶切除。近年来肺癌发病率逐年增加,Ⅲ期中央型肺癌增多,按常规肺切除术已难以适应,如强行分离血管、肺门,术中危险性大。采用心包内肺切除术,提高了Ⅲ期中央型肺癌患者的切除率和生存率,提高了手术的安全性。我院1994年4月至1997年4月共施行心包内肺切除术9例,手术效果满意,现报告如下。临床资料　本组9例,均为男性,年龄40～70岁,平均58岁。病理分类为鳞癌5例,腺癌2例,小细胞癌和肺泡癌各1例。左全肺切除4例,右全肺切除3例,左下肺切除2例。肺门固定6例,肺门或纵隔淋巴结肿大9例。1例主动脉…     

慢性阻塞性肺疾病合并肺癌的危险因素

目的分析慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并肺癌的危险因素,比较各危险因素在COPD合并肺癌中影响的差异性。方法对2011年至2013年山西省人民医院所有COPD合并肺癌患者进行对照分析。结果性别、年龄、吸烟史是COPD合并肺癌的独立危险因素;肺癌发生的OR值分别为:合并/肺癌,<50岁者0.2,50⁷0岁者0.44,>70岁者3.00);合并/肺癌/COPD,<600支/年11∶20∶13;60070岁者0.44,>70岁者3.00);合并/肺癌/COPD,<600支/年11∶20∶13;600¹000支/年14∶6∶4,>1000支/年9∶8∶17。结论年龄在70岁以上,吸烟指数在6001000支/年14∶6∶4,>1000支/年9∶8∶17。结论年龄在70岁以上,吸烟指数在600¹000支/年的男性患者是发生COPD合并肺癌的主要危险因素。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Isolation and characterization of glycosylated and non-glycosylated prolactins from alligator and crocodile

Two molecular forms of prolactin (PRL). glycosylated and non-glycosylated, were isolated from pituitary glands of two reptiles, alligator and crocodile. The reptilian PRLs were extracted under alkaline conditions from the precipitate obtained after pituitaries were first extracted with 0.25 m sucrose, 1 mM NH₄HCO₃, pH 6.3. Purification was performed by ion exchange chromatography on DE-52, gel filtration on Sephadex G-75 superfine, and reversed phase high performance liquid chromatography. Two forms of both alligator and crocodile PRL, designated PRLI and PRLII, with molecular weights of 26000 and 24000 were isolated. Alligator and crocodile PRLI and PRLII were stained specifically in immunoblots with anti-sea turtle PRL and anti-ostrich PRL. Sequence analysis revealed that both forms of alligator and crocodile PRLs consisted of 199 amino acid residues with a glycosylation consensus sequence (Asn-Ala-Ser) at position 60 in alligator and crocodile PRLs with a molecular weight of 26000 (PRLI). In contrast, Thr was substituted for Asn at position 60 in the PRLs with a molecular weight of 24000 (PRLII). The sequences of alligator PRLs differed from crocodile PRLs only in position 134: Val for alligator PRLs and He for crocodile PRLs. There is a high degree of structural conservation between the reptilian PRLs isolated in this study and avian PRL; each showed 92% sequence identity with chicken PRL and 89% with turkey PRL.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.