河南林州石村居民反流性食管炎发病特征和食管癌家族史调查

目的调查食管癌高发区河南林州市石村居民反流性食管炎(reflux esophagitis,RE)和食管癌家族史流行特征,加深对食管癌发病机制的了解。方法采用问卷调查表,包括一般情况、上消化道疾病史以及食管癌家族史调查三项主要内容,对石村334户508人进行逐一调查。采用Excel和SPSS 18.0进行数据分析。结果 RE评分>12分者有28人,占总调查人数的5.5%,其中男性8人(28.6%),女性20人(71.4%)。在调查的334户中,家族性食管癌52户(15.57%)。结论河南省食管癌高发区食管反流发生率明显低于西方国家,而食管癌家族聚集现象十分常见,提示中国食管癌的发病模式不同于西方。     

三姐妹共患食管癌两家系10例调查分析

食管癌的发病原因未能完全明确。在食管癌高发区存在明显的家族聚集性。本文报道并分析了本院治疗的食管癌中两个家族三姐妹均患食管癌及其三代母系遗传倾向的情况。１临床资料两组１０例患者临床资料，治疗方法和结果见附表。附表两组发病年龄、病检结果、治疗方法及生存...     

家族性食管癌组织中FHIT、p53蛋白的表达

目的:探讨家族性食管癌组织中脆性组氨酸三联体基因(FHIT)和p53蛋白的表达.方法:采用免疫组织化学ABC法对74例河南省林州市食管癌患者(其中33例家族性食管癌,4l例非家族性食管癌)手术切除标本癌及癌旁正常组织中FHIT及p53蛋白进行检测.结果:食管癌组织中FHIT蛋白异常表达率(39%,29/74)高于癌旁正常组织(3%,1/31),家族性食管癌组织中FHIT蛋白异常表达率(56%,18/33)高于非家族性食管癌组织(27%,11/41)(P均＜0.05).家族与非家族性食管癌组织p53蛋白阳性表达率差异无统计学意义(P＞0.05).结论:FHIT异常表达可能与食管癌家族高易感性密切相关;p53可能与其他易感因素协同作用,影响食管癌的发生.     

具有家族史的食管癌患者的遗传流行病学研究

太行山区是我国食管癌、胃癌、贲门癌的高发区.为了进一步的研究食管癌与遗传的关系,我们调查了河北省涉县47000人口,发现了癌症患者227例,其中食管癌患者就有118例,患病率(占调查人口)为0.25%,占其他癌症患者数的51%,并且在118例食管癌患者家庭中,发现有21个家庭表现出明显的家族史,我们应用遗传流行病学及群体遗传学的分析方法对21个家庭中的患者进行了分离比,相对危险性,适合度,基因突变率的分析.分析结果表明,这些家庭的食管癌患者的发病情况符合G·Mendel遗传规律,(P>0.05),属于单基因遗传病的常染色体显性遗传(AD).患者一级亲属的相对危险性高于对照组一级亲属的9.18倍,可信限在6.70—11.6,患者的二级亲属的相对危险性高于对照组二级亲属的21.9倍,可信限在15.99—27.8.适合度f=0.97,突变率u=37.5×10~(-6)/代.     

食管癌高发区反流性食管炎患病情况调查

目的:探讨河南食管癌高发区居民反流性食管炎(RE)的流行病学及组织病理学变化特征.方法:采用RE问卷调查、胃镜黏膜活检和组织病理学检查等技术,分析河南食管癌高发区居民RE变化特征和规律.结果:胃镜检查共发现26例RE患者(26/412,6%),RE洛杉矶分级B级为主(23/26).412例接受胃镜检查的居民中,327例接受问卷调查,其中RE患者21例;RE最常见的症状依次为烧心(33%),反酸(32%),反胃(30%).以胃镜检查正常者21例为正常对照,RE患者基底细胞过度增生(BCH)和间变(DYS)的检出率高于正常对照,未检出食管癌、肠上皮化生和Barrett's食管;RE患者食管下段上皮乳头高度和密度均高于正常对照(P＜0.05).RE患者食管下段黏膜病变组织中嗜酸性粒细胞浸润明显,正常对照无浸润.结论:食管上皮乳头升高和乳头密度增大及嗜酸性粒细胞浸润是RE主要的组织病理学改变,并常伴有BCH和DYS改变以及极少的Barrett's食管发生率,提示河南食管癌高发区食管贲门交界部腺癌的发生模式可能与西方不同.     

河南林州食管癌家族史阳性患者比较基因组杂交特征

目的 探讨河南食管癌高发区食管癌家族史阳性患者基因组变化特征.方法 应用比较基因组杂交技术分析13例食管癌家族史阳性和32例食管癌家族史阴性患者染色体基因组变化.结果 10q染色体部位DNA拷贝数扩增在食管癌家族史阳性患者为23%(3/13)而食管癌家族史阴性患者中无发生(P<0.05).15q染色体部位DNA拷贝数丢失在食管癌家族史阳性为38%(5/13),明显高于食管癌家族史阴性的6%(2/32)(P<0.05).3q、8q、7p、5p等染色体部位DNA拷贝数增加和3p、19q、9q等染色体部位DNA拷贝数丢失在食管癌家族史阳性和阴性患者中发生率均超过20%(P>0.05).结论 10q、15q可能存在与食管癌遗传高易感性相关的关键基因,而3q、8q、7p、5p、3p、19q、9q等可能存在与环境因素相关的食管癌关键基因.     

河南省信阳市51起新型冠状病毒肺炎聚集性疫情流行病学特征

目的 分析新型冠状病毒肺炎聚集性疫情的发生特点和流行规律,为制定疫情防控策略和措施提供科学依据。方法 根据国家卫生健康委《新型冠状病毒肺炎聚集性疫情流行病学调查指南(试行第一版)》,对2020年1月13日—3月2日报告的274例新型冠状病毒肺炎确诊病例及11例无症状感染者开展流行病学调查研究。结果 信阳市新冠肺炎聚集性疫情共发生51起,首例病例有武汉等地旅行或居住史者31起(60.78%),发病潜伏期中位数为7 d,传染人数中位数为2人。包括家庭聚集45起(88.24%),混合聚集4起(7.84%),工作聚集2起(3.92%)。共涉及139例确诊病例及10例无症状感染者,占全市总病例数的52.28%。输入性病例48例(32.21%),本地病例101例(67.79%);一代病例85例(57.05%),二代病例63例(42.28%),三代病例1例(0.67%)。暴露史有共同居住生活的84例(56.38%),共同聚餐的51例(34.23%),工作场所密切接触的12例(8.05%),娱乐场所聚集的2例(1.34%)。结论 51起聚集性疫情以家庭聚集性为主;病例的暴露史多为有共同居住生活史和共同聚餐史;多数聚集性疫情的首例病例有武汉等地旅行或居住史。     

食管癌高发区p53基因第五外显子突变分析

目的 :探讨高发区食管癌标本中p5 3基因的突变状况及其与危险因素的关系 .方法 :采用PCR扩增产物纯化后直接DNA序列测定技术对河南省林州市 4 0例食管癌标本p5 3基因第五外显子突变情况进行检测 .结果 :4 0例食管癌标本中 ,有 8例标本 10个位点发生突变 ,突变率为 2 0 % (8/4 0 ) .10个突变中 9个为点突变 ,1个为插入突变 .突变大多发生在G :C碱基对 ,G :C→A :T的置换最多 ,占 5 / 9,A :T→T :A的颠换占 3/ 9,G :C→C :G的颠换占 1/ 9.p5 3基因第五外显子突变与性别、年龄、食管癌家族史和吸烟无显著联系 (P >0 .0 5 ) ,但与食用酸菜有密切联系 (P <0 .0 5 ) ,其OR值为 5 .95(1.13～ 31.2 6 ) .结论 :高发区食管癌标本中 p5 3基因第五外显子突变位点较为分散 ,经常食用酸菜可引起 p5 3基因突变     

开顺饮加减治疗食管癌临床疗效观察

目的:观察开顺饮治疗食管癌的近期疗效.方法:采用开顺饮治疗食管癌60例患者.结果:60例患者中完全缓解1例(1.7%),部分缓解5例(8.3%).微效6例(10%),稳定35例(58.3%),进展13例(21.7%).结论:开顺饮治疗食管癌有一定近期疗效.     

新安县食管癌遗传流行病学研究

目的探讨河南省新安县食管癌发病的影响因素,为制定食管癌综合防治措施提供理论依据。方法采用以人群为基础的病例对照家系研究方法,调查新安县2个乡(磁涧、北冶)4289名72个病例对照家系的食管癌发病率,用二项分布拟合优度χ2检验进行分析、验证其家族聚集性;用Falconer回归分析方法估计遗传度。结果经频数分布拟合优度χ2检验,χ2=128.0644,P=0.000,说明食管癌在家族中并非按机会均等的概率分布,而呈明显的家族聚集倾向;食管癌先证者一级亲属的遗传度为75.70%。结论新安县调查地区食管癌有明显的家族聚集性,有较明显的遗传易感性。遗传因素在该地食管癌的发病中具有重要作用。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…