5-氮-2'-脱氧胞苷联合应用顺铂对食管癌细胞株Eca109 bax和bcl-2基因mRNA表达的影响

目的检测5-氮-2'-脱氧胞苷(5Aza-d C)联合应用顺铂(CDDP)对食管癌细胞株Eca109中bax和bcl-2基因m RNA表达的影响。方法培养食管癌细胞株Eca109,通过加入不同浓度的5Aza-d C联合应用CDDP后,提取细胞总RNA,通过RT-PCR检测细胞中bax和bcl-2基因m RNA表达变化。结果低浓度5Aza-d C+高浓度CDDP联合用药组的bcl-2表达量与空白对照组、中浓度5Aza-d C用药组和低浓度CDDP用药组比较,差异均有统计学意义(均P0.05);低浓度CDDP用药组与高浓度CDDP用药组,中浓度5Aza-d C+高浓度CDDP联合用药组,bcl-2表达量差异有统计学意义(P0.05)。而bax的表达量各组间差异无统计学意义(P0.05)。结论在食管癌细胞株Eca109中,bax和bcl-2的表达量均较高。低浓度5Aza-d C+高浓度CDDP联合用药组,使bcl-2 m RNA表达明显低于空白对照组及单一用药组。高浓度的CDDP及高浓度CDDP联合不同浓度5Aza-d C用药组,与低浓度CDDP用药组相比,可使bcl-2 m RNA表达降低。而药物对bax m RNA的表达无影响。提示食管癌细胞株中联合用药使bcl-2 m RNA表达降低,可能是癌基因bcl-2的高表达与食管癌的发生有关,但细胞株对不同药物及浓度反应有差异。不同用药组bax的表达量无明显差异,提示bax的表达可能与食管癌的发生无直接关系。     

小小『感冒』摊上『大病』

病例纪实 22岁的小张在安徽老家镇上打工,可是一次小小的“感冒”却让他“摊上了大事儿”. 随着救护车的鸣笛声,年轻的患者小张从安徽紧急转到省城医院的急诊科.当他被抬下救护车的时候,已是呼吸急促,病情危重.几天前,小张感觉不适,还有点发烧,以为是着凉感冒了.到了下午,妈妈不放心,带着小张到卫生所去挂了水.可是第二天醒来,小张仍然感觉浑身无力,又继续躺了两天.     

绝经后阴道流血287例临床分析

绝经后阴道流血〔1〕在妇科疾病中很常见,往往发生在老年患者(年龄>60岁)中,在临床往往被认为是恶性肿瘤的征兆。究其原因主要是由于老年患者在初次就诊时就已经是疾病晚期,错过了对其治疗的最佳时间,故临床上老年恶性肿瘤患者〔2〕的治疗和预后都很差,且生存率也明显降低。本文就我院诊治的绝经后阴道流血的老年病例资料进行相关分析以进一步了解其发病原因,以期达到早期诊治的目的。     

急性胰腺炎早期病情严重程度的临床指标分析

目的 探讨影响急性胰腺炎(AP)早期病情严重程度的临床指标.方法 入选临床确诊AP患者267例,根据CT分级分为轻症胰腺炎(MAP)组183例和重症急性胰腺炎(SAP)组84例,分析两组之间性别、病因、年龄和发病48 h内低氧血症的发生情况以及血清电解质、空腹血糖、C反应蛋白(CRP)、血淀粉酶变化,探讨影响AP早期病情严重程度的临床指标.结果 SAP组年龄、空腹血糖、CRP、血淀粉酶均高于MAP组[(57.76±14.65)、(48.48±14.42)岁,(10.74±4.91)、(6.66 ±2.13)mmol/L,(9.66±2.15)、( 5.84±1.74) mg/L,(412.88±347.86)、(274.04±241.92) mmol/L],血钙低于MAP组[(1.97±0.23)、(2.20 ±0.16)mmol/L],差异均有统计学意义(t值分别为-3.179、- 5.241、-10.105、-2.098、5.821,P均＜0.05)；SAP组48 h内发生低氧血症34例(40.47％),MAP组无一例低氧血症发生,组间比较差异有统计学意义(x2=84.880,P＜0.001).结论 CRP、血糖、血钙、低氧血症可以作为AP早期判断患者轻重程度的临床指标,对病情的早期预测、指导临床治疗有重要的参考价值.     

循证护理对前列腺增生并尿潴留患者导尿成功率及导尿效果的影响

目的探讨循证护理(EBN)对前列腺增生并尿潴留患者导尿成功率及导尿效果的影响。方法选取本院泌尿外科EBN模式开展前接收的45例前列腺增生并尿潴留患者为对照组,EBN模式开展后接收的45例前列腺增生并尿潴留的患者为EBN组,比较两组患者的导尿成功率与导尿效果。结果护理干预后,EBN组的尿路感染发生率、疼痛发生率及尿道黏膜损伤发生率分别为2.22%、11.11%、2.22%,显著低于对照组的13.33%、28.89%、17.78%,差异有统计学意义(P0.05);EBN组的一次性导尿成功率为97.78%,显著高于对照组的84.44%,差异有统计学意义(P0.05)。结论在EBN模式的指导下对前列腺增生并尿潴留患者进行导尿,可以提高一次性导尿成功率,保证导尿效果,值得临床推广。     

中药塌渍配合针刺治疗腰椎转移癌疼痛的机理研究

脊柱转移癌最常见的症状是疼痛,给肿瘤患者的躯体和心理带来巨大痛苦,严重影响患者的日常生活。大量的临床实践表明,祖国传统疗法在治疗癌性疼痛方面具有减少毒副作用、风险性小、不产生依赖和没有戒断反应的特点。本文将围绕中药塌渍和针灸治疗腰椎转移癌疼痛的机理研究展开论述。     

甲氨蝶呤与米非司酮联合治疗异位妊娠的疗效观察及护理

目的：对使用药物甲氨蝶呤与米非司酮联合治疗异位妊娠的临床护理方法进行探究。方法对2013年4月到2014年4月来我院就诊的30例采用甲氨蝶呤与米非司酮治疗患者的临床护理措施。结果对采用甲氨蝶呤与米非司酮联合治疗异位妊娠的患者给予有效地、全方面的综合护理，患者疾病均被成功治愈且顺利出院。结论在药物治疗期间可根据患者的实际情况，给予患者可行的、全方位的综合护理干预，能够促进患者早日康复，增强患者疾病治愈率，在临床疾病治疗中具有十分重要的意义。     

获卵数低多囊卵巢综合征患者再次促排卵的妊娠结局及影响因素分析#br#

Objective?To investigate the impact of different ovulation induction protocols on the clinical outcomes and analyze related factors when polycystic ovarian syndrome(PCOS) patients whose number of eggs obtained last time equal to or less than five received the ovarian hyperstimulation treatment again. Methods?The retrospective analysis was made on the clinical data of 242 PCOS patients whose number of eggs obtained last time was equal to or less than five in in vitro fertilization and embryo transfer(IVF/ICSI) in the Reproductive Center of Peking University Third Hospital from January 2011 to December 2018 who received the ovulation induction treatment again. The amount of Gn used, the number of eggs obtained, and the pregnancy outcome of different ovulation induction protocols was compared. At the same time, the multi-factor linear regression analysis model was used to analyze the related factors affecting the accumulative live birth rate. Results?242 patients used the ultra-long protocol, long protocol, short protocol, and antagonist protocol for ovarian hyperstimulation. The number of eggs obtained was 12.46±2.66, 12.28±86, 10.64±1.77, 13.25±0.97, respectively. There was no statistical difference among different groups (P=0.780). The amount of Gn used and the number of days of use in the antagonist protocol group was significantly smaller than those of the ultra-long protocol and long protocol groups (P＜0.05). The amount of Gn used in the ultra-long protocol group was significantly bigger than that of the long protocol, short protocol, and antagonist protocol groups (P＜0.05). In 115 transplant cycles, the rate of embryo implantation, clinical pregnancy rate, and accumulative live birth rate of different ovulation induction protocols had no statistical difference (P＞0.05). The multi-factor regression analysis showed that the treatment method was the important affecting factor of the accumulative live birth rate (P＜0.05) and the number of eggs obtained was a mediating variable. Conclusion?For PCOS patients whose number of eggs obtained last time was not big, after another time of ovulation induction, the average number of eggs obtained maybe bigger than ten and an ideal reproduction assistance outcome could be achieved.