心脏直视手术后心包及纵隔引流血的分析（附18例报告）

目的：为心脏直视手术后回输未经洗涤的心包及纵隔引流血提供可靠依据。方法：对１８例心脏直视手术后心包及纵隔引流血和１１例库血进行检测，并对各项结果进行Ｆ检验。结果：术后４小时及６小时心包及纵隔引流血分别占术后２４小时引流血量的５０．７％（３６０±９５ｍｌ）及５７．７％（４３０±１００ｍｌ）。心脏手术后病人血及其引流血经需氧菌及厌氧菌培养均阴性。引流血红细胞压积０．３１，库血０．３４（Ｐ＞０．０５）。引流血纤维蛋白降解产物（ＦＤＰ）２３１μｇ／ｍｌ，库血１２５０μｇ／ｍｌ（Ｐ＜０．０５），说明引流血的纤溶活性明显低于库血。ＶＩＩ因子测定，引流血虽较正常值低，但较库血略高。引流血中游离血红蛋白明显高于库血，分别为１３３８±４０６ｍｇ／Ｌ及２１８±８７ｍｇ／Ｌ（Ｐ＜０．０５）。结论：心脏直视手术后的纵隔及心包引流血回输是安全的。     

部分切除术与根治术治疗pT1bN0M0期肾癌的临床疗效对比

目的 比较肾癌部分切除术（partial nephrectomy, PN）和肾癌根治术（radical nephrectomy, RN）治疗pT1bN0M0期肾癌的临床疗效及预后评估,为pT1b期肾癌的治疗选择提供参考。方法 回顾性研究湖北省肿瘤医院从2004年1月至2010年12月诊断为pT1bN0M0的肾癌患者（PN=16例,RN=52例）。比较两组之间的5年总生存率（overall survival, OS）,5年无复发生存率（recurrence-free survival, RFS）,和5年癌症特异性生存率（cancer-specific survival, CSS）。同时收集了术前和术后肌酐和肾小球滤过率（estimated glomerular filtration rate, eGFR）以评价肾功能的改变。结果 PN与RN的5年OS（90.3% vs. 88.6%, P=0.552）、RFS（90.3% vs. 75.4%, P=0.121）和CSS（90.3% vs. 92.8%, P=0.875）方面差异均无统计学意义。而术后肾功能下降患者所占比例在PN组显著优于RN组（0 vs. 12.6%, P<0.01）。术后一年血肌酐和eGFR水平在RN组中要高于PN组 [（0.3±0.6）vs.（0.2±0.1）、（20.1±12.6）vs.（9.8±12.1）],但是差异无统计学意义（P=0.115, P=0.064）。结论 PN或RN对于pT1bN0M0期肾癌的治疗在预后和安全性方面差异均无统计学意义,PN术后肾功能指标显著优于RN,PN是治疗pT1b期肾癌的一个可行方案。     

根治性外放射治疗与根治性前列腺切除术治疗局限性高危前列腺癌的疗效比较

目的 比较根治性外放射治疗（ExRT）与根治性前列腺切除术（RP）治疗局限性高危前列腺癌患者的疗效。方法 回顾性分析诊断为高危前列腺癌（T2b-T4N0M0）并接受ExRT或RP的150例患者。高危前列腺癌的入选标准为PSA≥20 ng/ml或cT3以上或GS≥8。主要研究终点为无生化复发生存期,次要研究终点为无远处转移生存期、癌症特异性生存期及总生存期。结果 88例患者接受了ExRT及雄激素剥夺治疗（ADT）,其余62例患者接受了RP及盆腔淋巴结清扫术（PLND）。两组患者的中位年龄（68.9±5.2 vs. 64.3±6.5岁, P=0.012）及中位随访时间（60.2±32.3 vs. 45.8±25.5月,P=0.005）差异有统计学意义。ExRT组患者生化复发率显著低于RP组患者（23.9% vs. 58.1%, P<0.001）,而无生化复发患者生存期显著延长（96.2±7.4 vs. 38.7±4.6月, P<0.001）。两组无远处转移生存期、癌症特异性生存期及总生存期差异均无统计学意义。结论 与RP相比,接受ExRT治疗的局限性高危前列腺癌患者生化复发率低,无生化复发生存期显著延长。     

二阶导数光谱法测定鼻灵滴鼻剂中盐酸去氧肾上腺素的含量

目的建立鼻灵滴鼻剂中盐酸去氧肾上腺素的含量测定的二阶导数光谱法。方法采用二阶导数光谱法测定制剂中盐酸去氧肾上腺素的含量,λ=289nm,△λ=1nm,SLIT=2nm。结果在20~100mg·L~(-1)的范围内,振幅值(D)与浓度呈良好线性关系(r=0.9998)。回收率为100.2%,RSD为0.21%。结论本法可用于测定鼻灵滴鼻剂中盐酸去氧肾上腺素的含量。     

Bcl-xL overexpression and its association with the progress of tongue carcinoma

Apoptosis-related protein B-cell lymphoma-extra large (Bcl-xL) has a crucial role in the control of cell death through its inhibition of apoptosis. This study was designed to investigate the expression of Bcl-xL in relation to the development of tongue carcinoma and whether it has potential as a marker for the clinical diagnosis of tongue carcinoma and as a therapeutic target to evaluate the dynamic of tongue carcinoma progression. A statistical analysis of 100 cases oral tongue carcinoma tissue specimens were performed using pathological grading and clinical TNM staging, and 14 cases corresponding non-tumor tissues as control. The changes in Bcl-xL mRNA expression between different pathological grades and clinical TNM stages of tissue were analyzed by RT-PCR. Additionally, immunohistochemical SP method and Western blot assays were employed to detect changes in Bcl-xL protein expression in different tongue carcinoma tissues. The results showed the expression of Bcl-xL was significantly higher in tongue carcinoma tissues than in normal tongue tissues and was positively associated with the degree of differentiation and the clinical TNM staging, but negatively correlated with the degree of malignancy of the tumor. There was higher expression of Bcl-xL in oral tongue squamous cell carcinoma (OTSCC) tissues compared with oral tongue adenocarcinoma (OTA) tissues, but Bcl-xL expression in tissue with lymph node metastasis was significantly higher than that without lymph node metastasis. Thus, Bcl-xL overexpression may be closely related to the dynamic of the pathogenesis and development of tongue carcinoma. It may be a useful marker for clinical diagnosis and an aid to evaluating the efficacy of therapeutics in tongue carcinoma.     

独活寄生汤加减内服合自拟方外用治疗膝骨性关节炎64例疗效观察

[目的]探讨独活寄生汤加减内服合自拟方外用治疗膝骨性关节炎的疗效。[方法]独活寄生汤加减内服,自拟方为基础方加减外敷,制成的粉剂形成的膏剂以及用外洗自拟方形成的熏洗,水煎取汁,按膝关节骨性关节炎轻重程度分为5型进行治疗比较,共64例,按平均治疗率统计。[结果]治愈5例,显效28例,好转25例,无效6例,总有效率79.41%,以1期为标准组,与其他对比,疗效显著,差别有统计学意义（P〈0.05）。[结论]独活寄生汤加减内服合自拟方外用治疗膝骨性关节炎的疗效显著,尤其是1期患者。