甘氨双唑钠联合小剂量顺铂对中晚期食管癌放疗的增敏作用

目的探讨甘氨双唑钠联合小剂量顺铂对中晚期食管癌同期放疗的增敏作用并评估其应用前景。方法 62例中晚期食管癌患者全部采用三维适形放射治疗,总剂量60~70 Gy。所有患者被先后随机地（机械抽样法）分成A、B两组。A组：顺铂每天10 mg,连续静脉滴注5天,周一至周五;应用甘氨双唑钠700 mg/m2于放疗前静脉滴注,每周3次,用药后1小时内接受放疗。B组：为对照组,仅应用甘氨双唑钠700 mg/m2于放疗前静脉滴注,每周3次,用药后1小时内接受放疗。结果治疗结束后1月进行疗效评价,甘氨双唑钠联合小剂量顺铂总有效率为93.3%;对照组总有效率为70.0%,两组比较差异有统计学意义（P〈0.05）。结论甘氨双唑钠联合小剂量顺铂放疗增敏能提高中晚期食管癌的放疗效果,且较单用甘氨双唑钠放疗增敏效果好。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

预见性护理对减少冠状动脉内支架置入术后并发症发生的效果观察

目的探讨对冠状动脉内支架置入术后患者实施预见性护理干预措施防止和减少术后并发症发生的护理效果。方法选择2010年6月至2010年12月60例STENT术患者设为对照组,术后实施常规护理;选择2011年1月至2011年6月60例STENT术患者设为干预组,术后实施预见性护理干预措施。比较两组患者术后并发症的发生率。结果干预组患者术后并发症的发生率显著低于对照组(P<0.01)。结论对冠状动脉内支架置入术后患者实施有效的预见性护理能够防止和减少术后并发症的发生,提高手术成功率。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

目的 探讨透出液蛋白丢失对连续性非卧床腹膜透析（CAPD）患者营养不良-炎性反应-动脉硬化（MIA）综合征的影响。 方法 对130例无明显水肿和活动性感染的CAPD患者进行横断面的研究。用标准腹膜平衡试验（PET）评估CAPD患者腹膜转运功能。颈动脉彩色超声检测颈动脉内膜中层厚度（IMT）。检测患者血清白蛋白、夜间留腹透出液蛋白和超敏C反应蛋白（hs-CRP）的水平。残余肾功能（rGFR）为24 h尿尿素氮和尿肌酐清除的平均值。 结果 Pearson和Spearman相关分析显示,CAPD透出液蛋白的丢失与年龄、体质量指数（BMI）、夜间腹透液留腹的时间、血糖、4 h透出液肌酐与血肌酐比值（4 h D/Pcr）及hs-CRP水平呈正相关（分别为r = 0.204,P < 0.05;r = 0.314,P < 0.01;r = 0.265,P < 0.01;r = 0.212,P < 0.05;r = 0.401,P < 0.01和r = 0.216,P < 0.05）;与舒张压、血清白蛋白、透析液糖浓度及腹膜Kt/V呈负相关（分别为r = －0.209,P < 0.05;r = －0.123,P < 0.05;r = －0.271,P < 0.01;r = －0.212,P < 0.01）。总体上,透出液蛋白丢失量与IMT无相关,但患者rGFR小于1 ml·min^－1·（1.73 m²）^－1时,透出液蛋白丢失量与IMT呈正相关（r = 0.650,P < 0.01）。 结论 CAPD患者透出液蛋白的丢失与患者腹膜转运类型、营养不良和炎性反应状态密切相关。患者rGFR小于1 ml·min^－1·（1.73 m²）^－1时,透出液蛋白的丢失是颈动脉动脉硬化的危险因素。     

塞来昔布联合携带白细胞介素24基因的溶瘤腺病毒对人类膀胱尿路上皮癌T24细胞的作用

目的 评估塞来昔布联合携带白细胞介素24(IL-24)基因的溶瘤腺病毒(ZD55-IL-24)对人类膀胱尿路上皮癌T24细胞的选择性杀伤效能.方法 荧光显微镜观察ZD55-增强型绿色荧光蛋白(EGFP)对细胞的转染效率.以人类脐静脉内皮细胞(HUVEC)作为对照.RT-PCR法测IL-24 mRNA在细胞中的表达.MTT法测塞来昔布联合ZD55-IL-24对肿瘤细胞选择性抑制作用.流式细胞术检测细胞凋亡情况.结果 ZD55-EGFP感染细胞后,在相同时间下T24细胞中的荧光强度明显高于HUVEC细胞.ZD55-IL-24转染后在相同时间内T24细胞组IL-24 mRNA表达量均高于HUVEC组(t=-12.54,P＜ 0.01).ZD55-IL-24与塞来昔布联合对T24细胞的抑制率最高(P＜0.01).T24细胞各组的细胞增殖抑制率也明显高于HUVEC组(F=251.35,P＜ 0.01).联合用药组的T24细胞凋亡率也明显高于单独用药组;T24细胞组凋亡率明显高于HUVEC组(P＜ 0.001).结论 塞来昔布与ZD55-IL-24联合用药能最大程度地抑制T24细胞的增殖,而对正常细胞影响轻微.这种抑制作用可能与细胞凋亡有关.     

分级心理护理模式在鼻咽癌放疗期间的效果评价

目的探讨分级心理护理模式对鼻咽癌患者放疗期间症状及生存质量的影响,为临床开展有效的心理护理模式提供参考依据。方法选取2016年8月至2017年3月该院放疗科接受放射治疗的鼻咽癌患者39例作为对照组,临床配对筛选该院2017年4―12月进行治疗的鼻咽癌患者39例作为观察组。对照组给予鼻咽癌放疗常规护理,观察组按照放疗期间SCL-90症状自评量表、匹兹堡睡眠质量指数(PSQI)及口腔黏膜反应评分进行分级心理护理。比较2组患者SCL-90、PSQI、食欲情况、口腔黏膜损伤程度、放疗相关并发症和生存质量。结果经过分级心理护理,观察组PSQI及食欲较对照组均有明显改善(P0.05);口腔黏膜损伤程度明显低于对照组;QLQ-C30患者在社会角色功能、情绪和记忆功能,以及放疗相关并发症等方面与对照组比较,差异有统计学意义(P0.05)。结论鼻咽癌患者在放疗的不同阶段开展分级心理护理,效果优于常规心理护理,可明显降低患者负性情绪,减轻放疗相关并发症,促进患者康复并提高生活质量。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

B超诊断异位妊娠35例体会

<正> 异位妊娠破裂可引起大出血,甚至危及孕妇生命。1995～2002年在本站早期妊娠检查妇女中发现异位妊娠35例,其中输卵管妊娠30例,宫角妊娠3例,卵巢妊娠1例,宫内宫外同时妊娠1例,经手术剖腹探查证实,现将B超诊断体会报告如下。