舒尼替尼治疗转移性肾癌的疗效和安全性分析:单中心37例总结

Objective To evaluate the efficacy and safety of sunitinib in the treatment of metastatic renal cell carcinoma (RCC). Methods A total of 37 patients with metastatic RCC were treated with between June 2008 and April 2010, including 28 males and 9 females. The median age was 52 (17-74) years. All patients received a pathologic diagnosis of RCC, which consisted of 1 papillary cell carcinoma and 36 clear cell carcinomas, 4 of which accompanied with partial sarcoma differentiation. Thirty cases were treated with first line therapy and 7 cases showed progression on first-line cytokine or sorafinib therapy. Sunitinib monotherapy was administered in repeated 6-week cycles of daily oral therapy for 4 weeks, followed by 2 weeks off in 34 patients, while another 3 patients received 37. 5 mg Qd continuously until disease progression or unacceptable toxicities occurred. Overall response rate and safety were evaluated. Results The median follow up was 12 months (8 cycles),range 1.5-19. 5 months (1-13 cycles). 26.5% (9/34) patients achieved partial responses, 70.6%(24/34) patients demonstrated stable disease over≥3 months and 1 (2. 9%) patient developed progressive disease. The objective response rate was 26.5%, and the disease control rate was 97. 1%.The 12 months' overall survival rate was 95.8% (23/24), and 12 months' progression-free survival rate was 62.5 % (15/24). The most common treatment-related adverse events were thrombocytopenia (30 cases, 81.1%), thyroid dysfunction (18/22, 81.8%) ,hand-foot syndrome (27 cases, 73.0%),neutropenia (23 cases, 62.2%) and hypertension (18 cases, 48.6%). The major grade 3 adverse events included thrombocytopenia (8 cases, 21.6%), hand-foot syndrome (4 cases, 10.8%) and diarrhea (2 cases, 5. 4%). Most adverse events were ameliorated by treatment interruption. Ten (27.0%) patients had dose decrement or drug discontinuation and 1 patient quit the treatment for intolerable fatigue. Conclusion The efficacy and manageable adverse event profile of sunitinib as a single agent in first- or second-line therapy for patients with metastatic RCC.     

100例即将毕业大学生焦虑状态调查分析

焦虑是一种常见的情绪障碍,近年来国内不少研究表明大学一、二、三年级学生出现焦虑状态占总体人数的30.8％,但对大学毕业生焦虑状况的研究国内少见报道,为了解大学毕业生的焦虑状况,本研究用焦虑自评量表随机调查即将毕业的政教系大学生和在校同系     

中枢神经系统疾病髓鞘碱性蛋白和神经元特异性烯醇化酶的测定 及临床意义

通过对中枢神经系统疾病患者血清和脑脊液中MBP、NSE的同步动态检测,观察和探讨脑组织在缺血、出血以及其他脑实质性损害时大脑灰质神经元损害和脑白质脱髓鞘的程度、与临床症状的关系及其变化规律,对进一步研究急性脑血管病及其他中枢神经系统疾病的病理过程、临床判断脑损害程度及预后均有重要意义。该研究按照第二届全国脑血管病学术会议制定的诊断标准,对中枢神经系统疾病患者进行神经功能缺损评分,采用酶联免疫吸附法测定血清和脑脊液MBP、NSE。     

Neuron-specific Enclose and Myelin Basic Protein in Cerebrospinal Fluid of Patients with First Episode Schizophrenia

Schizophrenia , the most common disease ofmental illness , was regarded as functional diseasewithout organic change in the past . But recently ,more and more evidenceindicates that there are or-ganic changes in patients with schizophrenia , withthe advance of neuropathology and neuroi mag-ing[1 ,2].But it is unknown whether these organicchanges are caused by congenital aplasia or ac-quired brain damage[1]. Since 1980 s , many re-searchers reported that neuron-specific enclose(NSE) and myelin …     

探究性眼动分析对精神分裂症的诊断价值

目的：探讨探究性眼动分析（EM）对精神分裂症患者诊断价值。方法：对50例精神分裂症患者和48例正常健康者分别进行了EM测定，并将结果加以比较。结果：精神分裂症组中EM的异常率为84．0％（42／50）。精神分裂症组EM测定结果中凝视点（NEF）和反应探索评分（RSS）值显著低于对照组（P〈0．01）。结论：探讨探究性眼动分析可作为精神分裂症患者的诊断指标应用于临床。     

氟伏沙明和氯丙咪嗪治疗儿童少年强迫症的对比研究

目的：了解氟伏沙明治疗儿童少年强迫症的疗效和安全性。方法：用CCMD-3作为诊断标准，将在我院诊断明确的8～16岁的60例儿童少年强迫症患者随机分成2组，分别给予氟伏沙明和氯丙咪嗪治疗，共观察8周，采用Y—BOCS和TESS量表评定临床疗效和药物不良反应。结果：氟伏沙明治疗儿童少年强迫症的总有效率为90％，氯丙眯嗪治疗儿童少年强迫症的总显效率为86．7％，两者元显著性差异；氟伏沙明不良反应发生率33．3％，氯丙眯嗪不良反应发生率70％，两者有显著性差异，且氟伏沙明的不良反应较轻。结论：氟伏沙明对儿童少年强迫症的治疗有很好的疗效，且不良反应少。     

首发精神分裂症患者血浆IL-6、sIL-6R及IL-13水平研究

目的探讨首发精神分裂症患者血浆白细胞介素-6(IL-6)、可溶性白细胞介素-6受体(sIL-6 R)及白细胞介素-13(IL-13)水平的变化. 方法采用酶联免疫吸附法(ELISA)对30例精神分裂症患者和28例健康对照者血浆IL-6、sIL-6 R及IL-13水平进行检测.结果精神分裂症患者血浆IL-6[(20.18±2.59)pg/ml]及sIL-6 R[(33.87±16.51)pg/ml]水平显著高于对照组(P ＜0.05),而血浆IL-13[(16.15±11.98)pg/ml]水平显著低于对照组[(24.41±18.26)pg/ml](P ＜0.05);以阴性症状为主患者的IL-6[(21.04±1.72)pg/ml]及sIL-6 R[(32.83±15.72)pg/ml]水平均高于阳性组,其中阴性组患者IL-6显著高于阳性组[(18.28±3.22)pg/ml](P ＜0.05),阴性组患者血浆IL-13[(12.72±9.01)pg/ml]水平显著低于阳性组[(19.82±7.83)pg/ml](P ＜0.05);未发现患者组及对照组血浆IL-6、sIL-6 R及IL-13之间的相关性.结论精神分裂症患者存在IL-6、IL-13介导的免疫功能异常,血浆IL-6水平升高、IL-13水平降低可能是阴性症状为主患者的特征性免疫学指标之一.     

米氮平联合喹硫平治疗难治性抑郁症对照研究

目的 探讨米氮平联合喹硫平治疗难治性抑郁症的临床疗效与安全性.方法 将76例难治性抑郁症患者随机分为研究组38例,对照组38例,2组均口服米氮平治疗,研究组在此基础上联合喹硫平治疗,观察8周.于治疗前及治疗第2、4、6、8周末采用汉密顿抑郁量表、汉密顿焦虑量表、临床总体印象量表疾病严重程度分量表评定临床疗效,副反应量表评定不良反应.结果 治疗后2组汉密顿抑郁量表、汉密顿焦虑量表及临床总体印象量表疾病严重程度分量表评分均较治疗前显著下降(P＜0.01),治疗4、6、8周末研究组均较对照组下降更显著(P＜0.05或0.01);治疗8周末研究组显效率为73.7％,总有效率86.8％,对照组分别为42.1％、60.5％,研究组显效率、总有效率均显著高于对照组(x2=7.77、6.78,P＜0.01).研究组不良反应发生率为31.6％,对照组为26.3％,2组不良反应程度均较轻,同期副反应量表评分差异无统计学意义(P＞0.05).结论 喹硫平对治疗难治性抑郁症具有增效作用;米氮平联合喹硫平治疗难治性抑郁症疗效显著,起效快,安全性高,依从性好,显著优于单用米氮平治疗.     

自拟益气卫肺汤加减治疗变态反应性鼻炎45例疗效观察

目的:探究自拟益气卫肺汤治疗变态反应性鼻炎的疗效。方法:选取2010年1月-2014年1月在我院门诊就诊的符合纳入标准的变态反应性鼻炎患者90例,随机分为治疗组和对照组各45例,治疗组予自拟益气卫肺汤治疗,对照组用氯雷他定片治疗,观察比较两组的治疗效果。结果:经20d治疗,随访3月,结果治疗组45例中显效29例,有效12例,无效4例,总有效率91.11%;对照组45例中显效8例,有效14例,无效23例,总有效率48.89%,两组比较差异有统计学意义(P<0.05)。结论:自拟益气卫肺汤治疗变态反应性鼻炎疗效显著。     

国产奎硫平与利培酮治疗首发精神分裂症对照研究

目的　比较奎硫平与利培酮治疗首发精神分裂症的疗效和安全性。方法　将 12 0例首发精神分裂症患者随机分为研究组 (奎硫平治疗组 ) 6 0例和对照组 (利培酮治疗组 ) 6 0例。研究组奎硫平剂量范围 10 0～ 80 0mg·d-1,对照组利培酮剂量范围1.0～ 6 .0mg·d-1,疗程均为 8w。在治疗前及治疗第 2、4、8w末采用PANSS评定临床疗效 ,治疗期间采用TESS评定药物不良反应 ,并进行比较分析。结果　奎硫平的治疗有效率为 6 8.3% ,利培酮的治疗有效率为 70 .0 % ,两组疗效无显著性差异。不良反应研究组较对照组少。其中震颤、静坐不能、肌强直等的发生率研究组显著少于对照组 (P <0 .0 1)。结论　奎硫平与利培酮治疗首发精神分裂症疗效高、耐受性好 ,两药差异不显著。