鼻内镜鼻窦手术治疗复发性鼻窦炎和鼻息肉70例的疗效

目的探讨鼻内镜鼻窦手术治疗复发性鼻窦炎、鼻息肉的疗效及复发病因。方法对70例复发性鼻息肉、鼻窦炎患者行鼻内镜鼻窦手术治疗的临床资料进行回顾性分析。结果 70例患者均手术顺利,手术时间(79.6±9.5)min。术后随访6个月～1年,术后6个月根据患者自觉症状改善程度和内镜检查,按慢性鼻窦炎鼻息肉疗效评定标准,治愈43例,好转14例,无效13例,总有效率为81.43%。无严重手术并发症。复发性鼻窦炎、鼻息肉的病因主要有术前、术后未规范治疗,鼻中隔偏曲与中下鼻甲处理不当、术后鼻腔粘连、钩突残留、自然窦口堵塞等。结论选择正确的手术方法、术前术后综合治疗、术者良好的鼻窦解剖知识,以及熟练的手术操作是提高鼻窦炎、鼻息肉疗效,降低复发的主要措施。     

鼻中隔矫正术联合低温等离子消融手术治疗变应性鼻炎

变应性鼻炎是耳鼻喉科常见疾病,鼻中隔偏曲是常见的鼻腔结构异常。许多变应性鼻炎的患者伴有不同程度的鼻中隔偏曲,目前认为鼻中隔偏曲是变应性鼻炎的非免疫学或者是诱发因素。我科2011年3月至2012年6月,采用鼻中隔     

基于癌毒病机理论的消癌解毒方抗肿瘤研究进展

介绍了癌毒病机理论的相关内容,认为痰瘀郁毒是肿瘤的核心病机,并在癌毒病机理论的指导下,对消癌解毒方抗肿瘤的临床与实验研究进行了综述,消癌解毒方配合化疗具有较好的増效减毒、提高患者免疫功能的作用,其作用机制可能与其能够降低TGF-β1表达水平、抑制VEGF的生成、降低MMP-2活性、影响TLRs/NF?κB信号转导通路等有关。     

基于液质连用分析法分析补肾活血方中黄酮类化学成分

目的建立补肾活血方中黄酮类化学成分的分析方法测定淫羊藿次苷Ⅱ含量。方法化学成分定性分析采用UPLCESI-Q-TOF-MS技术,C18色谱柱(4.6mm×250mm,5μm),梯度洗脱(流动相:甲醇-0.1%甲酸溶液);质谱使用ESI离子源,正离子与负离子模式下采集数据。含量测定采用ACQUITY UPLC BEH C18(2.1mm×100mm ID,1.7μm,Waters,Milford,USA)色谱柱,乙腈-0.1%甲酸溶液为流动相梯度洗脱;经ESI离子源负离子化后,通过Waters-Xevo TQ三重四级杆串联质谱仪,采用多反应离子监测(MRM)对淫羊藿次苷Ⅱ进行含量测定。结果鉴定出补肾活血方中14个黄酮类化学成分。补肾活血方中淫羊藿次苷Ⅱ含量为0.092 80mg/g,单味药淫羊藿中淫羊藿次苷Ⅱ含量为0.010 08mg/g。结论采用液质连用分析法鉴定复方化学成分和测定含量,该方法快速简便、结果可靠,对于研究补肾活血方配伍前后物质变化具有积极意义。     

以毒攻毒法论治恶性肿瘤

癌毒是恶性肿瘤的病机关键,“祛邪解毒、扶正固本”为恶性肿瘤治疗的基本原则。以毒攻毒法作为“抗癌解毒八法”之一,是恶性肿瘤的临床常用治法。完善以毒攻毒法的理论内涵,可促进癌毒病机理论防治恶性肿瘤的推广和应用。从历史溯源、学术内涵、应用原则、临床应用等方面探讨以毒攻毒法在恶性肿瘤防治中的应用,认为需在符合癌毒亢盛、正气充实的原则下,根据肿瘤分期、分类的不同,使用具有抗癌作用的有毒中药祛除癌毒。     

清宣止咳颗粒中芍药苷的含量测定

目的:建立清宣止咳颗粒中芍药苷含量的测定方法。方法:采用反相高效液相法。KromosilC18柱(4·6×250mm,5μm),流动相为甲醇:水(33∶67),流速为1·0ml/min,紫外检测波长为230nm。结果:芍药苷对照品在0·4248～1·2744μg范围内有良好的线性关系,相关系数为0·9997,平均回收率为98·12%(RSD=1.22%,n=6)。结论:本法操作方法简单,准确,重复性好,可用于清宣止咳颗粒的质量控制。     

几丁糖预防CO2激光声带切除术后声带粘连短期观察的实验研究

Objective To observe the effect of immediate topical application of chitosan on preventing anterior giottic stenosis (AGS) after microsurgical resection of both vocal fold with CO<,2> laser , including the anterior commissure, in a canine model. Methods Sixteen canine larynges were injured by microresecting procedure of both vocal folds with CO<,2> laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution(control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor(bFGF) and traansforming growth factor betal (TGF-β1) were evaluated by enzyme-linked immunosorbent assay(ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery. Results Transmission electronic microscope examination of the ultrasmcture of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-β1, and bFGF and TGF-β1 in chitosan group, which was significantly higher than that in control group (z = -2.887 and -2.005, P =0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z = - 2. 619, P = 0. 008). The grade of collagen content in chitosan group was significantly lower than that in control group (P = 0. 003). Conclusion Chitosan is effective in preventing AGS after CO<,2> laser cordectomy.     

板蓝根水提取液中的化学成分

目的研究板蓝根水提取液中的化学成分。方法板蓝根水提取液经D101大孔树脂吸附，不同浓度乙醇洗脱部分经硅胶柱色谱反复分离纯化，测定所得化合物的理化常数和波谱数据，鉴定其化学结构。结果从板蓝根水提取液中分离得到5个化合物，分别鉴定为：3-［2′-(5′-羟甲基)呋喃基］-1(2H)-异喹啉酮-7-O-β-D-葡糖苷(I)、落叶松树脂醇-4，4′-二-O-β-D-吡喃葡糖苷(II)、落叶松树脂醇-4-O-β-D-吡喃葡糖苷(III)、2-羟基-1，4-苯二甲酸(IV)、甘露醇(V)。结论化合物I为新化合物，化合物IV和V在板蓝根中首次分离得到。     

基于癌毒病机理论辨治肿瘤组方思路探讨

基于癌毒致病的特点和病机规律,阐明肿瘤临床治疗实践中的立法要点,结合君臣佐使的传统组方理论梳理抗肿瘤方剂的组方结构和配伍特点,为提高抗肿瘤方药的安全性和有效性提供理论参考和依据。