注射用盐酸川芎嗪对COPD急性加重期患者TNF—α、IL-8、CRP水平的影响

目的：观察川芎嗪对COPD急性加重期患者TNF-α、IL-8、CRP水平的影响。方法：将60例急性加重期COPD患者随机分为两组,两组根据临床表现、痰培养结果及辅助检查合理使用抗生素并给予对症治疗,治疗组在此基础上予以注射用盐酸川芎嗪治疗,疗程2周,观察两组患者治疗后的临床效果以及两组患者治疗前后血清肿瘤坏死因子-α（TNF-α）、白细胞介素8（IL-8）及c-反应蛋白（CRP）水平的变化。结果：治疗后,两组患者血清TNF-α、IL一8、CRP水平均明显下降（P〈0．05）,治疗组患者变化幅度更大（P〈0．05）;治疗组患者总有效率为90％,对照组的总有效率为70％,差异存在统计学意义（P〈0．05）,治疗组激素用量明显少于对照组。结论：川芎嗪治疗COPD急性加重期患者可以明显降低机体炎症细胞因子活性,抑制气道炎症,明显提高疗效。     

食管腔内超声参与的非手术食管癌临床分期与预后的相关性研究

Objective To investigate the clinical staging of non-surgically treated esophageal cancer based on endoscopic ultrasonography (EUS) and computed tomography (CT) and its prognostic value. Methods A total of 290 patients with esophageal squamous cell carcinoma who received non-surgical treatment in our hospital from November 2003 to March 2012 were retrospectively reviewed. The clinical stage of each patient was evaluated based on EUS and CT according to the 2002 UICC TNM staging system. The survival rates and prognostic factors for patients of different stages were analyzed. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis;the multivariate analysis was performed using the Cox model. Results EUS could be completely performed in 178(61.4%) of all patients, and their EUS T and N stages were determined. There were no significant differences in overall survival (OS) between patients with EUS T₁-T₄ diseases (P=0.247);there were significant differences in OS and progression-free survival (PFS) between individuals of different EUS T stages among patients with EUS N₀ disease (P=0.000;P=0.006). OS and PFS also showed significant differences between patients with N₀ and N₁ diseases (P=0.012;P=0.016). EUS could not be completely performed in 112 patients, who had poorer OS and PFS than other patients (P=0.001;P=0.003). CT T and N stages also affected OS and PFS (OS P=0.004, PFS P=0.030;OS P=0.024, PFS P=0.020). The 1-, 3-, and 5-year sample sizes were 290, 174, and 73, respectively. The 1-, 3-, and 5-year OS rates for all patients were 61.7%, 27.8%, and 19.8%, respectively. OS and PFS varied significantly between patients of different 2002 UICC clinical stages (P=0.000 and 0.000). The multivariate analysis showed that sex, age and clinical stage were independent prognostic factors (P=0.004, 0.020, and 0.002).Conclusions The clinical staging based on EUS and CT can predict the survival in esophageal cancer
DOI:10.3760/cma.j.issn.1004-4221.2014.02.010
基金项目:首都特色临床应用研究(Z121107001012004)
作者单位:100021 北京协和医学院,中国医学科学院肿瘤医院放疗科
通信作者:肖泽芬,Email:xiaozefen@sina.compatients treated with non-surgical method. EUS is recommended as a basic means for pretreatment staging of esophageal cancer in China.
     

Hedgehog信号通路在肝癌中的研究进展

（Hedgehog）信号通路首先发现于果蝇遗传学研究，它控制着细胞生长、增殖和分化，在果蝇幼虫和哺乳动物胚胎的发育、成人机体内环境的维持中起重要作用，并与肿瘤等很多人类疾病的发生有关。在脊椎动物中，Hh信号通路主要由Hh配体、Patched（Ptc）受体、     

驻颜养生说少食

民谚云：“活到九十九，餐餐少一口”，“节食去百病，养颜姿色艳”。祖国医学历来主张少食以养颜，少食以增寿。但是，随着人们生活水平的逐渐提高，人们于繁忙的工作之外，又奔波于各美食店、美容店，一味提高体内蛋白质、碳水化合物、脂肪的储存；或借助于美容化妆品的帮助，     

以瘙痒为首发表现的尿毒症一例误诊误治

1病例资料男,56岁。因双小腿瘙痒2年,全身瘙痒1年,头晕、无力、夜尿增多2个月入院。2年前无明显诱因出现双小腿皮肤瘙痒,呈阵发性发作,且多于睡前、阴天下雨、饮酒、食辛辣食物后加重,难以忍受,常用手抓破皮肤亦不止痒,自服多种止痒药无效。1年前发展至全身瘙痒,多以头皮、胸腹、外阴、肛门、掌跖、外耳道为重。先后在多家医院皮肤科诊治为老年性瘙痒症,服用马来酸氯苯那敏、赛庚啶、地西泮等药物,瘙痒略有好转。近2个月出现头晕、无     

儿童脑动静脉畸形的临床特点与治疗

目的总结分析儿童脑动静脉畸形（AVMs）的临床特点及治疗效果。方法回顾性分析34例儿童脑动静脉畸形患者的临床资料。结果本组病例平均年龄10．4岁，其中21例表现脑出血；按Spetzler—Martin分级，Ⅰ级8例，Ⅱ级13例，Ⅲ级9例，Ⅳ级4例；随访30例中，疗效优22例，良5例，差1例，死亡2例。结论儿童脑AVM最常见的临床表现是脑出血，综合治疗能获得良好临床效果。     

替考拉宁治疗重症胰腺炎并发肠球菌属感染患者42例报道

目的 观察替考拉宁治疗并发肠球菌属感染的重症胰腺炎(SAP)患者临床价值.方法 回顾性分析2005年9月～2008年12月湖南省人民医院肝胆科收治的并发肠球菌属感染SAP患者42例的临床经过,观察其临床、细菌学疗效以及不良反应发生率.结果 替考拉宁治疗并发肠球菌属感染的SAP临床有效率为80.9%,细菌清除率为85.7%,未见明显不良反应发生.结论 替考拉宁治疗并发肠球菌属感染的SAP疗效显著,安全性好,使用经济方便,值得在临床上推广应用.     

糖尿病使亚太地区面临严峻挑战

据最近出版的柳叶刀杂志报道，糖尿病的流行使亚太地区的医疗制度面临着严峻的挑战。目前，糖尿病正在困扰着亚太地区特别是中低收入的国家。随着经济的不断增长，该地区糖尿病尤其是Ⅱ型糖尿病的患病率大幅度升高，在世界肥胖和糖尿病排名中居于首位。