黄嘌呤氧化酶抑制剂在心力衰竭治疗中的应用

黄嘌呤氧化酶在心力衰竭病理生理中有着重要作用,黄嘌呤氧化酶抑制剂可以应用于心力衰竭治疗.本文从内皮功能、心肌机械能量耦联、对心力衰竭长期作用及高尿酸几个方面综述了黄嘌呤氧化酶抑制剂的作用,并介绍了黄嘌呤氧化酶抑制剂对心力衰竭的临床应用情况.     

米索前列醇治疗产后出血的疗效观察

目的探讨米索前列醇舌下给药对择期剖宫产术后阴道出血的影响。方法对28例择期剖宫产产妇在术后即舌下置入米索前列醇400μg,30例同期剖宫产产妇在术后应用5%葡萄糖500ml加入缩宫素20u静脉点滴,观察术后出血量及产妇血压的变化。结果米索前列醇组24h的出血量较缩宫素组减少,差异有统计学意义(P<0.05),米索前列醇组出血发生率低于缩宫素组,差异有统计学意义(P<0.05)。结论米索前列醇舌下给药预防择期剖宫产术后出血疗效显著,简单易行。     

福善美与罗盖全联合治疗女性老年骨质疏松症

目的：监测骨密度变化，观察福善美与罗美全联合治疗老年骨质疏松症的疗效。方法：30例女性老年骨质疏松症患随机分成两组：联合治疗组（15例），服福善美同时服罗盖全；对照组（15例）单服罗盖全；分别测定其治疗前及治疗后6个月、12个月的腰椎及股骨近端骨密度并记录其疼痛等症状改善情况。结果：联合治疗组明显提高腰椎2－4骨密度值，6个月和12个月升幅分别为10．3％及12．4％，股骨近端BMD亦有升高。对照组腰椎BMD升幅为4．3％及6．7％，股骨近端BMD无明显升高。结论：福善美联合罗美全治疗老年人骨质疏松症有肯定疗效。     

米索前列醇配伍尼尔雌醇用于绝经后妇女取环60例分析

绝经后妇女卵巢功能逐渐减退，雌激素水平下降，阴道皱襞及弹性组织减少，子宫萎缩。给摘取宫内节育器(下称取环)带来很大难度，且患者取环时易发生疼痛、损伤等并发症。2000年7月～2002年7月，笔者将米索前列醇配伍尼尔雌醇用于绝经后妇女取环，取得良好的效果。现报告如下。     

Paclitaxel based vs oxaliplatin based regimens for advanced gastric cancer

AIM: To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin (PCF), and oxaliplatin combined with fluorouracil plus leucovorin (FOLFOX-4) regimens for advanced gastric cancer (AGC).METHODS: Ninety-four patients with AGC were randomly assigned to receive paclitaxel (50 mg/m² iv) on days 1, 8 and 15, cisplatin (20 mg/m² iv) and fluorouracil (750 mg/m² iv) on days 1-5, or oxaliplatin (85 mg/m² iv) and leucovorin (200 mg/m² iv) on day 1, followed by bolus fluorouracil (400 mg/m² iv) and fluorouracil (600 mg/m² iv) on days 1 and 2. The primary end point was the 1-year survival time.RESULTS: The overall response rate (ORR) of the patients was 48.0% and 45.5% to PCF and FOLFOX-4, respectively. The disease control rate (DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%, respectively. The median survival times (MSTs) of the patients were 10.8 and 9.9 mo, respectively, after treatment with PCF and FOLFOX-4. The 1-year survival rate of the patients was 36.0% and 34.1%, respectively, after treatment with PCF and FOLFOX-4. No significant difference was observed in ORR, DCR, MST or 1-year survival rate between the two groups. The most common adverse events were anemia, nausea and vomiting, and grade 3/4 alopecia in PCF treatment group, and anemia, grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.CONCLUSION: Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate. The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.     

米非司酮配伍米索前列醇用于稽留流产196例临床分析

1998年 2月～ 2 0 0 0年 12月 ,我们收治稽留流产患者196例 ,采用米非司酮配伍米索前列醇治疗 ,效果满意现报告如下。临床资料 :196例稽留流产患者的年龄 2 3～ 35岁 ,初孕妇 142例 ,经孕妇 5 4例。停经 7～ 18周 ,其中有少量阴道流血者 16 8例 ,无特殊症状者 2 8例 ;有 36例患者因阴道流血来站前行黄体酮或中药保胎治疗。妇科检查子宫小于停经周数 ,质地不软 ,宫口未开 ,多数患者阴道有血迹。B超检查无胎芽及原始心管搏动 ,妊娠囊变形 ,或有胎芽甚至胚胎结构 ,但无胎心反射。方法 :196例稽留流产患者确诊后 ,询问病史无使用米非司酮和米索…     

611例汉族人维生素D受体基因多态性与骨密度关系研究

采用PCR-RFLP分析了611名上海地区汉族人的维生素D受体(VDR)基因型,并测量其骨密度(BMD),统计分析发现男女性VDR基因分布差异存在统计学意义,Bb基因型在男性中的分布频率(26.9%)高于女性(12.7%,P<0.01)。不同基因型的人群BMD差异无统计学意义。     

嗜酸粒细胞性支气管炎与咳嗽变异性哮喘患者的气道炎症特征的研究

目的 探究嗜酸粒细胞性支气管炎(EB)和咳嗽变异性哮喘(CVA)患者气道炎症细胞、细胞因子和炎性介质的特征,阐明两者存在不同气道炎性特征的可能机制.方法检测杭州市第一人民医院门诊收治的15例EB患者(EB组)、15例CVA患者(CVA组)、14例支气管哮喘(简称哮喘)患者(哮喘组)和14名健康体检者(健康对照组)诱导痰中嗜酸粒细胞(EOS)百分比;流式细胞仪检测白细胞介素(IL)-5及干扰素(IFN)-γ刺激的EOS表面CD69的表达;实时荧光定量PCR方法检测各组诱导痰上清液中前列腺素E2(PGE2)、白三烯C4(LTC4)、IL-5、IFN-γ mRNA的表达水平;酶联免疫吸附法(ELISA)检测各组诱导痰上清液中PGE2、LTC4、IFN-γ和IL-5蛋白表达水平.结果 EB组、CVA组、哮喘组诱导痰中EOS百分比分别为(15.8±3.2)%、(13.0±2.7)%和(11.6±4.5)%,均明显高于健康对照组的(1.0±0.4)%(均P<0.05).在IL-5和IFN-γ刺激下,EB组诱导痰中EOS表达CD69分别为1.49±0.42和1.51±0.52、CVA组分别为1.37±0.41和1.42±0.32、哮喘组分别为1.42±0.72和1.37±0.46,3组间差异无统计学意义,但较健康对照组(分别为0.42±0.21和0.39±0.12)差异均有统计学意义(均P<0.05).EB组、CVA组、哮喘组诱导痰中IL-5的mRNA及蛋白表达水平明显高于健康对照组(均P<0.05),但3组间差异无统计学意义;各组诱导痰中IFN-γ的mRNA及蛋白表达水平较健康对照组差异均无统计学意义.EB组诱导痰中PGE2浓度为(839±69)ng/L,明显高于CVA组的(33±8)ng/L、哮喘组的(25±6)ng/L和健康对照组的(24±8)ng/L(均P<0.01),后3组差异无统计学意义;EB组PGE2限速酶前列腺素氧化环化酶2(PTGS2)的mRNA水平表达量显著增加,较CVA组、哮喘组及健康对照组差异均有统计学意义(均P<0.01);CVA、EB和哮喘组诱导痰中LTC4浓度明显高于健康对照组(均P<0.05),CVA、EB及哮喘组中LTC4限速酶白三烯C4合成酶(LTC4S)的mRNA表达水平明显高于健康对照组(均P<0.05),EB组LTC4的mRNA及蛋白表达水平与CVA组和哮喘组比较,差异也有统计学意义(均P<0.05).CVA组、哮喘组诱导痰中LTC4/PGE2比值明显高于EB组(t值分别为8.67和13.12,均P<0.05).结论 EB患者诱导痰中PGE2高表达以及CVA组LTC4/PGE2比值较EB组显著增高,这两者可能是EB缺乏气道高反应性的炎症基础.

Abstract：

Objective To explore the characteristics of airway inflammatory cells, cytokines and inflammatory mediators in eosinophilic bronchitis (EB) and cough variant asthma (CVA) patients and to elucidate the underlying mechanism of distinct airway inflammation between EB and CVA. Methods This study included 15 patients with EB (EB group), 15 patients with cough variant asthma (CVA, CVA group), 14 patients with bronchial asthma (asthma group) and 14 healthy controls (healthy group). Percentage of eosinophils (EOS) in sputum induced by hypertonic saline was detected by FACS. The percentage of CD+69 EOS stimulated by interleukin-5 (IL-5) and interferon γ (IFN-γ) was also detected by FACS. The expression of leukotriene C4 synthase (LTC4S) and prostaglandin-endoperoxide synthase-2 (PTGS2) mRNA in sputum was measured by real-time PCR and the concentration of leukotriene C4 (LTC4) and prostaglandin E2(PGE2) in sputum was measured by ELISA. Results The percentage of EOS in induced sputum was 15.8±3.2 (EB group), 13.0±2.7 (CVA group) and 11.6±4.5 (asthma group), respectively, which were significantly higher than 1.0±0.4 in the healthy group. The difference was significant and the t value was 16.31, 15.23 and 14.21 respectively (P<0.05). After stimulated by IL-5 and IFN-γ, the percentage of CD+69 EOS in induced sputum was 1.5±0.4 and 1.5±0.5 (EB group), 1.4±0.4 and 1.4±0.3 (CVA group) and 1.42±0.72 and 1.37±0.46 (asthma group) respectively. There was no statistical significance between these 3 groups, but when compared with 0.4±0.2 and 0.4±0.1 in healthy group, the difference was significant(P<0.05). The expression of IL-5 mRNA and protein in induced sputum of EB group, CVA group and asthma group were higher than the healthy group and the difference was all statistically different (P<0.05), but there was no statistical significance between EB group, CVA group and asthma group. The expression of IFN-γ mRNA and protein in induced sputum of each group was not different when compared with healthy group (P＞0.05). The concentration of PGE2 in induced sputum of EB group was(839±69)ng/L, which was higher than (33±8) ng/L of CVA group, (25±6) ng/L of asthma group and (24±8) ng/L of healthy group (all P<0.01). There was no statistical difference between CVA group, asthma group and healthy group. The expression of PTGS2 in induced sputum of EB group increased significantly; when compared with CVA group, asthma group and healthy group, the difference was significant (all P<0.01). The concentration of LTC4 in induced sputum of EB group, CVA group and asthma group was all higher than the healthy group (all P<0.05). The expression of LTC4S mRNA of EB group, CVA group and asthma group was also higher than the healthy group (all P<0.05). The expression of LTC4S mRNA and LTC4 in the EB group was higher than that in the CVA group and the asthma group (P<0.05). The value of LTC4/PGE2 in the CVA group and the asthma group was higher than that in the EB group (t=8.7 and 13.1, P<0.05). Conclusion These data suggest that the difference in airway function observed in subjects with eosinophilic bronchitis and CVA (or asthma) may be due to the results of differences in PGE2 production and an imbalance between the production of bronchoconstrictor LTC4 and bronchoprotective PGE2 lipid mediators.     

雷公藤内酯醇诱导胰腺癌细胞凋亡及对5-脂氧合酶和凋亡基因表达的影响

目的 探讨雷公藤内酯醇(TL)在胰腺癌化学预防和治疗中的应用价值.方法 采用人胰腺癌细胞株SW1990作为研究对象,MTT法和吖啶橙(AO)染色分别检测SW1990细胞的增殖和凋亡,采用半定量RT-PCR法检测5-脂氧合酶(5-LOX) mRNA、bcl-2 mRNA和bax mRNA的表达.结果 10 μg/ml的TL对SW1990细胞生长的抑制率达30%以上,0.1 μg/ml TL处理24 h后,SW1990细胞凋亡指数达38.5%,显著高于对照组的14.97%.5-LOX、bcl-2、bax mRNA表达从0.7160 ± 0.0251,0.2446 ± 0.0311和0.0260 ± 0.0065分别变化为0.2400 ± 0.0316,0.0700 ± 0.0158和0.0700 ± 0.0158.结论 TL能抑制胰腺癌细胞增殖和诱导细胞凋亡,其凋亡机制可能与下调5-LOX mRNA和bcl-2 mRNA、上调bax mRNA基因表达有关.     

慢阻肺患者血清1,25(OH)_2D_3、钙水平与肺功能关系的研究

目的分析探讨慢性阻塞性肺疾病急性加重期患者血清1,25-二羟维生素D3[1,25(OH)2D3]、钙(Ca2+)水平与其肺功能关系的相关性。方法选取2013年12月至2014年4月在我院住院的慢阻肺患者60例,分别在其慢阻肺急性加重期和稳定期,抽取静脉血,检测患者血清1,25(OH)2D3、Ca2+、磷(P)的水平,并同时检测其动脉血气分析及肺功能。结果急性加重期的血清1,25(OH)2D3、Ca2+、P以及FEV1/FVC等指标与稳定期相比,明显降低;急性加重期患者血清中1,25(OH)2D3、Ca2+与FEV1(%)呈正相关(r=0.341,0.454,P均0.01)。结论慢阻肺急性加重期患者的血清1,25(OH)2D3、Ca2+水平与FEV1(%)有相关性,在一定程度上反映了慢阻肺患者疾病严重程度。