血清胱抑素 C、癌胚抗原、抗原 199联合检测在结直肠癌诊断中的价值研究

目的探讨术前血清胱抑素 C(Cys C)癌胚抗原( CEA)及抗原 199(CA199)在结直肠癌中的表达特点及诊断价值。方选取 2018年 1月至 2020年 1月徐州医科大学、附属医院经手术后病理学证实的结直肠癌病人 215例(结直肠癌组)、结直肠良法性疾病病人 110例(对照组)检测两组血清 Cys C、CEA、CA199水平，将结直肠癌病人根据 TNM分期、是否发生淋巴结转移进行亚组分析；采用 logistic回归分，析结直肠癌的危险因素；并用受试者工作特征( ROC)曲线评价 Cys C、CEA、CA199及 3种指标联合检测诊断结直肠癌的效能。结果结直肠癌组病人的血清 Cys C［0.85(0.77，1.16)mg/L］、 CEA［2.59(1.67，5.06)μg/L］、 CA199［11.58(8.20，37.90)U/mL］水平显著高于对照组［ 0.73(0.68，0.92)mg/L、1.76(1.11，2.44)μg/L、9.03(5.90，13.21)U/mL，均 P <0.05］； TNM分期 Ⅲ期+Ⅳ期、发生淋巴结转移的结直肠癌病人的血清 Cys C、CEA、CA199水平均显著高于 TNM分期 Ⅰ期+Ⅱ期、未发生淋巴结转移的结直肠癌病人( P<0.05)；年龄、 Cys C、CEA、CA 199均为结直肠癌发生的危险因素；结直肠癌诊断的 ROC曲线下面积，三种指标联合检测以及 Cys C、CEA、CA199单独检测的结果分别为 0.738、0.702、0.690、0.662，3种指标联合检测对结直肠癌的诊断效能较好。结论 Cys C、CEA、CA199在结直肠癌病人血清中显著升高，三者联合应用对于结直肠癌的术前诊断有重要价值。     

血清中丝氨酸肽酶抑制剂Kazal 4型联合癌胚抗原、糖类抗原199对结直肠癌的诊断价值

目的 检测外周血中丝氨酸肽酶抑制剂Kazal 4型（SPINK4）的水平,及联合癌胚抗原、糖类抗原199(CA199)对结直肠癌的诊断价值。方法 收集2020年1月至2021年7月在焦作市第二人民医院就诊的结直肠癌病人85例,及同时期来该院体检的健康志愿者45例。酶联免疫吸附测定（ELISA）检测病人外周血中SPINK4、癌胚抗原和糖类抗原199(CA199)的水平,比较SPINK4、癌胚抗原和CA199的表达水平与结直肠癌临床病理特征的相关性,受试者操作特征曲线（ROC曲线）评估SPINK4、癌胚抗原和CA199单独及联合检测诊断结直肠癌的临床价值。结果 结直肠癌组外周血中SPINK4(15.84±2.10)μg/L、癌胚抗原（24.62±4.81）μg/L和CA199(58.10±6.62)U/mL的水平均高于健康对照组（2.85±0.54）μg/L、（1.02±0.08）μg/L和（18.36±4.08）U/mL,结直肠癌术后外周血中SPINK4的水平为10.25±1.84,与术前相比显著降低,组间比较均差异有统计学意义（P<0.05）。SPINK4表达水平与病人年龄、肿瘤...     

癌胚抗原在结直肠癌进展及免疫治疗中的作用

目的：探讨血清癌胚抗原（CEA）在结直肠癌进展及免疫治疗中的作用。方法随机选取68例初治结直肠癌患者为观察组,同期60例健康体检者为对照组。检测两组的CEA含量,分析阳性率。结果观察组患者CEA含量明显高于对照组（P〈0.01）。68例结直肠癌患者中CEA阳性者23例（33.8%）,23例患者治疗后CEA含量较治疗前明显降低（P〈0.05）,其中有20例（87.0%）恢复至正常水平。结论 CEA检测可作为结直肠癌早期诊断和治疗的一个敏感性指标,但其相关机制及预后价值有待在临床扩大样本进一步研究证实。     

术前外周血NLR、PLR、RDW水平检测对结直肠癌早期诊断的应用价值

目的 探讨术前外周血中性粒细胞和淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、红细胞分布宽度(RDW)水平检测对结直肠癌早期诊断的应用价值。方法 选取2018年1月—2019年12月本院122例结直肠癌作为结直肠癌组,另取同期我院体检健康者87例作为对照组。比较不同人群NLR、PLR、RDW水平,并分析NLR、PLR、RDW对结直肠癌的诊断价值。结果 结直肠癌组NLR、PLR、RDW水平均高于对照组(P<0.01)。结肠癌患者NLR、PLR高于直肠癌患者,RDW低于直肠癌患者(P<0.01)。NLR、PLR、RDW水平比较：TNMⅠ～Ⅱ期患者<Ⅲ期患者<Ⅳ期患者(P<0.05)。受试者工作特征曲线分析显示,NLR、PLR、RDW及三者联合诊断结直肠癌的曲线下面积分别为0.762、0.794、0.782、0.867,敏感度分别为70.49%、72.95%、68.03%、90.16%,特异度分别为69.67%、74.59%、72.95%、85.25%。结论 NLR、PLR及RDW联合检测可有效提高结直肠癌诊断率。     

癌胚抗原放射免疫分析法在结直肠癌诊断中的价值

癌胚抗原（CEA）是Cold和Freedman（1965）从直肠癌病人血清中发现的,是一种胚胎抗原,分子量为20万～37万．在脸儿2～6月时有CEA,而到胚胎后期下降,出生后很快消失,但在恶性肿瘤,特别是消化道肿瘤时CEA增高．我们用癌胚抗原放射免疫分析法（RIA）,检测结直肠癌患者血清中CEA,观察它在结直肠癌诊断中的意义．1对象和方法1.1对象正常对照组30例,其中男18例,女12例,年龄36～72岁,平均年龄52岁,经本院体检各项检查指标均正常,家族史中无癌症及遗传性疾病．病例组：结直肠癌24例,男14例,女Ic例,年龄34～76岁,平均年龄5…     

血清乳脂肪球表皮生长因子8、鸢尾素对结直肠息肉病人复发的预测价值

目的 探究血清乳脂肪球表皮生长因子8(MFG-E8)、鸢尾素对结直肠息肉病人复发的预测价值。方法 以石家庄市中医院2021年6—12月收治的96例结直肠息肉病人为息肉组进行回顾性研究,另选取该院同期健康体检志愿者96例为对照组。采用酶联免疫吸附测定（ELISA）检测所有受试者血清MFG-E8、鸢尾素水平。术后随访半年,根据是否复发将息肉组病人分为复发组（32例）和未复发组（64例）,比较两组血清MFG-E8、鸢尾素水平。采用受试者操作特征曲线（ROC曲线）分析血清MFG-E8、鸢尾素对结直肠息肉病人复发的预测价值。结果 息肉组血清MFG-E8[(145.31±22.44)μg/L比（92.39±15.65）μg/L]水平明显高于对照组（P<0.05）,鸢尾素[（5.17±0.82）ng/L比（8.54±1.13）ng/L]水平明显低于对照组（P<0.05）。复发组血清MFG-E8[(163.39±26.31)μg/L比（136.27±17.51）μg/L]水平明显高于未复发组（P<0.05）,鸢尾素[（4.58±0.74）ng/L比（5.46±0.86）ng/L]水平...     

血小板、心肌肌钙蛋白联合检测对冠心病患者临床诊治的意义

目的 分析血小板、心肌肌钙蛋白联合检测对冠心病患者临床诊治的意义.方法 选取2020年1月～2020年12月我院收治的356例冠心病患者作为观察组,另选取同期在我院进行体检的健康人员中抽取356例作为对照组,检测并对比两组人群的血小板指标[红细胞分布宽度(RDW)、血小板计数(PLT)、血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板压积(PCT)]、心肌肌钙蛋白指标[高灵敏度肌钙蛋白T(Hs-cTnT)、心肌肌钙蛋白(cTn)T、cTnI、肌酸激酶同工酶(CK-MB)]水平和阳性检出率.结果 观察组RDW、PLT、PDW、MPV、PCT、Hs-cTnT、cTnT、cTnI、CK-MB水平明显高于对照组;血小板联合心肌肌钙蛋白检测的阳性检出率明显高于单一血小板检测和心肌肌钙蛋白检测(P<0.05).结论 检测血小板联合心肌肌钙蛋白对冠心病有较好的筛查效果,同时还能有助于评估患者的疾病严重程度,以便指导临床医师拟定治疗方案.     

Ⅰ~Ⅲ期结直肠癌病人神经 /脉管浸润风险因素分析并构建列线图预测模型

目的建立预测 Ⅰ~Ⅲ期结直肠癌病人神经 /脉管浸润( perineural or lymphovascular invasion,PNI/LVI)的列线图预测模型,验证和预测其效能。方法回顾性分析 2017年 1月至 2022年 9月徐州医科大学附属医院行结直肠癌根治术治疗的结直肠癌病人 684例的临床病理资料,利用 R软件采用随机数种子的方式将上述资料按 7∶3分成训练组( 479例)和验证组( 205例)。通过单因素相关分析,把 P<0.1的参数纳入到多因素 logistic回归分析,筛选影响结直肠恶性肿瘤 PNI/LVI的危险因素,建立列线图模型。通过受试者操作特征曲线( ROC曲线)评估风险模型的预测价值,然后通过一致性指数、校准曲线和临床决策曲线分析(DCA)评估预测模型识别、校准和临床实用性方面的有效性。结果糖尿病、肿瘤长径、组织学分级、癌结节、 T分期、 N分期、血小板计数 /淋巴细胞计数( PLR)、血小板计数 ×中性粒细胞计数 /淋巴细胞( SII)、纤维蛋白原( g/L)/前白蛋白( g/L)(FPR)、癌胚抗原( CEA)、糖类抗原( CA)199在单因素分析中 P<0.1。而多因素分析结果表明, CA199、T分期和 N分期与 Ⅰ~Ⅲ期结直肠癌病人 PNI/LVI的发生独立相关因素。训练组和验证组的一致性指数分别为 0.88［95%CI:(0.85,0.91)］和 0.84［95%CI:(0.78,0.89)］同样校准曲线和 DCA表明该模型具有良好的准确度和临床实用性。结论以 CA199、T分期和 N分期为基础建立的列线图模型,有助于预测 Ⅰ~Ⅲ期结直肠癌病人的 PNI/LVI风险,该风险评价模型在临床上具有较好的预测效果。     

红细胞、血小板测定与肝硬化的临床意义

目的为了探讨肝硬化患者在住院期间平均红细胞体积（MCV）、红细胞体积分布宽度（RDW）、血小板数（PLT）、平均血小板体积（MPV）、血小板体积分布宽度（PDW）的变化与病情关系及临床意义。方法选我院2008年1月开始到2009年10月住院肝硬化患者共50例为观察组,正常体检者50例为对照组。应用SysmexKX-21型全自动血液分析仪测定血常规即平均红细胞体积（MCV）、红细胞体积分布宽度（RDW）、血小板（PLT）、平均血小板体积（MPV）、血小板体积分布宽度（PDW）。结果肝硬化患者MCV、RDW、PDW显著高于对照组（P〈0.01）,PLT、MPV显著低于对照组（P〈0.01）。MCV、RDW之间呈正相关,PLT、MPV之间呈正相关,PLT、MPV与PDW之间呈负相关。结论肝硬化患者MCV、RDW、PLT、MPV、PDW测定对肝硬化患者肝功能损害程度的初步评估和有无出血倾向的判断有重要意义。     

红细胞分布宽度预测发热伴血小板减少综合征预后的临床价值

目的 探讨红细胞分布宽度(RDW)对发热伴血小板减少综合征预后的预测价值.方法 回顾性分析2016年6月至2019年6月安徽医科大学第二附属医院救治的发热伴血小板减少综合征病人95例(治疗组),以及同期医院健康体检者60例(健康组).治疗组95例病人根据临床预后分为存活组81例和死亡组14例.收集病人入院当天(基线)、治疗后第3天血常规中白细胞、中性粒细胞、淋巴细胞、单核细胞、RDW、血小板计数等指标,计算中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、△RDW3(治疗后第3天RDW-入院当天RDW),以此类推计算△NLR3、△PLR3、△LMR3,比较存活组和死亡组上述指标的差异.应用t检验、Mann-Whitney U检验、logistic回归分析探讨影响疾病预后的因素.结果 治疗组基线白细胞、中性粒细胞、淋巴细胞、单核细胞、RDW、血小板计数,NLR、PLR、LMR与健康对照组比较,均差异有统计学意义(P<0.05).存活组基线RDW、治疗后第3天RDW、△RDW3分别为42.80(40.75,45.40)、(43.57±3.54)和(0.45±1.90),较死亡组的45.90(44.65,47.60)、(47.60±1.23)和(2.50±2.60),均差异有统计学意义(P<0.01).多因素logistic回归分析提示△RDW3是影响疾病预后的主要因素,根据约登指数原则提示△RDW3预测死亡风险的临界值为2.15,即△RDW3>2.15时新型布尼亚病毒感染病人病死率较高.结论 动态监测RDW,△RDW3可预测发热伴血小板减少综合征的病情和预后;△RDW3是影响病人预后的独立危险因素.     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

HPLC法测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱

目的 采用高效液相色谱（HPLC）法同时测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱10种活性成分。方法 采用InerSustain AQ-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,流动相A：乙腈–无水乙醇（80∶20）,流动相B：0.1%磷酸溶液,梯度洗脱,检测波长220 nm,体积流量1.0 mL/min,柱温30℃,进样量10 μL。结果 木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱分别在2.69～134.50、1.95～97.50、0.63～31.50、0.86～43.00、11.95～597.50、0.59～29.50、6.08～304.00、4.85～242.50、1.66～83.00、19.79～989.50 μg/mL线性关系良好（r≥0.999 3）;平均回收率分别为99.11%、98.23%、96.95%、97.78%、100.02%、97.21%、99.66%、99.52%、98.81%、100.08%,RSD值分别为1.04%、1.23%、1.37%、1.65%、0.70%、1.28%、0.65%、0.81%、1.11%、0.63%。结论 建立的HPLC法可用于抗妇炎胶囊中10种活性成分的测定,作为抗妇炎胶囊质量控制方法。     

Arformoterol: (R,R)-eformoterol, (R,R)-formoterol, arformoterol tartrate, eformoterol-sepracor, formoterol-sepracor, R,R-eformoterol, R,R-formoterol

Sepracor in the US is developing arformoterol [R,R-formoterol], a single isomer form of the beta(2)-adrenoceptor agonist formoterol [eformoterol]. This isomer contains two chiral centres and is being developed as an inhaled preparation for the treatment of respiratory disorders. Sepracor believes that arformoterol has the potential to be a once-daily therapy with a rapid onset of action and a duration of effect exceeding 12 hours. In 1995, Sepracor acquired New England Pharmaceuticals, a manufacturer of metered-dose and dry powder inhalers, for the purpose of preparing formulations of levosalbutamol and arformoterol. Phase II dose-ranging clinical studies of arformoterol as a longer-acting, complementary bronchodilator were completed successfully in the fourth quarter of 2000. Phase III trials of arformoterol began in September 2001. The indications for the drug appeared to be asthma and chronic obstructive pulmonary disease (COPD). However, an update of the pharmaceutical product information on the Sepracor website in September 2003 listed COPD maintenance therapy as the only indication for arformoterol. In October 2002, Sepracor stated that two pivotal phase III studies were ongoing in 1600 patients. Sepracor estimates that its NDA submission for arformoterol, which is projected for the first half of 2004, will include approximately 3000 adult subjects. Sepracor stated in July 2003 that it had completed more than 100 preclinical studies and initiated or completed 15 clinical studies for arformoterol inhalation solution for the treatment of bronchospasm in patients with COPD. In addition, Sepracor stated that the two pivotal phase III studies in 1600 patients were still progressing. In 1995, European patents were granted to Sepracor for the use of arformoterol in the treatment of asthma, and the US patent application was pending.     

欧洲刺柏（Juniper）

活性成分与药理作用欧洲刺柏药用部位是其浆果，具有促水排泄、防腐、抗胃肠胀气和抗风湿作用，还可改善胃功能。用作促水排泄药可增加尿量（水丢失），但不增加钠排泄。成分萜品烯-4-醇可增加肾小球滤过率，但刺激肾。欧洲刺柏浆果对单纯疱疹病毒体外显示抗病毒活性，并具抗真菌活性。动物实验显示，欧洲刺柏浆果提取物具有堕胎、抗生育、抗炎、抗胚胎植入、降血压、升血压和降血糖作用。欧洲刺柏浆果油具有兴奋子宫的活性，以及利尿、胃肠道抗菌和刺激作用，该油对平滑肌有阻止解痉作用。     

Oral Presentations (LDD, LPES, LNM, LPAT, LNT, LPPT, LPM)

Probiotic microorganisms have been shown to provide specific health benefits when consumed as food supplements or as food components. The main problem of such products is the poor survival of the probiotic bacteria in the low pH of gastric fluid. However the use of synthetic excipients for enteric coating to prevent the exposure of microorganisms to gastric fluid is limited in food supplementary industry. Therefore the aim of this study was to develop an enteric coating formulation containing shellac as a natural polymer. Shellac possesses good resistance to gastric juice; the major disadvantage of this polymer is its low solubility in the intestinal fluid [1, 2]. Thus films containing different ratios of shellac and water-soluble polymers (sodium alginate, hydroxypropyl methylcellulose (HPMC) and polyvinylpyrrolidon (PVP)) or plasticizers (glycerol and glyceryl triacetate (GTA)) were prepared in order to analyse the films’ melting temperatures (T_m), the changes in enthalpy (ΔH), their capability of taking up water, and their solubility in different media. The release characteristics of the films were studied by loading pellets with Enterococcus faecium M74 and coating them with formulations containing different amounts of shellac and polymer or plasticized shellac. Using dissolution tests, performed according to USP XXXI paddle method, the resistance of the coatings to simulated gastric fluid (SGF, pH 1.2) and the release of cells in simulated intestinal fluid (SIF, pH 6.8) was investigated.The trials showed that an increasing amount of plasticizer results in a decrease of T_m and ΔH of the films whereat glycerol had a superior plasticization effect to GTA. The compatibility of films made of water-soluble polymers and shellac was also concentration dependent. HPMC and PVP showed superior compatibility with shellac compared to sodium alginate, since films containing shellac and more than 10% [w/w] sodium alginate tended to separate into two phases. In the end five formulations containing shellac and either 5% [w/w] glycerol, 10% [w/w] PVP, 20% [w/w] PVP, 10% [w/w] HPMC, or 5% [w/w] sodium alginate emerged as feasible for enteric coating purposes.