支气管动脉介入治疗中晚期中央型肺癌的疗效分析

目的 探讨支气管动脉介入治疗中晚期中央型肺癌的临床疗效.方法 39例患者中采取支气管动脉化疗加栓塞25例,单纯支气管动脉灌注化疗14例;其中肿瘤为富血管型28例,乏血管型11例,全部病例术后随访6～12个月.结果 每组患者有效例数及有效率(完全缓解+部分缓解)分别为:支气管动脉化疗加栓塞21例(84.00％),单纯支气管动脉灌注化疗7例(50.00％);富血管型23例(82.14％),乏血管型5例(45.45％).结果显示,支气管动脉化疗加栓塞疗效明显优于单纯支气管动脉灌注化疗(P＜0.05);富血管型与乏血管型之间疗效比较差异有统计学意义(P＜0.05).结论 支气管动脉化疗加栓塞已成为治疗中晚期中央型肺癌的有效方法之一.     

支气管肺癌血液供应类型分析及其临床应用

目的 探讨中晚期支气管肺癌组织血液供应(血供)类型及其指导介入治疗的意义.方法 对76例肺癌患者行支气管动脉造影(BAG)检查,根据供血动脉在瘤体内的分布情况以及形态进行分析研究.结果 根据肿瘤组织内支气管动脉树X线解剖学形态特点分为四种类型:支气管动脉瘘型(13例、17.1%);多血供型(24例、31.6%);中血供型(28例、36.8%);少血供型(11例、14.5%).结论 支气管肺癌血供类型不同.根据不同血供类型采用不同的介入治疗术式可以提高疗效.     

肺癌的介入治疗进展

探讨肺癌的供血对介入治疗方法和疗效的影响。支气管动脉是肺癌的供血来源，肺动脉不参与肿瘤的供血。肺癌经支气管动脉化疗药物灌注（BAI）和碘油乳剂栓塞（BAE）治疗的近期疗效满意。BAI联合全身化疗是晚期肺癌的一种有效治疗方法。     

参麦注射液辅助支气管动脉介入治疗中晚期肺癌的疗效分析

目的 探讨参麦注射液辅助支气管动脉介入化疗治疗中晚期肺癌的临床效果和对免疫功能的影响.方法 60例中晚期肺癌患者随机分为对照组和观察组,每组30例,两组采用支气管动脉介入化疗,观察组在对照组的基础上应用参麦注射液.观察两组近远期疗效、副作用以及血清中T细胞亚群CD3+、CD4+、CD8+、CD+4/CD8+、NK的水平.结果 观察组近期有效率、1年生存率、2年生存率分别为76.67％、86.67％、46.67％,明显高于对照组的60.00％、73.33％、33.33％,P＜0.05;观察组的毒副反应发生率显著低于对照组,P＜0.05;治疗前两组T细胞亚群水平无明显差异,P＞0.05,治疗8周后观察组的CD3+、CD4+、CD;/CD8+、NK水平较治疗前显著上升,且明显高于对照组,P＜0.05,而对照组与治疗前比较无统计学差异,P＞0.05.结论 参麦注射液辅助支气管动脉介入治疗中晚期肺癌显著改善临床效果,降低毒副作用.     

支气管动脉化疗+栓塞与支气管动脉化疗联合氩等离子体治疗晚期中央型肺癌的疗效比较

目的探讨应用支气管动脉化疗联合氩等离子体治疗晚期中央型肺癌的近期疗效。方法分析比较我院45例晚期中央型肺癌分别行支气管动脉化疗+栓塞与支气管动脉化疗联合氩等离子体治疗疗效差别。结果支气管动脉化疗联合氩等离子体治疗晚期中央型肺癌组实体瘤缓解率(87.5%)及气道狭窄再通改善率(91.7%)明显优于支气管动脉化疗+栓塞组的57.1%及52.4%,且近期生存质量好。结论应用支气管动脉化疗联合氩等离子体治疗晚期中央型肺癌近期疗效明显优于支气管动脉化疗+栓塞治疗组,且能提高患者生活质量。     

90Y玻璃微球支气管动脉栓塞内照射治疗中晚期非小细胞肺癌

目的观察90Y玻璃微球支气管动脉栓塞内照射治疗中晚期非小细胞肺癌的临床疗效及安全性。方法中晚期非小细胞肺癌患者60例,随机分为实验组和对照组,各30例。实验组行支气管动脉灌注化疗后予90Y玻璃微球与碘油混合栓塞并内照射,对照组行支气管动脉灌注化疗后单纯予碘油栓塞,观察两组患者的有效率(RR)、疾病控制率(DCR)、中位疾病进展时间(mTTP)及安全性。结果 4个周期后,实验组与对照组RR分别为70.0%、43.3%,DCR分别为93.3%、70.0%,mTTP分别为13.1个月、8.9个月,两组相比,P均<0.05。两组患者均未出现严重不良反应。结论90Y玻璃微球支气管动脉栓塞内照射治疗中晚期肺癌疗效较好,疾病进展时间延长,且安全性较好。     

支气管动脉化疗栓塞术治疗非小细胞肺癌30例疗效分析

目的研究应用支气管动脉化疗栓塞术治疗非小细胞肺癌的治疗效果。方法选取2007年1月~2009年12月在我院住院治疗的30例非小细胞肺癌患者作为研究对象,采用支气管动脉化疗栓塞术进行治疗,作为观察组;并选取同期的30例行全身静脉化疗,作为对照组,观察两组患者的治疗效果。结果观察组中总有效率为73.3%,显著优于对照组56.7%(P0.05);患者Karnofsky评分由治疗前的(66.7±9.8)分上升至(84.8±8.9)分,显著高于对照组(P0.05);治疗后一年生存率为83.33%,两年生存率为56.67%,三年生存率为26.67%,明显优于对照组(P0.05),且患者未出现介入治疗相关并发症。结论支气管动脉化疗栓塞术可显著改善患者近期症状,提高近期患者生存率。     

中晚期肺癌介入治疗疗效分析

目的研究经支气管动脉灌注化疗药物及栓塞治疗中晚期肺癌的疗效。方法对本院近几年20例确诊的肺癌,并无法手术的中晚期肺癌患者,采用seldinger技术穿刺股动脉,进行选择性支气管动脉插管,然后注入化疗药物,部分患者使用明胶海绵颗粒进行栓塞治疗,观察改善情况,后1～3个月后复查CT观察肿瘤变化。结果肿瘤减小,咳嗽、胸痛、咯血、胸水等症状缓解。结论支气管动脉灌注化疗及栓塞治疗肺癌具有创伤小,效果确切等优点,是治疗肺癌的一种有价值的方法。     

支气管动脉灌注化疗治疗中央型非小细胞肺癌的疗效观察

目的观察支气管动脉灌注化疗治疗中央型非小细胞肺癌的疗效及不良反应。方法将2009年6月—2011年6月在我院进行治疗的80例非小细胞肺癌患者随机分为观察组和对照组,各40例,观察组采用支气管动脉灌注化疗治疗,对照组采用全身静脉化疗治疗,比较两组近期疗效、远期疗效、不良反应。结果观察组总有效率为73.3%,高于对照组的43.3%,差异有统计学意义(P<0.05);观察组半年生存率以及1年生存率与对照组比较,差异无统计学意义(P>0.05);观察组不良反应发生率和严重程度均低于对照组,差异有统计学意义(P<0.05)。结论支气管动脉灌注化疗治疗中晚期非小细胞肺癌疗效显著,安全性好,值得推广应用。     

过继性细胞免疫联合支气管动脉灌注化疗治疗中晚期非小细胞肺癌临床观察

目的 观察过继性细胞免疫治疗联合动脉灌注化疗治疗中晚期非小细胞肺癌(NSCLC)的疗效。方法将50例中晚期NSCLC患者随机分为观察组、对照组各25例。观察组采用细胞因子诱导的杀伤细胞和树突状细胞过继免疫治疗联合支气管动脉灌注化疗,对照组仅进行支气管动脉灌注化疗。观察两组的临床疗效和不良反应。结果 治疗后观察组完全缓解率、总有效率高于对照组(P均<0.05),而骨髓抑制、恶心呕吐、食欲下降发生比例低于对照组(P<0.05)。结论 过继性细胞免疫治疗联合支气管动脉灌注化疗治疗中晚期NSCLC临床疗效明显高于单纯支气管动脉灌注化疗,且不良反应小。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.