经动脉向恶性实体肿瘤组织灌注碳酸氢钠提高化疗药物疗效的初步观察

目的 经动脉向实体恶性肿瘤组织灌注碳酸氢钠,观察对ADM、MMC、5－Fu介入治疗的增效作用。方法 随机分组为单组介入化疗组和经动脉灌注碳酸氢钠后再灌注化学药物两组。Seldinger技术穿刺经股动脉进入肿瘤动脉血管,对照组单纯灌注化疗药物;治疗组先灌注碳酸氢钠再分别灌注生理盐水30ml和化疗药物。结果 加用碳酸氢钠组部分缓解率明显高于单纯化疗组。结论 向恶性肿瘤组织灌注碳酸氢钠可提高ADM、MMC、5－Fu疗效。     

干扰素与白介素—2瘤体局部注射配合化疗治疗恶性淋巴瘤

目的：评价干扰素（IFN）与白介素－2（IL－2）瘤体局部注射配合化疗治疗恶性淋巴瘤临床疗效。方法：单纯化疗组：26例,化疗配合IFN与IL－2组34例,每闪IFN300－600万U;IL020,50－100万U;瘤体局部注射,每隔三天一次,每个化疗周期使用3－5次。结果单纯化疗组：化疗2周期的完全缓解（CR）＋部分缓解（PR）12例,有效率46．2％,化疗周期的CR＋PR16例,有效率60．2％,合用化疗组;化疗2周期的CR＋PR22例,有效率64．6％,化疗4周期的CR＋PR27例,有效率79．4％,结论：IFN与IL－2配合化疗治疗恶性淋巴瘤的疗效高于疗效高于化疗组,明显缩短化周期,节省治疗费用,减轻毒副作用。     

经导管药盒系统动脉灌注治疗中、晚期恶性肿瘤30例疗效观察

目的评价中、晚期恶性肿瘤患者经导管药盒系统(PCS)动脉灌注化疗药物及榄香烯乳后的临床疗效。方法63例中、晚期恶性肿瘤患者随机分为A组31例(灌注化疗药物+榄香烯乳)、B组32例(单纯灌注化疗药物),比较2组近期疗效。结果A、B组总有效率分别为66.7%、46.7%,1y生存率分别为56.7%、43.3%,2组比较均具有显著性差异(P<0.05)。结论经PCS动脉灌注化疗药物加用榄香烯乳治疗中、晚期恶性肿瘤可行,且疗效优于单纯灌注化疗药物。     

两种双介入方法治疗晚期肺癌的临床疗效分析

目的探讨支气管动脉灌注化疗（BAI）合并肺动脉灌注化疗（PAI）及支气管动脉灌注化疗(BAI)合并CT导引下瘤内注射无水酒精(PEI)两种双介入方法治疗晚期肺癌的临床效果。方法对已确诊的35例晚期肺癌(其中肺转移癌4例)，分为A、B两组，A组12例行BAI PAI双介入方法治疗，B组23例行BAI PEI双介入方法治疗，并对其疗效进行分析。结果A组完全缓解(CR)1例，部分缓解(PR)8例，有效率75％；B组完全缓解(CR)2例，部分缓解15例，有效率73.9％。结论BAI PAI及BAI PEI这两种双介入方法治疗晚期肺癌临床疗效均增加。是一种较好的综合治疗方案。     

靶动脉灌注维拉帕米对晚期肺癌介入疗效的临床观察

目的观察靶动脉灌注维拉帕米联合化疗药物对肺癌介入治疗的临床效果。方法 16例晚期肺癌患者,用seldinger穿刺技术经靶动脉灌注维拉帕米联合化疗药物,每月介入治疗1次,每例介入治疗2次以上,2个月后判断疗效。结果 16例晚期肺癌患者中完全缓解(CR)1例,部分缓解(PR)15例,有效率(CR+PR)%为100%;16例患者KPS评分、体重稳定;16例患者治疗后均可评价毒副反应,其中4例出现白细胞下降,7例出现消化道反应,ALT/AST升高3例,发热2例,以上不良反应均短时间内缓解,未发现BUN/Cr升高及过敏反应;16例患者心功能在介入前后无显著变化;心电图亦未表现出显著差异。结论经晚期肺癌患者的靶动脉灌注维拉帕米联合化疗药物可提高化疗药物的疗效,使得病灶缩小,降低了患者的临床分期,从而为放疗或手术治疗提供了机会。     

支气管动脉灌化疗联合雾化吸入IL—2治疗晚期非小细胞肺癌临床分析

目的：评价支气管动脉导管化疗（简称动脉化疗）联合雾化吸入IL－2与同期单用动脉化疗治疗晚期非小细胞肺癌（NSCLC）的疗效。方法：41例晚期肺癌病人分成两组,治疗组21例,在采用环磷酰胺、阿霉素、顺铂动脉灌注化疗的同时雾化吸入IL－2;对照组30例单用动脉化疗。两组动脉化疗用药情况和剂量相同。结果：治组总有效率为76.19%,初治总有效率为83.3%,复治总有效率为33.3%;对照组总有效率为45.00％,初治总有效率为53.3%,复治总有效率20％。两组总有效率经统计学处理有差异（P＜0.05）。结论：动脉化疗联合雾化吸入IL－2治疗晚期NSCLC,疗效明显优化于单用动脉化疗,初治疗效较复治效果显著。     

中西药物疗法配合紫外线光疗治疗白癜风对患者血清 IL－17、IFN－γ及 Hcy水平的影响

目的：探讨联合中西药物疗法及紫外线光疗治疗白癜风对患者白细胞介素－17（ IL－17）、肿瘤坏死因子－γ（ IFN－γ）及同型半胱氨酸（ Hcy）的影响。方法将240例白癜风患者随机分为研究组和对照组各120例。对照组接受中西药物疗法治疗,研究组接受联合紫外线光疗及中西药物疗法治疗。对比2组治疗前后IL－17、IFN－γ及Hcy含量变化情况。结果治疗前2组IL－17、IFN－γ及Hcy水平比较差异均无统计学意义（ P＞0．05）。治疗后2组IL－17、IFN－γ及Hcy水平均低于治疗前,且研究组低于对照组,差异均有统计学意义（P＜0．05）。结论中西药物及紫外线光疗联合疗法可有效地降低白癜风患者IL－17、IFN－γ及Hcy含量。     

靶动脉灌注维拉帕米联合化疗药物对晚期胃癌介入疗效的临床观察

目的观察靶动脉灌注维拉帕米联合化疗药物对晚期胃癌介入治疗的临床效果。方法 38例晚期胃癌患者,用Seldinger穿刺技术经靶动脉灌注维拉帕米联合化疗药物,每月介入治疗1次,每例介入治疗3～4次,介入治疗2次后判断疗效。结果38例患者,胃癌原发灶可测定35例,其中病灶完全消失（CR）4例,占11.4%;肿瘤缩小在50%以上（PR）26例（74.2%）;病灶稳定者（SD,缩小在50%以下）3例（8.57%）,病灶进展者（PD）2例（5.71%）,有效率（CR＋PR）85.6%;6例腹膜后淋巴结转移患者淋巴结改变有效率（CR＋PR）100%;32例远处转移灶临床治愈或明显好转（CR）10例,好转（PR）14例,稳定（SD）5例,进展或恶化（PD）3例,有效率（CR＋PR）为75%;介入治疗后评价KPS评分及体重稳定,临床受益稳定;38例患者治疗后均可评价毒副反应,主要不良反应均短时间内缓解,未发现BUN/Cr升高及过敏反应;心电图在介入前后未表现出显著差异。结论经晚期胃癌患者的靶动脉灌注维拉帕米联合化疗药物可提高化疗药物的疗效,使得病灶缩小,从而延长患者生存期,提高了患者的生活质量。     

哮喘患者不同 FeNO 水平与哮喘炎症表型的关系研究

目的：探讨支气管哮喘患者的呼出气一氧化氮（ FeNO）水平变化与患者炎症表型的关系。方法选取呼吸内科收治的支气管哮喘患者100例（哮喘组）和门诊体检健康研究对象100例（健康组）,分别检测2组对象的FeNO水平及血清炎症因子等指标并进行比较分析。结果哮喘组患者的ECP、IL－2、IL－4、IL－6、IL－8、IL－13、TNF－α、IFN－γ、FeNO测定值均显著的高于健康组（ P ＜0．05）,哮喘组患者的IL－2、IFN－γ测定值均显著的低于健康组（ P ＜00．5）;急性发作期哮喘组患者的ECP、IL－2、IL－4、IL－6、IL－8、IL－13、TNF－α、IFN－γ、FeNO测定值均显著的高于缓解期哮喘患者（ P ＜0．05）,急性发作期哮喘组患者的IL－2、IFN－γ测定值均显著的低于缓解期哮喘患者（ P ＜0．05）;哮喘组患者的ECP、IL－2、IL－4、IL－6、IL－8、IL－13、TNF－α、IFN－γ与FeNO测定值呈显著的正相关关系（ P ＜0．05）,哮喘组患者的IL－2、IFN－γ测定值与FeNO测定值呈显著的负相关关系（ P＜0．05）。结论支气管哮喘患者的FeNO水平、炎症指标均显著的升高,FeNO水平与哮喘患者的病情及炎症反应程度具有显著的正相关关系。     

选择性动脉灌注化疗治疗中晚期消化道肿瘤的临床分析

目的探讨经皮介入选择性动脉灌注化疗-5全身静脉化疗治疗中晚期消化道肿瘤,在药物毒性反应,住院费用、患者接受度、住院天数的差别。方法A组经股动脉介入选择性动脉灌注化疗,B组经前臂浅静脉输液化疗,A、B组两组均采用FOLFOX方案化疗,28d／周期。结果胃肠道反应,选择性动脉灌注化疗A组是20％左右,全身静脉化疗治疗B组60％～100％;白细胞减少,A组是20％,B组是60％;平均住院天数,A组是6d,B组是12d;平均住院费用,A组多余B组200,--400元;A组全部完成选择性劝脉灌注化疗疗程,B组是80％完成,12％部分完成,有2例因副反应大患者拒绝在化疗。结论选择性动脉灌注化疗毒副反应小,费用不高,术后恢复快,患者易于接受,这种化疗方法优于全身静脉化疗。     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

A fetus with meckel-gruber syndrome associated with isomerism

Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.