晚期胃癌患者的凝血、纤溶功能的研究

目的 探讨晚期胃癌患者的凝血、纤溶功能的变化及其临床意义.方法 所有受试对象均抽取空腹静脉血送检凝血及纤溶功能指标.结果 晚期胃癌的APTT[(44.5±4.8)s]、PT[(14.8±2.0)s]明显延长,血浆Fg含量[5.0±1.9)g/L]增多,以及D二聚体的阳性率增高(75%),与对照组相比,差异有统计学意义(P＜0.05).结论 晚期胃癌患者凝血酶原时间、活化部分凝血活酶时间明显延长,反映了晚期胃癌患者存在着凝血功能紊乱D二聚体阳性率及纤维蛋白原含量增高,有利于癌栓形成和癌的远处转移.     

颅脑损伤患者术后凝血功能异常与肝功能、内毒素、血小板活化因子及预后的关系

目的 探讨颅脑损伤患者术后凝血功能异常与肝功能、内毒素(LPS)、血小板活化因子(PAF)及预后的关系。方法 选取2019年6月至2022年8月于我院接受手术治疗的80例颅脑损伤患者作为研究对象,分为观察组(凝血功能异常)32例和对照组(凝血功能正常)48例,均进行凝血功能指标、肝功能指标、LPS、PAF的检测,分析凝血功能异常与肝功能、LPS、PAF的相关性。基于格拉斯哥预后评分(GOS),评估颅脑损伤患者的预后,比较65例预后良好者(GOS 4～5分)与15例预后不良者(GOS 1～3分)的凝血功能指标。结果 发生凝血功能异常的患者凝血酶原时间(PT)水平[(17.43±2.08)s]、活化部分凝血活酶时间(APPT)水平[(54.79±4.45)s]高于凝血功能正常的患者(t=11.042、11.912,P<0.05),纤维蛋白原(FIB)水平[(1.84±0.26)g/L]、血小板计数(PLT)值[(97.43±11.05)×10⁹/L]低于凝血功能正常的患者(t=3.776、17.720,P<0.05)。观察组患者的血清丙氨酸氨基转移酶(AL...     

慢性阻塞性肺疾病患者急性加重期凝血状态的研究

目的 探讨慢性阻塞性肺疾病(COPD)急性加重期患者凝血状态相关指标的改变及其临床意义.方法 对62例COPD急性加重期(AECOPD)患者治疗前后及51例健康体检者的凝血四项即纤维蛋白原(Fb)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及D-二聚体分别进行测定.结果 COPD急性加重期(AECOPD)患者治疗后APTT[(29.6±3.2)s]、Fb[(2.4±1.3)g/L]明显低于治疗前[(35.4±3.8)s、(3.1±1.5)g/L,t值分别为9.118、2.754,均P<0.05],而AECOPD组治疗后和正常对照组之间差异无统计学意义(P>0.05).AECOPD组治疗后D-二聚体水平明显低于治疗前[(0.21±0.18)mg/L比(0.29±0.17)mg/L](t值为2.524,P<0.05),但明显高于正常对照组[(0.14±0.12)mg/L,t值为2.388,P<0.05].结论 AECOPD患者凝血机制异常,处于高凝状态.     

阿司匹林肠溶片治疗短暂性脑缺血发作的效果观察

目的 探究阿司匹林肠溶片治疗短暂性脑缺血发作的效果。方法 84例短暂性脑缺血发作患者,随机分为A组和B组,每组42例。A组选择氯吡格雷进行治疗, B组选择阿司匹林肠溶片进行治疗。比两组患者治疗前后凝血功能指标[血浆纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)]及治疗效果。结果 治疗前, A组患者的PLT(203.91±27.59)×10⁹/L、FIB(5.32±0.95)g/L、PT(11.43±2.46)s、APTT(20.28±6.03)s与B组的(205.12±29.01)×10⁹/L、(5.43±1.03)g/L、(11.15±2.89)s、(20.16±6.13)s比较,差异无统计学意义(P>0.05)。治疗后, A组患者的PLT(195.78±26.81)×10⁹/L与B组的(198.42±24.31)×10⁹/L比较,差异无统计学意义(P>0.05);B组患者的FIB(2.41±0.41)g/L低于A组的(3.62±0....     

血细胞多参数指标联合检测在原发性免疫性血小板减少症病情评估中的应用价值

目的：分析血细胞多参数指标联合检测在原发性免疫性血小板减少症(ITP)病情评估中的应用价值。方法：选取2021年12月—2022年12月某院95例ITP患儿作为研究组,另选95例同期健康体检儿童作为对照组。比较2组受试者入组时血细胞参数指标[血小板平均体积(MPV)、血小板平均宽度(PDW)、血小板计数(PLT)、大血小板比例(P-LCR)],比较研究组不同预后ITP患儿入组时病情程度、治疗方案,以及治疗前后血细胞参数指标的差异,分析治疗后血细胞参数指标与疾病转归的相关性及预测ITP患儿疾病转归的价值。结果：入组时,研究组MPV、PDW、P-LCR[(11.45±1.75)fL、(17.15±2.38)%、(42.45±6.74)%]水平高于对照组[(9.49±1.55)fL、(14.37±2.09)%、(23.10±4.57)%],PLT[(45.62±8.83)×10⁹/L]低于对照组[(228.97±48.20)×10⁹/L],差异均有统计学意义(P<0.05);治疗1、2个月后,研究组预后良好患儿MPV、PDW、P-LCR低于预...     

新生儿弥散性血管内凝血微剂量肝素联合冷沉淀治疗与临床护理研究

目的探讨用微剂量肝素联合冷沉淀治疗新生儿弥散性血管内凝血(DIC)的疗效和护理效果。方法选取2013年6月至2014年6月确诊为DIC的新生儿40例,随机分为观察组和对照组,每组20例。观察组积极治疗原发疾病的基础上给予肝素联合冷沉淀治疗,对照组不给予肝素联合冷沉淀治疗。比较2组治疗前后凝血指标。结果观察组治愈率(80.0%)较对照组(40.0%)高(P<0.05)。观察组治疗前后凝血酶原时间[(16.58±4.55)s,(14.11±3.41)s]、活化部分凝血酶原时间[(67.91±20.11)s,(52.90±13.89)s]、凝血酶时间[(43.77±20.07)s,(24.02±8.23)s]、纤维蛋白原[(0.92±0.62)mg/L,(1.51±0.48)mg/L]与对照组[(24.56±13.59)s,(36.45±17.88)s;(82.35±32.64)s,(93.65±31.23)s;(39.01±15.85)s,(34.02±12.10)s;(0.87±0.34)mg/L,(0.41±0.32)mg/L]比较差异有统计学意义(P<0.05)。结论用微剂量肝素联合冷沉淀治疗新生儿DIC有效。     

依诺肝素钠联合羟氯喹治疗复发性流产的效果观察

目的:探讨依诺肝素钠联合羟氯喹治疗复发性流产(RSA)的效果。方法:选取2019年1月—2022年1月某院收治的RSA患者86例为研究对象，采用随机数字表法分为常规组和联合组，每组43例。常规组给予羟氯喹口服，联合组在常规组基础上给予依诺肝素钠皮下注射。比较2组妊娠结局及治疗前后凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体、纤维蛋白原(FIB)]、妊娠激素[孕酮(P)、人绒毛促性腺激素(HCG)、雌二醇(E₂)]、血清可溶性Fms样酪氨酸激酶1(sFlt-1)、血管内皮生长因子(VEGF)水平。结果:联合组保胎总成功率为93.02%,高于常规组的72.09%,差异有统计学意义(P<0.05)。治疗后，联合组APTT、PT[(35.49±1.62)s、(13.74±1.08)s]长于常规组[(32.68±1.55)s、(11.25±1.02)s],D-二聚体、FIB水平[(112.06±15.71)μg/L、(3.35±0.34)g/L]低于常规组[(138.62±16.54)μg/L、(4.02±0.36)g/L],血清P...     

妊娠期高血压与产妇易栓症发生的关系研究

目的 研究妊娠期高血压和产妇发生易栓症的关系。方法 选取50例妊娠期高血压产妇作为妊娠期高血压组,另选取50例正常妊娠产妇作为正常妊娠组。检测并对比两组产妇的凝血指标(凝血酶原时间、凝血酶时间、活化部分凝血酶原时间、抗凝血酶Ⅲ、纤维蛋白原)、血小板指标(血小板计数、血小板压积、血小板分布宽度、平均血小板体积)及血脂指标(总胆固醇、甘油三酯)水平。结果 妊娠期高血压组产妇的活化部分凝血酶原时间(24.7±4.4)s短于正常妊娠组的(28.7±2.4)s,抗凝血酶Ⅲ(94.1±16.0)%低于正常妊娠组的(103.1±18.4)%,纤维蛋白原(4.1±0.6)g/L高于正常妊娠组的(3.6±0.8)g/L,差异有统计学意义(P<0.05);两组产妇的凝血酶时间、凝血酶原时间对比,差异无统计学意义(P>0.05)。妊娠期高血压组产妇的平均血小板体积(11.00±2.34)fl、血小板分布宽度(16.88±0.79)%、甘油三酯(3.27±0.76)mmol/L均高于正常妊娠组的(8.63±2.26)fl、(16.11±0.46)%、(2.81±0.92)mmol/L,差异有统计学...     

血管生成素-2检测对胃癌的诊断价值

目的 探讨血清血管生成素-2(Ang-2)检测对胃癌的诊断价值.方法 采用酶联免疫吸附法(ELISA)定量检测108例胃癌患者、50例慢性胃炎患者和50名健康体检者血清Ang-2水平.结果 胃癌患者血清Ang-2水平[(1539.0±449.3) ng/L]显著高于胃炎患者[(1044.6±246.1) ng/L,P＜0.01]和健康体检者[(1075.6 ±228.2) ng/L,P＜0.01].胃炎患者与健康体检者血清Ang-2水平差异无统计学意义.有淋巴结转移患者显著高于无转移患者(P＜0.01).血清Ang-2水平诊断胃癌的ROC曲线下面积为0.819.结论 血清Ang-2水平可以作为胃癌诊断的有价值指标之一.     

前列地尔联合罂粟碱对早期自体动静脉内瘘的保护作用研究

目的 探究前列地尔联合罂粟碱对早期自体动静脉内瘘的保护作用。方法 60例早期行自体动静脉内瘘患者,采用计算机随机化分组法分为观察组和对照组,每组30例。观察组应用前列地尔联合罂粟碱治疗,对照组应用罂粟碱联合阿司匹林治疗。比较两组手术前后血液学指标变化、术后临床指标及不良反应发生情况。结果 术后第8天,观察组血小板计数(112.36±10.98)×10⁹/L、血液粘度(2.06±0.42)mPa·s、红细胞聚集数(4.05±0.35)、纤维蛋白原(3.21±0.14)g/L、凝血酶原时间(13.02±2.64)s、活化部分凝血活酶时间(32.69±6.23)s、D-二聚体(3.12±0.42)mg/L;对照组分别为(115.39±10.78)×10⁹/L、(2.46±0.35)mPa·s、(4.75±0.36)、(4.39±0.52)g/L、(13.68±2.74)s、(32.74±6.10)s、(3.85±0.32)mg/L。观察组血液粘度、红细胞聚集数、纤维蛋白原、D-二聚体均低于对照组,差异有统计学意义(P<0.05)。两组血小板计...     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.