Malondialdehyde as biomarker of oxidative damage to lipids caused by smoking

Thiobarbituric acid reactive substances (TBARS) and malondialdehyde (MDA) have been used as biomarkers of lipid oxidation for more than thirty years. The validity of these biomarkers has been rightfully criticized for a lack of specificity and problems with post sampling formation. Numerous assays have been published for their analysis giving rise to reference intervals for healthy non-smoking humans varying more than to orders of magnitude. In spite of these problems, these biomarkers remain among the most commonly reported indices of oxidative damage and the present review focuses on the problems associated with MDA/TBARS analysis, their potential as biomarkers of oxidative stress and the effect of smoking on MDA status.     

吸烟对血管内皮功能的损害:1:1配对分析

目的观察吸烟及其吸烟量不同对中老年吸烟人群血管内皮功能的影响.方法选择2004-05/2004-10在鞍山市中心医院门诊进行健康体格检查者167人.纳入自愿参加实验的吸烟健康体检者85人为吸烟组.排除戒烟已超过2年者和确诊为肺心病和其他器质性心脏病患者.按相同性别、年龄、身高、体质量、职业11配对为不吸烟组(n=85),不吸烟是指一生中从未吸烟.共配成85对,其中男67对,女18对.根据吸烟者的吸烟指数将其分为大量吸烟组(吸烟指数≥100年支,n=39)和小量吸烟组(吸烟指数＜100年支,n=46).使用HP2500型彩色多普勒超声仪,同时记录肢体导联心电图,判断心动周期的舒张末期,测定3个心动周期肱动脉前后内膜之间的距离,取其均值.每位受试者分别测定安静时肱动脉内径,之后进行反应性充血试验,测血流介导的肱动脉内径,休息10 min后,舌下含服硝酸甘油后3.5～4.0 min再次测定含服硝酸甘油后肱动脉内径.反应性充血及含服硝酸甘油后血管内径的变化分别代表血管内皮依赖性舒张功能和非依赖性舒张功能.结果按意向处理分析,吸烟组安静时肱动脉内径、血管内皮依赖性舒张功能和血流介导的肱动脉血流量增长百分比均明显低于不吸烟组[(4.38±0.79)mm,(4.50±1.09)%,(217.8±99.6)%;(4.51±0.83)mm,(10.51±3.17)%,(375.6±197.4)%,t=3.173～4.539,P＜0.01].大量吸烟组的各项肱动脉血管内皮指标与小量吸烟组比较,无明显差异(P均＞0.05).结论中老年吸烟者较不吸烟者伴有更明显的血管功能损害,但与吸烟量并无直接关系.     

2012年山东省济南市居民恶性肿瘤死亡分析

目的了解济南市2012年居民恶性肿瘤死亡情况及其影响因素和变化趋势。方法死亡数据来源于济南市人口死亡信息登记管理系统,人口资料来源于济南市统计局和济南市公安局年度报表。死亡原因采用国际疾病分类标准ICD-10进行编码,对2012年济南市居民恶性肿瘤死亡数据进行分析。结果济南市居民2012年恶性肿瘤粗死亡率为142.78/10万,标化死亡率为104.48/10万,在全死因的构成比为24.70%;死亡率居前5位的恶性肿瘤依次是肺癌、胃癌、肝癌、食管癌和结直肠癌,占恶性肿瘤死亡总数的69.65%;死亡率随着年龄增长呈上升趋势,50岁之后明显增加。男/女性恶性肿瘤标化死亡率比为1.80。各年龄组恶性肿瘤死亡原因不同,白血病是少年儿童组恶性肿瘤死亡的第1位,占该年龄组恶性肿瘤死亡的40.00%。肝癌是青壮年组恶性肿瘤死亡的第1位,占该年龄组恶性肿瘤死亡的14.74%。肺癌为中、老年组恶性肿瘤死亡的第1位,分别占各自年龄组恶性肿瘤死亡的21.36%和27.28%。结论肺癌、胃癌、肝癌、食管癌、结直肠癌是威胁济南市居民健康的主要恶性肿瘤,为今后恶性肿瘤的防控重点,50岁以上为重点防控人群。     

肺源性与肺外源性急性呼吸窘迫综合征的再思考

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是由一系列疾病损伤导致的急性呼吸衰竭,重症患者具有较高的病死率。根据危险因素的不同,ARDS可分为肺源性ARDS和肺外源性ARDS两种亚型,前者由于损伤直接作用于肺泡上皮细胞,造成肺泡膜破坏,影响气血交换;而后者通过全身性因素导致血管内皮损伤,肺血管通透性增加、肺间质渗出,进而出现肺泡塌陷、水肿,呼吸衰竭。各种肺内外危险因素在重症ARDS患者中往往同时存在,影像和呼吸力学等临床特征也未能很好区分肺源性/肺外源性ARDS,生物标志物的诊断效应还需验证,甚至病死率在肺源性/肺外源性ARDS患者中也并无明显差异。本文对肺源性ARDS和肺外源性ARDS的危险因素、临床特征、病死率进行比较,并针对ARDS的发病机制、临床表现及治疗与预后需关注之处进行梳理,为临床医生更加全面了解ARDS的发病机制、规范系统地启动ARDS的精准化评估与治疗提供借鉴,从而降低ARDS患者的病死率。     

阿可达治疗晚期恶性肿瘤骨转移疼痛的疗效分析

Objective To study therapeutic efficacy of Aredia in treating malignant metastatic bone tumors. Method 60～ 90 mg Aredia was administrated iv in 31 cases with malignant metastatic tumors,once each week. Results Pain in 12 cases was significantly relieved.14 cases acquired relif.Total effective rate was 83.9% .Activity ability was improved by 80.6% .No apparent toxicological and adverse effects as well as fever and cold symptoms were observed.Conclusion Aredia is a kind of ideal drugs for treatment of pain caused by malignant metastatic bone tumors.It is convenient in use and could be endured by patients.     

膀胱癌常规超声误、漏诊原因分析

目的分析经腹超声检查膀胱癌的误、漏诊原因，并探讨避免的方法对策。方法对145例经手术病理证实的膀胱癌进行回顾性分析。结果超声诊断膀胱癌准确率83．4％（12l／145），漏诊发生率9．7％（14／145），误诊发生率6．9％（10／145），漏诊率与误诊率的差别无显著性（P〉0．5）。肿瘤体积小、位于膀胱前壁或顶部和膀胱不充盈为漏诊的主要原因。而血块、结石、前列腺增生组织、良性肿瘤为误诊对象。在对误、漏诊原因分析的同时还总结出了经验教训及鉴别要点。结论常规超声诊断膀胱癌是一种非常好的方法，但存在一定的误、漏诊率，应结合膀胱镜等多种方法综合检查以减少或避免误、漏诊现象。     

Analysis of therapeutic efficacy of Aredia in treating pain caused by advanced malignant metastatic bone tumors

Inrecentyears,biphosphatedrugs－－akindofanti－boneresorptionreagentwhichreversebonedamage．Now,itsapplyformetastaticbonetumorsbecomehottopic．Wetreated３１casesofmalignantmetastaticbonetumorswithArediaproducedbyNuohuaPharmacyfromMarch１９９７toMarch１９９９．Theeffectsweresat－isfying．Hereisthereport．１Subjectandmethod１．１Subjects３１patientswererecruited,including２４males,９females,agedfrom３１～７３yearsold．AllpatientswerediagnosedhistologicallyandpathologicallyunderhelpofX－…     

小儿肺炎支原体感染肺外损害79例诊治分析

目的 分析肺炎支原体感染伴肺外损害的临床特点,探讨其诊断和治疗.方法 对79例肺炎支原体感染伴肺外损害患儿临床表现、实验室检查、治疗效果进行回顾性分析.结果 79例患儿均有发热、咳嗽,查肺炎支原体IgM抗体均为阳性.胸部X线检查:两肺纹理增粗模糊39例,支气管肺炎21例,肺部实变影19例.肺外损害:发热伴消化系统症状30例(37.9%),其中B超检查示肝肿大1例;心血管系统表现(心悸、胸闷、心肌酶增高)26例;血液系统损害13例,其中白细胞减少10例,轻度贫血2例,血小板减少1例;胸腔积液3例;伴皮肤损害3例;伴有神经系统症状者2例;伴有泌尿系统损害者2例.均给予阿奇霉素5～10 mg·kg-1·d-1,静脉滴注,对阿奇霉素耐药者给予红霉素静脉滴注,合并细菌感染者给予头孢类等抗生素.经过2～4周的治疗,79例患儿全部治愈,肺外并发症均消失,异常化验指标恢复正常.结论 支原体感染可致支原体肺炎,同时可致肺外多器官系统损害,临床应提高认识,早期诊断并早期应用大环内酯类抗生素规范治疗.     

Usefulness of measurement of carotid arterial wall elasticity distribution in detection of early-stage atherosclerotic lesions caused by cigarette smoking

Purpose The aim of this study was to evaluate early-stage changes in the arterial wall caused by smoking. Methods A newly developed real-time ultrasonic measurement system was used to measure the elasticity distribution of the carotid arterial intima-media complex in 53 healthy male volunteers (mean age: 37.6 years), including 27 smokers. Simultaneous measurement of the elasticity distribution and intima-media thickness (IMT) was performed at six locations in the bilateral carotid arteries. Results The mean elastic modulus in the radial direction (Er) of the carotid arterial area where the IMT was less than 1.1 mm in smokers was larger than that in age-matched nonsmokers. There were no significant correlations between IMT and Er at the same location. However, a significant positive correlation was observed between the maximum IMT (maxIMT) and that of Er (maxEr) in six locations. In smokers, maxEr had a better correlation with the smoking index, and areas of IMT less than 1.1 mm containing harder lesions of Er ≥ 160 kPa were significantly more frequent than in nonsmokers. Conclusion Measurement of carotid arterial wall elasticity is useful for detecting distortion in the intramural elasticity distribution that occurs prior to IMT thickening caused by smoking as an early-stage atherosclerotic sign.     

Primary hyperparathyroidism-induced brown tumors caused by parathyroid carcinoma: a case report and literature review

Brown tumors represent a benign disease that is induced by primary or secondary hyperparathyroidism, with the pathological feature of osteitis fibrosa cystica. Primary hyperparathyroidism caused by parathyroid carcinoma resulting in brown tumors is extremely rare. Herein, we report the case of a 60-year-old male patient who was admitted for giant cell tumors of the bone with local pain and limited movement of the left knee joint. With early detection of multifocal osteolytic bone lesions, hyperparathyroidism (parathyroid hormone: 2365.00 pg/mL), and parathyroid cancer, the diagnosis of brown tumors was confirmed without any unnecessary or harmful interventions. Thereafter, he underwent parathyroidectomy, from which postoperative pathology confirmed parathyroid carcinoma, and total knee arthroplasty to restore movement of the knee joint. Seven months after surgery, the left knee joint had good range of movement. This case emphasizes that detecting patients’ parathyroid hormone levels should not be neglected when diagnosing multifocal osteolytic bone lesions. A comprehensive analysis combining clinical symptoms, imaging, and laboratory tests is conducive to accurate disease assessments and avoiding unnecessary or even survival-impairing surgery. However, when the tumor involves a large joint or seriously affects joint movement, surgery may be worth considering.     

低渗热灌注腹腔化疗治疗胃肠肿瘤恶性腹水的临床研究

Background:Malignant ascites,a commonly severe complication of gastrointestinal tumors,influence the quality of life and survival time of patients.A number of studies showed Intraperitoneal chemotherapy by hyperthermal perfusion with hot hypotonic liquids with unique drug kinematics was effective in treating primary and secondary tumors of abdominal cavity and preventing the metastasis.     

两种微创引流手术治疗恶性肿瘤引起的梗阻性黄疸效果的Meta分析

目的采用循证医学的方法评价经内镜逆行性胰胆管造影术(ERCP)和经皮肝穿刺胆道引流术(PTCD)治疗恶性梗阻性黄疸的临床效果。方法通过计算机检索有关ERCP或PTCD治疗恶性梗阻性黄疸的随机对照试验(RCT),检索时限为从建库起至2020年8月。两名评价者独立评价纳入文献的质量并提取资料,用RevMan 5.3软件进行Meta分析。结果共纳入8篇RCT研究,共736例患者。Meta分析结果显示:对于低位胆道梗阻者,两组手术成功率无显著差异(P=0.70),对于高位胆道梗阻者,ERCP组手术成功率低于PTCD组(P=0.0007),ERCP组总手术成功率低于PTCD组(P=0.008)。ERCP组治疗低位胆道梗阻者的临床疗效优于PTCD组(P=0.0001),而治疗高位胆道梗阻者的临床疗效低于PTCD组(P=0.005),两组总临床疗效无显著差异(P=0.81)。两组总并发症发生率无显著差异(P=0.60)。结论两种治疗方式均对恶性梗阻性黄疸有显著的临床疗效,但PTCD治疗有更高的手术成功率。