晚期前列腺癌间歇与持续性内分泌治疗的临床观察

目的:观察比较晚期前列腺癌间歇性内分泌治疗(IHT)与持续性内分泌治疗(CHT)的疗效和不良反应。方法:选取确诊的晚期前列腺癌患者共96例,之前未接受治疗,随机分为:间歇治疗组(A组)和持续治疗组(B组)。A组:54例,给予比卡鲁胺(50mg,口服,每日1次)和戈舍瑞林(3.6mg,皮下注射,每月1次)治疗,当患者血清PSA≤0.2ng/ml,暂停服用药物比卡鲁胺,当患者血清PSA>4ng/ml时,重新开始服用药物比卡鲁胺。B组:42例,同时给予比卡鲁胺和戈舍瑞林治疗,不间断治疗。终止治疗的标准是病人由激素依赖转为激素抵抗性前列腺癌。比较两组治疗前、治疗后半年、1年、2年后血清PSA、疼痛缓解及排尿梗阻症状改善情况、生活质量评分、不良反应。结果:血清PSA、疼痛缓解以及排尿梗阻改善情况上,两组治疗后各时间段较治疗前均得到显著改善(P<0.05),但两组之间无显著差异(P>0.05)。A组治疗后不良反应中去势综合征、转氨酶升高、贫血以及乳房发育发生率较B组显著降低(P<0.05),生活质量评分明显升高(P<0.05)。结论:IHT和CHT对晚期前列腺癌治疗效果无明显差异,都能缓解患者的症状和提高患者的生活质量,但IHT不良反应发生率较持续治疗显著降低,生活质量明显提高,值得临床椎广。     

甲状腺疾病局部免疫调节治疗的操作及护理

目的 总结甲状腺疾病局部免疫调节治疗中的操作要点及护理心得,为临床同类护理提供借鉴.方法 采用糖皮质激素等药物对110例自身免疫性甲状腺疾病患者进行甲状腺内局部免疫调节治疗1～3个疗程,并进行精心护理,定期随访2～3年.观察疗效并总结治疗中的操作及护理要点.结果 甲状腺局部免疫调节治疗后,所有患者的甲状腺功能均有所好转或恢复,总有效率达94%,患者自觉症状明显改善.治疗中并发症及不良反应少见.结论 甲状腺局部免疫调节治疗中护理人员应与医生密切配合.良好的心理疏导、完整的健康教育以及充分的术前准备、严密的术中配合、精心的术后护理是治疗成功的保证.     

The positive correlation between DJ‐1 and β‐catenin expression shows prognostic value for patients with glioma

The relationship between DJ‐1 and β‐catenin, and its impact on the prognosis for glioma patients has not been fully understood. This study determined the effect of DJ‐1 on β‐catenin and the prognostic significance of this interaction in glioma patients. We collected tumor specimens from 88 glioma patients and determined the expression of DJ‐1, β‐catenin and PTEN by using immunohistochemical staining. The involvement of DJ‐1 and β‐catenin in glioma cell lines was evaluated by immunohistochemistry and Western blotting. High DJ‐1 expression (37.5%) and high β‐catenin expression (34.1%) in glioma specimens were significantly associated with high grade and poor prognosis in glioma patients. However, only high levels of DJ‐1 (P = 0.014) was a strong independent prognostic factor, correlated with a reduced overall survival time. In vitro DJ‐1 expression was positively correlated with the expression levels of β‐catenin and p‐Akt, and negatively correlated with PTEN expression in U87, U251 MG, SWO‐38 and SHG44 human glioma cell lines. After the knockdown of DJ‐1, Akt, p‐Akt or β‐catenin expression levels were not affected in the PTEN‐null cell lines (U87 and U251 MG). However, in the SWO‐38 cell line, which has wild‐type PTEN protein, the level of PTEN increased while Akt/p‐Akt and β‐catenin levels were reduced. Furthermore, β‐catenin staining weakened in SWO‐38 cells after DJ‐1 levels decreased according to immunocytochemical analysis. In conclusion, DJ‐1 and β‐catenin may contribute to the development and recurrence of glioma and are valuable prognostic factors for glioma patients. DJ‐1 may regulate β‐catenin expression via PTEN and p‐Akt.     

Effects of music on gastric myoelectrical activity in healthy humans

The aim was to study the effects of listening to music on gastric myoelectrical activity in healthy humans. Gastric myoelectrical activity was recorded using surface electrogastrography from 17 healthy volunteers before and for 30 min after they listened to music. All subjects listened to the same music. Ten perceived the music as enjoyable and seven did not. The percentages of normal slow wave, dominant frequency and dominant power did not differ significantly between baseline and during music intervention. An analysis of covariance model that included the subjects' feelings about the music and dominant power showed significantly higher dominant power during music intervention in subjects who enjoyed the music (p < 0.01). In the individuals who enjoyed the music, dominant power (55.0 +/- 9.2 dB) was significantly higher during music intervention than at baseline (49.5 +/- 6.8 dB, p = 0.03). In the subjects who did not enjoy the music, dominant power was significantly lower during music intervention than at baseline (48.8 +/- 6.8 and 55.7 +/- 6.2 dB, respectively; p < 0.01). Listening to enjoyable music increases the amplitude of gastric myoelectrical activity in healthy humans. Music therapy may improve gastric motility and may be used to stimulate gastric emptying.     

老年糖尿病治疗方式对认知功能的影响及相应护理对策

目的 探讨老年男性2型糖尿病患者认知功能损伤与不同治疗方式之间的关系，找出规律，为临床护士制定相应的护理计划提供理论依据。方法 老年糖尿病患者43例，进行总体认知功能、词语学习、词语记忆、词语再认、视觉记忆、思维判断、空间技能、词语流畅、加工速度、空间执行功能等认知测试，调查糖尿病的治疗情况，并对不同治疗组间认知情况进行对比分析。结果 胰岛素治疗组的词语流畅性成绩明显减低（P〈0.05）。结论 糖尿病患者存在认知功能减退，其严重程度与治疗方式有关，必须采取针对性的护理措施。     

彩色多普勒超声评价肝移植术后肝动脉血流动力学改变及其临床意义

目的 探讨肝移植术后肝动脉血流动力学改变及其临床意义。方法 回顾性分析术后接受了系列多普勒超声检查的42例肝移植患者，依肝右动脉阻力指数（RI）不同分为低阻力型（RI＜0．5）、阻力正常型（0．5≤RI＜0．8）、高阻力型（RI≥0．8）。分析术后肝右动脉收缩期峰值流速（PSV）和RI的变化及其与患者术后2月内病情转归的关系。结果 肝移植术后第1～3d肝右动脉RI测值中，64．3％为阻力正常型，26．2％为高阻力型，9．5％为低阻力型。肝右动脉PSV术后早期测值偏低，之后逐渐上升。RI值于术后早期测值偏高，之后逐渐减低。肝移植术后2月内死亡或危重的患者共9例，其中6例（66．7％）术后第1～3d肝右动脉PSV％30cm／s和（或）RI＜0．5。结论 肝移植术后早期肝动脉RI增高是一种常见的表现，与临床表现无关；术后早期肝右动脉PSV＜30cm／s和（或）RI〈0．5会导致术后早期高死亡率。