微创治疗高血压性脑出血患者血清MMP-9水平的动态变化及其临床意义

目的探讨微创治疗高血压性脑出血患者血清中MMP-9水平的动态变化及其与脑水肿的关系。方法选择起病在24 h以内的高血压性脑出血患者,共入选120例,入院后常规予脱水降低颅内压、控制血压、营养支持等治疗,按治疗方法不同分为微创治疗组60例、内科保守治疗组60例,分别于入院第l、3、7、10和14天各抽取空腹静脉血进行血清MMP-9浓度测定;选取60例门诊高血压患者作为对照组,于当天抽取空腹静脉血1次测定血清MMP-9浓度。测定方法采用双抗体夹心酶联免疫吸附法(ELISA法)。结果高血压性脑出血患者血清MMP-9水平于起病后第l、3和7天升高,其中发病后第3天水平升高尤其明显,此后呈逐渐降低的趋势,但至起病后第14天仍高于高血压组水平(8.98±6.32)ng/mL,差异有显著性(P<0.01);微创治疗组中血清MMP-9水平于起病后第1天明显升高,经微创治疗后第3天逐渐降低(52.42±16.40)ng/mL,与内科保守治疗组(99.38±25.75)ng/mL比较,差异有显著性(P<0.05)。结论高血压性脑出血患者发病早期血清MMP-9水平开始升高,发病第3天后达到高峰,此后呈逐渐降低的趋势,第14天后仍处于较高水平;颅内血肿经微创引流清除,减轻压迫,缓解脑水肿,血清MMP-9水平逐渐下降,提示MMP-9可能参与了急性脑水肿的形成过程。     

肝动脉化疗及栓塞治疗肝脏转移性肿瘤

肝脏是转移性肿瘤的好发部位之一，其罹病频闪仅闪于淋巴结转移瘤居第二位。近年来经导管肝动脉化疗及栓塞被认为是治疗肝癌的一种有效方法，但大多数报道是有关原发性肝癌的治疗，对肝脏转移性肿瘤的治疔报道较少。笔者从1988年底至1994年8月对近百例肝转移瘤进行了介入治疗．其中影像学及随访资料较完整的54例，现报告如下。     

论扶正蠲痹在治疗类风湿关节炎中的主导地位

类风湿关节炎(类风关)病势缠绵,外罹肢节,内及脏腑,至筋挛骨损之时,每易致残.因发病机理未明,迄今尚无特效的治疗方法,故如何提高类风关治疗效果,一直是临床医学的重要课题.     

对香豆酸壳聚糖生物黏附微球的制备与体内外评价

摘 要 目的：以壳聚糖为生物黏附材料制备对香豆酸微球,延长药物在体内吸收时间并提高其口服生物利用度。方法: 采用喷雾干燥技术制备对香豆酸壳聚糖生物黏附微球,采用激光粒度仪和扫描电镜考察微球的粒径及外观形态,并考察其体外释放度;以大鼠为动物模型进行生物利用度评价。结果: 所制备的黏附微球粒径在4 μm左右,形态圆整,90 min内释放完全;在体内显示出较好的缓释和促吸收效果,大鼠口服后,相对生物利用度为222%。结论:制备的对香豆酸生物黏附微球具有较好的体内缓释效果,并显著提高了口服生物利用度,可为对香豆酸的制剂开发提供参考依据。     

当归芍药散合桂枝茯苓丸加减治疗单纯性卵巢囊肿临床研究

目的:观察当归芍药散合桂枝茯苓丸加减治疗单纯性卵巢囊肿的临床疗效。方法:选择2014年4月-2015年5月本院妇科门诊收治的单纯性卵巢囊肿患者164例,所有患者均经腹部彩超确诊,近2个月均未接受过任何卵巢囊肿方面的治疗,且无其他系统性疾病,随机分为联合治疗组与红金消结组各82例。联合治疗组给予当归芍药散合桂枝茯苓丸加减治疗,红金消结组给予红金消结浓缩丸治疗。结果:联合治疗组治疗后囊肿体积优于红金消结组(P0.05);联合治疗组治疗后症状改善情况明显优于红金消结组(P0.05);联合治疗组有效率96.34%,红金消结组有效率78.00%,联合治疗组优于红金消结组(P0.05)。结论:当归芍药散合桂枝茯苓丸加减治疗单纯性卵巢囊肿疗效显著,可明显缩小单纯性卵巢囊肿体积,改善患者临床症状。     

腹主动脉瘤血管腔内治疗的体会

目的 观察腹主动脉瘤血管腔内治疗的近期疗效.方法 对12例肾下型腹主动脉瘤进行分析.结果 术中出血平均245 mL,住院时间平均8.6 d,术后禁食时间平均1.5 d.白细胞、血红蛋白和血小板以及肾功能、肝功能均在正常范围;PT和APTT术后延长,1周内恢复正常.并发症包括:肺部感染1例、腹胀2例,经保守治疗好转;内漏1例,3个月后自然消失.结论 腹主动脉瘤血管腔内治疗具有安全、微创及对人体内环境干扰小的优点.     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

六黄合剂对胰岛素抵抗大鼠血管内皮细胞的影响

目的观察六黄合剂对胰岛素抵抗(IR)大鼠血管内皮细胞的影响,探讨其保护血管内皮的作用机制。方法健康SD大鼠32只,按体质量随机分为正常组、模型组、罗格列酮组和六黄合剂组,每组8只。应用地塞米松诱导IR大鼠模型,造模同时灌胃给药,罗格列酮组和六黄合剂组分别给予罗格列酮3 mg/(kg.d)和六黄合剂6.3 g/(kg.d)干预,正常组和模型组给予等体积蒸馏水,14 d后应用化学比色法测定大鼠脂代谢指标及血清一氧化氮(NO)的水平,应用透射电镜观察胸主动脉内皮细胞超微结构的变化。结果与模型组比较,六黄合剂组血清三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和游离脂肪酸(FFA)水平明显下降(P<0.01),血清总胆固醇(TC)水平下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平升高(P>0.05),血清NO水平明显升高(P<0.01)。电镜观察,IR大鼠胸主动脉内皮细胞超微结构发生明显病理改变。六黄合剂干预后,胸主动脉内皮细胞超微结构明显改善。结论六黄合剂能有效调节IR大鼠血脂水平,增加血清NO含量,改善IR早期大动脉内皮细胞的病理损害。