紫外线-核黄素光动力疗法对眼科常见致病细菌的体外杀菌作用

背景 金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌是眼科的常见致病菌,研究最佳杀菌方法对眼科的临床工作具有重要意义. 目的 观察紫外线-核黄素光动力疗法（PDT）对眼科常见致病细菌的体外杀菌作用. 方法 分别取金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌冻存菌各10株接种于血培养皿中,复活2次培养至对数生长期后刮取菌落,置于细菌稀释液中,制备0.5麦氏浓度的细菌悬液原液,原液稀释10倍用于PDT实验.分别用1、2、3 mW/cm2紫外线A（UVA）对不同质量分数核黄素作用后的细菌照射10、20、30 min,测量不同条件下抑菌圈直径的大小,确定最佳抑菌条件.将金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌分别分为正常对照组、单独核黄素作用组、单独紫外线照射组和PDT组,比较不同组间各种细菌菌落数的差异. 结果 当UVA强度为3 mW/cm2、作用30 min、核黄素质量分数为0.1％时,MH固体培养皿上抑菌圈直径接近6 mm,故上述参数为PDT法抑菌的最佳条件.正常对照组、单独核黄素作用组、单独紫外线照射组和PDT组的金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌的菌落数依次减少,差异均有统计学意义（F=110.990、190.841、118.197,均P=0.000）,单独紫外线照射组各种细菌的菌落数均明显少于正常对照组,差异均有统计学意义（t=14.640、7.550、5.320,P＜0.05）,PDT组各种细菌的菌落数亦明显少于正常对照组的菌落数,差异均有统计学意义（t=25.480、14.750、12.920,P＜0.05）.单独紫外线照射组细菌量较正常对照组降低46.4％～50.2％,PDT组的细菌量降低91.6％ ～96.7％,而单独核黄素作用组的细菌菌落数与正常对照组相比差异均无统计学意义（t=0.660、0.470、0.510,P＞0.05）.结论 在紫外线-核黄素PDT灭活微生物的最佳体外实验条件下,PDT法对金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌的杀菌效果最好.     

甘草酸二铵治疗肝纤维化的动态观察

目的 :观察甘草酸二铵治疗肝纤维化的疗效。方法 :2 0 0例 [男性 135例 ,女性 6 5例 ,年龄 (37±s 2 1)a]慢性肝炎病人分为A组 4 5例 ,B组 15 5例。A组用门冬氨酸钾镁 2 0mL ,B组用甘草酸二铵 30 0mg ,均加入 5 %葡萄糖注射液 5 0 0mL ,ivgtt ,qd ,连用 6wk后改为口服药治疗 8wk。观察肝功能、血清透明质酸 (HA)、Ⅲ型前胶原 (PCⅢ )及肝组织学变化。结果 :治疗 6wk时 ,B组的ALT复常率为 74 .2 % ,明显优于A组 (4 6 % ) ,P <0 .0 1。治疗结束后 ,B组的肝纤维化程度明显减轻 ,与A组相比 ,HA和PCⅢ水平明显降低。结论 :甘草酸二铵不但有良好的改善肝功能作用 ,还具有抗肝纤维化作用     

卵巢肿瘤中CD_(44)V_6与PCNA的表达及其意义

目的 :探讨卵巢良恶性肿瘤中 CD4 4V6 与 PCNA的表达及其临床意义。方法 :应用免疫组化 SP法对 42例恶性卵巢肿瘤、 2 4例良性卵巢肿瘤和 10例正常卵巢组织中 CD4 4V6 与 PCNA的表达进行检测。结果 :CD4 4V6 与 PCNA的表达特点相似 ,两者在恶性卵巢肿瘤中的表达均高于在良性卵巢肿瘤及正常卵巢中的表达 ;在发生转移的恶性卵巢肿瘤中的表达均高于未发生转移的恶性卵巢肿瘤中的表达。结论 :CD4 4V6 与 PCNA在恶性卵巢肿瘤的发生、发展及浸润、转移中起重要作用 ,可以作为预测恶性卵巢肿瘤转移潜能的指标     

5-氨基酮戊酸光动力疗法联合重组人干扰素α2b软膏治疗老年患者表浅基底细胞癌的临床观察

目的 探讨5-氨基酮戊酸光动力疗法(5-Aminolevulinic acid mediated photodynamic therapy,ALA-PDT)联合重组人干扰素α2b软膏治疗老年表浅基底细胞癌(Basal cell carcinoma,BCC)患者的疗效。方法 选取143例BCC老年患者,随机分为PDT组(72例)和手术组(71例),PDT组采用ALA-PDT疗法联合干扰素治疗,手术组采取常规外科手术治疗,对两组患者的疗效、手术创伤面积、病变面积、复发情况、安全性等进行随访比较。结果 PDT组治疗后完全缓解率显著高于手术组(81.94% vs.57.75%,P＜0.05),而两组总有效率比较无统计学差异(91.66% vs.81.73%,P＞0.05);随访1年后,PDT组患者复发率显著低于手术组(9.72% vs.22.54%,P＜0.05);此外,PDT组平均创伤面积、治疗后病变面积也显著小于手术组(P＜0.05)。结论 ALA-PDT联合干扰素是一种临床疗效好,复发率低,创伤性小的治疗表浅基底细胞癌的有效方法。     

The effect of socioeconomic factors on quality of life after treatment in patients with head and neck cancer

PURPOSE: To determine the effect of socioeconomic factors on quality of life (QoL) after treatment in patients with head and neck carcinoma (HNC). PATIENTS AND METHODS: The study population included 50 HNC patients seen in their control examinations after radiotherapy during a 2-month interval and who were willing to complete the Short-Form 36 QoL questionnaire. Socioeconomic, demographic, and tumor- and treatment-related factors were analyzed for their effect on physical component summary score (PCS) and mental component summary score (MCS) using the Mann-Whitney U test. RESULTS: All patients received radiotherapy, and 33 patients (66%) underwent surgery for the primary tumor and/or neck disease. Chemotherapy was given in 9 patients (18%). Mean PCS and MCS were 47.9 (range, 24.8-59.3) and 46.7 (range, 22-63.3) for the whole patient population. There was no significant factor affecting PCS. Education level of "middle school or higher," perceived economic status of "medium or higher," social security status of not being "absent or minimally covered," and unilateral type of neck surgery were found to increase MCS significantly. According to separate linear regression analyses performed for three socioeconomic variables, the most significant factor for MCS was social security status compared with education level and perceived economic status. It was the only parameter that retained its significance when all five parameters were combined in a linear regression model. CONCLUSION: This study demonstrated that educational status, perceived economic status, and social security status showed a significant effect on the QoL of HNC patients after radiotherapy. When all variables were taken into account, only "social security status" remained significant.     

电针对内毒素引起大鼠肝损伤保护作用的研究

目的：观察电针足三里能否减轻内毒素引起的大鼠肝损伤,并初步探讨其作用机制。方法：雄性Wistar大鼠40只随机分为4组：内毒素组、电针组、正常组和非穴组。尾静脉注射内毒素（5 mg/kg）制作大鼠肝损伤模型,正常组注射等量生理盐水;电针组于造模半小时后给予电针“足三里”治疗（2～100 Hz,2 mA,1.5 h）,非穴组针刺位置为“足三里”旁开5 mm、下5 mm,操作同电针组。结果：尾静脉注射内毒素可显著增加大鼠肝组织TNF-α含量和血浆ALT活性,电针可使两者明显降低（P〈0.01）,非穴组大鼠肝组织TNF-α含量和血浆ALT活性与内毒素组相比差异无统计学意义（P〉0.05）。结论：电针“足三里”可降低内毒素引起的异常升高的大鼠肝组织TNF-α含量和血浆ALT活性,具有器官保护作用,其机制可能与降低肝组织TNF-α含量有关。     

Effect of test order on sensitivity in vulvodynia

OBJECTIVE: To assess the effect of order of sensitivity testing at the vulva and thumb on the sensitivity determined at the second site tested among women with and without vulvodynia. STUDY DESIGN: We evaluated the stability of sensitivity measurements to pressure at the vulva and thumb when the order of testing was randomized to vulva first vs. thumb first; we repeated testing 1 week later in the opposite order. RESULTS: Stability of results over time and the influence of the order of testing were determined among 13 women with vulvodynia and 20 asymptomatic control women. We found a strong correlation between results compared between the first and second visits as well as no order effect. CONCLUSION: The order of testing at vulvar and peripheral sites has little impact on the results of pressure-responsive sensitivity testing among women with and without vulvodynia.     

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