前纵裂入路切除鞍区巨大肿瘤

背景与目的：鞍区巨大肿瘤手术难度较大，本文探索前纵裂入路切除鞍内、鞍上向单双侧海绵窦、第三脑室、蝶窦及伴颞叶发展的巨大肿瘤的手术适应症、方法与优缺点方法：总结分析2002年1月至2004年5月我科经前纵裂入路切除鞍区各部位发展的肿瘤17例。结果：肿瘤全切14例，近全切2例．部分切除1例；术后视力改善12例，无改变5例，尿崩或电解质紊乱8例，死亡1例，随访时间3～32个月，有1例复发，系巨大侵袭性垂体瘤术后，行γ-刀治疗后肿瘤基本得到控制。结论：前纵裂入路是切除鞍内、鞍上向单双侧海绵安、第三脑室、蝶窦及伴颞叶发展的肿瘤较理想的入路，利用自然脑裂的分离，手术视野、操作角度好、肓区少，有利于显露重要血管、神经及双侧海绵窦内侧壁，肿瘤全切率高。     

Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40～50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40～50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29.8% before radiation as compared to 57.6±22.6% during RT. The difference between these two groups was not significant (P=0.280). The decreased relative lung perfusion post-RT was found in six patients, whereas the increased relative lung perfusion post-RT was observed in 13 patients.CONCLUSION SPECT lung perfusion scaning is a simple, convenient and useful method for assessing regional lung function pre-RT and for monitoring the changes in regional lung function after irradiation.     

Clinical observation on acupuncture treatment of functional dyspepsia

目的:观察针刺治疗功能性消化不良的临床疗效.方法:根据中医经络理论选择以足三里等穴位,用平补平泻手法,辅以电针治疗功能性消化不良,并以常用西药多潘立酮作为对照进行临床观察.结果与结论:针刺组总有效率93.8%,显效率为63.3%,药物组分别为82.3%和43.1%,针刺组治疗非特异型功能性消化不良疗效好于药物组(P＜0.05);治疗动力障碍型者,两者无明显差异(P＞0.05),疗效均较突出.     

盐酸苯海拉明凝胶的制备及质量控制

目的:制备盐酸苯海拉明凝胶并建立其质量控制方法。方法:以羧甲基纤维素钠等作为凝胶基质,以正交试验筛选基质最佳配方,并采用紫外分光光度法在258nm波长处测定盐酸苯海拉明的含量。结果:制备的凝胶均匀细腻,分散性好;盐酸苯海拉明检测浓度在100～400μg/ml范围内线性关系良好(r=0.9999,n=6),平均回收率为99.95%,RSD=0.95%(n=9)。结论:该制剂质量稳定,质控方法可靠。     

药品在被少量大肠杆菌污染而造成漏检的有关问题的探讨

目的:探讨药品在被少量大肠杆菌污染后,按中国药典现行方法检验是否存在漏检可能,建立了在该种情况下可行的大肠杆菌检查的方法.方法:对8个品种人为污染少量大肠杆菌后,按中国药典检查.结果:药品在被少量大肠杆菌污染后,按药典法大肠杆菌阳性检出率为0～66%,改进法为100%.结论:药品在被少量大肠杆菌污染后,按中国药典现行方法检验存在漏检可能.     

HPLC法测定小儿咳喘灵颗粒中绿原酸的含量

目的:建立高效液相色谱法测定小儿咳喘灵颗粒中绿原酸的含量.方法:采用Analytical Technology(AT)C18柱(200mm×4.6 mm,5μm);以乙腈-0.2%磷酸溶液(13:87)为流动相;检测波长为327 nm;流速为1 ml·min-1;室温操作.结果:绿原酸在0.083～0.83 μg的浓度范围内呈线性关系,r=0.999 9,平均回收率为99.2%,RSD为0.7%.结论:该法简便、准确可靠,可用于该药的质量控制.     

人血浆中氯氮平及去甲氯氮平的固相萃取HPLC测定

建立了HPLC法测定人血浆中的氯氮平及去甲氯氮平含量.采甩C18柱,流动相为甲醇-水-三乙胺-乙酸(600:400:4:2),检测波长254nm,固相萃取法处理血样,地西泮为内标.氯氮平及去甲氯氮平在50～2000ng/ml范围内线性关系良好.平均方法回收率分别为103.1%和102.1%.     

布洛芬离子导入凝胶剂在家兔体内的药动学

目的:通过研究布洛芬凝胶剂的药动学,为布洛芬离子电导入经皮给药系统的临床应用提供理论依据.方法:采用反相高效液相色谱法测定布洛芬凝胶剂透皮给药后不同时间家兔血药浓度,计算药动学参数.结果:布洛芬离子导入凝胶剂的吸收速度、峰浓度及血药浓度时间曲线下面积虽低于离子导入溶液剂,但AUC及C max 分别为透皮给药对照组的 2.6 倍和 4.5 倍,且吸收速度快.结论:布洛芬凝胶剂经离子导入有良好的吸收性.     

AIF重组质粒的构建、表达和功能的研究

目的构建人凋亡诱导因子(AIF)基因功能片段的真核表达载体pcDNA3.1( )AIF,并初步研究AIF在细胞凋亡中的作用。方法从人细胞中提取总RNA,RTPCR扩增AIF基因片段;克隆到pMD18T载体上,通过酶切和测序进行鉴定;将AIF基因片段插入pcDNA3.1( ),构建真核表达载体;电转化淋巴母细胞Raji细胞,观察AIF的表达水平和功能。结果成熟AIF蛋白分子在真核细胞中表达,并转移到细胞核中,诱导Caspase非依赖性细胞凋亡。结论成功构建了pcDNA3.1( )AIF真核表达载体,AIF在Caspase非依赖性细胞凋亡中发挥重要作用。     

苦玄参中一个新苦玄参酮苷的分离与结构鉴定

目的研究苦玄参的三萜类化学成分。方法采用大孔树脂、硅胶柱色谱纯化，经理化常数、光谱学方法鉴定结构。结果分离得到了2个三萜成分，分别鉴定为3,11,22-三羰基-16α-羟基-(20S,24)-环氧苦味素-5,23-二烯(1)和3,11,22-三羰基-16α-羟基-(20S,24)–环氧苦味素-5,23-二烯-2β-O-β-D-吡喃葡糖苷(2)。结论化合物1为已知化合物苦玄参酮I，其13CNMR数据为本文首次报导；化合物2为新三萜皂苷。