内镜黏膜切除术对胃食管连接部病变的治疗价值

目的评价内镜黏膜切除术治疗胃食管连接部病变的疗效、安全性及应用价值。方法经术前内镜检查及黏膜活检证实后,采用内镜黏膜切除术切除51个胃食管连接部病变,其中低度异型增生39个,高度异型增生12个,病灶直径3～28mm,平均（10．9±4．0）mm。对手术前后病理结果进行对照,定期复查内镜进行随访。结果全组有44个病灶被完全切除,完全切除率为86．3％,手术前后病理结果相符的病灶仅26个（50．1％）,其余25个病灶中24个病灶术前活检病理级别偏低。并发症主要是出血,17例占33．3％,均经处理后停止出血,无一例发生穿孔或术后狭窄。51例患者随访中无1例复发或死亡。结论内镜黏膜切除术是治疗胃食管连接部病变安全、有效的方法,是阻断癌前病变和早期癌在体内进展的重要策略。     

骨髓CD34＋祖细胞IL-5Rα、CCR3表达与哮喘气道原位造血的相关性及地塞米松对其的干预

目的探讨抗原激发后骨髓祖细胞造血因子受体IL-5Rα、CCR3表达及与哮喘气道原位造血的关系。方法将C57BL/6小鼠随机分为对照组、模型组及地塞米松组各20只,后两组以卵白蛋白（OVA）致敏和激发建立哮喘模型,地塞米松组于抗原激发前经腹腔注射地塞米松。于最后一次抗原激发后48 h测气道反应性,检测骨髓CD3＋4祖细胞IL-5Rα mRNA、CCR3表达;观察造血因子受体对祖细胞净迁移率及嗜酸性粒细胞（Eos）克隆形成的影响。结果与对照组比较,模型组IL-5Rα mRNA和CCR3表达显著上调,CD3＋4祖细胞净迁移率及Eos细胞克隆数明显增加（P均〈0.05）。与模型组比较,地塞米松组IL-5Rα mRNA、CCR3表达明显下调,CD3＋4祖细胞净迁移率及Eos细胞克隆数明显减少（P均〈0.05）,气道反应性及气道Eos浸润相应明显减轻（P均〈0.05）。结论哮喘小鼠IL-5Rα mRNA、CCR3表达与哮喘气道原位造血关系密切;地塞米松干预可抑制IL-5Rα mRNA和CCR3表达,抑制气道原位造血,减轻气道Eos炎症和气道高反应性。     

依达拉奉治疗急性脑梗死150例疗效观察

目的：观察依达拉奉治疗急性脑梗死的疗效。方法：将300例脑梗死患者随机分为治疗组及对照组,每组150例。对照组予常规治疗,治疗组在常规治疗的基础上加用依达拉奉30mg＋生理盐水100甜静脉滴注,30min内滴完,每日2次,共14d。对2组患者治疗前及治疗后第14天分别进行神经功能缺损评分及疗效评价。结果：治疗组有效率89％,高于对照组有效率69％（P〈0．05）。结论：依达拉奉能殖致改善急性脑梗死患者的预后,是一种安全、有效的神经保护剂。     

早期肠内营养对休克后患者炎性反应的疗效研究

目的 研究早期肠内营养(EN)对休克患者内毒素及肿瘤坏死因子-α(TNF-α)的作用及全身炎性反应综合征(SIRS)的影响.方法 休克67例随机分为早期EN组和肠外营养(TPN)组,检测两组患者肠内营养治疗前、治疗后1、3、5 d血浆中内毒素与TNF-α水平;统计两组SIRS的持续时间与多器官功能障碍(MODS)的发生...     

分泌性中耳炎大鼠咽鼓管鼓室β-防御素的表达

目的 检测大鼠β防御素(rat β-defensin,rBD)在分泌性中耳炎大鼠咽鼓管鼓室的表达,探讨β防御素在分泌性中耳炎发病机制中的作用.方法 排除中耳感染的清洁级SD大鼠48只,随机分为4组,前3组36只行颈部切口经右侧听泡注入脂多糖(lipopolysaccharide,LPS)溶液(1 mg/mL)30 μL制作分泌性中耳炎动物模型,造模后分别于第1、3、7天断头取咽鼓管鼓室黏膜;对照组12只右侧听泡注入生理盐水30μL,左侧听泡作为正常组,3 d后断头取咽鼓管鼓室黏膜.逆转录聚合酶链反应(RT-PCR)检测咽鼓管鼓室rBD-1 mRNA和rBD-2 mRNA的表达.结果 正常大鼠咽鼓管鼓室存在rBD-1和rBD-2的表达,且rBD-1的表达较rBD-2强,差异有统计学意义;造模后第1、3、7天,rBD-1表达变化不明显;rBD-2则在造模后第1、3天明显增加,差异有统计学意义,第7天渐回复到正常水平.结论 在大鼠,rBD-1可能参与正常咽鼓管鼓室的防御功能,造模后rBD-2的表达增加可能与病原体入侵后的清除相关.     

Primary tracheobronchial amyloidosis in China: Analysis of 64 cases and a review of literature

Primary tracheobronchial amyloidosis (TBA) is a rare pulmonary disease.A systematic review was performed on 64 cases of primary TBA in China and progress in the diagnosis and treatment of this disease is discussed.The Chinese biological and medical databases from 1970 to 2010 were searched and 75 cases of complete clinical and pathological data were identified.The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time.The results showed that the morbidity associated with primary TBA has increased over recent years.The clinical manifestations were non-specific.Progressive dyspnea, cough and sputum were the most common symptoms.The percentage of patients undergoing computed tomography (CT) scan has increased over the years.The bronchoscopy and transbrochial lung biopsy (TBLB) were usually sufficient to establish the diagnosis.Treatment was reported for a total of 44 cases.Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration such as steroids and colchicines were reported to be effective in some patients.It is concluded that the demographic characteristics and clinical manifestations of primary TBA patients in China are largely consistent with findings reported in other countries.Dramatically more cases were reported in recent years, mainly due to the extensive application of bronchoscopy since 1990s.Chest CT scan provides important clues for the diagnosis of the disease.The definite diagnosis was confirmed by bronchoscopic findings and Congo red staining of biopsy specimen.Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration, such as steroids and colchicines were reported to be effective in some patients.     

重组活化凝血因子rFⅦa对脑出血早期血肿再扩大的干预研究

目的:探讨重组活化凝血因子(rFⅦa)在脑出血早期血肿再扩大中的临床价值。方法:选择发病6 h内完成头颅CT的64例脑出血患者,随机分为rFⅦa治疗组(rFⅦa组)和未应用rFⅦa组(对照组),rFⅦa组给予40μg.kg-1 rFⅦa静脉推注治疗,对照组常规治疗。两组患者分别在治疗前、治疗24 h后比较血肿变化,同时行格拉斯哥昏迷量表(GCS)评分和美国国立卫生研究院卒中量表(NIHSS)评分,3个月后改良的Rankin量表(mRS)评分以评价转归。结果:24 h后复查头颅CT时rFⅦa组血肿扩大(>33%)4例(12.5%),对照组血肿扩大11例(34.4%),两组比较有显著差异(P<0.05);24 h后rFⅦa组GCS评分较对照组增加(P<0.05),NIHSS评分却明显低于对照组(P<0.05);3个月后两组mRS评分在0～3分的患者所占该组比率分别为84%和59%,两组差异有统计学意义。临床未见有不良反应发生。结论:rFⅦa对于脑出血早期血肿扩大具有明显的抑制作用。     

Expression of IRF-4 and IBP in skin lesions of patients with psoriasis vulgaris

The expression of the interferon regulatory factor 4 (IRF-4) and the IRF-4-binding pro-tein (IBP) in psoriatic skin lesions was investigated. The expression of IRF-4 and IBP in skin lesions of 20 patients with psoriasis vulgaris were immunohistochemically dectected. Normal skin from 10 healthy people was used as normal control. The study showed that expression of IRF-4 was increased significantly in keratinocytes and inflammatory cells in the lesions of psoriasis vulgaris than that in the normal control. The detection revealed that IBP expression in keratinocytes, lymphocytes, hair follicles, and sebaceous glands in normal skin was significantly lower than that in the lesions of pso-riasis vulgaris (P<0.05). Both IRF-4 and IBP might be involved in the pathogenesis of psoriasis vul-garis.     

白术化学成分的药理作用研究进展

白术化学成分主要为挥发性成分和白术内酯类成分、苷类成分以及多糖类成分.本文综述了近年来白术的不同化学成分在抗胃溃疡、抗痴呆、抗肿瘤、抗炎、抗糖尿病等方面的药理作用的研究成果,为揭示其物质基础及研究新药奠定基础.     

制药工程专业药物化学课程教学方法探讨

制药工程是工科化工制药类专业,其目标是培养具备制药工程方面知识,在医药、农药、精细化工和生物化工等工程领域从事医药产品的生产、科技开发、应用研究和经营管理等方面的高级工程技术人才。本文针对制药工程专业的特点,通过实例分析,阐述了药物化学课堂教学方法的探索与思考。在如何处理知识断层问题、教材和讲授内容的选取、有效利用国家精品课程资源、建立与学生的良好互动方面做了较为详细的叙述。