茴三硫治疗慢性肝损害北京地区多中心临床研究

目的：观察茴三硫对慢性病毒性肝炎、药物性肝病、酒精性肝病、瘀胆性肝病等的保肝、利胆和解毒的作用。方法：本研究是一项随机对照的多中心临床研究。按病例选择标准将人选病例随机分成两组，实验组(茴三硫组，70例)给予茴三硫25mg，tid；对照组(硫普罗宁组，36例)给予凯西来1片，tid；两组疗程均为8周。根据两组病人治疗后症状改善及肝功能恢复情况的判定标准，来评估两组药物的显效率、有效率和总有效率。结果：茴三硫组的显效率、有效率和总有效率分别为52．9％、27．1％和80％，硫普罗宁组的显效率、有效率和总有效率分别为55．6％、27．8％和83．3％，治疗前后两组的各症状及肝功能改善率基本相同，两组间无显没差异(P＞0．05)，两组均未发生明显不良反应。结论：茴三硫治疗慢性病毒性肝炎、药物性肝炎等馒性肝损害，可以明显减轻患症状，改善肝功能，其疗效与硫普罗宁效果相近，临床观察无明显不良反应。     

生物胶复合物加解剖钢板内固定治疗胫骨平台骨折

目的探讨生物胶复合物加解剖钢板内固定治疗胫骨平台骨折的临床效果。方法采用切开复位、生物胶复合物植骨加解剖型支撑钢板内固定治疗胫骨平台骨折28例,受伤至手术时间5～10d,植入复合物量为3～8g。结果所有患者均获随访,随访6～24个月,全部骨折均获得临床愈合,未见关节面下陷,生物胶复合物中羟基磷灰石未见移动及吸收,治疗效果参照M echant评分标准,优13例,良11例,可3例,差1例,总优良率达85.3%。结论生物胶复合物加解剖钢板内固定治疗胫骨平台骨折的临床效果良好。生物胶复合物具有较强的成骨能力,可修复骨缺损。     

HPLC和1HNMR分析确定cis-A-和cis-B-羟甲芬太尼的组成和构型

羟甲芬太尼(1)是一个强效的镇痛剂和高亲和、高选择性的阿片μ受体激动剂。通过HPLC和¹HNMR分析,cis-A-l被确定为由等量的cis-(+)-(3R,4S,2'S)-l和:cis-(—)-(3S,4R,2'R)-1组成的外消旋体,cis-B-l被确定为由等量的cis-(—)-(3R,4S,2'R)-1和cis-(+)-(3S/,4R,2'S)-1组成的外消旋体。     

激素敏感型肾病综合征小儿的HLA

为了解中国汉族儿童激素敏感型肾病综合征与ＨＬＡ的关系，研究了３７名该病患儿的ＨＬＡ－Ａ，Ｂ，ＤＲ，ＤＱ抗原频率，ＨＬＡ－Ａ，Ｂ抗原与本病无关联，ＨＬＡ－ＤＲ７抗原频率（３７．８４％）较对照组（１１．２３％）有显著性增高（Ｐｃ＝１．７×１０－３），ＨＬＡ一ＤＱ抗原较对照组低（３２．４３％与６１．４０％，Ｐｃ＝７．７×１０－３），频复发或频反复病人与ＨＬＡ－ＤＲ９抗原相关（Ｐｃ＝２．９×ｌ０－２）。支持该病有免疫遗传基础的假说     

欧芹素乙和异欧芹素乙对小鼠腹腔巨噬细胞体外释放肿瘤坏死因子的抑制作用

研究了欧芹素乙（Ｉｍｐｅｒａｔｏｒｉｎ，Ｉｍｐ）和异欧芹素乙（Ｉｓｏ－ｉｍｐｅｒａｔｏｒｉｎ，Ｉｓｉ）及对照药物维拉帕米（Ｖｅｒａｐａｍｉｌ，Ｖｅｒ）对小鼠腹腔巨噬细胞体外释放肿瘤坏死因子（Ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ，ＴＮＦ）的影响。结果表明：Ｉｍｐ、Ｉｓｉ及Ｖｅｒ对小鼠腹腔巨噬细胞体外释放ＴＮＦ具有显著的抑制作用。药物浓度在１０－６～１０－４ｍｏｌ／Ｌ范围内，该抑制作用呈剂量依赖性：药物浓度达１０－４ｍｏｌ／Ｌ时，则可完全抑制ＴＮＦ的释放。     

微创经皮钢板骨桥接术联合锁定加压钛板治疗胫骨远端骨折

目的探讨微创经皮钢板骨桥接术（minimallyi nvasive percutaneous plate osteosynthesis，MIPPO）联合锁定加压钛板（locking compression plate，LCP）治疗胫骨远端骨折的近期疗效。方法2004年6月～2006年3月采用MIPPO联合LCP治疗胫骨远端骨折16例，AO分型：43A1型7例，43A3型5例，43B1型2例，43C3型2例。采用3种方法复位胫骨骨折后插入LCP，用锁定螺钉固定。结果16例随访5～20个月，平均11，5月。16例切口一期愈合，骨折无延迟愈合、畸形愈合、断钉、断板等并发症。术后X线检查4～12周（平均7．6周）骨痂形成并开始部分负重，8～20周骨性愈合（平均16周），此时开始完全负重。3例出现胫骨远端内植物局部不适。根据美国足踝骨科学会评分系统对踝关节功能评分，优14例（87．5％），良2例（12，5％）。结论MIPPO具有创伤小、固定牢靠、可早期功能锻炼等优点，近期疗效满意，是治疗胫骨远端骨折的有效方法。     

<Emphasis Type="Italic">p</Emphasis>-Glycoprotein ABCB5 and YB-1 expression plays a role in increased heterogeneity of breast cancer cells: correlations with cell fusion and doxorubicin resistance

Background  

Cancer cells recurrently develop into acquired resistance to the administered drugs. The iatrogenic mechanisms of induced chemotherapy-resistance remain elusive and the degree of drug resistance did not exclusively correlate with reductions of drug accumulation, suggesting that drug resistance may involve additional mechanisms. Our aim is to define the potential targets, that makes drug-sensitive MCF-7 breast cancer cells turn to drug-resistant, for the anti-cancer drug development against drug resistant breast cancer cells.     

推拿并牵引治疗腰椎间盘突出症230例

笔者2006年3月～2008年5月应用牵引配合手法推拿治疗腰椎间盘突出症230例，收到满意疗效，总结如下。     

The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy.

BACKGROUND AND PURPOSE: The potential risk of prolongation of treatment time in cervical cancer has been reported for many low-dose rate (LDR) studies, with an estimated loss of local control ranging from 0.3 to 1.6% per day of treatment prolongation. Since the treatment schedule for fractionated high-dose rate intracavitary brachytherapy (HDRICB) is not directly comparable with that for low-dose rate studies, this report aims to evaluate the adverse effect of treatment prolongation specifically for cervical cancer treated with HDRICB. MATERIAL AND METHODS: From September 1992 to December 1997, 257 patients diagnosed with uterine cervical cancer (35 Ib, 26 IIa, 122 IIb, 10 IIIa, 57 IIIb, 7 IVa), who underwent external radiotherapy combined with between two and four courses of HDRICB and a minimum of 3 years of follow-up (median 57 months), were analyzed. Treatment consisted of irradiation of the whole pelvis with 44-45 Gy consisting of 22-25 fractions by 5 weeks, with the dose boosted to 54-58 Gy (with central shielding) for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease. HDRICB was performed using an Ir-192 remote afterloading technique at 1-week intervals. The standard prescribed dose for each course of HDRICB was 7.2 Gy to point A for three insertions (before July 1995), or 6.0 Gy to point A for four insertions (after July 1995). Total prescribed point A doses (external beam radiotherapy+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while analogous dosage for larger lesions (stage IIb-IVa) ranged from 59 to 75.6 Gy (median, 65.6 Gy). Kaplan-Meier and multivariate analyses were used to test the effect of treatment time on pelvic control rate (PCR) and cause-specific survival (CSS) at 5 years. RESULTS: Median treatment time was 63 days. For all stages of disease, the 5-year CSS and PCR were significantly different comparing treatment times of less than and greater than or equal to 63 days [83% and 65% (P=0.004], 93% and 83% (P=0.02), respectively]. These associations were also significant for stage Ib/IIa [97% and 79% (P=0.01), and 100% and 87% (P=0.02), respectively), but not for stage IIb [75% and 72% (P=0.79), and 93% and 87% (P=0.83), respectively] or stage III [66% and 49% (P=0.2), and 83% and 72% (P=0.21), respectively]. Multivariate analysis identified three prognostic factors for CSS, stage (P<0.001), tumor response to external RT (P=0.001), and overall treatment time (OTT; P=0.006). Prognostic factors for pelvic failure were stage (P<0.001), tumor response to external RT (P=0.001), and OTT (P=0.03). Prolongation of treatment time resulted in a daily decrease in pelvic control rate of 0.67% overall, and 0.43% for stage Ib-IIa, 0.57% for stage IIb, and 0.73% for stage III patients. CONCLUSION: Analysis of the data from the current study demonstrates that the adverse effect of treatment prolongation was observed later in the treatment course for the high-dose rate (HDR) series compared to the LDR analog, however, treatment-time prolongation still negatively influenced the cause-specific survival and pelvic control rate for both dosage groups.