比索洛尔改善充血性心衰心功能及心肌重塑的疗效观察

目的　观察比索洛尔 (bisoprolol)对充血性心衰心功能及心肌重塑的临床疗效 .方法　 2 12例患者随机分为比索洛尔组和常规药物组 ,比索洛尔剂量起始量 0 .6 2 5 mg～1.2 5 0 mg,1次· d- 1 ,逐渐增加至最大剂量为 2 .5 mg～ 5 .0mg,1次· d- 1 .观察心功能、临床疗效、左室舒张末内径(L VEDD)、左室收缩末内径 (L VESD)、射血分数 (EF)、舒张早期 E峰流速 /舒张晚期 A峰流速 (VE/ VA) .结果　比索洛尔组与常规药物组比较 ,比索洛尔治疗 3m o后有效者(87.7% )高于常规药物组 (6 6 .0 % ) ,P <0 .0 5 ;冠心病(87.9% )和扩张型心肌病心衰 (91.9% )疗效明显好于常规药物组 (分别为 6 6 .7% ,6 7.4 % ) ;治疗 6 mo后重度心衰者疗效(90 .0 % )明显好于常规药物组 (6 5 .4 % ,P <0 .0 5 ) .治疗后比索洛尔组 L VESD[(44 .8± 3.9) m m vs(48.8± 4 .6 ) mm],EF[(40 .7± 7.5 ) % vs (35 .7± 5 .2 ) % ]优于常规药物组 (P<0 .0 1) ;L VEDD,VE/ VA也较治疗前有明显改善 .结论　比索洛尔改善充血性心力衰竭临床症状 ,促进心脏收缩、舒张功能恢复 ,部分逆转心肌重塑 .     

三尖杉酯碱诱导慢性髓系白血病K-562细胞凋亡的实验研究

目的阐明三尖杉酯碱（HT）作用于K562细胞的机制。方法应用细胞形态、DNA凝胶电泳和流式细胞仪等检测,观察HT对K562细胞株的作用方式,进一步用RT-PCR方法研究bcr/abl基因在转录水平的改变。结果0.01～100.00μg/ml浓度HT可诱导K562细胞凋亡,并呈时间和剂量依赖性。随着药物作用时间的延长,bcr/abl基因的转录下调。结论低浓度HT就可通过抑制bcr/abl基因的表达,诱导K562细胞凋亡。     

女性上生殖道感染

1 盆腔炎 盆腔炎是指女性一系列上生殖道炎症(Pelvic Inflammatory Disease,PID)疾患,包括子宫内膜炎、输卵管炎、卵巢炎、盆腔腹膜炎和盆腔结缔组织炎.它是性传播疾病的最重要的也是最常见的并发症.     

Ischemic rat brain extracts induce human marrow stromal cell growth factor production

Intravenous administration of human bone marrow stromal cells (hMSCs) after middle cerebral artery occlusion (MCAo) in rats provides functional benefit. We tested the hypothesis that these functional benefits are derived in part from hMSC production of growth and trophic factors. Quantitative sandwich enzyme‐linked immunosorbent assay (ELISA) of hMSCs cultured with normal and MCAo brain extracts were performed. hMSCs cultured in supernatant derived from ischemic brain extracts increased production of brain‐derived neurotrophic factor (BDNF), nerve growth factor (NGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF). These neurotrophins and angiogenic growth factors increased in a post‐ischemia time‐dependent manner. The hMSC capacity to increase expression of growth and trophic factors may be the key to the benefit provided by transplanted hMSCs in the ischemic brain.     

rhGM—CSF对小鼠口腔粘膜损伤的防治作用

目的：观察rhGM-CSF对TMX致实验性小鼠口腔粘膜损伤的疗效。方法：按随机分组原则将501只昆明种小白鼠分成8组，分别在相应时间给予不同药物（MTX，CF或rhGM-CSF）的处理因素，于第1－10天光镜下观察小鼠口腔粘膜的病理改变和积分情况。结果：IDMTX致口腔粘膜损伤病变率（45％－63％）和积分率（19．4％－56％）较其它组高，且死亡率很低（小于5％）；IDMTX＋GM0（或GM2）组的口腔粘膜损伤病变率（30．53％和30．99％）和积分率（19．47％和17．25％）比IDMTX组（55．56％和36．31％）明显减少，且溃疡严重程度较轻，二者相差显著（P＜0．01）。结论：IDMTX致小鼠口腔粘膜损伤模型可以用于粘膜损伤的研究；rhGM-CSF可以减少MTX致小鼠口腔粘膜损伤，并促进粘膜损伤恢复。     

Serum transforming growth factor-β1 level reflects disease status in patients with esophageal carcinoma after radiotherapy

AIM: To evaluate the relationship between changes in serum transforming growth factor β1 (TGFβ1) level and curative effect of radiotherapy (RT) in patients with esophageal carcinoma.METHODS: Ninety patients with histologically confirmed esophageal carcinoma were enrolled. Serum samples for TGFβ1 analysis were obtained before and at the end of RT. An enzyme-linked immunosorbent assay was used to measure serum TGFβ1 level. Multivariate analysis was performed to investigate the relationship between disease status and changes in serum TGFβ1 level.RESULTS: Serum TGFβ1 level in patients with esophageal carcinoma before RT was significantly higher than that in healthy controls (P ＜ 0.001). At the end of RT, serum TGFβ1 level was decreased in 67.82% (59/87) of the patients. The overall survival rate at 1,3 and 5 years was 48.28% (42/87), 19.54% (17/87)and 12.64% (11/87), respectively. Main causes of death were local failure and regional lymph node metastasis.In patients whose serum TGFβ1 level decreased after RT,the survival rate at 1, 3 and 5 years was 61.02% (36/59),28.81% (17/59) and 18.64% (11/59), respectively. The survival rate at 1 year was 17.86% (5/28) in patients whose serum TGFβ1 level increased after RT, and all died within 18 mo (P ＜ 0.01).CONCLUSION: Serum TGFβ1 level may be a useful marker for monitoring disease status after RT in patients with esophageal carcinoma.     

肩关节周围炎的循证针灸治疗

目的:从循证医学的角度,向临床医生介绍肩关节周围炎的循证针灸治疗方案的确立方法.方法:以一位具体的肩关节周围炎患者为例,介绍如何提出临床问题,怎样检索相关文献,如何对所检索的文献进行评价,如何结合本病例的具体情况和医生的个人经验,运用所检索的证据拟定治疗方案.结果:采用按照循证医学方法确立的肩关节周围炎的针灸治疗方案治疗15次后,患者生活质量明显好转.结论:通过临床提出问题、寻找证据、分析证据、循证决策、循证实践过程,不但患者可达到满意疗效,主管医生也提高了理论水平和临床能力.     

中耳畸形并发胆脂瘤三例

图 1　颞骨CT轴位片显示鼓室隔板将左鼓室分成内外两个腔隙,内侧腔隙可见听小骨样结构,咽鼓管呈高密度影　　图 2　颞骨CT冠位片显示双侧听小骨畸形,左侧水平段面神经下垂遮盖前庭窗,鼓室盾板消失　　图 3　颞骨CT轴位片显示左鼓室听小骨形态不规则,与鼓室壁分界不清楚　　先天性中耳畸形并发胆脂瘤临床少见。我院收治 3例,报道如下。例 1　女, 21岁。双耳听力下降 20年、间断流脓 10余年, 2002年 3月 13日入院。检查:双耳轮脚前各有一瘘管口,右外耳道正常,左外耳道轻度狭窄,双侧鼓膜大穿孔,左鼓室有上皮样组织。颞骨CT显示:双侧乳突气…     

经颅彩色双功超声在脑血管疾病中的临床应用和进展

经颅彩色双功超声是一种新型、无创的超声诊断仪,高空间分辨率显示颅内血管和脑实质的结构,笔者查阅了近年来相关文献,主要综述经颅彩色多普勒血流显像在颅脑血管疾病中的诊断价值,同时讨论二维经颅超声的应用及新的实验性显像技术。     

减少硬胶囊药料的吸附“沾盘”新工艺探讨

硬胶囊剂系指将一定量的药材提取物,药材提取物加药材细粉或辅料制成的均匀粉末或颗粒,充填于空心胶囊中制成,或将药材细粉直接充填于空心胶囊中制成.通常由中药复方制成胶囊剂,其药料最后常制成18～22目颗粒再充填于胶囊中,制成颗粒是为了增加药料的流动性,并减少充填时的粉末飞扬.我们在制备本院协定处方制剂“消渴安胶囊”、“仙灵胶囊”、“愈胃胶囊”及“脑立通胶囊”等时,发现整粒后的药料如果烘干后立即充填胶囊,以及粉性成分较多的药料如果按常规工艺制粒、整粒,烘干后进行充填胶囊,均会出现药料吸附性较强,充填中出现“沾盘”现象,对上述两种情形我们进行了多次工艺摸索,最终较好地解决了上述药料吸附问题,现介绍如下.