急性硬膜下血肿预后因素分析

目的 探讨CT征象、GCS评分、瞳孔变化、手术时机、血压、年龄、血糖、血白细胞计数和并发症对96例急性硬膜下血肿手术患者预后因素的影响。方法 对我科96例急性硬膜下血肿手术患者预后影响因素进行回顾性分析。结果 按COS标准，恢复良好46．9％，中度残疾9．4％，重度残疾6．3％，持续性植物生存5．2％，死亡32．2％。结论 CT征象、GCS评分、瞳孔变化、手术时机、血压、年龄、血糖、血白细胞和并发症是评价急性硬膜下血肿预后的可靠指标。及时、正确清除血肿，标准去骨瓣减压，维持正常血压，控制血糖和防治并发症，能有效改善急性硬膜下血肿患者预后，也是降低患者死残率的最有效措施。     

Phase II study of denileukin diftitox for relapsed/refractory B-Cell non-Hodgkin's lymphoma.

PURPOSE: Denileukin diftitox is a fusion protein combining diphtheria toxin and interleukin-2 (IL-2) that targets tumor cells expressing the IL-2 receptor. Its efficacy has been shown in CD25+ cutaneous T-cell lymphoma, but not in B-cell non-Hodgkin's lymphoma (NHL). A phase II study was performed to evaluate the efficacy and tolerability of denileukin diftitox for relapsed or refractory B-cell NHL. PATIENTS AND METHODS: Patients with relapsed or refractory B-cell NHL were eligible. Tumor CD25 expression was determined by immunohistochemistry or flow cytometry. Denileukin diftitox was administered intravenously at a dose of 18 microg/kg once daily for 5 days every 3 weeks, up to eight cycles. RESULTS: Of the 45 patients assessable for response, 32 (71%) were refractory to the last chemotherapy treatment, and all were previously treated with rituximab. Three complete responses (6.7%) and eight partial responses (17.8%) were observed, for an overall response rate of 24.5%. Nine patients (20%) had stable disease. Objective response rates were similar in CD25+ (22%) and CD25- histologies (29%), as were stable disease rates (22% and 18%, respectively). For responding patients, the median time to treatment failure was 7 months, with a median follow-up in survivors of 18 months (range, 9 to 28 months), and the projected progression-free survival at 20 months was 24% (95% CI, 0% to 60%). Most toxicities were low-grade and transient. CONCLUSION: Denileukin diftitox seems to be effective in relapsed or refractory, CD25+ and CD25- B-cell NHL and is well-tolerated at the dosage evaluated. Evaluation of denileukin diftitox in combination with other agents may be warranted.     

Polilactofate microspheres for Paclitaxel delivery to central nervous system malignancies.

PURPOSE: The purpose of this study was to demonstrate that surgically implanted, controlled-release, biodegradable polilactofate microspheres (Paclimer) can be used safely to bypass the blood-brain barrier and deliver paclitaxel to malignant brain tumors. EXPERIMENTAL DESIGN: The rate of paclitaxel release from Paclimer microspheres submerged in PBS was measured in vitro by high-performance liquid chromatography. In vivo studies of Paclimer were performed as intracranial implants in Fischer 344 rats in the presence or absence of 9L gliosarcoma. Mantel-Cox statistics were used to assess the efficacy of Paclimer at extending survival of tumor-bearing animals compared with control implants. Paclimer implants tagged with [(3)H]paclitaxel were used to measure biodistribution of paclitaxel from the Paclimer implant. RESULTS: Paclimer released paclitaxel at a constant rate for up to 3 months in vitro. In vivo, Paclimer implants placed intracranially in rats released active drug for up to 30 days after implantation and doubled the median survival of rats bearing established 9L gliosarcomas (median survival of paclitaxel-treated animals = 35 days; median survival of control-treated animal = 16 days; P < 0.0001). Active drug was distributed throughout the rat brain based on liquid scintillation counting and TLC. Rats implanted with Paclimer demonstrated no overt signs of neurotoxicity and exhibited local cytopathological changes consistent with exposure to an antimicrotubule agent. CONCLUSIONS: Paclimer extends survival in a rodent model of glioma with minimal morbidity and optimal pharmacokinetics.     

红毛五加多糖对实验性肝损伤的保护作用

红毛五加多糖能明显降低小鼠和大鼠四氯化碳、硫代乙酰胺及D-氨基半乳糖肝损伤所致血清谷丙转氨酶的升高,使磺溴酞钠滞留量减少;尚能使正常和四氯化碳中毒小鼠戊巴比妥钠诱导的睡眠时间显著缩短。     

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目的分析婴幼儿肾脏疾病病理类型的分布及其对诊断治疗的指导意义。方法中南大学湘雅二院于1996-01—2005-09采用快速经皮肾活检术,对73例临床诊断为10种肾脏疾病的婴幼儿进行肾组织病理检查。将穿刺取得的每份组织标本分成3部分,按常规方法对所有标本均分别进行光镜、电镜及免疫荧光检查,标本均做HE、PAS、PASM、Masson染色,均应用免疫荧光检测肾组织中IgG、IgM、IgA、C3、C4、C1q、Fb,部分病例根据血化验乙肝抗原阳性者加做免疫荧光,检测肾组织中的HBsAg、HBcAg。结果肾活检成功率为100%;最常见的病理类型为系膜增生性肾炎(51/73例,占69·9%);临床表现类似的疾病病理类型不同,同一病理类型的疾病,临床表现可以多样。结论肾活检病理诊断对婴幼儿肾脏疾病的诊断、治疗、估计预后均有重要价值。电镜在婴幼儿肾病理检查中起到不可忽视的作用。     

婴幼儿肾脏疾病肾组织病理类型的分布与临床

目的分析婴幼儿肾脏疾病病理类型的分布及其对诊断治疗的指导意义。 方法中南大学湘雅二院于1996 01—2005 09采用快速经皮肾活检术，对73例临床诊断为10种肾脏疾病的婴幼儿进行肾组织病理检查。将穿刺取得的每份组织标本分成3部分，按常规方法对所有标本均分别进行光镜、电镜及免疫荧光检查，标本均做HE、PAS、PASM、Masson染色，均应用免疫荧光检测肾组织中IgG、IgM、IgA、C3、C4、C1q、Fb，部分病例根据血化验乙肝抗原阳性者加做免疫荧光，检测肾组织中的HBsAg、HBcAg。 结果肾活检成功率为100%；最常见的病理类型为系膜增生性肾炎(51/73例，占69.9%)；临床表现类似的疾病病理类型不同，同一病理类型的疾病，临床表现可以多样。 结论肾活检病理诊断对婴幼儿肾脏疾病的诊断、治疗、估计预后均有重要价值。电镜在婴幼儿肾病理检查中起到不可忽视的作用。     

论大学生适应状况与人格特征及其应对策略

通过对400余名大学新生进行适应状况和人格特征的测试分析，表明适应的确是大学新生普遍面临的发展问题，提出应将实施以发展性模式为主、干预性模式为辅的新生适应教育策略，注重开展的丰富多彩有助于促进和改进家庭教育的活动。     

Phase II study of proteasome inhibitor bortezomib in relapsed or refractory B-cell non-Hodgkin's lymphoma.

PURPOSE: Evaluate efficacy and toxicity of bortezomib in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma. PATIENTS AND METHODS: Patients were stratified, based on preclinical data, into arm A (mantle-cell lymphoma) or arm B (other B-cell lymphomas) without limitation in number of prior therapies. Bortezomib was administered as an intravenous push (1.5 mg/m2) on days 1, 4, 8, and 11 every 21 days for a maximum of six cycles. RESULTS: Sixty patients with a median number of prior therapies of 3.5 (range, one to 12 therapies) were enrolled; 33 patients were in arm A and 27 were in arm B, including 12 diffuse large B-cell lymphomas, five follicular lymphomas (FL), three transformed FLs, four small lymphocytic lymphomas (SLL), two Waldenstrom's macroglobulinemias (WM), and one marginal zone lymphoma. In arm A, 12 of 29 assessable patients responded (six complete responses [CR] and six partial responses [PR]) for an overall response rate (ORR) of 41% (95% CI, 24% to 61%), and a median time to progression not reached yet, with a median follow-up of 9.3 months (range, 1.7 to 24 months). In arm B, four of 21 assessable patients responded (one SLL patient had a CR, one FL patient had a CR unconfirmed, one diffuse large B-cell lymphoma patient had a PR, and one WM patient had a PR) for an ORR of 19% (95% CI, 5% to 42%). Grade 3 toxicity included thrombocytopenia (47%), gastrointestinal (20%), fatigue (13%), neutropenia (10%), and peripheral neuropathy (5%). Grade 4 toxicity occurred in nine patients (15%), and three deaths from progression of disease occurred within 30 days of withdrawal from study. CONCLUSION: Bortezomib showed promising activity in relapsed mantle-cell lymphoma and encouraging results in other B-cell lymphomas. Future studies will explore bortezomib in combination with other cytotoxic or biologic agents.     

复方黄芩颗粒质量标准的研究

目的:建立复方黄芩颗粒的质量标准.方法:采用HPLC法对复方黄芩颗粒中的黄芩苷进行含量测定,以C18化学键合硅胶为固定相,以甲醇-水-磷酸(47:53:0.2)为流动相,测定波长280 nm;用TLC方法对方中黄芩,地榆进行了鉴别.结果:薄层鉴别斑点清晰,阴性对照无干扰,在0.2084～4.168μg范围内,黄芩苷峰面积与进样量有良好的线性关系(r=0.999 7),平均加样回收率为100.9%,RSD为2.5%.结论:方法可靠,操作简便,重现性良好,可用于该制剂的质量控制.     

放射治疗肺癌脊椎转移的临床研究

为探讨肺癌脊柱转移放射治疗的时间剂量分割方法及其疗效,将肺癌脊柱转移64例患者随机分为治疗组和对照组,治疗组每次3Gy,每周5次,共30Gy;对照组每次2Gy,每周5次,共50Gy;两组均使用6mVX线照射.分别比较疼痛缓解率、止痛起效时间、及脊髓压迫缓解率.结果显示治疗组和对照组的疼痛缓解率分别为87.5%和81.3%,无显著性差异(P＞0.05);平均止痛起效时间分别为8±2.2天和15±3.2天,差异性显著(P＜0.01);脊髓压迫缓解率分别为85.0%和81.8%,无显著性差异(P＞0.05).结果表明放射治疗肺癌脊柱转移疗效好,起效快,建议使用30Gy/10f/2W的时间剂量分割模式.