伊立替康治疗晚期非小细胞肺癌临床观察

目的：观察伊立替康（开普拓）联合顺铂治疗晚期非小细胞肺癌（Non-Small cell lung cancer,NSCLC）的疗效以及不良反应。方法：经病理学或细胞学确诊的初治晚期NSCLC患者30例,男性18例,女性12例,中位年龄45岁（波动于33-56岁之间）,KPS评分〉70。接受顺铂60-80 mg.（m^2）^-1联合开普拓60 mg.（m^2）^-1第1d、8d、15d静脉滴注,每4周重复。至少2周期以上,可评价疗效及不良反应。结果：全组PR7例,SD21例,PD2例,总有效率为23%。中位生存时间10.5个月,1年生存为率57%（17/30）。主要不良反应为延迟性腹泻和粒细胞减少。结论：伊立替康联合顺铂治疗晚期NSCLC疗效确切,不良反应发生率低,耐受性较好。     

长耽典籍若谈蔗饴——谈"功夫在医外"

文学素养的提高、医籍经典的研读,对培养医学大家具有重要意义.本文首先举例说明悟经典著作之精髓,临床才能得心应手,其次阐述古代文字和文化知识的重要性,再次谈及孙思邈、李时珍、岳美中等的著述中所论对典籍学习的重要性,最后从<左传>旁及古文化知识学习要有目的、有选择.     

大肠癌多层螺旋(MSCT)动态增强扫描与病理学指标的相关性研究

目的 探讨大肠癌细胞分化及淋巴结转移与MSCT增强程度及血管内皮生长因子(VEGF)、微血管密度(MVD)的相关性.方法 选择临床怀疑为大肠癌的患者行MSCT动态增强扫描,经病理证实为大肠癌的患者31例,病理标本HE染色判定其分化程度及淋巴结转移情况;免疫组化SP法染色,检测VEGF表达情况及MVD计数,与MSCT增强程度进行对照分析.结果 本研究结果表明大肠癌细胞分化程度越低,MSCT强化越明显,VEGF表达程度越高,MVD计数越高,差异有统计学意义(P<0.05).有淋巴结转移组MSCT增强程度、VEGF表达程度及MVD计数均高于无淋巴结转移组,差异有统计学意义(P<0.05).大肠癌MSCT增强程度与VEGF表达、MVD计数间两两相关,且均为正相关(P<0.05).结论 大肠癌MSCT的增强程度可间接反映其恶性程度(癌细胞分化程度)及淋巴结转移情况.     

恶性冬眠瘤的临床病理和免疫组化及超微结构观察

目的：了解恶性冬眠瘤独特的临床病理和免疫组化及超微结构变化。方法：收集2例恶性冬眠瘤和4例粘液性脂肪肉瘤的临床资料,所有标本光镜常规切片观察,免疫组化染色检测CKp,SMA,RMA,MyOD1,S100,PCNA,p53。冬眠瘤和粘液性脂肪肉瘤各1例取新鲜组织做透射电镜观察。结果：恶性冬眠瘤与粘液性脂肪肉瘤有显著的组织学、免疫组化和超微结构的不同;例1与腺泡状软组织肉瘤的组织学和免疫组化改变相似,唯有超微结构不同。例2免疫组化与有腺泡样结构的肉瘤不同。结论：恶性冬眠瘤的诊断主要靠超微结构的观察和免疫组化染色。     

Growth, puberty and obesity after treatment for leukaemia

Final height, body proportions, pubertal growth and body mass index were studied retrospectively in 142 survivors of acute lymphoblastic leukaemia (ALL). Treatment consisted of combination chemotherapy and cranial irradiation (18 or 24 Gy). Significant standing height loss and disproportion, with a relatively short back, was seen in both radiation dose groups. Girls were more severely affected than boys. Pubertal growth was adversely affected, with a reduction in peak height velocity in both sexes. Puberty occurred early in girls but at the normal time in boys. Nearly half the group were obese at final height, with no significant difference in incidence between the sexes. The relative roles of cranial irradiation and chemotherapy in the disturbance of growth, puberty and body composition observed in survivors of childhood ALL remain unclear. The aetiology is almost certainly multifactorial, with radiation-induced growth hormone insufficiency, early puberty, steroids and chemotherapy all having a role.     

Renal transplantation and osteoporosis

A cross sectional study assessed the bone mineral density (BMD) of 20 young adult patients who received a renal transplantation in childhood. The BMD of the lumbar spine, mainly trabecular bone, and of the total body, mainly cortical bone, were measured and expressed as an SD score. Fourteen patients (70%) had a BMD SD score of the lumbar spine below -1, of whom six patients were below -2. Fifteen patients (75%) had a BMD SD score of the total body below -1, of whom seven patients were below -2, Both trabecular and cortical bone appeared to be involved in the osteopenic process. The cumulative dose of prednisone was inversely correlated to both lumbar spine and total body BMD SD score. In a multiple regression analysis the cumulative dose of prednisone appeared to be the only factor with a significant effect on BMD SD score. Most young adult patients who had received a renal transplantation in childhood had moderate to severe osteopenia. Corticosteroid treatment played a major part in the development of osteopenia in these patients.     

窒息新生儿血清肝功能和心功能的变化及其临床意义

目的了解窒息新生儿血清肝功能和心功能的变化,有助于指导临床对窒息新生儿重要脏器损害的严重程度的判断,指导临床积极治疗。方法检测60例窒息新生儿(轻度窒息48例、重度窒息12例)的血清总胆红素(Tbil)、直接胆红素(Dbil)、谷丙转氨酶(ALT)、总胆汁酸(TBA)、肌酸激酶同工酶(CK-MB),并设40例正常新生儿作为对照。结果窒息后新生儿Tbil出现下降(P<0.05),并随着窒息程度加重下降愈明显(P<0.05);ALT、TBA、CK-MB出现升高(P<0.05),并随着窒息程度加重升高愈明显(P<0.05)。结论Tbil、ALT、TBA和CK-MB的变化反映肝功能和心功能损害情况,窒息时新生儿肝功能和心功能应予以保护,以减轻窒息对于新生儿重要脏器的损害。     

大鼠注射重组腺病毒Ad-HGF后血清中抗腺病毒抗体的检测

目的观察大鼠重复给与携带肝细胞生长因子基因的重组腺病毒（recombinant adenovirus carrying hepatocyte growth factor gene，Ad-HGF）后，血清中抗腺病毒抗体的出现时间及消失规律。方法大鼠给与不同剂量的Ad-HGF共14次，利用病毒中和反应（细胞病变效应及绿色荧光方法）观察血清中抗腺病毒抗体。结果手术及正常对照组和实验组动物给药7次前血清处理的细胞均出现明显细胞病变效应及强荧光。之后各剂量组动物血清均对腺病毒有不同程度的中和作用，停药后13周到14周抗体水平很低或已不存在。同时观察到动物性别及给药剂量大小无差异。结论大鼠肌注Ad-HGF7次后，动物血清中可检测到抗腺病毒抗体，停药后13周或14周抗体基本消失，此结果对Ad-HGF的实际应用具有指导意义。     

民办高校大学新生SCL—90量表测评分析

目的：了解民办高校大学一年级新生心理健康状况。方法：采用临床症状自评量表(SCL—90)，对中国信息大学一年级全体新生进行心理测量，并对1132个有效样本进行了比较分析。结果：①被试SCL—90测查中度或中度以上的心理问题检出率16．70％，男生检出率为16．15%，女生检出率为17．62％，男女生无显性差异；②不同群体比较：干部、知识分子家庭子女、高收入家庭及低收入家庭子女心理问题发生率较高；③按各种标准分类，不同群体被试的排在前几位的心理问题几乎均为人际关系敏感、强迫症状和抑郁，敌对症状也较为突出。结论：民办高校大学新生心理问题检出率较高，应予关注。