中药单体逆转肺癌多药耐药的研究进展

正一直以来,肺癌严重危害着人类的健康,其发病率高并呈逐年上升趋势。在中国,肺癌的总发病率已占到男性恶性肿瘤之首,预计到2025年我国肺癌总患病人数将超过100万[1]。临床上75%的肺癌患者就诊时已是晚期。当肺癌进入中晚期,化疗则为当前最主要的治疗手段,因为多药耐药     

用耳穴压豆法对肛肠术后患者进行止痛护理的效果观察

目的：探讨用耳穴压豆法对肛肠术后患者进行止痛护理的临床效果。方法：对2013年1月～2013年12月期间在我院进行肛肠手术的60例患者的临床资料进行回顾性研究。我们将这60例患者随机分成观察组和对照组,其中,观察组有31例患者,对照组有29例患者。我院对对照组患者进行常规的止痛护理,即为患者口服镇痛药进行止痛;在进行常规止痛护理的基础上,用耳穴压豆法对观察组患者进行止痛护理。观察并比较两组患者的止痛效果。结果：观察组患者止痛的总有效率明显高于对照组的患者,二者相比差异有显著性（P<0.05）。结论：用耳穴压豆法对肛肠术后患者进行止痛护理可明显地减少患者镇痛药物的用量,降低其发生药物不良反应的几率,提高其治疗的效果。该方法值得在临床上推广使用。     

乳腺癌骨转移74例临床病理分析

【目的】探讨乳腺癌骨转移的临床病理特点。【方法】回顾性分析306例乳腺癌病例中74例发生骨转移患者的临床资料。探讨骨转移与不同乳腺癌病理分型的关系。【结果】乳腺癌骨转移发生率26．5％（74／306）。乳腺癌非浸润性癌和早期浸润性癌不发生骨转移。以胸部骨转移（58．11％）多见。乳腺癌骨转移患者中,浸润性导管癌最为常见,单纯性癌、印戒细胞癌、髓样癌较少见,浸润性小叶癌、粘液癌很少见,非浸润性癌、早期浸润性癌、硬癌,腺癌临床基本不出现骨转移。【结论】乳腺癌以胸部骨转移发生率高,乳腺浸润性导管癌发生转移最为常见,其他类型较少见。     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

健脾补肾方减轻脾肾两虚证乳腺癌患者术后化疗心脏毒性及提高生活质量的临床研究

目的:探讨健脾补肾方对乳腺癌术后TEC方案化疗不良反应的影响,为健脾补肾方能更好的应用于临床提供依据.方法:依据标准,共收集60例,随机分为治疗组(健脾补肾方联合化疗组)和对照组(单纯西医化疗组),每组各30例.比较两组患者的心电图、心肌肌钙蛋白I、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、中医证候积分、卡氏评分.结果:1)两组患者化疗后心电图、CK、CK-MB异常率比较发现,第一周期化疗前后及第二周期化疗前比较均无明显差异,无统计学意义.在第二周期化疗后心电图、CK、CK-MB异常率比较,差异有统计学意义.说明健脾补肾方可降低第二周期化疗后心电图、CK、CK-MB异常率.2)化疗后治疗组中医证候积分有效率86.67%,高于对照组有效率53.33%,差异有显著统计学意义;治疗组卡式评分有效率93.33%,高于对照组有效率53.33%,治疗组高于对照组,差异有显著统计学意义.结论:健脾补肾方应用于脾肾两虚证乳腺癌患者术后化疗后,能减轻心脏毒副反应,并提高患者的生活质量.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

以抑郁症症状为首发症状的癫痫发作

文献报道,抑郁症症状可以成为癫痫的发作症状,但是不是癫痫独立的或首发的尚不清楚。我们回顾性分析了5例以抑郁为首发症状的单纯癫痫。所有患者的神经系统检查、脑脊液检查、磁共振检查均正常,可排除脑部器质性病变。全部患者首诊经精神科医生诊断为抑郁症,其中3例为中度抑郁,1例为重度抑郁。所有患者的随机脑电图检查均显示轻度异常,后经24小时动态脑电图监测,确诊为癫痫的复杂部分发作。予以卡马西平或者拉莫三嗪治疗后情绪正常,也无其它形式癫痫发作,多次脑电图检查显示恢复正常。随访8～18月无发作。因此,我们认为抑郁症症状可以是癫痫发作的首发表现,而诊断功能性的抑郁症则一定要排除以抑郁症状为首发症状的癫痫发作。     

麻痹性痴呆与阿尔茨海默病患者海马区氢质子磁共振波谱特点

目的 应用氢质子磁共振波谱(1 H-MRS)技术,探索麻痹性痴呆(GPI)患者、阿尔茨海默病(AD)患者和健康中老年人海马区代谢物水平特点.方法 纳入GPI患者35例,AD患者27例,健康中老年对照38名进行双侧海马区1 H-MRS检查,比较N-乙酰天门冬氨酸(N-acetylaspartate,NAA)/肌酸、胆碱/肌酸,NAA/胆碱,胆碱/NAA和肌醇/肌酸的水平;并同日进行简易精神状态检查(MMSE)、蒙特利尔认知检查量表(MoCA)评定,探索GPI、AD患者海马区代谢物水平与病程严重程度的相关性.结果 GPI、AD组双侧海马区的NAA/肌酸均显著低于健康对照组(左侧1.48 ±0.25、1.52±0.28和1.71 ±0.36,F=5.928,P=0.004;右侧 1.47±0.38、1.62±0.36和1.82±0.42,F=7.309,P=0.001),GPI组右侧海马区的胆碱/NAA (0.68±0.48)显著高于AD组(0.49 ±0.15)和健康对照组(0.53±0.14),差异有统计学意义(P =0.024,P=0.045).GPI组和AD组海马区各代谢物水平与MMSE、MoCA评分均无显著相关.结论 GH和AD患者均存在双侧海马区神经元损伤.