银莱汤加减治疗小儿肺胃积热型感冒40例病例系列研究

[目的]观察银莱汤加减治疗小儿肺胃积热型感冒的临床疗效。[方法]采用回顾性病例系列的科研设计方法,连续纳入2011年11月至2012年12月来门诊就诊的肺胃积热型感冒患儿40例,给予口服银莱汤加减治疗,门诊随访观察,根据疗效标准评价当次治疗效果。[结果]治愈33例,好转5例,无效2例,总有效率95.00％。[结论]银莱汤肺胃同治,清宣并用,对小儿肺胃积热型感冒具有明显的治疗效果,值得临床推广。     

Comparison of the 6th and 7th Editions of the UICC TNM Staging System for Gastric Cancer: Results of a Chinese Single-Institution Study of 1,503 Patients

Aim

To evaluate the prognostic efficacy of the 7th edition tumor–node–metastasis (TNM) classification compared with the 6th edition in gastric cancer patients.

Methods

A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend χ², likelihood ratio χ² statistics, and Akaike information criterion (AIC) calculations.

Results

Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio χ² scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.

Conclusions

Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.     

体位改良预防头颈部肿瘤患者PICC颈内静脉异位

目的寻找合适PICC置管体位,以预防或减少头颈部肿瘤患者导管颈内静脉异位的发生。方法将92例需行PICC置管的头颈部肿瘤患者按置管顺序单双号分为观察组和对照组各46例,对照组取常规体位,即患者平卧,置管侧上肢外展90°,穿刺成功送管,至导管末端到达肩关节位置时,嘱患者将头偏向穿刺侧,下颌紧贴锁骨,继续送管至预测长度。观察组取改良体位,即患者平卧,头枕5cm高枕头,置管侧上肢外展45°～90°,穿刺成功送管至导管末端到达肩关节位置时,患者配合抬高穿刺侧上肢,操作者继续送管至预测长度。结果观察组导管颈内静脉异位发生率为2.17%,对照组为23.91%,两组比较,差异有统计学意义(P<0.01)。结论体位改良能有效降低头颈部肿瘤患者PICC颈内静脉异位的发生。     

内毒素耐受和拟胆碱药物对巨噬细胞分泌肿瘤坏死因子-α的影响

目的:探讨内毒素耐受和拟胆碱药物卡巴胆碱对巨噬细胞肿瘤坏死因子-α(TNF-α)分泌的调节作用.方法:①分离小鼠腹腔巨噬细胞,将其与内毒素(LPS)作用不同时间(0、2、4、8 h);②小鼠腹腔巨噬细胞分为3组:空白对照组(RPMI1640常规培养),LPS耐受组(LPS预刺激20 h,再用LPS刺激4 h)和LPS不...     

伏硫西汀与文拉法辛治疗抑郁症临床研究

目的 探讨伏硫西汀治疗抑郁症的临床疗效及安全性.方法 将113例抑郁症患者按随机数字表法分为伏硫西汀组59例和文拉法辛组54例.伏硫西汀组给予伏硫西汀治疗,文拉法辛组予以文拉法辛治疗,观察8周.于治疗前后采用临床疗效总评量表评定临床疗效,汉密顿抑郁量表总分及认知障碍因子评定疾病严重程度及认知功能,副反应量表评定不良反应...     

Effect of Rapamycin on TGF-β1- induced epithelial-mesenchymal transition in LoVo colonic adenocarcinoma cells

Objective:To investigate the effect of Rapamycin on epithelial-mesenchyrnal transition(EMT) of LoVo colonic adenocarcinoma cells in vitro.Methods:Cultured LoVo colonic adenocarcinoma cells were divided into three groups: negative control group,EMT-inducing group(TGF-β1) and EMT-interfering group(TGF-β1 plus Rapamycin).E-cadherin expression in LoVo cells was detected by Western Blot,while the expression of vimentin was evaluated through immunocytochemistry.The Snail mRNA in LoVo cells was examined by RT-PCR.Results:TGF-β1 induced LoVo cell switching from polygonal to spindle-shaped.TGF-β1 enhanced the expression of vimentin,but lowered the level of E-cadherin.In contrast,Rapamycin impaired the transition induced by TGF-β1.Rapamycin dramatically abrogated TGF-β1-induced vimentin expression and restored E-cadherin expression in LoVo cells.Rapamycin significantly repressed the up-regulation of Snail mRNA expression induced by TGF-β1.Conclusion:Rapamycin dramatically abrogated TGF-β1 induced Snail mRNA expression in LoVo cells,hence inhibiting EMT of these cells in vitro.     

替米沙坦联合硝苯地平对EH患者的疗效及对血清中HGF、VEGF水平变化的影响

目的分析替米沙坦联合硝苯地平对原发性高血压(EH)患者的治疗效果及对血清肝细胞生长因子(HGF)、血管内皮生长因子(VEGF)水平的影响。方法回顾性选取2014年11月至2016年10月我院收治的原发性高血压患者98例,根据治疗方法不同分为对照组和观察组。对照组患者采用硝苯地平治疗,观察组患者采用替米沙坦联合硝苯地平治疗。观察并比较两组患者疗效、超声心动图指标水平、脂联素、细胞间黏附分子-1(ICAM-1)、HGF、VEGF水平及血管弹性指标水平变化情况。结果观察组患者总有效率为92.88%,对照组为79.60%,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后LVPWT、LVEDD及IVMI水平均较治疗前改善,观察组患者治疗后LVPWT、LVEDD及IVMI水平优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后脂联素水平较治疗前上升,ICAM-1、HGF及VEGF水平均较治疗前下降,观察组患者治疗后脂联素水平高于对照组,ICAM-1、HGF及VEGF水平低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后C1、C2及PWV水平均较治疗前改善,观察组患者治疗后C1、C2及PWV水平均优于对照组,差异有统计学意义(P<0.05)。结论替米沙坦联合硝苯地平治疗原发性高血压疗效确切,可改善患者左心室构造和血管弹性,降低血清HGF、VEGF水平。     

熟地和制首乌多糖对贫血小鼠骨髓有核细胞数和细胞周期的影响

目的:观察熟地多糖(RPS)和制首乌多糖(PPS)对骨髓抑制贫血小鼠外周血象、骨髓有核细胞(BMC)数和细胞周期的影响。方法:用60Co辐射和腹腔注射环磷酰胺(Cy)及氯霉素(Ch),建立骨髓抑制贫血小鼠模型,分别提取熟地和制首乌多糖,腹腔注射RPS(20mg/kg)和PPS(25mg/kg),观察对外周血象、BMC数的影响,并用流式细胞仪分析细胞周期。结果:RPS和PPS均能一定程度促进外周血象的恢复,明显提高骨髓抑制贫血小鼠BMC数量(P<0.01);流式细胞术分析表明,G0/G1期细胞比例明显减少(RPS:P<0.01,PPS:P<0.05),S期细胞比例明显增加(RPS:P<0.01,PPS:P<0.01)。结论:RPS、PPS能促进骨髓抑制贫血小鼠骨髓抑制的恢复,促进骨髓有核细胞进入增值周期。     

硫唑嘌呤在胰腺癌动物模型制作中的应用

目的筛选建立胰腺癌动物模型最适合成瘤的硫唑嘌呤(AZA)浓度。方法将40只SD大鼠按照AZA浓度的不同分为5组:空白对照组(A组)、2.6mg/kg AZA组(B组)、2.2mg/kg AZA组(C组)、1.8mg/kg AZA组(D组)、1.4mg/kgAZA组(E组),每组8只。A组每天灌服2mL生理盐水,B、C、D、E组每天灌服相应浓度的AZA生理盐水液2mL。第30天后进行SD大鼠皮下移植Mia PACAⅡ胰腺癌细胞悬液,通过检测大鼠血浆CA24-2和制作胰腺组织病理切片的方法来判断其是否成瘤。结果接种胰腺癌细胞后的第15、20、25、30天,各造模组大鼠血中的CA24-2水平均有不同程度的升高,其中B组在移植后的第15、20、25、30天,体内CA24-2水平分别为(51.56±2.14)、(51.61±1.21)、(54.66±1.02)、(56.00±0.38)U/mL,与C、D、E组比较,差异有统计学意义(P<0.05),且成瘤率最高,为83.3%。此外,胰腺病理切片镜下显示细胞核畸形、细胞大小不等,可见双核细胞及1～2个核仁,细胞核大且深染等病理特征,同时发现在移植部位的淋巴结和胰腺周围的淋巴结肿大。结论当AZA浓度为2.6mg/kg时,最有利于制作大鼠胰腺癌模型。     

“120”出诊中急性左心衰的救治体会

目的探讨“120”出诊中急性左心衰竭的救治措施。方法回顾分析34例急性左心衰竭的出诊病例,均经过了病情快速判断、心理安抚、吸氧、辅助端坐体位、心电监护、急救药物治疗、正确转运等处理,少部分患者进行了电除颤、心肺复苏治疗。结果34例患者经过急救处理后病情均不同程度的得到了缓解,安全到达医院者31例,急救有效率91．18％。结论急性左心衰竭是常见的危急重症。提高急救意识、熟练抢救方法、医护担架工积极配合、完善的抢救设备是提高抢救有效率的保证。另外,与患者及家属的积极有效沟通也至关重要,可有效减少医患纠纷。