爱可欣^TM敷料在包皮环切术切口护理中的应用

[目的]观察爱可欣^TM敷料应用于包皮环切术切口护理的效果。[方法]将78例包皮环切手术病人随机分成观察组与对照组，观察组病人用爱可欣^TM敷料护理手术切口，对照组病人用传统的方法即凡士林纱布护理手术切口。术后随访8d，观察术后第1天、第2天、第3天切口疼痛情况及切口愈合情况。[结果]观察组病人术后第1天、第2天、第3天疼痛明显低于对照组，观察组切口愈合时间比对照组明显缩短，甲级愈合率高于对照组。[结论]用爱可欣^TM敷料护理包皮环切手术切口，能有效地缓解手术切口疼痛，促进切口愈合。     

经皮冠状动脉腔内成形术后冠脉痉挛致室速及室颤

1999年12月,笔者对1例缺血性心脏病患者行经皮冠状动脉腔内成形术后,因冠脉痉挛致室性心动过速及室性纤维颤动,经积极救治和正确处理而转危为安.     

回生口服液对中晚期非小细胞肺癌患者化疗后血凝状态及疗效的影响

目的评价回生口服液对中晚期非小细胞肺癌（NSCLC）患者化疗后血凝状态及疗效的影响。方法将69例首次确诊且可接受化疗的中晚期NSCLC随机分为实验组35例和对照组34例,两组皆采用含铂三代一线方案（吉西他滨+顺铂,或多烯紫杉醇+顺铂）化疗,21天为一周期。其中实验组在化疗同时配合使用回生口服液,10毫升/次,3次/日,从化疗当天开始口服,全程使用直至化疗终止。所有患者至少接受2周期化疗并评价临床客观疗效,在化疗前和第二周期化疗结束后一周检测血小板（PLT）、D-二聚体（D-dimer）、纤维蛋白水平（FIB）。结果实验组总有效率74.3%（26/35）,临床受益率（CBR）为80.0%（28/35）,疾病进展时间（TTP）为(5.5±2.8)月,平均生存期为(11.1±5.8)月。对照组总有效率47.1%（16/34）,CBR为55.9%（20/34）,TTP为(4.2±2.5)月,平均生存期为(8.4±5.3)月,两组总有效率、CBR、TTP与平均生存期比较差异均有统计学意义（P<0.05）;化疗后实验组PLT(157±89)×109/L、D-dimer(2078±770)μg/ml、FIB(3.8±1.4)g/L,与对照组PLT(208±118)×109/L、D-dimer(2680±980) μg/ml、FIB(4.6±1.8)g/L比较差异均有统计学意义（P<0.05、P<0.01、P<0.05）,且对照组化疗后有3例（8.8%）发生深静脉血栓,实验组无1例发生。结论回生口服液配合化疗提高了NSCLC患者近期疗效,并在一定程度上改善了血液高凝状态,可预防深静脉血栓的发生,并能延长TTP和平均生存期,值得临床推广。     

塞来昔布对人鼻咽癌CNE-2细胞生长抑制及放射增敏研究

Objective To investigate the growth inhibition and radiosensitization of Celecoxib in hu-man nasopharyngeal carcinoma cell line CNE-2. Methods CNE-2 growth inhibition by Celecoxib was eval-uated by MTT method. Apoptosis-related changes in morphology were observed by transmission electron mi-croscopy (TEM). Cell cycle distribution and apoptosis rate were measured by flowcytometry (FCM). The ex-pression of COX-2 protein was observed by SP method after the treatment of Celecoxib. Cells were randomly planted into four groups: irradiation control(Ci), drug group(Cd), irradiation group(R), and Celecoxib plus irradiation group(D+R). Single irradiation of 2,4,6,8,and 10 Gy were administered for colonogenic assay. Cell cycle distribution and apoptosis rate were analyzed at 6 Gy irradiation. Results The growth of CNE-2 cell was inhibited by celecoxib in a dose-and time-dependent manner, the IC50 was 80 μmol/L After the treatment, cell ratio of GO and G, phases was increased (47.03±2.76 vs 56.17±1.95, t=4.68, P= 0.010), whereas the ratio of S and G2/M phases was decreased (33.07±1.86 vs 24.87±1.76, t=5.54, P = 0.010; 19.30±0.53: 17.73±0.83, t=2.75, P=0.050), and the apoptosis rate was increased (1.57±0.47:10.47±0.31, t = 27.39, P = 0.000) in a dose-dependent manner. Apoptosis with nuclear chromatin condensation, fragmentation and cell shrinkage was found by TEM. SP method showed that Celeib decreased COX-2 expression (17.48±0.34 vs 12.82±0.51,t=13.20,P =0.00). The sensitivity ratio(D0) was 1.15. FCM showed that the percentage of cells in G2/M phase was significanty more in R and D+R groups than in Ci and Cd groups (68.00±1.65,54.27±5.74,17.60±0.80,14.86±1.23, t=47.70,P=0.000; t=11.63, P=0.000), and also significantly different between R group and D + R group (t=3.99, P= 0.020). The apoptosis rate was higher in R and D + R groups than Ci and Cd groups(4.83±0.97,9.50± 1.35,1.33±0.86 and 2.28±0.42,t=4.67,P=0.010;t=8.81, P=0.000), D + R group than R group(t =4.85,P=0.010). Conclusions Celecoxib can markedly inhibit the growth and induce apoptosis in CNE-2 cells,which may depend on COX-2 pathway. Celeeoxib potently enhances the radiosensitivity of CNE-2 cells,which may due to the repair inhibit of radiation-induced DNA damage, inhibit of cell proliferation,and enhancement of cell apoptosis after irradiation.     

塞来昔布对人鼻咽癌CNE-2细胞生长抑制及放射增敏研究

Objective To investigate the growth inhibition and radiosensitization of Celecoxib in hu-man nasopharyngeal carcinoma cell line CNE-2. Methods CNE-2 growth inhibition by Celecoxib was eval-uated by MTT method. Apoptosis-related changes in morphology were observed by transmission electron mi-croscopy (TEM). Cell cycle distribution and apoptosis rate were measured by flowcytometry (FCM). The ex-pression of COX-2 protein was observed by SP method after the treatment of Celecoxib. Cells were randomly planted into four groups: irradiation control(Ci), drug group(Cd), irradiation group(R), and Celecoxib plus irradiation group(D+R). Single irradiation of 2,4,6,8,and 10 Gy were administered for colonogenic assay. Cell cycle distribution and apoptosis rate were analyzed at 6 Gy irradiation. Results The growth of CNE-2 cell was inhibited by celecoxib in a dose-and time-dependent manner, the IC50 was 80 μmol/L After the treatment, cell ratio of GO and G, phases was increased (47.03±2.76 vs 56.17±1.95, t=4.68, P= 0.010), whereas the ratio of S and G2/M phases was decreased (33.07±1.86 vs 24.87±1.76, t=5.54, P = 0.010; 19.30±0.53: 17.73±0.83, t=2.75, P=0.050), and the apoptosis rate was increased (1.57±0.47:10.47±0.31, t = 27.39, P = 0.000) in a dose-dependent manner. Apoptosis with nuclear chromatin condensation, fragmentation and cell shrinkage was found by TEM. SP method showed that Celeib decreased COX-2 expression (17.48±0.34 vs 12.82±0.51,t=13.20,P =0.00). The sensitivity ratio(D0) was 1.15. FCM showed that the percentage of cells in G2/M phase was significanty more in R and D+R groups than in Ci and Cd groups (68.00±1.65,54.27±5.74,17.60±0.80,14.86±1.23, t=47.70,P=0.000; t=11.63, P=0.000), and also significantly different between R group and D + R group (t=3.99, P= 0.020). The apoptosis rate was higher in R and D + R groups than Ci and Cd groups(4.83±0.97,9.50± 1.35,1.33±0.86 and 2.28±0.42,t=4.67,P=0.010;t=8.81, P=0.000), D + R group than R group(t =4.85,P=0.010). Conclusions Celecoxib can markedly inhibit the growth and induce apoptosis in CNE-2 cells,which may depend on COX-2 pathway. Celeeoxib potently enhances the radiosensitivity of CNE-2 cells,which may due to the repair inhibit of radiation-induced DNA damage, inhibit of cell proliferation,and enhancement of cell apoptosis after irradiation.     

脓腔内利福霉素换药治疗淋巴结核的效果观察

目的观察脓肿型、溃疡型淋巴结核切开引流病灶清除,脓腔内利福霉素纱条填塞换药的治疗效果。方法选择受治疗的73例脓肿型、溃疡型淋巴结核患者,在全身抗结核治疗的基础上,采用脓肿切开、脓腔及窦道内病灶清除及利福霉素钠纱条腔内填塞换药的治疗方法,观察患者的治疗效果。结果所有患者术后脓腔在21~45 d内全部愈合,平均愈合时间25.7 d,仅有2例在1年内复发,经再次同样处理后治愈。结论采用脓肿切开引流、病灶清除脓腔内利福霉素钠纱条填塞换药的方法治疗脓肿型、溃疡型淋巴结核效果好。     

蜂蜜敷料局部治疗糖尿病足部溃疡的效果评价

目的评价蜂蜜敷料局部治疗糖尿病足部溃疡的效果。方法抽取外科门诊就诊的糖尿病足溃疡患者105例,随机分为A、B、C三组,每组35例,分别使用自制的蜂蜜敷料、功能敷料和常规敷料治疗,观察三组伤口不同时间点的细菌清除率、面积愈合率及细菌清除时间、清创时间和治疗时间。结果蜂蜜敷料组(A组)的细菌清除率、面积愈合率明显优于B、C组(P<0.05),且细菌清除平均时间、清创时间和治疗时间短于功能敷料和常规敷料B、C组(P<0.05)。结论蜂蜜敷料治疗糖尿病足部溃疡有助于清除伤口感染和坏死组织,促进肉芽生长,有湿性愈合的作用。