便血患者1 193例的常见病因及其与年龄的相关性

目的探讨便血患者的常见病因及其与年龄的相关性。方法分析我院2001年1月至2005年10月诊治的1193例便血患者的肠镜或双气囊小肠镜检查结果。结果①便血患者的常见病因依次为结肠息肉(25.15%),直肠和结肠癌(13.75%),直肠和结肠炎症(10.65%),溃疡性结肠炎(5.11%),憩室病(2.51%),内痔(2.26%),血管发育不良(1.76%)。②结肠息肉(R=0.79,95%CI为0.02～0.06)、直肠和结肠癌(R=0.94,95%CI为0.03～0.05)、憩室(R=0.69,95%CI为0.00～0.02)、血管发育不良(R=0.65,95%CI为0.00～0.02)与年龄呈正相关(P值分别<0.05、0.01)。溃疡性结肠炎(R=0.90,95%CI为—0.03～0.01)与年龄呈负相关(P=0.00)。直肠和结肠炎症、内痔与年龄不相关(P值均>0.05)。结肠和直肠癌与息肉的发生率无显著关联(x~2=0.25,P=0.62)。结论结肠息肉、直肠和结肠癌、直肠和结肠炎症、溃疡性结肠炎、憩室病、内痔及血管发育不良均为便血的主要病因;随着年龄的增长,结肠息肉、直肠和结肠癌、憩室病及血管发育不良所致出血的发生率呈增长趋势,而溃疡性结肠炎所致出血的发生率随着年龄的增长呈下降趋势。结肠和直肠癌发生率与息肉发生率无显著关联。     

靶向非病毒载体一次及持续介导Ⅰ型单纯疱疹病毒胸腺嘧啶核苷激酶基因转导卵巢癌细胞的比较

目的比较靶向非病毒载体GE7系统介导Ⅰ型单纯疱疹病毒胸腺嘧啶核苷激酶(HSV1-tk)基因一次及持续转导卵巢癌细胞的转导效率及杀伤效应。方法靶向非病毒载体系统GE7分别与标志基因β-半乳糖苷酶(β-gal)基因和治疗基因HSV1-tk基因构成载体复合物,一次及持续体外转导卵巢癌细胞CaOV3,通过5-溴-4-氯-3-吲哚-β-D-半乳糖吡喃糖甙(X-gaI)染色比较GE7系统一次及持续转导外源基因的转导效率。将丙氧鸟苷(GCV)加入一次及持续转导HSV1-tk基因的卵巢癌细胞,通过细胞生长抑制曲线、流式细胞分析等,观察GCV对一次及持续转导GE7/HSV1-tk的卵巢癌细胞的杀伤作用。结果X-gal染色显示,GE7-次转导外源基因的平均转导效率可达80%,持续转导达85%。当GCV为1μg/mL时,GE7/HSV1-tk一次转导的生长抑制率达82%,凋亡指数为15,而持续转导可达90%,凋亡指数为30。在相同的GCV浓度下,持续转导GE7/pCMV-tk卵巢癌细胞生长抑制率显著高于一次转导(P<0.05)。结论GE7载体系统持续转导卵巢癌细胞较一次转导的平均转导效率高,持续转导的GE7/HSV1-tk/GCV基因治疗系统杀伤作用更大。     

不同炮制条件对何首乌水溶性糖含量和分子量的影响及其药效相关性研究

目的研究比较炮制条件对何首乌水溶性多糖含量和分子量的影响,并探讨其与药效的相关性。方法制首乌样品制备分别采用传统笼屉蒸法和流通蒸汽锅蒸法,并设定不同的蒸制时间。采用蒽酮-硫酸法测定样品中水溶性糖的含量;样品总糖溶液用不同分子量超滤膜过滤,并测定滤液中的糖含量,比较不同分子量多糖含量变化。建立大鼠血虚动物模型,比较样品粗多糖的药效差异。结果生何首乌及不同炮制品水溶性糖含量及其分子量分布不同。除炮制72h的制何首乌外,生首乌粗多糖和其他各制首乌样品粗多糖对模型大鼠红系指标均有一定改善作用。结论多糖为何首乌药效物质,炮制可导致何首乌多糖分子量的改变,其药效与分子量有关。     

术前快速康复操对腹腔镜结直肠癌根治术后恢复的影响

目的 观察术前进行快速康复操的锻炼对腹腔镜结直肠癌根治术患者术后恢复的影响.方法 选择拟行腹腔镜下结直肠癌根治手术患者200例,男122例,女78例,年龄32～80岁,ASAⅠ—Ⅲ级.随机分为两组:康复操组与对照组,每组100例.康复操组在术前进行快速康复操的锻炼,对照组仍采用传统的术前干预方案.两组患者均采用静-吸复...     

Efficacy and safety of transcatheter arterial chemoembolization-lenvatinib sequential therapy for patients with unresectable hepatocellular carcinoma: a single-arm clinical study

BackgroundRepeated transcatheter arterial chemoembolization (TACE) could cause ischemia of the tumor tissue and increases production of angiogenic factors in patients with hepatocellular carcinoma (HCC). Lenvatinib can inhibit the expression of angiogenic factors induced by ischemia after TACE and reduce angiogenesis and tumor recurrence. TACE-lenvatinib sequential therapy may improve clinical outcomes. There have been few investigations of TACE-lenvatinib sequential therapy for the treatment of unresectable HCC. We aimed to evaluate the efficacy and safety of TACE-lenvatinib sequential therapy for unresectable HCC.MethodsFrom May 2018 to May 2021, 53 consecutive patients who underwent TACE-lenvatinib sequential therapy were retrospectively reviewed. Of these, 30 patients who met the inclusion criteria were selected. Lenvatinib treatment started within 1 or 2 weeks after TACE at a dose of 8 or 12 mg once daily. Treatment response was assessed using dynamic magnetic resonance imaging (MRI) according to the modified response evaluation criteria in solid tumor (mRECIST). Blood tests were also performed at every response evaluation. Patients with complete response (CR) or partial response (PR) and stable disease (SD) received continuous lenvatinib therapy, and patients with progressive disease (PD) received repeated TACE. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were calculated. Statistical analysis was performed using the Kaplan-Meier method.ResultsThe median age was 58.5±9.1 years, and 16.7% (5/30) of patients were female. A total of 12 patients were categorized as Barcelona Clinic Liver Cancer (BCLC) Stage B and 18 were BCLC Stage C. The mean follow-up time was 15.7 months. The ORR was 76.7% (23/30), and the DCR was 96.7% (29/30). The median PFS was 6.1 months, and the median OS was 20.7 months. The most common lenvatinib-related AE was rash, and the most common TACE-related AE was elevated aspartate aminotransferase (AST). No treatment-related mortality was observed.ConclusionsFrom our findings, TACE-lenvatinib sequential therapy may prolong OS and PFS in patients with unresectable HCC, and the side effects are acceptable. The efficacy and safety of the sequential therapy should be confirmed in multiple center randomized controlled trials (RCTs) with a large sample and sufficient follow-up period.     

葛根丹参玉竹汤治疗2型糖尿病42例总结

目的:观察葛根丹参玉竹汤治疗2型糖尿病的临床疗效。方法:治疗组42例采用葛根丹参玉竹汤治疗,对照组35例采用二甲双胍治疗。结果:治疗组的总有效率为80.95%,而对照组仅为68.75%,两组比较,P<0.05。结论:葛根丹参玉竹汤治疗2型糖尿病疗效明显。     

银翘散主要活性成分对流感病毒性肺炎小鼠治疗作用的研究

目的:观察银翘散主要活性成分对流感病毒性肺炎小鼠的治疗作用.方法:昆明种小鼠随机分为正常组、模型组、中药组和病毒唑组,每组10只,采用鼻腔接种甲型流感病毒FM1株诱导幼龄小鼠肺炎,于感染前1 d,中药组灌服中药提取物,病毒唑组腹腔注射病毒唑注射液,正常组和模型组以等体积的生理盐水灌胃.观察各组小鼠的一般状态、肺组织形态学,各组小鼠感染5 d后处死,对肺指数及IV-RNA表达进行统计学分析.结果:与正常组比较,模型组小鼠肺指数显著增加,2组比较差异有高度统计意义(P<0.01);给药后中药组和病毒唑组小鼠肺指数显著下降,与模型组比较,P<0.01.但中药组与病毒唑组之间差异无统计意义(P>0.05).正常组肺组织未检测到IV-RNA,模型组检测到大量的IV-RNA,2组比较差异有高度统计意义(P<0.01);中药组和病毒唑组IV-RNA水平均低于模型组,差异有高度统计意义(P<0.01);但中药组与病毒唑组之间差异无统计意义(P>0.05).结论:银翘散主要活性成分对小鼠流感病毒性肺炎有较好的治疗作用.     

瑞芬太尼用于婴幼儿快通道心脏手术麻醉

目的 评价瑞芬太尼复合麻醉用于婴幼儿心脏手术安全性和有效性.方法 选择30例患儿,ASA Ⅰ～Ⅱ级,择期行房间隔缺损(ASD)或单纯室间隔缺损(VSD)修补术.随机分为2组,Ⅰ组芬太尼0.0 5～1 μg/(kg·min)持续泵入,Ⅱ组瑞芬太尼0.05～1.00 μg/(kg·min)持续泵入.分别于不同时间记录血流动力学参数,并采集动脉血标本测量应激激素浓度,观察术后机械通气时间和拔管时间.结果 与Ⅰ组比较,Ⅱ组在术中各时点血流动力学参数和应激激素浓度差异均无统计学意义,但术后通气时间和拔管时间均显著缩短(P＜0.01).结论 瑞芬太尼复合麻醉维持术中血流动力学稳定,有效抑制应激激素释放,术后能早期拔管,适用于婴幼儿心脏手术快通道麻醉.     

人精子甘露糖受体的部分特性研究

目的分离纯化人精子甘露糖受体并测定其分子量和等电点。方法用亲和层析法分离纯化人精子甘露糖受体,十二烷基磺酸钠-聚丙烯酰胺凝胶电泳法测定其分子量,等电聚焦电泳法测定其等电点。结果人精子甘露糖受体的分子量为66.3 ku,等电点为pH=5.1。结论用亲和层析法分离得到人精子甘露糖受体,并测得其分子量和等电点,可为后续开展人精子甘露糖受体有关理化特性和医用价值的研究积累有价值的资料。     

妇炎康胶囊中违法添加诺氟沙星的检测

目的:建立妇炎康胶囊中违法添加诺氟沙星的检测方法。方法:采用高效液相色谱结合二级管阵列紫外光谱检测,色谱柱C18(4.6mm×250mm,5μm);流动相为0.025mol/L甲酸溶液(以三乙胺调节pH至3.0±0.1)-乙腈(90∶10);流速为1mL/min;柱温为35℃;进样体积为10μL;检测波长为278nm。结果:结合高效液相色谱保留时间、紫外光谱等信息分析得出"妇炎康胶囊"中非法添加诺氟沙星。诺氟沙星在1.156～23.12μ/gmL范围内呈良好的线性关系,r=0.9992;检测限为1ng;加样平均回收率为103.51%,RSD为1.15%(n=6),每粒"妇炎康胶囊"中含诺氟沙星量为3.30mg。结论:本方法操作简便、准确、可靠,可用于检测妇炎康胶囊中违法添加诺氟沙星的定性和定量。