非小细胞肺癌患者呼出气冷凝液中p53蛋白检测的临床意义

Objective To study the clinical significance of the detection of p53 protein in exhaled breath condensate (EBC) of patients with non-small cell lung cancer (NSCLC). Methods EBC and plasma of 98 patients with NSCLC were collected,p53 protein expression in EBC and plasma was detected by enzyme-linked immunosorbent assay,and the data were compared with those of 98 healthy controls. p53 protein expression in cancer tissue of 98 patients with NSCLC was detected by immunohistochemistry. p53 protein expression in EBC and plasma and positive expression rate of p53 protein in cancer tissue were compared among patients with different lung cancer type,stage,histologic type,tumor size,and lymph node metastasis,smoking history. The specificity and sensitivity of diagnosis of p53 protein in patients with NSCLC were analyzed by ROC curve. Results ① The level of p53 protein in EBC of patients with NSCLC was significantly higher than that in healthy control group [(233.99±7.91) ng/L vs ( 130. 26 ± 4. 73) ng/L,P ＜0. 01]. The level of p53 protein in serum of patients with NSCI.C was significantly higher than that in healthy control group [(292. 58 ± 8. 79) ng/L vs (141. 66±3. 33) ng/L,P ＜0. 01]. ② The level of p53 protein in EBC of patients with central lung cancer was higher than that in patients with peripheral lung cancer [(248. 22 ± 8. 58) ng/L vs (215. 78 ± 6.61) ng/L,P＜0. 01]. ③The level of p53 protein in EBC of patients with positive immunostaining group was higher than that in negative group [(249.77 ± 8.07) ng/L vs (216.86 ± 7.44) ng/L,P ＜ 0. 05]. ④The level of p53 protein in serum of smokers was significantly higher than that in non-smokers [(310.18 ± 9.04) ng/L vs (254. 55 ± 6. 91) ng/L,P ＜0. 01]. ⑤The positive expression rate of p53 protein in cancer tissue was 47. 96% (47/98). ⑥The sensitivity and specificity of diagnosis of p53 protein were 95. 90% and 90. 04% in plasma,and those were 92. 90% and 79. 59% in EBC. The cut off values of p53 protein were respectively 175. 68 ng/L and 166. 26 ng/L in EBC and serum. Conclusions The detection of p53 protein in EBC of patients with NSCLC is helpful for the diagnosis of lung cancer.     

哮喘药物治疗中的药物不合理应用分析

支气管哮喘（简称哮喘）是由多种细胞（如嗜酸性粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、气道上皮细胞等）和细胞组分参与的气道慢性炎症性疾患。这种慢性炎症导致气道反应性的增高,通常出现广泛多变的可逆性气流受限,并引起反复发作性的喘息、气急、胸闷或咳嗽等症状,常在夜间和（或）清晨发作、加剧,多数患者的症状可自行缓解或经治疗缓解。     

伊曲康唑对健康成人肝细胞微粒体细胞色素P450同工酶1A2、3A4活性的作用

目的观察伊曲康唑对健康成人肝细胞微粒体细胞色素P450同工酶1A23、A4活性的作用,为临床上安全有效地联合用药提供实验依据。方法采用健康成人肝细胞微粒体,分为对照组和伊曲康唑处理组。处理组分别加入0.1、0.2、1.0、2.0、10.0、20.0 mg.L-1的伊曲康唑1mL,对照组仅加入培养液,孵育15 min后再加入CYP450同工酶1A2和3A4的相应底物(分别为非那西丁和睾酮)再孵育20min。反应终止后用高效液相色谱仪测量代谢产物(分别为对乙酰氨基酚与6β-羟基睾酮)的生成量代表1A2和3A4的活性。结果细胞色素P450同工酶1A2的相对活性百分比各处理组与对照组比较差异无显著性意义(P>0.05),而同工酶3A4的相对活性百分比随伊曲康唑质量浓度增加逐渐减小,各处理组与对照组比较差异均有显著性意义(P<0.05)。细胞色素P450同工酶3A4的相对活性百分比减小到对照组50%时(IC50)伊曲康唑的质量浓度为0.16 mg.L-1。结论伊曲康唑在临床应用血药质量浓度范围内,对健康成人肝细胞微粒体细胞色素P450同工酶1A2的活性无显著影响,然而对细胞色素P450同工酶3A4的活性有抑制作用。     

COPD诊治的进展

C0PD是一种常见的慢性呼吸系统疾病.八五期间我国部分地区的流行病学调查显示COPD占15岁以上人群的3.17%.在我国每年由于COPD造成的死亡人数约有100万.近年来国内外对COPD的研究有很大进展,现择要分述如下: