长春瑞滨化疗性静脉炎动物模型的建立

目的探讨建立长春瑞滨化疗性静脉炎动物模型适宜的给药浓度,为化疗性静脉炎的发生机制研究提供实验基础。方法选择实验用健康家兔28只,采用随机数字表法分为四组各7只。均于一侧耳缘静脉注药建模。第1组注射生理盐水10mL作为阴性对照,其余3组将长春瑞滨用10mL生理盐水溶解,分别按12.5mg/m2、25mg/m2和50mg/m2剂量注射。结果长春瑞滨组静脉炎症反应出现于注射后24h,48h左右表现最显著,约于1周恢复。25mg/m2组、50mg/m2组注射后48h有典型的静脉炎病理变化,50mg/m2组4只家兔分别于药物注射后第7～10天死亡,25mg/m2组家兔无死亡。结论参照人体用量采用长春瑞滨25mg/m2于家兔耳缘静脉化疗,能较好建立化疗性静脉炎动物模型。     

中药浴联合穴位按摩佐治小儿发热效果观察

目的观察中药浴联合穴位按摩辅助治疗小儿外感发热的临床效果。方法将174例急性上呼吸道感染致发热患儿随机分为对照组(88例)和观察组(86例),对照组在常规治疗的基础上,给予温水洗浴;观察组采用中药洗浴联合穴位按摩。结果两组患儿洗浴前后体温、解热时间比较,差异有统计学意义(P0.05,P0.01)。结论两种辅助治疗小儿发热的方法均有效,中药药浴联合穴位按摩治疗的临床效果优于温水洗浴。     

Surveying quality of life in patients with Fabry disease by the SF-36 scale

Objective To test the availability of the SF-36 scale for the Chinese patient with Fabry disease (FD), the quality of life(QOL) and its probable influence factors were analyzed. Methods The data were obtained from 50 healthy volunteers and 57 patients with FD enrolled in nephrology department of Ruijin hospital from Jan, 2003 to Jan, 2013. The SF-36 scale was used to evaluate the QOL of patients and to compare the difference between the patientsandcontrols. Furthermore, the influencing factors were estimated by multiple linear regressions. Results Between the patientsandcontrols, the differences of 8 dimensionalitiy's scores had statistical significance, which claimed that the reaction was sensitive. Especially, in the patient group, the Pearson correlation coefficient among each domain of the SF-36 was lower than its Cronbach's α coefficient (0.934), which indicated good internal consistency reliability. The two common factors were much the same to the theory assume, which illustrated the construct validity was available. Even the acceptability of the patient’ group at 100% proved the scale was appropriate for patients with FD. In addition, in role-physical (RP) and bodily pain (BP) , the scores of the male patients were less than the females (P﹤0.01), declared that the QOL of the males was inferior to the females. In the physical function (PF) and the mental health (MH), the scores of the patients with angiokeratoma were less than the group without it, so the patients who had evident clinical symptoms more likely contributed to depression. Using multiple linear regression, age, gender and clinical types were chosen into regression equation by stepwise regression, and the main potential predictor was age. Conclusions The SF-36 scale applies to evaluate the QOL of patients with FD. It is critical to concern and manage the QOL of FD patients, especially in their mental health aspect.     

高压氧促进重度缺氧缺血性脑病新生儿智能康复的疗效观察

目的观察高压氧治疗重度新生儿缺氧缺血性脑病（HIE），促进患儿智能康复的近期、远期疗效。方法将同期住院的47例重度HIE患儿随机分为高压氰（HBO）组24例、对照组23例，两组接受相同的常规药物治疗至生后3个月，HBO组自生后8—10d开始接受HBO治疗，10d为1个疗程，每间隔10—15d进行下1个疗程，共4个疗程。两组患儿均按双盲原则，于生后7d、28d行新生儿行为神经（NBNA）测定，2岁时行Bayley婴幼儿发育量表（BSID）测试，于5岁时行韦氏学龄前儿童智力量表（WPPSI）测试，以评价HBO治疗重度HIE的近期与远期智能康复情况。结果HBO组28d时NBNA评分明显高于对照组（P〈0．01）；2岁时Bayley智力测定，HBO组心理发展指数（MDI）明显高于对照组（P〈0．05）；5岁时WPPSI智力测定，HBO组总智商（FIQ）和言语智商（VIQ）明屁高于对照组（P〈0．05）。HBO组智力缺陷发生率为12．5％（3／24），明显低于对照组39．1％（9／23）（P〈0．05）。结论HBO不仅可显著提高患儿的近期疗效，且能够明显改善患儿的远期预后，促进其智能康复，防治智力低下。     

自体CIK细胞辅助治疗非霍奇金淋巴瘤患者的临床观察

目的观察细胞因子诱导杀伤细胞(cytokine induced killer cells)辅助治疗非霍奇金淋巴瘤的安全性及近期疗效。方法对6例经病理确诊为非霍奇金淋巴瘤并且存在结外器官侵犯的患者,取其自体外周血单个核细胞,在含10%血浆的RPMI-1640培养基中添加Anti-CD3mAb和rhIL-2联合诱导单个核细胞为CIK细胞,并将细胞进行自体回输。结果CIK细胞输注后可见患者体内CD3 CD56 细胞较前增加,影像学复查显示肿块缩小,治疗过程中主要出现畏寒、发热,未观察到其他明显副作用。结论自体单个核细胞可以高效扩增CIK细胞,回输治疗非霍奇金淋巴瘤安全有效,且无明显毒副作用。     

推拿加鹿衔草为主组方干预老年性膝骨关节炎

目的:观察推拿和鹿衔草为主组方治疗老年性膝关节骨关节炎的干预效果。方法:选择2002-03/2004-06在上海交通大学附属第一人民医院推拿科、中医科门诊就诊的老年性膝关节骨关节炎患者86例,均自愿参加观察。按随机分组表分成4组,即推拿 鹿衔草组、推拿组、鹿衔草组及自我锻炼组,分别为22,22,22及20例。①推拿组患者取俯卧位,以滚法作用于患肢后侧5min,重点在部委中(、委阳(;取仰卧位,用滚法作用于患者患侧大腿股四头肌,着重于膝关节髌骨上部5min;继而以按揉与弹拨法交替作用于患肢,配合点按犊鼻、内外膝眼、阳陵泉、鹤顶、膝阳关、梁丘等(位;作屈膝法,配合膝关节伸屈、旋内、旋外被动运动;最后以擦法擦热患膝。3次/周,共治疗4周。②鹿衔草组患者服用汤药(鹿衔草为主的基础方),辩证加减。1剂/d,分2次口服,共服用4周。③推拿 鹿衔草组治疗方法:在推拿治疗同时服用鹿衔草为主组方的汤药,共治疗4周,方法同上。④自我锻炼组:进行知识教育,并嘱患者自行进行功能锻炼,包括牵张训练、主动和被动活动度训练及增力训练等,锻炼时间为4周。采用WOMAC评分(包括疼痛、僵硬、日常生活3大类,用0～100mm视觉量表评分法,分数越高患者的机体功能越差,对生活的影响程度也越大)和20m步行时间对治疗前及治疗4周后的膝关节功能进行评估,并在治疗4周后评估疗效,疗效评定标准:①有效:关节疼痛、肿胀消失,活动功能恢复正常,理化检查正常。②好转:关节疼痛、肿胀减退,活动功能好转。结果:86例患者均进入结果分析,无脱落。①各组患者治疗4周后的WOMAC评分和20m步行时间均较治疗前显著降低(P<0.05)。治疗4周后推拿 鹿衔草组的WOMAC评分显著低于自我锻炼组(P<0.05);推拿 鹿衔草组和推拿组的20m步行时间显著短于自我锻炼组(P<0.05)。②经过4周的治疗和锻炼,推拿 鹿衔草组、推拿组、鹿衔草组及自我锻炼组患者的治疗有效率分别为86%,82%,82%和60%,各组比较差异均无显著性意义(P>0.05)。结论:单纯推拿、单纯服用鹿衔草及自我功能锻炼均能有效治疗老年性膝关节骨关节炎,明显改善患者膝关节运动功能,但推拿加鹿衔草综合治疗的疗效更优。     

雷帕霉素药物洗脱支架直接置人术治疗急性冠脉综合征的临床研究

目的 评价直接置入雷帕霉素药物洗脱支架(CYPHER^TM,codis治疗急性冠脉综合征(ACS)罪犯病变的安全性、可行性。方法 32例接受CYPHERTM支架直接置入的患者(直接支架组)和一般情况匹配的34例球囊扩张后行冠脉支架术的患者(常规支架组),比较两组的一般情况,冠脉造影及介入治疗即刻和临床随访结果。结果 直接支架组和常规支架组的成功率分别为97％和100％,直接支架组1例支架无法通过病变,球囊预扩张后成功置入原支架。两组无一例发生介入治疗相关的的严重心脏事件。随访期间两组严重心脏不良事件发生率无明显统计学差异。结论 CYPHER^TM支架直接置入术治疗ACS罪犯病变安全可行,成功率高。     

郭志强教授运用崇阳理论治疗反复胚胎移植着床失败的经验

本文介绍郭志强教授运用崇阳理论治疗反复胚胎移植着床失败的经验.郭老认为妇人体质"阴常不足,阳亦常虚",形成"阴阳相济,阴基阳主"的崇阳理论.认为反复胚胎移植着床失败的主要病机为肾阳不足,胞宫寒冷,不能摄精成孕,提出治疗应从阳气着手,并秉持着求子先调经的原则,在胚胎移植前采用中药序贯疗法调经促孕,胚胎移植后予两固汤补肾温阳,顾护阳气,促进着床.     

Muscle-specific knockout of PKC-lambda impairs glucose transport and induces metabolic and diabetic syndromes

Obesity, the metabolic syndrome, and type 2 diabetes mellitus (T2DM) are major global health problems. Insulin resistance is frequently present in these disorders, but the causes and effects of such resistance are unknown. Here, we generated mice with muscle-specific knockout of the major murine atypical PKC (aPKC), PKC-lambda, a postulated mediator for insulin-stimulated glucose transport. Glucose transport and translocation of glucose transporter 4 (GLUT4) to the plasma membrane were diminished in muscles of both homozygous and heterozygous PKC-lambda knockout mice and were accompanied by systemic insulin resistance; impaired glucose tolerance or diabetes; islet beta cell hyperplasia; abdominal adiposity; hepatosteatosis; elevated serum triglycerides, FFAs, and LDL-cholesterol; and diminished HDL-cholesterol. In contrast to the defective activation of muscle aPKC, insulin signaling and actions were intact in muscle, liver, and adipocytes. These findings demonstrate the importance of aPKC in insulin-stimulated glucose transport in muscles of intact mice and show that insulin resistance and resultant hyperinsulinemia owing to a specific defect in muscle aPKC is sufficient to induce abdominal obesity and other lipid abnormalities of the metabolic syndrome and T2DM. These findings are particularly relevant because humans who have obesity, impaired glucose tolerance, and T2DM reportedly have defective activation and/or diminished levels of muscle aPKC.     

Evaluation of the vascular architecture of hepatocellular carcinoma by micro flow imaging: pathologic correlation.

OBJECTIVE: The purpose of this study was to evaluate micro flow imaging (MFI) in depicting the vascular architecture of hepatocellular carcinoma (HCC) and the correlation between pathologic differentiation and the intratumoral vascular architecture pattern. METHODS: Micro flow imaging and contrast harmonic imaging (CHI) were performed in 37 patients with HCC. A sulfur hexafluoride-filled microbubble contrast agent was used. The enhancement level and intratumoral vessels were evaluated on CHI. The vascular architecture of each tumor was evaluated on MFI. Pathologic differentiation of the tumors was classified according to the Edmondson grading system. RESULTS: All 37 HCCs showed hyperenhancement in the arterial phase and hypoenhancement in the portal and late phases on CHI. Intratumoral vessels in the arterial phase were visualized in 20 (54.1%) HCCs. On MFI, the vascular architecture in all lesions was clearly delineated and categorized into 3 patterns: cotton, shrubbery, and deadwood, identified in 12 (32.4%), 22 (59.5%), and 3 (8.1%) of the tumors evaluated, respectively. A chi(2) test showed that pathologic differentiation significantly correlated to the vascular pattern (P = .006). Three (75%) of 4 Edmondson grade I HCCs showed the cotton pattern; 18 (75.0%) of 24 Edmondson grade II HCCs showed the shrubbery pattern; and the deadwood pattern was shown only in Edmondson grade III and IV HCCs. CONCLUSIONS: The MFI technique is more effective in depicting the intratumoral vascular architecture. The vascular architecture pattern correlates with pathologic differentiation of HCC.