多模式镇痛对子宫切除术后疼痛及T淋巴细胞亚群的影响

目的观察多模式镇痛用于子宫切除术后镇痛的临床效果及对T淋巴细胞亚群的影响。方法 60例ASAⅠ~Ⅱ级择期在腰硬联合麻醉下行子宫切除患者,将患者随机分为观察组和对照组,观察组应用帕瑞昔布钠复合舒芬太尼术后镇痛,对照组应用舒芬太尼术后镇痛。记录两组术后VAS评分及各个时间点抽取外周静脉血检测T淋巴细胞亚群含量。结果与T0相比较,两组T1、T2、T3、T4的CD3+、CD4+含量下降(P0.05),CD8+含量升高(P0.05);与对照组相比较,观察组T2、T3、T4的CD3+、CD4+含量升高(P0.05),CD8+含量降低(P0.05)。结论多模式镇痛对于子宫切除患者镇痛效果显著,并可以保护T淋巴细胞功能从而减轻免疫抑制。     

Fast volumetric imaging of bound and pore water in cortical bone using three‐dimensional ultrashort‐TE (UTE) and inversion recovery UTE sequences

We report the three‐dimensional ultrashort‐TE (3D UTE) and adiabatic inversion recovery UTE (IR‐UTE) sequences employing a radial trajectory with conical view ordering for bi‐component T₂* analysis of bound water (T₂*^BW) and pore water (T₂*^PW) in cortical bone. An interleaved dual‐echo 3D UTE acquisition scheme was developed for fast bi‐component analysis of bound and pore water in cortical bone. A 3D IR‐UTE acquisition scheme employing multiple spokes per IR was developed for bound water imaging. Two‐dimensional UTE (2D UTE) and IR‐UTE sequences were employed for comparison. The sequences were applied to bovine bone samples (n = 6) and volunteers (n = 6) using a 3‐T scanner. Bi‐component fitting of 3D UTE images of bovine samples showed a mean T₂*^BW of 0.26 ± 0.04 ms and T₂*^PW of 4.16 ± 0.35 ms, with fractions of 21.5 ± 3.6% and 78.5 ± 3.6%, respectively. The 3D IR‐UTE signal showed a single‐component decay with a mean T₂*^BW of 0.29 ± 0.05 ms, suggesting selective imaging of bound water. Similar results were achieved with the 2D UTE and IR‐UTE sequences. Bi‐component fitting of 3D UTE images of the tibial midshafts of healthy volunteers showed a mean T₂*^BW of 0.32 ± 0.08 ms and T₂*^PW of 5.78 ± 1.24 ms, with fractions of 34.2 ± 7.4% and 65.8 ± 7.4%, respectively. Single‐component fitting of 3D IR‐UTE images showed a mean T₂*^BW of 0.35 ± 0.09 ms. The 3D UTE and 3D IR‐UTE techniques allow fast volumetric mapping of bound and pore water in cortical bone. Copyright © 2016 John Wiley & Sons, Ltd.     

电子支气管镜检查联合多种取材方法诊断弥漫性肺间质性疾病的临床研究

目的研究和分析对弥漫性肺间质性疾病(ILD)患者采用电子支气管镜检查联合多种取材方法的临床诊断情况和意义。方法随机选择2011年6月~2014年6月期间,在我院呼吸道科进行就诊的弥漫性肺间质性疾病患者40例。分别对他们进行TBLB(支气管肺活检)检测和电子支气管镜检查联合多种取材方法检测,并就两种临床检测方法的诊断情况和结果进行统计、对比和分析。结果使用TBLB检测出结节病2例,联合检测出结节病2例;使用TBLB检测出继发性肺纤维化4例,联合检测出继发性肺纤维化4例;使用TBLB检测出特发性肺纤维化16例,联合检测出特发性肺纤维化16例;使用TBLB检测出肺结核3例,联合检测出肺结核7例;使用TBLB检测出转移性肺癌1例,联合检测出转移性肺癌3例;使用TBLB检测出原发性肺癌2例,联合检测出原发性肺癌4例,且差异均无统计学意义(P0.05)。但联合检测总检出率(90%)明显高于TBLB总检出率(70%),差异有统计学意义(P0.05)。结论对弥漫性肺间质性疾病(ILD)患者应用电子支气管镜检查联合多种取材方法进行临床诊断,其检出符合率高,准确率好,是一种科学、理想、有效的临床诊断方法。     

Enhanced antitumor efficacy by combination treatment with a human umbilical vein endothelial cell vaccine and a tumor cell lysate-based vaccine

Angiogenesis inhibitors combined with other anticancer drugs have been shown to inhibit tumor growth in animal models and some of them were recently used in clinical trials. In the present study, a whole hepatocellular carcinoma cell lysate based vaccine with diphtheria toxin (DT) and two tandem repeats of microbial HSP70 peptide epitope 407-426 (2 mHSP70407-426, M₂) as adjuvant, which was called HDM, was combined with a whole human umbilical vein endothelial cell (HUVEC) vaccine to develop a combination treatment regimen. This combination treatment regimen was named HUVEC-HDM, which was supposed to enhance its antitumor efficiency. HUVEC-HDM was administrated subcutaneously in both prophylactic and therapeutic procedures. Compared to either single vaccine, HUVEC-HDM induced a more significant inhibition on the growth and metastasis of H22 hepatocellular carcinoma in mice and prolonged the survival of tumor-bearing mice. Besides, HUVEC-HDM immunization elicited strong humoral and cellular immune responses targeting tumor cell as well as tumor angiogenesis, which could be responsible for the enhanced antitumor effect. Moreover, histochemistry analysis showed that HUVEC-HDM induced large areas of continuous necrosis within tumors, correlating well with the extent of tumor inhibition. These results not only highlight the superiority of the combined HUVEC-HDM treatment regimen, but also support the translation of such approaches into the clinic for the treatment of patients with hepatocellular carcinoma.     

枳术健胃颗粒的制备及HPLC法测定辛弗林的含量

目的:建立枳术健胃颗粒的制备方法及制剂中辛弗林的HPLC含量测定方法。方法:正交试验设计优化制备工艺,样品以55%的乙醇回流提取,采用Zobax-C18(4.6mm×200mm)色谱柱,甲醇-水(0.02%磷酸及0.1%十二烷基磺酸钠)(55:45)为流动相,流速为1.0mL/min,检测波长为224nm。结果:枳术健胃颗粒中辛弗林的标准曲线方程为y=36.0756+226.5055x,r=0.9998,线性范围为0.24～0.96mg,平均回收率99.9%。结论:制备工艺可行,HPLC方法可用于枳实中辛弗林的质量控制。     

1+3模式在规范皮试药物使用管理中的应用简

针对皮试药物使用中存在的问题，通过寻找根本原因，提出整改措施，通过1＋3模式对皮试药物使用管理进行持续质量改进，有效地降低了皮试药物使用缺陷率，提高了用药安全。     

Celiac Disease and Metabolic Bone Disease

Celiac disease is a common autoimmune gastrointestinal disorder affecting multiple organs, precipitated in genetically vulnerable persons by the ingestion of gluten. Gluten is poorly digested and is presented to the intestinal mucosa as a large polypeptide. Binding to human leukocyte antigen-DQ2 and human leukocyte antigen-DQ8 molecules on antigen-presenting cells stimulates cellular and humeral immune reactions. Although common serological tests are available to diagnose celiac disease, the diagnosis of celiac disease is often delayed or missed because of lack of recognition as the disease presentation in adults is highly variable and may be asymptomatic. Celiac disease is a common secondary cause of metabolic bone disease and delayed treatment with gluten-free diet affects bone mineral density and fracture risk, so it is crucial to diagnose and treat celiac disease promptly. In this article, we will review recent studies of celiac disease in adults and provide practical, easily accessible information for busy clinicians.     

颞下经小脑幕入路治疗基底动脉顶分叉部动脉瘤:附三例报告

探讨基底动脉顶分叉部动脉瘤的手术适应证及手术操作技巧。回顾分析3例经颞下入路手术治疗基底动脉顶分叉部动脉瘤患者临床表现、影像学资料及手术过程。其中2例动脉瘤完全夹闭,1例因保护穿支动脉而残留部分瘤颈。术后随访6个月至2年,均恢复良好,改良Rankin量表评分分别为2分、0分、1分;日常生活活动能力量表(Barthel指数)评分为65分、100分和95分。     

春季角结膜炎中医药治疗最新进展

春季角结膜炎是一种比较难治的眼病,症状明显,但发病原因尚不明确,近年来随着中医眼科对该病认识的不断深入,在临床治疗上取得了较好的效果,本文对相关情况进行了总结.