益气除痰法延长非小细胞肺癌中位生存期的作用

目的:观察益气化痰法延长Ⅲ、Ⅳ期非小细胞肺癌(NSCLC)生存期的作用.方法:采用前瞻性、多中心、随机、对照的临床流行病学方法,将符合标准的病例按肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型四型辨证施治,辨病治疗以益气化痰法为主,辨证治疗分别以宣肺除痰、益气除痰、滋阴化痰、益气养阴法为主.用乘积极限(K-M)法分析不同证型的中位生存期及中位疾病进展时间.结果:肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型肿瘤总缓解率分别为9.1%、23.6%、11.5%、13.2%(P<0.05);瘤体总稳定率分别为69.7%、77.8%、69.2%、78.9%(P>0.05);中位生存期分别为308天、401天、300天和326天(P>0.05);1年累积生存率分别为45.63%、51.53%、41.95%、46.01%(P>0.05).结论:益气化痰法可使Ⅲ、Ⅳ期NSCLC的中位生存期达到9个月,与化疗配合应用可达到12个月,是晚期非小细胞肺癌的一种有效治法.其中,脾虚痰湿型患者中位生存期达到13个月,有可能进一步提高疗效.     

The association of XRCC1 haplotypes and chromosomal damage levels in peripheral blood lymphocyte among coke-oven workers.

Theoretically, a haplotype has a higher level of heterozygosity than individual single nucleotide polymorphism (SNP) and the association study based on the haplotype may have an increased power for detecting disease associations compared with SNP-based analysis. In this study, we investigated the effects of four haplotype-tagging SNPs (htSNP) and the inferred haplotype pairs of the X-ray cross-complementing group 1 (XRCC1) gene on chromosome damage detected by the cytokinesis-block micronucleus assay. The study included 141 coke-oven workers with exposure to a high level of polycyclic aromatic hydrocarbons and 66 nonexposed controls. The frequencies of total MN and MNed cells were borderline associated with the Arg(194)Trp polymorphism (P = 0.053 and P = 0.050, respectively) but not associated with the Arg(280)His, Arg(399)Gln and Gln(632)Gln polymorphisms among coke-oven workers. Five haplotypes, including CGGG, TGGG, CAGG, CGAG, and CGGA, were inferred based on the four htSNPs of XRCC1 gene. The haplotype CGGG was associated with the decreased frequencies of total MN and MNed cells, and the haplotypes TGGG and CGAG were associated with the increased frequencies of total MN and MNed cells with adjustment for covariates among coke-oven workers. This study showed that the haplotypes derived from htSNPs in the XRCC1 gene were more likely than single SNPs to correlate with the polycyclic aromatic hydrocarbon-induced chromosome damage among coke-oven workers.     

中西医结合治疗输卵管阻塞性不孕症

陈益昀主任中医师是全国第二、三批中医药专家学术经验继承指导老师，临床悬壶五十余载，治学严谨，注重实际。几十年的临床实践加之深厚扎实的理论功底，尤其能够结合现代医学知识，使其在治疗疾病，立法用药上独树一帜。笔者有幸随师学习，获益匪浅，兹将陈老师运用中西医结合治疗输卵管阻塞性不孕症的经验总结介绍如下：     

注射用对氨基水杨酸钠细菌内毒素检验探讨

用<中国药典>2000年版附录细菌内毒素检验法对PAS进行细菌内毒素检测并建立实验方法.实验结果表明用TAL试剂对PAS最大无干扰浓度为5mg/ml,无干扰作用,提示用细菌内毒素检查法检查PAS中的内毒素是可行的.     

高催乳素血症的临床分析

目的探讨女性高催乳素(PRL)血症的原因和治疗。方法对60例高催乳素血症患者临床资料进行回顾性分析。结果垂体腺瘤22例(36.7%),其中2例行手术治疗,20例予溴隐亭治疗。空蝶鞍l例(1.7%),予手术治疗。药物所致7例(11.7%),其中5例停止服药后3个月恢复正常月经。伴多囊卵巢综合症3例(5.0%),其中1例予促排卵治疗妊娠。甲状腺功能减退2例(3.3%),予口服甲状腺素治疗4月后月经恢复正常。特发性25例(41.7%),其中5例无临床症状者予定期观察,20例伴临床症状者予溴隐亭治疗。60例高催乳素血症患者采用溴隐亭治疗者40例,均取得良好效果。结论高催乳素血症应针对病因进行治疗。溴隐亭仍是治疗高催乳素血症的首选药物。     

夏至草提取物对急性血瘀大鼠淋巴微循环的作用

目的:观察夏至草提取物(HLE)对急性血瘀大鼠淋巴微循环的作用.方法:(Dextran)以10ml/kg经静脉注射,1 min注完,诱导大鼠急性血瘀症模型,6 min后治疗组按1.0g/kg(含生药)从颈静脉注射HLE,对照组颈静脉注射等量的生理盐水,通过显微电视录像观察肠系膜微淋巴管(ML)收缩性的变化.结果:夏至草提取物使ML自主收缩频率、收缩活性指数(Index Ⅰ)、总收缩活性指数(IndexⅡ)、淋巴动力学指数(LD-Index)和血压显著高于对照组(P《0.05～0.01).结论:夏至草提取物对急性血瘀大鼠淋巴微循环障碍有非常好的改善作用.     

王不留行对家兔离体主动脉环张力的影响及其机制

目的:研究王不留行水煎液(DSC)对兔离体主动脉环张力的影响及其机制.方法:采用家兔离体主动脉环张力记录法.结果:DSC可浓度依赖性地引起动脉血管静息张力的增加.用10-7mol/L酚妥拉明、10-5mol/L异搏定、10-6mol/L苯海拉明或无钙K-H液温育后均可明显减弱DSC的收缩作用;而去除内皮细胞后,10-7mol/L阿托品则无明显影响.结论:DSC可引起主动脉环收缩,其机制可能与平滑肌细胞上的肾上腺素能α受体、异搏定敏感的Ca2 通道、细胞外Ca2 以及组胺H1受体有关,而与血管内皮细胞和胆碱能M受体无关.     

加减地黄饮子对Aβ-40所致痴呆大鼠学习记忆、脑酶活性的影响

用大鼠海马注射β淀粉样蛋白诱导的老年性痴呆模型,并以正常老龄鼠为空白对照,西药脑复康为阳性对照,对加减地黄饮子预防组和治疗组从行为学、单胺氧化酶(MDA)改变等方面进行了初步的实验观察,以探讨加减地黄饮子对Aβ-40所致痴呆大鼠学习记忆及MDA活性影响.实验证明造模大鼠较好地模拟了老年性痴呆行为学表现和MDA改变;加减地黄饮子可改善老年性痴呆大鼠行为学功能,并能降低单胺氧化酶的活性.     

Phacoemulsification in eyes with corneal opacities after deep anterior lamellar keratoplasty

To evaluate the maneuverability and efficacy of phacoemulsification and intraocular lens (IOL) implantation in eyes with corneal opacities after deep anterior lamellar keratoplasty (DALK), twelve eyes of 12 patients with mild to moderate corneal opacities after DALK and coexisting cataracts were analyzed retrospectively. Phacoemulsification and IOL implantation assisted with anterior capsule staining, as well as non-invasive optical fiber illumination, were performed on all eyes. No intraoperative or postoperative complications were noted. Mean corrected distance visual acuity (logMAR) improved from 1.24±0.17 to 0.73±0.22. Post-phaco intraocular pressure was maintained between 13 to 20 mm Hg in all cases throughout the follow-up period. Mean endothelial cell density decreased from 2258.42±205.94 to 1906.25±174.23 cells/mm2. Phacoemulsification and IOL implantation are safe and valid in eyes with mild to moderate corneal opacities after DALK and coexisting cataracts when assisted with anterior capsule staining and non-invasive optical fiber illumination.     

Comparative evaluation of the impact of minimally invasive preparation vs. conventional straight‐line preparation on tooth biomechanics: a finite element analysis

Minimally invasive endodontics emphasizes preservation of a maximal amount of healthy tooth tissue. However, whether the tooth structure preserved by minimally invasive endodontics can maintain higher fracture resistance is unclear. This study aimed to compare the biomechanics on teeth after minimally invasive (MI) preparation and straight‐line (SL) preparation using finite element analysis. Six finite element analysis models of a mandibular first molar were constructed and divided into two groups (MI and SL). Two loads of 250 N, one vertically stimulating the vertical masticatory force and the other given 45° to the longitudinal axis of the tooth, were applied. Stresses in the teeth were calculated and analyzed. Under both vertical and 45° loads, the greatest stresses were located at the margin of the cavities on the occlusal surfaces. The stress concentration areas of teeth with minimally invasive access cavities were smaller than those of teeth prepared with straight‐line opening in coronal and cervical areas. The stress concentration points in the cervical areas increased with the increase of canal taper in the coronal third. Minimally invasive access preparation reduced the stress distribution in crown and cervical regions. A smaller taper cervical enlargement caused lower stress in the cervical region.