Hyperfractionated radiation therapy combined with concomitant chemotherapy for inoperable stage III non-small cell lung cancer: clinical analysis of 70 cases]

OBJECTIVE: To evaluate the effect of hyperfractionated radiation therapy and concomitant chemotherapy for inoperable stage III non-small cell lung cancer (NSCLC). METHODS: Seventy patients were randomized equally into two group. The therapy group received radiotherapy with hyperfractionated radiation therapy combined with concomitant chemotherapy, and the control group was treated with chemotherapy only. RESULT: The overall response rate, including the rate of both complete (CR) and partial responses (PR), in the therapy group was 60.0% with a CR rate of 8.6%. The overall response rate in the control group was 40.0% with a CR rate of 5.7%. The difference in overall response rate was statistically significant between the two groups (P<0.05). The median survival time, 1- and 2-years survival rate were 12.8 months, 48.6%, and 25.7%, respectively, in the hyperfractionated radiotherapy group, and 9.4 months, 34.3%, and 17.1%, respectively, in the chemotherapeutic group (P 0.031). The major toxic effects of the chemotherapy were myelosuppression and radiation esophagitis. CONCLUSION: Hyperfractionated radiation therapy plus concomitant chemotherapy with paclitaxel for inoperable stage III NSCLC improves the short-term response of the patients, but fail to raise the survival rate.     

小脑延髓池的显微外科解剖研究

目的研究小脑延髓池的显微外科解剖特征,探讨其临床意义.方法选择经10%福尔马林固定成人头颈标本15例,显微镜下(5～25倍)模拟枕下极外侧入路、颈-乳突入路和耳前颞下窝入路的手术操作,分别自后、侧和前方显露小脑延髓池内结构,详细观测其神经血管结构的形态特征.结果小脑延髓池位于延髓外侧,上至桥延沟,下达枕骨大孔,侧方沿枕骨形成蛛网膜袖套进入颈静脉孔和舌下神经管.舌咽神经、迷走神经和副神经的根丝自上而下起自橄榄体背侧、延髓和脊髓的后外侧沟,根丝逐级汇合后分别进入舌咽神经道和迷走神经道.椎动脉于小脑延髓池的下端入颅后经该池行向前上内进入延髓前池.小脑下后动脉(PICA)可分为延髓前段、延髓侧段、扁桃体延髓段、脉络膜扁桃体段和皮质段.主要的静脉有小脑延髓裂内静脉、延髓静脉、小脑岩面下组静脉和岩下桥静脉.结论小脑绒球和Luschka孔脉络丛复合体及颈静脉孔硬膜返折可作为辨认舌咽神经脑池段的解剖标志,深刻认识小脑延髓池的蛛网膜界限对手术处理累及小脑延髓池的不同性质病变,保护重要神经功能意义重大.     

Nuclear Factor κB and Anesthetic Preconditioning during Myocardial Ischemia-Reperfusion

Background: Volatile anesthetic preconditioning (APC) protects against myocardial ischemia-reperfusion (IR) injury, but the precise mechanisms underlying this phenomenon remain undefined. To investigate the molecular mechanism of APC in myocardial protection, the activation of nuclear factor (NF) [kappa]B and its regulated inflammatory mediators expression were examined in the current study.

Methods: Hearts from male rats were isolated, Langendorff perfused, and randomly assigned to one of three groups: (1) the control group: hearts were continuously perfused for 130 min; (2) the IR group: 30 min of equilibration, 15 min of baseline, 25 min of ischemia, 60 min of reperfusion; and (3) the APC + IR group: 30 min of equilibration, 10 min of sevoflurane exposure and a 5-min washout, 25 min of global ischemia, 60 min of reperfusion. Tissue samples were acquired at the end of reperfusion. NF-[kappa]B activity was determined by electrophoretic mobility shift assay. The NF-[kappa]B inhibitor, I[kappa]B-[alpha], was determined by Western blot analysis. Myocardial inflammatory mediators, including tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase, were also assessed by Western blot analysis.

Results: Nuclear factor [kappa]B-DNA binding activity was significantly increased at the end of reperfusion in rat myocardium, and cytosolic I[kappa]B-[alpha] was decreased. Supershift assay revealed the involvement of NF-[kappa]B p65 and p50 subunits. APC with sevoflurane attenuated NF-[kappa]B activation and reduced the expression of tumor necrosis factor [alpha], interleukin 1, intercellular adhesion molecule 1, and inducible nitric oxide synthase. APC also reduced infarct size and creatine kinase release and improved myocardial left ventricular developed pressure during IR.     

关木通引起慢性间质性肾炎7例报告

目的　观察关木通所致慢性肾损伤的临床和病理改变特点。方法　本组 7例中 ,男 5例 ,女 2例。 3例服关木通汤药 ,4例服含关木通成药。分析服用时间、累积总量与肾损害首发症状及症状出现时间、肾功能和肾病理改变的关系。结果　汤药组 :服药时间平均 3 3 3个月 ,累积总量平均 82 9 3 g ,首发症状为乏力 3例 ,夜尿增多 2例 ,平均时间为 8 3个月 ,Cr平均 40 2 μmol/L。肾病理 :3例均为重度寡细胞性肾间质纤维化 ,肾小管广泛萎缩。成药组 :服药时间平均 7 5个月 ,累积总量平均 13 6g ,乏力 3例 ,夜尿增多 1例 ,恶心呕吐、头痛头晕 1例 ,平均18 8个月 ,Cr 3 62 8μmol/L。肾病理为重度寡细胞性间质纤维化和灶状纤维化各 2例 ,肾小管灶状萎缩 3例 ,广泛萎缩 1例。结论　汤药组关木通积累大 ,发病时间早 ,肾病理改变重。提示关木通所致肾损其临床表现、病理改变与服用关木通时间、剂量相关。     

1例乙酸钙不动杆菌致角膜溃疡病人的护理

不动杆菌为条件致病菌,致病力不强,一般情况下很少引起感染,但当机体抵抗力降低或正常免疫屏障被破坏时可引发疾病,确切的致病因子目前尚无定论[1].我院于2005年8月24日收治1例因乙酸钙不动杆菌所致角膜溃疡病人,经过及时、有效的治疗及精心护理,取得了较好的疗效,现将其护理总结如下.     

032 百里香与报春花根固定组方对急性支气管炎病人的疗效和耐受性

Visual Basic作为一门可视化的高级编程语言，已经在各高等院校作为计算机基础教育的一门主干课程，随着多媒体技术、校园网建设和互联网技术的发展，原来滞后的教学方法势必影响高校计算机基础教学的效果。本文针对医学院校的计算机基础教育，着重探讨在新的历史时期Visual Basic的教学方法。     

豚鼠内耳磁微粒栓塞缺血模型初探

OBJECTIVE: To set up an inner ear ischemic model in guinea pig with ferromagnetic embolism. METHODS: A magnet was fitted in the external auditory canal and carbonyl iron filings (1%, 1 ml/kg) was injected into jugular, then the inner ear vessels were obstructed by ferromagnetic spheres. Cochlear blood flow (CBF) and number of red blood cells in the stria vessels were used to detect the model's ischemia of cochleae. The slice of temple bone and basal membrane stained by silver nitrate were used for inner ear's histopathological observations. RESULTS: The iron spheres were amassed in the one and two-day-later's model of inner ear vessels, which resulted in embolism. The number of red blood cells in the stria vessels decreased and then recovered to normal level after 4 days, but the CBF decreased to 50% +/- 10% of basic level immediately and recovered to 99% +/- 41% 4 days later. Scattered lesion of out hair cell cilium could be seen in cochleae in eight-day-later's model, and degenerations in different degree were found in vascular stria. CONCLUSION: The methods of inner ear ischemic model with ferromagnetic embolism could be practical and the decrease of CBF was reversible, so it may be an ideal model for studying some ischemic inner ear diseases and evaluating the effects of therapeutic drugs.     

PRENATAL DIAGNOSIS Ⅰ. EARLY DIAGNOSIS OF OPEN NEURAL TUBE DEFECTS BY QUALITATIVE ACETYLCHOLINESTERASE ISOENZYME IN AMNIOTIC FLUID

The measurement of amniotic fluid (AF) acetylcholinesterase isoenzyme (AChEI) is a relatively new method for early diagnosis of open neural tube defects (NTDs). As quantitative methods are of unproven reliability at present, the authors used a high resolving power qualitative method-vertical slab polyaerylamide gel electrophoresis. The benefits of this technique are: simplicity of operation, accuracy, unsophisticated equipment, and easily available reagents. Combined results of 9 NTDs studies revealed that samples from early pregnancy gave more accurate results than those from late pregnancy.     

米诺环素对压力作用下体外培养视网膜神经细胞凋亡的抑制

目的 观察米诺环素对压力系统作用下大鼠视网膜神经细胞(RNs)的活性及凋亡的影响，探讨其对受损RNs保护的可能机制。 方法 制备大鼠RNs体外加压培养模型，通过细胞形态学观察、四唑盐（MTT）比色法测定细胞活力、吖啶橙/溴化乙锭（AO/EB）染色法检测细胞凋亡率等方法观察不同浓度的米诺环素对上述损伤细胞的保护作用，并用免疫细胞化学法观察iNOS和caspase 3表达的改变。 结果 加压培养后RNs与对照组相比形态改变较明显，细胞活力降低，5393%的细胞发生凋亡。20000 μmol/L的米诺环素治疗组则细胞形态改善，活力显著增高，1729%的细胞发生凋亡；免疫细胞化学法显示细胞内iNOS和caspase-3表达较加压损伤组减少。 结论 一定剂量的米诺环素在体外可有效抑制压力引起的大鼠RNs损伤及凋亡；抑制iNOS和caspase-3的表达可能是其潜在作用机制。     

电脑比配色仪与比色板之间的相近性分析

目的：通过对比色记录的分析，比较Vita比色板、松风Vintage Halo比色板和电脑比配色仪之间的相近性和差异性。方法：随机抽取100名年龄在21～24岁的本地在校大学生，由男女两位测试者使用电脑比配色仪、Vita比色板和松风Vintage Halo比色板对被测试者的左上中切牙进行比色分析。结果：三种比色方法均以A色调最为集中，占总数的55％以上。其次是D色调占总数20％以上。男女测试者的选色在A、R、VR．系列中无明显差异。结论：电脑比配色仪、Vita比色板、松风Vintage Halo比色板均不能完全覆盖本地区青年天然中切牙的色度特征，只在A色调系列中重复率较高。