柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱临床研究

目的：观察柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱的临床疗效。方法：选取胃肠功能紊乱患者110例,按单双数随机分为2组各55例。对照组予西药奥美拉唑肠溶胶囊治疗,观察组予柴胡桂枝干姜汤联合耳穴压豆治疗。观察比较2组胃肠功能指标改善情况及临床疗效。结果：观察组胃肠功能指标嗳气减少、腹胀减轻、腹部隐痛消失时间均短于对照组,差异均有统计学意义（P<0.05）。临床疗效总有效率观察组96.36%,对照组72.73%,2组临床疗效总有效率比较,差异有统计学意义（P<0.05）。结论：柴胡桂枝干姜汤联合耳穴压豆治疗胃肠功能紊乱患者,相较于单纯使用奥美拉唑肠溶胶囊治疗,可明显缩短改善嗳气、腹胀、腹部隐痛的时间,提高临床疗效。     

1例肺移植的干燥综合征患者联用奈玛特韦/利托那韦与环孢素、他克莫司导致肾功能损伤

1例76岁右单肺移植的干燥综合征男性患者在新冠病毒感染后使用奈玛特韦/利托那韦治疗,导致合并使用的免疫抑制剂环孢素和他克莫司全血药物谷浓度升高,引起血肌酐升高,后通过停用环孢素、调整他克莫司剂量使他克莫司浓度维持在治疗浓度,血肌酐水平较前改善,患者好转出院。此病例可为临床安全用药实践提供参考。     

前列腺癌与增生性病变的流式细胞分析

应用流式细胞分析术（ＦＣＭ）对２０例前列腺癌（ＰＣ）和１５例良性前列腺组织作了ＤＮＡ含量检测，着重分析了ＰＣ及增生性病变的细胞增殖指数（ＰＩ）与ＤＮＡ指数（ＤＩ）。结果表明在良恶性前列腺组织中有明显差异（Ｐ＜０．０１）。２０例ＰＣ的组织学分级与ＦＣＭ检测结果有关，ＰＣ－Ⅲ与ＰＣ１－Ⅰ、ＰＣ－Ⅱ与ＰＣ－Ⅰ、ＰＣ－Ⅲ与ＢＰＨ的ＰＩ、ＤＩ相差显著（Ｐ＜０．０１）。本研究结果提示良恶性前列腺病变的ＰＩ与ＤＩ能较客观地反应不同细胞的生物活性，并对分化低、分级高的ＰＣ的恶性程度判断及其预后的推测，以及癌前病变的分析有意义。     

包裹天然骨架CpG ODN和HBsAg的非磷脂脂质体疫苗的免疫效果

非磷脂脂质体NovasomeR○(Np )是由Brij5 2、胆固醇和油酸组成 ,可作为同时传递佐剂和抗原的载体。我们将HBsAg与天然骨架CpGODN (phosphodiesterCpGODN ,pdCpGODN )包裹于Np后免疫BALB/c小鼠 ,检测其免疫效果。结果显示 ,包裹pdCpGODN和HBsAg的Np在小鼠中诱导了很高滴度的抗 HBs抗体产生并诱生了HBsAgS2 8 3 9特异性的CTL ,而铝佐剂组和仅包裹HBsAg的Np组诱生的抗体滴度较低 ,未检测到CTL活力。抗体亚类分析结果表明包裹pdCpGODN和HBsAg的Np诱生的免疫应答类型与pdCpGODN剂量有关 ,较低剂量 (2 4 μgpdCpGODN )诱生的为IgG2a为主的Th1型应答 ,而较高剂量(4 7μgpdCpGODN )诱生的是Th1/Th2混合型应答。铝佐剂和仅包裹HBsAg的Np组诱生的是以IgG1为主的Th2型应答。此外 ,包裹pdCpGODN和HBsAg的Np免疫小鼠脾淋巴细胞在体外HBsAg刺激培养后特异性增殖并分泌高水平的IFN γ。这些结果表明包裹pdCpGODN和HBsAg的Np能增强HBsAg的免疫原性 ,诱生体液 /细胞免疫均衡应答 ,有可能发展为慢性乙肝的治疗性疫苗     

GK型机械瓣空化可视化研究

对国产GK27型机械二尖瓣进行了单次关闭方式的离体空化实验，采用数码相机拍摄了空泡照片。机械瓣阻塞体关闭后，云状空泡出现在挡座周围，呈放射状向外运动，空化原因是机械瓣关闭时阻塞体与挡座的撞击形成的局部挤压射流，挤压缝隙出口射流速度高达9m/s，局部低压造成空化，在机理上，这是附壁射流引起的旋涡空化。关闭速度是衡量机械瓣空化趋势的重要指标之一。空化历时随心室载荷率的增加而增加，在载荷率为2750mmHg/s时，最大空化历时达440μs。机械瓣空化临界载荷率为420mmHg/s，这比动物实验所得的正常生理条件750mmHg/s低，因此在人体正常生理条件下，机械二尖瓣存在空化的可能。     

气功外气对人鼻咽癌细胞株的抑制作用和DNA合成影响的初步探讨

为寻找祖国医学治疗鼻咽癌的新途径,我们进行了气功外气对体外培养的人鼻咽低分化鳞癌细胞株(CNE—2)的抑制作用试验,实验共进行了三次,光镜观察受功组比对照组生长缓慢,外气对细胞生长的抑制率分别为33％(P<0.05);43％(P<0.05);55％(P<0.001)。同时进行了~3H—TdR掺入试验,观察外气对CNE—2细胞株DNA合成的影响。实验进行了四次,其抑制率分别为:34％(P<0.01);35％(P<0.01);39％(P<0.01),53％(P<0.001),模仿者为17％(P>0.05)。     

大肠癌“移行粘膜”病理变化研究——粘液组化、免疫组化及电镜观察

对200例大肠癌旁“移行粘膜”进行了粘液组化HID／AB及PAT／KOH／PAS检测,单克隆抗体MC3和CEA免疫组化标记,凝集素PNA、UEA－1及DBA受体测定,扫描电镜观察。其结果与10例正常直肠粘膜、130例癌组织、155例各型腺瘤型息肉及3－5个月胎儿大肠粘膜进行对照。结果表明大肠粘膜从良性到恶性的各阶段粘液组化及免疫组化的改变有显著差异（P＜0．05或P＜0．01）,癌旁“移行粘膜”也存在类似癌及胎儿大肠的不成熟性病理变化,异常范围88．0％的病例在2－3cm以内。     

心脏直视手术患儿补体4基因多态性对体外循环中补体激活程度的影响

目的：研究补体4基因多态性与体外循环中补体系统激活程度和肺功能障碍之间的关系。方法：选择武汉市及周边地区在体外循环（CPB）下进行心脏直视手术的患儿156例,于术前抽血用交叉免疫电泳法进行补体4基因型分析。分别于CPB开始前,CPB结束时以及鱼精蛋白中和肝素后10min抽取动脉血样,以放免法对补体3和4活化产物C3a和C4a进行测定。同时记录肺顺应性。结果：补体4基因型AABB,AOBB,OOBB,AABO及AAOO出现频率分别为51．28%,17.95%,4.49%,19.87%及6．41％,CPB结束时C4a水平无明显升高,C3a水平显著升高。鱼精蛋白中和肝素后10min时C4a和C3a水平显著升高,以OOBB组升高最显著,其次为AOBB组;同时OOBB组肺顺应性下降最显著,其次为AOBB组,结论：体外循环由替代途径激活补体系统,鱼精蛋白－肝素复合物由经典途径激活补体系统,国人补体4基因型中,OOBB型出现的频率较白种人高,该基因型在体外循环中补体系统被激活及肺功能受损程度最严重。     

Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma:experience at an institution in southern China

Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types -- colorectal mucinous,signet-ring cell, and non-mucinous adenocarcinoma, to clarity the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies.Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients (P <0.001). Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma (P <0.001). Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion (P <0.01). The rate of radical resection, hepatic metastasis and local recurrence did not differ among types (P ＞0.05). Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰor Ⅳ disease (P ＞0.05). Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior.Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.     

Early operation for fulminant acute pancreatitis: a possible way to decrease mortality

Background Although the indication and the timing for surgery in fulminant acute pancreatitis (FAP) are still controversial, our experience of surgical treatment for fulminant acute pancreaUtis may help improve the outcome for patients.Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1,2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association.Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% (11/26). The postoperative mortalities in the ＞72 hour operation group and the <72 hour operation group were highly significantly different (7/8 vs 22.2% (4/18), respectively).Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.