消瘤止痛巴布剂中苦参碱的体外透皮吸收实验

目的测定消瘤止痛巴布剂和消瘤止痛软膏中苦参碱的体外经皮渗透性.方法采用高效液相色谱法和Franz扩展池法以小鼠皮为透过屏障进行观察.结果消瘤止痛巴布剂中苦参碱能透过小鼠皮.结论且巴布剂优于软膏剂(P＜0.05).     

高效液相色谱法测定当归补血汤分煎液与合煎液中阿魏酸含量

目的；比较当归补血汤（当归，黄芪）分煎液与合煎液中阿魏酸含量。方法：采用HypersilC18，以甲醇-0.05%乙酸（45：55）为流动相，在324nm波长处测定。结果：分煎液阿魏液平均回收率为100.86%,RSD=2.33%。合煎液阿魏酸平均回收率为101.37%,RSD=1.52%。结论：合煎液中阿魏酸含量高于分煎液。     

苦参碱通过抑制microRNA-192调控顺铂耐受肺腺癌A549细胞对顺铂的敏感性

目的探讨苦参碱通过调控microRNA影响顺铂耐受A549(A549/DDP)细胞对顺铂的敏感性。方法采用生物信息学手段对GEO数据库中的相关microRNA芯片数据(访问编号GSE43249)进行数据挖掘,筛选出与A549细胞顺铂敏感性相关的microRNA。体外培养对顺铂敏感的A549细胞及A549/DDP,使用实时荧光定量PCR(qRT-PCR)法在体外培养的细胞中验证生物信息学的结果,并考察苦参碱对A549/DDP细胞中microRNA水平的影响。通过转染micro RNA-192(mi R-192)模拟序列上调A549/DDP细胞的mi R-192水平。CCK-8细胞活力实验考察苦参碱处理及(或)mi R-192上调对A549/DDP细胞顺铂敏感性的影响。结果芯片数据挖掘显示与顺铂敏感的A549细胞相比,A549/DDP细胞中共有11个microRNA存在显著变化(P0.05),其中mi R-192及mi R-194变化在体外培养的细胞中得到了验证。与未经处理的A549/DDP细胞相比,苦参碱处理后的A549/DDP细胞中mi R-192水平显著降低(P0.05)。苦参碱处理可以增加A549/DDP细胞对顺铂的敏感性,miR-192的上调可以消除这种效果。上调miR-192水平可诱导A549细胞的顺铂耐受。结论苦参碱可能通过抑制mi R-192调控A549对顺铂的敏感性。     

青刺果多糖的提取及含量测定

目的 研究青刺果多糖的提取工艺并测定多糖的含量.方法 采用正交实验,进行水提醇沉法的优选;以葡萄糖标准液绘制标准曲线,用苯酚-硫酸,紫外分光光度法于490 nm波长处测定青刺果多糖的含量.结果 多糖的最佳提取条件为100℃.料液比为1:20,提取时间8 h,乙醇终浓度为85%.测定青刺果多糖含量最高达36.44%.结论 最佳提取条件得率高,测定方法准确,对青刺果多糖含量的测定获得较满意结果.     

不同切口方法对超声导引下改良塞丁格技术PICC置管后减少渗液的效果观察

目的 探讨不同切口方法对超声导引下改良塞丁格技术(MST)行经外周中心静脉置管(PICC)后减少穿刺点渗液的效果观察.方法 将680例需行PICC置管患者根据切口方法的不同随机分为纵切口组(342例)和横切口组(338例).比较2组患者置管后渗液发生率及渗液量的发生情况.结果 纵切口组患者渗液发生率及渗液量低于横切口组,差异均有统计学意义(P均＜0.05).结论 超声导引下MST行PICC穿刺时采用纵向切口法,可有效降低置管后渗液发生率,减少穿刺部位的渗液量,提高患者满意度.     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

关节镜下肌腱固定和切除术在肱二头肌长头腱病变治疗中的应用进展

肱二头肌长头肌腱（10ngheadofbicepsbrachiiIelq（10n,LHBT）损伤主要起因于年轻患者急性创伤和老年患者的退行性病变,以后者为主,典型患者以往有肩关节过度活动史,尤其是肩外展动作。二头肌腱腱鞘是盂肱关节滑膜的延续并且与肩袖紧密相连,LHBT损伤常可引起周围相关结构的病变,例如肩袖损伤、肩峰下碰撞、上盂唇前后病变等,后者可继发加重LHBT病变,引起肩前区永久性疼痛、肩关节功能障碍口。患者专科检查时在结节问沟通常伴有明显压痛,疼痛在患侧臂外展伸直时加重。LBHT损伤的诊断除依赖病史和体格检查外,辅助检查尤为重要,包括x线片、核磁、超声等。x线片仅在晚期出现肌腱伴有钙化或盂肱间隙明显减少等时才有一定价值;国外有报道超声诊断LBHT损伤的敏感性达88％,特异性98％,对于肌腱全层撕裂、部分撕裂、肌腱等病变尤其敏感。MRI诊断价值一般,     

替吉奥单药治疗老年晚期乳腺癌的临床疗效与安全性

目的 观察替吉奥单药治疗老年晚期乳腺癌的疗效与安全性。方法 回顾性分析老年晚期乳腺癌患者65例,研究组32例(S组)：替吉奥 40～60 mg(＜1.25 m²,40 mg; 1.25～1．5 m²,50 mg;＞1.5 m²,60 mg),于早、晚饭后口服,连服14天,21天重复。对照组33例（X组）：卡培他滨每日2000 mg/m²,分2次,连服14天,21天重复,至少2周期后评价疗效。结果 65例患者均可评价疗效, S组、X组有效率（RR）分别为31.3％(10/32)、27.3％(9/33),疾病控制率（DCR）分别为78.1％（25/32）、69.7％(23/33）,中位疾病进展时间（TTP）分别为7.5、7.0月,中位总生存时间（OS）分别为17.3、15.2月,两组比较差异无统计学意义（P＞0.05）。研究组与对照组常见的不良反应为骨髓抑制、胃肠道反应、口角炎、乏力,多见Ⅰ～Ⅱ度,可耐受,两组差异无统计学意义;对照组手足综合征明显高于研究组,差异有统计学意义（P=0.000）。 结论 替吉奥单药治疗老年乳腺癌疗效肯定,耐受性好于卡培他滨,值得临床进一步研究、推广。     

中晚期宫颈癌顺铂加一体化后装腔内放疗的临床观察

目的:探讨顺铂加一体化后装腔内放疗在中晚期宫颈癌治疗中的临床应用价值.方法:将126例中晚期宫颈癌患者随机分为顺铂加一体化后装治疗组(A组64例)和一体化后装治疗组(B组62例).A组于后装治疗的前4～6 h给予顺铂30 mg/m2,静脉滴入,两组后装与体外放疗方案相同,观察两组患者的治疗效果及不良反应.结果:A组和B组的近期有效率均为100%,其中CR率分别为96.88%和95.16%.A组和B组1、2和3年累积生存率分别为100 0A、97.30%、92.43%和100%、93.89%、74.41%,A组3年累积生存率与B组比较差异有统计学意义,X2=1.56,P<0.05.A组和B组的局部复发率分别为4.69%和16.13%,差异有统计学意义,P=0.035;远处转移率分别为3.13%和14.52%,两组比较差异有统计学意义,P=0.024.对两组患者的毒副反应进行比较,上消化道反应与白细胞下降A组与B组,差异无统计学意义,P>0.05.结论:顺铂加一体化后装治疗中晚期宫颈癌有较好的临床疗效,可降低局部复发率和远处转移率,提高3年累积生存率,毒副反应可耐受.     

良恶性胸腔积液的鉴别诊断

胸腔积液是一个常见的临床表现,其良恶性的判断治疗和与预后密切相关.许多方法和指标都曾尝试用于恶性胸腔积液的诊断,各有利弊.随着分子生物学和实验技术的迅速发展,新的诊断指标和检测方法不断涌现.本文综述了近年来相关的临床研究结果,对各种诊断方法进行了客观评价.