参附注射液治疗肝硬化腹水脾肾阳虚证患者疗效观察

目的:探讨参附注射液对于肝硬化腹水脾肾阳虚证患者的治疗作用。方法:84例肝硬化腹水脾肾阳虚证患者随机分为治疗组和对照组,治疗组采用常规西医治疗加参附注射液治疗,对照组只采用常规西医治疗,共治疗28d。结果:治疗组在综合疗效、腹水消退时间、肝功能及血常规各指标改善情况均优于对照组,差异有统计学意义(P<0.05)。结论:参附注射液对肝硬化腹水脾肾阳虚证患者有一定治疗作用。     

从莪术 虎杖两味中药探讨寒热药性对大鼠大脑不同部位单胺类神经递质的影响

目的:从中枢单胺类神经递质的含量差异探讨中药寒热药性的科学内涵。方法:将莪术、虎杖两味药性相反的中药给大鼠灌胃给药1个月后,用HPLC-ECD(高效液相色谱-电化学)法检测大鼠大脑不同部位单胺类神经递质的含量。结果:温热药莪术明显促进大鼠大脑不同部位单胺类神经递质的分泌,与空白组相比有统计学差异(P0.05,P0.01);寒凉药虎杖明显抑制大鼠大脑不同部位单胺类神经递质的分泌,与空白组相比有统计学差异(P0.05,P0.01)。结论:中药的寒热药性与中枢单胺类神经递质存在一定的相关性。     

晚期鼻咽癌放疗联合辅助性化疗的临床研究

目的 分析评价晚期（N2,N3期）鼻咽癌放疗加辅助化疗的疗效.方法 86例N2,N3期鼻咽癌患者随机分为放化组（A组,46例）和单放组（B组,40例）,均首先接受根治性放疗,其后放化组46例接受辅助化疗（LV＋5Fu＋DDP）3～4个疗程.结果 放化组5年生存率43.5%,单放组37.5%（P＞0.05）;放化组远处转移发生率19.6%,单放组45%（P＜0.05）;放化组远处转移发生时间平均放疗后18.3个月,单放组7.8个月;放疗后达到CR的放化组与单放组的5年生存率为42.9%、56.5%（P＞0.05）,非CR的放化组与单放组的5年生存率为44.4%、11.8%（P＜0.05）.结论 放疗加辅助性化疗N2,N3期鼻咽癌有助于延缓远处转移发生时间,减少远处转移;对于根治性放疗后未达CR者,辅助化疗能提高生存率.     

EGFR mutation types and abundance were associated with the overall survival of advanced lung adenocarcinoma patients receiving first-line tyrosine kinase inhibitors

BackgroundEpidermal growth factor receptor tyrosine kinases inhibitors (EGFR-TKIs) are currently recognized as the standard treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. Clinically found patients with different EGFR mutational status have different prognosis.MethodsA retrospective cohort study was performed to explore the relationship between EGFR mutations and abundance with patient survival by using patient data from the Affiliated Cancer Hospital of Zhengzhou University between January 2013 and November 2016. All patients involved in the present study had sensitive EGFR mutations [either exon 19 deletion (DEL) or exon 21 L858R] and treated by EGFR-TKIs. They were followed up every three months until lost or dead. Mutation abundance was calculated as the copies of EGFR mutation divided by copies of EGFR locus, and the cut-off values for 19DEL and L858R were 4.9% and 9.5%, respectively.ResultsTotal of 236 patients were included, comprising 116 (49.2%) patients with 19DEL mutation and 120 (50.8%) patients with L858R mutation. The median follow-up duration was 23.2 months (95% CI: 14.9–26.7 months). Overall survival (OS) was significantly longer in patients with 19DEL mutation (20.9 months, 95% CI: 17.7–24.1 months versus 17.0 months, 95% CI: 14.4–19.6 months in patients with L858R; P=0.008) and in patients with high mutation abundance (20.9 months, 95% CI: 18.3–23.5 months versus 13.0 months, 95% CI: 10.3–15.7 months in patients with low mutation abundance; P<0.001). Multivariate Cox regression including age, performance status and tumor stage revealed that longer OS was independently associated with 19DEL mutation (HR: 0.48, 95% CI: 0.39–0.67, P=0.033) and high mutation abundance (HR: 0.62, 95% CI: 0.50–0.79, P=0.027).ConclusionsEGFR mutation types and abundance was associated with the patients’ survival which might be used to predict the efficacy of targeted therapy by EGFR-TKIs.     

吗啡缓释片与羟考酮缓释片在中重度癌性疼痛中的应用效果

目的 探讨吗啡缓释片与羟考酮缓释片在中重度癌性疼痛中的应用效果。方法 选取2019年4月至2021年2月大连大学附属中山医院收治的100例中重度癌性疼痛患者作为研究对象,用随机数字表法将其分为对照组和观察组,各50例。对照组接受吗啡缓释片治疗,观察组接受羟考酮缓释片治疗,比较两组患者镇痛有效率、疼痛控制见效时间、不良反应等。结果 两组患者治疗前数字评价量表（NRS）评分的比较,差异无统计学意义（P>0.05）;治疗后,观察组NRS评分低于对照组,差异有统计学意义（P<0.05）。观察组药效见效时间短于对照组,差异有统计学意义（P<0.05）。观察组不良反应发生率8%低于对照组32%,差异有统计学意义（P<0.05）。结论 在治疗中重度癌性疼痛中,吗啡缓释片与羟考酮缓释片两者的效果基本相当,但羟考酮缓释片见效速度更快,不良反应少,临床可根据实际状况选择给药。     

电致孔条件下巴布剂中青藤碱透皮吸收的药动学研究

目的:将巴布剂结合电致孔透皮给药,与被动扩散透皮给药进行比较,初步考察在电致孔条件下巴布剂中青藤碱透皮吸收的药动学特点.方法:以青风藤为模型药物,以活体兔分别进行被动扩散给药(PD)和电致孔透皮给药(EP),高效液相色谱仪测定不同时间的血药浓度,采用统计矩分析法处理分析血药浓度数据.结果:电致孔技术透皮给药的AUC0→∞为43.396,是被动扩散的1.32倍,体内平均滞留时间为20.025,是被动扩散的86%,cmax为1.825,是被动扩散的1.31倍, tmax减小,比被动扩散提前4 h;消除速率常数λ二者一致;电致孔技术透皮给药的药-时曲线比被动扩散的药-时曲线平滑且下降较慢.结论: 将电致孔技术与巴布剂结合能够提高药物透皮吸收的速度和程度,从而提高生物利用度.     

A Novel Model of Ultrasonic Fatigue Test in Pure Bending

The very high cycle fatigue (VHCF) failure of in-service components is mainly caused by the vibration of thin-wall elements at a high frequency. In this work, a novel model of ultrasonic fatigue test was developed to test thin-wall material in bending up to VHCF with an accelerated frequency. The theoretical principle and finite element analysis were introduced for designing a sample that resonated at the frequency of 20 kHz in flexural vibration. In the advantage of the second-order flexural vibration, the gauge section of the sample was in the pure bending condition which prevented the intricate stress condition for thin-wall material as in the root of cantilever or the contact point of three points bending. Moreover, combining the constraint and the loading contact in one small section significantly reduced heating that originated from the friction at an ultrasonic frequency. Both strain gauge and deflection angle methods were applied to verify the controlling of stress amplitude. The fractography observation on Ti6Al4V samples indicated that the characterized fracture obtained from the novel model was the same as that from the conventional bending test.     

木犀草素促进囊性纤维化跨膜电导调节因子氯离子通道开放

目的：研究木犀草素对依赖于3，5-环腺苷酸（cAMP）的囊性纤维化跨膜电导调节因子（CFTR）Cl^-通道的激活作用。方法：利用稳定共表达人CFTR与一种对卤族元素敏感的荧光绿蛋白突变体（EYFP-H148Q）的Fischer大鼠甲状腺（FRT）细胞模型，测定木犀草素对CFTR介导的I^-内流速度。结果：木犀草素能够以剂量依赖的方式激活CFTR的I^-转运，其对CFTR Cl^-通道的激活效应具有作用迅速、可逆的特点。木犀草素在发挥激活作用时依赖于腺苷环化酶激动剂Forskolin的存在，其单独与细胞孵育不提高细胞内cAMP的水平。结论：发现了木犀草素能够以剂量依赖方式激活CFTR，并且初步确定了木犀草素通过直接与CFTR结合发挥作用。     

FISH法对肺腺癌穿刺标本EML4-ALK融合基因的检测

目的 探讨采用肺腺癌穿刺活检标本检测棘皮动物微管相关类蛋白4(EML4)与间变性淋巴瘤激酶(ALK)融合基因(EML4-ALK)的可行性.方法 对20例肺腺癌经皮肺穿刺标本应用荧光原位杂交(FISH)法检测EML4-ALK融合基因.结果 20例标本中,19例通过FISH检测成功,检测成功率为95.00％.其中阳性2例,阳性率为10.00％.结论 肺腺癌穿刺活检标本可用作检测EML4-ALK融合基因,为靶向治疗提供参考依据.