选择不同黏膜下注射液行内镜黏膜下剥离术的临床研究

内镜黏膜下剥离术（ESD）可完整大块地切除病变,提供完整的病理诊断资料,实现根治肿瘤的效果,但ESD手术操作时问长、技术难度高,出血及穿孔并发症发生率高。黏膜下注射液的停留时间长有助于减少并发症的发生,提高手术成功率,Fujishiro等在动物实验及临床研究中应用透明质酸、甘油果糖混合液黏膜下注射,证实其具有保持较好黏膜下液体垫和良好的安全性等优点,推荐其作为ESD优选的黏膜下注射液。     

分泌性中耳炎患者中耳积液中HP感染情况及积液细胞中COX-2的表达变化

目的观察分泌性中耳炎患者中耳积液中幽门螺杆菌（HP）感染情况及积液细胞中环氧合酶-2（COX-2）的表达。方法采集54例手术治疗的慢性分泌性中耳炎患者的中耳积液,采用快速尿素酶方法检测HP感染情况,采用免疫组化法检测患者中耳积液细胞中的COX-2。结果本组37例HP呈阳性,43例COX-2表达阳性。结论慢性分泌性中耳炎患者中耳积液存在幽门螺杆菌感染,积液细胞中COX-2阳性表达率高。     

The correlation between chemotherapeutic efficacy and breast cancer susceptibility gene 1 and class Ⅲ β-tubulin protein expression in non-small cell lung cancer patients

Objective To investigate the predictive value of breast cancer susceptibility gene 1 (BRCA1) and class Ⅲβ-tubulin protein expression in tumor tissue for the efficacy of taxol and cisplatin combined chemotherapy (TP) in stage Ⅲβ/Ⅳ non-small cell lung cancer(NSCLC) patients. Methods A total of 92 stage Ⅲβ/Ⅳ NSCLC patients were recruited with 87 patients evaluated. Bronchoscopy or lung puncture tumor biopsy samples were obtained with BRCA1 and class Ⅲβ-tubulin protein expression examined immunohistochemically before chemotherapy. The patients were randomly assigned to be received 4 to 6 cycles of TP chemotherapy regiments and followed up until death or lost. Response rate (RR) , overall survival (OS) and time to tumor progression (TTP) were assessed. Results Among the 87 evaluated patients, the positive expression rates of BRCA1 and class Ⅲβ-tubulin were 57. 5% (50/87) and 48. 3%(42/87) respectively. There was no significant difference in clinical characteristics among patients with different positive expression rate. According to different expression of BRCA1 and class Ⅲβ-tubulin, the patients were divided into four groups: group A (low expression of both BRCA1 and class 1 p-tubulin) ,group B (high expression of both BRCA1 and class Ⅲβ-tubulin) , group C (high expression of only BRCA1) and group D (high expression of only class Ⅲβ-tubulin). The RR was higher in group A than other three groups (60. 7% , 34. 8% , 9/19 and 6/17 respectively). The OS and TTP were longer in group A than other three groups [OS: (539. 4 ± 17. 6) days, (267. 2 ± 20. 5) days, (325. 6 ± 24. 1) days and (283.7±26.2) days respectively ; TTP: (256. 9 ± 28. 4) days, (143.8±17.6) days, (179. 3 ± 19. 8)days and (152. 6 ±23. 5) days respectively]. There were no significant differences among the other three groups. Conclusions The expression level of BRCA1 and class Ⅲβ-tubulin in tumor tissue is probably a predictor for the efficacy of TP chemotherapy in NSCLC patients. TP chemotherapy is more suitable for the NSCLC patients with lower expression of both BRCA1 and class Ⅲβ-tubulin. Our study may provide a new sight for tailored chemotherapy in NSCLC patients.     

胆管舒胶囊治疗肝内胆管炎疗效观察

目前,对于肝内胆管炎主要以超声诊断为主,但临床往往忽视肝脏超声这一表现,仅针对高热、咽部充血等症状而采用大量抗生素、激素等相关药物联合静脉或口服给药。虽然患者临床症状可缓解,但肝内胆管炎性表现吸收较缓慢,患行临床症状常反复出现。2005年9月－2010年9月,笔者采用中药胆管舒胶囊治疗肝内胆管炎97例,结果显示肝内胆管炎症吸收较快,临床症状改善持久,且无明显不良反应。现总结报道如下。     

某地区104例皮炎湿疹类皮肤病患者斑贴试验结果分析

目的检测和分析苏州地区皮炎湿疹类皮肤病接触变应原。方法采用瑞典进口"瑞敏牌"斑贴试验试剂盒对患者做斑贴试验,并对试验结果、与发病部位及职业等相关因素进行分析。结果 104例皮炎湿疹患者中有59例出现一种或一种以上阳性反应,阳性率为56.73%;变应原阳性率最高的是硫酸镍;手部皮炎湿疹的阳性率最高,达71.43%,以硫酸镍和芳香混合物阳性率最高,其次为泛发全身的(53.33%),以硫酸镍阳性率最高;教师和厨师的阳性率最高。结论斑贴试验可以明确皮炎湿疹类皮肤病患者的接触性致敏原,有助于该类疾病的诊断、治疗以及预防。     

Elf-1和Survivin在前列腺癌中的表达及意义

目的观察Elf-1和Survivin蛋白在前列腺癌组织中的表达,探讨Elf-1和Survivin与前列腺癌的相关性。方法应用免疫组织化学方法检测48例前列腺癌组织和20例前列腺增生组织Elf-1和Survivin蛋白的表达。结果前列腺癌组织中Elf-1和Survivin蛋白的阳性表达率分别为72．92％（35／48）和79．17％（38／48）,前列腺增生组织中Elf-1和Survivin蛋白的阳性表达率分别为5％（1／20）和0（0／20）,Elf-1和Survivin蛋白阳性表达率在前列腺癌组织和前列腺增生组织中差异具有统计学意义（P〈O．01）,Elf-1和Survivin蛋白表达与前列腺癌病理分级、临床分期和骨转移情况具有相关性,前列腺癌Elf-1和Survivin的表达呈正相关（P〈0．01）。结论Elf-1和Survivin表达异常在前列腺癌发生发展中具有重要作用,检测Elf-1和Survivin的表达对判断前列腺癌的预后具有重要意义。     

草果挥发油成分的气相色谱-质谱联用分析

目的用气相色谱-质谱(GC-MS)法鉴定云南产草果果实中挥发油的化学成分。方法采用水蒸气蒸馏法对草果果实挥发性成分进行提取,运用GC-MS法对其进行分析鉴定,归一法确定各成分的相对百分含量。气相色谱用HP-5MS毛细管柱(0.25 mm×0.25μm,30 m),进样口温度为250℃;柱温为40℃(保持2 min)至150℃(保持2 min),升温速度为10℃/min,150℃至250℃(保持5 min),升温速度为15℃/min;分流比为10∶1;流速为1.0 mL/min。结果鉴定了33个化合物,主要的成分有桉油精(14.58%),3,7-二甲基-2,6-辛二烯醛(6.66%),α,α,4-三甲基-3-环己烯1-甲醇(8.49%),α-蒎烯(5.65%),β-蒎烯(4.54%)等。结论该方法分离效果良好,可用于草果药材的质量评价。     

白芍多糖水提工艺优化的初步研究

目的:对白芍中白芍多糖的水提取工艺进行优化.方法:以白芍多糖的得率为最终指标,采用正交试验法优选提取条件,系统考察粉碎度、溶剂量、提取时间、乙醇沉淀对白芍多糖得率的影响.结果:在白芍粉末为40目,用水量为0.5L,时间为3h的条件下,白芍多糖的得率最高.结论:影响白芍中白芍多糖得率的显著因素顺序为:粉碎度＞时间＞用水量.     

上位颈椎前路手术咽后入路“窗口”显露技术的临床应用观察

目的：探讨上颈椎前路减压经咽后入路＂窗口＂显露技术在上颈椎损伤手术中的应用。方法：2000年1月至2008年7月手术治疗上位颈椎损伤患者5例,男4例,女1例;年龄16～68岁,平均35岁。C2椎弓骨折（HangmanⅡ型）2例,C2,3椎间盘突出症2例,C2椎体结核1例。所有患者经高位前方咽后入路舌下神经、喉上神经、咽和颈动脉之间的＂窗口＂成功获得显露。Hangman骨折复位后行C2,3椎间盘切除椎间植骨融合内固定。C2,3椎间盘突出症患者行相应椎间盘切除,减压植骨融合内固定。C2椎体结核行病灶清除并植骨等。结果：5例患者均成功在舌下神经、喉上神经、咽和颈动脉之间的＂窗口＂显露出C1前弓-C3椎体。随访5～26个月,平均13.5个月。无伤口感染,无颈部重要血管神经损伤。患者的神经症状恢复良好,所有患者植骨都获得了融合。结论：前方咽后入路的＂窗口＂显露技巧可使上颈椎获得理想的显露,创伤小,切口并发症少,有相关经验后也比较安全。