奈达铂联合5-Fu治疗中晚期宫颈癌32例

目的探讨奈达铂联合5-Fu治疗中晚期宫颈癌的疗效及毒副反应。方法经病理或细胞学确诊的68例中晚期宫颈癌随机分为两组,单纯放疗组36例,放化疗结合组32例,治疗后1月进行疗效及毒副作用评价。结果与单纯放疗组相比,放化疗结合组治疗有效率明显提高（P〈0.05）;两组治疗方案均存在不同程度的白细胞和血小板下降、消化道反应、静脉炎和脱发;其中以白细胞下降和消化道反应为主,发生率均超过50%;两组之间比较,各毒副反应发生率无明显差异（P〉0.05）。结论奈达铂联合5-Fu放疗治疗中晚期宫颈癌可提高近期疗效,不影响放疗进程,毒副反应无明显增加,值得临床推广使用。     

Toll样受体9基因启动子单核苷酸多态性与儿童变应性哮喘的相关性

目的 研究Toll样受体9(toll-like receptor 9,TLR9)基因启动子区单核苷酸多态性在浙江汉族儿童中的分布,探讨其与哮喘易感性及其表型之间的相关性.方法 对312例变应性哮喘患儿(哮喘组)和339名健康儿童(对照组)采用DNA直接测序法检测TLR9基因-1486(rs187084)和-1237(rs5743836)单核苷酸多态性;采用ELISA法检测两组不同基因型血清干扰素γ(interferon-γ,IFN-γ)、白细胞介素12(interleukin-12,IL-12)和白细胞介素4(interleukin-4,IL-4)水平;采用化学发光法检测血清总免疫球蛋白E(immunoglobulin E,IgE)水平;采用酶免疫荧光法检测血清变应原特异IgE.结果 (1)哮喘组和对照组均存在-1486位点T→C突变,哮喘组TT、TC和CC 3种基因型的频率分别是3 8.8%、48.4%和12.8%,对照组分别是41.0%、44.3%和14.7%;未发现-1237位点存在多态性.(2)哮喘组和对照组-1486位点各基因型的频率分布差异无统计学意义(P＞0.05),年龄分层后比较差异也无统计学意义(P＞0.05).(3)哮喘组-1486位点3种基因型的血清IFN-γ和IL-4水平差异有统计学意义(P＜0.01),CC基因型的IFN-γ水平较低而IL-4水平较高;对照组2种细胞因子的差异无统计学意义(P＞0.05).哮喘组和对照组血清IL-12水平在3种基因型间差异均无统计学意义(P＞0.05).(4)哮喘组-1486位点不同基因型血清总IgE水平差异无统计学意义(P＞0.05).结论 浙江汉族儿童不存在TLR9基因-1237位点多态性.TLR9基因-1486 C/T位点单核苷酸多态性与浙江汉族儿童哮喘易感性、血清IL-12及总IgE水平无关;-1486 C/T位点多态性与哮喘患儿血清IFN-γ和IL-4水平有关联,CC基因型的IFN-γ水平较低而IL-4水平较高.

Abstract：

Objective To investigate the distribution characteristics of the single nucleotide polymorphisms (SNPs) in the promoter region of the toll-like receptor 9 gene (TLR9)in Chinese Han children from Zhejiang province, and their associations with asthma susceptibility and phenotypes. Methods A case-control study was conducted. A total of 312 asthmatic children aged between 1.9 and 11.6 and 339 age matched healthy controls were enrolled in this study from April 2007 to November 2008. The -1486 C/T in rs187084 and -1237 C/T in rs5743836 loci of the TLR9 gene were genotyped by direct DNA sequencing of the PCR products. Serum levels of IFN-γ, IL-12 and IL-4 were detected by enzyme linked immunosorbent assay. Serum levels of total IgE were detected by chemiluminescence, and serum levels of ildren (P＜0.01). The CC genotype had the lowest levels of serum IFN-γand the highest levels of serum IL-4 among the three genotypes. There were no significant differences in these cytokines among the healthy controls (P＞0.05). No statistical differences of serum IL-12 were found among the three genotypes in the two groups (P＞0.05). (4) There were no significant differences of total IgE (log-transformed) among the three genotypes in the asthmatic children (P＞0. 05). Conclusion The -1237 C/T polymorphism of TLR9 gene was not detected in Chinese Han children in this study. The - 1486 C/T polymorphism was associated with the levels of serum IFN-γ and IL-4 in children with asthma.However, there were no correlations between the -1486C/T polymorphism and serum IL-12 levels, total IgE levels or asthmatic susceptibility.     

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目的探讨哮喘预测指数在婴幼儿喘息转归评估中的临床意义。方法选择2007年4月至2008年4月温州医学院附属育英儿童医院哮喘专科门诊就诊的婴幼儿喘息患儿129例,分为哮喘预测指数阳性组43例、哮喘预测指数阴性组86例,选择健康体检儿童69例为对照组,喘息缓解期测定潮气呼吸肺功能。比较各组每分通气量(MV),潮气量(VT/kg),呼吸频率(RR),吸气时间(TI),呼气时间(TE),吸呼比(TI/TE),达峰时间比(TPEF/TE),达峰容积比(VPEF/VE),潮气呼吸呼气峰流速(PTEF),25%、50%、75%潮气量时呼气流速(TEF25%,TEF50%,TEF75%)。67例随访到4岁,其中哮喘预测指数阳性组26例,哮喘预测指数阴性组23例和对照组18例,测定脉冲震荡肺功能。比较各组呼吸总阻抗(Z5)、肺弹性阻力(X5)、共振频率(Fres)、总气道阻力(R5)及中心气道阻力(R20)。结果哮喘预测指数阳性组TPEF/TE、VPEF/VE、TI/TE、TEF25%、TEF50%、TEF75%均比哮喘预测指数阴性组和对照组下降,TE升高(P<0.01);哮喘预测指数阴性组TPEF/TE、VPEF/VE比对照组下降(P<0.05)。随访患儿中,哮喘预测指数阳性组X5比哮喘预测指数阴性组和对照组下降,Fres升高(P<0.01);哮喘预测指数阳性组Z5比哮喘预测指数阴性组升高(P<0.05)。结论婴幼儿喘息患儿早期出现肺功能损害,哮喘预测指数阳性患儿损害持续存在,日后可发展为哮喘,应早期干预治疗。     

探讨瘢痕子宫再次妊娠经阴道分娩的影响因素

目的 研究瘢痕子宫再次足月妊娠经阴道分娩的影响因素。 方法 样本取自本院 2018 年 4 月至 2020 年 4 月间产科收治的 100 例瘢痕子宫再次足月妊娠产妇,根据“分娩结局”划分为甲组 ( 阴道分娩, n=70) 、乙组 ( 剖宫产, n=30) ,分析影响阴道分娩因素、观察分娩结局。 结果 阴道分娩的保护因素是孕期合理增重、距上次剖宫产时间延长,危险因素是抑郁情绪、新生儿体质量过重,P<0.05 。 结论 孕期合理增重、心理状态良好,把握距上次剖宫产术时间间隔利于提高阴道分娩成功率,值得借鉴。     

阿伦膦酸钠对骨质疏松症的疗效观察

目的观察阿伦膦酸钠治疗绝经后骨质疏松症的临床疗效。方法选取100例绝经后骨质疏松症患者应用阿伦膦酸钠治疗12个月,于治疗前后测定肝肾功能、ALP、骨钙素、尿NTX及腰椎、股骨颈、wards三角区骨密度。结果应用阿伦膦酸钠治疗12个月后患者骨密度较前升高（P〈0．01）,尿NTX及ALP（碱性磷酸酶）较治疗前降低（P〈0．05）。结论阿伦膦酸钠对绝经后骨质疏松症患者的治疗是有效的。     

参芪扶正加同步放化疗治疗局部晚期非小细胞肺癌的临床研究

目的观察参芪扶正注射液联合同步放化疗对局部晚期非小细胞肺癌的治疗效果。方法将67例局部晚期非小细胞肺癌患者随机分为两组,综合组36例,采用依托泊苷＋顺铂同步放化疗,放疗予常规分割,2Gy／f,总量56-70Gy,同时应用参芪扶正注射液250mL／d静脉滴入,2周为1个疗程,共2个疗程。对照组31例,采用依托泊苷＋顺铂同步放化疗。放疗结束后1个月评价疗效;分别于治疗前,治疗后1天,治疗后1月抽取患者外周血,采用流式细胞术检测患者外周血中T细胞亚群百分率（CD3＋;CD4＋、CD8＋、CD4＋／CDs＋）及NK细胞含量变化观察免疫功能变化;通过KPS评分,体重变化来观察生存质量改善情况。结果2组有效率分别为75％和70．9％（P〉0．05）;2组治疗前免疫功能差异无统计学差异（P〉0．05）,与本组治疗前相比,综合组治疗后一天测免疫功能稍下降（P〉0．05）而对照组明显下降（P〈0．01）,综合组治疗后一月明显改善（P〈0．05）对照组有改善（P〉0．05）;综合组3～4级I血液学毒性的发生率为13．9％明显低于对照组的355％（P〈0．05）,综合组3～4级消化道不良反应以及≥2级放射性食管炎、肺炎发生率均低于对照组（P〉0．05）;综合组治疗后KPS评分及体重评分改善人数明显高于对照组（P〈0．05）。结论参芪扶正注射液联合同步放化疗可以减轻放化疗引起的胃肠道反应,减少3～4级骨髓抑制和≥2级放射性食管炎、肺炎的发生,使患者的免疫功能、生存质量得到改善,并有可能进一步提高局部晚期非小细胞肺癌同步放化疗的疗效。     

微波热疗联合放射治疗在颈部淋巴结转移癌的应用

 目的　探讨微波热疗联合放射治疗对颈部淋巴结转移癌局部控制的临床应用价值。方法　2004年10月至2007年10月收治的62例颈部淋巴结转移癌（N1～N4）患者随机分为两组,对照组行单纯常规放疗,局部总剂量DT 60～70 Gy／6～7周;联合组除常规放疗外同时配合微波热疗每周3次,温度控制在（42±1）℃,每次30～40 min。结果　联合组在起效时间上明显短于对照组,差异有统计学意义（P＜0.01）;联合组有效率明显高于对照组,差异有统计学意义（P＜0.05）。结论　微波热疗对放疗有协同增敏作用,二者配合对颈部淋巴结转移癌的治疗可明显提高局控率,减少局部放疗剂量,值得临床推广使用。     

同期放化疗治疗食管鳞癌的近期疗效及安全性分析

目的:探讨对食管鳞状细胞癌(鳞癌)患者进行同期放化疗的近期疗效及安全性.方法:选取连云港市第二人民医院肿瘤科收治的90例食管鳞癌患者作为研究对象.随机将其分为对照组和观察组.对对照组患者进行单纯放疗,对观察组患者进行同期放化疗,然后比较两组患者的近期疗效、不良反应的发生率、1年内的总生存率及无进展生存率.结果:观察组患...     

慢性间歇性低氧对幼鼠脑区AMPK通路的影响

目的:探讨慢性间歇性低氧对幼鼠脑区腺苷酸活化蛋白激酶(AMP-activated protein kinase,AMPK)通路的影响。方法:第一部分:将3~4周龄的SD幼鼠随机分为4组(n=8):2周空气模拟对照(2AC)组、2周慢性间歇低氧(2IH)组、4周空气模拟对照(4AC)组和4周慢性间歇低氧(4IH)组。第二部分:将3~4周龄的SD幼鼠随机分为2组(n=8):4周慢性间歇性低氧组(4IH)和4周慢性间歇性低氧用药组(4IHI)。造模结束后行八臂迷宫测试,TUNEL法检测细胞凋亡,RT-qPCR法了解腺苷A2a受体的mRNA表达,Western blot法测定AMPK及哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)的磷酸化水平。结果:与对照组相比,2IH组和4IH组的参考记忆错误(RME)、工作记忆错误(WME)和总错误(TE)次数明显增加,差异有统计学显著性(P0.01);4IH与2IH组比较,各项错误次数亦明显增加(P0.01)。4IHI组比4IH组RME、WME和TE次数减少,差异有统计学显著性(P0.01)。与对照组相比,2IH组和4IH组海马和前额皮层区的神经元凋亡增多,以4IH组凋亡明显(P0.05);4IHI组凋亡较4IH组减少(P0.05)。2IH组和4IH组海马和前额皮层区腺苷受体A2a的mRNA和AMPK磷酸化蛋白的水平升高,mTOR磷酸化蛋白的水平下降,4IH组较2IH组改变明显(P0.05)。4IHI组较4IH组海马和前额皮层区的AMPK磷酸化蛋白水平下降,mTOR磷酸化蛋白水平升高(P0.05)。结论:慢性间歇性低氧诱导神经元凋亡,从而引起幼鼠学习记忆障碍,呈时间依赖性。慢性间歇性低氧上调腺苷A2a受体,激活海马和前额皮层区AMPK,抑制mTOR的活性,诱导神经元凋亡,进而影响幼鼠学习记忆能力。     

Toll样受体9基因启动子单核苷酸多态性与儿童变应性哮喘的相关性

Objective To investigate the distribution characteristics of the single nucleotide polymorphisms (SNPs) in the promoter region of the toll-like receptor 9 gene (TLR9)in Chinese Han children from Zhejiang province, and their associations with asthma susceptibility and phenotypes. Methods A case-control study was conducted. A total of 312 asthmatic children aged between 1.9 and 11.6 and 339 age matched healthy controls were enrolled in this study from April 2007 to November 2008. The -1486 C/T in rs187084 and -1237 C/T in rs5743836 loci of the TLR9 gene were genotyped by direct DNA sequencing of the PCR products. Serum levels of IFN-γ, IL-12 and IL-4 were detected by enzyme linked immunosorbent assay. Serum levels of total IgE were detected by chemiluminescence, and serum levels of ildren (P＜0.01). The CC genotype had the lowest levels of serum IFN-γand the highest levels of serum IL-4 among the three genotypes. There were no significant differences in these cytokines among the healthy controls (P＞0.05). No statistical differences of serum IL-12 were found among the three genotypes in the two groups (P＞0.05). (4) There were no significant differences of total IgE (log-transformed) among the three genotypes in the asthmatic children (P＞0. 05). Conclusion The -1237 C/T polymorphism of TLR9 gene was not detected in Chinese Han children in this study. The - 1486 C/T polymorphism was associated with the levels of serum IFN-γ and IL-4 in children with asthma.However, there were no correlations between the -1486C/T polymorphism and serum IL-12 levels, total IgE levels or asthmatic susceptibility.