大剂量甲氨蝶呤静脉给药时间对淋巴瘤患者脑脊液中药物浓度的影响

背景与目的:甲氨蝶呤(methotrexate,MTX)在脑脊液中高于最小有效治疗浓度是治疗中枢淋巴瘤的必要条件,目前尚不明确大剂量MTX(high doseMTX,HD-MTX)静脉给药时间对MTX穿透血脑屏障的影响.本研究探索HD-MTX静脉不同给药时间对脑脊液中MTX浓度的影响,以获得更好的中枢淋巴瘤防治效果并尽可能减少MTX外周毒性.方法:34例非霍奇金淋巴瘤患者分别接受MTX 1～3g/m2 6 h持续静脉给药或24 h持续静脉给药,其中17例交替使用两种给药方法;采用高效液相色谱法检测MTX停药0 h、24 h、48 h的MTX血清浓度,及停药0 h后脑脊液中MTX浓度;比较两组血中和脑脊液中MTX浓度以及毒性反应,并对影响MTX浓度的因素进行相关分析.结果:给药结束时6 h给药组的MTX血清浓度显著高于24 h给药组:自身对照结果6 h给药组的脑脊液中MTX浓度为0.70 Ixmol/L,明显高于24 h给药组的0.49 Ixmol/L(校正值,P=0.044).MTX的脑脊液浓度与血清浓度呈正相关,中枢侵犯患者脑脊液MTX浓度显著高于无中枢侵犯的患者.自身对照结果6 h组和24 h组Ⅱ～Ⅳ度粘膜炎的发生率分别15.4%和37.8%.Ⅲ～Ⅳ度骨髓抑制的发生率分别为46.2%和67.6%.结论:在提高MTX的中枢浓度和降低外周毒性方面,HD-MTX 6 h给药方案优于24 h给药方案.     

Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

ObjectiveTo compare the results and 5- and 8-year overall survival (OS) and disease-free survival (DFS) of hand-assisted laparoscopic surgery (HALS) and laparoscopic-assisted surgery (LAS) in radical gastrectomy for advanced distal gastric cancer.MethodsA total of 124 patients admitted to our institution from May 2009 to April 2013 were randomly divided into a HALS group (n = 62) and a LAS group (n = 62). Postoperatively, 110 patients were followed for 5 and 8 years, and 14 patients were lost to follow-up. The 5- and 8-year OS and DFS rates of the groups were compared and analyzed.ResultsThe 5- and 8-year OS rates, respectively, were 38.8% and 19.4% in the HALS group and 38.3% and 15.3% in the LAS group (log-rank test, χ² = 0.250). The 5- and 8-year DFS rates, respectively, were 23.1% and 10.6% in the HALS group and 19.3% and 11.6% in the LAS group (log-rank test, χ² = 0.109). No significant differences were found.ConclusionCompared with LAS, HALS radical gastrectomy for advanced distal gastric cancer had a lower conversion rate to open surgery, shorter surgical duration, and more thorough dissection of lymph nodes; 5- and 8-year OS and DFS rates were similar to those with LAS.     

First-Principles Study on the Adsorption Behavior of O2 on the Surface of Plutonium Gallium System

To deeply understand the adsorption process of oxygen on the surface of a plutonium gallium system and to reveal the chemical reaction mechanism at the initial stage of oxidative corrosion on the surface of plutonium gallium alloy at a theoretical level, the adsorption behavior of oxygen molecules on the surface of a plutonium gallium system was investigated by a first-principles approach based on density flooding theory. The results show that the molecular bond length increases and finally breaks when the surface oxygen molecule is adsorbed on the surface of plutonium gallium system and dissociates into two atomic states. The most likely adsorption position of oxygen molecules on the surface of plutonium gallium system is hole-site vertical adsorption with the adsorption energy size of 10.7 eV. The bonding between oxygen atom and surface is mainly due to the overlapping hybridization of Pu-6s, Pu-7s, Pu-6d, Ga-3d and O-2p orbitals. Oxygen molecules mainly interact with the atoms of the first layer on the surface of the plutonium gallium system. The oxygen atoms after stable adsorption are able to diffuse to the subsurface of the plutonium gallium system after overcoming the energy barrier of 16.7 eV and form a stable structure. The research results reveal the initial reaction process and adsorption law of oxygen on the surface of plutonium gallium system from microscopic level, which is helpful to further explore the surface corrosion prevention technology of plutonium gallium system and improve the reliability and safety of plutonium gallium alloy components.     

灵芪胶囊对H22荷瘤小鼠p53和bcl-2蛋白表达的影响

目的：探讨灵芪胶囊对H22荷瘤小鼠的抑瘤作用及其抑瘤作用机制。方法：采用体内实验法,于无菌条件下抽取传代7d、生长良好的H22荷瘤小鼠腹水,无菌0．9％氯化钠溶液1：3稀释（约含瘤细胞2×10^6／ml）,按0．2ml／7,接种于消毒后的小鼠右前肢腋部皮下,制成肿瘤模型,灌胃给药灵芪胶囊11d后,称取小鼠体重,脱椎处死小鼠,取脾脏及胸腺称重并计算胸腺指数和脾脏指数。用免疫组化法检测各组凋亡相关基因突变型p53和bcl-2基因的表达。结果：灵芪胶囊在明显抑制肿瘤生长的同时不降低体重,在一定剂量对荷瘤动物的免疫器官指数无明显影响;灵芪胶囊三个剂量组突变型p53基因和bcl-2基N的表达均低于模型组。结论：灵芪胶囊对H22荷瘤小鼠有明显抑瘤作用,其机制可能与抑制突变型p53基N和bcl-2基因表达有关。     

蜂海绵Haliclonasp.化学成分的研究

对采自我罱海的蜂海绵Ｈａｌｉｃｌｏｍａｓｐ．的化学成分进行了研究。结果表明：从Ｈａｌｉｃｌｏｎａｓｐ．中分离出２个结晶性化合物１和２。应用波谱分析和元素分析鉴定１和２的结构分别为１，３－二甲基黄嘌呤和对羟基苯甲酸。这是从海绵中分离出上述化合物的首次报道。     

小檗胺在升高白细胞的同时对乳酸脱氢酶的影响

采用酶细胞化学及平板聚丙烯酰胺凝胶电泳法观察小檗胺(Ber)在升高白细胞的同时,是否对细胞内酶代谢及其同工酶有影响。结果表明:ip Ber的小鼠粒细胞内LDH酶反应明显增强,酶反应的强弱与用药时间长短成正比。LDH同工酶谱分析,所有标本均显示5条区带,LDH_2比例发生变化,对照组及Ber组中出现LDH’_5亚带。提示,Ber在升高白细胞的同时对细胞内酶的代谢有一定影响,同时伴有同工酶谱比例改变。     

Resin Flow Analysis for the Foam Core Sandwich Spoiler by Vacuum-Assisted Resin Injection Process

This article presents the numerical analysis and experimental investigation for the manufacturing of a foam core sandwich spoiler by vacuum-assisted resin injection (VARI) process. To find an injection scheme that guarantees both a good impregnation of the preform and a filling time compatible with the process window, the finite element model (FEM) was applied to analyze the effect of different injection schemes on the resin flow front patterns. Based on the obtained results, two optimal injection schemes are selected to form the spoiler structure. The experimental results show that the best molding quality can be achieved from the thick-end injection with a thin-end exit scheme. The comparison between simulation and experimental results shows that the overall deviation of the numerical analysis on resin flow time is 15.9%.     

Retrograde axonal transport of true blue dye by the peripheral autonomic nerves in canine nasal mucosa

Summary In this study we employed retrograde axonal transport of (E)-2,2-vinylendi-benzofuran-5-carboxamidin-diaceturate or true blue (TB) to study the peripheral autonomic innervation of the canine nasal mucosa. After injection of TB into the nasal mucosa, labeled neurons were found in the ipsilateral sphenopalatine ganglion (SPG) and the superior cervical ganglion (SCG). There were no labeled neurons in the middle cervical or stellate ganglia. This indicated that the origin of the postganglionic sympathetic fibers of the nasal mucosa was only from the ipsilateral SCG. When TB was injected into the nasal mucosa of dogs following a caudal or ethmoidal neurectomy, labeled neurons could still be found in the SPG and SCG. When TB was injected into the nasal mucosa of dogs following ethmoidal and vidian neurectomies or with maxillary neurectomy added, some labeled neurons could still be found in both the ipsilateral SPG and SCG. These results support the concept that another pathway — perhaps perivascular — exists for postganglionic sympathetic fibers other than the vidian and ethmoidal nerves. Labeled neurons were still observed in SPG when TB was applied to the canine nasal mucosa following neurectomy of either the ethmoidal or the caudal nasal nerve. However, retrograde labeled neurons could not be found in SPG following simultaneous neurectomies of the ethmoidal and caudal nasal nerves. These results show that the postganglionic parasympathetic fibers originating in the SPG travel along the ethmoidal and caudal nasal nerves.Presented at Tenth Midwinter Meeting of the Association for Research in Otolaryngology, Clearwater Beach, Florida, 3 February 1987     

不明原因感音神经性聋患者红细胞免疫功能检测

为探讨不明原因感音神经性聋患者红细胞免疫功能，采用酵母菌花环试验对５０例不明原因感音神经性聋患者红细胞免疫功能进行检测，并与正常组进行比较，结果显示：不明原因感音神经性聋患者红细胞Ｇ３ｂ受体（ＲＢＣ－Ｃ３ｂＲ）花环率降低，红细胞免疫复合物（ＲＢＣ－ＩＣ）花环率升高，且皆与正常组有显著性差异，提示不明原因的感音神经性聋患者有继发性红细胞免疫功能低下，可能与红细胞免疫调节功能紊乱有关。     

Association between private health insurance and medical use by linking subjective health and chronic diseases

This empirical study identifies the negative aspects of private health insurance (PHI) by analyzing the association between subjective health conditions, 2 weeks of outpatient care, chronic diseases, and hospitalizations for 1 year. We used frequency analysis, χ² testing, an analysis of variance, and logistic and multiple logistic regression models to analyze the association between PHI and subjective health conditions, outpatient care, chronic disease status, and hospitalization. The PHI group had good subjective health but had more outpatient care for 2 weeks. There were few chronic diseases in the private insurance group, and there was no significant difference in hospitalizations for 1 year. Hospitalization may occur when essential medical care is required, regardless of health insurance type. This study confirmed that as the PHI lowers the burden of personal medical expenses, the PHI can lead to an increase in the medical resource expenditures on the outpatient medical service and higher public health costs. The government should work to redefine the role of private and national health insurance. Also, the effectiveness of PHI should be reevaluated so that it does not lead to indiscriminate use of medical services by minimizing the burden of private insurance.