惠州市突发化学中毒事故危害评估与医学应急救援资源系统的研制与应用

的决策提供科学数据.     

糖尿病患者的心理及饮食护理

糖尿病是一种慢性的全身代谢性疾病,以高血糖为其共同主要标志.目前世界上约有1.7亿之多的糖尿病患者,随着物质生活水平提高,糖尿病患者明显有上升的趋势,以成为严重危害人民健康的一大杀手.临床比较重视的是药物控制和饮食调理,而患者的心理在漫长的病程中倍受煎熬,不良的情绪因素会引起体内某些激素的大量分泌,如胰高血糖素,肾上腺皮质激素的升高会引起糖尿病病情反复.因此,只有药物控制、饮食调理、心理护理三管齐下,才能有效的控制病情,鼓励患者增加信心在生活上有规律,身体情况许可者,可进行适当的运动,注意个人卫生,预防感染.对有微血管病变的患者,可设法促进周围循环.按时测体重,以作为计算饮食和观察疗效的参考.饮食治疗是一项基础治疗措施,不论糖尿病类型,病情轻重或有无并发症,也不论是否应用药物治疗,都应严格和长期执行.     

IA期非小细胞肺癌的肿瘤大小对其预后的影响

背景与目的 肿瘤大小对预后的影响在肺癌的不同分期组间已明确，但其在同一分期中，尤其是直径小于3cm的肿瘤中对预后的影响尚未明确。本研究的目的是探讨IA期非小细胞肺癌中肿瘤大小对预后的影响。方法 回顾性分析自1995年1月至2003年12月我院胸外科手术治疗IA期非小细胞肺癌142例，用Kaplan-Meier生存曲线统计不同肿瘤大小患者的生存率，并对发病年龄、性别、病理类型、肿瘤大小、手术方式以及是否接受放化疗等因素进行COX回归比例风险模型多因素分析。结果 全组肿瘤直径≤2．0cm者60例，2．1～3．0cm者82例。全组3年、5年生存率分别为84．41％、70．89％，其中肿瘤直径≤2．0cm组分别为94．91％和81．40％，2．1～3．0cm组分别为82．18％和64．91％（P=0．0353）。单因素及多因素分析均显示，肿瘤大小为独立的预后因素。结论 肿瘤大小是IA期非小细胞肺癌的独立预后因素。临床工作中应进一步提高影像学诊断水平，使患者获得更早期的治疗。     

隆凸切除成形与重建术治疗中晚期肺癌

目的 总结分析肺癌侵及隆凸外科治疗的手术适应症、技术方法、术中及术后管理。方法 全组共67例．右肺中心型肺癌46例。右侧纵隔型肺癌4例，侵及上腔静脉及无名静脉11例；左侧中心型肺癌17例；手术方式：行右隆凸全肺或肺叶切除隆凸重建术50例，11例同时行受侵上腔静脉及无名静脉切除人工血管置换；左隆凸全肺切除17例。结果 全组围术期死亡8例(11．94％)，循环衰竭6例(8．96％)．呼吸衰竭2例(2．99％)。1、3及5年生存率分别为77．21％、48．23％及32．54％。结论 对肺癌侵犯隆凸和上腔静脉及双侧无名静脉者，切除原发病变和部分受侵器官可达到临床完全性切除之目的。配合多学科的综合治疗，患者能获得良好的远期生存。     

不同促渗剂对黄芩苷离体鼠皮透过行为的影响

[目的]研究辛酸/癸酸甘油酯(Lab)、二乙二醇单乙基醚(Trans P)以及丙二醇(PG)对黄芩苷透皮行为的影响.[方法]采用改良Franz扩散池,考察Lab、Trans P和PG在不同浓度下,对黄芩苷离体鼠皮透过行为的影响.[结果]与空白组相比,3%Trans P与5%PG的表观渗透系数增加了3.15和3.05倍,有差异(P＜0.05),几种促渗剂对黄芩苷透过的增渗作用依次为3%Trans P＞5%PG＞7%PG＞5%Trans P＞7%Trans P＞3%PG＞1%Trans P＞10%PG＞5%Lab.[结论] 3%Trans P与5%PG的促渗效果比较明显,可进一步应用于黄芩苷透皮制剂中.     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.     

复合麻醉与硬膜外在经皮肾手术中的应用比较

目的探讨椎管内复合麻醉应用于经皮肾手术治疗的安全性和可靠性。方法选择ASAⅠ～Ⅱ级患者100例，随机分为两组，单纯硬膜外组50例，CSEA组50例。手术治疗均为经皮肾。监测两组患者麻醉效果，对术中镇痛质量进行评价及观察术中患者生命体征变化。结果两组患者麻醉后血压均下降，但两者之间无差别（P〉0．05）。结论CSEA可作为经皮肾手术治疗的麻醉选择，麻醉效果确切而安全。     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.     

非小细胞肺癌循环肿瘤细胞检测技术与临床应用的研究进展

转移和复发被认为是影响恶性肿瘤预后的主要因素,对于转移与复发形成的相关基础理论中,"种子和土壤"假说认为,原发肿瘤在生长过程中,有微小肿瘤细胞个体或集团通过循环系统的运送到达远处器官,如同种子播散在土壤中,形成与原发灶特性极其类似的转移灶,这一理论非常形象地说明了恶性肿瘤的转移途径,并点明"种子"肿瘤细胞即循环肿瘤细胞(CTCs)是转移和复发的关键,并有相关可靠的临床研究依据。近年来CTCs又引起肿瘤研究者的热情,将CTCs作为潜在肿瘤生物学标志物及研究肿瘤转移过程成为研究的热点。在本综述中,我们将对CTC生物学和转移相关基因检测、现今最常用的检测技术,及其在临床研究尤其在肺癌领域中的应用进行阐述。