羟丙基-β-环糊精用于静脉给药的研究概况

羟丙基-β-环糊精是β-环糊精的一种化学修饰性衍生物，对于水难溶性药物具有良好的包合增溶效果。现对其理化性质、静脉给药后的毒性、药动学和组织分布的研究概况进行综述，并简要介绍其在国内外制剂中的使用情况，同时围绕静脉给药，对实际应用泾丙基-β-环糊精时需考虑的一些问题进行较详细的概述。     

Intensity-modulated radiotherapy for cervical esophageal squamous cell carcinoma: clinical outcomes and patterns of failure

The objective of the study was to report clinical outcomes and patterns of failure for these patients with cervical esophageal squamous cell carcinoma (CESCC) treated with intensity-modulated radiotherapy (IMRT). A total of 64 patients with CESCC treated with definitive IMRT from May 2005 to March 2012 in our center were analyzed. Forty-two patients received radiotherapy alone and 22 patients received concurrent chemoradiotherapy. The location and extent of locoregional failures were transferred to the pretreatment planning computed tomography for dosimetry analysis. For all patients, the overall 2-year local failure-free survival, regional failure-free survival, distant failure-free survival, and overall survival rate was 74.5, 88.0, 66.6 and 42.5 %, respectively. Twenty-eight patients had developed treatment failure. Of the 28 patients, 14, 5, and 18 had developed local failure, regional failure, and distant metastasis, respectively. All of the 14 local failures were considered in-field failures. Of the five regional failures, three were considered in-field failures and two were marginal failures. The most frequently observed acute toxicity was mainly Grade 1 or 2. The incidence of acute Grade 3 mucositis (including pharyngitis), skin reaction, and leukopenia was 4.7, 12.5 and 10.9 %, respectively. IMRT provides satisfactory locoregional control for CESCC. Distant metastasis remains the predominate pattern of failure and the predominate pattern of locoregional failures is in-field failure.     

不同类型丙烯酸酯人工晶状体囊袋旋转稳定性的临床比较

目的比较不同类型丙烯酸酯折叠人工晶状体（IOL）植入后的囊袋旋转稳定性。方法将79例（83只眼）随机分为4组,A组25例（26只眼）,选择植入Aleon公司SA60AT一片式疏水性丙烯酸酯折叠IOL;B组22例（22只眼）,选择Amo公司AR40e三片式疏水性丙烯酸酯折叠IOL;C组21例（21只眼）,选择CanonStaar公司的KS—X丙烯酸酯预装式折叠IOL;D组13例（14只眼）,选择Bausch＆Lomb公司的Akreos-ADAPT一片式亲水性丙烯酸酯折叠IOL,记录术后IOL襻的位置,计算并比较IOL襻的旋转角数。结果术后3个月时旋转角度小于或者等于5°者A组为84．6％,B组为86．4％,C组为100％,D组为92．9％;术后第1周、1个月、3个月的IOL平均旋转角数A组分别为（2．04±2．32）°、（2．27±2．13）°和（2．62±2．71）°,B组分别为（2．18±2．11）°、（2．41±2．40）°和（2．73±2．57）°,C组分别为（2．00±1．95）°、（2．05±1．50）°和（2．14±1．71）°,D组分别为（1．29±2．09）°、（1．43±2．34）°和（1．50±2．31）°,各组不同时间段比较,差异无统计学意义（均P〉0．05）;四组人工晶状体的旋转度数3个月内均出现逐渐增加趋势,但平均增加不到1°。结论四种型号的丙烯酸酯折叠人工晶状体均具有良好的囊袋旋转稳定性。     

原发性鼻腔透明细胞癌1例并文献复习

目的:探讨原发性鼻腔透明细胞癌的临床表现及病理特点,总结其诊断及治疗方法。方法:分析1例原发性鼻腔透明细胞癌患者的临床资料,复习1992年以来11例相关文献,做出总结报道。结果:12例原发性鼻腔-鼻窦透明细胞癌中8例(66.7%)主要表现为鼻出血,4例(33.3%)出现骨质破坏;CT显示鼻腔、鼻窦内条片状类似软组织密度影,行单纯手术切除治疗3例(25.0%),手术切除联合放、化疗7例(58.3%),单纯放化疗2例(16.7%)。治疗后随访6个月～10年,仅1例患者因出现肺部转移死亡,余均健在。结论:原发性鼻腔-鼻窦透明细胞癌较罕见,早期症状以鼻出血多见,病理学上需与转移性透明细胞癌及多种含透明细胞的涎腺肿瘤鉴别。治疗以手术切除联合放化疗为主,短期内预后较好。早期局限于鼻腔和鼻窦的有基底的肿瘤可考虑鼻内镜手术,术后建议每半年复查一次。     

Jacobsen 综合征合并Paris-Trousseau 综合征1 例报告并文献复习

目的探讨Jacobsen综合征合并Paris-Trousseau综合征的临床特征。方法回顾分析1例Jacobsen综合征合并Paris-Trousseau综合征患儿的临床资料,并复习相关文献。结果患儿,女,1岁2个月,发育落后,能独坐,不会独走,四肢肌力可,尖头,眼距较宽、眼睑下垂,鼻梁低,眉毛稀疏;语言发育落后。脑电图未见异常,MRI示白质脑病。患儿新生儿期血小板减少。应用染色体微阵列芯片分析技术发现患儿11q23.3~q25区域存在缺失,缺失片段的大小为15.7 Mb,该区域包括Paris-Trousseau综合征以及Jacobsen综合征的缺失区域,患儿确诊为Jacobsen综合征合并Paris-Trousseau综合征。结论 Jacobsen综合征合并Paris-Trousseau综合征患儿颅面骨畸形,大脑白质发育异常,新生儿期血小板减少,染色体芯片检测有助于明确诊断。     

卤虫卵油脂肪酸组成分析及α-亚麻酸含量测定

目的采用毛细管气相色谱法分析卤虫卵油的脂肪酸主要组成并建立测定卤虫卵油中α-亚麻酸含量的方法。方法采用DB-WAX毛细管柱;程序升温:起始温度150℃,升温速率3℃.min-1,结束温度240℃,保持10 min;氢焰离子化检测器温度250℃。结果卤虫卵油中不饱和脂肪酸占总脂肪酸质量分数超过70%,其中油酸、α-亚麻酸质量分数分别为26.9%、27.7%。α-亚麻酸甲酯质量在0.719～3.60μg内线性关系良好(r=0.999 8,n=5),平均回收率为101.6%,RSD=2.3%。结论毛细管气相色谱法可作为卤虫卵油α-亚麻酸的含量测定方法。     

抗癌活性肽对人胃癌BGC-823细胞周期的调控

目的:探讨抗癌活性肽(anti-cancer bioactive peptide,ACBP)对人胃癌细胞BGC-823细胞周期的影响及其作用机制。方法:体外培养BGC-823细胞,将不同浓度的ACBP作用于细胞,MTT法测定不同浓度的ACBP对BGC-823细胞的生长抑制率;HE染色观察形态学变化;半定量RT-PCR检测细胞周期负性调控分子p27基因mRNA表达的变化。结果:不同浓度(10.0～25.0mg/L)ACBP均能抑制BGC-823细胞的生长,细胞出现明显的凋亡特征性改变,且具有浓度和时间依赖性,25.0mg/LACBP作用72h抑制率为(84.4±2)%,中效浓度(IC50)为7.86mg/L。RT-PCR发现经ACBP处理后,BGC-823细胞的p27mRNA表达明显增加。结论:ACBP对BGC-823细胞的生长有明显的抑制作用,并可诱导细胞凋亡,其抑癌机制可能与其调控细胞周期有关,使p27mRNA重获表达,从而发挥抗BGC-823细胞增殖的作用。     

Function and Significance of Very Low Density Lipoprotein Receptor Subtype Ⅱ

To explore the functions of very low density lipoprotein receptor (VLDL-R) subtype Ⅱ in lipoprotein metabolism and foam cells formation, the recombinant plasmid with the two subtypes cDNA was constructed respectively, the ldl A7 cell lines were transfected and two cell lines expressing VLDL-R were obtained: one stably expressing the VLDLR with the O-linked sugar region (type Ⅰ VLDLR) and the other without the O-linked sugar region (type Ⅱ VLDLR). In the study on binding of VLDLR to their nuclein labeled natural ligands (VLDL and β-VLDL), it was found that surface binding of^125I-VLDL or ^125I-β-VLDL of ldl-A7 cells transfected with type Ⅰ VLDLR recombinant (ldl-A7-VRI) was more higher than that of ldl-A7 cells transfected with type Ⅱ VLDLR recombinant (ldl-A7 VRⅡ). After being incubated with VLDL for different time, the contents of triglyceride and total cholesterol in cells were mensurated, and the formation of foam cells and accumulation of lipid in cells was observed by oil-red O staining. The results showed that the contents of triglyceride and total cholesterol in IdI-A7-VR Ⅰ were much higher than those in ldl-A7-VR Ⅱ, and IdI-A7-VR Ⅰ could transform into foam cells notably. It was suggested that type Ⅰ VLDLR binds with relative higher affinity to VLDL and β-VLDL, and internalizes much more lipoprotein into cells. As a result, we can conclude that type Ⅰ VLDLR plays a more important role in lipoprotein metabolism and foam cells formation than type Ⅱ VLDLR。     

硝普钠降压联合扩容用于嗜铬细胞瘤切除术

目的 :观察硝普钠控制性降压并扩容治疗对嗜铬细胞瘤切除围术期循环的影响。方法 :12例患者在切下肿瘤前用 0 0 1%硝普钠溶液经颈内静脉点滴调控血压 ,将MAP控制在 8～ 10kPa ,同时快速输入乳酸钠平衡液和代血浆各 2 0～ 30ml·kg-1·h-1扩容至尿量 10 0ml·h-1以上 ,之后根据出血量调整输液速度。监测指标 :MAP ,HR ,,尿量SpO2 。结果 :手术人均 2 10min ,硝普钠用量人均 38 333mg ,艾司洛尔 330mg ,输液总量 72 5 0ml(117ml·kg-1) ,尿量 6 10ml,SpO2 98%～ 10 0 % ,血压和心率均在理想范围 ,无任何并发症。结论 :硝普钠控制性降压配合及时大量扩容有利于维护嗜铬细胞瘤术中循环平稳和减少并发症     

结直肠肿瘤患者术后焦虑评分同术后并发症的相关性

目的 了解结直肠肿瘤患者术后焦虑评分对术后并发症的影响.方法 前瞻性纳入2010年2月至5月四川大学华西医院胃肠外科中心结直肠外科专业组126名结直肠癌确诊患者,并根据焦虑评分分为3组,组间比较术后并发症发生率;评估分析患者术后焦虑的相关因素;探索术后焦虑评分同患者术后并发症发生率的临界评分值.结果 3组间术后并发症发生率有着明显不同(χ2＝17.904,P＜0.001),同时可能焦虑组(焦虑评分＜7～13分)术后并发症发生率低于无焦虑组(焦虑评分＜7分)(χ2＝11.027,P＝0.002)及焦虑组(焦虑评分>14)(χ2＝20.677,P＜0.001),无焦虑组及焦虑组差异无统计学意义(χ2＝1.636,P＝0.274);术后焦虑的主要危险因子有费用类型(P＝0.053),居住地(P＝0.018),内科合并症(P＝0.014),新辅助化疗(P＝0.053),DUKES分期(P＝0.009),术后普食天数(P＝0.001);而分析得术后焦虑评分的临界值为17分,术后焦虑评分>17分时患者术后并发症发病率较高(χ2＝12.538,P＝0.004).结论 结直肠癌患者术后焦虑评分同术后并发症的发生有着一定的相关性,焦虑评分高者更易发生术后并发症,但适度的焦虑患者术后并发症的发生率相对较低.