瘤内注射重组人p53腺病毒治疗晚期肺癌临床试验观察

目的 观察重组人p53腺病毒注射液(rAd-p53)在晚期肺癌治疗中的疗效和毒副反应。方法 12例IIIb-IV期肺癌及3例肺转移癌,CT定位经皮肺穿刺瘤内注射rAd-p53,1 次/周×4/疗程;通过临床观察、CT及病理对照及短期随访进行评价。结果 治疗后2 月观察肿瘤缩小5例(33.3%),无变化7例(46.7%),增大3例(20%);治疗后病理观察:癌组织坏死,癌细胞稀少(6/11,54.5%);除自限性发热外,无明显毒副反应。结论rAd-p53瘤内注射治疗肺癌,无明显毒副作用,能较好地抑制局部肿瘤的发展,尤其对失去手术机会,不能耐受放化疗的患者,是一种可行的有前景的方法。     

颅内黑色素瘤的诊断与治疗--附五例临床分析及文献复习

为讨论颅内黑色素瘤的临床表现、影像学特征及治疗方法 ,对本科近 13年来治疗的 5例颅内黑色素瘤进行回顾性分析。结果示颅内黑色素瘤的临床表现不具有特征性。影像学上CT表现为高密度或混杂密度 ,增强扫描呈不同程度强化。核磁共振检查 (MRI)表现为短T1短T2 信号 ,也可以因顺磁性黑色素含量不同和瘤内有无出血 ,表现为高、低或混杂信号 ,注射二乙胺五乙酸钆 (GD DTPA)后出现不同程度的强化。 5例患者中 ,3例手术全切 ,1例大部分切除 ,1例未手术。初步研究结果提示 ,颅内黑色素瘤的预后差 ,主张在手术基础上进行包括放疗及化疗的综合治疗     

胃粘膜瓣成型预防食管胃吻合术后反流的观察

目的:介绍胃粘膜瓣成型预防食管胃吻合术后反流的临床应用.方法:食管、贲门癌50例,行部分食管部分胃切除,用吻合器作食管胃吻合后行胃粘膜瓣成型.结果:成型组术后无反流症状,上消化道造影及放射性核素显像表明该手术方法抗反流作用明显.食管镜检查示胃粘膜瓣成型组吻合口粘膜充血、水肿、糜烂、溃疡较常规手术组明显减轻.结论:胃粘膜瓣成型术可有效预防食管胃吻合术后胃食管反流.     

Methadone versus morphine as a first-line strong opioid for cancer pain: a randomized, double-blind study.

PURPOSE: To compare the effectiveness and side effects of methadone and morphine as first-line treatment with opioids for cancer pain. PATIENTS AND METHODS: Patients in international palliative care clinics with pain requiring initiation of strong opioids were randomly assigned to receive methadone (7.5 mg orally every 12 hours and 5 mg every 4 hours as needed) or morphine (15 mg sustained release every 12 hours and 5 mg every 4 hours as needed). The study duration was 4 weeks. RESULTS: A total of 103 patients were randomly assigned to treatment (49 in the methadone group and 54 in the morphine group). The groups had similar baseline scores for pain, sedation, nausea, confusion, and constipation. Patients receiving methadone had more opioid-related drop-outs (11 of 49; 22%) than those receiving morphine (three of 54; 6%; P =.019). The opioid escalation index at days 14 and 28 was similar between the two groups. More than three fourths of patients in each group reported a 20% or more reduction in pain intensity by day 8. The proportion of patients with a 20% or more improvement in pain at 4 weeks in the methadone group was 0.49 (95% CI, 0.34 to 0.64) and was similar in the morphine group (0.56; 95% CI, 0.41 to 0.70). The rates of patient-reported global benefit were nearly identical to the pain response rates and did not differ between the treatment groups. CONCLUSION: Methadone did not produce superior analgesic efficiency or overall tolerability at 4 weeks compared with morphine as a first-line strong opioid for the treatment of cancer pain.     

银环蛇毒素对白血病K562细胞株凋亡诱导作用的研究

目的 探讨银环蛇毒素及其若干组分在体外对白血病K562细胞株的凋亡诱导作用。方法 采用阳离子交换层析法分离纯化银环蛇粗毒，应用MTT法、荧光显微镜和流式细胞术等研究毒素对K562细胞株的凋亡作用。结果 除Ⅳ峰毒素外，银环蛇粗毒及分离的部分组分IV峰、Ⅶ峰和Ⅷ峰等毒素的荧光显微图末见特征性的凋亡小体，DNA含量分布组方图中的二倍体峰前末见Gl细胞群。结论 银环蛇毒对K562细胞具有杀伤作用，但并非是细胞凋亡作用，而是致细胞坏死，而粗毒中的某些组分可能具有促K562细胞凋亡作用。     

缝线法矫正乳头内陷

目的介绍一种中度以下乳头内陷的矫正方法。方法采用8字缝合法或荷包缝合法，使乳头、乳晕处基底部周围组织向乳头中底部靠拢，使乳头下撵托组织增加，并形成一定的疤痕组织衬托，使乳头突出。结果17例病人，15例达到Ⅰ期效果．2例(8字缝合法、荷包缝合法各1例)术后乳头内陷再度复发，采用切开法Ⅱ期矫正后痊愈。结论缝合法矫正乳头内陷，乳头、乳晕局部无切口，操作简单，损伤较小。     

木犀草素对博莱霉素引起的大鼠肺纤维化模型的治疗作用

目的:研究木犀草素对大鼠肺纤维化的治疗作用。方法:观察不同剂量的木犀草素对博莱霉素诱导的大鼠肺纤维化肺组织的肺重量指数、丙二醛(MDA)、羟脯氨酸(HYP)含量及组织学变化的影响。结果:木犀草素在20,40和80mg·kg~(-1)剂量下连续灌胃给药21d,对模型大鼠的上述指标有不同程度的抑制作用,对其组织形态也有明显改善,且呈剂量效应关系。结论:木犀草素对大鼠肺纤维化模型具有较好的治疗效果。     

唾液酸及其衍生物的应用前景

唾液酸(sialic acid, SA)是广泛存在于生物系统中的一类天然糖类化合物,是构成细胞表面复合糖质的成分,具有重要的生物活性;同时它还是某些毒素的受体和病原微生物的作用部位.近年来,以SA为先导化合物进行生物活性研究和新药开发成为一个新热点.     

鼻咽分泌物中β2微球蛋白测定的临床意义

To study its clinical significance, beta 2-microglobulin (beta 2-MG) in nasopharyngeal secretion was examined using radioimmunoassasy methods in 73 patients with nasopharyngeal carcinoma (NPC), 30 with chronic nasopharyngitis and 30 normal control subjects. In 31 NPC patients, the examination was repeated before and after radiotherapy. The average concentrations of beta 2-MG were 4.87 +/- 2.51 mg/L in NPC group, 1.05 +/- 0.64 mg/L in chronic nasopharygitis group, and 0.85 +/- 0.32 mg/L in the control. The beta 2-MG concentration was higher in the NPC patients than in both chronic pharyngitis patients and normal subjects (P < 0.01). The concentration was lowered down in NPC patients after radiotherapy, and remained high when the treatment failed to control the condition. It seems that beta 2-MG level in nasopharyngeal secretion is closely related to the prognosis and recurrence of nasopharyngeal carcinoma.