大承气汤对急性呼吸窘迫综合征大鼠血小板及凝血系统的作用

[目的]通过观察大承气汤对急性呼吸窘迫综合征(ARDS)大鼠血小板及凝血系统的作用,探讨其防治ARDS的机理,为临床用药提供依据。[方法]清洁级大鼠24只,分为对照组,模型组和治疗组。每天灌胃2次,7日后检测血小板和凝血系统的变化。[结果]三组的平均血小板体积及活化部分凝血酶时间有明显差异(P<0·01)血小板计数,凝血酶时间及凝血酶原时间有明显差异(P<0·05)。[结论]大承气汤可通过影响大鼠血小板和凝血系统而使大鼠肺部微血栓减少。大承气汤可通过影响大鼠血小板和凝血系统从而有效地治疗大鼠急性呼吸窘迫综合征。     

多囊卵巢综合征患者脂糖代谢分析

目的 分析多囊卵巢综合征（PCOS）患者糖、脂代谢情况。方法 将300例PCOS患者和45名正常对照者按体重指数（BMI）各分为2组：PCOSⅠ组和正常Ⅰ组（BMI〈25kg／m^2），PCOSⅡ组和正常Ⅱ组（BMI≥25kg／m^2）；各组均行血脂（TC和TG）测定及糖耐量和胰岛素释放试验。结果 ①肥胖组TC和TG水平均明显高于非肥胖组；②血糖水平仅PCOSⅡ组1h、2h时明显升高，而胰岛素释放量则各组间均有明显差异。结论①血脂升高仅与肥胖相关，即与PCOS无关；②肥胖加重了PCOS患者的胰岛素抵抗和高胰岛素血症的程度。     

胃癌中survivin和cyclinD 1基因的表达及其相关性研究

目的探讨survivin基因表达与胃癌生物学行为及与cyclinD1表达的关系.方法利用免疫组化S-p法检测50例胃癌和24例慢性胃炎中survivin和cyclinD1的表达.结果 Survivin和cyclinD1的阳性检测率分别为66%(33/50)和64%(32/50),survivin和cyclinD1的阳性表达与胃癌组织学类型相关(P<0.05,P<0.01),survivin表达与淋巴结转移有关,survivin的阳性表达与cyclinD1的阳性表达呈正相关.survivin和cyclinD1的高表达均与患者术后<3年生存期相关(P<0.01,P<0.05)).结论 Survivin和cyclinD1基因在胃癌的发生、发展中起着不同的作用,它们的检测对胃癌恶性程度的判定、预后和进一步治疗提供有效的依据.     

Expression of cytochrome p450 and other biotransformation genes in fetal and adult human nasal mucosa.

Despite recent progress in the identification and characterization of numerous nasal biotransformation enzymes in laboratory animals, the expression of biotransformation genes in human nasal mucosa remains difficult to study. Given the potential role of nasal biotransformation enzymes in the metabolism of airborne chemicals, including fragrance compounds and therapeutic agents, as well as the potential interspecies differences between laboratory animals and humans, it would be highly desirable to identify those biotransformation genes that are expressed in human nasal mucosa. In this study, a global gene expression analysis was performed to compare biotransformation enzymes expressed in human fetal and adult nasal mucosa to those expressed in liver. The identities of a list of biotransformation genes with apparently nasal mucosa-selective expression were subsequently confirmed by RNA-polymerase chain reaction (PCR) and DNA sequencing of the PCR products. Further quantitative RNA-PCR experiments indicated that, in the fetus, aldehyde dehydrogenase 6 (ALDH6), CYP1B1, CYP2F1, CYP4B1, and UDP glucuronosyltransferase 2A1 are expressed preferentially in the nasal mucosa and that ALDH7, flavin-containing monooxygenase 1, and glutathione S-transferase P1 are at least as abundant in the nasal mucosa as in the liver. The nasal mucosal expression of CYP2E1 was also detected. These findings provide a basis for further explorations of the metabolic capacity of the human nasal mucosa for xenobiotic compounds.     

益气除痰法延长非小细胞肺癌中位生存期的作用

目的:观察益气化痰法延长Ⅲ、Ⅳ期非小细胞肺癌(NSCLC)生存期的作用.方法:采用前瞻性、多中心、随机、对照的临床流行病学方法,将符合标准的病例按肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型四型辨证施治,辨病治疗以益气化痰法为主,辨证治疗分别以宣肺除痰、益气除痰、滋阴化痰、益气养阴法为主.用乘积极限(K-M)法分析不同证型的中位生存期及中位疾病进展时间.结果:肺郁痰瘀型、脾虚痰湿型、阴虚痰热型及气阴两虚型肿瘤总缓解率分别为9.1%、23.6%、11.5%、13.2%(P<0.05);瘤体总稳定率分别为69.7%、77.8%、69.2%、78.9%(P>0.05);中位生存期分别为308天、401天、300天和326天(P>0.05);1年累积生存率分别为45.63%、51.53%、41.95%、46.01%(P>0.05).结论:益气化痰法可使Ⅲ、Ⅳ期NSCLC的中位生存期达到9个月,与化疗配合应用可达到12个月,是晚期非小细胞肺癌的一种有效治法.其中,脾虚痰湿型患者中位生存期达到13个月,有可能进一步提高疗效.     

Elevated serum cytokines correlated with altered behavior, serum cortisol rhythm, and dampened 24-hour rest-activity patterns in patients with metastatic colorectal cancer.

PURPOSE: Incapacitating symptom burden in cancer patients contributes to poor quality of life (QOL) and can influence treatment outcomes because of poor tolerance to therapy. In this study, the role of circulating cytokines in the production symptoms in cancer patients is evaluated. EXPERIMENTAL DESIGN: Eighty patients with metastatic colorectal cancer with either normal (group I, n = 40) or dampened (group II, n = 40) 24-hour rest/activity patterns measured by actigraphy were identified. Actigraphy patterns were correlated with QOL indices, serum cortisol obtained at 8:00 a.m. and 4:00 p.m. and with serum levels of transforming growth factor-alpha, tumor necrosis factor-alpha, and interleukin 6 (IL-6) obtained at 8:00 a.m. and analyzed in duplicate by ELISA. Cytokine levels and survival were also correlated. RESULTS: Group II patients had significantly higher pre treatment levels of all three cytokines, displayed significantly poorer emotional and social functioning, had higher fatigue, more appetite loss, and poorer performance status compared with group I patients. Transforming growth factor-alpha (TGF-alpha) and IL-6 were significantly increased in the patients with WHO performance status >1 and in those with appetite loss. Fatigue was significantly associated with elevated TGF-alpha only. IL-6 was increased in those patients with extensive liver involvement and multiple organ replacement, and it was significantly correlated with dampened cortisol rhythm. In a multivariate analysis, IL-6 was correlated with poor treatment outcome. CONCLUSIONS: Significant correlations were found between serum levels of TGF-alpha and IL-6, circadian patterns in wrist activity and serum cortisol and tumor-related symptoms in patients with metastatic colorectal cancer. These data support the hypothesis that some cancer patient's symptoms of fatigue, poor QOL, and treatment outcome are related to tumor or host generated cytokines and could reflect cytokine effects on the circadian timing system. This interplay between cytokine signaling pathways, the hypothalamic-pituitary-adrenal axis, the autonomic nervous system, and efferent pathways of the suprachiasmatic nucleus that control circadian physiology, opens the way to new rational interventions for symptom management in cancer patients.     

清肝明日方对急性葡萄膜炎患者细胞因子mRNA表达的干预作用

目的研究清肝明目方对急性葡萄膜炎患者细胞因子mRNA表达的干预作用。方法应用逆转录-聚合酶链反应（RT—PCR）检测技术在使用清肝明目方干预治疗前后，检测急性葡萄膜炎患者外周血中白细胞介素2（interleukin-2，IL-2）、转化生长因子β（transforming growth factorβ，TGF—β）和mRNA的表达强度。结果葡萄膜炎急性发作期患者外周血中IL-2 mRNA表达较正常人增高，而TGF—βmRNA降低；经清肝明目方干预治疗后患者IL-2的mRNA表达水平降低，TGF—βmRNA表达升高，其中TGF—βmRNA表达的升高与单纯使用激素组比较差异有显著性意义。结论清肝明目方对急性葡萄膜炎患者细胞因子mRNA表达有一定干预作用。并具有保持激素减量后病情稳定，减少复发的作用。     

尿激酶溶栓治疗急性心肌梗死的护理体会

80年代医学界开展了急性心肌梗死静脉溶栓治疗，从根本上改善了预后，被誉为急性心肌梗死治疗学上最重要的进展，临床上常用尿激酶进行溶栓治疗，现将护理体会总结如下。