保留肾单位手术治疗早期小肾癌21例临床分析

OBJECTIVE: To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma. METHODS: Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection. RESULTS: All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients. CONCLUSION: As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.     

Lipid extract from completely sporoderm‐broken germinating Ganoderma sinensis spores elicits potent antitumor immune responses in human macrophages

Ganoderma sinensis has been used widely in Oriental countries for the prevention and treatment of various diseases including cancer. Previous studies have shown that the lipid extract from Ganoderma exhibits direct cytotoxicity against tumor cells. Here, it is reported that the lipid extract from germinating G. sinensis spores, at lower concentrations that have no direct tumoricidal activity, induce potent antitumor immune responses in human monocytes/macrophages. Upon stimulation with the lipid extract, monocytes/macrophages exhibited markedly increased production of proinflammatory cytokines and surface expression of costimulatory molecules. Conditioned medium from stimulated cells effectively suppressed the growth of tumor cells. Apparently, the lipid extract triggered macrophage activation via a mechanism different from that associated with LPS. Moreover, it was observed that the lipid extract could partially re‐establish the antitumor activity of the immunosuppressive tumor‐associated macrophages. These results indicated that in addition to its direct tumoricidal activity, the lipid extract from G. sinensis spores could exert antitumor activity by stimulating the activation of human monocytes/macrophages. Copyright © 2008 John Wiley & Sons, Ltd.     

喉癌患者术后的适应性研究

喉癌是头颈部最常见的恶性肿瘤,目前手术仍是治疗喉癌的主要手段.通过对喉癌术后患者的适应状态、适应测量及影响适应的因素进行综述,提出对喉癌术后适应干预的研究应该针对患者的年龄与性别、个性特征提供不同的应对、治疗方式、术后时间、社会支持和信息等方面知识.     

非依赖型糖尿病全血低切变率粘度值的临床意义

目的:为了探讨非依赖型糖尿病全血低切变率粘度值测定的临床意义。方法:对91例非依赖型糖尿病血液流变学低切率粘度值进行了检测,并对其结果及形成机制进行了分析讨论。结果:91例非依赖型糖尿病低切变率粘度值和对照组相比有显著性差异,p<0．01。结论:非依赖型糖尿病全血低切变率粘度增高,可造成微血管循环障碍,是非依赖型糖尿病易形成心梗、脑梗及其他微血管病的一种重要因素。     

白术、枳实、玫瑰花挥发油-β-环糊精包合物的制备工艺研究

目的确定白术、枳实、玫瑰花挥发油-β-环糊精包合物的最佳包合工艺。方法采用正交试验法,对挥发油与β-环糊精的包合进行3因素3水平考察。结果挥发油与β-CD投料比为1:9,β-CD与加水量的比为9:100倍,包合时间为4h,包合率为85.3%。结论用此法得到的挥发油-β-环糊精包合物的包合率较高,包合物性质稳定,而且包合操作简单。     

支气管结核纤维支气管镜下局部清理、注药与联合微波治疗的疗效比较

支气管结核患者由于支气管局部的肉芽组织增生、溃疡、干酪性坏死、管腔狭窄阻塞等改变，虽然使用强有力的全身抗痨方案治疗，亦很难将其治愈，常常迁延不愈，局部结构组织破坏明显，引起永久性狭窄、闭塞，导致肺不张、毁损肺等严重的并发症。全身抗痨结合纤维支气管镜清理支气管局部的增生肉芽、坏死组织后注入异烟肼、链霉素的方法可使疗效明显提高。近年来微波技术已逐渐应用于通过纤维支气管镜治疗多种气道疾病。现将我院近5年来确诊的支气管结核用纤支镜局部病灶清理、注抗痨药治疗与同时联合微波热灼治疗的疗效进行分析、报告如下。     

计算机医嘱输入系统对用药错误的助长作用

背景：医院的计算机医嘱输入（computerized physician order entry，CPOE）系统被广泛认为能从技术上解决用药错误，后者是最常见的可以预防的医院诊疗错误的来源。已发表的研究表明，CPOE可减少高达81％的用药错误。然而，很少研究关注CPOE助长用药错误作用的范围或类型。     

Cytotoxic lipid esters from Peucedanum ledebourielloides

Two cancer cell growth inhibitory esters, 1,2-dipalmitoyl-3-glucosyl glycerol (1) and 1,6-dihydroxy-hexane-bis-palmitoyl ester (2), together with arachidic acid-2-hydroxy-glycerol ester, daucosterol, and oleanolic acid, were isolated from the roots of Peucedanum ledebourielloides (Apiaceae family). The structures were determined by spectroscopic analyses. The esters 1 and 2 displayed significant activity against the SGC-7901, HT-29, and HL-60 cancer cell lines.     

中西医结合治疗类风湿性关节炎的临床研究

目的：观察滋肾通痹颗粒联合小剂量西药“采氟米特”治疗类风湿性关节炎患者临床疗效及免疫学指标的变化。方法：应用中药补肾滋阴类药物生地，女贞子、杜仲、鸡血藤等，联合西药“来氟米特”提高免疫功能，应用中药藤类药物宣痹通络。活血舒筋治疗“顽痹”。中西药结合治疗类风湿性关节炎（RA）患者共70例。治疗前后进行总疗效、主要症状、体征及实验室指标对比观察。结果：70例中临床治愈率24．3％；有效率25．7％；总有效率为94．3％。关节疼痛、肿胀。功能障碍指数、晨僵时间、双手握力和15米步行速度等观察指标治疗后明显优于治疗前（P〈0．01）。结论：中西医结合治疗RA能明显提高机体免疫能力。抗过敏、改善临床症状及实验室指标。中西医结合治疗RA能取长补短，增强疗效，减少副作用，减轻患者经济负担。可使RA患者长期维持治疗。