顺铂等化疗药物对胃癌细胞端粒酶活性的影响

目的：探讨端粒酶作为化疗敏感性指标的可行性。方法：选择IC50剂量的顺铂，丝裂霉素C，阿霉素及5－氟脲嘧啶和甲酰四氢叶酸处理胃癌细胞，采用半定量TRAP－银染法检测药物处理前后胃癌细胞端粒酶活性。并应用流式细胞学检测细胞周期和细胞凋亡率。结果：顺铂，丝裂霉素C和阿霉素在诱导两细胞凋亡的同时，下调端粒酶活性，且其抑制作用呈时间依赖关系；5－氟脲嘧啶和甲酰四氢叶酸对胃癌细胞端粒酶活性无明显抑制作用，结论：化疗前后细胞端粒酶活性的变化，可作为化疗敏感性指标。     

康惠尔透明贴对化疗性静脉炎防治作用的临床研究

目的:探讨康惠尔透明贴对化疗性静脉炎的防治作用。方法:病人分为两组,第一组为未发生静脉炎的化疗患者,实验组使用康惠尔透明贴,对照组使用3M透明敷贴。第二组为已发生静脉炎的化疗患者,对实验组的患处使用康惠尔透明贴,对照组使用硫酸镁湿敷。结果:第一组:实验组(I)与对照组(I)相比较其静脉炎的发生率明显降低,差异有显著性(P<0.05)。第二组:实验组(II)其化疗性静脉炎疼痛持续时间及静脉炎治愈时间均明显短于对照组(II),差异有显著性(P<0.05)。结论:康惠尔透明贴用于化疗性静脉炎不仅有预防作用,而且还有较好的治疗作用。     

浅静脉炎的超声诊断研究

目的探讨浅静脉炎的声像图特征。方法回顾性分析浅静脉炎患者64例，观察病变的位置、范围、形态、边界、回声特点、血流分布等。结果所有患者均表现为局部静脉曲张，管径增宽明显，管壁不均匀增厚，管壁回声增强，腔内可见低、等回声团，探头加压管腔不变形，病变区域内无明显血流信号，皮下组织水肿。结论浅静脉炎的声像图表现具有一定的特征性，结合临床表现超声易做出正确诊断。     

Limited-sampling models for anticancer agents

Pharmacokinetic parameters of antineoplastic drugs are usually generated from concentration/time profiles obtained after multiple venipunctures. With limited-sampling models (LSM) this number can be reduced to between one and three timed plasma samples. LSMs may facilitate population pharmacokinetic/pharmacodynamic studies, which eventually may lead to a dosing strategy based on the characteristics of the individual patient. In this article, the development, validation and application of several LSMs reported in the literature are reviewed.Abbreviations LSM limited-sampling model - AUC area under the concentration/time curve     

不同化疗方案治疗晚期胃癌的疗效评价

目的比较FAM、UFTM、FEP和LFP／M四种化疗方案治疗晚期胃癌的效果。方法应用回顾性分析,总结出每个方案的近期和远期疗效,作出统计学处理。结果近期疗效：四种方案的有效率分别为FAM34．4％,UFTM32．6％,FEP47．0％和LFP／M44．0％。经统计学处理各组间P值均大于0．05,无显著差异。远期疗效：有效病例治后中位缓解期和生存期分别为FAM5月和11．5月,UFTM4．5月和8．5月,FEP5月和10月,LEP／M4月和9月,毒副反应在骨髓抑制方面以FAM和LFP／M为重,UFTM最轻。消化道反应以FEP和LFP／M为重,UFTM最轻．结论四种方案治疗晚期胃癌,近期疗效各组间无显著差异。但以FEP和LFP／M方案的有效率更高一些,仍可作为首选方案。UFTM方案的不良反应最轻,适用于全身状况较差,体质较弱的患者。FAM方案的生存期较长,副反应也不大,对心脏无病变的患者仍不失为较好的治疗方案。     

Studies in Phlebitis. II. Early Detection of Amiodarone-Induced Phlebitis in a Rabbit Model

Pharmaceutical Research -     

黄连消肿膏防治化疗性静脉炎疗效观察

目的观察黄连消肿膏防治化疗性静脉炎的临床疗效。方法采用随机对照试验方法，将431例符合纳入标准的化疗患者随机分为黄连消肿膏组（216例）和硫酸镁组（215例）。黄连消肿膏组从静脉推注或滴注化疗药物的第1天起，常规皮肤消毒后，将黄连消肿膏平摊于3层无菌纱布上，外敷静脉穿刺处，每8h更换纱布1次；硫酸镁组采用传统的50％硫酸镁溶液湿敷治疗。两组均以5d为1个疗程，4个疗程后评价疗效。结果黄连消肿膏组在静脉炎发生率、静脉反应发生率、疼痛评分、客观疗效等方面与硫酸镁组比较，差异均有统计学意义（P〈0.05）。结论黄连消肿膏对化疗静脉具有保护作用，能防治化疗药物引起的静脉炎。     

精密过滤输液器在减少注射用七叶皂苷钠不良反应中的作用

目的：探讨精密过滤输液器在减少输注七叶皂苷钠引发不良反应中的作用。方法：对136名住院并使用七叶皂苷钠,排除外周血管病变及静滴过程中药物外渗的患者,随机分为普通组和精密组,分别采用普通输液器和精密过滤输液器,对输液时疼痛及输液后静脉炎的发生率进行比较,应用疼痛标尺、INS静脉炎分级标准进行分级,并进行统计学处理。结果：在使用七叶皂苷钠后,患者疼痛程度及静脉炎的发生率方面,精密组要远远低于普通组具有统计学意义,P〈0.01。结论：使用精密过滤输液器可有效减轻输液时疼痛,并降低输液后静脉炎的发生率。     

静脉留置针导致静脉炎原因分析与对策

静脉留置针已广泛用于临床，使用不当可引起静脉炎。笔者对200例静脉留置针病人进行了观察，发现留置针引起静脉炎与穿刺部位的选择、输入药物的性质、输液量及封管方法等有关。采取相应措施可减少静脉炎的发生。     

Autoimmune pancreatitis: with special reference to a localized variant

In 2006, the Japan Pancreas Society revised the diagnostic criteria for autoimmune pancreatitis (AIP) so as to more clearly define its morphological, pathological, and immunological features, as follows: (1) diffuse or segmental narrowing of the main pancreatic duct with an irregular wall and diffuse or localized enlargement of the pancreas recognized by imaging studies; (2) high serum gamma globulin, IgG, or IgG4 levels, or the presence of autoantibodies; and (3) marked interlobular fibrosis and prominent infiltration of lymphocytes and plasma cells in the periductal area, occasionally with lymphoid follicles in the pancreas. Establishing a diagnosis of AIP has become easier with knowledge of its immunological abnormalities, including serum IgG4 levels. However, the localized form of AIP sometimes mimics pancreatic cancer. The rate of focal mass formation in patients with AIP is reportedly 24%–43%; however, there have been few reports on the histological findings of localized AIP, in contrast to mass-forming pancreatitis (MFP). Our review of patients who had undergone resection due to a preoperative diagnosis of MFP with possible cancer revealed 72% to be patients with localized AIP. For the discrimination of these conditions, it is important to recognize the characteristic ultrasonographic findings of AIP, i.e., (1) diffuse or localized enlargement and hypoechogenicity of the pancreas; (2) rarity of calcification, cystic lesions, and peripancreatic fluid collection; (3) thickened layer structure of the bile duct wall; (4) iso/hypervascularity in the swollen portion of the pancreas; (5) attenuation of pancreatic swelling and bile duct wall thickening after steroid therapy; and (6) multiple hypoechoic masses in various organs, including the pancreas. Contrast-enhanced endoscopic ultrasonography is potentially a useful tool in the differential diagnosis and for assessment of the efficacy of steroid therapy by enabling evaluation of the vascularity of the lesions. Along with the presence of IgG4-positive plasma cells, verification of obliterative phlebitis is highly specific for the histological diagnosis of AIP.