参附注射液对老年慢性充血性心力衰竭患者左心功能的影响

目的:研究参附注射液对老年慢性充血性心力衰竭患者左心功能的影响.方法:采用体内标记红细胞法,应用核素门控平衡法分别测定快速注射参附注射液前、注射后10分钟、30分钟、 60分钟后左心功能参数HR、LVEF 、PER、PFR的变化.结果:快速注射参附注射液对老年慢性充血性心力衰竭患者心率无明显影响,使老年慢性充血性心力衰竭患者LVEF、PER、PFR明显下降, 注药后10分钟下降到高峰水平,60分钟后仍维持在较低水平,其中左心舒张期功能参数PFR下降幅度大于左心收缩期功能参数PFR.结论:快速注射参附注射液使老年慢性充血性心力衰竭患者心功能下降.     

Risk Factors of Gastric Cancer in Wuwei City- an Endemic Region of Gastric Cancer

OBJECTIVE Studies have shown that risk factors of gastric cancer include living habits, eating moldy pickled food, dystrophy, lack of nutrients, and genetics, etc. This study explores the prevalence of these factors in Wuwei, a city in northwest China with a high incidence of gastric cancer.METHODS Family histories of the residents in Wuwei City were investigated with a case-control method. Segregation ratio and heredity degree of gastric cancer were calculated using theLi-Mantel-Cart and Falconer's regression methods. Chronic gastritis patients were followed-up by home visits, gastroscopy, and pathology. Carcinogenic fungi and volatilile N-nitroso compounds were noted in the residents' meals. Helicobactor pylori (Hp) was assessed in their gastric mucosa and the total content of serum vitamin C in 293 healthy adults was determined.RESULTS In Wuwei City, the segregation ratio of gastric cancer was 0.077. The heredity degree of first-degree relatives was 22.91%. The incidence rate of cancer per year in people in an atrophic gastritis group was 1.09%. Eight kinds of nitrosamines and 14 kinds of carcinogenic fungi were detected in the residents' food. Total average vitamin C in the serum of the 293 healthy adults in the summer was 5.74±2.79 mg/L. The positive rate of Hp in gastric mucosa of the residents was 67%.CONCLUSION The majorextrinsic factors include infection of Hp, atrophic gastritis (especially atrophic hyperplasia), and genetic susceptibility.     

CIK细胞对慢性粒细胞白血病G0期CD34+白血病细胞的杀伤作用

目的研究细胞因子诱导杀伤细胞(cytokine induced killer,CIK)对慢性粒细胞白血病(chronic myeloid leukemia,CML)中G0期原始干细胞(CD34+)的杀伤作用。方法5例CML慢性期患者外周血标本在体外诱导培养CIK细胞,流式细胞仪(FCM)检测其表型。G带法检测CIK细胞核型。应用免疫磁珠技术分选CD34+CML白血病细胞,AO染色后利用FCM检测CIK细胞对G0期CD34+CML白血病细胞的杀伤作用。半固体培养法检测CIK细胞对正常骨髓CFU-GM、BFU-E集落的影响。结果CIK细胞在培养第3周时,CD3+细胞数量达(97.29±3.55)%,CD3+CD56+细胞绝对数量增加了356倍,染色体分析证实,CIK细胞为正常核型,流式细胞仪检测CIK细胞对G0期CD34+CML白血病细胞平均杀伤率为66.73%。对照组与加入CIK细胞组的CFU-GM集落数分别为150±16和145±20,差异无统计学意义,P=0.38;两组的BFU-E集落数分别为68±5和65±8,差异无统计学意义,P=0.23。集落类型、大小两组相似,差异无统计学意义,P=0.46。结论CIK细胞可从CML患者外周血中大量扩增,来源于正常淋巴细胞,对G0期CD34+CML白血病细胞有明显抑制作用,对正常造血前体细胞无抑制作用,可作为过继细胞免疫治疗的效应细胞治疗CML。     

Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40～50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40～50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29.8% before radiation as compared to 57.6±22.6% during RT. The difference between these two groups was not significant (P=0.280). The decreased relative lung perfusion post-RT was found in six patients, whereas the increased relative lung perfusion post-RT was observed in 13 patients.CONCLUSION SPECT lung perfusion scaning is a simple, convenient and useful method for assessing regional lung function pre-RT and for monitoring the changes in regional lung function after irradiation.     

黄芪总黄酮抗肝损伤作用初探

目的研究黄芪总黄酮(total navonoids 0f Astragalus,TFA)对扑热息痛所致小鼠肝损伤的预防功效。方法观察不同剂量(0、100、300、400、500 ms/kg)扑热息痛对c57BL/6J小鼠肝脏的损伤作用,比较经1天或5天(每天2次)的TFA预处理后对扑热息痛(400 mg/kg)所致肝损伤的防护作用。结果扑热息痛对小鼠肝损伤作用具有明显的量效关系。不同剂量的TFA对扑热息痛诱导小鼠肝损伤有不同程度的防护作用,其作用强度与药物浓度成正比；TFA可增加血清中SOD活性(P＜0．05)；高剂量的TFA(100mg/kg)具有降低肝组织中脂质过氧化物质的作用；此外,在相同TFA剂量下,5天组对扑热息痛诱导小鼠肝损伤的预防作用优于1天组。结论提示TFA可预防扑热息痛诱导的肝损伤,其预防作用与其使用时间有密切关系。     

茵陈五苓散对大鼠酒精性肝损伤防治作用的研究

目的观察茵陈五苓散对大鼠酒精性肝损伤血清ALT、AST和病理组织学的影响，为临床酒精性肝损伤的防治提供实验依据。方法采用白酒灌胃造模，50只Wistar大鼠随机分成正常组、模型组、预防1组、预防2组、治疗组，分别于实验第5周、第9周末尾静脉取血，分离血清，测定ALT、AST。并于第9周取血后肝脏取材，常规HE染色，光镜观察。结果模型组血清ALT、AST明显升高，预防1、2组、治疗组血清ALT、AST均低于模型组，差异具有显著性（均P〈0．01）。模型组成功建立酒精性肝损伤病理学模型，预防组、治疗组病理学改变较模型组显著减轻。结论茵陈五苓散能有效地预防和治疗大鼠酒精性肝损伤。     

加替沙星在正常与肝损害模型家犬体内的药动学比较研究

目的:比较加替沙星在正常与肝损害模型家犬体内的药动学。方法:家犬腹腔注射四氯化碳溶液,建立肝损害模型;给药 后分别在规定时间点取样,以高效液相色谱法测定各时间点加替沙星血药浓度,利用3p87软件计算其药动学参数,并与正常家犬 比较。结果:加替沙星在正常家犬与肝损害模型家犬体内分布均呈一室模型,tmax分别为(2．35±0．75)h、(1．06±0．32)h,t1／2ke分 别为(8．38±2．03)h、(8．91±1．21)h,Cmax分别为(2．29±0．11)、(2．63±0．07)mg／L,AUC分别为(33．82±6．78)、(36．80± 4．67)(μg·h)／ml,经t检验无显著性差异(P>0．05)。结论:加替沙星在正常与肝损害模型家犬体内药动学比较无显著性影响。     

慢性乙型肝炎病毒感染者血清白细胞介素-2干扰素-γ检测及其临床意义

目的探讨慢性乙型肝炎病毒(HBV)感染者外周血白细胞介素-2(IL-2)、干扰素(IFN)-γ活性与病毒载量、肝功能以及肝纤维化的关系。方法IL-2检测采用放射免疫法(RIA法),IFN-γ检测采用酶联免疫吸附试验(ELISA)。结果HBV-DNA高载量组与低载量组相比IL-2水平明显低下(P<0.05),两组间IFN-γ水平无统计学意义。随着肝功能损害程度加重,IL-2水平逐渐降低,IFN-γ逐渐增高;与非肝硬化组比较,肝硬化组的IL-2的含量显著降低,而IFN-γ显著升高(P均<0.01)。结论在乙型肝炎慢性化过程中,IL-2与HBV清除有关,其降低的程度与肝损伤严重程度及肝纤维化相关;IFN-γ的抗病毒作用不明显,但它作为炎症介质参与了肝脏炎症坏死和肝纤维化的形成过程。     

磁共振成像在分析脊髓栓系综合征神经损伤因素中的价值

目的研究腰骶椎磁共振成像(MRI)在评估脊髓栓系综合征(TCS)神经功能损伤中的价值,分析影响神经系统损害的因素。方法搜集TCS患者58例,按年龄分为小儿及成人两组,行MRI腰骶椎脊髓及终丝成像。神经损伤的轻重程度依临床表现分为4级。在MRI图像中观察脊髓圆锥的位置、形态及脊椎的全貌,按圆锥在椎管内的位置分为高低两级。结果58例TCS患者脊髓圆锥位置均低于L2椎体下缘,小儿组合并脊柱侧弯或腰椎生理曲度加大或硬膜囊扩张的脊柱畸形患者神经损伤程度较未合并脊柱畸形患者轻,差异有统计学意义(P=0.0035)。小儿组脊髓圆锥的位置较成人组低、神经损伤的程度较成人组严重,差异均有统计学意义。结论MRI可全面显示脊髓圆锥、终丝及周围组织形态,能为TCS患者脊髓张力的判断及神经损伤的评估提供重要的影像学依据。     

吸入性肾上腺皮质激素治疗哮喘和慢性阻塞性肺疾病

近年来,在支气管哮喘和慢性阻塞性肺疾病的治疗药物中,肾上腺皮质激素可对抗炎症或过敏介质,通过对慢性阻塞性肺疾病者的前炎症因子、炎症细胞、氧化应激的影响而发挥良好的疗效.吸入性肾上腺皮质激素疗效确切,对过敏介质选择性高,在治疗支气管哮喘、气管炎、慢性阻塞性肺疾病上显示了良好的前景.