全反式维甲酸治疗急性早幼粒细胞白血病期间D-二聚体测定的临床意义

目的　探讨在全反式维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL)前后弥漫性血管内凝血(DIC)发生率与D 二聚体含量的关系及意义。方法　应用ELISA法检测 30例APL患者 (包括 12例合并DIC患者 )发病时及应用ATRA治疗后D 二聚体水平的变化 ,并与正常对照组比较。结果　 30例APL患者治疗前血浆D 二聚体水平 (2 .38± 0 .98mg/L)较正常对照组 (0 .2 5± 0 .0 9mg/L)明显升高 (P <0 .0 1) ,其中 12例并发DIC者(2 .5 2± 0 .12mg/L)明显高于 18例不并发DIC者 (2 .18± 0 .96mg/L)。结论　APL患者D 二聚体检测值随维甲酸治疗逐渐降低 ,并可预测ATRA治疗过程中DIC变化及预后。     

D-二聚体测定与急性早幼粒细胞白血病

目的探讨D -二聚体含量与急性早幼粒细胞白血病(APL)经全反式维甲酸(ATRA)治疗前后弥漫性血管内凝血(DIC)发生率的关系及意义。方法应用ELISA法检测21例APL患者(包括7例合并DIC患者)发病时及应用ATRA治疗后D -二聚体水平的变化 ,并与正常对照组比较。结果21例APL患者治疗前血浆D -二聚体水平(2.38±0.98)mg/L较正常对照组(0.25±0.09)mg/L明显升高(P<0.01) ,其中7/21例并发DIC者(2.52±0.12)mg/L明显高于14/21例不并发DIC者 ,(2.18±0.96)mg/L。结论APL患者D -二聚体检测值随维甲酸治疗逐渐降低 ,并可预测ATRA治疗过程中DIC变化及预后     

ALPPS与采用不同栓塞材料PVE对肝再生及手术切除率影响研究

目的 比较不同栓塞材料的门静脉栓塞术（PVE）与联合肝脏分隔和门静脉结扎的二步肝切除术（ALPPS）对剩余肝体积（FLR）增长速率的影响,比较各组FLR的增长速率,二期手术切除率、术中数据和术后并发症。方法 采用单中心、前瞻性、非随机对照的对比研究。2014年11月至2019年12月,海军军医大学第三附属医院共126例因FLR不足导致无法切除的肝细胞癌（HCC）或肝内胆管癌（ICC）病人,将其分为4组：ALPPS组及分别采用氰基丙烯酸正丁酯（NBCA）、微球、明胶海绵作为栓塞材料的PVE组。主要终点为FLR增长速率和二期手术切除率。结果 各组的手术切除例数及二期手术切除率分别为：ALPPS组38例（99.4%）,NBCA组32例（76.2%）,明胶海绵组20例（60.6%）,微球组10例（83.3%）。ALPPS组、NBCA组、微球组的FLR增长速率分别为15.1 mL/d,10.0 mL/d和 8.5 mL/d,均高于明胶海绵组（3.7 mL/d）。结论 采用NBCA及微球作为栓塞材料的PVE导致FLR增长速率低于ALPPS,两种栓塞材料的PVE二期手术切除率相当。使用NBCA作为栓塞材料的PVE其FLR增长速率高于微球,且这两种栓塞材料的栓塞效果均优于明胶海绵。     

循环应用CAG和IA方案治疗老年急性髓性白血病的临床观察

目的:观察循环应用CAG、IA方案治疗老年初治急性髓性白血病(AML)的疗效及不良反应.方法:25例老年初治AML患者分为CAG、IA循环化疗组(Ⅰ组)以及常规方案化疗组(Ⅱ组),Ⅰ组10例患者给予CAG方案治疗,如达不到完全缓解原方案再次治疗,完全缓解后给予IA方案化疗.间歇1个月后再循环应用CAG、IA方案化疗;Ⅱ组15例患者予常规柔红霉素(DNR)+阿糖胞苷(DA)或米托蒽醌+阿糖胞苷(MA)方案化疗,完全缓解后应用DA、MA、HA和IA等方案化疗.结果:Ⅰ组2个周期完全缓解率为60%(6/10),总有效率达到80%(8/10),而Ⅱ组2个周期的完全缓解率仅为26.7%(4/15),总有效率为53.3%(8/15);Ⅰ组无化疗相关死亡病例,Ⅱ组化疗相关死亡率为20%.结论:循环应用CAG、IA方案治疗老年初治AML患者较传统常规化疗方案治疗具有完全缓解率及2年生存率高,毒副反应小的优点.     

Chemoprotective effect of plant phenolics against anthracycline-induced toxicity on rat cardiomyocytes. Part III. Apigenin, baicalelin, kaempherol, luteolin and quercetin

Flavonoids are found universally in plants and act as free radical scavenging and chelating agents with antiinflammatory, antiischemic, vasodilating and chemoprotective properties. In this study, the antilipoperoxidative and cytoprotective effects of apigenin, baicalein, kaempferol, luteolin and quercetin against doxorubicin-induced oxidative stress were investigated in isolated rat heart cardiac myocytes, mitochondria and microsomes. After preincubation of cardiomyocytes with the test compounds for 1 h the cardiomyocytes were treated with the toxic agent, doxorubicin (100 micro M for 8 h). Cardiomyocyte protection was assessed by extracellular LDH and cellular ADP and ATP production. Cytoprotection was concentration dependent for baicalein > luteolin congruent with apigenin > quercetin > kaempferol. All test compounds had signi fi cantly better protective effects than dexrazoxan, an agent currently used for adjuvant therapy during anthracycline antibiotic therapy. In microsomes/mitochondria the IC(50) values of lipid peroxidation inhibition for quercetin, baicalein, kaempferol, luteolin, and apigenin were 3.1 +/- 0.2/8.2 +/- 0.6, 3.3 +/- 0.3/9.6 +/- 0.5, 3.9 +/- 0.3/10.1 +/- 0.8, 22.9 +/- 1.7/18.2 +/- 0.7, and 338.8 +/- 23.1/73.1 +/- 6.4 mM, respectively. The antilipoperoxidative activity of apigenin differed from its cytoprotective effects, but correlated with the free radical scavenging of 2,2-diphenyl-1-picrylhydrazyl radical and half peak oxidation potential (E(p/2)). Apigenin was the least effective of the flavonoids studied in all models except the cardiomyocyte model where its cardiomyocyte cytoprotective effect was comparable to other compounds.     

Comparative evaluation of serum C-reactive protein (CRP) levels in the different histological subtypes of esophageal cancer (squamous cell carcinoma and adenocarcinoma of esophagus)

Elevated C-reactive protein (CRP) levels have been found in patients with several malignancies. The aim of the present study was to analyze the diagnostic and prognostic values of CRP levels measurement in esophageal cancer (EC) patients in relation to its different histological subtypes (squamous cell carcinoma-ESCC and adenocarcinoma-AC of esophagus) and compared them with classic tumor markers-carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC-Ag). The diagnostic sensitivity, specificity, and the areas under receiver operating characteristic curves (AUC) for all the proteins tested were defined. Serum CRP levels were statistically higher in EC, ESCC, and AC patients compared to healthy subjects and significantly increased in EC and ESCC patients with the presence of lymph node and distant metastases. The percentage of elevated CRP results in all the analyzed subgroups (EC, ESCC, and AC) was higher than CEA and SCC-Ag, similarly as AUC for CRP in comparison to SCC-Ag. Serum CRP level was a significant predictor of EC and ESCC patients' survival in univariate analysis. In conclusion, these results indicate that CRP can be used as an adjunct in evaluating the tumor markers-CEA and SCC-Ag and may improve the clinical diagnosis and follow-up of EC patients, especially for ESCC subgroup.     

Effect of beta radiation brachytherapy in the treatment of restenosis of coronary stents

Brachytherapy currently represents the only treatment method for in-stent restenosis (ISR) confirmed in randomised clinical studies. In a group of 46 patients, selected for brachytheraphy on the bases of clinical signs of restenosis accompanied with development or deterioration of angina pectoris and with angiography results showing significant in-stent restenosis, we used a beta radiation system BetaCath NOVOSTE. This therapy was safe. Results of acute angiography were positive in 91% of patients. Clinical restenoses within 6 month of clinical monitoring occurred in 8.6% of patients. Due to impairment of more arteries in the majority of patients from the sample, following revascularisation of nontarget vessels was necessary in 19.6% of patients. We haven't observed late thrombosis. It was probably eliminated by prolonged administration of a combination of aspirin and clopidogrel. Dosimetry results during brachytherapy showed that doses of radiation both for a surgeon and a patient corresponded to a fraction of doses received from an x-ray apparatus during fluoroscopy and acquisition. Both an edge restenosis and a diffuse restenosis were identified in stenoses of patients with in-stent restenosis. Brachytherapy with beta radiation seems to be an efficient method for treatment of coronary in-stent restenosis.     

温莪术内生真菌的分离及其抗菌活性的初步研究

 目的研究温莪术内生真菌的种群组成及其代谢产物抗菌活性。方法采用内生菌常规分离法对健康温莪术植株体内的内生真菌进行了分离鉴定。以大肠杆菌、金黄色葡萄球菌、链球菌、沙门氏菌、巴氏杆菌为测试菌种,对温莪术根、茎、叶中分离的56株内生真菌进行抗菌活性筛选。结果经初步鉴定,这些内生真菌为5目、6科、24属;抑菌实验表明,56株内生真菌中有39株对5种测试菌均有不同程度的抑制作用。结论温莪术植物含有丰富多样的内生真菌,且多数内生真菌都表现为较高的抑菌活性。