河北省探索解决看病贵的长效机制

为有效解决广大群众看病难、看病贵问题,河北省卫生厅以落实全国卫生工作会议精神为契机,在推广邯郸市实施医疗惠民工程经验的基础上,着手建立解决看病贵问题的长效机制.     

染色体1pter-p36.21杂合性缺失与瘢痕疙瘩的关系

目的寻找瘢痕疙瘩1pter-36.21中可能存在的肿瘤抑制基因的杂合性丢失(LOH)区域,为发现和定位瘢痕抑制基因提供线索和依据。方法采用聚合酶链反应(PCR)-变性聚丙烯酰胺凝胶电泳技术,对25例瘢痕疙瘩组织和外周静脉血标本进行微卫星分析。结果瘢痕疙瘩组织在所选的位点上的LOH发生率为60%(15/25),明显高于正常对照组织的4%(1/25,P<0.05),在所选的位点上均未发现微卫星不稳定性(MSI)。D1S243位点、D1S468位点、D1S507位点、D1S199位点的LOH发生率分别为28%(7/25)、40%(10/25)、52%(13/25)、12%(3/25),其中D1S243、D1S468、D1S507的LOH发生率比较具有统计学意义(P<0.05)。结论发生在D1S243-D1S468-D1S507位点的LOH存在与瘢痕疙瘩有关的潜在瘢痕抑制基因(SSG),而1pter-36.21上LOH微卫星不稳定性与瘢痕疙瘩发生的关系不大。     

46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

MAPK 通路抑制剂对低氧高二氧化碳性肺动脉收缩的影响

目的： 观察肺主动脉环、二级肺动脉环在急性低氧高二氧化碳介质中张力的变化；探讨 MAPK 信号通路抑制剂 U0126、SB203580 对低氧高二氧化碳性肺血管收缩的影响。方法: 制备离体 SD 大鼠肺主动脉环、二级肺动脉环。分别观察肺主动脉环、二级肺动脉环在常氧及急性低氧高二氧化碳介质中的张力变化；在急性低氧高二氧化碳条件下分别用 U0126、SB203580 孵育二级肺动脉，观察各自对低氧高二氧化碳性肺动脉收缩的影响。结果: 在常氧条件下,肺主动脉、二级肺动脉张力均无明显变化。急性低氧高二氧化碳条件下二级肺动脉发生双向性收缩反应，肺主动脉只在低氧高二氧化碳早期出现较明显的收缩峰，后期则变化不明显。二级肺动脉分别经ERK1/2上游激酶抑制剂 U0126、p38 MAPK 通路抑制剂 SB203580 孵育后，Ⅱ期持续收缩幅度明显下降（P<0.05)，Ⅰ期快速收缩峰、Ⅰ期舒张均没有明显变化。结论: 在离体条件下，急性低氧高二氧化碳（PO₂ = 30-35 mmHg，PCO₂=55-60 mmHg)可使肺主动脉出现早期快速收缩，并可使二级肺动脉环发生双向性收缩反应；急性低氧高二氧化碳条件下，U0126、SB203580 均能减弱二级肺动脉环的Ⅱ期持续收缩反应。这为临床治疗缺氧和高碳酸血症引起的肺血管收缩及肺动脉高压提供了理论依据。     

唑来膦酸联合泰索帝治疗晚期非小细胞肺癌骨转移疗效分析

目的 评价唑来磷酸联合泰索帝治疗晚期非小细胞肺癌骨转移的疗效及安全性.方法 41例晚期非小细胞肺癌骨转移患者随机分为唑来膦酸联合泰索帝(A组)及单用唑来磷酸(B组)治疗,对两组疗效进行分析比较.结果 A组骨痛缓率、生存质量改善率略好于B组(P>0.05).毒副作用差异无显著性.A组骨转移灶修复率52.4%(11/29),B组20.0%(4/20).差异有显著性(P<0.05).结论 唑来膦酸联合泰索帝治疗晚期非小细胞肺癌骨转移有较好的治疗用,毒性可耐受.     

3TSR治疗裸鼠胃癌的实验研究

目的： 探讨血管形成抑制剂3TSR对人胃癌裸鼠皮下移植瘤的抑制作用及机制。方法: 建立人胃癌裸鼠皮下种植瘤模型,实验分为对照组(腹腔注射PBS 0.2 mL)、3TSR组(腹腔注射3TSR 3 mg/kg BW)，每组8只。给药3周后处死动物,提取瘤体，测量各组荷瘤体积，HE染色检测肿瘤坏死面积百分比，免疫组织化学方法检测肿瘤微血管表达、肿瘤细胞增殖指数，原位末端标记法(TUNEL法)检测肿瘤细胞凋亡率,CD31/TUNEL/DAPI重复染色法测定肿瘤血管内皮细胞凋亡率。结果: 3TSR组平均肿瘤体积为(648.34±126.90) mm3,较对照组显著缩小(P<0.05)； 3TSR组平均肿瘤坏死面积百分比为（39.6±7.8）%,较对照组扩大69.2%，2组间有显著差异(P<0.05)。3TSR组肿瘤平均微血管数为12.8±4.1,平均微血管面积为（689.3±118.6）μm2，均显著低于对照组(P<0.05)，3TSR组增殖指数和凋亡率分别为(40.0±7.1)%和(3.4±1.2)%，与对照组比较无显著差异(P>0.05),3TSR组肿瘤血管内皮细胞凋亡率为(11.6±2.8)%,显著高于对照组的(2.9±1.5)%,P<0.05。结论: 3TSR能抑制裸鼠胃癌新生血管形成，具有显著减少肿瘤体积、肿瘤血管和增加肿瘤细胞坏死的作用，但对胃癌细胞无直接抑制作用，其机制可能与诱导内皮细胞凋亡有关。     

类固醇激素在变应性鼻炎治疗中的应用

目的：对类固醇激素在变应性鼻炎治疗中的应用作一综述,方法：对类固醇激素在变应性鼻炎治疗中的应用加以分析,整理。结果：展现类固醇激素在变应性鼻炎治疗领域的最新成果,结论：选择合适的应用方法,有地临床医师运用类固醇激素在主为应性鼻炎的治疗中提高疗效,避免或尽量减少副作用的发生。     

46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

蝙蝠葛苏林碱在兔体内的药代动力学及组织分布

目的:研究蝙蝠葛苏林碱(DS)在兔体内的药代动力学和组织分布特征.方法:兔耳缘静脉注射给予DS后,采用高效液相色谱法测定各时间点血浆和组织器官药物浓度,并用3p97程序计算药代动力学参数.结果:兔DS 2.5、5、10 mg·kg-1静脉注射给药后,体内动力学行为符合二房室开放模型.T1/2β分别为 3.0±0.6、3.4±0.9 和 6.9±0.6 h;Cls分别为 3.1±0.6、3.6±0.4 和 4.4±0.3 L·h·kg-1;Vd分别为 13.1±2.7、18.0±6.2 和 43.6±4.4 L·kg-1;AUC0～t分别为 0.84±0.13、1.41±0.17 和 2.30±0.18 mg·h·L-1.在DS 2.5～5 mg·kg-1范围内主要药动学参数无显著性差异(P>0.05),但DS 10 mg·kg-1静脉注射后,C0超比例增加(P＜0.01),T1/2β明显延长(P＜0.01).结论:在 2.5～5 mg·kg-1范围内DS的消除为线性动力学,而10 mg·kg-1静脉注射后,本品在兔体内的消除未呈线性动力学.组织分布以肺脏含量最高,其次为肾、脾和肝脏.各组织器官中药量均显著高于血浆药物浓度.     

雷公藤多甙对大鼠胶原免疫性关节炎黏膜免疫的影响

目的:观察雷公藤多甙对于大鼠胶原免疫性关节炎黏膜免疫的影响.方法:Ⅱ型胶原与完全弗氏佐剂免疫大鼠,以雷公藤多甙治疗,观察大鼠黏膜免疫各项指标.结果:雷公藤多甙可以改善CIA大鼠病理改变,降低肠道PP结中CD4/CD8比值,对脾中T细胞亚群有调节作用,并可降低关节中致炎细胞因子的表达.结论:雷公藤多甙对CIA模型大鼠有抗炎和免疫抑制的作用.