三维适形放射治疗局部复发鼻咽癌疗效观察

目的：观察三维适形放疗治疗局部复发鼻咽癌的近期疗效及放射损伤的发生率。方法：对42例局部复发鼻咽癌病例采用三维统计计划系统放射治疗计划，以剂量体积直方图评价和优化放射治疗计划，头部固定装置及多叶光栅技术实施适形放射治疗。计划靶区为临床所见肿瘤区外放7－10mm，计划靶区体积（PTV）中位体积为47．6cm^2(27.9-61.8cm^3)，时间－剂量－分次采用：（5－5．5周）－（60－70Gy)-(24-28次），结果：三维适形放疗后，肿瘤局部控制率85．7％（36／42），2年生存率73．8％（31／42），放射损伤包括听力丧失7．1（3／42），张口困难35．7％（15／42），吞咽困难7．1％（3／42），慢性副鼻窦炎28．6％（12／42），脑神经损伤21．4％（9／42），结论：三维适形放疗治疗鼻咽放疗后鼻咽部局部复发有较好的近期疗效，而放射损伤较低，远期疗效尚待进一步观察。     

加热及增加细胞内氧自由基水平对恶性胶质瘤细胞生物学特性的影响

本文就加热及同时增加细胞内氧自由基水平对恶性胶质瘤细胞存活、增殖和细胞间隙连结通讯的影响做初步观察。用Ｍ．Ｔ．Ｔ法测定胶质瘤细胞存活率；用Ｋｉ－６７抗增殖细胞核抗原单克隆抗体，通过免疫组织化学ＡＢＣ染色分析胶质瘤细胞的增殖活性；用划痕染料示踪技术观察胶质瘤细胞的细胞间隙连结通讯。结果表明，Ｈ２Ｏ２和３ＡＴ能增强加热对胶质瘤细胞存活与增殖的抑制作用，促进胶质瘤细胞间隙连结通讯的改善，存在着明显的剂量和时间效应。实验结果提示，通过内外源性增加胶质瘤细胞内的氧自由基水平，将有助于强化加热治疗胶质瘤效果，并可以减少加热的剂且，降低副作用。     

Quinone oxidoreductase gene polymorphism and genetic susceptibility to nasopharyngeal carcinoma]

OBJECTIVE: To ascertain whether the point mutation of cDNA609 C to T of quinone oxidoreductase (NQO1) gene is associated with the genetic susceptibility to nasopharyngeal carcinoma. METHODS: Polymerase chain reaction-restriction fragment length polymorphism was employed to assess the polymorphism of NQO1 genes both in 120 patients with nasopharyngeal carcinoma and 120 healthy subjects matched for age, gender and origin. RESULTS: The allelic frequency of mutant T allele of NQO1 gene was significantly higher in patients with nasopharyngeal carcinoma than in the healthy subjects (P<0.05), and the individuals with T allelic genotype of NQO1 gene were at greater risk to develop nasopharyngeal carcinoma. CONCLUSION: The cDNA 609 T allele of NQO1 gene is very likely to be associated with the genetic susceptibility to nasopharyngeal carcinoma.     

进展期胃癌术后辅助性化疗的10年随访结果

报告１０２例进展期胃癌术后患者，随机进行３组不同化疗方案并经平均随访１０．７年的结果。所有病例均为１９８３年５月到１９８５年５月间手术者。术后随机给予单一５－ＦＵ、５－ＦＵ＋ＣＣＮＵ和ＭＴＸ＋ＭＭＣ＋５－ＦＵ三组不同化疗。随访至１９９４年１２月止，死亡７７例，存活２５例。结果３、５和１０年总生存率分别为４２．１％；２９．４％和２４．５％。三组间比较，总自下而上率并无显著差异（Ｐ〉０．０５），但中位     

强的松龙.葡聚糖连接物在大鼠胃肠道内容物中的水解

观察强的松龙．葡聚糖连接物的结肠定向释放特性。方法通过将所合成的强的松龙．葡聚糖连接珠与大鼠胃肠道不同部位内容物稀释液一起孵育,观察强的松龙的释放情况。结果在１６０ｍｉｎ的卵育过程中,强的松龙．葡聚糖连接物的在胃肠道上部内容物中水解释放出少量强的松龙及强的椴龙琥珀酸半酯,最在释放量小于３μｍｏｌ．Ｌ＾－１;而在胃肠道下部内容物中水解释放出大量强的松龙及强的松龙琥珀酸半酯最大释放量为１４μｍｏｌ．Ｌ     

地塞米松·葡聚糖的合成及其肠内容物中的转释特性

目的　探讨地塞米松·葡聚糖 (平均相对分子质量 5× 10 5 )作为结肠定位地塞米松前体药物的可能性 .方法　以琥珀酸酐为交联剂 ,合成地塞米松前体药物 .将前体药物与大鼠胃肠道不同部位内容物一起孵育 ,检测地塞米松的释放情况 .结果　经高效液相色谱 (HPL C)分析 ,10 0 mg所合成的前体药物中载有地塞米松 9.2 mg.在 16 0 min的孵育时间内 ,前体药物在大鼠结肠及盲肠内容物中释放出地塞米松的量是其在小肠近端及小肠远端内容物中释放量的 2 .7倍 ,在胃内容物中无地塞米松的释放 .结论　地塞米松前体药物能在盲肠、结肠内容物中特异地释放出地塞米松 ,因此地塞米松·葡聚糖 (平均相对分子质量 5× 10 5 )可以作为结肠定位地塞米松前体药物 ,有选择性地将地塞米松运送到结肠     

MN9202保护血栓大鼠尾动脉血管作用

观察新二氢吡啶类钙拮抗剂２,６－二甲基－４－（３－硝基苯基）－１,４－二氢－３,５－吡啶二羧酸－３－甲酯－５－正戊酯（ＭＮ９２０２）对血栓形成大鼠尾动脉血管平滑肌及内皮功能的影响。方法大鼠脚趾ｓｃ注射角叉来胶制备血栓模型,并于注射角叉菜胶前２４ｈ,１ｈ及注射后２４ｈｉｐＭＮ９２０２１μＭＯＬ．ＫＧ＾－１,取尾动脉血栓波及不同区域的三段血管,以去甲肾上腺素（ＮＥ）,乙酰胆碱（ＡＣｈ）,亚硝酸钠（Ｎａ     

Web-Based Immersive Virtual Patient Simulators: Positive Effect on Clinical Reasoning in Medical Education

Background

Clinical reasoning is based on the declarative and procedural knowledge of workflows in clinical medicine. Educational approaches such as problem-based learning or mannequin simulators support learning of procedural knowledge. Immersive patient simulators (IPSs) go one step further as they allow an illusionary immersion into a synthetic world. Students can freely navigate an avatar through a three-dimensional environment, interact with the virtual surroundings, and treat virtual patients. By playful learning with IPS, medical workflows can be repetitively trained and internalized. As there are only a few university-driven IPS with a profound amount of medical knowledge available, we developed a university-based IPS framework. Our simulator is free to use and combines a high degree of immersion with in-depth medical content. By adding disease-specific content modules, the simulator framework can be expanded depending on the curricular demands. However, these new educational tools compete with the traditional teaching

Objective

It was our aim to develop an educational content module that teaches clinical and therapeutic workflows in surgical oncology. Furthermore, we wanted to examine how the use of this module affects student performance.

Methods

The new module was based on the declarative and procedural learning targets of the official German medical examination regulations. The module was added to our custom-made IPS named ALICE (Artificial Learning Interface for Clinical Education). ALICE was evaluated on 62 third-year students.

Results

Students showed a high degree of motivation when using the simulator as most of them had fun using it. ALICE showed positive impact on clinical reasoning as there was a significant improvement in determining the correct therapy after using the simulator. ALICE positively impacted the rise in declarative knowledge as there was improvement in answering multiple-choice questions before and after simulator use.

Conclusions

ALICE has a positive effect on knowledge gain and raises students’ motivation. It is a suitable tool for supporting clinical education in the blended learning context.