中国实用医刊杂志   部级期刊

摘要：目的 总结颈胸段椎管内神经源性肿瘤的诊断与手术治疗方法.方法 回顾我科近5年来收治的15例颈胸段椎管内神经源性肿瘤患者的诊断及手术治疗情况.15例肿瘤全切或次全切,14例行内固定植骨融合术.结果 除1例转移瘤因原发病并发症于术后2年死亡外,其余病例症状均获得改善,在最长36个月的随访中未出现脊柱后凸畸形.结论 MRI为诊断椎管内肿瘤的有效方法,术中应注意保护脊髓及神经根,内固定重建对维持脊柱的稳定性有重要价值,可防止远期后凸畸形的发生. Abstract： Objective To summarize the diagnosis and surgical intervention of intraspinal neuromas in cervical vertebra and thoracic vertebra. Methods A retrospective review was made on 15 cases of ntraspinal neuromas of cervical vertebra and thoracic vertebra in last 5 years. Total resection or sub-total resection was achieved in all cases, and internal fixation and fusion were used in 14 cases. Results In addition to 1 case of metastatic tumor died in 2 years after surgery because of the primary disease and complications, the symptoms of the remaining were improved after surgery, no kyphosis in the longest follow-up of 36 months. Conclusions MRI is an effective way for the diagnosis of intraspinal tumors. Pay attention to protecting the spinal cord and nerve roots during the surgery. Stability reconstruction plays important roles in maintaining stability of spine, and it can prevent the occurrence of kyphosis.

摘要：目的 研究兔体内巴洛沙星对多索茶碱的药动学影响.方法 采用高效液相色谱法测定多索茶碱单用及与巴罗沙星合用后不同时间兔体内多索茶碱的血清浓度,以3p97药动学软件对药-时数据进行处理,并进行统计学分析.结果 主要药动学参数如下:多索茶碱单用:T1/2α (11.3±1.7),T1/2β(87±10), CL(s)(0.033±0.005),V(C)(0.96±0.12), AUC0-T(988±137);与巴罗沙星合用:T1/2α (12.7±2.6), T1/2β(90±13), CL(s)(0.032±0.005), V(C)(0.99±0.18), AUC0-T(1029±137).结论 多索茶碱的药动学符合一级动力学消除,二室开放模型,兔体内两药合用时,巴洛沙星对多索茶碱的药动学无显著影响,但会延缓多索茶碱的代谢产物茶碱的消除. Abstract： Objective To investigate the effects of balofloxacin in rabbits on pharmacokinetics of doxofylline.Methods After single-use of doxofylline and combination with balofloxacin, the concentration of doxofylline in serum were measured by high-performance liquid chromatography(HPLC).The concentration-time data were accessed by 3p97 pharmacokinetic program,and analyzed by statistical methods. Results The pharmacokinetic parameters were single-use of doxofylline, T1/2α(11.3±1.7),T1/2β(87±10),CL(s)(0.033±0.005),V(C)(0.96±0.12),AUC0-T(988±137). Doxotylline in comlination with balofloxacin, T1/2α(12.7±2.6),T1/2β(90±14),CL(s)(0.032±0.005),V(c)(0.99±0.18),AUC0-T(1029±127).Conclusions The pharmacokinetic of doxofylline is correspond with first order kinetics elimination and two compartment open model.Balofloxacin has no effect on the pharmacokinetics of doxofylline,but can postpone the elimination of theophylline,which is the metabolic products of doxofylline.

摘要：目的 探讨诺维本(长春瑞滨)联合顺铂方案治疗蒽环类和(或)紫杉类耐药晚期乳腺癌的疗效与安全性.方法 73例蒽环类和(或)紫杉类耐药晚期乳腺癌患者接受诺维本联合顺铂方案化疗.诺维本(法国Pierre Fabre公司产品)25 mg/m2,第1天和第8天,静脉滴注;顺铂75～80 mg/m2,静脉滴注, 分割为2～5 d.3周为1个周期,每2个周期治疗结束2周后评价疗效.结果 71例均可评价近期疗效和不良反应,总有效率为63.4%(45/71),完全缓解4.2%(3/71),部分缓解59.2%(42/71),稳定32.4%(23/71),进展4.2%(3/71).既往放疗者疗效优于未放疗者(P=0.029),转移部位为单个者疗效优于多个者(P=0.005).主要不良反应为骨髓抑制和胃肠道反应.结论 诺维本联合顺铂方案是治疗蒽环类和(或)紫杉类耐药晚期乳腺癌安全有效的方案. Abstract： Objective To investigate the efficacy and security of vinorelbine combined with cisplatin in the treatment of advanced breast cancer patients resistant to antracyclines and/or taxanes.Methods Seventy-three patients with advanced breast cancer resistant to anthracyclines and/or taxanes received NP regimen:Vinorelbine(NVB 25 mg/m2,intravenous infusion, day 1,8) plus cisplatin(DDP 75-85 mg/m2,intravenous infusion in 2-5 days).Three weeks as one period of treatment.The evaluation was performed two weeks after every two periods of treatment. Results Seventy-one patients were evaluated for efficacy and toxicity of the therapy, the overall response was 63.4%(45/71),3 cases (4.2%) had complete response,42 cases(59.2%)had partial response,while 23 cases(32.4%) had stable disease and progressive disease were 3 cases(4.2%).The efficacy in patients who had received radiotherapy were more effective than those without radiotherapy(P=0.029).The efficacy in patients with single metastatic organ were more effective than those with multiple organs(P=0.005). The common toxicities were myelosuppression and gastrointestinal reactions.Conclusions Vinorelbine combined with cis

摘要：目的 探讨腔内激光治疗(EVLT)大隐静脉曲张的手术体会及疗效.方法 2007年8月至2009年3月我院对108例144条肢体大隐静脉曲张行高位结扎、腔内激光治疗或腔内激光治疗辅助局部曲张静脉切除.结果 本组一次治愈率95.1%(136/144),余7例8条肢体术后残留少量曲张静脉存在,二期在局部麻醉下行手术切除或再次激光治疗.25例术后可在大隐静脉主干部位或小腿局部出现条索状硬结,并伴有局部轻度疼痛,5例出现局部浅表静脉炎,7例出现程度不同的皮肤灼伤,无深静脉血栓、肺栓塞等严重并发症发生.平均手术时间(40±5) min(单侧肢体);术后住院时间4～9 d,平均5.8 d.108例随访1～18个月,平均10个月,未见复发.结论 ELVT应正确选择病例,掌握手术技巧可减少并发症的发生,ELVT联合大隐静脉高位结扎、局部切除,疗效确切. Abstract： Objective To explore the treatment experience and curative effect of endovenous laser treatment(ELVT)for patients with great saphenous vein varicosis.Methods One hundred and eight cases (144 limbs)with varicose great saphenous veins were performed endovenous laser treatment.The opreration included high ligation and photocoagulation of varicose veins,or photocoagulation of varicose veins combined with local resection of varicose veins.Results The cure rate on one group was 95.1%(136/144),reoperations of local resection or laser photocoagulation under local anesthesia were required in 7 cases (8 limbs)due to remnant varicose veins.Main complications involved local funicular callosity along the stem of the great saphenous vein in 25 cases,local skin phlebitis in 5 cases,and skin burn in 7 cases.Deep vein thrombosis and pulmonary embolism no found.The mean operation time was (40±5) min(single limb),the duration of postoperative hospital stay was 4～9 d(mean 5.8 d),all cases were followed up for 1-18 months (mean 10 months), no found recurrence.Conclusions The managements of selecting patient correctly,opera

摘要：目的 观察紫杉醇联合奈达铂方案治疗晚期食管癌的疗效和不良反应.方法 将60例晚期食管癌患者随机分为两组,紫杉醇+奈达铂组30例,应用紫杉醇150 mg/m2,第1天,奈达铂80 mg/m2,第2～4天;5-氟尿嘧啶+顺铂组30例,用5-氟尿嘧啶500 mg/m2,第1～5天,顺铂80 mg/m2,第2～4天;两组均21 d为1个周期,2个周期后按实体瘤疗效评价标准(RECIST)评价疗效,按WHO抗癌药物急性与亚急性表现和分度标准评价不良反应.结果 紫杉醇+奈达铂组30例,有效率为50%,中位疾病进展时间6.7个月,中位生存时间11.8个月;5-氟尿嘧啶+顺铂组30例,有效率36.7%,中位疾病进展时间3.9个月,中位生存时间8.9个月,两组比较差异有统计学意义.紫杉醇+奈达铂组不良反应稍重,主要表现为白细胞减少、血小板下降和脱发,但是可耐受.结论 紫杉醇联合奈达铂治疗晚期食管癌的疗效较高,不良反应可耐受. Abstract： Objective To observe the efficacy and the side effects of paclitaxel combined with nedaplatin in treating advanced esophageal cancer. Methods Sixty patients with advanced carcinoma of esophagus were divided into two groups.Thirty ptients were given paclitaxel 150 mg/m2 intravenous infusion on the first day, and nedaplatin 80 mg/m2 intravenous infusion divided into d 2-4. Thirty patients were given 5-Fu 500 mg/m2 on d 1-5,and cisplatin 80 mg/m2 intravenous infusion divided into d 2-4. Cycles were repeated every 21 days. After two consecutive treatment courses, the evaluation of the efficacy and toxicities were carried out. Results The overall response rate of PTX+NDP group was much higher than that of 5-Fu +DDP group(50% vs 36.7%, P＜0.01).The median time to progress was 6.7 months vs 3.9 months.The median survival time was 11.8 months vs 8.9 months.The difference was obvious.The adverse effects of the former were more sever than that of the later.The major adverse effects were bonemarrow depression, thrombocytopenia and alopecia. Conclusions Paclitaxel co

摘要：目的 探讨CpG寡聚脱氧核苷酸(CpG ODN)在肿瘤免疫治疗中的作用.方法 将CpG ODN刺激体外培养的人外周血单个核细胞(PBMC),ELISA法检测其分泌细胞因子白细胞介素-12(IL-12)、干扰素-γ(INF-γ)的表达, MTT法检测CpG ODN作用后的PBMC对淋巴瘤细胞株HUT-78细胞杀伤活性.结果 与对照组相比,经CpG ODN作用后的PBMC对HUT-78细胞杀伤活性显著提高(P＜0.05),同时CpG ODN能明显促进PBMC分泌细胞因子IL-12、INF-γ(P＜0.05).结论 CpG ODN可增强PBMC介导的抗淋巴瘤细胞的作用,其杀伤活性与分泌细胞因子有关. Abstract： Objective To study the immunotherapy role of CpG ODN(CpGoligodeoxynucleotide) on tumor.Methods After treated with synthetic CpG ODN for 48 hours, the inhibiting effect of PBMC on HUT-78 cells were detected by MTT method.The secretions of TNF-γ and IL-12 from PBMC determined using ELISA method.Results The PBMC treated with CpG ODN enhanced their antitumor effect on HUT-78 cells and increased the secretion levels of TNF-γ and IL-12.Conclusions CpG ODN increases the cytotoxicity of PBMC on HUT-78 cells in vitro, as well as facilitates the IL-12 and TNF-γ secretion.

摘要：目的 观察长期吸入沙美特罗/氟替卡松及噻托溴铵治疗稳定期慢性阻塞性肺疾病(COPD)患者的疗效.方法 将95例稳定期COPD患者随机分为三组:A组吸入沙美特罗/氟替卡松和噻托溴铵;B组吸入沙美特罗/氟替卡松;C组吸入噻托溴铵.治疗半年,评估肺功能1秒钟用力呼气容积(FEV1)、FEV1与用力肺活量的比值与治疗满意度.疗效比较采用优势检验.结果 全部病例完成半年随访,吸入沙美特罗/氟替卡松和噻托溴铵可明显减缓肺功能的恶化,同时发现吸入沙美特罗/氟替卡松和噻托溴铵组有着明显的治疗满意度.结论 吸入沙美特罗/氟替卡松和噻托溴铵在改善症状方面优于噻托溴铵,具有较好的依从性. Abstract： Objective To observe therapeutic effects of inhaling salmeterol/fluticasone and tiotropium bromide for stable COPD patients. Methods Ninety-five cases of stable COPD patients were divided randomly into three groups, group A inhaling salmeterol/fluticasone and tiotropium bromide, group B inhaling salmeterol/fluticasone, group C inhaling tiotropium bromide. All were for half a year. Lung function(FEV1,FEV1/FVC) and AECOPD manifestations and therapeutic satisfaction were evaluated. Therapeutic effects were compared with advantage test. Results All follow-ups of half a year were completed. It was found that inhaling salmeterol/fluticasone and tiotropium bromide could decrease obviously worsening of lung function. And meanwhile there was more satisfactory therapy than another two groups.Conclusions Inhaling salmeterol/fluticasone is better than inhaling tiotropium bromide in improving symptoms and with better compliance.

摘要：目的 探讨使BPI能高效率穿透细胞膜或多种屏障,中和不同解剖部位的LPS,构建TAT-BPI原核表达载体并鉴定的方法,为研制多肽抗生素打下基础.方法 人工合成编码TAT蛋白转导区的DN段,插入载体pUC57后得到pUC57-TAT重组质粒;提取正常人外周血多形核粒细胞总RNA, 采用RT-PCR技术扩增BPI N端cDN段,构建pUC57-TAT-BPI克隆载体;用酶切和双脱氧测序法进行鉴定.结果 获得含有约630 bp的TAT-BPI融合蛋白基因片段序列,测序分析与Genebank中该序列相符,同源性分析TAT序列中第10、30位核苷酸有突变,氨基酸同源性为93%,蛋白质同源性为90%,在BPI序列中234、454、495、556位核苷酸有突变,氨基酸同源性为98%,蛋白质同源性为95%.结论 成功构建了TAT-BPI融合蛋白的原核表达载体,为进一步研究BPI的抗菌作用奠定了基础. Abstract： Objective To enable BPI efficiently penetrate the cell membrane or a variety of barriers, and neutralize endotoxin in different anatomical parts, construct and identify a prokaryotic expression vector of TAT-BPI, in order to lay the foundation for new bio-antibiotic development. Methods A synthesized DNA fragment encoding TAT protein transduction domain was inserted into pUC57 vector. Then Total RNA was extracted from human polymorphonuclear neutrophils(PMN) and then the human BPI cDNA gene was amplified by RT-PCR. The PCR product was cloned into pUC57 plasmid and the sequence was confirmed by restriction enzyme digestion and dideoxy-mediated-chain termination. Results Restriction enzyme digestion and DNA sequence analysis revealed that bioactive N-terminal fragment of BPI were not only identical to those of the published human BPI sequence but also were contained in the recombinant vector. Conclusions pUC57-TAT-BPI is successfully constructed, which lays the foundation for studying the protein of BPI.

摘要：目的 探讨经皮肾镜微造瘘治疗有症状肾盏憩室结石的可行性与临床疗效.方法 回顾性分析20例肾盏憩室结石患者的治疗及效果,20例患者全部顺利碎石取石,同时处理肾盏憩室颈口.结果 平均手术时间45 min,平均住院天数11 d.术中平均出血量50 ml,无严重并发症发生.结论 经皮肾穿刺微造瘘碎石取石是治疗有症状肾盏憩室结石的一种有效方法,具有创伤小、并发症少、恢复快、结石清除率高等优点. Abstract： Objective To assess the safety,feasibility and the curative effect of treatment with minimally invasive percutaneous nephrolithotomy(PCNL)in calyceal diverticula with calculi. Methods Twenty cases suffering from calculi within calyceal diverticula,were treated with minimally invasive percutaneous nephrolithotomy,dealing with orifice of calyceal diverticulum at the same time. Results The average hospitalization days was 11 days,average operation time was 45 min.No major complications and all calculus were removed.Conclusions Minimally invasive percutaneous nephrolithotomy is safe and effective in treating calyceal diverticula. Compared to open surgery,it may offer advantages with respect to less invasion and postoperative complications,high stone free rate, easy recovery and short hospitalization.