论著
目的 比较脂溶性高杉尖三酯碱(HHRT)与水溶新丝裂霉素C(MMC)和5-氟尿嘧啶(5-Fu)三种药物对人Tenon's囊成纤维细胞(HTFs)增殖率的抑制情况。方法 采用冻存的人眼Tenon's囊成纤维细胞,常规复苏体外培养稳定后,接种于96孔板,分别加入不同浓度HHRT、MMC及5-Fu,继续培养;采用MTT法于加药后24 h、48 h、72 h检测不同浓度HHRT、MMC及5-Fu对体外培养的人眼Tenon囊成纤维细胞增值率的抑制情况。结果 一定浓度的HHRT、MMC及5-Fu,对HTFs的抑制作用呈现不同的剂量和时间依赖性,在药物浓度达到相应程度作用72 h后三者对HTFs的最大抑制率均可达70%以上,且组间对比差异有统计学意义。结论 三种药物均对人眼Tenon's囊成纤维细胞增殖具有明显抑制作用,其最大抑制率均可达70%以上,三种药物对成纤维细胞抗增殖效应的时间浓度依赖性有所差别。
Objective To investigate and compare the inhibitory effects of Mitomycin C(MMC), 5-Fluorouracil(5-Fu) and Homoharringtonine(HHRT) on cultured Human Tenon's fibroblasts(HTFs) proliferation. Methods Fibroblasts were recovered and cultured from cell bank.Fibroblasts were treated with different concentration of MMC, 5-Fu and HHRT for 48h and 72h respectively. The proliferation of fibroblasts was detected using MTT assay. Results Fibroblasts were cultured in MMC, 5-Fu or HHRT demonstrated a dose-dependent and time-dependent inhibition of fibroblasts proliferation.The maximum inhibition rate was found when HTFs were treated with different concentration of MMC, 5-Fu or HHRT for 72h. And the three agents maximum inhibition rates were all more than 70%. The differences of proliferation in control and treated groups was statistically significant(P<0.01). Conclusion The three agents had inhibitory effect on HTFs. And the three agents maximum inhibition rates were all more than 70%. The inhibitory effects of MMC,5-Fu and dexamethasone on fibroblast proliferationwas MMC>HHRT>5-Fu.
个案报道
临床诊疗
论著
目的 探讨体外循环手术前后患者血清HMGB1、CK、CK-MB、LDH、LD1、AST水平变化及意义。方法 采用ELISA法检测57例体外循环患者手术前后血清HMGB1表达水平,采用临床常规方法检测血清中CK、CK-MB、LDH、LD1、AST水平。对体外循环手术前后血清HMGB1表达水平与CK、CK-MB、LDH、LD1、AST的水平进行比较与相关分析。结果 体外循环手术患者HMGB1、CK、CK-MB、LDH、LD1、AST水平在手术后0.5小时、24小时、48小时、72小时均高于手术前(P<0.05);HMGB1、CK、CK-MB、LD1、AST水平在手术后24小时达高峰,LDH水平高峰出现于手术后48小时,其他各指标渐渐下降。体外循环手术阻断时间延长,则HMGB1、CK、CK-MB、LDH、LD1、AST水平升高。体外循环手术后患者血清中HMGB1表达水平与CK、CK-MB、LDH、AST指标呈正相关关系(P<0.05)。结论 体外循环手术后患者血清HMGB1、CK、CK-MB、LDH、LD1、AST水平升高,HMGB1参与了心肌的缺血再灌注损伤过程。
Objective To investigate before extracorporeal circulation and after HMGB1, CK, CK-MB, LDH, LD1, AST levels and significance in serum of patients. Methods 57 cases before extracorporeal circulation surgery and after, the levels of HMGB1 were detected by ELISA,while the levels of CK and CK-MB and LDH and LD1 and AST were detected by using conventional methods of clinical. Difference of HMGB1 and CK, CK-MB, LDH, LD1 and AST levels were compared. The relationship were been analyzed on the patients before extracorporeal circulation surgery and after. Results In extracorporeal circulation surgery, HMGB1, CK, CK-MB, LDH, LD1, AST levels after surgery in 0.5 hours, 24 hours, 48 hours,72 hours were higher than before surgery (P<0.05); HMGB1, CK, CK-MB, LD1, AST levels peaked at 24 hours aftersurgery, LDH levels was peaked at 48 hours after surgery, and then gradually declined. Extracorporeal circulation blocking was prolonged, the levels of HMGB1 and CK and CK-MB and LDH and LD1 and AST were elevated. After extracorporeal circulation surgery in serum the levels of HMGB1 expression and CK,CK-MB,LDH, AST indicators showed a positive correlation(P<0.05). Conclusion The levels of HMGB1, CK, CK-MB, LDH, LD1 and AST were elevated after extracorporeal circulation surgery. HMGB1 was involved in myocardial ischemia and reperfusion injury.
论著
目的 观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法 收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果 脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例 (5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论 肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。
Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time,to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen.RECIST 1.0 was taken to know the result. Results For brain metastasis of the 15 patients, complete response (CR) and partial response(PR) were 1 and 5 patients, respectively. 4 patients were stable disease (SD) and progression disease(PD) in 5 patients. The overall response rate(ORR) was 40% and the disease control rate(DCR) was 66.7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲexpression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin-Ⅲ expression may be associated with the efficacy of this regimen.
个案分析
综述
KOA是临床上最常见,发病起源于关节软骨的慢性退行性关节疾病。近年来,应用黄芪治疗KOA的报道不断增多,并且开展了大量的机制研究。本文综述了黄芪在KOA治疗中的应用现状及研究进展,同时指出从PPAR-γ信号通路探索黄芪干预KOA的具体分子机制具有积极的理论和实践意义。
临床诊疗
目的 对经皮冠状动脉介入(PCI)治疗术前高敏C反应蛋白(hs-CRP)水平进行测定,探究其与患者术后发生造影剂肾病相关性。方法 选取2011年4月—2013年5月在我院进行PCI手术疗的患者120例为实验对象。根据术前hs-CRP值分为3组:A组(hs-CRP<1 mg/L,n=56),B组(hs-CRP 1~3 mg/L,n=40)和C组(hs-CRP>3 mg/L,n=24)。观察各组术后造影剂肾病的发生情况以及探究其两者之间的相关性。结果 A、B、C组患者术后CIN的发生率分别为8.93%、22.5%和50.0%,经过统计学比较,差异有统计学意义(P<0.05)。患者术前hs-CRP水平年龄在75岁以上、男性、糖尿病、贫血、水化治疗均与CIN显著独立相关。C组MACE发生率均高于A组、B组(P<0.05)。结论 接受PCI手术治疗的患者,其术前hs-CRP水平与其术后CIN的发生具有一定的相关性,患者术前hs-CRP水平越高,术后更可能发生CIN,hs-CRP的水平可作为辅助CIN诊断的指标。
临床诊疗
目的 动态观察乳腺癌患者辅助内分泌治疗5年后的血脂及肝功能水平的变化,探求辅助内分泌治疗与高脂血症及脂肪肝发病率的关系。方法 56例乳腺癌患者实行辅助内分泌治疗,术后随访5年动态抽血测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)及谷草转氨酶(AST)、谷丙转氨酶(ALT)、直接胆红素(DBIL)、总胆红素(TBIL)等参数的变化,B超监测其肝脏变化。结果 经过2年内分泌治疗TG由(1.203±0.723)mmol/L上升至(1.701±1.271)mmol/L,5年内分泌治疗后TG降至(1.389±0.706)mmol/L。经过2年内分泌治疗LDL由(2.497±0.990)mmol/L上升至(2.950±0.984)mmol/L,5年内分泌治疗后LDL为(2.867±0.886)mmol/L。结论 辅助内分泌治疗2年会导致其TG和LDL的升高,5年随访仅发现LDL升高,辅助内分泌治疗会增加乳腺癌患者诱发心血管疾病的风险。
论著
目的 探讨连续护理在提高乳腺癌保乳患者生存质量中的应用效果,号召我院为病人提供持续性、连续性护理开展APN排班。方法 随机抽取2011年1月—2014年1月我院收治的117例乳腺癌患者的临床资料。观察两组患者术后生存质量、焦虑情况、抑郁情况、术后上肢水肿情况。结果 两组患者术后1周生存质量比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年生存质量高于对照组,差异有统计学意义(P<0.05)。两组患者术后1周焦虑情况比较,差异无统计学意义(P>0.05);观察组术后1个月、3个月、6个月、1年忧郁情况优于对照组,差异有统计学意义(P<0.05)。观察组患者术后上肢水肿情况优于对照组,差异有统计学意义(P<0.05)。结论 连续护理在提高乳腺癌保乳患者生存质量中的应用效果较好,能够改善患者术后生存质量、焦虑抑郁情况、术后上肢水肿情况,值得临床推广。
Objective To explore the effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy. Methods 117 cases of patients with breast cancer were randomly divided into observation group(59 cases) and control group(58 cases). The control group were cared by routine postoperative care, including health education. On the basis of the control group, the observation group were cared by continuous nursing intervention, including cognitive intervention, psychological intervention, social support, life care, functional exercise, the prevention of complications and discharge instruction. The quality of life, anxiety situation, depression amd upper limb edema were compared in the two groups. Results There has no significant difference on the quality of life after 1 week in the two groups(P>0.05); The quality of life after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). There has no significant difference on the anxiety situation after 1 week in the two groups(P>0.05); The anxiety situation after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The depression situation after 1 week, 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P<0.05). The upper limb edema situation for the observation group were better than the control group(P<0.05). Conclusion The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy is good. It can improve the quality of life, situations of anxiety, depression and upper limb edema. It is worthy of clinical promotion.