目的 分析2009—2011年惠州市区医院三七总皂苷制剂的用药情况,并评价其安全性。方法 根据惠州市区医院2009—2011年三七总皂苷制剂的用药金额和用药量以及药品DDD值,计算其DDDs,分析药品的用药金额排序、DDDs排序以及用药金额排序与DDDs排序的比值;从药物不良反应报告评价其安全性。结果 三七总皂苷制剂用药金额和DDDs逐年增加,口服制剂安全性优于注射剂。结论 三七总皂苷制剂用药金额和用药频度逐年增加,其安全性较好。

Objective To analyse the usage and safety of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. Methods Calculate the DDDs and analyse the sequence of consumption sum, the sequence of DDDs, the ratio of the sequence of consumption sum to the sequence of DDDs according to the consumption sum, the consumption amount and DDD of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. We evaluated its safety according to adverse event reports. Results The consumption sum and DDDs increased year by year, oral medication was safer than injection. Conclusion The consumption sum and DDDs of Panax Notoginseng Saponins drugs of hospitals in Huizhou increase year by year, and they are safe.

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.

目的 分析肺动脉栓塞超声心动图表现,探讨超声心动图估测肺动脉高压对肺动脉栓塞的诊断意义。方法 回顾性分析确诊肺动脉栓塞患者的超声心动图影像表现,就超声诊断征象进行对比分析。结果 累及肺动脉主干、两侧肺动脉近端的肺动脉栓塞检出率92.31%。肺动脉栓塞患者肺动脉高压检出率达78.38%。结论 经胸超声心动图估测肺动脉收缩压具有重要的诊断提示意义。

Objective To analyze the doppler echocardiography in the cases of pulmonary embolism and evaluate the relationship between pulmonary hypertension and pulmonary embolism. Methods To retrospectively analyze the echocardiography findings of the pulmonary hypertension. The causes of disease were classification analyzed. Results The detection rate of the embolus in the main pulmonary trunk and proximal pulmonary arteries is 92.31%. The detection rate of the pulmonary hypertension is 78.38%. Conclusion The estimation of pulmonary artery pressure in the echocardiography is helpful to diagnosis.

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.

目的 观察葛根素对新西兰白兔视网膜缺血/再灌注损伤组织中细胞凋亡的保护作用。方法 新西兰白兔30只随机分为缺血再灌注对照组和葛根素治疗实验组,各组右眼应用前房灌注加压法建立视网膜缺血再灌注模型,分别于再灌注后第12、24、72 h处死动物,摘除眼球,制作石蜡切片,用TUNEL法检测细胞凋亡,计算凋亡指数。结果 对照组缺血再灌注12 h在神经节细胞层和内核层可见凋亡细胞;24 h神经节细胞层细胞数有所减少,视网膜神经节细胞层、内核层及外核层均见凋亡细胞明显增多;72 h神经节细胞层细胞数明显减少,神经节细胞层、内核层及外核层仍见凋亡细胞,但较24 h有所减少。葛根素治疗视网膜的凋亡细胞在各个时间段的表达规律与对照组相似,但凋亡细胞计数在12 h,24 h,72 h均较对照组明显减少,两组间差异有统计学意义。结论 葛根素能减轻缺血-再灌注损伤的视网膜细胞凋亡,对视网膜有保护作用。

Objective To observe the protective effects of Puerarin on apoptosis of ischemic injury in rabbit retina. Methods Retinal ischemia was induced in rabbits by increasing intraocular pressure to 120 mmHg for 60 minutes. TdT-mediated biotin-dUTP nick end labelling(TUNEL) staining technique was used to examine the apoptosis of retinal ganglion cells in the control group and the puerarin treatment group. Results The number of apoptotic cells in 12, 24 and 72h after reperfusion in the puerarin treatment group was obvious lower than that in the control group(P<0.05). Conclusion Puerarin has protective effects in protecting against apoptosis in ischemia reperfusion injury of rabbit retina.

目的 探讨心肌细胞RyR2和L型钙通道的基因变异与室性心律失常和心源性猝死的相关性。方法 回顾分析2010年1月—2012年12月在我院就诊的慢性心力衰竭患者622例的临床资料,并选取同一时期体检中心体检的健康人群516例作为对照组,门诊或者电话随访记录慢性心力衰竭患者的死亡为终点,通过候选基因分析可能具有相关功能的4个基因变异,rs41315858(G1885E)、rs3766871(G1886S)、rs790896(G>A)和rs723672(T>C),采用Logestic、Cox回归分析对4个候选基因变异进行相关性研究。结果 入选622例慢性心力衰竭患者和516例对照组,基因分析结果显示RyR2上的基因变异rs376687lA等位基因携带可以增加慢性心力衰竭患者发生室性心律失常的风险性;校正可能与该疾病相关的危险因素后,rs376687lA等位基因携带会增加心源性死亡和心源性猝死的风险,RyR2上的基因变异rs790896A等位基因携带可以降低心源性猝死风险。结论 RyR2上的基因变异rs376687lA是室性心律失常和心源性猝死的遗传学预测因子,而rs790896A等位基因是慢性心力衰竭患者的保护因子,可降低室性心律失常和心源性猝死的风险。

Objective To investigate the myocardial cells RyR2 and L-type calcium channel gene variants with ventricular arrhythmias and sudden cardiac death correlation. Methods Retrospective analysis of patients with chronic heart failure from January 2010 to December 2012 in our hospital including 622 cases of clinical data, and to select 516 cases of healthy people in medical examination center during the same period as a control group.Clinic or telephone follow-up recorded chronic patients with heart failure and sudden death acting as end. We analyzed possible candidate genes, according to four gene variants related functions, rs41315858 (G1885E), rs3766871 (G1886S), rs790896 (G> A) and rs723672 (T> C), by using Logestic, Cox regression analysis of four candidate gene variants for related research. Results 622 cases of chronic heart failure patients were enrolled and 516 patients in the control group. Genetic analysis showed that the gene variant alleles carried rs376687lA RyR2 may increase in patients with chronic heart failure ventricular arrhythmia risk; correction may be associated with the disease after risk factors, rs376687lA allele carries an increased risk of cardiogenic death and sudden cardiac death, and gene mutation alleles carried on rs790896A RyR2 can reduce the risk of sudden cardiac death. Conclusion Gene mutation rs376687lA RyR2 on genetics is predictor of ventricular arrhythmias and sudden cardiac death, and rs790896A allele is protective factor in patients with chronic heart failure which can be reduced ventricular arrhythmias and sudden cardiac death in risk.

目的 评价实时荧光定量PCR分析低氧性肺动脉高压大鼠肺动脉平滑肌基因表达时12个候选内参基因表达的稳定性,获得最适合的内参基因。方法 以低氧性肺动脉高压大鼠肺动脉平滑肌为研究对象,选择文献报道的常用12种内参基因为候选内参基因,利用geNorm和NormFinder程序分析实时荧光定量PCR数据,筛选出最适内参基因。结果 12个候选内参基因在低氧性肺动脉高压大鼠肺动脉平滑肌表达稳定性由强到弱顺序为:TBP>B2M>HPRT1>HMBS>RPL13a>18sRNA>PPIA>ACTB>GUSB>TFRC>GAPDH>PGK1,平均表达稳定度(M值)均<0.5,geNorm和NormFinder评估后推荐使用TBP和B2M一起作为该研究时的内参基因。结论 同时使用TBP和B2M是实时荧光定量PCR分析低氧性肺动脉高压大鼠肺动脉平滑肌基因表达的最适合内参基因,为低氧性肺动脉高压相关基因研究提供最优内参基因。

Objective To compare and select the suitable reference genes in real-time quantitative PCR analysis of rat pulmonary artery smooth muscle cells mRNA expression level of pulmonary hypertension. Methods To choose appropriate reference gene, the expression of twelve commonly use housekeeping genes were examined in rat pulmonary artery smooth muscle cells of hypoxia-induced pulmonary hypertension by using geNorm and NormFinder programs. Results The expression consistency of 12 genes was (from high to low): TBP>B2M>HPRT1>HMBS>RPL13a>18sRNA>PPIA>ACTB>GUSB>TFRC>GAPDH>PGK1. The average expression stability(M) values of them were low than 0.5. TBP and B2M reference genes were recommended to use in the same condition. Conclusion TBP and B2M reference genes were the most suitable combination of the reference genes for real-time quantitative PCR analysis in rat pulmonary artery smooth muscle cells of hypoxia-induced pulmonary hypertension.

目的 探讨个体化术前访视在手术室临床护理路径的作用。方法 将167例进入手术室临床护理路径的子宫肌瘤截石位阴式全子宫切除手术患者随机分为实验组和对照组,分别予以或不予个体化术前访视,其他手术室临床护理路径相同,比较两组的护理效果。结果 两组均未出现手术体位并发症,实验组的术中心理应激变化小于对照组,实验组术后首次肛门排气时间、下床活动时间均早于对照组,实验组患者满意度高于对照组(P均<0.05)。结论 手术室临床护理路径应从个体化术前访视开始。

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。