中药消癌平、金龙胶囊联合奥宁治疗老年巨块型原发性肝细胞性肝癌的前瞻性研究

目的:探索中药消癌平、金龙胶囊联合奥宁治疗老年巨块型原发性肝细胞性肝癌的疗效和应用价值.方法:2位老年原发性肝细胞性肝癌患者,第一例采用消癌平60 ml+5%葡萄糖液250 ml,静脉滴注16天,奥宁15-18 μg/h,Civ(连续静脉泵入),16天;第二例在前一例基础上加用金龙胶囊4粒,3次/日,连续口服14天.每次治疗结束休息一周进行AFP、影像学评价和QOL评分.结果:第一例患者治疗2个周期AFP降至162.8 μg/L,肿块7.910.2 cm,增大约18%,QOL评分48分,疗效评价SD,该患者治疗两周期后,自行转其他医院行超声聚焦刀治疗后死亡.第二例患者治疗3周期后,AFP降至1107μg/L,B超示肿瘤缩小至4.514.33 cm,缩小约70%,QOL评分53分,疗效评价PR,目前患者无症状.结论:消癌平、奥宁联合奥宁治疗巨块型原发性肝细胞性肝癌是一种有效的方法.     

美罗华联合CHOP方案与CHOP方案治疗老年复发性弥漫性大B细胞性淋巴瘤的临床研究

目的:探讨美罗华联合CHOP方案与CHOP方案治疗老年复发性弥漫性大B细胞性淋巴瘤的临床疗效和不良反应.方法:选择老年复发性弥漫性大B细胞性淋巴瘤60例,按治疗方案分成研究组(30例)和对照组(n＝30),研究组采用美罗华联合CHOP方案,对照组给予单纯CHOP方案.评估比较两组患者疗效和不良反应,并随访两组患者的生存时间.结果:两组患者均完成治疗及治疗效果评估,研究组CR为10例,PR为15例,总有效率为83.3％(25/30);对照组CR为3例,PR为6例,总有效率为30.0％(9/30),研究组有效率明显高于对照组(X2=8.42,P＜0.05).随访期间,研究组MST、PFS明显长于对照组(P＜0.05).研究组和对照组1年生存率、2年生存率比较,差异有统计学意义(P＜0.01).两组间抗癌药物毒性分度比较,差异无统计学意义(P＞0.05).结论:美罗华联合CHOP方案用于老年复发性弥漫性大B细胞淋巴瘤,能明显提高治疗有效率,延长无进展生存期和生存时间,且没有增加老年患者毒副作用,应用安全.     

增强剂量的CTOP方案联合放疗治疗非何杰金氏淋巴瘤的疗效观察

目的:分析增强剂量CTOP方案联合放疗治疗非何杰金氏淋巴瘤的疗效.方法:我院从2005年5月至2008年5月期间初治43例非何杰金氏淋巴瘤患者,随机分成对照组和观察组,分别采用常规剂量(THP40mg/m2)和增强剂量(THP60mg/m2)CTOP方案治疗6-8个疗程,第4-6个疗程后放疗一次,观察疗效及不良反应.结果:对照组总有效率(CR+PR)为81.82%,观察组的总有效率(CR+PR)为85.71%,疗效有所提高.两组毒副作用差异无显著性.结论:增强剂量CTOP方案结合放疗治疗非何杰金氏淋巴瘤有较好的疗效,与常规剂量CTOP方案相比毒副作用相仿.     

普理灵疝装置治疗110例老年腹股沟疝的临床观察

目的:探讨普理灵疝装置(prolene hernia system,PHS)治疗老年腹股沟疝的临床疗效.方法:回顾性分析新疆维吾尔自治区人民医院2008年12月～2012年12月应用普理灵疝装置治疗的110例老年腹股沟疝患者的临床资料,对手术方法、术后能力恢复、并发症和复发率等项目进行分析.结果:110例老年腹股沟疝患者的手术时间平均50min,其中42例局麻患者术后即能下床活动,68例硬膜外麻醉患者术后第2天能离床活动.本组患者无死亡,无切口感染、缺血性睾丸炎、尿潴留等.术后有排尿困难4例,在12h后症状缓解;部分术后伤口稍微疼痛,于术后1～2天缓解;伤口异物感3例,全部切口Ⅰ期愈合,平均住院时间4d.术后110例随访2～18个月,无明显异物感,无慢性疼痛,无复发病例.结论:PHS可有效降低老年腹股沟疝术后的复发率、手术创伤小,患者恢复快,适合于老年人腹股沟疝的外科治疗.     

鸦胆子油乳治疗肺癌肺叶切除术后胸液过多的疗效观察

目的:观察鸦胆子油乳剂胸腔内注射治疗肺癌肺叶切除术后胸液过多的疗效和不良反应.方法:对80例肺癌肺叶切除术后第48.72小时胸液量＞200ml患者,随机分为治疗组和对照组,每组各40例.治疗组患者采用经胸腔闭式引流管注入鸦胆子油乳剂30 ml.夹闭胸管24小时后观察疗效和不良反应.结果:治疗组40例中,术后第72-96小时胸液引流量＜100 ml者37例,占92.5%;对照组40例中,术后第72.96小时胸液引流量＜100 ml者8例,占20.0%;两组有统计学意义(P＜0.05).不良反应为发热(＜38.5℃)2例,胃肠道反应2例.胸痛3例.结论:鸦胆子油乳剂治疗肺癌肺叶切除术后胸液过多疗效显著,不良反应轻.     

比阿培南治疗淋巴瘤患者合并中重度感染的临床疗效观察

目的:评价化疗期间,出现中重度感染后应用比阿培南抗感染的疗效.方法:回顾性分析我科104例应用比阿培南的淋巴瘤合并中重度感染患者,予以比阿培南0.3-0.6g/次,静脉滴注,1/8小时或1/12小时,治疗5-16天,观察其应用比阿培南后的临床疗效及不良反应.结果:治疗中度发热的患者31例,其中痊愈+显效28例,有效率为90.3％(28/31)；治疗高热以上的患者73例,其中痊愈+显效56例,有效率为76.7％(56/73).总有效率为80.8％.其中感染发生在Ⅳ度骨髓抑制期的有52例,痊愈+显效44例,有效率为84.6％.且104例患者中,仅l例发生皮肤过敏反应,其余未观察到明确的不良反应.结论:比阿培南在治疗淋巴瘤患者合并中重度感染的应用中,为安全有效的碳青霉烯类药物.     

硼替佐米皮下注射的护理体会

目的:探讨治疗多发性骨髓瘤硼替佐米采用静脉注射浓度进行皮下注射(1mg/ml)患者的观察要点及护理;方法:注射用硼替佐米3.5mg/支加生理盐水3.5ml溶解,用法为1.0-1.3 mg/m2,于治疗第1、4、8、11天时皮下注射,两次给药之间至少间歇72小时,12天为一疗程;结果:30例患者在化疗期间均未发生严重局部皮肤反应,原发疾病无进展,周围神经病变相比静脉注射后明显减轻。结论:硼替佐米治疗多发性骨髓瘤疗效确切,采取静脉注射浓度进行皮下注射1mg/ml皮下注射,患者对局部不良反应是可以耐受的,并减少了毒副作用。     

老年骨质疏松性椎体压缩骨折PKP治疗中不同骨水泥注入量的疗效及安全性对比

目的:探讨经皮椎体后凸成形术(PKP)治疗中应用不同剂量骨水泥注入的临床效果及安全性。方法:选取2013年3月~2014年5月收治的骨质疏松性椎体压缩骨折老年患者82例为研究对象,通过随机数字表法分为A、B两组,每组41例,A组患者选择低剂量(2-4ml)骨水泥注入,B组患者选择常规剂量(4.5-6ml)骨水泥注入,观察疗效及安全性。结果:两组患者术前椎体前缘高度无明显差异,术后均有明显改善,但术后两组差异无统计学意义(P0.05);A、B两组患者术后并发症发生率为分别为2.44%、9.76%,差异有统计学意义(P0.05)。结论:应用低剂量骨水泥注入,可达到理想治疗效果,降低术后并发症发生率,值得推广。     

康莱特注射液联合NP方案化疗治疗老年晚期非小细胞肺癌的临床观察

目的:探讨康莱特注射液联合NP方案治疗老年晚期非小细胞肺癌患者的近期疗效、毒副反应及生活质量.方法:将127例患者随机分为两组,治疗组64例,予NP方案:NVB25mg/m2第1、8天静点+DDP 80mg/m2分三天,第1,2,3天静点,每3周重复.同时给予康莱特液200ml qd第1-21天静点.对照组予NP方案:NVB25ml/m2第1、8天静点+DDP 80mg/m2分三天,第1,2,3天静点,每3周重复.两组患者在治疗4周期后,进行评价.结果:在近期疗效上,治疗组优于对照组.P＜0.05.在白细胞减少、贫血及呕吐的发生上,治疗组优于对照组,均P＜0.05.生活质量的提高及体重的增加方面,治疗组优于对照组,均P＜0.05.结论:康莱特注射液联合NP方案化疗治疗老年晚期非小细胞肺癌,能提高近期疗效,减少毒副反应,提高生活质量.     

ICE方案治疗复发难治性非霍奇金弥漫大B细胞淋巴瘤临床观察

目的:观察ICE方案(异环磷酰胺IFO,卡铂CBP,依托泊苷VP-16)治疗复发/难治性非霍奇金弥漫大B细胞淋巴瘤(Non-hodgkin's lymphoma,NHL)的疗效及安全性。方法:20例经系统化疗后复发或进展的非霍奇金弥漫大B细胞淋巴瘤(DLBCL)患者,采用ICE方案化疗至少2周期,IFO 5 g/m2,第2天,持续24小时静脉输注,CBP按AUC=5,max 800 mg,第2天,静脉输注,VP-16.100 mg/m2,第1-3天,静脉输注。结果:完全缓解(complete response,CR)5例,部分缓解(partial response,PR)8例,疾病稳定(stable disease,SD)4例,疾病进展(progress disease,PD)3例,总有效率(overall response rate,ORR,CR+PR)65%,化疗副作用主要为骨髓抑制(Ⅰ、Ⅱ度6例,Ⅲ、Ⅳ度14例),其他不良反应包括胃肠道反应、粘膜损伤、肝肾毒性及脱发等均可耐受。结论:ICE方案可用于非霍奇金弥漫大B细胞淋巴瘤的二线化疗方案。     

壳聚糖酶的克隆表达与壳寡糖的制备分析

目的:克隆壳聚糖酶基因于大肠杆菌中实现高表达,制备壳寡糖。方法:以枯草芽孢杆菌总DNA为模板扩增壳聚糖酶基因(CSN),克隆至载体pET23a(+)上,转化菌株BL21(DE3)。重组子经0.5 mmol/L IPTG诱导后,SDS-PAGE和质谱检测与鉴定重组酶。酶纯化后水解壳聚糖,薄层色谱分析其水解产物。结果:质谱证明壳聚糖酶(31.5kDa)成功表达,表达量占菌体总蛋白的45%左右。纯化后重组酶浓度为900 mg/L,纯度95%、回收率85%,酶活力为10 000 U/mg。壳聚糖降解产物为壳二糖至壳四糖。结论:原核表达载体pET23a(+)-CSN构建正确,壳聚糖酶表达量与活性高,适用于水解壳聚糖制备壳寡糖。     

国内外蝗害治理技术现状与展望

本文首先概述了国内外蝗虫发生与为害的态势,总结了现阶段我国蝗虫发生与为害的主要特点:即农田飞蝗暴发频繁而且严重,草原土蝗的发生时常造成严重的经济损失,而且侵入城市干扰市民生活,我国与周边国家之间蝗虫过境迁移频繁,使用化学农药污染环境和农产品;分析了国内外蝗虫防治对策与技术的发展现状,重点介绍了应急防治和可持续治理对策、...     

Synthesis and turnover of cerebrosides and phosphatidylserine of myelin and microsomal fractions of adult and developing rat brain.

The synthesis and turnover of cerebrosides and phospholipids was followed in microsomal and myelin fractions of developing and adult rat brains after an intracerebral injection of [U-14C]serine. The kinetics of incorporation of radioactivity into microsomal and myelin cerebrosides indicate the possibility of a precursor-product relationship between cerebrosides of these membranes. The specific radioactivity of myelin cerebrosides was corrected for the deposition of newly formed cerebrosides in myelin. Multiphasic curves were obtained for the decline in specific radioactivity of myelin and microsomal cerebrosides, suggesting different cerebroside pools in these membranes. The half-life of the fast turning-over pool of cerebrosides of myelin was 7 and 22 days for the developing and adult rat brain respectively. The half-life of the slowly turning-over pool of myelin cerebrosides was about 145 days for both groups of animals. The half-life of the rapidly turning-over microsomal cerebrosides was calculated to be 20 and 40 h for the developing and adult animals respectively. The half-life of the intermediate and slowly turning-over microsomal cerebrosides was 11 and 60 days respectively, for both groups of animals. The amount of incorporation of radioactivity into microsomal cerebrosides from L-serine was greatly decreased in the adult animals, and greater amounts of the precursor were directed towards the synthesis of phosphatidylserine. In the developing animals, considerable amounts of cerebrosides were synthesized from L-serine, besides phosphatidylserine. The time-course of incorporation indicated that a precursor-product relationship exists between microsomal and myelin phosphatidylserine. The half-life of microsomal phosphatidylserine was calculated to be about 8 h for the fast turning-over pool in both groups of animals.     

Identification and composition of the tonsillar and anal enterococcal and streptococcal flora of dogs and cats

Enterococcus faecalis was the most frequently isolated enterococcal species from anal swabs and tonsils of dogs and cats, although in the anal samples from dogs Ent. hirae was found almost as often as Ent. faecalis. Most Ent.faecium strains from dog tonsils differed from those associated with humans and other animals in that they fermented sorbitol. Typical Ent. avium as well as atypical Ent. avium -like strains were seen in dogs, while the related species Ent. raffinosus was associated with cat tonsils. Enterococcus cecorum also occurred mainly in cats. Certain atypical strains, presumptively identified as Ent. cecorum , shared characteristics with Ent. columbae.
The most frequent streptococcal species in tonsils of cats and dogs were Streptococcus suis and Strep. canis. Streptococcus canis and Strep. bovis predominated in anal swabs. The canine Strep. suis differed from the common porcine strains in fermenting mannitol.
Forty-seven of the 288 isolates examined could not be identified or related to known species. The characteristics of two groups of these bacteria, provisionally called 'Ton 31 group' and 'O7 group' are described.     

Molecular characterisation of species and genotypes of Cryptosporidium and Giardia and assessment of zoonotic transmission

The molecular characterisation of species and genotypes of Cryptosporidium and Giardia is essential for accurately identifying organisms and assessing zoonotic transmission. Results of recent molecular epidemiological studies strongly suggest that zoonotic transmission plays an important role in cryptosporidiosis epidemiology. In such cases the most prevalent zoonotic species is Cryptosporidium parvum. Genotyping and subtyping data suggest that zoonotic transmission is not as prevalent in the epidemiology of giardiasis. Molecular characterisation of Cryptosporidium and Giardia is a relatively recent application that is evolving as new genes are found that increase the accuracy of identification while discovering a greater diversity of species and yet unnamed taxa within these two important genera. As molecular data accumulate, our understanding of the role of zoonotic transmission in epidemiology and clinical manifestations is becoming clearer.     

白术同源四倍体的诱导和鉴定及其与二倍体过氧化物酶的比较

以白术（Atractylodes macrooephala Koidz.）二倍体组培苗为材料,对其四倍体诱导方法进行研究,共获得45个白术同源四倍体株系,为优良株系的选育提供了材料。此外,还分析比较了其中8个白术四倍体株系与二倍体的过氧化物酶同工酶（POD）的酶谱差异,发现四倍体各株系过氧化物酶同工酶谱比二倍体的均多了Rf0.310的谱带,且总过氧化物酶比活力也发生了很大改变,对探讨白术四倍体优良株系的生理生化机理具有一定的参考价值。     

Kinetics and thermodynamics of peroxidase- and laccase-catalyzed oxidation of N-substituted phenothiazines and phenoxazines

N -substituted phenothiazines (PTs) and phenoxazines (POs) catalyzed by fungal Coprinus cinereus peroxidase and Polyporus pinsitus laccase were investigated at pH 4–10. In the case of peroxidase, an apparent bimolecular rate constant (expressed as k _cat/K _m) varied from 1 ×10⁷M⁻¹s⁻¹to 2.6×10⁸M⁻¹s⁻¹ at pH 7.0. The constants for PO oxidation were higher in comparison to PT. pH dependence revealed two or three ionizable groups with pK _a values of 4.9–5.7 and 7.7–9.7 that significantly affected the activity of peroxidase. Single-turnover experiments showed that the limiting step of PT oxidation was reduction of compound II and second-order rate constants were obtained which were consistent with the constants at steady-state conditions. Laccase-catalyzed PT and PO oxidation rates were lower; apparent bimolecular rate constants varied from 1.8×10⁵M⁻¹s⁻¹ to 2.0×10⁷M⁻¹s⁻¹ at pH 5.3. PO constants were higher in comparison to PT, as was the case with peroxidase. The dependence of the apparent bimolecular constants of compound II or copper type 1 reduction, in the case of peroxidase or laccase, respectively, was analyzed in the framework of the Marcus outer-sphere electron-transfer theory. Peroxidase-catalyzed reactions with PT, as well as PO, fitted the same hyperbolic dependence with a maximal oxidation rate of 1.6×10⁸M⁻¹s⁻¹ and a reorganization energy of 0.30 eV. The respective parameters for laccase were 5.0×10⁷M⁻¹s⁻¹ and 0.29 eV. Received: 20 September 1999 / Accepted: 24 February 2000