自身免疫病的生物学治疗进展

临床工作中,自身免疫病的治疗极具挑战性,传统上采用的糖皮质激素和免疫抑制剂等化学药品治疗虽然有效,但长期使用都不可避免的带来很多毒副作用。近10余年来,基于该病发病机制中不同环节的特异性生物学治疗成为热点,它们的应用使治疗过程能够终止自身免疫反应的破坏作用而又不伤害正常的免疫防御系统成为可能。     

原发性肺癌的介入治疗

肺癌是我国最常见的恶性肿瘤之一，临床上８０％的肺癌在确诊时已属晚期。近年来介入治疗对晚期肺癌患者提供了一个有效的治疗手段。为进一步提高疗效，肺癌介入技术面临着发展和创新的紧迫任务。     

OPTIMIZATIONS FOR 5-AMINOLEVULINIC ACID BASED PHOTODYNAMIC THERAPY IN PURGING LEUKEMIA CELL HL60

Photodynamictherapy(PDT),whichinvolves administrationofatumorlocalizing photosensiti zingagentthatmayrequiremetabolizingsynthesis(i.e.,aprodrug),followedbyactivationofthea gentbylightofaspecificwavelength.Thistherapy resultsinasequenceofphotochemicalandph…     

“活血化淤”治疗老年病分析

本文采用中西医结合方法，对老年病进行探讨，着重阐述了“淤”的机理及老年病的关系，并结合临床，以“化淤”法变通施治。通过病例综合分析，证实“化淤”治疗老年病是行之有效的大法。     

宫颈癌二维与三维适形近距离治疗剂量学的比较研究

目的通过对宫颈癌二维与三维近距离治疗中点剂量与体积剂量的对照研究,评估二者在靶区、直肠及膀胱剂量学上的差异及联系。方法选取2014年7月至2015年12月,在我院诊治的初发宫颈癌患者52例,临床分期为ⅡB~ⅢB期。入组患者均完成全盆腔三维适形外照射(10MV-X线DT 50Gy/2Gy/25F)。于放疗开始后第2周给予同步化疗,方案为:顺铂25mg/m2 d1~3,氟尿嘧啶300mg/m2 d1~5。外照射结束后即开始后装治疗。治疗采用高剂量率192铱后装治疗机,施源器采用宫腔管和阴道球三管施源器。模拟机下模拟定位,将图片传输至计划系统,后行CT定位,数据传输至CT模拟系统工作站(CT-SIM)。按照ICRU38号文件勾画GTV、HR CTV、IR CTV及直肠、膀胱等危及器官。应用PLATO治疗计划系统,设定A点及直肠、膀胱参考点,同时将各点坐标导入到CT影像中,根据已勾画完成的靶区及危及器官分别按照A点及HRCTV 500cGy的处方剂量设计二维近距离计划和三维近距离计划,通过DVH图及各参考剂量点来评价计划。结果 (1)二维、三维计划中左、右A点的剂量变化比较无统计学差异。(2)三维近距离治疗计划直肠、膀胱点剂量均大于二维近距离治疗计划,但二者无统计学差异(P>0.05)。(3)直肠二维近距离治疗计划点剂量与三维近距离治疗2cc的体积剂量有相关性;膀胱二维近距离治疗计划点剂量与三维近距离治疗2cc的体积剂量无相关性。(4)三维近距离治疗计划的HR CTV-D100、HRCTV-D90、IR CTV-D100、和IR CTV-D90比分别为处方剂量的99.9%、119.3%、66.9%、84.9%,三维适形近距离治疗的靶区等剂量线覆盖能够满足治疗要求。结论 (1)三维近距离治疗靶区等剂量线满足治疗要求,危及器官剂量未见明显增加,但是在CT定位时,由于对靶区认识的不准确性,可能使对三维治疗计划的评价具有主观性;(2)直肠与膀胱二维点剂量评价不能替代三维体积剂量评价,但点剂量评价为主的二维后装适形治疗亦能够较好地反映危及器官辐射受量。     

胆石性肠梗阻的诊治体会

胆石性肠梗阻老年女性多见,发病率低,症状复杂多变,术前确诊率低。现结合本院诊治的１６例,就提高确诊率和恰当术中处理,进行探讨。     

Effect of ABCA1-V771M polymorphism on plasma lipid levels and its relationship with coronary atherosclerotic heart disease

Objective To explore the risk association of ABCA1-V771M polymorphism with coronary heart disease (CHD) in Hart nationality in Northwest of China. Methods With case-control study, ABCA1-V771M polymorphism was detected in 204 unrelated Hart nationality people in Northwest of China, and all the subjects by coronary angiography were grouped into 106 cases and 98 controls. The genotypes and alleles frequency distribution of ABCA1-V771M polymorphisms were analyzed by PCR-RFLP analysis, and the clinical statistics of serum lipids were compared and its effects of ABCA1-V771M polymorphism on the plasma lipid levels and coronary atherosclerotic heart disease were analyzed. Results The genotypic frequencies of ABCA1-V771M polymorphism matched well under Hardy-Weinberg equilibrium (P>0.05), V and M allelic frequencies were 33.3% and 66.7%. In comparison with VV VM genotype carriers, MM genotypes carriers had much lower plasma levels of HDL-C (P<0. 001) and much higher plasma levels of TG (P<0. 05). M allelic frequency in CHD group was significantly higher than V allelic frequency (P<0. 05). M allele was related with more severity of atherosclerosis in the coronary artery than V allele (P<0.05). However, there was no obvious difference in the incidence of AMI among carriers with three genotypes of ABCA1-V771M polymorphism (P>0.05). Conclusion ABCA1-V771M polymorphism was not only associated with the plasma levels of HDL-C and TG, but also related to the susceptibility and severity of coronary atheroselerotic heart disease. Moreover, M771 allele appeared to be atherogenie among Han population in Northwest of China.     

中药治疗绝经后骨质疏松症的疗效观察及其机制探讨

目的 观察中药治疗绝经后骨质疏松症的临床疗效并探讨其机制。方法 ２５例患者用中药治疗６个月,于治疗前后分别测定患者腰椎（Ｌ２－４）,股骨颈和Ｗards三角骨密度和血清中雌二醇、睾酮、甲旁腺素、降钙素和骨钙素。结果 治疗６个月后发现,患者骨密度分别增加2.07%、1.68%和2.12%。血清中雌二醇升高（Ｐ＜0.05)。结论 补肾中药可以治疗绝经后骨质疏松症,其部分机制是中药促进雌二醇的分泌而降低骨转换率。     

从胆石症构成变迁看治疗中的问题

本文报告我院1978～1987年住院胆石病827例临床与实验系列研究结果,该病占同期胆道疾病的59.84%.胆囊结石占84.52%,胆总管结石占8.71%,胆道残余结石占3.14%。化学组份分析,胆固醇类结石占80.71%,胆石核心蛔虫卵检出率为20%。胆汁细菌培养总阳性率为45.83%,胆囊结石为29%,胆管结石为88%.胆结石中胆汁酸测定结果,胆固醇石及黑色结石不含游离胆汁酸,而胆色素石游离胆汁酸含量较高.本研究进一步证明本地区以胆固醇类结石为主,对其治疗中的新问题,应引起足够的重视.