实验性碱烧伤角膜新生血管的观察研究

目的利用碱烧伤诱导实验性角膜新生血管(CRNV)的发生,探讨定量分析CRNV和观察CRNV通透性的方法。方法取36只C57BL/6小鼠,随机分为:实验组(n=30):采用浸润l mol/L NaOH的滤纸片接触角膜5 s,诱导碱烧伤CRNV;对照组(n=6):不进行任何处理。于碱烧伤后第4、7、10、14天测量CRNV面积;第3、7、10、16、28天取眼球做切片的HE染色行组织学检查;第10天使用CD31抗体标记CRNV并计数,行荧光血管造影观察CRNV的通透性;每日观察角膜溃疡和前房积血等情况。结果实验性碱烧伤CRNV存在生长和消退的过程。无菌性角膜溃疡和前房积血较为常见,发生率分别为6.7%和10.0%。眼球切片的HE染色可观察到不同时间角膜组织的病理变化。碱烧伤后第10天,CD31抗体免疫组化标记并记数CRNV,荧光血管造影可观察到显著的CRNV渗漏。结论CD31抗体免疫组化标记、记数CRNV及联合CRNV面积测量,是CRNV定量分析较为客观的方法;荧光造影是观察和记录CRNV通透性可行的方法。     

双金解毒胶囊对吗啡依赖性动物的药效学研究

目的观察双金解毒胶囊对吗啡依赖性动物模型的脱毒药效.方法以剂量递增法造成动物对吗啡的依赖性,用纳洛酮催促戒断、自然戒断模型上,以盐酸苯氨咪唑啉作为阳性对照,评价双金解毒胶囊对吗啡依赖动物戒断症状的抑制作用.结果在吗啡依赖大鼠纳洛酮催促戒断模型,双金解毒胶囊1.6 g和3.2 g/kg,均可显著控制大鼠的戒断症状(P＜0.01),对大鼠体质量的恢复,0.8 g、1.6 g和3.2 g/kg组均较盐水对照组为快(P＜0.01).在吗啡依赖大鼠自然戒断模型,双金解毒胶囊1.6 g和3.2 g/kg组自然戒断症状显著较盐水对照组为轻(P＜0.01),体质量恢复亦较快(P＜0.01).双金解毒胶囊0.4 g、0.8 g和1.6 g/kg均可显著改善吗啡依赖猴的戒断症状(P＜0.05与0.01).结论双金解毒胶囊对吗啡依赖大鼠和猴有脱毒作用.     

黄芪对诱发性小鼠胸腺细胞凋亡的调节作用

以氢化可的松致小鼠胸腺细胞凋亡 ,同时注射黄芪注射液 ,用 Td T缺口末端标记法检测小鼠胸腺石蜡切片内凋亡细胞。结果显示 ,黄芪可防止氢化可的松所致的小鼠胸腺重量减轻及细胞凋亡的增加。     

槲皮素对非酒精性脂肪性肝病大鼠抵抗素和胰岛素抵抗的影响

目的观察槲皮素对非酒精性脂肪性肝病(NAFLD)大鼠血清抵抗素和胰岛素抵抗(IR)的影响。方法采用高脂饲料对SD大鼠进行造模,造模4周后用槲皮素灌胃治疗,槲皮素治疗组分为高剂量组[300 mg/(kg·d)]和低剂量组[75 mg/(kg·d)],疗程为2个月。检测治疗前后血清三酰甘油(TG)、空腹血糖(FBG)、空腹胰岛素(FINS)、血清抵抗素水平,计算胰岛素抵抗指数(HOMA-IR),观察肝脏病理变化。结果槲皮素治疗组大鼠血清抵抗素、TG、FBG、FINS、HOMA-IR的表达量低于模型组(P<0.05),且高剂量治疗组上述指标低于低剂量治疗组(P<0.05)。相关性分析显示抵抗素表达量与HOMA-IR和肝脏病变程度呈正相关。结论槲皮素能降低NAFLD大鼠血清TG、FPG、FINS、HOMA-IR和抵抗素水平,改善IR,而且剂量越高效果越明显。     

姜黄素抗家兔慢性心力衰竭的机制研究

目的：观察姜黄素对家兔慢性心力衰竭的治疗作用并探讨其机制.方法：采用主动脉瓣返流联合腹主动脉缩窄制作慢性心力衰竭家兔模型,心衰和假手术动物均进一步分为姜黄素组和安慰剂组.10wk后行超声心动图测定心动能的指标,检测左室心肌肌浆网Ca^2＋-ATP酶的表达水平.结果：与假手术组相比,心衰组、心衰姜黄素组左室内径增大、室壁增厚,射血功能、心肌肌浆网Ca^2＋-ATP酶的表达水平降低（P〈0.05）;与心衰组相比,心衰姜黄素组左室内径、室壁厚度较小,射血分数、心肌肌浆网Ca^2＋-ATP酶的表达水平较高（P〈0.05）.结论：姜黄素可改善兔慢性心力衰竭模型的心功能,其机制可能与增加肌浆网Ca^2＋-ATP酶的表达有关.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on early postoperative gait restoration in patients undergoing total hip arthroplasty （THA）. Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads （conventional group） and for 12 THAs （BHR group） using metal-on-metal femoral heads with an average size of 45 mm （range, 40-49mm）. All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length （SL）, single limb support （SLS）, cycle duration （CD）, and swing power （SP）. Harris Hip Scores and gait analysis parameters for both groups were compared. Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harristm postop - HarriSpreop and Harris3m postop- HarriSpreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal - SLaffected, （SLSnormal - SLSaffected）/CD, and SPnormal - SPaffected in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected, （SLSnormal- SLSaffected）/CD, and SPnormal - SPaffected were not significant, but the mean of SPnorrnal - SPaffected in the BHR group was significantly lower than that in the conventional group. Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

急性早幼粒细胞白血病的并发症及其危险因素分析

目的：总结儿童及青少年急性早幼粒细胞白血病诊治中的主要并发症,分析其发生的危险因素。方法：回顾性分析 2010年1月—2021年5月南京医科大学第一附属医院收治的43例初诊急性早幼粒细胞白血病儿童及青少年病例,总结分析各类并发症的发病率,根据分化综合征临床诊断标准分为分化综合征组和非分化综合征组,采用多因素Logistic回归分析分化综合征发生的危险因素,采用Kaplan-Meier生存分析评估患者的累积无事件生存率和总生存期。结果：43例急性早幼粒细胞白血病患者中,与非分化综合征组比较,分化综合征组的维甲酸诱导后血清铁蛋白、乳酸脱氢酶(lactate dehydrogenase,LDH)、白细胞介素6(interleukin-6,IL-6)、白蛋白都高于非分化综合征组,差异有统计学意义(P ＜ 0.01)。多因素Logistic逐步回归分析显示,外周血白细胞数(white blood cell,WBC)最高值(WBC_max)、血清铁蛋白、LDH和IL-6显著升高是诱导治疗期间发生分化综合征的独立危险因素(P ＜ 0.01)。高危组和低危组累积总生存率和无事件生存率相比,差异无统计学意义。结论：儿童及青少年急性早幼粒细胞白血病诊治过程中可出现出血和分化综合征等多种并发症。维甲酸诱导治疗后的WBC、LDH、血清铁蛋白和 IL-6 等炎症因子过度升高是发生分化综合征的危险因素。     

肾移植术后两种免疫抑制方案的对比研究

目的 探讨两种免疫抑制方案的疗效和副作用。方法 根据肾移植术后所用免疫抑制方案将121例肾移植分为两组，CMP方案组：环孢霉素A(CsA) 霉酚酸酯(MMH) 泼尼松(Pred)，CAP方案组：CsA 硫唑嘌呤(Aza) Pred，术后观察两组移植。肾功能，排斥反应发生频率及免疫抑制剂的用量和副作用。结果 术后CMP组急性排斥反应发生率低于CAP组，而排斥反应的逆转率却高于CAP组；术后半年内CMP组CsA用量低于CAP组CAP组肝肾中毒，骨髓抑制的发生率明显低于CAP组，两组感染的发生率无明显差异。结论 肾移植术后CMP方案优于CAP方案；MMF在肾移植术后的应用，可以减少肾移植排斥反应的发生，减少药物的副作用，提高肾移植的成功率。     

Therapeutic Effectiveness of Sustained Low‐Efficiency Hemodialysis Plus Hemoperfusion and Continuous Hemofiltration Plus Hemoperfusion for Acute Severe Organophosphate Poisoning

There is no report on the effects of sustained low‐efficiency dialysis (SLED) plus hemoperfusion (HP) (SLED + HP) in patients with acute severe organophosphate (OP) poisoning (ASOPP). This study was designed to compare the therapeutic effectiveness between SLED + HP and continuous hemofiltration (CHF) plus HP (CHF + HP) in patients with ASOPP. In order to assess the two treatment methods, 56 patients with ASOPP were divided into CHF + HP group and SLED + HP group. The biochemical indicators, in‐hospital duration, hemodynamic parameters, Acute Physiology, and Chronic Health Evaluation (APACHE II) score, and survival and mortality rates were compared. In both groups after treatment, the levels of serum creatine kinase isozyme MB, creatine kinase, creatinine, glutamic‐oxalacetic transaminease, and glutamate‐pyruvate transaminase, and the APACHE II scores on the first, second, and seventh day decreased (P < 0.05), whereas the levels of serum acetylcholinesterase increased. The two groups showed no statistical differences in in‐hospital duration, biochemical indicators, APACHE II score, hemodynamic parameters, survival rate, or the mortality rate (P > 0.05). In conclusion, SLED has similar hemodynamic stability to CHF and the two treatment methods have similar effects on ASOPP patients. More importantly, SLED plus HP is relatively economical and convenient for patients with ASOPP in clinical practice.     

奈达铂联合长春瑞滨治疗非小细胞肺癌临床观察

目的观察国产奈达铂(捷佰舒)联合长春瑞滨组成NN方案治疗非小细胞肺癌的疗效和毒副反应。方法32例均经病理组织学或细胞学检查证实的非小细胞肺癌,应用奈达铂80~100mg/m2,d1,长春瑞滨25mg/m2,d1、d8,静脉滴注,21天为1周期,至少2周期。结果32例患者中,CR2例,PR15例,NC9例,PD6例,总有效率(CR PR)53.12%(17/32)。奈达铂主要毒副反应为骨髓抑制(白细胞下降Ⅲ度和Ⅳ度分别为18.75%和12.50%)和胃肠道反应(恶心、呕吐Ⅲ度和Ⅳ度分别为6.25%和0)。结论奈达铂联合长春瑞滨组成的NN方案治疗非小细胞肺癌耐受性好,疗效与第三代化疗方案相当。