喹诺酮类药物半衰期的定量构动关系研究

 目的应用多元线性回归方法研究喹诺酮类药物的分子结构和半衰期间的定量构动关系(QSPR)。方法利用Hyperchem和Chemoffice软件计算了25个喹诺酮类药物的结构参数和电性参数。随机选取20个药物做训练集以建立QSPR模型,5个常用药物做检验集以检验模型的准确性。结果影响喹诺酮半衰期的主要参数E_HOMO,φ₃,LogP,DM4个分子描述符进入模型,模型复相关系数达0.958。检验集的计算值与实验值复相关系数达0.924。结论所建立的模型能够很好地预测喹诺酮类药物的半衰期,并有效地描述其影响因素。     

Squamous cell carcinoma developing in a huge dermoid cyst of the ovary in an 80-year-old woman--case report

A case of an 80-year-old patient with squamous cell carcinoma originating from a huge septated dermoid cyst of the right ovary is reported. There were bilateral dermoids in the patient. The tumor sizes were 30 x 40 x 20 cm and 4 x 3 x 5 cm in the right and left ovary, respectively, confirmed by ultrasound and computed tomography. Squamous cell carcinoma arose in the solid part of a huge dermoid cyst of the left ovary. Total abdominal hysterectomy and bilateral salpingo-oophorectomy, omentectomy and appendectomy were performed. The tumor was confined to the right ovary. The patient was categorized as FIGO Stage IA. She recovered uneventfully and there was no evidence of recurrence in the early-stage case during one year of follow-up. The clinical and pathological features, treatment modalities and prognosis of squamous cell carcinoma are described.     

Thecoma associated with pregnancy: a case report

Ovarian thecoma, which belongs to the group of sex-cord stromal tumors, is a relatively rare neoplasm. In this report we present a pregnant woman with a solid ovarian mass diagnosed during pregnancy and operated on at the 19th gestational week. At surgical exploration, torsion of the ovarian tumor was observed together with ascites and unilateral salpingo-oophorectomy was performed. Pathological examination revealed a luteinized thecoma. After the surgery, the pregnancy continued uneventfully until term.     

Hyperglycemia and atherosclerosis. Causal relation or association?

Hyperglycemia may lead to atherosclerosis by different pathogenic mechanisms. Nonenzymatic glycation and oxidation of LDL may increase its atherogenicity. Glycation may modify some arterial wall structural proteins. Increased blood glucose leads to hypertriglyceridemia which results in decrease of HDL-cholesterol level and in increase of atherogenic dense LDL particles. Hyperglycemia also adversely affects processes of platelet aggregation, hemocoagulation and fibrinolysis. It accelerates the development of diabetic nephropathy--a condition with a high prevalence of macrovascular diseases. Prospective epidemiologic studies have shown that diabetic patients in worse metabolic control had an increased cardiovascular morbidity and mortality. Therapeutic randomized studies in type 1 (DCCT) and type 2 (UKPDS) diabetic patients have shown that better diabetes control had a preventive effect against development of microvascular complications. The incidence of macrovascular complications both in type 1 diabetic patients on intensive insulin or sulfonylurea treatment has been decreased on the level of borderline statistical significance. Metformin lead to a significant decrease in myocardial infarction incidence in the subgroup of obese type 2 diabetic patients. In conclusion, maximal possible metabolic control of diabetes prevents the development of microvascular complication, but more impressive decrease in macrovascular disease incidence probably requires to affect another important risk factors for atherosclerosis, such as dyslipidemia and hypertension.     

T3期胆囊癌手术治疗联合辅助治疗的多中心回顾性研究

目的探讨根治性切除后T3期胆囊癌患者行辅助治疗的临床价值。方法回顾性收集2013年1月至2018年12月中国7家医疗机构肝胆中心通过外科治疗的415例T3期胆囊癌患者的临床和病理学资料。男性251例, 女性164例, 年龄(61±11)岁(范围:26～88岁)。根据根治性切除术后是否接受辅助治疗, 将患者分为单纯根治性切除组(A组, n=358)和根治性切除联合术后辅助治疗组(B组, n=57)。采用倾向性评分匹配法对两组患者的一般资料进行1∶1匹配, 卡钳值取0.02。比较匹配前后两组患者临床和病理学特征、总体生存及无病生存情况。采用Cox回归模型进行多因素分析, 并将具有至少一项独立预后因素的患者归类为高危临床病理学亚型, 通过亚组分析探讨具有高危临床病理学亚型患者根治性切除后接受辅助治疗的临床价值。结果匹配后两组患者各有42例, B组胆囊切除术后胆囊癌的发生率和清扫淋巴结数量高于A组(χ2=9.224、2.570, P值均<0.05)。匹配前后两组患者的总体生存率和无病生存率的差异均无统计学意义(P值均>0.05)。单因素和多因素分析结果显示, CA19-9>3...