rhGM-CSF对小鼠口腔粘膜损伤的防治作用

目的：探讨rhGM-CSF促进口腔腔溃愈合的作用机制。方法：取体外培养的胎儿口腔粘膜成纤维细胞，用rhGM-CSF刺激成纤维细胞后第2、4、6天用细胞计数及^3H－胸腺嘧啶掺入法（^3H-TdR）测定其增殖情况，结果rhGM-CSF对胎儿口腔粘膜成纤维细胞增殖及DNA合成有刺激作用，在80－100ng/ml时，细胞生长达到最佳状态，过高浓度rhGM-CSF的刺激作用反而下降。结论：rhGM-CSF可以通过刺激成纤维细胞增殖及DNA合成促进口腔溃疡愈合。     

Marked improvement of delayed methotrexate-induced leukoencephalopathy treated with high-dose folinic acid

We report the case of a patient with delayed methotrexate (MTX)-induced leukoencephalopathy who showed a marked improvement both in clinical and neuroimaging findings after a high-dose of the active form of folinic acid (leucovorin) treatment. The patient developed progressive affective impairment accompanied by headache, nausea and vomiting after treatment with MTX during the chemotherapy for acute lymphoblastic leukemia, and diagnosed as delayed type MTX-induced leukoencephalopathy. After an intravenous injection of high-dose folinic acid (total 1920 mg), neurological deficits and white matter changes dramatically improved in a few weeks. Although delayed MTX-induced leukoencephalopathy may cause irreversible brain damage, an early treatment with high dose leucovorin may thus facilitate the marked improvement of clinical findings and white matter abnormalities.     

异位妊娠152例临床分析

目的：回顾性总结本院近年来异位妊娠的诊疗情况,并对临床常用诊疗手段进行临床分析,方法：152例经B超,测定尿－HCG和血β-hCG或／和后穹窿穿刺诊断为异位妊娠患,手术治疗143例,9例输卵管妊娠未破裂,我活动性内出血且生命体征稳定的病人,采用米非司酮及MTX药物保守治疗,结果：手术组病人均痊愈出院,非手术组 人除1例病人因包块增大而行择期手术治疗外,其余8例病人的疗效满意,未见明显严重并发症,结论：手术治疗仍是治疗异位妊娠最常采用的手段,对较早发现未破裂型异位妊,娠,采用MTX和米非司酮进行保守治疗不失为一种有用的选择,但应注意适应证以提高疗效和安全性。     

替尼油甙为主的联合方案配合氨甲喋呤椎管内化疗治疗肺癌转移

目的：研究以替尼泊甙（Ｖｍ－２６）为主的联合化疗方案配合氨甲喋呤（ＭＴＸ）椎管内注射治疗非上细胞肺癌脑转移的疗效,方法：联合应用替尼泊甙为主的化疗方案配合氨甲喋呤椎管内化疗,每４周为１周期,治疗２～３周期。结果：颅内瘤灶有效率５２％,肺内瘤灶有效率６０％,症状,体征缓解率８４％,结论：替尼泊甙为主的联合方案配合氨甲喋呤椎管内化疗治疗非小细胞肺癌脑转移,疗效显著。     

Effect of de novo purine synthesis inhibitors on 5-fluorouracil metabolism and cytotoxicity

Methotrexate pretreatment of L1210 cells had been shown previously by us to cause an enhancement of the intracellular accumulation of 5-fluorouracil and of the formation of 5-fluorouracil nucleotides which was correlated with synergistic cytotoxicity. This effect of methotrexate was associated with increases in 5-phosphoribosyl-1-pyrophosphate, the cofactor required for the conversion of 5-fluorouracil to 5-fluorouridine-5'-monophosphate (FUMP). Because these influences on 5-fluorouracil metabolism were most likely mediated by the activity of methotrexate as an inhibitor of purine synthesis, the effects of other agents that inhibit purine synthesis were examined. An inhibitor of amidophosphoribosyltransferase, 6-methylmercaptopurine ribonucleoside, the glutamine antagonists, azaserine and 6-diazo-5-oxo-L-norleucine (DON), and the L-aspartate analogue inhibitor of adenylsuccinate synthetase, L-alanosine, all reduced the incorporation of [1-14C]glycine into adenine and guanine bases isolated from nucleic acids. Each drug also resulted in intracellular elevations of 5-phosphoribosyl-1-pyrophosphate that were 15- to 25-fold greater than control levels. These alterations in de novo purine nucleotide synthesis were associated with enhanced intracellular 5-fluorouracil accumulation and synergistic cytotoxicity.     

RP-HPLC进行甲氨蝶呤血药浓度监测时保留时间校准方法研究

目的 建立RP—HPLC进行MTX血药浓度监测时保留时间校准方法。方法应用容量因子与流动相比例的三次方多项式模型，建立MTX流动相比例与保留时间的函数，并通过此函数用保留时间求算流动相比例，与理论流动相比例比较，从而计算流动相应该补充组分的量，达到调整保留时间的目的。结果四种不同色谱条件下容量因子与流动相比例的三次方多项式模型拟合关系良好，R0均为1．000，保留时间经校准后RSD为0.9％(n=5)。结论本方法能准确校准因流动相比例引起变化的保留时间，适用于MTX血药浓度监测时保留时间的校准，方法新颖、有效、简单。     

99锝-亚甲基二膦酸盐联合甲氨蝶呤治疗活动性类风湿关节炎疗效观察

目的:观察99锝-亚甲基二膦酸盐(99Tc-MDP)治疗活动性类风湿关节炎(RA)的临床疗效。方法:将60例活动性RA患者随机分为两组。试验组30例,应用99Tc-MDP联合甲氨蝶呤(MTX)治疗;对照组30例,应用MTX治疗。分别在治疗前、治疗16周后进行28个关节的疾病活动度评分(DAS28)。结果:治疗16周后试验组DAS28明显低于对照组(P<0.01)。两组治疗16后DAS28明显低于治疗前(P<0.01)。结论:99Tc-MDP联合MTX治疗活动性RA能够显著减低疾病活动度、改善关节功能,且安全性好。     

康复新液与浓替硝唑对低危妊娠滋养细胞肿瘤MTX化疗后口腔溃疡的疗效观察

目的比较康复新液与浓替硝唑含漱液对低危妊娠滋养细胞肿瘤MTX化疗性口腔溃疡的临床疗效。方法我院2013年12月至2015年12月收治的低危滋养细胞肿瘤患者,选取50例合并口腔溃疡患者作为研究对象,分为2组,每组25例。治疗组:给予康复新溶液,对照组给予浓替硝唑含漱液,评价两组疗效和毒副反应。结果康复新液组治疗有效率为96%,浓替硝唑组为80%,两组比较差异有统计学意义(P<0.05)。口腔溃疡的愈合情况比较:治疗组愈合时间为(4.3±1.9)d;对照组为(7.1±2.6)d,两组比较差异有统计学意义(P<0.05)。所有患者均未发生与康复新液和浓替硝唑相关的不良反应。结论康复新液治疗低危妊娠滋养细胞肿瘤患者相关化疗性口腔溃疡安全有效,值得临床推广。     

宫颈妊娠9例诊治分析

目的 探讨宫颈妊娠的诊治方法.方法 对9例宫颈妊娠患者的临床资料进行回顾性研究.结果 9例宫颈妊娠中,术前B超明确诊断3例,误诊6例,误诊率66.7%.1例入院后直接行全子宫切除术.1例因血、尿HCG正常,拟诊宫颈肌瘤直接行宫腔镜下宫颈妊娠物电切术.7例用MTX和(或)米非司酮保守治疗 宫腔镜下宫颈妊娠物电切术或宫颈搔刮术.其中5例行MTX全身化疗,有3例保守成功,另2例术中出血较多,血压下降,分行用消毒纱布填塞压迫止血和全子宫切除术.2例行MTX宫颈局部注射 全身化疗,其中1例因用药后阴道流血增加行子宫动脉灌注MTX 栓塞术.本文9例病理诊断均为宫颈管坏死机化组织中见蜕变的蜕膜、绒毛组织;均痊愈出院.结论 妊娠妇女如出现宫颈增大、子宫异常体征,应借助B超检查,考虑宫颈妊娠的可能,早期明确诊断.子宫颈妊娠只有少数需要切除子宫,大部分可采用全身、局部化疗,能够成功地治疗需要保留子宫和生育功能的患者.