目的 探讨术前放化疗联合术后呼吸训练治疗中晚期食管癌的临床安全性和有效性.方法 选择2018年10月至2020年5月在我院接受治疗的中晚期食管癌患者86例,用随机数字法分为对照组和观察组各43例.对照组采用术前放化疗联合手术治疗,观察组在对照组治疗的基础上加用术后呼吸训练,比较两组患者的治疗效果和并发症情况.结果 观察组患者的肿瘤标志物均低于对照组,差异有统计学意义(P<0.05);观察组患者的6 min步行距离和步行呼吸频率较对照组明显改善(P<0.05),胸腔积液/积气低于对照组(P<0.05).结论 在中晚期食管癌患者的治疗中,采用术前放化疗联合术后呼吸训练可改善呼吸功能,减少并发症,促进患者的术后恢复.

目的 探讨晚期食管癌患者实施多西紫杉醇+顺铂治疗的临床效果.方法 选择河南科技大学第一附属医院2019年1月至2020年12月就诊的晚期食管癌患者80例,以随机数字表法分为对照组(常规治疗)和观察组(多西紫杉醇+顺铂治疗)各40例,对比两组疗效.结果 观察组总有效率97.50％,对照组为80.00％,差异有统计学意义(P<0.05);观察组生存时间及肿瘤进展时间相较对照组为长,而生存质量评分(QOL)则高于对照组,差异有统计学意义(P<0.05).结论 将多西紫杉醇+顺铂治疗方案用于晚期食管癌患者,可优化临床疗效、延长生存时间、延缓肿瘤进展时间,同时可提高其生存质量,具积极推广价值.

目的 分析对食管癌患者应用胸腹腔镜、食管癌根治术联合治疗的临床效果.方法 选择2018年1月至2020年1月我院诊治的88例食管癌患者,随机分为对照组(行食管癌根治术)和观察组(行胸腹腔镜联合食管癌根治术)各44例,对比分析两组的临床指标、炎性因子指标及并发症发生率.结果 与对照组相比,观察组的各项临床指标均明显大幅降低(P<0.05),治疗后观察组各项炎性因子指标远低于对照组(P<0.05),观察组6.82％(3/44)的并发症发生率远低于对照组(P<0.05).结论 应用胸腹腔镜、食管癌根治术联合治疗食管癌,患者的身体炎性反应及并发症发生率明显降低,住院时间亦大幅缩短,对其术后恢复具有积极影响,值得临床大力推广.

Objective:To investigate the effects of intravenous thrombolysis with alteplase in the treatment of cerebral ischemic stroke (CIS).Methods:A total of 80 CIS patients who were treated in the First Affiliated Hospital of Henan University of Science and Technology from February 2018 to February 2019 were selected as the research objects. All the patients were divided into control group and study group by double-blind method, with 40 cases in each group. The control group received routine treatment, and the study group was treated by alteplase based on routine treatment. The American National National Institute of Health stroke scale (NIHSS) score and treatment effects of the two groups were compared and analyzed.Results:After treatment, the clinical effective rate of the study group was 92.5% (37/40), which was higher than the 72.5% (29/40) of the control group ( P<0.05). The incidence of adverse reactions in the study group was 5.00% (2/40), which was lower than the 15.00% (6/40) in the control group after treatment ( P<0.05). At 2 hours, 24 hours, 14 days and 3 months after treatment, the NIHSS scores of the study group were significantly lower than those of the control group ( P<0.05). Conclusions:Using alteplase in the treatment of CIS can improve the neurological function of patients, promote the clinical efficacy, with low incidence of adverse reactions, which is safe and reliable.

目的:探究桑黄素(morin)对脂多糖(LPS)诱导的急性肺损伤(ALI)模型大鼠的作用机制及影响.方法:将大鼠分为Control、LPS、morin(10 mg/kg)、morin(20 mg/kg)及morin(40 mg/kg)组,利用LPS建立ALI模型.桑黄素处理模型大鼠后,称量各组大鼠右肺干湿重,计算肺干湿重比值,并利用HE染色检测肺损伤情况,Tunnel检测肺组织凋亡细胞百分比,ELISA检测炎症因子TNF-α、IL-6和IL-1β的浓度,试剂盒检测超氧化物歧化酶(SOD)和丙二醛(MDA)浓度.不同剂量桑黄素处理大鼠原代肺巨噬细胞,确定用药浓度.将大鼠原代巨噬细胞分为Control、LPS、morin(10μmol/L)、morin(20μmol/L)、morin(50μmol/L)及morin(50μmol/L)+胰岛素样生长因子(IGF-1)组,利用LPS建立ALI模型.桑黄素处理细胞后,RT-PCR检测细胞上清中TNF-α、IL-6和IL-1β的mRNA水平,免疫印迹检测磷酸化磷脂酰肌醇-3激酶(p-PI3K)、磷酸化丝氨酸苏氨酸蛋白激酶(p-Akt)、磷酸化核因子κB抑制蛋白(p-IκBα)及核因子κB p65(NF-κB p65)在各组大鼠组织及原代巨噬细胞中的表达.结果:与Control组比较,LPS组大鼠肺干湿重比值显著升高,肺泡中充满红细胞及蛋白渗出物;与LPS组比较,morin(10 mg/kg)、morin(20 mg/kg)及morin(40 mg/kg)组中大鼠肺干湿重比值显著降低,肺泡中红细胞及蛋白渗出物显著减少.桑黄素可降低ALI大鼠组织凋亡细胞百分比及Bax和cleaved Caspase-3的表达,升高Bcl-2的表达.与Control组比较,LPS组大鼠组织肺泡中大量炎性细胞浸润,TNF-α、IL-6和IL-1β的浓度显著升高.与LPS组比较,morin(10 mg/kg)、morin(20 mg/kg)及morin(40 mg/kg)组中炎性细胞浸润显著减少,TNF-α、IL-6和IL-1β的浓度显著降低.此外,与Control组比较,LPS组大鼠肺组织中SOD浓度显著下降,MDA浓度显著上升.与LPS组比较,morin(10 mg/kg)、morin(20 mg/kg)及morin(40 mg/kg)组中SOD浓度显著上升,MDA浓度显著下降.桑黄素可降低ALI大鼠肺组织中p-PI3K、p-Akt、p-IκBα和NF-κB p65表达水平.桑黄素细胞用药浓度设置为10、20、50μmol/L.与Control组比较,LPS组大鼠原代肺巨噬细胞培养上清中TNF-α、IL-6和IL-1β的mRNA水平显著升高.与LPS组比较,morin(10μmol/L)组无显著差异;morin(20μmol/L)及morin(50μmol/L)组中TNF-α、IL-6和IL-1β的mRNA水平显著降低.与morin(50μmol/L)组比较,morin(50μmol/L)+IGF-1组中TNF-α、IL-6和IL-1β的mRNA水平显著升高.同时,与Control组比较,LPS组大鼠原代肺巨噬细胞中p-PI3K、p-Akt、p-IκBα和NF-κB p65表达水平显著升高.与LPS组比较,morin(10μmol/L)、morin(20μmol/L)及morin(50μmol/L)组中p-PI3K、p-Akt、p-IκBα和NF-κB p65表达水平显著降低.与morin(50μmol/L)组比较,morin(50μmol/L)+IGF-1组中p-IκBα和NF-κB p65的表达水平显著升高.结论:桑黄素可通过抑制PI3K/Akt/NF-κB信号通路减轻ALI对模型大鼠的影响.