目的:研究鞘内连续注射吗啡联合倍他米松治疗癌性骨痛(cancer-induced bone pain CIBP)的机制。方法:癌性骨痛患者126例,随机分为2组:吗啡组Morphine(M组),鞘内泵入单纯吗啡;吗啡联合倍他米松组Betarmethasone(B组),鞘内泵入吗啡和倍他米松(1 mg/周),患者均行椎管内镇痛药物输注港皮下植入术。手术前、手术后第1、3、7天评定疼痛缓解程度、生存质量评分和SF-36量表,手术后第7天测定血浆内啡肽、血浆胃动素和脑脊液中前列腺素E2(PGE2)、P物质(SP)、降钙素基因相关肽(CGRP)。结果:B组爆发痛的次数少于M组(P<0.05);静息卧床时两组疼痛都得到缓解NRS评分<2分,两组比较(P>0.05);B组下床活动后疼痛次数对比吗啡组明显减少(P<0.05);SF-36量表各维度比较B组生活质量有显著改善,日常生活能力得分有显著差异(P<0.05);术后第7天,血浆内啡肽水平,两组比较(P>0.05);血浆胃动素B组高于M组(P<0.05);脑脊液中PGE2、SP、CGRP浓度M组高于B组(P<0.05)。结论:鞘内泵入吗啡联合倍他米松对比鞘内泵入吗啡治疗癌性骨痛,爆发痛的次数减少,改善胃肠动力,提高了患者生存质量。脑脊液中PGE2、SP、CGRP浓度低于鞘内注射吗啡组,可减轻吗啡耐受,增强了镇痛效果。
The cytotoxicities of single-walled carbon nanotubes （SWNTs） and acid purified single-walled carbon nanotubes （SWNT-COOH） were investigated by spectroscopic analysis. Cell viability and cell apoptosis were applied to assessing the cytotoxicity of SWNT-COOH, cetyltrimethyl ammonium bromide （CTAB） and acid purified carbon nanotubes modified with cetyltrimethyl ammonium bromide （SWNT-COOH/CTAB）. The results indicate that SWNTs are more toxic than SWNT-COOH. Concentration and time-curve analyses indicate that cytotoxicity of SWNT-COOH/CTAB is more related to the toxicity of the surfactant CTAB. The cytotoxicity effect of CTAB and SWNT-COOH/CTAB is acceptable at low concentrations （0.5-25μg/mL）. The cytotoxicity observation suggests that SWNT-COOH/CTAB can safely applied to biomedical field at low concentrations （0.5-25μg/mL）.
