黄连解毒液防治头颈部肿瘤放射性皮炎的随机对照双盲临床研究

目的:观察黄连解毒液外用防治头颈部肿瘤放射性皮炎的临床疗效。方法:将90例头颈部恶性肿瘤放疗患者随机分成治疗组及对照组,各45例,治疗组给予黄连解毒液外用涂擦放疗区域皮肤,2次/d;对照组给予重组人表皮生长因子外用溶液(金因肽)外喷于放疗区域皮肤,2次/d,放疗第一天开始,观察至治疗结束。观察2组患者首次发生放射性皮炎的时间、Ⅲ度以上放射性皮炎发生率、发生放射性皮炎皮损程度、放射性皮炎临床治疗疗效及不良反应。结果:治疗组首次发生放射性皮炎的时间治疗组晚于对照组(13.22±3.87dvs11.44±3.79d,P=0.030),Ⅲ度以上放射性皮炎发生率(46.7%vs75.6%,P=0.005)、放射性皮炎治疗有效率(95.6%vs82.2%,P=0.044)均优与对照组,2组均未出现严重不良反应。结论:在观察病例中,黄连解毒液外用凃擦,能延缓首次发生放射性皮炎的时间、降低Ⅲ度以上放射性皮炎发生率及放射性皮炎皮损程度、提高放射性皮炎临床治疗效果,具体机制有待进一步深入研究。     

疮疡灵治疗乳腺癌放疗所致放射性皮炎临床研究

目的:观察疮疡灵治疗乳腺癌放疗所致放射性皮炎的临床疗效。方法:选取126例乳腺癌放疗患者作为研究对象,随机分为试验组和对照组,其中试验组给予疮疡灵防治放射性皮炎,对照组予以复方醋酸地塞米松软膏防治放射性皮炎,疗程结束后比较两组患者放射性皮炎的发生率及损伤程度,评价临床效果及生存质量。结果:试验组放射性皮炎的发生率明显低于对照组,且损伤程度较轻,两组比较,差异有统计学意义(P0.05);试验组有效率为90.5%,对照组有效率为65.1%,且试验组患者生存质量明显优于对照组,差异有统计学意义(P0.05)。结论:疮疡灵可降低乳腺癌放射性皮炎的发生率及严重程度,改善患者生存质量,临床疗效明显。     

射线防护剂预防鼻咽癌放射性皮炎的临床与护理效果观察

目的 观察射线防护剂预防鼻咽癌放疗期间放射性皮炎的临床效果.方法 将70例鼻咽癌首次放疗患者随机分为观察组和对照组各35例.观察组在第1天放疗时即使用射线防护剂外喷,3次/日,两组均进行常规的皮肤护理和健康教育.结果 观察组放射性皮炎的发生程度明显轻于对照组(P＜0.01);观察组能明显提高皮肤的照射耐受量,延缓2级放射性皮炎的发生时间(P＜0.01).结论 射线防护剂预防鼻咽癌放射性皮炎效果显著.     

自制复方二黄油治疗放射性皮肤黏膜损伤的研究

目的观察自制复方二黄油对急性放射性皮肤黏膜损伤的疗效.方法将头颈部恶性肿瘤放射治疗后所致Ⅲ度急性放射性皮炎80例患者随机分成治疗组46例,对照组34例;40例Ⅲ度急性放射性黏膜炎患者随机分成治疗组20例,对照组20例.治疗组使用自制复方二黄油涂于创面,对照组用金因肽喷于创面.根据RTOG急性放射性黏膜炎和皮炎的分级标准进行临床评价.结果Ⅲ度急性放射性皮炎患者治疗组和对照组的有效率分别为91.3%(42/46)和73.5%(25/34),两组比较有显著性差异(χ2=3.909,P＜0.05).Ⅲ度急性放射性黏膜炎患者治疗组和对照组的有效率分别为90.0%(18/20)和55.0%(11/20),两组比较有显著性差异(χ2=4.514,P＜0.05).Ⅲ度放射性皮炎愈合时间≤10 d,治疗组68.8%(22/32),对照组27.3%(6/20),两组比较有显著性差异(χ2=5.959,P＜0.05).两组均未发现毒副反应,治疗组的费用仅为对照组的1/4.结论自制复方二黄油治疗急性放射性皮肤黏膜损伤明显优于金因肽,疗效安全可靠,经济,使用方便,值得临床推广使用.     

自制复方二黄油治疗放射性皮肤黏膜损伤的研究

目的　观察自制复方二黄油对急性放射性皮肤黏膜损伤的疗效。方法　将头颈部恶性肿瘤放射治疗后所致Ⅲ度急性放射性皮炎 80例患者随机分成治疗组 4 6例 ,对照组 34例 ;4 0例Ⅲ度急性放射性黏膜炎患者随机分成治疗组 2 0例 ,对照组2 0例。治疗组使用自制复方二黄油涂于创面 ,对照组用金因肽喷于创面。根据RTOG急性放射性黏膜炎和皮炎的分级标准进行临床评价。结果　Ⅲ度急性放射性皮炎患者治疗组和对照组的有效率分别为 91 . 3%(42 / 4 6 )和 73. 5 %(2 5 / 34) ,两组比较有显著性差异 (χ2 =3 90 9,P <0 . 0 5 )。Ⅲ度急性放射性黏膜炎患者治疗组和对照组的有效率分别为 90 . 0 %(1 8/ 2 0 )和 5 5 . 0 %(1 1 /2 0 ) ,两组比较有显著性差异 (χ2 =4. 5 1 4 ,P <0 . 0 5 )。Ⅲ度放射性皮炎愈合时间≤ 1 0d ,治疗组 6 8 .8%(2 2 / 32 ) ,对照组 2 7 3%(6 / 2 0 ) ,两组比较有显著性差异 (χ2 =5 . 95 9,P <0 . 0 5 )。两组均未发现毒副反应 ,治疗组的费用仅为对照组的 1 / 4。结论　自制复方二黄油治疗急性放射性皮肤黏膜损伤明显优于金因肽 ,疗效安全可靠 ,经济 ,使用方便 ,值得临床推广使用。     

藻酸盐治疗Ⅲ度放射性皮炎的疗效观察

目的通过对发生Ⅲ度放射性皮炎的放疗患者使用藻酸盐,了解能否减轻患者伤口疼痛,缩短皮炎愈合时间。方法将60例发生Ⅲ度放射性皮炎的患者随机分为两组,对照组采用传统的换药方法,试验组采用生理盐水清洗,用纱布抹干后内敷藻酸盐外覆盖透明贴。结果试验组皮炎愈合时间明显比对照组缩短。结论采用生理盐水清洗,用纱布抹干后内敷藻酸盐外覆盖透明贴,大大缩短了皮炎的愈合时间,使患者能尽快完成治疗。     

软聚硅酮敷料在预防放射性皮炎中的临床应用

目的 观察软聚硅酮敷料对放射性皮炎的保护效果.方法 将96例恶性肿瘤患者随机分为两组:实验组(n=46)采用美皮康超薄型(软聚硅酮敷料)于放射治疗间歇期保护放射野的皮肤,同时予以常规教育与护理;对照组(n=50)仅予以常规教育与护理.观察并比较两组放射性皮炎的发生率及照射野皮肤疼痛的发生率.结果 实验组放射性皮炎的发生率较对照组明显降低(P＜0.01),且实验组照射野皮肤疼痛的发生率也较对照组明显减少(P＜0.01),均差异有显著性.结论 软聚硅酮敷料能有效预防恶性肿瘤放疗患者的放射性皮炎的发生.     

奥克喷预防乳腺癌放射性皮炎的疗效观察及护理

目的观察奥克喷预防乳腺癌放射性皮炎的临床疗效。方法回顾性分析2010年5月～2011年5月我院52例乳腺癌术后首次接受放射性治疗的患者资料。观察组25例,每次接受放疗前后使用奥克喷外喷放疗照射野皮肤;对照组27例,放疗前后局部不予任何处理或药物。两组均进行常规的皮肤护理和健康教育。结果观察组发生放射性皮炎的几率明显低于对照组,两组差异具有统计学意义（P〈0.05）。结论奥克喷能有效预防乳腺癌放疗所致的放射性皮炎,并能减轻放射性皮炎发生程度。     

比亚芬联合金因肽预防和治疗皮肤放射性损伤临床疗效观察

目的观察比亚芬联合金因肽预防和治疗皮肤放射性损伤的临床效果。方法将需要接受放射治疗的134例恶性肿瘤患者随机分为两组,每组67例,治疗组于第一次放疗后给予比亚芬预防性治疗,对治疗组中出现放射性皮炎者则予以金因肽局部外喷;对照组仅行常规皮肤护理,对出现放射性皮炎者行传统换药处理。结果治疗组和对照组出现1、2、3级放射性皮炎的发生率分别为:40.3%、53.7%、6.0%和17.9%、59.7%、22.4%;治疗组放射性皮炎在照射剂量达40 Gy之前的发生率为38.8%(26/67),对照组为62.7%(42/67);治疗组放射性皮炎治愈时间为(7.3±2.15)d,对照组为(14.7±2.89)d。结论比亚芬联合金因肽能显著减少皮肤放射性损伤的发生,推迟放射性皮炎的发病时间,有效缩短放射性皮炎的治愈时间。     

糖代谢紊乱与鼻咽癌放射性皮炎关系的临床观察

目的 观察糖代谢紊乱对鼻咽癌放射性皮炎的影响.方法 前瞻性观察住院鼻咽癌742例,治疗前后分别检测空腹和餐后2 h血糖,分析血糖与放射性皮炎程度的关系.结果 7例因放疗诱发了糖尿病,放疗中4例糖尿病发生了酮症酸中毒;放疗后糖代谢紊乱发生率高于放疗前(P＜0.05);合并糖代谢紊乱者和单纯鼻咽癌患者3级以上放射性皮炎发生率分别为25.49%和9.38%,两组差异有统计学意义(χ2=16.027,P=0.000);FPG(r=0.099,P=0.007)、2 h BG(r=0.088,P=0.016)与放射性皮炎程度均呈正相关.结论 鼻咽癌患者放疗可诱发糖代谢紊乱,甚至诱发糖尿病;高血糖可加重放射性皮炎而影响鼻咽癌患者预后,应加强放射野皮肤的保护,并良好控制血糖.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.