以DA方案为主的联合化疗治疗急性髓系白血病的临床观察

目的探讨急性髓系白血病的化疗疗效。方法采用以ＤＡ方案为主的化疗方案治疗２５例急性髓系白血病（ＡＭＬ）患者,获得完全缓解（ＣＲ）后即行ＤＡ、ＨＡ、ＥＡ或大剂量甲氨蝶呤（ＨＤ－ＭＴＸ）交替强化两次共六个疗程,与单一ＤＡ,ＨＡ或ＨＯＡＰ方案治疗１９例ＡＭＬ患者,在诱导化疗获ＣＲ后常规单一方案强化疗效比较。结果二者ＣＲ率无明显差异（Ｐ＞０．０５）（前者ＣＲ率５６％,后者ＣＲ率４７４％）,二者治疗有效率亦无显著差别（Ｐ＞０．０５）（前者８００％,后者７３７％）。而二者无病生存期比较存在差异性（Ｐ＜０．０５）,前者中位生存期１３５个月。后者中位生存期５个月,结论提示急性髓系白血病在诱导缓解取得ＣＲ后,即行不同的ＡＭＬ强化治疗方案交替治疗,可使患者的无病生存期延长     

急性白血病钙素基因甲基化的PCR检测

应用多聚酶链反应（ＰＣＲ）技术检测了１０例急性淋巴细胞白血病（ＡＬＬ）和２２例急性髓细胞白血病（ＡＭＬ）降钙素（ＣＴ）基因的甲基化程度。结果表明,７例ＡＬＬ与１６例ＡＭＬ的ＣＴ基因都发生了高度甲基化。临床完全缓解的３例ＡＭＬ和２例ＡＬＬ中有１例ＡＬＬ为阳性,另有１例阴性的ＡＭＬ于１个月后转为阳性,随后出现临床复发。提示急性白血病ＣＴ基因高度甲基化的ＰＣＲ检测,对ＡＬＬ与ＡＭＬ微小残留病有很重要的诊断价值,特别为缺乏恒定肿瘤细胞标志的ＡＭＬ提供了一个新的分子基因标志。     

低分子肝素治疗不稳定心绞痛的临床观察

目的： 观察低分子肝素 （ Ｌ Ｍ Ｗ Ｈ, 商品名速避凝） 治疗不稳定心绞痛 （ Ｕ Ａ Ｐ） 的疗效。方法： 将４６ 例 Ｕ Ａ Ｐ 患者分为２ 组： 在常规治疗的基础上, Ａ 组加用阿斯匹林; Ｂ 组加用 Ｌ Ｍ Ｗ Ｈ 及阿斯匹林, 连续７ ｄ 。结果： Ａ 组和 Ｂ 组７ ｄ 内的心绞痛再发率、缓解率、急性心肌梗塞发生率及心性死亡的发生率分别为６３６ ％ 和２５ ％ （ Ｐ ＜ ００１） 、５４５ ％ 和８７５ ％（ Ｐ＜ ００５） 、９１ ％ 和０ 、４５ ％ 和０ , ２ 组均无出血发生。结论： Ｌ Ｍ Ｗ Ｈ 加阿斯匹林较单用阿斯匹林治疗 Ｕ Ａ Ｐ 疗效更好。     

p16,bcl—2,bax和fas／apo—1基因在急性白血病中的表达及 …

采用免疫组织化学染色法，检测了６１例急性白血病（ＡＬ）的ｐ１６，ｂｃｌ－２，ｂａｘ和ｆａｓ／ａｐｏ－１基因表达，结果表明，急性髓系白血病（ＡＭＬ）和急性淋巴细胞白血病（ＡＬＬ）组的ｐ１６ｂａｘ和ｆａｓ／ａｐｏ－１表达均显著低于对照组（Ｐ〈０．００１），ＡＬＬ组的ｐ１６，ｆａｓ／ａｐｏ－１表达又显著低于ＡＭＬ组（Ｐ〈０．０５），ＡＭＬ和ＡＬＬ组ｂｃｌ－２基因表达均显著高于对照组（Ｐ〈０．００１），Ａ     

氯胺酮-安定静脉麻醉下小儿手术时的内分泌功能变化

检侧了２０例小儿手术期间肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡｇⅡ）。醛固酮（ＡＬＤ）及皮质醇（ＣＯＲ）的变化。氯胺酮 安定静脉麻醉下，分别于麻醉前、麻醉后２０ｍｉｎ，切皮后５ｍｉｎ，３０ｍｉｎ及术后１ｈ，２４ｈ分取５ｍｌ静脉血，检测ＰＲＡ，ＡｇⅡ，ＡＬＤ，ＣＯＲ含量的变化。结果：麻醉后２０ｍｉｎ的ＣＯＲ值较对照值增高（Ｐ＜００５）切皮后５ｍｉｎ，３０ｍｉｎ和６０ｍｉｎ的ＡＬｄ，Ｃｏｒ值均较对照值有显著性增高（Ｐ＜００５或＜００１），且切皮后５ｍｉｎ，３０ｍｉｎ和６０ｍｉｎＡＬＤ，ＣＯＲ值均明显高于麻醉后２０ｍｉｎ值（Ｐ＜００１）。直至手术后２４ｈ时的ＡＬＤ值仍分别较对照值和麻醉后２０ｍｉｎ值有高度显著性（Ｐ＜００１）。提示本麻醉法不能阻止手术的伤害性剌激，引起应激效应激素的分泌过度增加。     

初发性急性髓性白血病伴三系病态造血的形态学特征及预后意义

对２７５例初发性（ｄｅｎｏｖｏ）急性髓性白血病（ＡＭＬ）患者的骨髓片回顾分析，结果３６例ＡＭＬ有粒、红、巨三系病态造血（ＡＭＬ－ＴＭＤＳ），占１３．７％。其中Ｍ１、Ｍ２、Ｍ４、Ｍ５、Ｍ６型病态造血比率分别为１０．０％、１７．８％、２０．０％、１０．２％、３７．５％。同时３６例ＡＭＬ－ＴＭＤＳ与性别一致、年龄相匹配的无三系病态造血的急性髓性白血病患者的外周血象以及完全缓解（ＣＲ）率、ＣＲ１、持续期、生存期进行了比较研究，发现血小板计数有非常显著性差异Ｐ＜０．０１，缓解期、生存期亦有显著差异，Ｐ值均＜０．０５。     

骨髓增生性疾病降钙素基因高度甲基化的检测

①目的探讨骨髓增生性疾病（ＭＰＤ）与降钙素（ＣＴ）基因高度甲基化的关系。②方法采用多聚酶链反应（ＰＣＲ）技术检测了５０例慢性粒细胞白血病（ＣＭＬ）、６例原发性骨髓纤维化（ＭＦ）及１例真性红细胞增多症（ＰＶ）病人的ＣＴ基因高度甲基化的阳性程度。③结果４２．００％的ＣＭＬ和６６．６７％的ＭＦ病人发生了ＣＴ基因高度甲基化；１例ＰＶ病人为阴性。ＣＭＬ病人阳性率分别为慢性期２０．６９％，加速期为６６．６７％，急变期为７７．７８％，慢性期比加速期和急变期的阳性率均明显降低（χ２＝９．６７７１，Ｐ＜０．０１）。④结论ＣＴ基因的高度甲基化与ＣＭＬ，ＭＦ病人的病程进展有关，它可作为ＣＭＬ，ＭＦ病人判断预后的一个有临床应用价值的分子标志     

急性髓性白血病骨髓涂片增殖细胞核抗原表达的研究

目的：探讨急性髓性白血病（ＡＭＬ）骨髓细胞动力学的变化。方法：免疫组化ＡＢＣ法。结果：正常组、初发ＡＭＬ、完全缓解ＡＭＬ及未缓解ＡＭＬ组，其增殖细胞核抗原（ＰＣＮＡ）表达率分别为：１２３±２６、３２８±７６、１４６±４４、２７４±５８正常组和初发ＡＭＬ及未缓解ＡＭＬ组相比较，Ｐ＜００１，存在明显差异，与完全缓解组无显著差别。缓解组与未缓解组也存在有一定差别。结论：①ＡＭＬ完全缓解与未缓解其细胞增殖活性不同。②在骨髓涂片上研究ＰＣＮＡ表达，方法简单，结果肯定，对了解骨髓细胞动力学的变化，有较高的临床价值，对指导ＡＭＬ治疗有一定意义。     

急性白血病P-糖蛋白表达及其临床意义

目的 评价骨髓涂片急性白血病（ＡＬ）细胞中Ｐ－糖蛋白表达及其临床意义。方法 采用免疫组化Ｓ－Ｐ法检测５１例ＡＬ患者骨髓涂片的因病细胞中Ｐｇｐ表达的阳性率。结果 ５１例ＡＬＰｇｐ阳性率为２７．５％,Ｐｇｐ阳必的急性非淋巴细胞白血病以Ｍ４、Ｍ５表达率同,而８例Ｍ３无１例阳性表达。初且ＡＬＰｇｐ阳性率为１９．５％,复发难治组一率为６０．０％,后者高于前者。Ｐｇｐ阳性者完全缓解为６０．０％,后者高于前者。     

5/6肾大部分切除大鼠甲状旁腺细胞凋亡的变化及钙三醇的调节作用

目的：探讨慢性肾功能衰竭（ＣＲＦ）大鼠甲状旁腺细胞凋亡的变化以及钙三醇的调控作用。方法：研究对象为ＳＤ大鼠，分３组：Ａ组：ＣＲＦ组；Ｂ组：ＣＲＦ加用钙三醇组，每天皮下注射钙三醇５０ｎｇ；Ｃ组：假手术对照组。术后８周，采用流式细胞术检测大鼠甲状旁腺凋亡细胞比率（ＡＰＯ）和细胞周期，同时检测血清肌酐（ＳＣｒ）、Ｃａ＋｛２＋｝、Ｐ＋｛３－｝、碱性磷酸酶（ＡＬＰ）、全段甲状旁腺素（ｉＰＴＨ）以及尿内生肌酐清除率（ＣＣｒ）。结果：Ａ组和Ｂ组大鼠ＣＣｒ均较Ｃ组下降了近一半；Ａ组ＡＬＰ和ｉＰＴＨ显著高于Ｂ组和Ｃ组（％Ｐ％＜０．０１），而Ｂ组和Ｃ组差异无显著性（％Ｐ％＞０．０５）；Ａ组ＡＰＯ、Ｓ期细胞比率（ＳＰＲ）和增殖指数（ＰＩ）分别为（０．２３±０．１９）％、（１１．９９±２．７３）％和（１６．９３±３．４２）％，Ｂ组分别为（１．３２±０．５１）％、（２．９５±１．５８）％、（５．２４±２．２９）％，Ｃ组分别为（１．２９±０．４５）％、（０．７３±０．４６）％、（１．７６±０．７０）％，Ａ组ＡＰＯ显著低于Ｂ组和Ｃ组（％Ｐ％＜０．０１），Ａ组ＳＰＲ和ＰＩ显著高于Ｂ组和Ｃ组（％Ｐ％＜０．０１），但Ｂ组ＳＰＲ和ＰＩ仍高于Ｃ组     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.