肝动脉化疗栓塞与无水酒精注射序贯治疗原发性肝癌

目的：评价原发性肝癌肝动脉化疗栓塞（TACE）与经皮穿刺无水酒精注射（PEI）序贯治疗的疗效。方法：不能手术切除的原发性肝癌患者共42例，其中16例行TACE＋PEI序贯治疗，26例行单纯TACE治疗。结果：CT及增强CT显示肿瘤组织完全坏死率，TACE＋PEI组87，5％，TACE组38．5％；彩超显示肿瘤血流信号消失率，TA—CE＋PEI组75．0％，TACE组34．6％；2年生存率，TACE＋PEI组81．3％，TACE组42．3％。两组疗效比较，TACE＋PEI组明显优于PEI组。并发症两组无明显差异。结论：TACE＋PEI对原发性肝癌有明显疗效。     

经皮无水乙醇注射联合肝动脉化疗栓塞治疗少血供肝癌

目的探讨B超引导下经皮肝穿刺瘤内注射无水乙醇（PEI）联合肝动脉化疗栓塞（TACE）治疗少血供肝癌的疗效。方法经组织学及三期cT增强扫描确诊的64例少血供肝癌分为两组：研究组（A组）34例,先行TACE,再行B超引导下PEI;对照组（B组）30例,仅行TACE治疗。结果研究组半年、1年、2年生存率分别为88．2％、63．3％、42．1％,近期有效率为73．5％。对照组半年、1年、2年生存率分别为60％、44．4％、25．0％,近期有效率为43．3％。两组间比较生存率和近期有效率差异均有统计学意义（P〈0．01）。结论少血供肝癌TACE＋PEI疗效优于单纯TACE,是一种值得推荐的治疗方法。     

栓塞化疗合并注射无水乙醇治疗原发性肝癌(附112例报告)

目的探讨栓塞化疗合并瘤内注射无水乙醇治疗原发性肝癌（简称肝癌）的疗效。方法回顾性分析采用动脉插管栓塞化疗（TACE）与经皮注射无水乙醇（PEI）序贯治疗112例肝癌患者（研究组），并与同期病例相似的70例肝癌（对照组）单纯采用TACE治疗的疗效相比较。结果首次治疗后AFP下降有效率（CR＋PR）：研究组为68．8％，对照组为30．0％；肿瘤体积缩小率（CR＋PR）：研究组为78．6％，对照组为34．3％。第2疗程川1P下降有效率（CR＋PR）：研究组为77．8％，对照组为28％；肿瘤体积缩小率（CR＋PR）：研究组为80．5％，对照组为45．0％。以上两组间差异均有统计学意义（P均〈0．05）。结论TACE合并PEI治疗肝癌可以提高疗效，是合理有效的治疗方法。     

肝动脉化疗栓塞及经皮无水酒精注射治疗中晚期肝癌疗效观察

目的：评估肝动脉化疗栓塞术（transcatherter arterial chemoembolization TACE）及CT导向下经皮无水酒精注射（percutaneous ethanol injection PEI）治疗中晚期肝癌的疗效。方法：把42例经证实为原发性肝癌患者随机分成两组，在进行TACE的间歇期，21例在cT导向下行PEI，并与同期21例单纯行TACE相比较。结果：单纯行TACE组，1a及2a．生存率分别为45％，12％；TACE联合PEI组，1a及2a生存率分别为70％、31％。AFP下降幅度单纯TACE组为54％，TACE联合PEI组为76％。结论：TACE联合PEI为原发性肝癌较好的一种综合治疗方法，可提高肝癌治疗疗效。     

TACE、PEI双介入间隔疗法治疗晚期原发性肝细胞癌临床观察

目的对照观察肝动脉化疗栓塞（tmrlscatheter arterial chemoembolization,TACE）和经皮肝穿刺无水乙醇注射（percutaneolls ethanol injection,PEI）双介入间隔疗法治疗晚期原发性肝细胞癌（hepatocellular carcinonla,Hcc）临床效果。方法观察组25例采用间隔2周进行TACE、PEI分别配合治疗,每疗程TACE2～3次、PEI2～4次。对照组29例单纯进行TACE治疗。两组观察期3年。结果观察组1年内生存率与对照组相比无明显差异,2年、3年内生存率高于对照组（P〈0．05）;观察组肿瘤缩小总有效率高于对照组（P〈0．05）。结论TACE、PEI间隔双介入疗法较单纯TACE治疗晚期原发性肝细胞癌能够提高治疗效果,延长患者存活时间,改善生存质量。     

肝动脉化疗栓塞结合无水乙醇瘤内注射治疗原发性肝癌

目的探讨肝动脉化疗栓塞结合无水乙醇瘤内注射治疗原发性肝癌的临床疗效。方法将80例原发性肝癌患者分为TACE联合超声引导下PEI治疗40例（治疗组）和单纯TACE治疗40例（对照组），比较两组的治疗效果。结果治疗组与对照组AFP下降率为87．5％和52．5％，肿瘤体积缩小有效率为82．5％和40．0％，1、2年生存率分别为92．5％、52．5％和57．5％、30．0％，差异有统计学意义（P〈0．05）。结论肝动脉化疗栓塞结合无水乙醇瘤内注射治疗原发性肝癌的临床疗效明显优于单纯肝动脉化疗栓塞组。     

肝动脉插管化疗栓塞术后联合HIFU治疗中晚期肝癌的疗效

目的观察肝动脉插管化疗栓塞术（TACE）后联合高强度聚焦超声（HIFU）在中晚期肝癌治疗中的疗效。方法采用TACE联合HIFU组（n=32）与单纯TACE组（n=20）对比,观察两组治疗前后肿瘤大小、血供、甲胎蛋白（AFP）的水平,随访1年,比较两组0．5年生存率,1年生存率、中位生存期有无差异。结果①经过治疗,两组的肿瘤缩小,肿瘤血供减少,血清AFP下降,且肿瘤缩小率、肿瘤血供消失和减少率、血清AFP水平下降在两组间差异有统计学意义（P＜0．05）。②单纯的TACE治疗者有效率78．13％,0．5年生存率84．38％,1年生存率68．75％,中位生存期9．7月;TACE加HIFU治疗者有效率90．00％,0．5年生存率95．00％,1年生存率85．00％,中位生存期11．2月,差异均有统计学意义（P〈0．05）。结论TACE联合HIFU是中晚期肝癌行之有效的治疗方法,其疗效略优于单纯TACE。但尚需大规模的临床随机试验进一步证实。     

三种介入治疗方案对原发性肝癌的疗效分析

目的：探讨肝动脉化疗栓塞术（TACE）、无水酒精消融术（PEI）及肝动脉化疗栓塞术＋无水酒精消融术（TACE＋PEI）3种介入治疗方案对原发性肝癌（PHC）的治疗效果。方法：回顾分析我院2007年1月～2011年4月间收治的PHC患者98例,分别采用TACE、PEI、TACE＋PEI3种介入治疗方案进行治疗,对比3种方案的治疗效果。结果：TACE＋PEI组患者治疗后临床有效率、生存率均较另外两种方案明显升高,差异均有统计学意义（P〈0．05）。结论：TACE＋PEI介入治疗PHC,疗效显著,可提高患者生存率,是临床上保守治疗原发性肝癌的有效治疗方案。     

肝动脉化疗栓塞联合无水乙醇注射治疗中晚期肝癌的近期疗效观察

目的 探讨肝动脉化疗栓塞术(TACE)联合CT引导下经皮无水乙醇注射(PEI)治疗中晚期肝癌的临床疗效.方法 10例应用TACE PEI治疗,10例单纯应用TACE治疗,比较两组患者治疗后的肿瘤大小、甲胎蛋白(AFP)的下降情况及生存率.结果 联合组肿瘤缩小较明显,AFP复常率高于TACE组,而术后不良反应及肝功能损害较轻,患者的生存期延长.结论 TACE PEI联合治疗中晚期肝癌优于单纯TACE.     

彩超导向下多方法联合治疗中晚期肝癌的临床价值

目的：探讨彩色多普勒超声（简称彩超）导向下多方法联合治疗中晚期肝癌的临床价值。方法：在彩超引导下对治疗组117例中晚期肝癌患者行多电极射频治疗（RF）＋无水乙醇瘤内注入（PEI）＋门静脉化疗栓塞（SPVE）联合肝动脉化疗栓塞（TACE）治疗，观察并比较与对照组（110例单纯TACE的肝癌患者）治疗前后的声像图特征和临床疗效的关系。结果：治疗组术后3个月复查彩超，肿瘤缩小25.0％以上者为87.2％（104／117）：肿瘤血供消失和减少率为88.0％（103／117）；甲胎蛋白（AFP）转阴率为78．3％（54／69）；1年和2年生存率分别为73．5％和62．4％，显著高于对照组的59．4％和32．6％。结论：多方法联合治疗中晚期肝癌是一种有效的治疗方法，彩超为指导治疗、动态监测和判断疗效提供依据。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.