草酸铂为主方案治疗晚期消化道肿瘤近期疗效观察

目的:探讨以草酸铂(OXA)及氟脲嘧啶(5-Fu)为基础化疗方案治疗晚期消化道肿瘤近期疗效及患者的耐受性。方法:晚期大肠癌共20例采用A方案,OXA130mg/m2静脉滴注>3h,d1;CF200mg/m2静脉滴注2h,d1～5,5-Fu2000mg/m2持续静脉泵入共120h;3周为1个周期;晚期胃癌共15例采用B方案,HCPT10mg静脉滴注d1～5,余药物同A方案。结果:A方案CR1例,PR7例,总有效率为40%,B方案CR2例,PR6例,总有效率53.3%。二方案毒性表现相似,主要为腹泻、黏膜炎及神经毒性。结论:以草酸铂为主方案是较理想的治疗方案,耐受性良好,有效率较高。     

FOLFOX4方案治疗晚期胃癌37例临床观察

目的:观察草酸铂(艾恒)联合亚叶酸钙和5-Fu组成的FOLFOX4方案治疗晚期胃癌的疗效和毒副反应。方法:37例晚期胃癌患者行FOLFOX4方案化疗,草酸铂(艾恒)85mg/m2,d1;亚叶酸钙200mg/m2,d1~2;5-Fu400mg/m2静推,继予5-Fu600mg/m2持续滴注22h,d1~2;2周重复1次,2次为1周期;每个病例至少接受2个周期化疗。结果:37例患者中CR 2例,PR 16例,SD 13例,PD 6例,总有效率(CR PR)18例(48.65%)。20例初治患者有效率为55.0%,17例复治患者有效率为41.18%。化疗后白细胞减少发生率为45.95%,其中Ⅲ度白细胞下降发生率为5.41%,有21.62%患者出现周围神经病变。结论:该方案具有较好的疗效和耐受性。     

奥沙利铂联合氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床探讨

目的:观察奥沙利铂(oxaliplatin,L-OHP)联合氟尿嘧啶(fluorouracil,5-Fu)、亚叶酸钙(leucovorin,CF)治疗晚期胃癌的近期疗效及毒副反应。方法:入选者为病理证实的晚期胃腺癌患者。化疗方案:L-OHP100mg/m2静脉滴注2h,d1,CF200mg/m2静脉滴注2h,d1￣2,5-Fu400mg/m2,静脉滴注2h,d1,5-Fu600mg/m2持续静脉泵入22h,d1￣2,每3周重复,至少完成3个周期后判效,4个周期以上为有效病例。结果:全组54例均可评价疗效及不良反应,治疗总周期221个周期,平均4.1个周期。CR7例(13.0%),PR24例(44.4%),有效率(CR PR)59.3%,SD17例(31.5%),PD6例(11.1%)。主要不良反应为轻度感觉神经毒性,恶心、呕吐及骨髓抑制。结论:L-OHP联合5-Fu、CF治疗晚期胃癌疗效较好,不良反应轻,可耐受,是晚期胃癌化疗的良好选择之一,同样适用于新辅助化疗。     

OLF方案治疗进展期胃癌42例报告

目的探讨草酸铂（L-OHP）联合5-氟尿嘧啶（5-Fu）/亚叶酸钙（CF）方案治疗进展期胃癌近期疗效及其毒副反应。方法 L-OHP130mg/m^2,静脉滴注3h,d1,CF100mg/m^2,静脉滴注2h,d1～5;5-Fu500mg/m^2,静脉滴注d1～5.5-Fu每天静滴时间维持在6h～8h,CF在5-Fu前使用,21d重复。结果 42例进展期胃癌患者,获得CR3例（7.1%）,PR23例（54.8%）,SD9例（21.4%）,PD7例（16.7%）,总有效率（CR＋PR）达61.9%.主要不良反应为恶心、呕吐、白细胞和血小板减少及轻度周围神经毒性,无化疗相关死亡。结论 L-OHP联合5-Fu/CF方案一线治疗晚期胃癌具有较好的疗效和安全性。     

周剂量多西紫杉醇联合顺铂及5-Fu治疗晚期胃癌临床观察

目的 观察周剂量多西紫杉醇联合顺铂及与5-氟尿嘧啶(5-Fu)治疗晚期胃癌的疗效和毒副反应.方法 28例晚期胃癌患者,Karnofsky评分≥70分,预计生存期＞3个月,未接受手术且未行任何化疗.多西紫杉醇25mg/m2静脉滴注,顺铂30 mg/m2静脉滴注,5-Fu 600 mg/m2(24 h持续泵入),均为第1、8、15天使用.行2周治疗后判定疗效并随访.结果 28例患者均完成2个周期以上化疗,其中CR1例,PR 11例,SD10例,PD 6例,有效率42.9%.毒副反应主要表现为骨髓抑制、脱发和消化道反应,其他毒副反应较少,且可耐受,无化疗相关死亡.结论 周剂量多西紫杉醇联合顺铂及5-Fu作为晚期胃癌的一线化疗方案,具有疗效相对较高,不良反应相对较小的优点.     

CF/5-Fu联合DDP方案两种给药方法治疗晚期胃肠道腺癌的临床观察

目的观察CF/5-Fu联合DDP两种给药方法治疗晚期胃肠道腺癌的临床疗效及不良反应。方法治疗组静点CF(200mg/m2)2 h,d 1,静冲5-Fu(500mg/m2)后使用化疗泵持续静脉滴注5-Fu(2.5g/m2)48 h,静点DDP(20 mg/m2.d)连用5天;对照组静点CF(100 mg/m2)2h,d 1~5,静点(5-Fu 500mg/m2)4 h,d 1~5,余同治疗组。结果治疗组总有效率(CR PR)为68.7%,对照组总有效率为26.9%,临床疗效统计学处理用确切概率法,组间差异有显著性(P<0.05)。血液性毒性的发生率,恶心、呕吐的发生率两组无统计学差异(P>0.05),腹痛腹泻发生率治疗组毒副反应较对照组低,两组统计学处理差异有显著性(P<0.05)。结论将5-Fu静点改为持续静脉灌注治疗晚期胃肠道腺癌,疗效好,毒副反应轻,值得临床推广应用。*     

多西紫杉醇联合化疗方案治疗进展期胃癌的疗效观察

目的 探讨多西紫杉醇联合奥沙利铂、5-氟尿嘧啶(5-Fu)和亚叶酸钙(CF)化疗方案治疗进展期胃癌的疗效和不良反应.方法 2006年1月-2009年1月我院共收治了47例进展期胃癌患者,按照化疗方案的不同,将患者分为两组:观察组(26例)和对照组(21例).观察组化疗方案:多西紫杉醇75 mg/m2,静脉滴注,第1天;奥沙利铂85 mg/m2,静脉滴注,第1天;5-Fu 500 mg/m2,持续静脉滴注,第1～5天;CF 300 mg/m2,静脉滴注,第1～5天.对照组:奥沙利铂130 mg/m2,静脉滴注,第1天;5-Fu及CF使用方法同观察组.3周为1个周期,治疗3个周期后按WHO标准评价近期疗效和毒副反应.结果 观察组治疗后完全缓解(CR)6例,部分缓解(PR)11例,疾病稳定(SD)8例,疾病进展(PD)1例;对照组CR、PR、SD、PD分别为2、7、6、6例,两组患者疗效间差异有统计学意义(P＜0.05).两组患者毒副反应主要是白细胞减少、恶心、呕吐、脱发、周围神经毒性,但未有因此而死亡的病例.两组患者各种毒副反应发生率间差异无统计学意义(P＞0.05).结论 多西紫杉醇联合奥沙利铂、5-Fu和CF治疗进展期胃癌的疗效较好,且不增加毒副反应,患者可以耐受.     

草酸铂联合氟脲嘧啶、甲酰四氢叶酸治疗晚期胃癌的疗效分析

目的：评价草酸铂为主联合治疗晚期胃癌的近期疗效和不良反应。方法；对18例晚期胃癌患者给予联合化疗，草酸铂100mg／m^2静脉滴注2h(第1～15d)，甲酰四氢叶酸100mg／m^2静脉滴注2h，(第1-5d)，氟脲嘧啶500mg／m^2静脉滴注4h，(第1-5d)，每3周重复。治疗周期2～6周期.结果：CR2例，PR10例，SD4例，PD2例，总有效率66.7％。不良反应：骨髓抑制、胃肠道反应和感觉神经毒性。结论：以草酸铂为主的联合化疗，疗效高、不良反应轻、耐受性好。可作为晚期胃癌治疗的一种选择。     

草酸铂联合氟脲嘧啶、亚叶酸钙治疗晚期胃癌30例效果观察

目的:观察草酸铂联合氟脲嘧啶和亚叶酸钙治疗晚期胃癌的近期疗效和不良反应。方法:化疗OLF3方案:草酸铂30mg/m2,静滴第1日;亚叶酸钙200mg/m2,静滴2小时,第1~3日;5-氟脲嘧啶400mg/m2,快速静注后再用5-氟脲嘧啶600mg/m2持续静滴22小时,第1~3日;21日为1周期,完成2周期后评定疗效,有效病例4周后确认。结果:全组完全缓解3例,部分缓解11例,总有效率(CR+PR)46.6%;主要不良反应为轻度血液学毒性和外周感觉神经毒性。结论:含草酸铂联合5-Fu和亚叶酸钙治疗晚期胃癌有效且毒性较小。     

改良FOLFOX方案治疗晚期胃癌临床观察

目的观察大剂量氟尿嘧啶(5-FU)联合奥沙利铂(OXA)与亚叶酸钙(CF)治疗晚期胃癌的疗效和安全性.方法改良FOLFOX方案,CF 200mg/m2,静脉滴注2 h,5-FU 500mg于CF滴完后静脉推注,继5-FU 4000 mg持续静脉摘注46 h;奥沙利铂130 mg/m2,静脉滴注4 h.每3周重复.结果全组21例中,CR 2例,PR 8例,有效率(CR PR)47.6%,不良反应主要为胃肠道反应和外周神经毒性反应.结论大剂量氟尿嘧啶联合奥沙利铂与亚酸钙治疗晚期胃癌疗效较高,不良反应轻,可作为晚期胃癌的一线化疗方案应用.     

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.     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.