促红细胞生成素治疗非小细胞肺癌化疗所致贫血的临床研究

目的评价促红细胞生长素(EPO)治疗非小细胞肺癌(NSCLC)患者化疗所致贫血的临床疗效及副反应。方法64例NSCLC患者分成观察组34例和对照组30例,观察组化疗同时皮下注射EPO,剂量为150 u.kg-1体重,每周3次;对照组化疗同时给予利血君口服,观察两组的治疗效果和不良反应。结果治疗2周后观察组和对照组血红蛋白浓度、红细胞压积、红细胞总数均较治疗前显著降低(P<0.01)。治疗4周起观察组血红蛋白浓度、红细胞压积、红细胞总数均明显上升(P<0.01),且高于对照组同期水平(P<0.01)。治疗结束后观察组血红蛋白浓度、红细胞压积、红细胞总数均较治疗前显著增加(P<0.01)。结论EPO对非小细胞肺癌采用以顺铂为主联合化疗方案所致贫血有肯定的疗效。     

促红细胞生成素治疗癌性贫血疗效观察

目的 探讨促红细胞生成素(EPO)治疗恶性肿瘤化疗后贫血患者的临床疗效.方法 将41例恶性肿瘤化疗后贫血的患者分为观察组(21例)和对照组(20例),两组均接受2个周期的化疗.观察组在每1个化疗周期结束48 h后给予EPO 12000 U皮下注射,3次/周,连续3周,共用6周.两组的辅助治疗相同.于第2个周期的EPO治疗结束后评价疗效.结果 EPO治疗6周后,观察组的血红蛋白水平、血细胞比容、红细胞计数均较治疗前有明显上升,差异有统计学意义(P＜0.01).对照组化疗前后血红蛋白水平、血细胞比容、红细胞计数的变化不明显.结论 EPO能改善化疗相关性贫血,提高肿瘤患者的生活质量,值得临床推广应用.     

高聚生配合诺维本为主联合化疗晚期乳腺癌探讨

目的　探讨高聚生配合诺维本为主联合化疗晚期乳腺癌的疗效。方法　比较分析 31例晚期乳腺癌采用高聚生配合以诺维本为主联合化疗 (治疗组 )和 31例晚期乳腺癌采用以诺维本为主联合化疗传统方案 (对照组 )的疗效、毒副反应、免疫水平。结果　治疗组化疗缓解率 6 7 7% ,显著优于对照组化疗缓解率 5 1 6 % (P <0 0 5 )。高聚生治疗的患者在化疗一周后免疫功能提高和没有用高聚生治疗的患者一周后明显下降相比较有显著差异 (P <0 0 5 )。治疗组化疗骨髓抑制低于对照组。结论　高聚生配合诺维本为主联合化疗的综合治疗晚期乳腺癌可以取得预期的最佳疗效。     

PDCD5在晚期非小细胞肺癌患者血清中的表达及与化疗药物敏感性的相关性研究

目的：研究程序化细胞死亡分子5(PDCD5)在晚期非小细胞肺癌(NSCLC)患者血清中的表达,探讨其与化疗药物敏感性的关系。方法收集经病理证实为晚期 NSCLC 患者40例作为肺癌组,体检健康者20例为正常组。肺癌组给予铂类药物联合其他化疗药物进行化疗,治疗周期为21 d,治疗2周期后进行疗效评估,分为有效组和无效组。采用ELISA 法分别检测肺癌组化疗前后及正常组血清中 PDCD5蛋白的水平,并分析其与疗效、临床特征的关系。结果正常组血清中 PDCD5蛋白的水平高于肺癌组,差异有统计学意义(P <0．05)。化疗前 PDCD5蛋白的水平有效组高于无效组,差异有统计学意义(P <0．05)。化疗后 PDCD5蛋白的水平有效组显著高于无效组,差异有统计学意义( P <0．01)。有效组化疗后 PDCD5蛋白的水平高于化疗前,差异有统计学意义(P <0．05)。无效组化疗后 PDCD5蛋白的水平低于化疗前,差异有统计学意义(P <0．05)。肺癌组血清中 PDCD5蛋白的水平与有无淋巴结转移及肿瘤的分化程度有关(P <0．05),与患者是否吸烟、性别、病理类型均无关(P>0．05)。结论晚期 NSCLC 患者血清中 PDCD5蛋白的水平有望成为化疗敏感性的预测因子,其表达水平降低可能与肺癌的发生有关,也可能为晚期 NSCLC 患者不良预后因素。     

脂质体紫杉醇联合卡铂与紫杉醇联合卡铂一线治疗晚期非小细胞肺癌的疗效和安全性的比较

目的 比较脂质体紫杉醇联合卡铂与紫杉醇联合卡铂一线治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法 54例初治的晚期NSCLC患者随机分为两组,每组27例,分别给予脂质体紫杉醇(175 mg/m²)+卡铂 AUC5方案(试验组)和紫杉醇注射液(175 mg/m²)+卡铂AUC5方案(对照组)化疗,两组化疗周期均为21 d,均不少于2周期。化疗2周期后,比较两组患者的疗效和不良反应。结果 试验组和对照组在治疗总有效率(显效+有效)(44.4%比33.3%,P=0.577)、骨髓抑制发生率(81.5% 比63.0%,P=0.080)、胃肠道反应发生率(96.3%比77.8%,P=0.100)和肿瘤中位进展时间(6个月比5个月,P=0.420)方面差异均无统计学意义。试验组的过敏反应发生率为0,明显低于对照组的11.1%(P=0.000)。结论 脂质体紫杉醇联合卡铂与紫杉醇联合卡铂方案一线治疗晚期NSCLC的疗效相当,但过敏反应发生率明显低于紫杉醇联合卡铂方案。     

TC和PC化疗方案在晚期卵巢癌术后患者中的效果及安全性比较

目的比较铂类联合紫杉醇(TC)和铂类联合环磷酰胺(PC)化疗方案在晚期卵巢癌术后患者中的效果及安全性。方法选取2013年1月至2015年1月大连医科大学附属第一医院收治的84例晚期卵巢癌患者为研究对象,依据化疗方法不同分为研究组和对照组,各42例。研究组行TC化疗方案,对照组行PC化疗方案。观察两组患者的临床疗效,治疗前后的血清学指标[甲胎蛋白(AFP)、糖类抗原125(CA125)]及生活质量(角色功能、情绪功能、社会功能)评分,不良反应及预后情况。结果研究组总有效率高于对照组[83. 33%(35/42)比59. 52%(25/42)](P <0. 05)。治疗后两组AFP、CA125均低于治疗前,两组不同时点间比较差异有统计学意义(P <0. 05)。治疗后两组患者角色功能、情绪功能、社会功能评分均高于治疗前,且研究组高于对照组(P <0. 05),两组各指标组间、时点间、组间和时点间交互作用差异有统计学意义(P <0. 05)。研究组胃肠道反应、白细胞降低以及脱发少于对照组(P <0. 05)。结论晚期卵巢癌术后行TC化疗方案可提高治疗效果,改善患者生活质量,减少不良反应。     

恶性肿瘤患者化疗相关贫血的治疗

目的本课题研究我科恶性肿瘤患者化疗后贫血的发生状况及药物干预治疗。方法选择我科2008年1月～2010年7月收治的化疗前血红蛋白正常的肿瘤患者82例,统计化疗后贫血的发生率,贫血的程度,含铂与非含铂方案对贫血的影响,对发生贫血的患者分为两组,单药组单用促红细胞生成素10000U,皮下注射,每周3次,连续8周治疗36例;联合组给予促红细胞生成素10000U,皮下注射,每周3次,和蔗糖铁0.2g,静脉滴注,每周2次,连续8周治疗37例,观察治疗前后血红蛋白的变化及不良反应。结果 82例恶性肿瘤患者化疗后贫血的发生率为85.37%,其中轻度贫血37例（45.12%）,中度贫血22例（26.83%）,重度贫血9例（10.98%）,极重度贫血2例（2.44%）,无贫血12例（14.63%）。单药组治疗后血红蛋白平均升高（20.1±3.3）g/L,联合组治疗后血红蛋白平均升高（22.1±3.5）g/L,两组比较差异有统计学意义。化疗后贫血发生以轻到中度为主（71.95%）,含铂方案贫血发生率90.63%,非含铂方案贫血发生率66.67%,两组比较差异有统计学意义。未见促红细胞生成素和蔗糖铁的明显不良作用。结论恶性肿瘤患者化疗后贫血的发生率高,含铂方案的化疗导致贫血的发生率更高。促红细胞生成素、蔗糖铁能纠正恶性肿瘤患者化疗所致的贫血,两者联合使用疗效更佳。     

重组人促红细胞生成素治疗肿瘤化疗中贫血的临床研究

目的:研究重组人促红细胞生成素(rhEPO)对接受化疗的肿瘤患者提升血红蛋白的治疗效果.方法:151例肿瘤化疗患者随机分为三组.常规剂量组:rhEPO 10 000 U/次,皮下注射(s.c.),每周3次,持续8周;冲击治疗组:rhEP0 20 000 U,1次/天,连用2天后,10 000 U,1次/天,连用6天,随后同常规剂量组;对照组:不给予rhEPO,其他同治疗组.结果:经EPO治疗后,冲击组从第2周开始平均Hb水平较治疗前提高2.6 g/L(P=0.000),与常规组相比,第2周时平均Hb水平提高2.9 g/L,但无明显统计学差异(P=0.053);而第3.4周冲击组平均Hb水平比常规组分别高3.8g/L和34g/L,具有显著性差异(P=0.048、P=0.029);至5、6、7、8周时.冲击组虽然平均Hb水平比常规组高,但两者差异不显著(P>0.05).冲击组 常规组与对照组相比,从第三周开始平均Hb水平即稳步升高(P<0.01).结论:rhEPO能有效治疗肿瘤患者化疗中贫血,保障化疗正常进行.冲击疗法与常规疗法相比,能较快地提高化疗中患者Hb水平,但对后期Hb水平两者差异不大.     

逐步递量加速超分割照射加化疗治疗局部晚期非小细胞肺癌

[摘要] 目的 研究逐步递量加速超分割放射治疗加TP方案化疗对局部晚期非小细胞肺癌(NSCLC)的近期疗效。方法 逐步递量加速超分割放射治疗组（治疗组）56例;常规分割放疗组（对照组）56例。治疗组第1,2周为1.2 Gy/次,第3,4,5周分别为1.3,1.4,1.5 Gy/次,均 2次/ d,间隔6 h 以上,5 d/周,总剂量为63～66 Gy/48～50次/33～35 d。对照组1.8～2 Gy/(次.天),5 d/周,总剂量60～70 Gy/30～38次/42～52 d。两组均给予TP方案（紫杉醇和顺铂)同期和辅助化疗,共4周期。结果 治疗组和对照组分别有2例和3例患者未完成治疗计划。在按计划完成治疗的107例患者中,治疗组和对照组的有效率分别为83.3%和66.0%,治疗组明显优于对照组(P＜0.05);治疗组的1年生存率（63.0%）也优于对照组（49.1%）,但两组间比较无显著性差异(P＞0.05)。治疗组急性放射反应高于对照组, 对症处理后,患者能耐受,不影响治疗的进行。结论 逐步递量加速超分割放射治疗加TP方案化疗治疗局部晚期NSCLC近期疗效较好,急性放射反应能为患者耐受。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.