胸部肿瘤立体定向放射治疗近期疗效观察

目的 探讨胸部肿瘤立体定向放射治疗（ＳＲＴ）的疗效及有关影响因素。方法 １９９７年１０月至１９９８年１２月胸部肿瘤患者４１例,４８个病灶,采用ＳＴＡＲ－１０００型立体定向放射治疗系统进行治疗,单靶点照射３５个病灶,多靶点照射１３个病灶,单次剂量５～１０Ｇｙ,总剂量２４～４４Ｇ中位剂量３７Ｇｙ。结果 立体定向放射治疗后１～５月３１例患者３８个病灶复查了ＣＴ或ＭＲＩ,ＣＲ１１个病灶、ＰＲ１３个病灶、Ｓ     

高剂量率腔内近距离放疗配合外照射治疗鼻咽癌44例

采用高剂量率腔内放疗配合外照射治疗鼻咽癌４４例，Ｔ１￣Ｔ２ ３７例，颅外Ｔ３ ７例。常规外照射剂量７０￣７５Ｇｙ，Ｔ３病例缩野加量１０￣１２Ｇｙ。腔内照射在外照射剂量达６０￣６５Ｇｙ时进行，每周一次，５￣７Ｇｙ，共２次，总剂量为１０￣１４Ｇｙ。在治疗后已有３０个月的病例有３１例，其生存率为８７％（２７／３１），Ｔ１￣Ｔ３局部控制率为９３．５％（２９／３１），Ｔ３局部控制率为６６．７％（４／６），主     

直肠癌术前体外大分割及腔内放疗的临床观察

３８例直肠癌患者中，ＤｕｋｅｓＡ，Ｂ，Ｃ期分别为７，２４，７例，放疗方法，体外放疗分为全盆腔对野照射，肿瘤量３５Ｇｙ分１０次，每周５次，其中１５例体外疗期间近距离腔内放疗，直肠粘膜下１０ｍｍ处参考点剂量１６Ｇｙ，分２次进行，放疗后１０～２０ｄ行根治术，结果：患者均耐受全疗程放疗，放疗后肿瘤完全消失２例，肿瘤缩小≥５０％者１３例，放疗后保肛手术指征扩大，单纯体外放疗组与体外加腔内放疗组的肿瘤消退情况     

97例非何杰金淋巴瘤放射治疗

目的：分析非何杰金淋巴瘤（ＮＨＬ）放射治疗效果。方法：自１９８０年１月至１９９１年１１月间，用钴－６０体外照射９７例ＮＨＬ患者。局部照射１２例，扩大野照射７６例，大面积不规则野照射９例。常规照射肿瘤剂量１８０～２００ｃＧｙ／次，不规则野肿瘤剂量１４０～１８０ｃＧｙ／次，总剂量２３～６０Ｇｙ。结果：Ⅰ、Ⅱ、Ⅲ、Ⅳ期５年生存率分别为６１．５％，４０．０％，１４．３％，０。总５年生存率４６．４％。淋巴结直径≤５ｃｍ和＞５ｃｍ生存率分别为６２．２％（２３／３７），２５％（１１／４４）（Ｐ＜０．０１）。治疗结束时淋巴结残留者５年生存率２２．７％（１０／４４），全消者５年生存率６４．９％（２４／３７），（Ｐ＜０．０１）；野内复发占１９．１％，野外复发占８０．９％，死于野内、外复发者分别占１５．８％和８４．２％。结论：淋巴结直经＞５ｃｍ或治疗结束时淋巴结残留者预后差；复发是本病的主要失败原因     

对维纳斯VPW532nm激光治疗鲜红斑痣的临床评价

目的：评价维纳斯激光治疗仪可调脉宽（ＶＰＷ）５３２ｎｍ激光治疗鲜红斑痣的临床疗效。方法：用维纳斯激光治疗仪中的倍频５３２激光在７～１４丁／ｃｍ＾２能量、７～１０脉宽、４～５℃冷却头温度的条件下治疗鲜红斑痣，同一患者每２～３月进行１次治疗。结果：１５７例鲜红斑痣中，治疗了１次的患者共６０例，其中弱效（颜色消退小于２５％）３８例（６３．３％），有效（颜色消退２５～５０％）１７例（２８．３％），显效（颜     

组织间插植与阴道盒后装放射治疗子宫颈癌的疗效比较

目的探讨组织间插植与阴道盒后装放射治疗消除巨大子宫颈肿块的疗效和并发症。方法宫颈癌大体积外生肿瘤（直径＞４０ｍｍ）应用高剂量率铱－１９２放射源近距离后装放射治疗消除肿瘤共４３例，分两组用不同方法对比观察。第１组２８例，用阴道盒容器；第２组１５例，用组织间插植。结果宫颈肿块消退至２０ｍｍ左右或宫颈外形恢复时间第１组需用２～３次，平均２．５４次，放射剂量为源旁１５ｍｍ（阴道粘膜下５ｍｍ），ＤＴ２０～３０Ｇｙ，平均ＤＴ２５．４Ｇｙ；第２组需１～３次，平均１．９次，放射剂量为源旁１０ｍｍ，ＤＴ１０～３０Ｇｙ，平均ＤＴ１８．７Ｇｙ；直肠、膀胱放射反应发生率第２组低于第１组分别为１３．３％、６．７％和３２．１％、１４．３％。结论组织间插植后装放射治疗消除宫颈巨大肿块是一种安全有效的方法，不增加肿瘤的转移。     

胆管癌的腔内近距离治疗（附14例分析）

自１９９１年３月至１９９７年１２月,对１４例不能手术的这癌进行了腔内近距离治疗,其中１２例为肝门部胆管癌。腔内治疗采用高剂量率＾１９２ｉｒ,剂量参考点距施源器中心轴的距离是１０～１２ｍｍ,参考点剂量为每次７００～１０００ｅＧｙ,共３～５次,近距离照射总量为２８００～４０００ｃＧｙ。一的平均生存时间为１１．２月。１、２、３、４年生存率分别为４２．９％（６／１４）,３３．３％（４／１２）,２５．０％（     

86例浅表转移癌的放射治疗

８６例浅表转移癌进行６０Ｃｏ外照射治疗，剂量５０～８０Ｇｙ，其中６７例放疗后３个月内病灶完全消退，１年生存率４７％，２年生存率３６％．病灶的消除率与病灶大小、照射剂量及原发病灶放射敏感性有关．     

外伤性迟发性颅内血肿的诊治

我院从１９８８年１０月～１９９９年１０月共收治经ＣＴ扫描或手术证实外伤性迟发性颅内血肿（ＤＴＩＣＨ）４８例,占同期颅脑伤住院患者３％,颅内血肿的６．５％,现分析如下。 １临床资料 １．１一般资料：男 ３７例,女 １１例,年龄（１～７５岁）平均３８．６岁;车祸伤３０例,跌伤１０例,坠落伤５例,打伤２例,砸伤１例。 １．２着力部位及方式：枕及顶枕部２９例,顶部９例,额及额顶部７例,颞顶部３例。减速性伤４０例,加速伤３例,混合伤５例。 １．３临床症状及体征：伤后有原发性昏迷者４４例,入院时ＧＣＳ≤ ８分８例…     

手术后置管后装照射治疗原发性肝癌

目的：探讨手术后置管后装照射原发性肝癌的治疗效果。方法：自１９９８年１月至１９９８年１０月,将４０例行肝癌切除术的原发性肝癌患者随机分为放疗组和对照组,每组２０例。放疗组术中放置施源管（２～５根,平均３．８５根/人）;确定驻留点２～８个,平均３．７个/人;术后３～１４d行后装和射治疗;单次照射剂量５～１０Ｇy,平均８Ｇy;照射共６８次,平均３．４次/人;总剂量１０～４０Ｇy,平均３０Ｇy。对照组术后不放     

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.     

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.     

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.