治疗小细胞肺癌的几种化疗方案近期疗效比较

７４例经病理学证实的小细胞肺癌，局限期３５例，广泛期３９例，均为初治病例。主要以ＡＣＯ、ＣＥ、ＣＯＭＥ和ＣＯＰ方案治疗。其中ＡＣＯ方案有效率７５％，ＣＥ方案有效率８４％，ＡＯＥ方案有效率１００％，ＣＯＭＥ方案有效率８５％，ＣＯＰ方案有效率５０％，其它方案有效率５５％，结果表明，含ＡＤＭ、ＣＢＰ和ＶＰ－１６的联合方案优于其它方案（Ｐ〈０．０５）。毒副反应主要是胃肠道反应和胃髓抑制。     

晚期非小细胞肺癌CMCV方案与EP方案临床观察（附31例报告）

目的 观察ＣＭＣＶ方案与ＥＰ方案治疗非小细胞肺癌的疗效和毒副作用。 方法 采用随机分组的方法，将１９９２年１０月至１９９４年１２月住院的晚期非小细胞肺癌患者３１例，分为２组，即ＣＭＣＶ方案组和ＥＰ方案组，观察其疗效及其毒副作用。 结果 ２组均无完全缓解病例，部分缓解率分别为５０．０％（８／１６）和５３．３％（８／１５），中位数生存期分别为１１．５月和１１．０月；两者无显著性差异。但白细胞下降和恶心     

异环磷酰胺联合化疗治疗晚期非小细胞肺癌近期疗效

４０例晚期非小细胞肺癌患，经用ＩＦＯ＋ＤＤＰ或ＩＦＯ＋ＶＰ－１６治疗，２例ＣＲ（５％），１７例ＰＲ（４２．５％），ＣＲ＋ＰＲ为４７．５％（１９／４０）。毒性反应主要是骨髓抑制和消化道症状。结果揭示含异环磷酰胺的联合化疗治疗晚期非小细胞肺癌疗效较好，有一定程度骨髓抑制，配合Ｇ－ＣＳＦ治疗恢复较快。     

维拉帕米联用阿霉素、长春新碱、足叶己甙体外净化白血病细胞

采用体外克隆形成培养技术研究维拉帕米（ＶＰＬ）联用阿霉素（ＡＤＭ）、长春新碱（ＶＣＲ）和足叶己甙（ＶＰ－１６）体外净化白血病细胞，结果显示：ＶＰＬ２．２μｍｏｌ／Ｌ能明显增加单一应用的不同浓度ＡＤＭ、ＶＣＲ或ＶＰ－１６对白血病细胞克隆形成单位（Ｌ－ＣＦＵ）的抑制作用，而不增加其对正常粒巨系克隆形成单位（ＧＭ－ＣＦＵ）的毒性。０．９２μｍｏｌ／ＬＡＤＭ、０．０２５０μｍｏｌ／ＬＶＣＲ及１．７０μｍｏｌ／ＬＶＰ－１６联合应用下，Ｌ－ＣＦＵ集落存活率为１１．６１％％，再联用２．２０μｍｏｌ／ＬＶＰＬ则为３．５２％；而相同条件下ＧＭ－ＣＦＵ集落存活率分别为３５．８１％及２６．０５％（与相应Ｌ－ＣＦＵ组相比，Ｐ＜０．０１），提示ＶＰＬ能明显增加上述化疗药物联合应用下的选择性体外净化白血病细胞作用。     

MVP和P—MVP方案治疗晚期非小细胞肺癌的效果

①目的 探讨ＭＶＰ和Ｐ－ＭＶＰ方案对晚期非小细胞肺癌（ＮＳＣＬＣ）的效果及免疫功 能的影响。②方法选择４２例晚期ＮＳＣＬＣ分别进行ＭＶＰ及Ｐ－ＭＶＰ方案各３周期的化疗、不良反应及免疫学指标、ＡgＮＯＲs变化。③结果ＭＶＰ组有效率４０．０％,Ｐ－ＭＶＰ组５４．５％,两组比较差异无显著性（χ＾２＝０．８９８,Ｐ＞０．０５）;ＮＳＣＬＣ病人的ＣＤ３,ＣＤ４,ＣＳ４/ＣＤ８均低于对照组（t＝２．０８２～３．２７     

诺维本联合化疗治疗非小细胞肺癌46例

为了观察抗肿瘤新药诺维本联合化疗治疗晚期非小细胞肺癌（ＮＳＣＬＣ）的疗效及毒性反应,将晚期ＮＳＣＬＣ４６例初治患者随机分为２组,２６例为ＮＰ方案：诺维本（ＮＶＢ）＋顺铂（ＤＤＰ）,２０例为ＮＥ方案：诺维本（ＮＶＢ）＋表阿霉素（ＥＰＩ）。４６例患者ＣＲ０例,ＰＲ２２例,总有效率４７．８％。白细胞减少发生率：ＮＰ组：７８．８％,ＮＥ组：７０．０％;静脉炎发生率：ＮＰ组：４８．０％,ＮＥ组：４２。．５％     

EP／CAV方案交替使用治疗小细胞肺癌42例临床观察

本文报道１９９５年２月至１９９５年９月应用ＥＰ／ＣＡＶ方案交替治疗４２例小细胞肺癌的近期疗效。４２例小细胞肺癌中，局限期１８例，ＣＲ７（３８．８％），ＰＲ９例（５０％），ＣＲ＋ＰＲ共１６例（８８．８％）。广泛期２４例，ＣＲ２６例（ＰＲ１２例（４２％）ＣＲ＋ＰＲ共１８例（６７％）。总有效率８０．９％。主要毒副反庆为胃肠道反应：恶心、呕吐、骨髓抑制：白细胞及血小板下降。大部分按ＷＨＯ分级为Ⅰ－Ⅲ级，患     

ICE与CAP方案治疗晚期非小细胞肺癌的近期疗效比较

目的 比较ＩＣＥ与ＣＡＰ方案治疗晚期非小细胞肺癌的近期疗效。方法 将３８例非小细胞肺癌随机分为治疗组（ＩＣＥ方案）和对照组（ＣＡＰ方案）,观察两组的疗效及毒副作用。结果 治疗组ＣＲ２例,ＰＲ１０例,有效率６３．１６％;对照组ＣＲ０例,有效率２６．３２％,两者有差异（Ｐ〈０．０５）。结论 ＩＣＥ方案治疗晚期非小细胞肺癌疗效较好。     

MVP和P-MVP方案治疗晚期非小细胞肺癌的效果

①目的　探讨ＭＶＰ和Ｐ－ＭＶＰ方案对晚期非小细胞肺癌（ＮＳＣＬＣ）的效果及免疫功能的影响。②方法　选择４２例晚期ＮＳＣＬＣ分别进行ＭＶＰ及Ｐ－ＭＶＰ方案各３ 周期的化疗,观察疗效、不良反应及免疫学指标、ＡｇＮＯＲｓ变化。③结果　ＭＶＰ组有效率４０．０％ ,Ｐ－ＭＶＰ组５４．５％ ,两组比较差异无显著性（χ２＝ ０．８９８,Ｐ＞ ０．０５）;ＮＳＣＬＣ病人的ＣＤ３,ＣＤ４,ＣＤ４／ＣＤ８ 均低于对照组（ｔ＝ ２．０８２～３．２７６,Ｐ均＜ ０．０５）。ＭＶＰ组治疗后上述指标较治疗前降低（ｔ＝ ２．０４２～３．０１３,Ｐ＜ ０．０５）,而Ｐ－ＭＶＰ组上述指标较治疗前无明显下降（ｔ＝ ０．９７２～１．８７８,Ｐ＞ ０．０５）,Ｐ－ＭＶＰ治疗后ＣＤ３,ＣＤ４ 及ＡｇＮＯＲｓ高于ＭＶＰ组（ｔ＝ ２．１２１～２．９７２,Ｐ＜ ０．０５）;ＭＶＰ组不良反应发生率及强度较Ｐ－ＭＶＰ组稍高。④结论　Ｐ－ＭＶＰ方案与ＭＶＰ方案比较虽然不能提高疗效,但可增强免疫功能。     

异环磷酰胺联合化疗方案治疗晚期恶性肿瘤62例临床观察

目的：观察异环磷酰胺（ＩＦＯ）联合化疗对晚期恶性肿瘤的疗效。方法：６２例晚期恶性肿瘤中,肺癌３５例用ＩＦＯ＋ＤＤＰ或（ＣＢＰ）方案,恶性淋巴瘤１３例用ＩＦＯ＋ＭＴＸ＋ＶＰ－１６方案;乳腺癌６例用ＩＦＯ＋ＤＤＰ＋ＡＤＭ或ＩＦＯ＋ＤＤＰ＋ＶＰ＋１６方案;食道癌４例用ＩＦＯ＋５－ＦＵ＋ＤＤＰ或（ＣＢＰ）方案;卵巢癌、软组织肉瘤４例用ＩＦＯ＋ＡＤＭ＋ＤＤＰ或（ＣＢＰ）方案,静脉化疗。结果：总有效率５６．５     

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.     

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.     

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.