小剂量G—CSF对化疗引起的粒细胞减少症的治疗作用

应用小剂量（２μｇ／ｋｇ）粒细胞集落刺激因子（Ｇ－ＣＳＦ）于１８例肺癌患者化疗中，以观察预防发生中性粒细胞减少症的疗效。其中小细胞肺癌５例，非小细胞肺癌１３例，随机分成Ｇ－ＣＳＦ组及对照组各９例，化疗方案为ＣＥ（卡铂－ＶＰ１６）。结果Ｇ－ＣＳＦ组粒细胞绝对计数（ＡＮＣ）＜２．０×１０９／Ｌ，发生例数５例，持续天数为３．６±３．５天；对照组持续天数１６．８±７．１天，Ｐ＜０．０５。ＡＮＣ最低值至恢复正常（ＡＮＣ＞２．０×１０９／Ｌ）的天数Ｇ－ＣＳＦ组及对照组分别为２．６±１．３天，８．９±５．３天（Ｐ＜０．０５）。Ｇ－ＣＳＦ组化疗后的第２０天ＡＮＣ均已恢复正常，ＡＮＣ为（９．７±６．８）×１０９／Ｌ故可在第２２天顺利接受第二周期化疗。对照组ＡＮＣ（１．６６±０．８）×１０９／Ｌ（Ｐ＜０．０１）。由此可见，小剂量Ｇ－ＣＳＦ能有效地防治肺癌化疗引起的粒细胞减少症     

粒—巨噬细胞集落刺激因子在儿童恶性肿瘤化疗中的应用

目的：探讨粒－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）对儿童恶性肿瘤化疗的影响和临床应用价值。方法：３４例３８例次肿瘤化疗后粒细胞缺乏患者，用ＧＭ－ＣＳＦ２￣５μＧ／ＫＧ·Ｄ＾－１，３￣５Ｄ，观察中性粒细胞回升、发热、口腔溃疡等情况。结果：用ＧＭ、ＣＳＦ疗效明显，与对照组比较，中性粒细胞升至≥１．５×１０＾９／Ｌ提前了８．３ｄ，发热和口腔溃疡减少了３３％、２８％，输血或成分输血减少２．４次。结论：ＧＭ     

生白灵对放疗化疗引起白细胞减少的治疗作用

目的观察生白灵（Ｈｅｍａｒｉｓｉｎ）对放疗（化疗）引起白细胞减少的治疗作用。方法对由放疗／化疗引起的白细胞减少到３．５×１０９／Ｌ以下的１２例病人，给予生白灵（５０μｇ，一次／ｄ，肌肉注射，连用５ｄ）治疗。结果用药第４ｄ时，治疗组白细胞升至４．６４×１０９／Ｌ，第１０ｄ达到７．５０×１０９／Ｌ，与惠尔血（７５μｇ／日，连用３ｄ）的作用相当，对照组１０ｄ以后才恢复至正常（≥４．０×１０９／Ｌ），治疗组未见明显副作用。结论生白灵可作为恶性肿瘤放疗（化疗）的一种更为经济的辅助药物。     

rHuGM—CSF治疗化疗后白细胞和血小板减少的临床观察

观察了用重组人粒细胞—巨噬细胞集落刺激因子（ｒＨｕＧＭ—ＣＳＦ）治疗儿童急淋化疗后白细胞和血小板减少的临床效果。选择住院化疗患儿，用ｒＨｕＧＭ—ＣＳＦ皮下注射，每次１５０μｇ，每日１次，连续２～３次。用药后取静脉血计数白细胞和血小板。结果：６例急淋患儿，用药后白细胞均增加，增幅＞０５×１０９／Ｌ４例，＞０１×１０９／Ｌ２例，６例中有５例血小板增幅＞２０×１０９／Ｌ。提示用ｒＨｕＧＭ—ＣＳＤ治疗小儿急淋化疗后白细胞和血小板减少有效，值得深入探讨     

在急性白血病治疗中粒细胞集落刺激因子的作用

本文观察了急性白血病患者化疗后骨髓抑制期，中性粒细胞绝对值＜０．５×１０９／Ｌ时，基因重组粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）的作用情况。可见：注射ｒｈＧ－ＣＳＦ２～３μｇ／ｋｇ／ｄ，共７天，外周血白细胞数于第三天开始逐渐上升，第８天均值达４．２１×１０９／ｌ，中性粒细胞低于０．５×１０９／Ｌ时间缩短，感染发生率降低，感染程度减轻，易于控制，各项指标均优于未用ｒｈＧ－ｃｓｆ组，提示ｒｈＧ－ＣＳＦ对急性白血病是一个具重要作用的细胞因子。     

rhG—CSF治疗抗癌化疗所致白细胞数Ⅲ°或Ⅳ°低下的疗效

目的观察基因重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）在抗癌化疗所致的白细胞严重低下（Ⅲ°、Ⅳ°）恢复治疗中的效果。方法４２例患者给予ｒｈＧ－ＣＳＦ１５０μｇ／ｄ,皮下注射,白细胞升至４．０×１０９／Ｌ或中性粒细胞升至２．０×１０９／Ｌ后停药。结果Ⅲ°白细胞低下者治疗后第４天白细胞恢复至（７．４０±２．３３）×１０９／Ｌ;Ⅳ°第４天仅恢复至（２．５７±２．１６）×１０９／Ｌ,第７天恢复至（６．１９±２．３２）×１０９／Ｌ。结论ｒｈＧ－ＣＳＦ对抗癌化疗所致的严重白细胞低下具有较快的恢复作用,但Ⅳ°比Ⅲ°恢复慢。     

粒细胞集落刺激因子治疗粒细胞缺乏症28例疗效观察

用重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）治疗粒细胞缺乏症（粒缺）２８例，观察其临床疗效，并与未用ｒｈＧ－ＣＳＦ而其他治疗相同的对照组２０例比较。结果，２３例（８２．１％）中性粒细胞数升至≥０．７×１０９／Ｌ，其中１９例（６７．９％）升至≥１．０×１０９／Ｌ，均显著高于对照组的５５．０％和３５．０％（Ｐ＜０．０５）；ｒｈＧ－ＣＳＦ治疗组并发感染治疗有效率（７５．０％）亦显著优于对照组（Ｐ＜０．０５），且平均发热时间较短（Ｐ＜０．０５）。分析认为，ｒｈＧ－ＣＳＦ治疗粒缺有满意疗效，无明显副反应，可列为首选药物。     

国产重组人粒细胞集落刺激因子治疗化疗后粒细胞减少症的临床疗效观察

目的：评价国产重组人粒细胞集落刺激因子（ｒｈＧＣＳＦ）治疗肿瘤化学治疗后引起的粒细胞减少症的临床疗效和不良反应。方法：采用随机、自身交叉的对照方法观察了６０例恶性肿瘤化疗患者应用国产ｒｈＧＣＳＦ的效果。结果：国产ｒｈＧＣＳＦ具有明显的升高中性粒细胞作用,表现为：①合并使用ｒｈＧＣＳＦ周期（Ａ周期）ＷＢＣ最低值、中性粒细胞绝对计数（ＡＮＣ）最低值明显高于单纯化疗周期（Ｂ周期）;②Ａ周期ＷＢＣ＜２０×１０９／Ｌ、＜３０×１０９／Ｌ、＜４０×１０９／Ｌ持续天数显著缩短;ＡＮＣ＜０５×１０９／Ｌ、＜１０×１０９／Ｌ、＜１５×１０９／Ｌ、＜２０×１０９／Ｌ持续天数显著缩短;③Ａ周期化疗序日ｄ２１的ＷＢＣ值、ＡＮＣ值明显高于Ｂ周期;④Ａ周期化疗序日ｄ２１ＷＢＣ＜４０×１０９／Ｌ的病例数、ＡＮＣ＜２０×１０９／Ｌ的病例数明显少于Ｂ周期。使用国产ｒｈＧＣＳＦ不良反应轻微。结论：国产ｒｈＧＣＳＦ是一种安全有效的治疗粒细胞减少症的药物。     

MMC方案预处理后异基因外周血造血干细胞移植治疗慢性粒细胞白血病

为进一步探讨慢性粒细胞白血病（ＣＭＬ）的治疗，对３例ＣＭＬ患者采用ＨＬＡ相合同胞兄妹异基因外周血干细胞移植治疗，预处理方案为马法兰（Ｍ）１７０ｍｇ／ｍ２×１，甲环亚硝脲（Ｍ）４００ｍｇ／ｍ２×１，环磷酰胺（Ｃ）６０ｍｇ／ｋｇ×２。供者造血干细胞动员用重组人粒细胞集落刺激因子３００μｇ／ｄ×６，血细胞分离机连续采集外周血单个核细胞，其中ＣＤ３４＋细胞为１２．８～２０．０×１０６／ｋｇ，ＣＦＵ－ＧＭ集落数为３．５～４．３×１０５／ｋｇ。结果显示：移植后患者中性粒细胞恢复达≥０．５×１０９／Ｌ，＋１４～＋２０天；血小板≥２．０×１０９／Ｌ在＋１６～＋３４天。移植后＋１００天骨髓染色体核型分析：２例完全嵌合，Ｐｈ１（－），１例部分嵌合（７３％为供者核型），外周血和骨髓检查正常。结果表明，ＨＬＡ相合同胞兄妹异基因外周血干细胞移植采集方便，重建造血功能快；ＭＭＣ预处理方案对白血病细胞的清除和保证移植物存活均有作用，且移植相关毒性低。     

骨髓异常增生综合征转化为急性粒细胞性白血病p15基因获得甲基化1例

患者,男,７６岁。因多饮、多尿、乏力２个月,伴纳差、面色苍白于１９９８年７月１２日入院。查体：体温３７．２℃,血压 １５／８ ｋＰａ,呼吸 １８次／ｍｉｎ。贫血貌,全身浅表淋巴结未扪及肿大,皮肤粘膜苍白。心肺无异常,肝脾助下未触及。血常规： Ｈｂ ５．５ ｇ／Ｌ, ＲＢＣ ２．８ × １０１２／Ｌ,ＷＢＣ ０．９ ×１０９／Ｌ, Ｐｌｔ ５５ ×１０９／Ｌ,呈全血细胞减少象。骨髓象：骨髓增生极度减低,粒：红＝０．４：１,粒系增生减低占２１％,其中早幼占１．５％,中幼及以下阶段可见形态大致正常,红系增生明显活跃…     

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.