冰帽对预防乳腺癌术后化疗患者脱发的效果分析

目的 探讨佩戴冰帽持续降温对预防乳腺癌患者术后化疗引起脱发的效果.方法 选择化疗方案含有多西他赛的乳腺癌术后化疗患者120例,随机分为A、B、C 3组,各40例.A组于多西他赛输注前30 min将电子冰帽戴在头上,佩戴至化疗药输注结束;B组于多西他赛输注时开始佩戴,至化疗药输注结束摘下;C组于多西他赛输注时开始佩戴电子冰帽,佩戴至化疗药输注结束后2 h.分析3组6个疗程结束后的脱发程度.结果 A组中发生Ⅰ度脱发19例,Ⅱ度脱发15例,Ⅲ脱发6例;B组中发生Ⅰ度脱发22例,Ⅱ度脱发12例,Ⅲ脱发5例;C组中发生Ⅰ度脱发33例,Ⅱ度脱发6例,Ⅲ脱发1例;3组发生0度脱发和Ⅳ度脱发均为0例.3组比较,差异有统计学意义(P<0.05).结论 化疗期间佩戴冰帽可以预防化疗引起脱发,佩戴时间越长,预防化疗引起脱发的效果越显著.     

护理干预对肿瘤病人化疗致脱发的防治研究

目的:探讨防治化疗致脱发的护理干预措施。方法:随机将60例化疗病人分为两组。常规组按肿瘤化疗常规护理;干预组对膳食、心理、生理实施护理干预。结果:干预组和常规组在化疗致脱发的Ⅰ、Ⅱ、Ⅲ、Ⅳ度的毒性反应中存在显著的差异(U=3.319,P<0.01)。结论:干预组通过护理干预措施可提高化疗病人的机体免疫力,改善头皮毛囊的血液营养状态,减少各种物理刺激因素,减轻化疗致脱发的毒性反应,对化疗致脱发起积极有效防治作用,提高了病人的生活质量,而常规组的脱发反应较严重。     

电子冰帽预防化疗脱发25例的疗效观察

目的:探索电子冰帽在预防急性白血病化疗脱发中的作用。方法:应用电子冰帽头部冷却法,在化疗前后应用,预防化疗脱发。结果:25例应用电子冰帽患者15例没有脱发;7例轻度脱发;1例中度脱发;2例完全脱发。20例未用电子冰帽患者2例没有脱发;5例轻度脱发;8例中度脱发;5例完全脱发。结论:电子冰帽在预防急性白血病化疗脱发中作用明显,收到良好效果。     

氨磷汀联合化疗治疗恶性肿瘤800例临床分析

目的：观察氨磷汀在肿瘤化疗中减轻骨髓抑制的程度。方法：回顾分析山西省肿瘤医院2003年1月至2009年1月间800例肿瘤患者采用氨磷汀联合化疗的疗效。结果：800例患者中0度骨髓抑制480例,Ⅰ度骨髓抑制240例,Ⅱ度骨髓抑制64例,Ⅲ度骨髓抑制40例,Ⅳ度骨髓抑制16例。结论：氨磷汀明显减轻抗肿瘤药物所致的骨髓抑制程度。     

冰帽预防多西紫杉醇引起脱发的护理

目的研究多西紫杉醇化疗过程中佩戴冰帽预防脱发。方法收集2007年至2008年我科接受多西紫杉醇化疗患者100例,随机分为冰帽组和观察组各50例,对冰帽组患者在化疗过程中佩戴冰帽。结果冰帽组无4度脱发,对照组3例（6％）;2度以上脱发冰帽组12例（24％）,对照组34例（76％）。佩戴舒适度,满意：冰帽组40例（81．6％）,对照组19例（38％）;不满意：冰帽组9例（18．4％）,对照组31例（62％）。结论化疗患者佩戴冰帽可有效降低脱发。     

足三里穴位封闭减轻化疗胃肠道反应疗效观察

目的：探讨足三里穴位封闭减轻化疗病人胃肠道反应的疗效。方法：对150例化疗病人随机分为3组对比观察，Ⅰ组用甲氧氯普胺肌肉注射，Ⅱ组用足三里穴位封闭，Ⅲ组用托烷司琼静滴。结果：对恶心、呕吐控制总有效率Ⅰ组52％，Ⅱ组82％，Ⅲ组84％。Ⅰ组与其他两组相比有高度显著性，Ⅱ组与Ⅲ组比较无统计学差异，结论：采用足三里穴位封闭对减轻化疗病人胃肠道反应有明显效果，价格低廉，有临床应用价值。     

穴位注射对肿瘤化疗引起消化道反应的临床观察

目的:通过双侧足三里穴位注射、肌肉注射胃复安,观察对肿瘤患者化疗过程中消化道不良反应及骨髓抑制程度的减毒作用.方法:将选取病例随机分为穴注组和肌注组.穴注组:胃复安10mg注入双侧足三里穴,1次/日,与化疗方案同步;肌注组:胃复安10mg肌肉注射,1次/日,与化疗方案同步.结果:消化道反应程度:穴注组0度1例,Ⅰ度6例,Ⅱ度8例,Ⅲ度、Ⅳ度0例:肌注组0度0例,Ⅰ度4例,Ⅱ度9例,Ⅲ度2例,Ⅳ度0例.骨髓抑制程度:穴注组0度0例,Ⅰ度9例,Ⅱ度6例,Ⅲ度、Ⅳ度0例;肌注组0度0例,Ⅰ度3例.Ⅱ度10例,Ⅲ度2例,Ⅳ度0例.结论:穴注组对于减弱化疗患者消化道反应及骨髓抑制程度明显优于肌注组.     

蓝芝合剂联合化疗治疗晚期消化道肿瘤40例临床观察

目的观察蓝芝合剂联合化疗治疗晚期消化道肿瘤的临床疗效。方法80例晚期消化道肿瘤患者均经病理学确诊,随机分为冶疗组和对照组,治疗组化疗的同时,口服蓝芝合剂,对照组化疗方法同治疗组,二组均治疗二周期后复查评价近期疗效、及药物毒副反应。结果治疗组近期疗效有效率40％,对照组近期疗效有效率10％,具有统计学意义。治疗组血液毒性白细胞减少Ⅱ度、Ⅲ度,消化道反应Ⅱ度、Ⅲ度与对照组比较具有统计学意义（P〈0．05）。结论二组在近期疗效、药物毒副反应方面差异有统计学意义,提示蓝芝合剂能提高化疗疗效,降低化疗毒副反应,增加患者的耐受性。     

西咪替丁减轻铂类化疗药物毒副作用的临床观察

目的：西咪替丁减轻铂类化疗药物毒副作用临床观察的应用价值。方法：收集头颈部恶性肿瘤患者146例，随机分为对照组和治疗组，对照组采用DF方案，治疗组采用DF方案加西咪替丁，21～28天为1个周期。观察两组病人的肿瘤客观疗效、生存质量、化疗毒副作用。结果：两组病人的肿瘤客观疗效无明显差异，治疗组的恶心、呕吐、胃痛与对照组相比有显著性差异（P〈0．01）。结论：西咪替丁与铂类化疗药物同时使用可减轻胃肠道毒副作用而改善病人在化疗中的不良反应。     

足三里穴位封闭减轻化疗胃肠道反应疗效观察

目的探讨足三里穴位封闭减轻化疗病人胃肠道反应的疗效.方法对150例化疗病人随机分为3组对比观察,Ⅰ组用甲氧氯普胺肌肉注射,Ⅱ组用足三里穴位封闭,Ⅲ组用托烷司琼静滴.结果对恶心、呕吐控制总有效率Ⅰ组52%,Ⅱ组82%,Ⅲ组84%.Ⅰ组与其他两组相比有高度显著性,Ⅱ组与Ⅲ组比较无统计学差异,结论采用足三里穴位封闭对减轻化疗病人胃肠道反应有明显效果,价格低廉,有临床应用价值.     

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.