紫杉醇联合奈达铂与顺铂联合5氟尿嘧啶/亚叶酸钙治疗晚期食管癌对比研究

目的 观察紫杉醇联合奈达铂(TN方案)与顺铂联合5氟尿嘧啶/亚叶酸钙(PLF方案)治疗晚期食管癌的近期疗效和毒副反应.方法 将48例晚期食管癌随机分为A、B两组.A组24例应用TN方案,B组24例应用PLF方案,两方案均以21d为1周期.至少化疗两个周期方可评价疗效和毒副反应.结果 TN方案有效率54.1%,PLF方案有效率29.2%;两组共同的毒副反应为骨髓抑制,TN组轻度肌肉关节疼痛发生率较高(75%),PLF组消化道毒副反应、肾损害发生率较高.结论 TN方案治疗晚期食管癌有效率高于PLF方案,毒副反应可耐受.     

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。     

ELF静脉化疗与HCPT腹腔化疗对晚期胃癌的疗效评价

目的观察并评价静脉与腹腔化疗治疗晚期胃癌的近期疗效及毒副反应。方法ELF(CF、5-Fu、VP16)静滴加羟基喜树碱(HCPT)腹腔化疗35例晚期胃癌．记录近期疗效及毒副反应。结果35例总有效率57．1％,其中CR8．6％,毒副反应较轻,主要为骨髓抑制、消化道反应。结论静脉化疗加腹腔化疗治疗晚期胃癌疗效肯定．毒副反应较轻,值得推广。     

NP方案和TP方案治疗晚期非小细胞肺癌的临床观察

目的：探讨NP和TP方案对晚期非小细胞肺癌（NSCLC）的疗效和毒性。方法：72例晚期NSCLC患者随机分成NP组和TP组,两组患者接受至少2个周期以上的NP或TP方案的化疗,比较两组化疗方案的近期疗效和毒副反应。结果：NP和TP组近期疗效的有效率分别为44．4％、47．2％,中位生存期分别为8．5、8．7个月,1年生存率分别为16．7％、19．4％。毒副反应方面,两组均以白细胞降低为主,均在可耐受的范围内。结论：NP和TP化疗方案对晚期NSCLC均有较好的临床疗效,化疗毒副反应可耐受。因此,NP和TP化疗方案均可作为晚期NSCLC的一线治疗方案。     

卡培他滨联合奥沙利铂治疗晚期大肠癌的临床观察

目的:对比观察卡培他滨联合奥沙利铂及亚叶酸钙、氟尿嘧啶联合奥沙利铂治疗晚期大肠癌的近期疗效和毒副反应。方法:56例晚期大肠癌随机分为XELOX组和OLF组。XELOX组28例,采用奥沙利铂、卡培他滨联合化疗;OLF组28例,采用奥沙利铂、亚叶酸钙、氟尿嘧啶联合化疗。两组均21d重复,2个周期后评价疗效和毒副反应。结果:XELOX组近期有效率50.0%,OLF组近期有效率42.9%,差异无统计学意义(P>0.05)。XELOX组白细胞减少、恶心、呕吐、腹泻和腹痛的毒副反应发生率均低于OLF组,差异有统计学意义(P<0.05)。结论:卡培他滨联合奥沙利铂是治疗晚期大肠癌的有效化疗方案,较亚叶酸钙、氟尿嘧啶联合奥沙利铂方案具有给药方便、毒副反应轻的优点,患者更易接受。     

依托泊苷与醛氢叶酸和氟脲嘧啶治疗40例晚期胃肠道肿瘤的近期疗效观察

目的：观察ELF方案治疗晚期胃肠道肿瘤的近期疗效和毒副反应。方法：40例晚期胃肠道肿瘤病人用ELF方案治疗：依托泊苷(Vp-16)100mg静脉点滴，第1～3d；醛氢叶酸(CF)100～300mg静脉点滴，第1～3d；氟脲嘧啶(5—Fu)750～1000mg静脉点滴，第1～3d；28d为1疗程。结果：总缓解率为52．5％(21／40)，完全缓解率(CR)为5％(2／40)，部分缓解率(PR)为47．5％(19／40)。主要毒副反应为骨髓抑制和胃肠道反应，多为Ⅰ～Ⅱ级。其它毒副反应少见。结论：ELF方案治疗晚期胃肠道肿瘤的疗效肯定，毒副反应可以耐受，价格低廉。     

替吉奥联合多西他赛和卡铂治疗头颈部鳞癌的临床观察

目的：观察替吉奥联合多西他赛和卡铂治疗晚期头颈部肿瘤的疗效及毒副反应。方法：采用随机、对照、开放性的临床试验设计。入选52例初治的晚期头颈部肿瘤患者,随机分为两组,实验组26例采用DCS方案化疗;对照组26例,采用多西他赛、顺铂、亚叶酸钙及氟尿嘧啶方案（ DCF方案）化疗;至少3个周期后评价疗效及不良反应。结果：治疗组的近期有效率（RR）为53.8％,略优于对照组的42.3％,差异无统计学意义（P＞0.05）;治疗组的不良反应及严重反应发生率均明显低于对照组（ P＜0.05）。结论：替吉奥联合多西他赛和卡铂化疗方案治疗晚期头颈部肿瘤疗效好,不良反应可耐受。     

通泰合剂联合化疗治疗晚期大肠癌临床观察

目的观察通泰合剂联合化疗治疗晚期大肠癌的临床疗效。方法应用通泰合剂联合化疗治疗晚期大肠癌20例(治疗组)与单纯化疗组20例(对照组)患者进行近期临床客观疗效、临床症状、生活状态的改变、肿瘤指标(CEA)、化疗不良反应的程度及化疗耐受性方面的比较。结果在肿瘤治疗效果的客观指标如近期客观疗效、血清CEA水平降低方面,2组差异无统计学意义(P0.05),但在减轻化疗药物毒副反应、改善临床症状、提高生活质量、改善一般状况方面,治疗组有明显优势(P0.05)。结论通泰合剂联合化疗能缓解晚期大肠癌患者化疗期间的毒副反应,改善患者临床症状,提高患者生活质量。     

晚期乳腺癌围手术期区域化疗临床研究

目的 对新辅助局部化疗方案治疗乳腺癌的临床疗效进行研究.方法对46例晚期乳腺癌患者围手术期区域化疗临床资料回顾性分析,并对其进行前瞻性研究.结果新辅助化疗方案,治疗后手术切的除率为92.4%,肿瘤的有效率为81.8%,晚期乳腺癌围手术期区域化疗,临床缓解效果满意.结论局部新辅助化疗方案治疗乳腺癌近期有效率较高,毒副反应病人可以耐受.     

羟基喜树碱与氟尿嘧啶联合化疗晚期胃肠道肿瘤的疗效观察

目的：观察羟基喜树碱(HCPT)与氟尿嘧啶(5-Fu)联合化疗晚期胃肠道肿瘤的疗效。方法：48例晚期胃肠道肿瘤病人用HCPT与5-Fu联合化疗：连用5d，21d为1周期。结果：28例胃癌，CR2例，PR12例，总缓解率为50％；大肠癌20例，CR3例，PR8例，总缓解率55％；主要毒副反应为骨髓抑制和胃肠道反应，多为Ⅰ-Ⅱ级。其它毒副反应少见。结论：HCPT和5-Fu联合化疗晚期胃肠道肿瘤的疗效肯定，毒副作用可以耐受，价格低廉，值得临床推广。     

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.