大涎腺恶性肿瘤术后放疗110例疗效分析

目的 分析大涎腺恶性肿瘤术后放疗疗效和影响预后的因素。方法 采用常规设野,原发灶区域先用＾６０Ｃｏγ线燠钽４０Ｇｙ／４周后,腮腺及上腺恶性肿瘤用深度Ｘ线补量１０～２０Ｇｙ／１～２周,舌下腺癌缩野后仍用＾６０Ｃｏγ线有量１５Ｇｙ／１．５周,颈部有淋巴结转移者,术后给予肿瘤量４５～５５Ｇｙ／４．５～５．５周。结果 本组５年随访率９５．５＾（１－５／１１０）１０年随访率９１．２（７３／８０）,采用直接法     

鼻咽癌3种分割放疗方式所致口腔粘膜损伤的比较

目的 比较鼻咽癌常规分割、全程超分割、后程加速超分割３种放射治疗方式所致的放射性口腔粘膜损伤。方法 ７２例首程放疗的鼻咽癌患者随机分为常规分割组（ＣＦＲ）、全程超分割组（ＦＨＲ）,后程加速超分割组（ＬＡＨＲ）各２４例。鼻咽部总剂量：ＣＦＲ组７０￣７２Ｇｙ／７￣７．５周,每天照射１次,每次２Ｇｙ;ＦＨＲ组８０．５￣８２．８Ｇｙ／７￣７．５周,每天照射２次,间隔６ｈ以上,每次１．１５Ｇｙ;ＬＡＨＲ组先     

热疗合并放射治疗晚期颈部转移癌38例分析

自１９９２年３月～１９９４年８月，热疗合并放射治疗晚期颈部转移癌３８例（热放组），单纯放疗３５例（单放组）。放射治疗采用６０Ｃｏ或（和）电子线照，１．８～２．０Ｇｙ／次，５次／周；加热采用９１５ＭＨＺ微波热疗机，２次／周。热放组平均放射剂量５９．５Ｇｙ，单放组６５．５Ｇｙ。结果：热放组和单放组的ＣＲ、ＰＲ分别为５７．９％、２６．３％和３１．４％、２０％，差异有显著性（Ｐ＜０．０５）；１、２、３年生存率分别为６８．４％、５７．９％、４２．１％和５１．４％、３７．１％、２０％，２、３年生存率差异有显著性（Ｐ＜０．０５），认为：热疗合并放射治疗可增加放射敏感性，提高局部控制率     

96例青年鼻咽癌放射治疗疗效分析

目的：分析青年鼻咽癌放射治疗疗效。方法：从１９８６年１月至１９９０年１０月，使用＾６０ＣＯγ线治疗青年鼻咽癌９６例。鼻咽部ＤＴ６４￣８０Ｇｙ／６￣８周。颈部转移淋巴结ＤＴ６０￣７０Ｇｙ／６￣８周。预防剂量４５Ｇｙ以上。结果：本组５年生存率为３９．６％（３８／９６）。Ⅱ、Ⅲ、Ⅳ期５年生存率分别为８４．６％（１１／１３）、４７．４％（１８／３８）、２０．０％（９／４５）。结论：青年鼻咽癌病情进展快，颈     

放射治疗晚期肝癌23例

目的：探讨晚期肝癌＾６０Ｃｏ移动条野放射治疗效果。方法：采用移动条野技术放射治疗晚期肝癌２３例,中平面剂量达２０～３０Ｇｙ后,缩野对肝脏肿块局部照射２０～３０Ｇｙ／２～３周,肿瘤量ＤＴ４０～６０Ｇｙ,并观察全组放疗反应和生存情况。结果：２３例完成放疗,中位生存期１０个月。１、２、３和５年生存率分别为３９．１％、１７．４％、１１．１％和８．３％。结论：对无手术指征的中晚期肝癌,放射治疗是值得选择的治     

食管癌加速超分割放疗的临床研究

目的：评价加速超分割放射治疗食管癌的疗效。方法：食管鳞癌９８例随机分为常规组和加速超分割组。常规组：１８０～２００ｃＧｙ／次，５次／周，总量６０００～７０００ｃＧｙ／６～７周；加速超分割组：１５０ｃＧｙ／次，２次／日，间隔６小时，总量５４００ｃＧｙ／３５周。两组病人均采用６０Ｃｏ远距离外照射。结果：常规组１，３，５年生存率分别为４６％（２３／５０）、２０％（１０／５０）、１２％（６／５０）；加速超分割组１，３，５年生存率分别为７０８％（３４／４８）、３９６％（１９／４８）、２９２％（１４／４８），加速超分割组明显优于常规组（Ｐ＜００５），而两组放疗反应和并发症无明显差异。结论：加速超分割放疗能明显提高食管癌病人的生存率，但不增加放疗反应及并发症。     

^60Co外照射加高剂量率腔内后装放射治疗上颌窦癌

目的：探讨＾６０Ｃｒ外照射加高剂量率腔内后装治疗上颌窦癌的疗效和后装放射治疗的作用，方法：上颌窦癌患者２４例，用＾６０Ｃｏ常规外照射３０Ｇｙ后，开始内，外照射同时进行，腔内照射参考点为距源中心轴１０ｍｍ处，１０００ｃＧｙ／次．周。结果：随访５年以上，失访者以死亡计算。１年生存率８３．３％（２０／２４），２年生存率６２．５％（１５／２４），８３．３％（２０／２４），的患者从放疗后期到放疗结束１年后局     

放疗加化疗综合治疗中晚期食管癌96例疗效观察

目的：比较放疗加化疗综合治疗与单纯放疗对中晚期食管癌的闻效。方法：对确诊的９６全名晚期食管癌患者随机分为放疗加化疗组（化放组）和单纯放疗组（单放组）,各４８例。放疗均采用６ＭＶ－Ｘ线体外照射肿瘤量６０￣７０Ｇｙ／３０￣３５次／６￣７周,化放组在放疗第１、５周各予５－ＦＵ、顺铂联合化疗共２个周期。结果：化放组完全缓解（ＣＲ）率４５．８％,总有效率８３．３％,单放组ＣＲ率２５．０％,总有效率６４．６％     

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     

依那普利治疗原发性高血压

目的：评价依那普利治疗原发性高血压的疗效与安全性。方法：３０例原发性高血压病人，用依那普利５ｍｇ／天￣１０ｍｇ／天（第１周）及１０ｍｇ／天￣２０ｍｇ／天（第２周￣３周）口服，１次／天￣２次／天，疗程３周。结果：显效１３例（４３．４％），有效９例（３０．０％），无效８例（２６．１％），不良反应轻。结论：依那普利治疗原发性高血压安全和有效。     

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.