雷替曲塞与奥沙利铂联合治疗晚期结直肠癌患者的效果分析

目的:分析雷替曲塞与奥沙利铂联合治疗晚期结直肠癌患者的效果。方法:选取104例晚期结直肠癌患者,根据治疗方法的不同分为对照组和研究组。对照组患者48例,给予行氟尿嘧啶+亚叶酸钙+奥沙利铂治疗;研究组患者56例,给予行雷替曲塞联合奥沙利铂治疗。对比两组患者的临床疗效、不良反应及生活质量。结果:研究组患者的总有效比对照组高(P<0.05);除呕吐外,两组患者的不良反应发生率对比均未显示高度差异(P>0.05);治疗后,两组患者的生存质量各维度评分均较治疗前提高,且研究组患者的提高幅度比对照组大(P<0.05)。结论:雷替曲塞联合奥沙利铂治疗晚期结直肠癌患者的疗效确切,可有效提高其临床疗效与预后质量,且安全性高,具临床推广应用价值。     

雷替曲塞在晚期结直肠癌治疗中的应用价值

目的:探讨晚期结直肠癌采用雷替曲塞治疗临床效果。方法:选择晚期结直肠癌患者60例,随机分为两组,对照组30例采取指氟尿嘧啶/亚叶酸钙(5-Fu/LV)+奥沙利铂治疗,观察组30例采用雷替曲塞联合奥沙利铂治疗,对两组临床效果进行回顾性比较分析。结果:观察组总有效率为40%,对照组总有效率为23.3,两组间差异有统计学意义(P<0.05)。两组主要不良反应为神经毒性和消化道反应,均经处理后缓解,差异不明显。结论:雷替曲塞联合奥沙利铂方案治疗晚期结直肠癌给药方便,患者有较好耐受性,疗效满意,值得临床推广应用。     

雷替曲塞与5-氟尿嘧啶联合奥沙利铂治疗晚期结直肠癌的疗效比较

目的比较雷替曲塞与5-氟尿嘧啶（5-Fu）/亚叶酸钙（LV）联合奥沙利铂治疗晚期结直肠癌的疗效、不良反应和生存期。方法经病理组织学确诊的晚期结直肠癌患者45例,23例（A组）采用雷替曲塞联合奥沙利铂方案化疗,22例（B组）采用5-Fu/LV联合奥沙利铂方案化疗,观察疗效、疾病控制率及不良反应,并随访及观察无疾病进展时间、总生存时间及1年生存率。结果 A、B两组患者,近期有效率分别为42.86%和15.00%（P〈0.05）;疾病控制率分别为80.95%和65.00%（P〉0.05）;A组转氨酶升高发生率高于B组,B组呕吐发生率高于A组,但均无明显差异（均P〉0.05）;中位疾病进展时间分别为8.9个月和5.6个月（P〈0.05）;中位生存期分别为12.9个月和10.7个月,1年生存率分别为52.4%和40%（均P〉0.05）。结论雷替曲塞联合奥沙利铂方案是晚期复发转移性结直肠癌有效的姑息治疗方案,疗效优于传统的5-Fu/LV联合奥沙利铂方案。     

雷替曲塞联合奥沙利铂治疗晚期结直肠癌近期疗效观察

目的比较雷替曲塞或5-氟尿嘧啶（5-Fu）／亚叶酸钙（GF）联合奥沙利铂治疗晚期结直肠癌的有效性和安全性。方法经病理组织学确诊的晚期结直肠癌患者40例,随机分入治疗组和对照组。治疗组：雷替曲塞3mg／m^2d1奥沙利铂130mg／m^2d1.对照组：亚叶酸钙200mg／m^2d1-5氟尿嘧啶375mg／m^2d1-5奥沙利铂130mg／m^2d1。两方案均以21d为{周期,每2个周期评价疗效及不良反应。结果治疗组和对照组的有效率分别为45．0％（9／20）和15．0％（3／20）,两组间比较差异有统计学意义（P〈0．05）。临床获益率比较,两组分别是80．0％（16／20）和500％（10／20）,两组间比较差异有统计学意义（P〈0.05）。治疗组转氨酶升高率高于对照组,对照组呕吐发生率高于治疗组,但均无明显差异（P〉0．05）。结论雷替曲塞联合奥沙利铂治疗晚期结直肠癌安全、有效。     

雷替曲塞用于晚期结直肠癌治疗的效果观察

目的分析晚期结直肠癌患者的治疗方法和效果。方法选取我院收治的晚期结直肠癌患者60例,随机分为两个组别,其中对照组(氟尿嘧啶+亚叶酸钙+奥沙利铂治疗)、试验组(雷替曲塞+奥沙利铂治疗)各30例,观察临床疗效和不良反应。结果试验组治疗有效26例(86.7%),高于对照组的19例(63.3%);患者呕吐、疲劳发生率低于对照组。P0.05,差异有统计学意义。结论雷替曲塞治疗晚期结直肠癌疗效确切,病灶控制率高、不良反应少,是一种安全有效的治疗方案。     

雷替曲塞联合伊利替康一线治疗晚期结直肠癌的临床研究

目的 评价雷替曲塞联合伊立替康(CPT-11)治疗晚期结直肠癌的疗效和不良反应.方法 将59例晚期初治结直肠癌患者随机分为治疗组(31例)和对照组(28例).治疗组采用雷替曲塞+CPT-11方案治疗,对照组采用CPT-11+5-FU+LV方案治疗.结果 治疗组和对照组的有效率分别为41.9％和17.9％,差异有统计学意义(P＜0.05);疾病控制率分别为87.1％和64.3％,差异有统计学意义(P＜0.05).两种治疗方案的不良反应发生率比较无明显差异.结论 雷替曲塞联合CPT-11作为一线方案治疗晚期结直肠癌是有效的.     

贝伐珠单抗联合雷替曲塞或卡培他滨治疗老年晚期结直肠癌的疗效及安全性观察

目的观察贝伐珠单抗联合雷替曲塞或卡培他滨治疗老年晚期结直肠癌的疗效及安全性。方法将58例老年晚期结直肠癌患者按随机数字表法分为观察组（贝伐珠单抗联合雷替曲塞组）30例,对照组（贝伐珠单抗联合卡培他滨组）28例。比较两组患者临床疗效及不良反应发生率。结果观察组疾病控制率（DCR）、肿瘤进展时间（TTP）为80.0%、（8.4±1.5）个月,对照组为78.6%、（8.2±1.6）个月;两组比较差异均无统计学意义（均P＞0.05）。观察组恶心呕吐、手足综合征发生率均明显低于对照组,差异均有统计学意义（均P＜0.05）;但两组患者血小板下降、中性粒细胞下降、贫血、转氨酶升高、高血压、蛋白尿、腹泻、口腔黏膜炎、手足综合征等不良反应发生率比较,差异均无统计学意义（均P＞0.05）。结论贝伐珠单抗联合雷替曲塞治疗老年晚期结直肠癌的疗效确切,与联合卡培他滨方案效果相当,且患者能耐受不良反应。     

探析雷替曲塞与奥沙利铂联合对延缓晚期肠癌病情进展的影响

目的研究雷替曲塞与奥沙利铂联合治疗延缓晚期肠癌病情的治疗效果及治疗进展。方法选取我院2011年1月-2014年1月期间延缓晚期肠癌病患者100例作为研究对象。将患者随机的分为对照组和治疗组两组,对照组患者使用奥沙利铂联合氟尿嘧啶/亚叶酸钙方案进行治疗,治疗组患者则使用雷替曲塞与奥沙利铂联合治疗。分析比较两组患者1年内的生存率情况及不良反应发生情况,同时分析不良反应的严重程度等。结果治疗组患者的生存率明显高于对照组,两组差异有统计学意义(P0.05)。结论雷替曲塞与奥沙利铂联合治疗延缓晚期肠癌病可以取得显著的治疗效果,同时具备很高的安全性以及有效性,值得临床推广使用。     

雷替曲塞联合奥沙利铂治疗术后复发晚期大肠癌的疗效观察

目的:探讨雷替曲塞联合奥沙利铂治疗术后复发晚期大肠癌的临床疗效。方法:选取2010年4月-2013年4月入住本院普外科接受治疗的76例术后复发晚期大肠癌患者,按照随机数字表法将其分为治疗组和对照组各38例,其中治疗组给予雷替曲塞联合奥沙利铂化疗;对照组给予氟尿嘧啶联合奥沙利铂化疗。观察比较两组患者在治疗效果、不良反应等方面的差异。结果:治疗组总有效率44.74%,明显高于对照组的13.16%,比较差异有统计学意义(字2=8.02,P0.05)。治疗组发生呕吐14例,不良反应发生率为36.84%,对照组发生呕吐25例,不良反应发生率为65.79%,治疗组的不良反应发生率明显低于对照组,比较差异有统计学意义(字2=6.37,P0.05)。结论:雷替曲塞联合奥沙利铂治疗术后复发晚期大肠癌效果显著,不良反应少,值得广泛应用于临床。     

斑蝥酸钠维生素B6联合雷替曲塞和奥沙利铂治疗晚期结直肠癌的临床研究

目的探讨斑蝥酸钠维生素B6联合雷替曲塞和奥沙利铂治疗晚期结直肠癌的临床疗效。方法以2012年1月至2016年1月在我院接受治疗的50例晚期结直肠癌患者为研究对象,随机分成治疗组(25例)和对照组(25例)。对照组给予雷替曲塞联合奥沙利铂方案化疗,治疗组在对照组基础上加用斑蝥酸钠维生素B6治疗,对比2组患者的治疗效果。结果治疗后,治疗组与对照组客观缓解率(ORR)分别为(44.00%比16.00%,x~2=4.667,P=0.031);临床获益率(CBR)分别为(72.00%比44.00%,x~2=4.023,p=0.045)。治疗组生存期明显长于对照组组(P0.05)。治疗后,治疗组与对照组患者生存质量改善率分别为(44.00%比16.00%,x~2=4.667,P=0.031)。两组在不良反应发生率上比较没有明显差别(P0.05)。结论斑蝥酸钠维生素B6联合雷替曲塞和奥沙利铂治疗晚期结直肠癌具有很好的临床疗效,还有助于改善患者生活质量,值得临床应用。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.