原发性食管小细胞癌43例临床分析

目的 探讨原发性食管小细胞癌的临床特点和综合治疗方法.方法 分析43例原发性食管小细胞癌的临床资料,其中单纯化疗3例、单纯放疗8例、手术+化疗7例、放疗+化疗19例、手术+放化疗6例,分析其中位生存时间.结果 43例患者,2例失访,单纯化疗、单纯放疗、手术+化疗、放疗+化疗、手术+放化疗的中位生存时间分别为6.5、6.3、15.7、13.2、16.1个月.结论 原发性食管小细胞癌恶性程度高,预后差,该病应早期诊断,并选择合理的综合治疗,以改善患者预后.     

原发性食管小细胞癌(PESC)42例临床分析

目的:探讨原发性食管小细胞癌的临床特点、治疗方法及预后。方法:回顾性分析原发性食管小细胞癌患者42例的临床资料。结果:手术+化疗、放射治疗+化疗、单纯化疗的中位生存时间分别为9、8、7个月,全组的中位生存期为8个月,生存最长者为60个月。结论:对于原发性食管小细胞癌应采用全身化疗为主的综合治疗。     

原发性食管小细胞未分化癌12例治疗分析

目的 讨论原发性苗管小细咆未分化癌的治疗方式及预后。方法 分析收治的12例原发性食管小细胞未分化癌的临床资料，结合献讨论。结果 手术 化疗6例中位主存11个目，放疗 化疗4例中位生存期9．5个月，单纯放疗2例只生存3个月。结论 以化疗为主的综合治疗是提高原发性食管小细咆未分化癌生存率的关键。     

50 例原发性食管小细胞癌的临床分析

目的：探讨原发性食管小细胞癌的临床特点和综合治疗方法。方法分析50例原发性食管小细胞癌的临床资料，其中放疗加化疗治疗21例，术后化疗或联合放化疗29例，分析其中位生存时间。加过全组手术根治切除率为72%，手术死亡2例，放疗加化疗的中位生存时间7.2个月，术后化疗或联合放化疗的中位生存时间16个月。结论原发性食管小细胞癌是一种全身性疾病，恶性程度较高，应采用综合治疗已达到延长生存的目的。     

食管小细胞癌21例的外科治疗

目的探讨食管小细胞癌的外科治疗和综合治疗的方法和疗效.方法回顾分析我科1981～2004年外科治疗的食管小细胞癌19例的临床特征、治疗方法并进行随访,与同期收治广泛期未手术2例进行比较,分析治疗方法与预后的关系.结果19例行外科治疗,术后辅助化疗和放疗,1、3、5年生存率分别为56.25%(9/16)、27.27%(3/11)、10%(1/10),术后生存时间4～68个月,中位生存时间16个月.同期收治2例广泛期行单纯化疗,生存时间分别为2个月和7个月.外科治疗明显优于非手术者.结论食管小细胞癌恶性程度高,转移早,预后差,外科手术加上全身化疗和(或)放疗可明显提高食管小细胞癌生存时间.     

原发性食管小细胞癌

１９８５１０月－１９９４年９月收治原发性食管小细胞癌１９例。按治疗方法分为单纯手术，放疗，化疗，手术＋放疗和化疗，放疗＋化疗五组。各组事位存期分别为７．５，７、８．５、１４、１３．５月。结果显示：单纯手术，放疗或化疗预后较差，开展综合治疗可延长生存期，提高治疗效果。     

原发性食管小细胞癌

１９８５年１０月～１９９４年９月收治原发性食管小细胞癌１９例。按治疗方法分为单纯手术、放疗、化疗、手术＋放疗和（或）化疗、放疗＋化疗五组。各组中位生存期分别为７．５、７、８．５、１４、１３．５月．结果显示：单纯手术、放疗或化疗预后较差，开展综合治疗可延长生存期，提高治疗效果。     

原发性食管小细胞癌以外科手术为主的综合治疗及影响因素分析

目的:探讨原发性食管小细胞癌的临床疗效以及影响疗效的相关因素。方法:回顾性分析我院2005年6月至2013年1月间收治的原发性食管小细胞癌71例患者的临床资料,并根据治疗方式分为观察组(手术联合放化疗)50例,对照组(单纯化疗)21例。两组间采取KaplanMeier法及Log-rank检验,计算各组生存率以及中位生存时间,采用Cox比例风险回归模型进行多因素分析。结果 :全组患者中位生存期为11个月,观察组的中位生存期为16个月,1、2、3年总的生存率分别为62.0%、28.0%以及12.0%;对照组中位生存期为8个月,1、2、3年总的生存率分别为42.8%、19.0%以及9.5%,两组差异有统计学意义(P<0.05);单因素分析显示年龄、治疗方式、淋巴结转移、肿瘤分期、伴发严重的基础疾病对预后有影响,Cox比例风险回归模型分析显示治疗方式与肿瘤分期是局限期原发性食管小细胞癌的独立影响因素。结论 :原发性食管小细胞癌预后较差,以外科手术为主联合放化疗的综合治疗方法可提高患者的生存率;治疗方式和肿瘤分期是影响预后的独立因素。     

原发性食管小细胞癌临床特征及预后分析

目的探讨食管小细胞癌的临床特征和预后。方法收集经食管吞钡片、胸部CT、食管镜检查并经病理学检查确诊的15例食管小细胞癌病例,分析患者的临床特征及预后。结果 15例患者的中位生存期为8.82个月(生存期29 d～26个月);6个月生存率为53%,1年生存率为20%,2年生存率为7%,3年生存率为零。接受单纯手术、单纯化疗和综合治疗患者的中位生存期分别为8、4.1和11.83个月。结论食管小细胞癌的最佳治疗方案尚不明确,以化放疗为主的综合治疗可获得较单一治疗更长的生存期。     

原发性食管小细胞癌临床特征及预后分析

目的探讨食管小细胞癌的临床特征和预后。方法收集经食管吞钡片、胸部CT、食管镜检查并经病理学检查确诊的15例食管小细胞癌病例,分析患者的临床特征及预后。结果 15例患者的中位生存期为8.82个月(生存期29 d～26个月);6个月生存率为53%,1年生存率为20%,2年生存率为7%,3年生存率为零。接受单纯手术、单纯化疗和综合治疗患者的中位生存期分别为8、4.1和11.83个月。结论食管小细胞癌的最佳治疗方案尚不明确,以化放疗为主的综合治疗可获得较单一治疗更长的生存期。     

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.