153Sm-EDTMP治疗乳腺癌骨转移的临床疗效评价

目的 探讨^153Sm-乙二胺四甲基膦酸(^153Sm-EDTMP)治疗乳腺癌伴骨转移的临床效果。方法 对76例乳腺癌骨转移疼痛患者采用两次给药法静脉注射^153Sm-EDTMP进行治疗并进行疗效评价．结果 治疗后骨痛完全缓解者25例，中度缓解者40例，总有效率为85．52％(65／76)。治疗后有6例骨转移灶完全消失，16例转移灶数量减少或病灶缩小，总有效率为28．95％(22／76)。未见严重的毒副作用，仅见Ⅲ度以内的血液学毒性反应。结论 ^153Sm—EDTMP能快速、有效地缓解乳腺癌骨转移疼痛，且副作用小，是一种安全、有效的方法。     

153Sm-EDTMP治疗骨转移癌疗效分析

目的评价153Sm-EDTMP对骨转移癌的临床疗效.方法对确认癌症骨转移的380例患者,静脉给药153Sm-EDTMP0.8～1.0mCi/kg体重,然后从临床表现和骨扫描影像等方面,评价和分析其疗效.结果骨转移灶疼痛缓解总有效率67.5%.骨痛缓解时间2～24周,平均(5.8±3.4)周.生活质量(KPS评分)平均升高10%.治疗后骨转移灶数目较治疗前明显减少(P＜0.001),其代谢活性即ROI比值(T/NT)显著减低(P＜0.001).治疗后WBC和PLT可有一过性下降.结论作为骨转移癌镇痛治疗剂,153Sm-EDTMP能有效缓解疼痛,减少甚至消退转移灶,有较高的临床应用价值.     

153Sm-EDTMP治疗骨转移癌疗效分析

目的评价153Sm-EDTMP对骨转移癌的临床疗效.方法对确认癌症骨转移的380例患者,静脉给药153Sm-EDTMP0.8～1.0mCi/kg体重,然后从临床表现和骨扫描影像等方面,评价和分析其疗效.结果骨转移灶疼痛缓解总有效率67.5%.骨痛缓解时间2～24周,平均(5.8±3.4)周.生活质量(KPS评分)平均升高10%.治疗后骨转移灶数目较治疗前明显减少(P＜0.001),其代谢活性即ROI比值(T/NT)显著减低(P＜0.001).治疗后WBC和PLT可有一过性下降.结论作为骨转移癌镇痛治疗剂,153Sm-EDTMP能有效缓解疼痛,减少甚至消退转移灶,有较高的临床应用价值.     

~(153)Sm-EDTMP联合唑来磷酸治疗前列腺癌骨转移

目的:评价153钐-乙二胺四亚甲基磷酸(153Sm-EDTMP)联合唑来磷酸治疗前列腺癌骨转移的临床疗效及不良反应。方法:使用153Sm-EDTMP联合唑来磷酸静脉注射治疗20例去势后前列腺癌骨转移伴有不同程度骨痛患者,观察其镇痛效果、骨转移灶的变化及不良反应。结果:20例患者接受治疗后,止痛的总有效率94.12%,无效5.88%,骨转移灶有明显减少。所有患者均未发现严重的不良反应。结论:153Sm-EDTMP联合唑来磷酸对去势治疗后的前列腺癌骨转移骨痛的临床止痛疗效明显,对多发骨转移癌伴骨痛是一种有效的治疗方法。     

153Sm-EDTMP、89SrCl2治疗前列腺癌、乳腺癌骨转移瘤的对比研究

目的 探讨153Sm-EDTMP、89SrCl2治疗前列腺癌、乳腺癌骨转移瘤疗效.方法 将乳腺癌,前列腺癌骨转移瘤患者各30例随机分成两组,每组15例乳腺癌患者(均为女性)与15例前列癌患者,分别接受153Sm-EDTMP、89SrCl2治疗,疗效观察分别采用VAS、Karnofsky、骨显像评价.结果 153Sm-EDTMP组止痛效果总有效率为83%,89SrCl2组的总有效率为90%,差异无显著性(P＞0.05).患者的生存质量明显提高,骨显像可见部分病例病灶变小,甚至消失.结论 153Sm-EDTMP、89SrCl2治疗前列腺癌,乳腺癌骨转移瘤效果良好,各有优缺点,但影响治疗疗效的因素繁多,有待于进一步的研究和探讨.     

~(153)Sm-EDTMP治疗乳腺癌骨转移骨痛

目的:评价153Sm-EDTMP治疗乳腺癌骨转移骨痛的临床价值。方法:对51例临床确诊为乳腺癌多发骨转移伴骨痛患者进行治疗,153Sm-EDTMP按18.5MBq/kg体重剂量静脉注射给药。治疗前患者白细胞≥3.5×109/L,血红蛋白≥90g/L,血小板≥9.0×1010/L。结果:依据疼痛、活动能力及止痛药物用量的增减进行疗效评价,骨痛缓解总有效率86.3%,其中显效39.2%(20例),有效47.1%(24例),无效13.7%(7例);其中18例治疗后骨显像示骨转移灶减少。结论:用153Sm-EDTMP治疗乳腺癌骨转移骨痛疗效明显,可改善患者生活质量,骨髓毒性主要是白细胞、血小板降低,但均轻微、短暂,可自行恢复,可多次重复使用。     

~(153)Sm-EDTMP治疗骨转移癌疗效观察及其骨显像的意义

目的评价~(153)Sm-EDTMP治疗骨转移癌的疗效及治疗剂量~(153)Sm-EDTMP骨显像的临床价值。方法对30例骨转移癌骨痛患者进行~(153)Sm-EDTMP治疗后8～24h行~(153)Sm-EDTMP骨显像,观察其疗效和显像效果。结果30例肿瘤骨转移骨痛患者,疼痛缓解总有效率为73.3%.~(153)Sm-EDTMP骨显像效果优于~(99m)Tc-MDP,动态~(153)Sm-EDTMP骨显像有利于观察疗效和评价预后。结论~(153)Sm-EDTMP对骨转移癌病人有较好的疗效,治疗剂量~(153)Sm-EDTMP骨显像有重要的临床价值。     

153Sm-EDTMP治疗前列腺癌内分泌治疗后骨转移骨痛的效果评价

目的:评价153Sm-EDTMP(153钐-乙二胺四甲撑膦酸)对前列腺癌患者行内分泌治疗后骨转移灶骨痛的治疗效果.方法:选择18例前列腺癌已行双侧睾丸切除术+口服福至尔治疗3～6个月、骨转移灶及骨痛未缓解患者,用153Sm-EDTMP治疗,153Sm-EDTMP用量为37MBq/kg体重·次,1次/月×(3～6)个月.密切观察骨痛缓解情况,治疗3个月后行骨扫描了解骨转移灶情况.结果:18例患者中14例骨痛有不同程度缓解,占77.8%,骨扫描示骨转移灶客观反应率为55.5%(10/18).结论:对晚期前列腺癌、在行内分泌治疗后存在骨转移顽固性骨痛患者,153Sm-EDTMP内放射治疗仍有较好效果.     

153Sm-EDTMP治疗多发性骨转移及进行全身骨显像的观察

目的评价153Sm-EDTMP治疗多发性骨转移和进行全身骨显像的效果.方法对68例肿瘤骨转移且有骨痛的患者进行连续3次153Sm-EDTMP治疗后再行全身骨显像,评价其疗效和显像效果.结果疼痛完全缓解者占33.8%,部分缓解者占42.7%,总有效率达76.5%;153Sm-EDTMP骨显像质量比99mTc-MDP更好;不良反应主要为骨髓抑制.结论 153Sm-EDTMP使用安全有效,是比较理想的内照射治疗药物和骨显像剂.     

肺癌多发性骨转移疼痛治疗的临床观察

目的观察153Sm-乙二胺四甲基膦酸(153Sm-EDTMP)联合帕米膦酸二钠治疗肺癌多发性骨转移疼痛的疗效及毒副作用。方法将102例肺癌多发性骨转移疼痛患者,随机分为联合组(153Sm-EDTMP联合帕米膦酸二钠)1、53Sm-EDTMP内照射组,帕米膦酸二钠组,分别观察骨痛缓解效果及毒性反应。结果联合组缓解骨痛总有效率为91.4%,153Sm-EDTMP内照射组为68.6%,帕米膦酸二钠组为65.6%,联合组明显高于另外两组,差异均有显著性统计学意义(P<0.05)。3组均无严重的毒副作用。结论153Sm-EDTMP联合帕米膦酸二钠治疗肺癌多发性骨转移疼痛能提高疗效,不良反应小,值得临床推广使用。     

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.     

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.