绒毛膜上皮癌与恶性葡萄胎208例临床分析

<正> 结果分析一、发病率:我科1972.12～1984.12收容住院的患者,绒毛膜上皮癌(简称绒癌)与恶性葡萄胎(简称恶葡)共计208例,其中绒癌108例,恶葡100例。同时期妊娠数为62245人次。绒癌与恶葡的总发病率为0.334％(1:299妊娠),其中绒癌的发病率为0.174％(1:576妊娠),恶葡的发病率为0.16％     

绒毛膜癌和恶性葡萄胎的综合治疗

1973～1978年上海肿瘤医院共收治绒癌59例及恶性葡萄胎39例。晚期绒癌(Ⅲ_B、Ⅳ期)占57.6％。治疗以四药联合化疗为主,配合手术或放疗。直径大于3厘米的肺团块转移灶,过去单用化疗或化疗合并手术疗效很差,自采用四药联合化疗合并分段放射的新疗法后效果良好。绒癌生存率为81.4％,恶葡生存率为94.9％,晚期绒癌生存率为79.4％,肺团块转移病例的生存率为90％;5例脑转移病例,经全脑放射及化疗,4例完全康复。     

综合疗法治疗恶葡绒癌肺转移51例分析

1958～1978年我科共收治恶性葡萄胎(简称恶葡)和子宫绒毛膜上皮癌(简称绒癌)共219例。其中恶葡109例,绒癌110例。临床上最常出现转移是肺部,经肺部X光摄片证实为肺转移有83例,占转移灶的37.8％。74年以来进行综合治疗肺转移51例,取得较好的成效。恶性滋养叶肿瘤是一种具有高度恶性的妇科肿瘤,原发于子宫,很快通过血路转移到身     

应用MTX—CF治疗恶性滋养细胞肿瘤(附34例临床小结)

自1979年1月～1985年12月,我们应用MTX—CF 治疗恶性滋养细胞肿瘤34例(恶葡28例,绒癌6例),其中Ⅰ期25例(占73.5%)、Ⅱ_A期4例、Ⅱ_B 期1例、Ⅲ_A 期3例、Ⅳ期1例。单一用MTX-CF 治疗辅以切宫(9例)的21例(Ⅰ期16例,占80%)全部获得近期治愈。应用其他化疗药物2个疗程以上产生耐药而改用MTX-CF 治疗的13例中获近期治愈的有11例(84.6%)。因此,我们认为MTX-CF 治疗非转移性滋养细胞肿瘤有很高的疗效,即使是转移性滋养细胞肿瘤,应用其他化疗药物产生耐药后改用MTX-CF 治疗仍有较好的疗效。     

腹壁下动脉灌注化疗治疗妇癌体会

为寻求多种治疗中晚期妇癌的方法,以提高疗效,我们从1981年4月至1987年5月采月腹壁下动脉灌注化疗,配合手术、放疗或全身化疗,治疗妇癌29例,收到一定疗效。总结如下: 资料和方法年龄28～71岁,41岁以上25例。首次治疗17例,重复治疗12例。其中宫颈癌Ⅱ110例,Ⅲ期4例,Ⅳ期1例,复发癌6例;卵巢癌Ⅳ期1例,复发癌3例;外阴癌Ⅲ期1例;绒癌Ⅳ期1例,恶葡Ⅲ期1例;宫体癌复发1例。病例选择:(1) 肿瘤局限于盆腔而不能手术根治或暂不能手术者;(2) 手术、放     

恶性滋养细胞肿瘤177例临床分析

恶性滋养细胞肿瘤(包括恶性葡萄胎与绒毛膜癌,以下简称恶葡及绒癌)是恶性程度很高之肿瘤,具有发病快、死亡率高的特点。自应用化疗以来,治疗方法虽然不断改进,但晚期绒癌死亡率仍高,现将我院1972～1977年间收治的177例恶葡及绒癌总结于下,并对住院期间死亡的11例进行分析,以期提高晚期患者的疗效。资料分析 1972～1977年,我院共收治177例恶性滋养细     

68例滋养叶细胞肿瘤临床分析

滋养叶细胞肿瘤系由绒毛膜的滋养叶细胞过度增生而来,按滋养叶细胞增生的程度,有无绒毛侵蚀的能力及其生物学的特性而分为:良性葡萄胎(简称良葡),恶性葡萄胎(简称恶葡),绒毛膜癌(简称绒癌)。恶葡和绒癌恶性程度高,发病快,生长迅速,在早期即可随血行转移至全身器官,死亡率高,对妇女生命威胁很大。我院自1975年1月—1979年5月收治滋养叶细胞肿瘤患者68例,其中良葡33例;恶葡23;绒癌12例,其中11例发生于葡萄胎之后,1例为足月妊娠分娩后。     

静脉应用化疗药物时血管的选用及保护——绒癌恶性葡萄胎病人化疗786个疗程的点滴体会

绒毛膜上皮癌(简称绒癌)及恶性葡萄胎(简称恶葡)在我省比较多见,妇科病房经常有20—30名这类病人,占住院病人的1/2。绒癌和恶葡都是由绒毛膜上皮细胞发生的恶性肿瘤,特点是发展快,转移早而广泛。     

侵蚀性葡萄胎和绒毛膜癌的临床治疗

目的 提高侵蚀性葡萄胎(侵葡)和绒毛膜癌(绒癌)的早期诊断和治愈率. 方法回顾性分析2001年1月～2008年1月确诊为侵蚀性葡萄胎和绒毛膜癌患者278例. 结果 总治疗有效率92.9%,近期治愈率达到78.6%;Ⅰ期近期治愈率100%,Ⅱ期近期治愈率88.9%,Ⅲ期近期治愈率70.6%,侵葡和绒癌在近期治愈率上无显著性差异. 结论 早期诊断、早期治疗是提高侵葡和绒癌治愈率的关键.     

刮宫标本对恶性葡萄胎和绒毛膜上皮癌诊断价值的探讨

<正> 刮宫标本对恶性葡萄胎(以下简称恶葡)和绒毛膜上皮癌(以下简称绒癌)的诊断价值目前看法不尽一致。我们对82例因诊断或高度疑似恶葡和绒癌而施行子宫切除术的病例,进行了术前刮宫标本和切除子宫病理检查对照观察,现报告如下:     

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.