高聚金区素联合顺铂治疗恶性胸腔积液疗效观察

目的：为观察生物调节剂高聚金葡素治疗恶性胸腔积液的疗效。方法：应用高聚金葡素联合顺铂及单用顺铂分别治疗两组恶性胸腔积液患者。结果：高聚金葡素联合顺铂组治疗有效率为83．3％，而对照组顺铂为58．3％（P＜0．005），结论：高聚金葡素联合顺铂是治疗恶性胸腔积液一种有效的方法。     

顺铂联合金葡素胸腔注射治疗恶性胸腔积液疗效观察

目的：观察顺铂联合金葡素胸腔内注射治疗恶性胸腔积液的疗效及安全性。方法我院收治的50例恶性胸腔积液患者,随机分为观察组和对照组各25例。对照组采用顺铂胸腔注射,观察组采用顺铂联合金葡素胸腔注射,4周后评价疗效及记录不良反应。结果观察组总有效率为92.00%,对照组总有效率为52.00%,差异有统计学意义（P＜0.05）;两组不良反应差异无统计学意义（P＞0.05）。结论顺铂联合金葡素胸腔注射可作为恶性胸腔积液的保守治疗方法之一。     

胸腔闭式引流术后注入高聚金葡素,顺铂治疗恶性胸水疗效观察

对恶性胸水患者于胸腔闭式引流术后采用胸腔注入抗癌药物治疗，报告其疗效观察结果。３０例恶性胸水均经组织学或细胞学检查证实，均为单侧胸腔积液。随机分两组，每组１５例。观察组应用高聚金葡素４０００单位，顺铂６０～８０ｍｇ；对照组单用顺铂６０～８０ｍｇ。结果：观察组ＣＲ１０例，ＰＲ４例，总有效率９３．４％；对照组ＣＲ４例，ＰＲ９例，总有效率８６．７％；两组总有效率相近，而ＣＲ率差异有显著性（χ２＝４．８，Ｐ＜０．０５）。观察表明，胸腔闭式引流术后注药法较常规胸穿注药法，可提高疗效；高聚金葡素联用顺铂治疗恶性胸水，疗效优于单用顺铂治疗者，其远期疗效有待进一步观察。     

高聚金葡素联合顺铂治疗恶性胸腔积液疗效观察

目的　为观察生物调节剂高聚金葡素治疗恶性胸腔积液的疗效。方法　应用高聚金葡素联合顺铂及单用顺铂分别治疗两组恶性胸腔积液患者。结果　高聚金葡素联合顺铂组治疗有效率为 83 3% ,而对照组顺铂为 5 8 3% (P <0 0 0 5 )。结论　高聚金葡素联合顺铂是治疗恶性胸腔积液一种有效的方法     

恶性胸腔积液的局部治疗进展及药物选择

目的探讨胸腔积液的治疗方法进展及相关药物使用情况。方法将2011年3月-2012年6月期间来该院就诊并最终确诊为恶性肿瘤伴中至大量胸腔积液的120例患者随机分为A、B、C、D4组,每组30例患者。A组给予非抗癌硬化剂沙培林治疗,B组给予抗癌药物顺铂治疗,C组给予生物免疫制剂高聚金葡素治疗,D组给予抗癌药物联合生物免疫制剂即顺铂和高聚金葡素联合治疗。所有患者经胸腔穿刺抽液后注入相应治疗药物,比较不同药物的治疗效果和不良反应。结果A、B、C、D组有效率分别为46．7％、50．0％、43．3％、83．5％,D组临床有效率明显高于其他三组（P〈0．05）。结论恶性胸腔积液治疗药物多种多样,治疗效果差别不大,但是D组高聚金葡素联合顺铂治疗恶性胸腔积液临床治愈率明显高于其他组,值得临床推广应用。     

胸腔灌注高聚金葡素联合顺铂治疗恶性胸腔积液32例

目的观察胸腔内注入高聚金葡素和顺铂治疗恶性胸腔积液的疗效。方法32例患者均经病理确诊为恶性胸腔积液，经穿刺或胸腔置管排液后注入高聚金葡素4000～6000u、顺铂60～90mg。结果CR11例，PR16例，NC5例，有效缓解率84．4％。毒副反应：白细胞下降2例，恶心呕吐6例，发热5例。结论胸腔内注入高聚金葡素联合顺铂治疗恶性胸腔积液是一种有效，毒副反应小，可耐受的方法。     

高聚金葡素联合顺铂治疗84例肺癌所致胸腔积液的临床观察

目的观察高聚金葡素联合顺铂治疗肺癌所致胸腔积液的临床疗效。方法将84例肺癌合并胸腔积液患者随机分为3组,尽量抽尽胸腔积液至不易抽出为止,A组胸腔内注入高聚金葡素3200～4000u,B组胸腔内注入顺铂80～100mg,C组胸腔内注入高聚金葡素3200-4000u＋顺铂80～100mg,3～5d重复用药1次,连用3～4次后观察疗效。结果3组总有效率分别为53．6％、57．1％、82．1％,C组总有效率明显高于A组与B组,A组与c组、B组与C组比较差异均有统计学意义（P〈0．05）,而A组与B组两组比较差异无统计学意义（P〉0．05）。结论高聚金葡素联用顺铂治疗肺癌所致胸水疗效肯定、安全,是治疗肺癌所致胸水较好的方法之一,值得临床推广应用。     

白介素-2联合顺铂局部治疗恶性胸腔积液临床观察

目的：观察白介素-2联合顺铂治疗恶性胸腔积液的临床疗效。方法：将63例恶性胸腔积液患者分为治疗组35例和对照组28例,两组患者放尽胸腔积液后治疗组注入顺铂加白介素-2,对照组只注入顺铂。结果：治疗组CR10例,PR18例,总有效率为80．00％,对照组CR3例,PR12例,总有效率为53．57％,两组比较差异有统计学意义（P〈0．05）。结论：白介素-2联合顺铂治疗恶性胸腔积液疗效确切,毒副作用较低。     

卡铂联合金葡素治疗恶性胸腔积液疗效观察

目的：观察卡铂（carboplatin，CBP）联合金葡素C（staphylococcal enterotoxinC，SEC）治疗恶性胸腔积液的疗效。方法：104例恶性胸腔积液患者随机分为联合组（36例）、卡铂组（38例）、金葡素组（30例）。联合组36例患者抽尽胸腔积液后，经胸腔内注入卡铂加金葡素进行治疗；卡铂组和金葡素组患者胸腔内只注入卡铂或金葡素。观察3组患者的近期疗效、生活质量改善、毒副反应及生存状况。结果：联合组治疗有效率为83．3％，卡铂组为47．4％，金葡素组为43．3％，3组比较，差异有显著性（P〈0．05）；治疗后3组患者生活质量均有不同程度的改善，其中联合组卡劳夫斯基评分高于其他两组；联合使用并没有增加毒副反应；3组的中位生存期比较，差异无统计学意义（P〉0．05）。结论：卡铂联合金葡素治疗恶性胸腔积液有确切疗效。     

高聚金葡素胸腔内注射对肺癌恶性胸腔积液疗效的观察

目的：评价高聚金葡素治疗肺癌恶性胸水的临床疗效。方法：56例肺癌恶性胸水患者随机分成二组,在全身化疗基础上,Ⅰ组胸腔内注入高聚金葡素;Ⅱ组胸腔内注射顺铂。结果：经2w～3w的治疗,Ⅰ组大部分患者胸水减少或消失,有效率82．1％,Ⅱ组有效率42．9％,差异有显著性（P〈0．01）,Ⅰ组患者kamofsky评分上升率为78．6％,Ⅱ组为46．8％,两组比较,差异有显著性（P〈0．05）。结论：在全身化疗的基础上,高聚金葡素胸腔内注射能有效控制肺癌恶性胸水,提高生存质量。     

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.