参芪注射液对老年结肠癌根治术患者免疫功能和白细胞介素水平的影响

目的探讨参芪注射液对老年结肠癌根治术患者免疫功能及白细胞介素水平的影响。方法选择结肠癌根治术的老年患者125例，随机分为观察组63例、对照组62例，2组术后均采取常规FOLFOX4化疗方案，观察组在化疗基础上给予参芪注射液，比较2组治疗前后卡氏评分（KPS）、免疫功能以及白细胞介素水平变化。结果治疗后，2组患者KPS评分均较治疗前明显升高（P<0.05），且观察组升高程度高于对照组（P<0.05）；观察组CD4+、CD4+/CD8+水平明显升高（P<0.05），而对照组CD4+、CD4+/CD8+水平则明显降低（P<0.05），观察组CD4+、CD4+/CD8+水平明显高于对照组（P<0.05）；观察组IL-2、IL-2/IL-10水平明显高于对照组（P<0.05），IL-10水平明显低于对照组（P<0.05）。结论参芪注射液可有效提高老年结肠癌根治术化疗患者细胞免疫功能，改善生活质量，其免疫作用的发挥可能与调节辅助性T细胞因子而发挥免疫正向调节作用有关。     

自拟参芪扶正汤辅助治疗非小细胞肺癌的研究

目的:探讨自拟参芪扶正汤辅助化疗对非小细胞肺癌(NSCLC)近期疗效、毒副反应和生存质量的影响。方法:120例晚期NSCLC患者随机分为研究组和对照组,各60例,两组给菌予顺铂+吉西他滨(GP)双周化疗方案,研究组额外再给予自拟中药参芪扶正汤,治疗2个周期。比较两组的近期疗效、毒副反应和生存质量,两组治疗前后的CD4、CD8、CD4/CD8和自然杀伤细胞(NK)的变化。结果:研究组和对照组分别有57例和55例用于最终评价。研究组总缓解率明显高于对照组(P<0.05)。两组生存质量比较差异具有统计学意义(P<0.05)。治疗后,研究组CD4、CD8、CD4/CD8都无明显变化(P>0.05),但NK细胞明显增加(P<0.05);而对照组CD4、CD8、CD4/CD8、NK细胞都有明显变化(P<0.05)。两组治疗后四项指标比较差异均具有统计学意义(P<0.05)。研究组的血小板下降和白细胞下降的发生率都明显低于对照组(P<0.05)。结论:自拟参芪扶正汤辅助化疗能明显提高晚期NSCLC患者的近期疗效、降低毒副反应、提高生存质量、改善免疫功能。     

rhGM-CSF预防非小细胞肺癌放疗所致急性放射性食管炎的效果观察

目的 探讨注射用重组人粒细胞-巨噬细胞集落刺激因子（rhGM-CSF）预防非小细胞肺癌（NSCLC）放疗所致急性放射性食管炎的效果。方法 选取2016年6月至2020年10月医院收治的168例拟接受放疗的NSCLC患者为研究对象，以随机数字表法分为对照组（n=84）和研究组（n=84）。对照组采用三维适形放疗联合化疗进行治疗，研究组在对照组的基础上采用rhGM-CSF治疗，2组均治疗2～6个周期。比较2组治疗前后免疫功能、生活质量核心问卷（QLQ-C30）评分，比较2组治疗后放射性食管炎发生情况以及放射性食管炎视觉模拟量表（VAS）评分。结果 治疗后，2组CD4+、CD3+、CD16+CD56+水平均升高（P<0.05），研究组高于对照组（P<0.05）；治疗后，2组放射性食管炎分级等级差异有统计学意义（P<0.05），且研究组3～4级放射性食管炎发生率低于对照组（P<0.05）;2组放射性食管炎患者VAS评分均降低（P<0.05），研究组放射性食管炎患者VAS评分低于对照组（P<0.05）;2组QLQ-C30评分均降低（P<0.05），研究组...     

疏肝健脾益肾法对肝郁型转移性三阴性乳腺癌T细胞亚群及预后的影响*

目的探讨疏肝健脾益肾法治疗肝郁型转移性三阴性乳腺癌（TNBC）对患者T细胞亚群及预后的影响。方法选取肝郁型转移性TNBC患者62 例,随机分为观察组与对照组,各31 例。对照组采用常规化疗,观察组在对照组的基础上采用疏肝健脾益肾法治疗,15 d为1 个周期,2组均治疗4 个周期并定期随访2 年。比较2组患者临床疗效、治疗前后T淋巴细胞亚群水平及血清肿瘤标记物水平;统计2组随访期间生存状况及毒副反应发生情况。结果治疗后观察组总缓解率（RR）为83.87%,显著高于对照组的70.97%（P<0.05）;与治疗前相比,治疗后2组全血CD3+、CD4+细胞百分率及CD4+/CD8+比值均显著升高,且观察组显著高于对照组（P<0.05或P<0.01）;2组CD8+细胞百分率显著下降,且观察组显著低于对照组（P<0.05或P<0.01）;与治疗前相比,治疗后2组血清TSGF、CEA、CA125、CA15-3水平均显著下降,且观察组显著低于对照组（P<0.01）;随访期间观察组无进展生存期较对照组显著延长,总生存率显著高于对照组（P<0.05）;观察组Ⅰ~Ⅱ级与Ⅲ~Ⅳ级呕吐、Ⅰ~Ⅱ级白细胞计数下降及血小板计数下降的发生率均显著低于对照组（P<0.05）。结论疏肝健脾益肾法辅助化疗可有效控制肝郁型转移性TNBC疾病进展,调节T细胞亚群水平,增强其细胞免疫,降低血清肿瘤标记物水平及毒副反应发生率,改善患者生存状况,临床疗效显著。     

益气解毒化瘀汤联合乌司他丁对瘀毒内阻型脓毒症患者细胞免疫功能和凝血功能的影响

目的观察益气解毒化瘀汤联合乌司他丁对瘀毒内阻型脓毒症患者细胞免疫功能和凝血功能的影响。方法选择瘀毒内阻型脓毒症患者85例,随机分为观察组43例和对照组42例,对照组在常规治疗基础上给予乌司他丁,观察组在对照组基础上给予益气解毒化瘀汤,比较2组患者临床疗效、治疗前后APACHE II评分、炎症水平变化、细胞免疫功能变化、凝血功能变化情况。结果治疗后观察组和对照组APACHE II评分均较治疗前明显降低（P<0.05）,观察组APACHE II评分显著低于对照组（P<0.05）。观察组与对照组PCT、CRP、WBC水平均较治疗前降低（P<0.05）,观察组PCT、CRP以、WBC水平明显低于对照组（P<0.05）。观察组与对照组CD4+ 以及CD4+ /CD8+ 较治疗前明显升高（P<0.05）,治疗前后2组CD8+ 无明显变化（P>0.05）,治疗后观察组CD4+ 以及CD4+ /CD8+ 明显高于对照组（P<0.05）。观察组与对照组PT、APTT、D-D水平均较治疗前明显降低（P<0.05）,PLT水平较治疗前明显升高（P<0.05）,观察组PT、APTT水平明显低于对照组（P<0.05）,观察组PLT水平明显高于对照组（P<0.05）。结论益气解毒化瘀汤联合乌司他丁治疗瘀毒内阻型脓毒症患者具有着较好的治疗效果,其作用机制可能与抑制机体炎症反应、提高细胞免疫功能以及改善患者凝血功能有关。     

参麦注射液联合化疗对晚期非小细胞肺癌患者T细胞亚群及细胞因子的影响

目的?研究参麦注射液联合化疗对晚期非小细胞肺癌（NSCLC）患者的T细胞亚群及细胞因子表达的影响。方法?将符合研究标准的48例患者随机分为联合治疗组和单纯化疗组,鳞癌患者均予多西紫杉醇联合顺铂化疗、腺癌及大细胞癌均予培美曲塞二钠联合顺铂化疗,联合治疗组在上述方案上加用参麦注射液。在化疗前及化疗2周期后检测外周T淋巴细胞亚群及NK细胞活性等免疫指标,检测外周血细胞因子水平,同时评价患者化疗近期疗效及不良反应。结果?治疗后联合治疗组CD4+水平及CD4+/CD8+明显升高(P<0.05~0.01),与单纯化疗组比,CD3+、CD4+水平及CD4+/CD8+有显著性差异（P<0.01）。联合治疗组IFN-γ、TNF-α、IL-2、IL-6含量明显升高（P<0.01）,与单纯化疗组比,IFN-γ、IL-2有显著性差异（P<0.01）。2组近期疗效无统计学差异。联合治疗组中血液学毒性发生率较单纯化疗组下降（P<0.05~0.01）。结论?参麦注射液联合化疗能改善晚期非小细胞肺癌患者的细胞免疫功能,进一步逆转Th1向Th2漂移。      

康艾注射液对晚期非小细胞肺癌患者化疗后免疫功能和生活质量的影响

目的观察晚期非小细胞肺癌(Non-small-cell lung carcinoma,NSCLC)化疗同时应用康艾注射液对化疗后免疫功能和生活质量的影响。方法将48例晚期NSCLC患者随机分为治疗组25例,对照组23例。治疗组化疗同时应用康艾注射液,对照组仅给予化疗。化疗方案均选择常规含铂两药联合方案,化疗4个周期。观察两组化疗后免疫功能和生活质量变化。结果 CD3+、CD3+CD4+、CD3+CD8+和T+B+NK、CD19+、NK淋巴细胞百分数和CD4+/CD8+比值比较:治疗组治疗后较治疗前无明显下降,各指标均有所上升,但差异无统计学意义(P>0.05);对照组治疗后各指标呈下降趋势,其中CD3+、CD3+CD4+下降明显,差异有统计学意义(P<0.05)。治疗组生活质量改善率明显高于对照组,组间比较差异有显著性(P<0.05)。治疗组化疗导致的毒副反应轻于对照组,组间比较差异有显著性(P<0.05)。结论康艾注射液配合化疗治疗晚期非小细胞肺癌能减轻化疗免疫功能损伤及毒副反应,改善生活质量。     

参麦注射液联合化疗治疗中晚期非小细胞肺癌临床观察

目的：评价参麦注射液联合紫杉醇（PTX）加顺铂（PDD）组成的TP方案全身化疗治疗中晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法：将62例晚期NSCLC患者随机分为治疗组31例和对照组31例,分别接受TP方案加参麦注射液或单纯TP方案化疗。结果：治疗组有效率51.61%高于对照组有效率48.39%,差异无统计学意义（P〉0.05）;治疗组毒性反应低于对照组（P〈0.05）。治疗组生活质量明显改善（P〈0.05）。结论：参麦注射液配合TP方案化疗在治疗非小细胞肺癌中可提高化疗疗效,减轻化疗毒性,提高患者生活质量。     

依替米星联合头孢他啶对重症肺炎患者病原菌清除率、血清炎症因子及血气分析指标的影响

目的：依替米星联合头孢他啶对重症肺炎患者病原菌清除率、血清炎症因子及血气分析指标的影响。方法：选取2019年1月-2022年1月于宜春市第二人民医院就诊的重症肺炎患者80例,采用随机数字表法分为研究组和对照组,各40例。两组均给予常规治疗,对照组采用亚胺培南西司他丁钠治疗,研究组采用依替米星联合头孢他啶治疗。比较两组临床疗效、病原菌清除率;比较两组治疗前后血清炎症因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白（hs-CRP）]及血气分析指标[二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）、血氧饱和度（SaO2）]。结果：研究组总有效率（95.00%）与对照组（77.50%）对比明显升高（P<0.05）。研究组病原菌清除率（90.00%）与对照组（70.00%）对比明显升高（P<0.05）。治疗后研究组血清IL-1β、TNF-α及hs-CRP水平与对照组对比均明显降低（P<0.05）。治疗后研究组PaCO2与对照组对比明显降低,PaO2及SaO2与对照组对比均明显升高（P<0.05）。结论：依替米星联合头孢他啶治疗重症肺...     

喹诺酮类药物在肺结核治疗中的效果及患者用药毒副反应观察

目的 分析喹诺酮类药物在肺结核患者中的应用效果及毒副反应发生情况。方法 选择2018 年2 月至2019 年7 月我院结核科诊治的肺结核患者159 例为对象，以随机数字表法分组，对照组患者应用常规抗结核方案（异烟肼+利福平+乙胺丁醇+吡嗪酰胺+硫酸阿米卡星注射液）治疗，实验组患者在对照组基础上加用喹诺酮类药物（左氧氟沙星）治疗，对比两组患者的治疗总有效率、毒副反应总发生率、痰菌转阴率和炎症因子（IL-6、IL-18、IL-10、TNF-α、IFN-γ）水平。结果 实验组患者的总有效率（96.21%）高于对照组总有效率（82.50%）（P＜0.05）；实验组的毒副反应总发生率（7.59%）略低于对照组毒副反应总发生率（10.00%）（P＞0.05），均未影响治疗疗程；实验组治疗3 个月后、6 个月后、10 个月后的痰菌转阴率均高于对照组（P＜0.05）；实验组治疗3 个月后的炎症因子水平（IL-6、IL-18、IL-10、TNF-α、IFN-γ）均低于对照组（P＜0.01）。结论 喹诺酮类药物联合抗结核药物在肺结核患者中应用疗效肯定，促进炎症反应控制，促进结核分枝杆菌的清除，且用药安全性高，不会增加毒副反应发生，值得推广。     

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.