动脉灌注化疗在宫颈癌术前治疗中的作用

目的探讨宫颈癌术前髂内动脉灌注化疗的疗效及临床意义。方法41例宫颈癌(ⅠB期13例、ⅡA期9例、ⅡB期15例、Ⅲ期4例)术前行髂内动脉灌注化疗,观察并评定其近期疗效,并与手术资料进行对照。结果经髂内动脉灌注化疗后38例(13例ⅠB期、24例Ⅱ期及1例Ⅲ期)局部情况改善,顺利完成了根治手术,动脉灌注化疗近期有效率80.49%(33/41);其中2例ⅠB期、1例ⅡB期经动脉灌注化疗后,术后切除标本中未发现癌细胞,另35例动脉灌注化疗后行宫颈癌根治术的标本中断端无癌细胞,淋巴结转移阳性者2例。结论术前髂内动脉灌注化疗能缩小原发病灶肿瘤大小,改善局部情况,增加手术机会,提高手术切除率。     

子宫动脉灌注新辅助化疗治疗子宫颈癌38例

目的:评价子宫动脉灌注新辅助化疗在巨块型子宫颈癌和Ⅱ,Ⅲ期宫颈癌患者治疗中的作用。方法:临床观察巨块型ⅠB2期,Ⅱb择期和Ⅲ期子宫颈鳞状细胞癌患者38例,术前采用Seldinger技术子宫动脉插管灌注化疗,化疗后施行子宫广泛切除术及盆腔淋巴结清扫术或根治性放疗。结果:子宫动脉灌注化疗治疗ⅠB2期,Ⅱb期和Ⅲ期子宫颈癌有效率为65.78%。结论:选择性子宫动脉灌注化疗可有效缩小局部肿瘤、改善宫旁情况。明显减少ⅠB2期宫颈癌患者术中出血;明显降低了Ⅱb期和部分Ⅲ期子宫颈癌患者临床分期,提高了手术可切除率,近期疗效明显。     

动脉灌注栓塞化疗治疗宫颈癌的临床观察及对细胞增殖与凋亡的影响

目的 探讨动脉灌注栓塞化疗治疗宫颈癌的作用机制及临床疗效.方法 将86例Ⅰb2~Ⅱb期宫颈癌患者分为两组:A组(46例)先行动脉灌注栓塞化疗,根据化疗效果决定手术治疗或放疗;B组(40例)直接行广泛全子宫切除+盆腔淋巴结清扫术.根据MRI测量化疗前后宫颈病灶大小,计算手术出血量并统计淋巴结转移率、宫旁浸润率及阴道浸润率...     

子宫动脉介入化疗栓塞术治疗宫颈癌42例

目的:探讨子宫动脉介入化疗栓塞术在晚期宫颈癌治疗中的作用及意义。方法:42例宫颈癌患者行子宫动脉造影,确定肿瘤区位置,分别于双侧子宫动脉灌注化疗药物,共用顺铂60mg(用生理盐水60ml溶解),化疗后栓塞,术后1~2周评价效果,确定进一步治疗方案。结果:42例宫颈癌患者经介入治疗后,2例(ⅡB期)行放疗;34例行广泛性子宫切除术+盆腔淋巴结切除术,手术均顺利。结论:子宫动脉性介入化疗栓塞术治疗宫颈局部中晚期浸润癌可使局部病灶缩小明显,增加晚期宫颈癌手术机会、延缓肿瘤进展、提高患者生活质量。     

宫颈癌术前子宫动脉化疗栓塞治疗的临床疗效观察

目的探讨术前子宫动脉化疗栓塞在宫颈癌治疗方面的临床价值.方法对12例宫颈癌患者在手术前行子宫动脉化疗栓塞,观察症状缓解的程度、疗效和近期不良反应.化疗栓塞后3～4周行子宫根治术及盆腔淋巴结清扫术.结果宫颈癌患者临床症状明显缓解,近期疗效观察有效10例,无效2例,各期次疗效没有显著差别.不良反应经对症处理后均缓解.2例Ⅱ期根治手术后阴道切除缘癌细胞阳性,3例ⅠB期清扫下的淋巴结中发现转移.结论宫颈癌术前子宫动脉化疗栓塞是治疗宫颈癌安全有效的的治疗宫颈癌安方法,值得临床进一步推广使用.     

中晚期宫颈癌术前介入治疗效果评价

目的探讨宫颈癌术前介入治疗的效果和应用价值。方法对25例宫颈癌患者采用Seldinger技术行超选择动脉“夹心式”栓塞化疗,栓塞剂为明胶海绵,化疗药物为顺铂(DDP)80~100mg加丝裂霉素10mg。结果总有效率为80%。其中9例Ⅱa期患者完全缓解2例,部分缓解7例,均顺利手术切除。10例Ⅱb期患者部分缓解8例,均顺利手术切除,稳定2例,行局部放疗。6例Ⅲ期患者行2~3次介入治疗,部分缓解3例,行手术治疗,稳定1例,行局部放射治疗,进展2例,1例接受局部放疗,1例病情进展放弃治疗。术后病理检查,宫颈病灶完全消失的1例,另19例患者宫颈局部仍有肿瘤残留,可见大量坏死组织及淋巴细胞浸润。淋巴结转移2例。结论介入性动脉化疗栓塞治疗可有效地缩小肿瘤体积,提高手术切除率。     

宫颈癌术前子宫动脉栓塞化疗30例临床分析

目的探讨子宫颈癌术前行子宫动脉栓塞化疗的方法及疗效。方法对30例子宫颈癌(Ⅰb期4例,Ⅱa期6例,Ⅱb期25例,Ⅲa期5例)行选择性子宫动脉栓塞化疗,观察其疗效和毒副反应。介入性化疗2周后行广泛性子宫切除及盆腔淋巴结清扫术。结果30例患者阴道出血、流液,腰骶部疼痛症状均明显缓解,栓塞化疗总有效率达83.3%。结论子宫颈癌术前选择性子宫动脉栓塞化疗,有助于提高手术切除率,减少复发和转移。     

宫颈癌术前介入治疗57例

目的：探讨子宫颈癌术前骼内动脉灌注化疗疗效及其临床意义。方法：宫颈癌57例中Ⅰ期巨块型11例，Ⅱa期8例，Ⅱb期29例，Ⅲ期5例，Ⅳ期4例，术前均行2疗程介入化疗。化疗方案：顺铂100mg，阿霉素50mg。结果：近期有效率为85．9％，其中Ⅰb期2例，Ⅱa期1例，经2次介入治疗后属病理完全缓解，同时经介入治疗后提高了Ⅱb、Ⅲ期手术率，分别为78．1％和40．0％。其中Ⅱb期29例经介入治疗后23例手术，术后病理证实，宫旁浸润1例，盆腔淋巴结转移6例，脉管癌栓1例，手术彻底性也较高。结论：宫颈癌术前介入治疗使病灶缩小，提高了Ⅱb、Ⅲ期手术切除率。Ⅱb期手术也较彻底。     

宫颈癌先期介入化疗八例临床分析

目的探讨髂内动脉或子宫动脉栓塞化疗在宫颈癌治疗中的近期临床疗效.方法对8例(Ⅰb2期1例,Ⅱa期5例,Ⅱb期2例)宫颈癌患者实施新辅助化疗.选择卡铂、博莱霉素经子宫动脉或髂内动脉栓塞化疗,异环磷酰胺静脉化疗.介入性化疗后3～4wk行子宫根治术及盆腔淋巴结清扫术,进行疗效、毒副作用的观察和评定.结果 8例患者症状均明显缓解,近期有效率100%(部分缓解75%,完全缓解25%).术后病理检查各断端均未见癌细胞,淋巴结转移2例.治疗后毒副作用有恶心、呕吐、发热及白细胞减少等.其中有4例患者出现臀部及下肢疼痛.结论宫颈癌术前介入性化疗近期疗效好,毒副作用轻,且增加根治手术的机会,是宫颈癌辅助治疗的有效方法.     

新辅助化疗结合手术治疗晚期宫颈癌41例临床疗效观察

目的：评价新辅助化疗结合广泛全子宫切除治疗晚期宫颈癌（FIGOⅡb-Ⅳ期）的临床疗效。方法：选取2000年6月-2004年6月在我院确诊的原发宫颈癌（FIGOⅡb-Ⅳ期）患者41例,新辅助化疗方案为卡铂400mg/m^2、丝裂霉素10mg/m^2、长春新碱1mg/m^2,经髂内动脉、子宫动脉灌注化疗＋栓塞1个疗程,经阴道超声测量肿瘤体积。化疗后3周来院评估化疗效果,其中的40例成功实施广泛全子宫切除术加盆腔淋巴结清扫术。结果：新辅助化疗后有效率32/41,有效率为78.0%;9例病变稳定（SD）或进展（PD）。与化疗前相比肿瘤体积显著缩小（P=0.035）。除一例因肺转移放弃手术外均成功实施了宫颈癌根治术、盆腔淋巴结清扫术。主要毒副作用为恶心、呕吐、白细胞减低。结论：新辅助化疗结合手术治疗晚期宫颈癌（FIGOⅡb-Ⅳ期）是安全可行的。MVC方案新辅助化疗可以显著缩小肿瘤体积,降低临床分期,为以往没有手术机会的晚期肿瘤患者提供了手术机会,改善了生存质量。     

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.     

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.