深部热疗联合同步放化疗治疗局部晚期宫颈癌的疗效分析

目的探讨深部热疗联合同步放化疗治疗局部晚期宫颈癌的临床疗效和毒副反应。方法将62例局部晚期宫颈癌患者随机分为单纯放化疗组30例和热疗联合放化疗组32例,均给予盆腔放疗＋腔内后装治疗,化疗为顺铂联合氟尿嘧啶（PF）方案,热疗为盆腔深部热疗。治疗结束时,评价两组近期疗效;治疗后3个月,比较局部控制率和1年无瘤生存率。并观察毒副反应。结果热疗联合放化疗组总有效率显著高于单纯放化疗组,差异有统计学意义（P〈0．05）。热疗联合放化疗组局部控制率及1年无瘤生存率均显著高于单纯放化疗组,差异有统计学意义（P〈0．05）。两组主要毒副反应为恶性呕吐、自细胞下降、膀胱反应和直肠反应,但均未出现治疗相关性死亡。结论热疗联合放化疗能够提高局部晚期宫颈癌患者的近期疗效及局部控制率,值得临床广泛推广。     

热疗联合顺铂同期放化疗治疗局部晚期宫颈癌临床观察

目的：：评价深部热疗联合顺铂同期放化疗治疗局部晚期宫颈癌疗效及毒性反应。方法：IIb-IIIb期病理确诊宫颈癌初治患者被分为两组。研究组采用顺铂同步放化疗+热疗,对照组采用顺铂同步放化疗。比较两组患者的近期疗效、局控率、生存率及毒性反应。结果：研究组的有效率为100%,对照组有效率为85.7%。研究组2年局控率和生存率分别为100%和95.3%,对照组2年局控率和总生存率是92.2%和100%。研究组2年局控率高于对照组(P<0.05)。两组患者急性和晚期毒性反应比较差异没有统计学意义(P跃0.05)。结论：热疗联合同期放化疗能提高局部晚期宫颈癌的局控率,有较好的耐受性,没有明显增加毒性反应,还需要增加样本量及延长随访时间验证其临床价值。     

同步放化疗后巩固化疗治疗年轻局部晚期宫颈癌患者的临床疗效

目的 观察同步放化疗后巩固化疗治疗年轻局部晚期宫颈癌患者的临床疗效.方法 112例局部晚期宫颈癌年轻患者分为观察组以及对照组,每组56例,年龄均＜40岁,对照组患者仅进行同步放化疗,观察组患者采用同步放化疗后进行紫杉醇联合顺铂巩固化疗,比较两组患者的近、远期疗效及毒副反应发生情况.结果 观察组总有效率为94.6％,高于对照组的80.4％(P＜0.05).观察组2年生存率为87.5％,高于对照组的62.5％ (P ＜0.05),两组患者不良反应发生率及1年生存率比较,差异无统计学意义(P＞0.05).结论 同步放化疗后巩固化疗可明显改善局部晚期宫颈癌年轻患者的预后,延长患者临床生存时间.     

局部中晚期宫颈癌同步放化疗与单纯放疗疗效比较

目的：探讨并比较同步放化疗治疗局部中晚期宫颈癌的临床疗效及不良反应。方法选择初治Ⅱb-Ⅳa期宫颈癌患者120例,按随机数字表法分为同步放化疗组（放化组）60例和单纯放疗组（单放组）60例。观察两组的疗效和副反应,并做比较分析。结果两组近期有效率、5年生存率、局部复发率和远处转移率、胃肠道反应、骨髓抑制反应差异均有统计学意义（P＜0.05）;放射性直肠炎、膀胱炎差异无统计意义（P＞0.05）。结论同步放化疗能提高局部中晚期宫颈癌近期疗效,提高5年生存率,降低5年的局部复发率、远处转移率,但胃肠道反应及骨髓抑制反应增加明显。     

深部热疗联合顺铂增敏同步放疗治疗中晚期宫颈癌的临床研究

目的：观察深部热疗联合顺铂增敏同步放疗治疗中晚期宫颈癌的疗效及安全性。方法：138例Ⅲ期宫颈癌患者,按就诊顺序随机均分为深部热疗联合顺铂增敏同步放疗组（试验组）和顺铂增敏同步放疗组（对照组）。两组患者均进行根治性放疗;放疗第1 d开始行顺铂化疗,顺铂40 mg/m2,每周1次,共5~6周期。试验组：放化疗方法同对照组,于化疗及腔内放疗当日行盆腹腔深部热疗,每周2次,每次热疗60min,共6周。结果：两组的近期疗效、肿瘤局部控制情况、3年无瘤生存率及局控率间差异有统计学意义（P〈0.05）,但两组3年生存率间差异无统计学意义（P〉0.05）;两组毒副反应比较,差异无统计学意义（P〉0.05）。结论：深部热疗联合顺铂增敏同步放疗可以提高患者近期疗效及3年无瘤生存率、3年局部控制率,且无严重的并发症,是中晚期宫颈癌治疗中的一种安全有效的模式,具有临床推广价值。     

重组人内皮抑制素联合同步放化疗对局部晚期非小细胞肺癌的疗效及安全性分析

目的探讨重组人内皮抑制素联合同步放化疗（化疗方案为长春瑞滨联合卡铂）治疗局部晚期非小细胞肺癌（NSCLC）的疗效及安全性。方法122例局部晚期NSCLC患者分别接受同步放化疗（单纯治疗组）76例,重组人内皮抑制素联合同步放化疗（联合治疗组）46例;比较两组患者无进展生存期（PFS）、总生存期（OS）及不良反应发生率。结果单纯治疗组疾病客观反应率（ORR）为86.8%,疾病缓解率（DCR）为92.1%;联合治疗组ORR为80.4%,DCR为91.3%;两组患者ORR及DCR比较,差异均无统计学意义（均P＞0.05）。联合治疗组中位PFS及OS（14.5、21.5个月）均明显高于单纯治疗组（9.3、15.0个月）,差异均有统计学意义（均P＜0.05）。病理类型亚组分析显示,肺腺癌患者联合治疗组中位PFS高于单纯治疗组（P＜0.05）,中位OS比较差异无统计学意义（P＞0.05）;肺鳞癌患者两组中位PFS及OS比较,差异均无统计学意义（均P＞0.05）。两组患者恶心呕吐、放射性肺炎发生率比较,差异均有统计学意义（均P＜0.05）;骨髓抑制、放射性食管炎发生率比较,差异均无统计学意义（均P＞0.05）。两组患者3级以上不良反应有骨髓抑制、放射性肺炎。结论重组人内皮抑制素联合同步放化疗能有效改善局部晚期NSCLC患者的生存情况,且未增加严重的不良反应。     

放化疗联合热疗治疗中晚期宫颈癌效果观察

目的：观察放化疗联合热疗治疗中晚期宫颈癌临床疗效。方法：中晚期宫颈癌患者50例,随机分为对照组和观察组各25例。对照组接受放化疗治疗,观察组给予放化疗联合热疗治疗。比较两组临床近期疗效、淋巴细胞亚群、血清血管内皮生长因子（VEGF）水平、疾病控制率及治疗后1年生存率。结果：观察组疾病控制率96.00%,1年生存率100.00%,分别高于对照组的68.00%和76.00%,差异均有统计学意义（P＜0.05）。治疗后观察组CD3+细胞（68.79±5.58）%,CD4+细胞（45.89±4.63）%,CD4+/CD8+ 1.86±0.23,分别高于对照组的（61.21±5.17）%,（41.26±4.71）%和1.49±0.31,CD8+细胞（23.34±1.79）%,低于对照组的（26.17±2.58）%,差异均有统计学意义（P＜0.05）。治疗后观察组血清VEGF为216.39±21.08 pg/mL,低于对照组的279.87±25.41 pg/mL,差异有统计学意义（P＜0.05）。两组不良反应发生率比较,差异均无统计学意义（P＞0.05）。结论：放化疗联合热疗治疗中晚期宫颈癌能增强抗肿瘤效果,改善机体免疫功能及VEGF水平,不良反应较少。     

晚期宫颈癌患者局部热疗加化疗、放疗的临床对比研究

目的观察局部热疗、化疗、放疗综合治疗晚期宫颈癌的临床疗效。方法将2003年12月至2005年11月间120例临床Ⅱ、Ⅲ期宫颈癌患者随机分成单纯放疗组（A）、热放疗组（B）、放化疗组（C）、热放化疗组（D）,观察其近期疗效及3年内局部复发情况,并统计1、3年生存率。结果治疗结束时完全缓解率CR分别是单纯放疗组（A）56.7%、热放疗组（B）66.7%、放化疗组（C）60.0%、热放化疗组（D）93.3%,近期疗效热放化疗组（D）与其它3组之间两两比较有显著性差异（P〈0.05）,A、B、C3组间无统计学意义（P〉0.05）。3年内局部复发率分别为：A：50.0%、B：40.0%、C：36.7%、D：10.0%,D组与其它3组之间两两比较有统计学意义（P〈0.05）,A、B、C 3组之间两两比较无统计学意义（P〉0.05）。3年生存率分别为：A：50.0%、B：60.0%、C：50.0%、D：86.7%,D组与其它3组之间两两比较有统计学意义（P〈0.05）,A、B、C 3组之间两两比较无统计学意义（P〉0.05）。结论局部热化放综合治疗晚期宫颈癌可提高其近期疗效及3年生存率。     

同步及序贯放化疗治疗直肠癌有效性和安全性的系统评价

目的 系统评价不同时序放化疗治疗直肠癌的有效性及安全性,为临床实践与研究提供参考。方法 计算机检索Cochrane Library、PubMed、EMBase、Web of Science以及中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普期刊数据库（VIP）和万方期刊数据库（Wanfang）相关文献,进一步进行文献筛选,并提取文献主要信息,包括试验分组、患者性别、年龄、KPS评分、临床分期及结局指标。比较同步放化疗（同步组）和序贯放化疗（序贯组）治疗直肠癌患者总生存率、无进展生存率、总有效率、完全缓解率和毒副作用发生率的差异。结果 共纳入12篇文献,1 191例患者。Meta分析结果显示,同步组和序贯组1年总生存率比较,差异无统计学意义〔OR=1.47,95%CI（0.96,2.26）,P＞0.05〕。同步组2年总生存率〔OR=2.04,95%CI（1.26,3.30）,P＜0.05〕、3年总生存率〔OR=2.04,95%CI（1.50,2.78）,P＜0.05〕高于序贯组,差异有统计学意义。两组5年总生存率比较,差异无统计学意义〔OR=1.30,95%CI（0.73,2.33）,P＞0.05〕。同步组1年无进展生存率〔OR=2.68,95%CI（1.76,4.07）,P＜0.001〕、2年无进展生存率〔OR=2.66,95%CI（1.19,5.95）,P=0.02〕、3年无进展生存率〔OR=1.70,95%CI（1.18,2.45）,P=0.004〕及总有效率〔OR=2.49,95%CI（1.25,4.97）,P=0.01〕高于序贯组,差异有统计学意义;两组完全缓解率比较,差异无统计学意义（P＞0.05）。同步组腹泻发生率高于序贯组,差异有统计学意义〔OR=2.94,95%CI（1.88,4.60）,P＜0.001〕。两组恶心呕吐、白细胞计数下降、血小板计数下降、神经毒性、腹痛和皮肤黏膜反应发生率比较,差异无统计学意义（P＞0.05）。同步组重度腹泻发生率高于序贯组,差异有统计学意义〔OR=2.39,95%CI（1.31,4.38）,P=0.005〕。两组重度恶心呕吐、重度白细胞计数下降和重度神经毒性发生率比较,差异无统计学意义（P＞0.05）。结论 与序贯放化疗相比,同步放化疗可提高直肠癌患者总生存率和无进展生存率,但腹泻的发生风险增加,不同时序放化疗方式各有利弊。     

同期放化疗联合艾迪治疗局部晚期下咽癌的临床研究

目的：探讨局部晚期下咽癌应用同期放化疗联合艾迪注射液综合治疗的临床疗效。方法：将104例局部晚期下咽癌患者进行随机分组,观察组52例,采用同期放化疗联合艾迪注射液,放疗结束后再化疗2～4周期;对照组52例,利用同期放化疗,放化疗方法同于观察组。观察两组近期疗效、1年总生存率、生活质量及不良反应。两组患者临床资料比较,差异无统计学意义（ P＞0．05）。结果：两组近期疗效相比较,均有所改善,其中观察组为82．7％,对照组为78．8％,3年总生存率观察组为54．5％,对照组为51．9％,两组差异无统计学意义（ P＞0．05）;两组患者生活质量相比较,观察组生活质量较对照组明显增高,两组差异有统计学意义（ P＜0．05）;两组不良反应相比较,观察组放疗反应较对照组明显减轻,两组差异有统计学意义（ P＜0．05）。结论：同期放化疗联合艾迪注射液治疗局部晚期下咽癌可提高患者的生活质量,降低患者的放化疗反应。     

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.