吡咯替尼联合多西他赛治疗HER2阳性晚期乳腺癌患者的效果及对T淋巴细胞亚群水平的影响

目的：探讨吡咯替尼联合多西他赛治疗人表皮生长因子受体2(HER2)阳性晚期乳腺癌患者的效果及对T淋巴细胞亚群水平的影响。方法：选取2020年6月-2021年12月上饶市人民医院80例HER2阳性晚期乳腺癌患者作为研究对象,采用随机数字表法分为对照组(40例,接受多西他赛治疗)与研究组(40例,接受吡咯替尼联合多西他赛治疗)。比较两组治疗前后的糖类抗原125(CA125)、血管内皮生长因子(VEGF)、T淋巴细胞亚群(CD8⁺、CD4⁺和CD4⁺/CD8⁺)、癌胚抗原(CEA)水平、临床疗效及药物不良反应。结果：治疗前两组的CA125、CD8⁺、VEGF、CD4⁺、CEA、CD4⁺/CD8⁺水平比较,差异均无统计学意义(P>0.05);治疗后研究组的VEGF、CEA、CA125、CD8⁺水平均低于对照组,CD4⁺、CD4⁺/CD8^+<...     

安罗替尼与紫杉醇联合顺铂化疗方案治疗晚期非小细胞肺癌的效果

目的 探讨安罗替尼与紫杉醇联合顺铂化疗方案在晚期非小细胞肺癌(NSCLC)患者治疗中的应用效果。方法 选取信阳市中心医院2019年2月至2021年2月信阳市中心医院62例NSCLC患者,按照随机数字表法分为两组,各31例。对照组接受紫杉醇联合顺铂方案治疗,研究组在对照组的基础上接受安罗替尼治疗。比较两组近期疗效、治疗前后肿瘤细胞生长因子[基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(BFGF)]水平、细胞免疫功能[T淋巴细胞(CD3⁺、CD4⁺、CD8⁺)、CD4⁺/CD8⁺]、生存期、生活质量及毒副反应。结果 研究组疾病缓解率、疾病控制率高于对照组(P<0.05);治疗后,研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺较对照组升高,MMP-9、VEGF、BFGF、CD8⁺较对照组降低(P<0.05);研究组中位无进展...     

黄芪注射液辅助化疗治疗子宫内膜癌临床疗效及对血清肿瘤标志物的影响

目的 观察黄芪注射液辅助化疗治疗子宫内膜癌(EC)的疗效及对血清肿瘤标志物的影响。方法将我院72例EC患者随机分为观察与对照组各36例。对照组采用紫杉醇+顺铂化疗方案治疗,观察组采用黄芪注射液辅助紫杉醇+顺铂化疗方案治疗。比较两组客观缓解率、疾病控制率糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、 T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺%和CD4⁺/CD8⁺)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)水平。结果 治疗后观察组疾病控制率高于对照组(P<0.05),两组客观缓解率差异无统计学意义(P>0.05);两组CA19-9、CA125水平均低于治疗前观察组CA19-9、CA125水平均低于对照组(P<0.05);两组CD3⁺、CD4⁺百分比和CD4⁺/CD8⁺均高于治疗前,CD8⁺百分比低于治疗前,观察...     

贞芪扶正胶囊联合吉西他滨加顺铂化疗方案治疗晚期非小细胞肺癌的临床研究

目的 观察贞芪扶正胶囊联合吉西他滨加顺铂(GC)化疗方案治疗晚期非小细胞肺癌(Non-small cell lung cancer, NSCLC)的临床疗效。方法 选取2019年6月—2021年6月期间于我院就诊的晚期NSCLC患者106例,按随机数字表法分组,偶数者纳入对照组,奇数者纳入试验组,每组各53例。试验组采用贞芪扶正胶囊联合GC化疗方案治疗,对照组采用GC化疗。治疗4个疗程后,观察比较两组患者临床疗效及不良反应,治疗前后的血清肿瘤指标[血清糖类抗原125(Carbohydrate antigen 125,CA125)、细胞角蛋白19血清片段21-1(Cytokeratin-19-fragment CYFRA21-1,CYFRA21-1)、癌胚抗原(Carcinoembryonic antigen, CEA)]、免疫功能指标(CD3⁺、CD4⁺、NK细胞、CD4⁺/CD8⁺)。结果 治疗后试验组临床总有效率54.72%(29/53)明显高于对照组32.06%(17/53),差异有统计学意义...     

卡瑞利珠单抗联合放化疗对局部晚期非小细胞肺癌患者生存预后的影响

目的 探讨卡瑞利珠单抗(Cam)联合放化疗对局部晚期非小细胞肺癌(NSCLC)患者血清程序性细胞死亡受体1(PD-1)、胸苷激酶1(TK1)、基质金属蛋白酶9(MMP-9)和生存预后的影响。方法 选取2018年6月—2020年6月徐州医科大学附属宿迁医院收治局部晚期NSCLC患者60例,并按照随机数表法分为研究组和对照组,每组各30例。研究组采取Cam联合放化疗治疗,对照组采取放化疗治疗,比较两组患者近期疗效情况和治疗前、治疗3个月时T细胞亚群(CD3⁺、CD4⁺、CD4⁺/CD8⁺)和血清PD-1、TK1、MMP-9水平,Kaplan-Meier法分析患者1年生存情况,记录不良反应。结果 治疗3个月时,研究组患者的疾病控制率(86.67%)、客观缓解率(53.33%)均高于对照组(63.33%、26.67%)(P<0.05);两组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺较治疗前均呈升高趋势,且研究组高于...     

卡瑞利珠单抗联合TP方案对中晚期NSCLC患者疗效免疫功能及外周血VEGF bFGF CA125和CEA的影响

目的:观察卡瑞利珠单抗联合TP化疗方案(紫杉醇+顺铂)对中晚期非小细胞肺癌(NSCLC)患者疗效、免疫功能及外周血血管内皮生长因子(VEGF)、糖类抗原125(CA125)、癌胚抗原(CEA)和碱性成纤维细胞生长因子(bFGF)的影响。方法:选取2020年1月至2023年1月我院收治的102例中晚期NSCLC患者为对象，采用简单随机法分为两组。对照组给予TP方案治疗，观察组在对照组基础上联合卡瑞利珠单抗。比较两组疗效、免疫功能及外周血因子的变化，统计两组毒副反应。结果:观察组客观缓解率(ORR)为56.86%(29/51),疾病控制率(DCR)为80.39%(41/51),高于对照组的33.33%(17/51)和58.82%(30/51),差异有统计学意义(P<0.05)。治疗前，两组VEGF、bFGF、CA125、CEA及免疫功能比较，差异无统计学意义(P>0.05)。与治疗前比较，两组VEGF、bFGF、CA125、CEA及CD8⁺治疗后均下降，CD4⁺、CD4⁺/CD8⁺治疗后均升...     

XELOX与FOLFOX化疗方案治疗晚期结直肠癌患者的效果比较

目的：比较XELOX与FOLFOX化疗方案治疗晚期结直肠癌患者的效果。方法：回顾性分析2018年5月至2020年6月该院收治的80例晚期结直肠癌患者的临床资料,按照治疗方案不同将其分为研究组41例与对照组39例。对照组予以FOLFOX化疗方案(氟尿嘧啶+亚叶酸钙+奥沙利铂)治疗,研究组予以XELOX方案化疗(奥沙利铂+卡培他滨)治疗,比较两组疾病控制率、治疗前后血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)]水平、T细胞亚群指标(CD4⁺、CD3⁺、CD8⁺)水平和不良反应发生率。结果：两组疾病控制率比较,差异无统计学意义(P>0.05);治疗后,两组血清CEA、CA125、CA19-9水平均低于治疗前,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);治疗后,研究组CD4⁺、CD3⁺、CD8⁺水平均高于对照组,差异有统计学意义(P<0.05);研究组...     

健脾益肾汤联合TP化疗方案治疗晚期非小细胞肺癌患者的效果

目的：观察健脾益肾汤联合TP化疗方案治疗晚期非小细胞肺癌(NSCLC)患者的效果。方法：回顾性分析2020年4月至2022年4月该院收治的98例晚期NSCLC患者的临床资料,根据治疗方法不同将其分为对照组和观察组各49例。对照组给予TP化疗方案治疗,观察组在对照组基础上联合健脾益肾汤治疗。比较两组客观缓解率、疾病控制率,Karnofsky功能状态(KPS)评分、T细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺)水平、血清学指标[癌胚抗原(CEA)、细胞角质蛋白19片段(CYFRA21-1)、潜在转化生长因子β结合蛋白2(LTBP2)、Ⅳ型胶原蛋白α3(COL4A3)]水平及6个月生存率。结果：观察组客观缓解率为57.14%,高于对照组的36.73%,观察组疾病控制率为87.76%,高于对照组的65.31%,差异均有统计学意义(P<0.05);治疗后,观察组KPS评分高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CD3⁺...     

大分割容积旋转调强放疗与常规分割动态调强放疗治疗老年NSCLC的近期疗效观察

目的 比较大分割容积旋转调强放疗与常规分割动态调强放疗治疗老年非小细胞肺癌(NSCLC)的近期疗效和不良反应。方法 选择2020年1月至2021年9月南部战区海军第一医院肿瘤放疗科收治的66例老年NSCLC患者为研究对象,按随机数表法分为研究组和对照组各33例,研究组患者开展大分割容积旋转调强放射治疗,对照组患者实施常规分割动态调强放射治疗,两组共治疗4周。比较两组患者治疗4周后的疗效、不良反应和危及器官的受量;比较两组患者治疗前及治疗4周后的肿瘤标志物[癌胚抗原(CEA)、糖抗原125 (CA125)]、T淋巴细胞亚群[T淋巴细胞(CD3⁺)、辅助性T细胞(CD4⁺)、细胞毒性T细胞(CD8⁺)、CD4⁺/CD8⁺]、血小板-淋巴细胞比值(PLR)和中性粒细胞-淋巴细胞比值(NLR)。结果 研究组患者的治疗总有效率为84.85%,明显高于对照组的60.61%,差异有统计学意义(P<0.05);研究组患者的总不良反应发生率为12.12%,明显低于对照组的36.36%,危及...     

改良PCH方案用于人表皮样生长因子受体2阳性局部晚期女性乳腺癌的临床研究

目的 研究改良PCH方案(曲妥珠单抗+紫杉醇+卡铂)用于人表皮样生长因子受体2(HER-2)阳性局部晚期女性乳腺癌的临床疗效。方法 选择2017年1月至2019年1月南京医科大学康达学院附属滨海人民医院收治的134例HER-2阳性局部晚期乳腺癌女性患者,使用随机数表法将其分为观察组和对照组,每组67例。对照组使用注射用紫杉醇和卡铂,观察组采用改良PCH方案,化疗后两组均行改良乳腺癌根治术。观察两组临床疗效;比较治疗前和治疗后6个月两组血清组织多肽特异性抗原(TPS)、癌胚抗原(CEA)、糖类抗原125(CA125)、CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺;记录两组不良反应发生情况。结果 观察组疾病控制率高于对照组(P <0.05)。治疗后6个月,两组TPS、CEA、CA125水平较治疗前降低;观察组低于对照组(P <0.05)。治疗后6个月,两组CD3⁺、CD4⁺、CD4⁺/CD8^...     

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.