去甲氧柔红霉素治疗AML的临床分析

目的:比较去甲氧柔红霉素和柔红霉素治疗急性髓细胞白血病(AML)的疗效.方法:对78例分别应用去甲氧柔红霉素和柔红霉素治疗的初诊AML病人进行随机对照分析.结果:早期诱导失败两组相似(去甲氧柔红霉素与柔红霉素组分别为8.82%和11.36%;P>0.01),但40天后的晚期诱导失败,去甲氧柔红组较少(11.76".73%;P<0.01),同时完全缓解率(CR)较高(73.53%和56.82%;P<0.01).结论:含去甲氧柔红霉素的诱导方案比用柔红霉素的方案具有更高的CR,可以作为临床治疗AML,的首选蒽环类药物.     

去甲氧柔红霉素、柔红霉素分别联合阿糖胞苷诱导治疗初治成人急性髓系白血病的疗效及预后分析

目的 探讨去甲氧柔红霉素、柔红霉素分别联合阿糖胞苷诱导治疗初治成人急性髓系白血病的疗效及预后。方法 选取2018年1月至2020年1月在本院确诊的初治成人急性髓系白血病患者82例,采用简单随机分组将患者分为治疗组和对照组,每组各41例。对照组患者采用柔红霉素联合阿糖胞苷治疗,治疗组采用去甲氧柔红霉素联合阿糖胞苷治疗,均持续治疗3周。治疗后比较两组疗效以及不良反应,随访1年观察生存以及复发情况。结果 治疗组患者治疗的有效率为75.60%,明显高于对照组患者治疗的53.65%(P<0.05);治疗组患者治疗期间的不良反应发生率与对照组患者无显著差异(P>0.05);治疗组治疗半年和1年的生存率为的87.80%和60.97%,与对照组治疗的70.73%和51.21%无显著差异(P>0.05),治疗组治疗1年的复发率为17.07%,明显高于低于对照组的36.58%(P<0.05)。结论 去甲氧柔红霉素联合阿糖胞苷治疗可以明显提高成人急性髓系白血病患者的临床疗效,同时降低复发率,且安全性较好。     

去甲氧柔红霉素联合阿糖胞苷治疗急性白血病16例的护理体会

去甲氧柔红霉素和阿糖胞苷联合应用治疗急性白血病有协同作用,能提高疗效。2004年3月~2006年12月,我科对16例急性白血病患者应用去甲氧柔红霉素与阿糖胞苷联合治疗,辅以良好的护理,效果满意,现作报道。     

柔红霉素与去甲氧柔红霉素治疗急性髓细胞白血病的疗效比较

目的探讨柔红霉素＋阿糖胞苷和去甲氧柔红霉素＋阿糖胞苷治疗急性髓细胞白血病的疗效。方法选自本院2000年2月～2007年11月住院的60例患者，分别采用柔红霉素＋阿糖胞苷方案（DA组，n=32）或去甲氧柔红霉素＋阿糖胞苷方案（IA组，n=28），疗程3-7d（根据血常规及骨髓检查结果决定用药时间），观察DA组和IA组骨髓相，对比疗效。结果DA组和IA组的完全缓解率分别为58．4％和75．0％，临床感染率分别为34．2％和32．5％，两组完全缓解率之间有统计学差异，而两组患者的感染发生率无差别（P〉0．05）。结论治疗急性髓细胞白血病时，去甲氧柔红霉素＋阿糖胞苷联合化疗组的完全缓解率显著高于柔红霉素＋阿糖胞苷联合化疗组，而两组骨髓抑制及感染率无显著性差异。证实去甲氧柔红霉素是疗效可靠、毒副作用小的抗白血病药物。     

不同蒽环类抗生素在急性早幼粒细胞白血病治疗中的应用比较

目的观察米托蒽醌、吡喃阿霉素和去甲氧柔红霉素3种蒽环类抗生素在急性早幼粒细胞白血病治疗中的效果和毒副作用的差异。方法将60例急性早幼粒细胞白血病患者随机分为3组,分别给予米托蒽醌、吡喃阿霉素和去甲氧柔红霉素治疗,比较其治疗效果和毒副作用。结果米托蒽醌、吡喃阿霉素和去甲氧柔红霉素3组的治疗总有效率分别为75.0%、75.0%和80.0%,差异无统计学意义（P〉0.05）。去甲氧柔红霉素组心脏毒性的发生率明显低于米托蒽醌组和吡喃阿霉素组（P〈0.05）。结论米托蒽醌、吡喃阿霉素和去甲氧柔红霉素3种蒽环类抗生素均可用于治疗急性早幼粒细胞白血病,去甲氧柔红霉素抗肿瘤活性高,毒副作用较低,有推广价值。     

含去甲氧柔红霉素化疗方案治疗急性淋巴细胞白血病的疗效观察

目的观察含去甲氧柔红霉素化疗方案治疗急性淋巴细胞白血病（ALL）的疗效及副作用。方法收集2005年1月-2008年8月我科收治的初治急性淋巴细胞性白血病31例,按照诱导方案分成去甲氧柔红霉素IOLP组及柔红霉素DOLP组。比较两组CR率及化疗毒副作用发生率。结果IOLP组及DOLP组CR率为（94．44％＆76．92％,P〈0．05）。两组不良反应发生率类似,恶心、呕吐及腹泻发生率10LP组低于DOLP组。IOLP组骨髓抑制时间较DOLP组长。结论去甲氧柔红霉素联合化疗治疗ALL能达到较好的缓解率,骨髓抑制时间较长。     

去甲氧柔红霉素增强预处理的造血干细胞移植治疗高危因素的恶性血液疾病

目的 回顾性分析去甲氧柔红霉素增强预处理的造血干细胞移植对于有高危因素的恶性血液疾病的治疗效果.方法 2003年8月～2004年12月,该科对收治的8例具有高危因素的恶性血液疾病患者进行了以去甲氧柔红霉素(IDA)增强预处理的外周血造血干细胞移植.其中7例异基因外周血造血干细胞移植(Allo-PBSCT),预处理方案在改良的经典马利兰加环磷酰氨[BuCy2,Bu 4 mg/(kg·d),移植前8 d(-8 d～-6 d);Cy,1 g/(m2·d),-3 d,-2 d]基础上,加用2 d或3 d的去甲氧柔红霉素(IDA,20 mg/d,-8 d,-7 d;或10 mg/d,-9 d～-7 d);1例外周造血干细胞自体移植(Auto-PBSCT),采用IDA(10 mg/d,-9 d～-7 d)+Ara-C(1 g/d,-9 d～-3 d)+IFO(2.4 g/d,-5 d,-4 d)预处理方案.结果 8例患者均获得较快植入,中位植活时间为21 d;仅1例患者发生严重黏膜炎;未发生明显心脏毒性.中位随访15个月(2.5～23个月),5例存活,其中4例为无病生存,1例为无进展存活;3例死亡,其中,1例Ph+的ALL和1例多次复发的NHL死于复发,1例MUD移植患者死于混合感染.结论 中等剂量的去甲氧柔红霉素预处理增强方案,可有效减少高危恶性血液疾病移植后复发,患者耐受良好.     

IE方案治疗难治性和复发性白血病13例疗效观察

目的 探讨以口服去甲氧柔红霉素为主联合化疗方案治疗难治性和复发性白血病的疗效。方法 对难治性及复发性白血病均采用ＩＥ（去甲氧柔红霉素,足叶乙甙）方案诱导化疗,完全缓解后再用其他方案巩固强化。结果 完全缓解率４６．１５％,部分缓解率２３％,总缓解率６９．１５％。结论 去甲氧柔红霉素口服吸收良好,对难治性及复发性白血病有较好疗效。值得推广应用。     

去甲氧柔红霉素治疗难治性复发性急性白血病23例临床观察

我们应用法玛西亚普强有限公司生产的去甲氧柔红霉素(ＩＤＡ) ,对 2 3例难治性复发性急性白血病进行治疗。观察一个疗程疗效及其毒副作用 ,现将结果报告如下 :1　临床资料1 1　一般资料 :我们自 1998年～ 2 0 0 0年应用法玛西亚普强有限公司生产的去甲氧柔红霉素治疗 2 3例难治     

联用去甲氧柔红霉素治疗白血病患儿14例

去甲氧柔红霉素(IDA)是柔红霉素的衍生物，对急性白血病的治疗具有疗效好、对心脏毒性低的优点。我院近年来联合应用IDA治疗儿童急性白血病14例取得良好疗效，报道如下。……     

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.