~（125）I─抗AFP的质量和安全性检定

应用三氯醋酸法、琼脂糖免疫扩散法、细菌培养、鲎试验、动物安全试验等方法检定￣（１２５）Ｉ－抗ＡＦＰ的质量和安全性。检定结果：￣（１２５）Ｉ－抗ＡＦＰ为无色、透明、澄清的液体，ｐＨ值为６．５，放化纯度为９８％，放射比为５５．５ｍＢｑ／ｍｇ抗体蛋白，细菌培养无菌生长，鲎试验阴性，抗体活性及贮存稳定性良好，动物安全试验合格。检定方法简便、快速、敏感、特异。     

125I抗AFP抗体在肝癌病人体内的药代动力学观察

目的：用＾１２５Ｉ标记抗ＡＦＰ多克隆抗体治疗１２例原发性肝癌患者，观察其药代动力学特征。方法：用改良氯胺－Ｔ法制备＾１２５Ｉ－抗ＡＦＰ抗体，标记率为６５％～８３％，比放射性为５５．５～７４ＭＢｑ／ｍｇ（ＩｇＧ）。全部病便采用Ｓｅｌｄｉｎｇｅｒ插管技术，经肝动脉注射给药。给药后在不同时间点采集外周静脉血测放射活性。所得数据用计算机程序ＰＫ－ＧＲＡＰＨ模拟出＾１２５Ｉ－抗ＡＦＰ抗体的药代动力学模型、血     

~（125）I－抗AFP制备的研究

用亲和层析法提纯马抗ＡＦＰ，采用氯胺Ｔ改良法标记１２５Ｉ，经ＳｅｐｈａｄｅｘＧ５０柱分离，以ｒ计数与紫外同步监测进行标记物的收集。并对１２５Ｉ－抗ＡＦＰ制备方法及其稳定性等进行探讨和测定。结果：１２５Ｉ和抗ＡＦＰ的利用率分别为６０％～８０％和５０％～７３％；标记率为６５％～８３％，１２５Ｉ－抗ＡＦＰ的比放射性为５５．５～７４ＭＢｑ／ｍｇ；放化纯度５ｄ内为９７％～９８％，１４ｄ为９３％；抗体活性标记后与标记前基本不变，４℃保存５ｄ和１４ｄ均无降低。表明１２５Ｉ－抗ＡＦＰ的生物活性及稳定性良好。     

异环磷酰胺,顺铂,阿霉素联合治疗非小细胞肺癌的临床观察

目的：观察ＩＡＰ（异环磷酰胺加阿霉素加顺铂）方案治疗肺癌的疗效和毒副反应。方法：异环磷酰胺１．５￣２．０ｇ／ｍ＾２，静滴，第１￣５天，阿霉素４０ｍｇ／ｍ＾２，静滴，第１天；顺铂５０ｍｇ，静注，第３￣５天，或１００ｍｇ／ｍ＾２，静滴，第３天，联合治疗中晚期非小细胞肺癌３５例。结果：安全缓解７例，部分缓解１３例，稳定７例，恶化８例，有效率（ＣＲ＋ＰＲ）为５７．１％。中位缓解期５个月，中位生存期９个月。     

^125I—抗AFP放射免疫治疗原发性肝癌临床观察

将纯化抗ＡＦＰ多抗，用氯胺Ｔ氧化法标记＾１２５Ｉ，得＾１２５Ｉ－抗ＡＦＰ抗体进行导向治疗不能切除的肝癌２２例。均经静脉滴注。全组＾１２５Ｉ中位剂量为２８９．３（１００．３－７０８．９）ＭＢｑ，抗ＡＦＰ抗体的ＩｇＧ量为５．２ｍｇ。     

卵巢子宫内膜异位囊肿患者囊内液及血清CA—125的测定

经放射免疫测定，１７例卵巢子宫内膜异位囊肿（ＥＣＯ）囊内液ＣＡ－１２３均值Ｍ（Ｑ）为１１５．９×１０＾３（１２０．５×１０＾３）ＫＵ／Ｌ，明显高于患者血清ＣＡ－１２５水平「均值为４９．３（１９．２）ＫＵ／Ｌ〉Ｐ〈０．０１」，后者也明显高于无ＥＣＯ的异位症患者「ＣＡ－１２５为１７．５（９．８）ＫＵ／Ｉ」和正常妇女「血ＣＡ－１２５为１５．９（４．０）ＫＵ／Ｌ」，Ｐ值均〈０．０５。ＥＣＯ患者血清ＣＡ－１     

表皮生长因子及其受体在胃癌中的表达

目的：观察表皮生长因子（ＥＧＦ）及其受体（ＥＧＦＲ）在胃癌中的表达，加深对胃癌发生分子基础的了解。方法：采用免疫组织化学方法（ＡＢＣ法），分析探讨两者在５２例原发性胃癌组织中的变化。结果：ＥＧＦ、ＥＧＦＲ在胃癌中的阳性表达率分别为４０４％（２１／５２）和４８１％（２５／５２），两者同时阳性表达率为３６５％（１９／５２）；ＥＧＦ在中、晚期胃癌，淋巴结转移胃癌，低分化胃癌中的免疫阳性反应率为４７６％（２０／４２）；５３１％（１７／３２）；５２３％（１８／３４），分别高于其在早期（１０％，１／１０）、淋巴结阴性（２０％，４／２０）、高分化胃癌（１６７％，３／８）中的表达，Ｐ＜００５；ＥＧＦＲ表达与临床进展无明显相关性，Ｐ＞００５，但其在淋巴结转移（５９４％，１９／３２）、低分化胃癌（６１８％，２１／３４）中的表达率分别高于其在淋巴结阴性（３０％，６／２０）、高分化胃癌（２２２％，３／１８）中的表达，Ｐ＜００５。结论：ＥＧＦ、ＥＧＦＲ在胃癌转移过程中起一定作用，并可能是胃癌恶性程度的影响因素。     

小儿病毒性心肌炎柯萨奇病毒B组特异性IgM检测及临床意义

应用间接ＥＵＳＡ法测定９６例小儿病毒性心肌炎柯萨奇病毒Ｅ特异性ＩｇＭ（ＣＶＢ。－ＩＭ牡）。结果阳性３０例，总阳性率３１．３％：１９例健康儿中有１例阳性，阳性率５．３％，两者比较差异有显著意义（ｘ＝４，２０，Ｐ＜０．０５）病程＜２月者阳性率为４２．４％（２８／６６例）．病程２～６月者阳性率为７．７（１／１３例），病程＞６月者阳性率为５．９％（１／１７例）．后两组与病程＜２月组比较差异均显著（分别为４，９．６．６１，Ｐ均＜（０．０５）。提示ＣＶＢ－ＩＭ测定对小儿病毒性心肌炎病原学的早期诊断有临床意义     

丝裂霉素、长春酰胺和顺铂联合治疗晚期非小细胞肺癌

对经细胞学、组织学证实的３７例Ⅲ～Ⅳ期非小细胞肺癌患者，用丝裂霉素（８～１０ｍｇ／ｍ２，第１天），长春酰胺（３．０ｍｇ／ｍ２，第１、８天），顺铂（４０～５０ｍｇ／ｍ２，第２、３天），配合水化利尿，联合化疗，２１天重复。其中Ⅲａ期６例，Ⅲｂ期１９例，Ⅳ期１２例。鳞癌８例，腺癌２６例，鳞腺癌３例。结果：ＣＲ２例，占５．４％，ＰＲ２０例，占５４．０％，ＮＣ１１例，占２９．７％，ＰＤ４例，占１０．６％，ＰＲ（ＣＲ＋ＰＲ）占５９．４％。毒副作用：胃肠道反应Ⅰ度～Ⅱ度７８．３％，Ⅲ度１０．８％。骨髓抑制：白细胞减少Ⅰ度～Ⅱ度６４．８％，Ⅲ度１３．５％，Ⅳ度２．７％。血小板降低Ⅰ度～Ⅱ度４８．６％，Ⅲ度２．７％。共有６例（１６．２％）出现Ⅰ度～Ⅱ度周围神经毒性。本组结果表明：丝裂霉素、长春酰胺和顺铂组成的联合化疗方案为治疗非小细胞肺癌较好的方案。     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

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.