抗癌药物对乳腺癌细胞动力学及凋亡基因Bc1-2/Bax的影响

探讨抗癌药物对乳腺癌细胞动力学及凋亡基因Ｂｃｌ－２／Ｂａｘ的影响。方法用流式细胞术测定乳腺癌细胞核ＤＮＡ含量（ＤＩ）、Ｓ期细胞比率（ＳＰＦ）、细胞凋亡指数（ＡＩ）、凋亡基因Ｂｃｌ－２、Ｂａｘ的表达及雌激素受体（ＥＲ）等进行定量分析。结果①用药组与对照组相比,ＤＩ、ＳＰＦ及Ｂａｘ明显低于对照组（Ｐ＜０．０１）,而ＡＩ（Ｐ＜０．０５）、Ｂｃｌ－２（Ｐ＜０．００１）则高于对照组,ＥＲ于两组间无统计学差异;②ＡＩ与ＳＰＦ、Ｂｃｌ－２及ＥＲ的表达均呈正相关,而与Ｂａｘ无明显相关关系。结论抗癌药物主要通过细胞凋亡而发挥作用,用药后的生物学指标可表现为ＡＩ及Ｂｃｌ－２升高,ＳＰＦ、ＤＩ值及Ｂａｘ下降;ＡＩ与ＳＰＦ、Ｂｃｌ－２及ＥＲ均呈正相关。根据这些指标可判定药物的疗效,并可用于预后的预测。     

肝动脉栓塞加手术切除治疗大肝癌37例

作者报告３７例大肝癌采用肝动脉栓塞（ＴＡＥ）加手术切除的疗效及临床病理研究结果。３７例肝癌直径５￣２４ｃｍ（平均１１．２ｃｍ），ＴＡＥ与动脉灌注化疗同时进行，化疗药物包括氟尿嘧啶（５－ＦＵ），阿霉素（ＡＤＭ）或表阿霉素（Ｅ－ＡＤＭ），丝裂霉素（ＭＭＣ）和顺铂（ＣＤＤＰ），多采用三种药物联合方案，肝动脉末梢栓塞剂采用国产或进口碘化油，用明胶海绵颗粒作近端栓塞。手术切除前进行１￣４次ＴＡＥ，每次相隔４     

肝动脉栓塞加手术切除治疗大肝癌37例

作者报告３７例大肝癌采用肝动脉栓塞（ＴＡＥ）加手术切除的疗效及临床病理研究结果。３７例肝癌直径５～２４ｃｍ（平均１１．２Ｃｍ）。ＴＡＥ与动脉灌注化疗同时进行。化疗药物括氟尿嘧啶（５－ＦＵ）、阿霉素（ＡＤＭ）或表阿霉素（Ｅ－ＡＤＭ）、丝裂霉素（ＭＭＣ）和顺铂（ＣＤＤＰ）。多采用三种药物联合方案。肝动脉末梢栓塞剂采用国产或进口碘化油，用明胶海绵颗粒作近端栓塞。手术切除前进行１～４次ＴＡＥ，每次相隔４～６周。１７例ＡＦＰ值增高者ＴＡＥ后１０例降至正常水平。肿瘤直径由平均１１．２ｃｍ降至８．５ｃｍ（缩小２６％）。栓塞后手术切除病理标本显示９２％有肿瘤组织坏死，范围达４０％～１００％。１、２、３年生存率分别为８０％、６６．７％和５３．３％。作者认为ＴＡＥ加手术切除是大肝癌的有效治疗方法。     

吸入麻醉药对离体鼠肝线粒体内膜流动性的影响

使用ＤＰＨ（１，６－ｄｉｐｈｅｎｙｌ　１，３，５－ｈｅｘａｔｒｉｅｎｅ）作为荧光探剂，应用荧光偏振技术研究不同浓度的氟烷、安氟醚、异氟醚、七氟酸在能化和非能化条件下对离体鼠肝线粒体内膜流动性的影响，以探讨四种吸入麻醉药的肝毒性。材料与方法根据Ｅｓｔａｂｒｏｏｋ［１］方法提取肝线粒体内膜体，用ＤＰＨ标记，将实验组七氟醚（Ｓ）、安氟醚（Ｅ）、异氟醚（Ｉ）、氟烷（Ｈ）分５μｌ、５０μｌ、１００μｌ浓度加入到比色杯基质４ｍｌ中，对照组（能化组）则先加５ｍＭ琥珀酸５μｌ，使用日立８５０荧光分光光度仪加偏振…     

细胞表面半乳糖基转移酶介导外胎盘锥扩展和次生滋养层巨细胞迁移的证据

细胞表面半乳糖基转移酶（ＧａｌＴａｓｅ）是层粘连蛋白（ＬＮ）非整合素类受体，能与其上寡糖链的Ｎ－乙酰葡糖胺（ＧｌｃＮＡｃ）残基识别和结合。作者从妊娠第８．５天雌鼠子宫蜕膜中剥离胚胎，显微分离外胎盘锥（ＥＰＣ）后进行体外培养。用（１）ＬＮ预先半乳糖基化；（２）外源ＧｌｃＮＡｃ底物竞争；（３）ＧａｌＴａｓｅ抗体阻断；（４）α乳清蛋白处理等方法干扰滋养层细胞与ＬＮ的相互作用，均对ＥＰＣ粘附无影响，但抑制ＥＰＣ扩展和次生滋养层巨细胞（ＳＴＧＣｓ）迁移。证明ＧａｌＴａｓｅ虽不参与ＥＰＣ起初的粘附，但通过与ＬＮ寡糖链上ＧｌｃＮＡｃ的结合介导ＥＰＣ扩展和ＳＴＧＣｓ迁移。     

内镜及非手术综合疗法治疗重症急性胰腺炎

我院近１０年来开展内镜鼻胆（胰）管引流［Ｅｎ－ｄｏｓｃｏｐｉｃｎａｓｏ－ｂｉｌｌａ（ｐａｎｃｒｅａｔｉｃ）ｄｒａｉｎｇｅ,ＥＮＢ（Ｐ）Ｄ］及内镜乳头括约肌切开术（Ｅｎｄｏｓｃｏｐｉｃｓｐｈｉｎｃｔｅｒｏｔｏｍｙ,ＥＳＴ）治疗３６例重症急性胰腺炎（ＳＡＰ）（１９８６年４月起开展ＥＮＢ（Ｐ）Ｄ,１９９４年１０月后开展ＥＮＢ（Ｐ）Ｄ及ＥＳＴ）,探索内镜对ＳＡＰ的治疗效果和临床应用价值报道如下。资料与方法１．一般资料本组男１４例,女２２例,年龄２２～７９岁,平均５４．６岁。其中６０岁以上１６例。２８例合…     

核素在血管性阳萎诊断中的应用

阳萎（Ｉｍｐｏｔｅｎｃｅ），现在文献中多称为勃起功能障碍（ＥｒｅｃｔｉｌｅＤｙｓｆｕｎｃｔｉｏｎ，ＥＤ），是一种常见的难治性泌尿男科疾病。据文献报道，美国有不少于三千万男子患有程度不同的ＥＤ。国内虽然缺乏具体的统计资料，但估计ＥＤ患者人数也非常可观。...     

1，25二羟维生素D3对乳腺癌细胞株生长及凋亡的影响

目的　研究１ ，２５ 二羟维生素 Ｄ３［１ ，２５（ Ｏ Ｈ）２ Ｄ３］ 对乳腺癌细胞株 Ｍ Ｃ Ｆ７ 生长及凋亡的影响。　方法　采用四唑氮蓝比色（ Ｍ Ｔ Ｔ） 法检测细胞增殖，光镜和电镜形态学观察，流式细胞仪测定细胞周期和凋亡率，末端脱氧核苷酸转移酶介导的原位酶标记（ Ｔ Ｕ Ｎ Ｅ Ｌ） 法计数凋亡细胞，免疫印迹法检测ｂｃｌ２ 蛋白表达。　结果　１０ － ７ ｍｏｌ／ Ｌ 的１ ，２５（ Ｏ Ｈ）２ Ｄ３ 就可以抑制 Ｍ Ｃ Ｆ７ 增生，改变细胞周期时相分布，致 Ｇ０／ Ｇ１ 期阻滞，加强细胞毒性化疗药阿霉素（ Ａｄｒ） 的作用，促进细胞凋亡，下调ｂｃｌ２ 蛋白表达。　结论　１ ，２５（ Ｏ Ｈ）２ Ｄ３ 可以作为细胞调亡诱导剂成为新一类乳腺癌激素治疗药。     

上皮钙粘附素和树突细胞在膀胱癌中的表达及临床意义

目的：探讨膀胱癌中树突细胞（ＤＣ）和上皮钙粘附素（Ｅ－ｃｄ）的表达及其与生物学行为的关系。方法：采用免疫组织化学ＬＳＡＢ法检测Ｅ－ｃｄ和ＤＣ。结果：６９例膀胱癌中３５例Ｅ－ｃｄ正常表达（５０．７％）,２２例ＤＣ正常表达（３１．９％）,Ｅ－ｃｄ正常表达率在Ⅰ,Ⅱ,和Ⅲ级肿瘤中分别为７２．２％,６５．２％和２５．０％,在Ｔｉｓ￣１期和Ｔ２￣４期肿瘤中分别为７８．８％和２５．０％。ＤＣ正常表达率在Ⅰ、Ⅱ     

同位素技术能诊断阳萎吗?

同位素技术能诊断阳萎吗？阳萎（Ｉｍｐｏｔｅｎｃｅ），现在文献中多称为勃起功能障碍（ＥｒｅｃｔｉｌｅＤｙｓｆｕｎｃｔｉｏｎ，ＥＤ），是一种常见的难治性男科疾病。据文献报道，美国有不少于三千万男子患有程度不同的ＥＤ。国内虽然缺乏具体的统计资料，但估计ＥＤ...     

阿仑膦酸钠联合钙尔奇D与钙尔奇D单药治疗对老年女性糖尿病骨质疏松疗效的观察

目的观察阿仑膦酸钠(ALN)联合钙尔奇D与钙尔奇D单药治疗老年女性糖尿病骨质疏松症的骨密度变化以及ALN的安全性。方法老年女性2型糖尿病(T2DM)骨质疏松患者72例,随机分为:ALN联合钙尔奇D组37例,给予ALN(70mg/w)和钙尔奇D(600mg/d);钙尔奇D组35例(600mg/d)总疗程6个月。采用双能X线骨密度测量仪(DXA)测定治疗前后腰椎及髋部骨密度。结果钙尔奇D组治疗前后腰椎及髋部骨密度各部位均有增加,但仅在L1及L4部位T值治疗前后有统计学差异(P0.05);ALN联合钙尔奇D治疗组,腰椎和髋部骨密度均有增加,尤其在腰椎的L1、L3、L4及L总部位均有统计学意义(P0.05)。ALN主要不良反应为上腹部不适,钙尔奇D则以便秘为主。结论ALN联合钙尔奇D治疗可以明显提高老年女性糖尿病骨质疏松患者的骨密度,并具有良好的耐受性和安全性。     

利维爱对绝经后骨质疏松妇女骨密度及骨代谢的影响

目的探讨利维爱治疗绝经后骨质疏松症的疗效及副反应情况.方法根据骨密度测定的结果,将61例自然绝经的骨质疏松妇女随机分成两组,治疗组（利维爱组）33例,对照组（钙尔奇-D组）28例.治疗组予以利维爱2.5 mg/d,3个月,继以1.25 mg/d,9个月,联合钙尔奇-D 600 mg/d,疗程1年;对照组仅予以钙尔奇-D 600 mg/d,疗程1年.观察治疗前后腰椎（L2-4）、股骨颈（FN）、Ward三角区、大转子（GT）骨密度（BMD）、骨钙素（BGP）、前胶原氨端肽原（PINP）的变化,以及治疗前后体重指数（BMI）、阴道出血、乳房胀痛变化的情况.BGP及PINP均采用放射免疫法测定.结果治疗组应用利维爱联合钙尔奇-D治疗1年后,各部位骨密度均有较显著的上升,BGP及PINP不同程度的下降,与对照组治疗后比较差异有显著性,对照组治疗前后无变化.治疗组与对照组治疗前后体重指数无明显变化,两组间比较无差异.治疗组治疗1年期间,1例患者出现阴道出血,2例出现乳房胀痛,继续服药后症状消失.结论利维爱能有效增加绝经后骨质疏松妇女骨密度,且副反应少,患者耐受性良好.     

经皮用雌二醇凝胶预防绝经早期骨丢失用量的探索

探索经皮用雌激素凝胶对中国妇女预防绝经早期骨丢失的用量 ,进行 2年开放随机前瞻性研究。采用周期性联合应用雌孕激素 ,雌激素为经皮用雌二醇 (E2 )凝胶 ,孕激素为口服微粉化孕酮 (microprogesterone,MP)和醋甲羟孕酮 (MPA)。 60名妇女 ,身体健康 ,绝经 1～ 5年 ,随机进入 4组 :G1 :E2 1 .5 mg/ d+ MP1 0 0 mg/ d;G2 :E2 1 .5mg/ d+ MPA 2 mg/ d;G3 :E2 0 .75 mg/ d+ MP 1 0 0 mg/ d;G4:E2 0 .75 mg/ d+ MPA 2mg/ d。每日睡前应用 ,每月连用 2 5 d。用 SPA法测前臂骨密度 (CBMD) ;QCT法测腰椎松质骨骨密度 (TBMD) ;DEXA法测腰椎 (L 2 -4 )与髋部骨密度。分别在用药 0、 6、1 2、 1 8和 2 4个月时测量骨密度、骨代谢生化指标、评分绝经症状及骨质疏松症状及记录阴道出血。结果 :5 9名 (98% )完成 1年 ;5 6名 (93 % )完成 2年。用药 6个月时 4组症状平均缓解约 80 % ;2年时腰椎 TBMD平均升高 4.3 %～ 7.5 % ;L 2 -4升高 2 .7%～4.5 % ;股骨颈升高 2 .0 %～ 4.2 %。E2 1 .5 mg(G1 + G2 )与 E2 0 .75 mg(G3 + G4)比较 ,对骨密度的改善无显著性差异 (P=0 .0 7～ 0 .93 )。不规则阴道出血率 G2最高 (41 .3 % )、G3最低 (1 0 .2 % )。结论 :每日经皮用 0 .75 mg E2 凝胶可有效缓解绝经相关症状 ,预防绝经早期     

The effect of ipriflavone on osteopenia in ovariectomized women

This study evaluated the preventative effect of ipriflavone on osteopenia in 21 female patients who had either reached natural menopause or had been bilaterally ovariectomized at least 3 years before the beginning of the study. Out of the 21 patients, 18 had been ovariectomized, 11 of whom were monitored continuously for more than 48 weeks. These 11 patients were divided into groups A and B. The remaining three patients who reached natural menopause were administered the drug for less than 48 weeks, and were excluded from the study. Ipriflavone 600 mg/day was administered to group A (n=4), and ipriflavone 600 mg plus ‘Premarin’ 0.625 mg/day to group B (n=7), each day for 48 weeks. The bone mineral density (BMD) of L2–L4 of the subjects who were monitored continuously for 48 weeks was measured using dual-energy x-ray absorptiometry (DXA) (Norland XR-26). The BMD of those subjects who received ipriflavone alone decreased only slightly for the first 36 weeks, a smaller decrease than those who did not, and at 48 weeks a slight improvement appeared. Those subjects receiving ipriflavone plus ‘Premarin’ showed an increase in BMD at 24 weeks but at 48 weeks the BMD had returned to the pretreatment level. Next we divided groups A and B into 2 sub-groups (A₁, A₂; B₁, B₂) according to their BMD levels following the 48-week treatment. In all groups, there was a tendency for serum osteocalcin, urinary hydroxyproline/creatinine ratio, and urinary calcium/creatinine ratio to decrease; the decrease in the hydroxyproline/creatinine ratio was especially evident in groups A₁ and B₁. Thus, our study suggested ipriflavone, administered alone, had a potentially preventative effect on rapid bone loss in females who had recently been ovariectomized.     

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer

The aim of this study was to assess the effect of adjuvant anastrozole, alone or associated with risedronate, on BMD and bone fracture risk in women more than 70 years old with hormone receptor-positive early breast cancer (EBC). In a group of 51 elderly women (aged 76.4 ± 5.0 years) considered for adjuvant aromatase inhibitors for EBC, 24 patients with T-scores ≥ -2 and no prevalent fractures received anastrozole 1 mg/day (group A), and 27 patients with T-scores < -2, or with T-scores ≥ -2 and prevalent fractures (group B), received anastrozole (1 mg/day) plus risedronate (35 mg/week). Both groups received supplementation with 1 g calcium carbonate and 800 IU vitamin D per day. Differences in BMD and frailty fractures were evaluated after 1 and 2 years. In group A, significant decreases in BMD were observed in the lumbar spine (Δ BMD, -0.030 ± 0.04 g/cm(2), P < 0.05), femoral neck (Δ BMD, -0.029 ± 0.05 g/cm(2), P < 0.05), and trochanter (Δ BMD, -0.026 ± 0.03 g/cm(2), P < 0.01) after 2 years. The greatest percent reduction in height (Hpr) emerged in the thoracic spine (3.6 ± 2.4%, P < 0.01), although only one incident vertebral fracture was observed. In group B, BMD increased in the lumbar spine (Δ BMD, 0.038 ± 0.04, P < 0.001), although no significant changes were seen in the hip regions. The decline in Hpr was negligible (about 1%). No incident fractures were observed at follow-up. In conclusion, anastrozole treatment for EBC in elderly women seems to have only mild negative effects on the femoral bone. Risedronate makes the use of anastrozole safer, even for osteopenic or osteoporotic elderly patients.     

Toxicity and effects of adjuvant therapy in colon cancer: results of the german prospective, controlled randomized multicenter trial fogt-1

In this adjuvant three-arm multicenter trial, we studied whether modulating the standard 5-fluorouracil (S-FU) treatment with either folinic acid (FA) or interferon-alpha-2_a (IFN-α) was superior to the recommended standard of adjuvant treatment in RO resected colon cancer, 5-FU plus levamisole (LEV) for 12 months, in terms of toxicity and outcome. From July 1992 to October 1999, a total of 813 patients with resected colon cancer in stage II (T4N0M0; n = 63) or stage III (TxNl-3M0; n = 750) were randomized into three treatment groups and stratified according to N stage and participating centers (64 hospitals). The patients received a postoperative loading dose of S-FU (450 mg/m² on days 1 to 5 [arms A and C]) or S-FU (450 mg/m²) plus FA (Rescuvolin, Medac, Hamburg, Germany, 200 mg/m² on days 1 to 5 [arm BJ). After completion of the first chemotherapy cycle, LEV was administered orally at a dosage of 1.50 mg per day on days 1 to 3, once every 2 weeks. After a 4-week chemotherapy-free interval, the treatment was continued weekly for 52 weeks. Treatment in one arm A ("standard") (n = 279) consisted of 5-FU intravenously (450 mg/m² on day 1, once a week) plus LEV 5-FU plus LEV was modulated in arm B (n = 283) with FA (200 mg/m² on day 1, once a week) and in arm C (n = 251) with IFN-α at 6 million units three times a week repeated weekly. Treatment dosages were adjusted if toxic events above WHO grade 2 occurred. Patients were closely followed to determine recurrence and survival; the latter was calculated according to Kaplan-Meier analysis. Toxic events above WHO grade 2, mainly leukopenia, diarrhea, and nausea, occurred in 113 (14%) of 649 patients who had completed treatment in arms A (8.4%), B (13.5%), and C (31.7%). Discontinuance rates were as follows: 28% for all patients, 29% in arm A, 21% in arm B, and 34% in arm C. Overall relapse rates were 27% for all patients, 30% in arm A, 24% in arm B, and 28% in arm C. Relapses were local (8%) distant (78%), or combined (12%). Fouryear overall survival rates in arms A, B, and C were 66.1%, 77.5%, and 66.2%, respectively. The 4-year survival rate in arm B was significantly higher compared to arm A (P <0.02, log-rank test) with arm A being equal to arm C. Adjuvant therapy with 5-FU plus FA plus LEV for 12 months is superior to the recommended standard (5-FU + LEV for 12 months). IFN-α modulation of 5-FU (plus LEV) adds to the toxicity with no therapeutic benefit.     

不同用药方案阿仑磷酸钠治疗老年性骨质疏松症的临床疗效分析

目的探讨阿仑膦酸钠的不同给药方案防治老年性骨质疏松症的临床疗效与安全性。方法采用随机平行对照实验,连续入选600例老年性骨质疏松症患者,按给药间隔分成两组。A组为常规间隔,每周1次口服阿仑膦酸钠70 mg;B组为长间隔,每两周口服阿仑膦酸钠70 mg。两组均联用钙尔奇D600每日1片。测定两组治疗前、治疗26、52 w的骨密度值,检测治疗前、治疗13、52 w的血清钙、磷、碱性磷酸酶水平及尿钙/肌酐比值;观察不良反应与新生骨折的发生情况。结果与治疗前相比,治疗26、52 w两组骨密度均明显增加,差异有统计学意义(P0.05);而两组骨密度变化率比较无显著差异(P0.05)。与治疗前相比,治疗13、52 w两组血清碱性磷酸酶水平、尿钙/肌酐比值均明显减少,差异有显著统计学意义(P0.01);血钙、血磷水平无明显变化。A、B两组治疗52w总有效率分别为85.31%和84.89%,差异无统计学意义(P0.05);不良反应发生率分别为9.09%和3.60%,差异有显著统计学意义(P0.01)。两组均无新生骨折发生。结论阿仑膦酸钠防治老年性骨质疏松症安全有效。与常规间隔用药相比,延长用药间隔的临床疗效相似、不良反应发生率较低,更为便捷经济。因此,阿仑膦酸钠间断、小剂量的用药方案在临床值得推荐。     

Efficacy of low-dose,intermittent eel calcitonin treatment for osteoporosis

The efficacy of low-dose intermittent calcitonin treatment for osteoporosis was evaluated. Twenty subjects (19 women, 1 man, mean age 59.1 ± 8.1) who exhibited osteopenia on plain X-ray were treated once a week with either a 10-IU or 20-IU i.m. injection of eel calcitonin (Elcatonin). Bone mineral density (BMD) of the lumbar spine as determined by dual photon absorptiometry significantly increased in the 20-IU group at 3 (7.2%) and 6 (10.7%) months, while the results were not significant in the 10-IU group (2.0% and 2.4%, respectively). Forearm BMD assessed by single photon absorptiometry did not change significantly in either group. The urinary hydroxyproline/creatinine ratio was significantly suppressed in both groups (P < 0.05). Serum bone Gla-protein showed a tendency to increase at 6 months in both groups. Spontaneous back pain disappeared by the end of this study in all patients who received 20IU per week, although it persisted in some of the patients in the 10-IU group. These results suggest that low-dose, intermittent calcitonin is effective at least after 6 months in the treatment of osteoporosis with a minimum dose of calcitonin at 20IU per week.     

降钙素治疗骨质疏松症骨质量病变的研究

目的研究降钙素在骨质疏松症治疗中对骨密度bonemineraldensityBMD、骨强度及骨质疏松脆性骨折发生率的作用。方法为期1年的单中心、前瞻性、随机研究135例原发性骨质疏松症女性患者随机分成降钙素 钙剂组和钙剂组,进行开放、对比研究。降钙素 钙剂组66例鲑鱼降钙素50IU,肌内注射,第1周每天1次,第2周隔日1次,以后每周2次;同时口服元素钙600mg每天1次。钙剂组69例元素钙600mg每天1次。治疗前后分别进行血清钙、磷、碱性磷酸酶、骨钙素、尿羟脯氨酸、双能X线BMD和超声骨强度测量以及脊椎胸腰段正、侧位X线片比较。结果治疗1年后,降钙素 钙剂组53例获随访,与治疗前比较,腰椎BMD上升约1%P<0.05,髋部BMD无明显变化,桡骨和胫骨骨强度均明显改善;钙剂组59例获随访,腰椎、髋部BMD和桡骨、胫骨骨强度均较治疗前下降P<0.05。两组治疗前后各项生化检测指标无明显变化,骨质疏松脆性骨折的发生率钙剂组明显高于降钙素 钙剂组。结论降钙素治疗骨质疏松症有良好作用,不仅能有效地缓解骨痛,还能确实提高骨质量,降低骨质疏松脆性骨折的发生率。     

Quantifying the effect of changes in the hemodialysis prescription on effective solute removal with a mathematical model

One potential benefit of chronic hemodialysis (HD) regimens of longer duration or greater frequency than typical three-times-weekly schedules is enhanced solute removal over a relatively wide molecular weight spectrum of uremic toxins. This study assesses the effect of variations in HD frequency (F: per week), duration (T: min per treatment), and blood/dialysate flow rates (QB/QD: ml/min) on steady-state concentration profiles of five surrogates: urea (U), creatinine (Cr), vancomycin (V), inulin (I), and beta2-microglobulin (beta2M). The regimens assessed for an anephric 70-kg patient were: A (standard): F = 3, T = 240, QB = 350, QD = 600; B (daily/short-time): F = 7, T = 100, QB = 350, QD = 600; C/D/E (low-flow/long-time): F = 3/5/7, T = 480, QB = 300, QD = 100. HD was simulated with a variable-volume double-pool model, which was solved by numerical integration (Runge-Kutta method). Endogenous generation rates (G) for U, Cr, and beta2M were 6.25, 1.0, and 0.17 mg/min, respectively; constant infusion rates for V and I of 0.2 and 0.3 mg/min, respectively, were used to simulate middle molecule (MM) G values. Intercompartment clearances of 600, 275, 125, 90, and 40 ml/min were used for U, Cr, V, I, and beta2M, respectively, For each solute/regimen combination, the equivalent renal clearance (EKR: ml/min) was calculated as a dimensionless value normalized to the regimen A EKR, which was 13.4, 10.8, 6.6, 3.7, and 4.8 ml/min for U, Cr, V, I, and beta2M, respectively. For regimens B, C, D, and E, respectively, these normalized EKR values were U: 1.04, 0.96, 1.58, and 2.22; Cr: 1.03, 1.08, 1.80, and 2.55; V: 1.06, 1.32, 2.21, and 3.12; I: 1.05, 1.54, 2.57, and 3.62; beta2M: 1.00, 1.27, 1.73, and 2.19. The extent of post-HD rebound (%) was highest for regimens A and B, ranging from 16% (urea) to 50% (inulin), and lowest for regimen E, ranging from 6% (urea) to 28% (beta2M). The following conclusions can be made: (1) Relative to a standard three-times-weekly HD regimen of approximately the same total (weekly) treatment duration, a daily/short-time regimen results in modest (3 to 6%) increases in effective small solute and MM removal. (2) Relative to a standard three-times-weekly HD regimen, a three-times-weekly low-flow/long-time regimen results in comparable effective small solute removal and progressive increases in MM and beta2M removal. A daily low-flow/long-time regimen substantially increases the effective removal of all solutes.