应用网织红细胞计数评价重组人红细胞生成素治疗慢性肾衰竭的疗效探讨

目的探讨网织红细胞计数（Ret）在应用重组人红细胞生成素（rhEPO）治疗慢性肾衰竭中的变化及临床意义。方法用仪器法对54例慢性肾衰竭患者治疗前后的网织红细胞及其参数进行测定，并将治疗后2d、7d的结果与治疗前比较进行分析。结果慢性肾衰竭患者红细胞计数（RBC）和血红蛋白浓度（Hb）治疗后比治疗前结果不具显著性上升（P〉0.05），治疗后Ret比治疗前极显著性升高（P〈0．01）。结论Ret作为用rhEPO治疗慢性肾衰竭（CRF）的观察指标比其它红细胞参数更敏感。     

大剂量低频率使用 rhEPO 治疗血液透析贫血患者的疗效

【目的】观察大剂量低频率注射重组人促红细胞生成素（rhEPO ）治疗维持性血液透析贫血患者的临床疗效。【方法】对30例慢性肾功能衰竭（CKD 5期）维持性血液透析合并贫血患者,采用 rhEPO （10000 IU/支）,每周1次皮下注射,治疗期间监测患者血红蛋白（Hb）,红细胞比容（HCT ）,外周血白细胞计数,血小板计数,肝肾功能,电解质,血压等指标及用药期间的不良反应,比较治疗前后患者贫血状况的改善情况。【结果】治疗前后患者Hb、HCT相比较差异具有显著性（ P＜0．01）,30例患者中显效2例,有效26例;无效2例,总有效率为93％（28/30）;治疗前后患者白细胞,血小板,血脂,肝肾功能,电解质无明显变化（ P ＞0．05）;【结论】大剂量低频率使用rhEPO治疗慢性肾衰竭贫血患者,疗效显著,使用安全,可明显改善患者贫血症状,提高生活质量。     

rhEPO治疗老年慢性病合并贫血临床疗效观察

目的：探讨重组人促红细胞生成素（rhEPO）治疗老年慢性病合并贫血的临床疗效。方法随机选择100例老年慢性贫血病例,分为观察组和对照组各50例。对照组给予常规治疗;观察组给予rhEPO治疗,比较两组患者的治疗效果。结果治疗前两组患者血红蛋白（Hb）、平均红细胞血红蛋白（MCH）、平均红细胞容积（MCV）、平均红细胞血红蛋白浓度（MCHC）、血清铁蛋白（SF）、血清铁（SI）、血清转铁蛋白受体（STIR）差异无统计学意义（P均＞0.05）;治疗后观察组Hb、MCV、MCHC、SF、STIR方面改善显著,均优于对照组（P均＜0.05）;治疗后观察组各症状改善情况均优于对照组,差异有统计学意义（P＜0.05）。结论rhEPO治疗老年慢性病贫血,疗效确切,值得临床推广。     

重组人红细胞生成素治疗化疗相关性贫血临床观察

目的 观察重组人红细胞生成素(reecmbinant human erythropoietin，rhEPO)治疗肿瘤化疗诱发贫血的疗效及安全性。方法 46例化疗治疗诱发贫血的患者分为rhEPO治疗组(23例)和对照组(23例)。治疗组给予rhEPO。对照组不给rhEPO，其他治疗相同。观察rhEPO对血红蛋白、输血、生活质量的影响及副反应。结果 治疗组血红蛋白平均提高17．4g／L，而对照组无改变。治疗组KPS评分与对照组比较显著提高。结论 rhEPO是治疗肿瘤化疗诱发贫血的安全、有效药物，能提高血红蛋白水平，改善生活质量。     

重组人红细胞生成素在肿瘤相关贫血中的应用

重组人红细胞生成素（rhEPO）用于治疗慢性肾衰性贫血的疗效已众所周知,使90％～95％的贫血患者得以纠正,生活质量得到提高,并大大减少了异体输血对患者的危害。80年代末和90年代初,有人就rhEPO对其他原因所致贫血的疗效进行了研究,特别是对肿瘤相关性贫血的研究,其中包括肿瘤性贫血及肿瘤化疗或放疗所致贫血。人们从事及关注rhEPO在肿瘤相关性贫血中的应用的主要原因是由于     

蔗糖铁治疗血液透析患者贫血疗效观察

肾性贫血是慢性肾功能衰竭维持性血液透析(HD)患者的重要并发症之一,严重影响患者的生存质量和寿命.重组人促红细胞生成素(rhEPO)的广泛应用,极大地改善了慢性肾功能衰竭的贫血状况,但临床实践发现,仍有相当数量的HD患者应用 rhEPO治疗后贫血状况未得到明显改善,影响其疗效的主要原因是铁缺乏.     

皮下与静脉注射重组人类促红细胞生成素对慢性肾衰竭患者贫血的疗效比较

目的比较皮下注射与静脉注射重组人类促红细胞生成素对慢性肾衰竭患者贫血的疗效。方法30例慢性肾衰竭患者分为皮下注射组15例，静脉注射组15例。皮下注射组每周给予重组人类促红细胞生成素75u／kg，每周2次，静脉注射组每周给予重组人类促红细胞生成素100u／kg，分2次使用，透析患者于透析后静脉注射。治疗共8周。结果2组病例在治疗前贫血状况无统计学差异（P〉0．05）；在应用促红细胞生成素治疗8周后，皮下注射组与静脉注射组贫血状况也无统计学差异（P〉0．05），皮下注射组高血压发生率低于静脉注射组。结论皮下注射较静脉注射重组人类促红细胞生成素用量小，节省费用，高血压发生率低，是较经济、有效的给药途径。     

老年慢性肾衰竭患者腹膜透析治疗的临床疗效分析

目的：研究腹膜透析和促红细胞生成素等综合治疗慢性肾衰竭的临床疗效变化。方法：对22例（61—82岁）慢性肾衰竭患者，进行了前瞻性的治疗研究，应用腹膜透析、重组人促红细胞生成素注射液宁红欣（rHuEPO）3000IU，每周2次或3次皮下注射。以后参考效果调整剂量。蛄果：经过腹膜透析与rHuEPO，治疗后患者病情明显好转，食欲普遍增进。体力增强。血晕均显著升高。肾功能明显好转。结论：腹膜透析与重组人红细胞生成素宁红欣等综合治疗慢性肾衰竭能取得满意的疗效。     

重组人红细胞生成素治疗老年髋部骨折围术期贫血效果研究的Meta分析

目的 系统评价重组人红细胞生成素（Recombinant human erythropoietin,rhEPO）对老年髋部骨折围术期失血性贫血的治疗效果。方法 通过检索重组人红细胞生成素（rhEPO）治疗老年髋部骨折围术期失血性贫血的临床研究文献,收集符合要求的随机对照试验（Randomized controlled trial,RCT）文献,运用Cochrane系统评价的方法,使用Revmen5.3软件进行Meta分析。结果 共纳入4篇文献,总计307例老年髋部骨折术后病例,结果显示,重组人红细胞生成素治疗老年髋部骨折围手术期失血性贫血术后输血率较对照组低[总输血率：OR=0.47,95%CI（0.26,0.83）,Z=2.59,P=0.01],血红蛋白（Hemoglobin,Hb）、红细胞压积（Hematocrit,Hct）均高于对照组[血红蛋白：OR=7.74,95%CI（3.86,11.61）,Z=3.91,P＜0.0001;红细胞压积：OR=2.95,95%CI（0.69,5.22）,Z=2.55,P=0.01],差异有统计学意义。结论 重组人红细胞生成素（rhEPO）治疗老年髋部骨折围术期失血性贫血有效。     

铁剂联合rhEPO在治疗肿瘤相关性贫血中的疗效研究

目的评价铁剂与重组促红细胞生成素（rhEPO）在治疗肿瘤相关性贫血中的疗效。方法69例肿瘤相关性贫血患者,分为铁剂治疗组（A组）、rhEPO治疗组（B组）,铁剂＋rhEPO治疗组（C组）以及对照组,所有患者均接受2周期的化疗,其中A、B、C组分别于每1个周期化疗结束48h后给予右旋糖酐铁150mg/d、rhEPO、右旋糖酐铁＋rhEPO治疗,3次/周,连续3周,共用6次。对照组仅接受2周期化疗。所有组别的其他辅助治疗相同,于第二个周期的rhEPO治疗结束后评价疗效。结果A、B、C 3组患者经过6周的治疗, Hb、HCT明显升高,同时患者的症状和生活质量有了一定改善,但C组疗效优于A、B组。结论应用铁剂十rhEPO治疗肿瘤相关性贫血疗效明显,能有效改善肿瘤相关性,提高生活质量。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.