CT导引下^125I粒子植入术治疗恶性肿瘤

目的评价CT导引下瘤体内植入治疗恶性肿瘤的操作方法、可行性、安全性及其疗效。方法7例8个病灶CT导引下穿刺并在瘤体内植入^125I粒子，其中恶性肿瘤3例（4个病灶），原发性肿瘤2例，转移性肿瘤2例。其中男性5例，女性2例，年龄42～81岁（平均51．2岁）。在CT导引下将^125I粒子植入病灶内，采用治疗计划系统计算布源，^125I粒子的放射性活动为22，26，30，33MBq／粒，较大活度的粒子间距为1．5cm，较小活度的粒子间距为1．0cm。结果7例粒子植入均顺利完成，术中无并发症发生，粒子在病灶内的分布与植入前计划基本一致。每个瘤体内植入^125I粒子数为10～30（平均14粒）。3例恶性骨肿瘤患者植入术后疼痛均有明显缓解。术后2～5个月复查CT，6个病灶明确缩小，1个病灶内出现坏死组织，1个病灶大小无明显变化。结论CT导引下瘤体内植入呵粒子近距离放射治疗恶性肿瘤是一种安全、有效、可靠的治疗方法。     

125Ⅰ粒子永久性植入在治疗恶性肿瘤中的应用

目的:评价在CT 导引下瘤体内125Ⅰ粒子永久性植入治疗恶性肿瘤的安全性及其疗效.方法:8例12个病灶(10次)行CT 导引下瘤体内125Ⅰ粒子植入,在 CT 导引下穿刺植入125Ⅰ粒子.植入术后立即及术后 2～5个月行CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效.结果:8例粒子植入均顺利完成 ,粒子分布满意,单个瘤体内植入125Ⅰ粒子数为2～60 粒(平均32.5粒) .未见急性并发症和与治疗相关的放射损伤.CT检查示3个病灶消失,7个病灶明显缩小,其余2个病灶大小无明显变化.植入术前及植入术后病灶平均直径分别为4.02 cm和2.16 cm (t=3.62, P＜0.05) .结论:CT导引下125Ⅰ粒子植入近距离放射治疗对原发及转移性恶性肿瘤的近期治疗效果满意.     

CT导引下125I粒子植入术治疗恶性肿瘤

目的评价CT导引下瘤体内植入治疗恶性肿瘤的操作方法、可行性、安全性及其疗效。方法7例8个病灶CT导引下穿刺并在瘤体内植入125I粒子,其中恶性肿瘤3例(4个病灶),原发性肿瘤2例,转移性肿瘤2例。其中男性5例,女性2例,年龄42～81岁(平均51.2岁)。在CT导引下将125I粒子植入病灶内,采用治疗计划系统计算布源,125I粒子的放射性活动为22,26,30,33MBq/粒,较大活度的粒子间距为1.5cm,较小活度的粒子间距为1.0cm。结果7例粒子植入均顺利完成,术中无并发症发生,粒子在病灶内的分布与植入前计划基本一致。每个瘤体内植入125I粒子数为10～30(平均14粒)。3例恶性骨肿瘤患者植入术后疼痛均有明显缓解。术后2～5个月复查CT,6个病灶明确缩小,1个病灶内出现坏死组织,1个病灶大小无明显变化。结论CT导引下瘤体内植入125I粒子近距离放射治疗恶性肿瘤是一种安全、有效、可靠的治疗方法。     

肝癌肝移植术后复发及肝外转移瘤的125I粒子植入治疗

目的评价CT导向下^125I粒子植入术治疗肝癌肝移植术后复发及肝外转移瘤的临床价值。方法肝癌肝移植术后复发及肝外转移瘤患者11例行^125I粒子植入术共33人次,年龄35—68岁,中位年龄56岁。所有患者病灶总数为45个,平均每人4．09个病灶,病灶平均直径为2．5cm。术前采用治疗计划系统（TPS）计算布源,术中将活度为30MBq的^125I粒子在CT导向下植入肿瘤病灶内。粒子按照0．5—1．0cm平面插植。肿瘤周边匹配剂量（MPD）100—150Gy,每个患者植入粒子数10—100颗不等。结果45个病灶,完全缓解（CR）17个;部分缓解（PR）20个;无变化（NC）7个;进展（PD）1个。总有效率为82．2％。术中1例出现气胸,肺压缩在30％以内,经保守治疗好转,手术中少量出血者3例;术后1周痰中带血,体温升高者5例。2个月随访过程中发生粒子移位2例;白细胞下降2例,程度较轻。未见大出血、胆汁瘘、胰瘘等严重并发症。结论CT导向下^125I粒子植入术治疗肝癌肝移植术后复发及转移瘤疗效确切,创伤小,并发症少。     

CT导引下^125粒子组织间植入治疗恶性肿瘤中的应用和进展

CT导引下植入^125I粒子治疗恶性肿瘤是一种新的治疗方法，它应用TPS计划系统，按照治疗计划将^125I粒子在CT导引下穿刺植入到恶性肿瘤内，在术后用CT检查观察粒子在瘤体内的分布、有无并发症及疗效。主要适用于未经治疗的原发肿瘤、手术难以切除的侵犯重要功能组织及器官的肿瘤、复发或转移的肿瘤治疗。此种治疗方法安全、有效，可行，并发症发生率低．目前已成为治疗恶性肿瘤的重要手段之一。     

放射性粒子~(125)I在肺癌治疗中的临床探讨

目的:探讨在CT引导下组织间植入125I粒子治疗肺部恶性肿瘤的方法和疗效。方法:选取2008年5月-2011年2月的36例肺癌患者(其中鳞癌22例,腺癌11例,肺泡细胞癌3例,均为周围型肺癌,病灶直径2.0～12cm大小不等)采用治疗计划系统(TPS)计算布源,在螺旋CT导引下将125I粒子植入病灶内,术后2～6个月CT复查,随访6个月。结果:36例肺癌患者的52个病灶粒子植入均顺利完成,52个病灶共植入粒子2 340粒,平均每个瘤体内植入45粒。术后2～6个月CT复查,完全缓解(CR)14例,部分缓解(PR)20例,无变化(NC)2例,总有效率(CR+PR)为94%。仅在粒子植入后,8例出现少量气胸,保守治疗后痊愈。未见其他严重并发症和治疗相关的放射性损伤。结论:在CT引导下经皮穿刺125I粒子植入治疗肺癌是一种简便易行、疗效好、安全且发病症少的微创治疗手段。     

CT引导下125I粒子植入治疗肺癌的临床分析

目的观察125I粒子植入治疗肺癌的临床疗法。方法 25例均不适宜行外科手术治疗的恶性肿瘤患者,行CT导引下瘤体内125I粒子植入,其中原发肺癌16例,转移性肺癌9例。根据治疗计划系统（TPS）计算布源,采用18.5～37MBq活度的125I粒子,粒子间距一般在1.0～1.5cm左右。结果随诊CT复查25例患者：CR 8个,PR 10个,NC 7个。总有效率（CR＋PR）为72%。结论 125I粒子永久性植入治疗肺癌效果满意,并发症少,易于防护,有良好的临床应用前景。     

~(125)I粒子永久性植入组织间治疗恶性肿瘤(附16例报告)

目的探讨碘125（^125I）粒子组织间永久植入治疗恶性肿瘤的临床疗效。方法对16例B、C期各类恶性肿瘤行根治性手术联合^125I粒子植入或姑息性手术在肿瘤部位直接植入^125I粒子，以及CT引导下将呵粒子直接植入肺癌组织中。术后观察血象，临床表现，定期复查B超、X线及CT，了解肿瘤复发或转移情况。结果16例中存活时间最长达37个月。结论^125I粒子组织间永久性植入治疗中晚期恶性肿瘤是安全有效的，有一定的应用前景。     

CT引导下经皮放射性^125I粒子植入治疗恶性肿瘤的临床研究

目的探讨CT引导下经皮放射性^125I粒子植入治疗恶性肿瘤的临床应用价值。方法回顾性分析35例CT引导下经皮放射性^125I粒子植入治疗恶性肿瘤的临床资料。结果25患者顺利完成手术,无严重并发症,随访2～6月,完全缓解6例（17．14％）,部分缓解24例（68．58％）,病变稳定2例（5．71％）,进展3例（8．57％）,未出现放射相关副作用。结论CT引导下经皮放射性^125I粒子植入治疗恶性肿瘤具有创伤少、并发症少、疗效肯定、安全等优点。     

125I 粒子植入联合深部热疗治疗骨转移癌疼痛的临床观察

目的：探讨CT引导下^125I粒子植入联合深部热疗对于骨转移癌疼痛的治疗作用。方法：50例骨转移癌疼痛患者采用CT引导下^125I粒子植入术，粒子植入术后行深部热疗，治疗结束后1个月观察患者的疼痛控制率、患者的活动能力及不良反应。结果：治疗后1个月疼痛控制总有效率达96％，其中70％的患者疼痛能完全消失；活动能力改善总有效率96％，明显改善达68％；不良反应方面，皮肤硬结2例，穿刺口渗血3例、穿刺口疼痛5例，一过性低热2例。结论：CT引导下^125I粒子植入联合深部热疗治疗骨转移癌疼痛疗效确切，不良反应少，临床值得推广。     

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.