小剂量G—CSF对化疗引起的粒细胞减少症的治疗作用

应用小剂量（２μｇ／ｋｇ）粒细胞集落刺激因子（Ｇ－ＣＳＦ）于１８例肺癌患者化疗中，以观察预防发生中性粒细胞减少症的疗效。其中小细胞肺癌５例，非小细胞肺癌１３例，随机分成Ｇ－ＣＳＦ组及对照组各９例，化疗方案为ＣＥ（卡铂－ＶＰ１６）。结果Ｇ－ＣＳＦ组粒细胞绝对计数（ＡＮＣ）＜２．０×１０９／Ｌ，发生例数５例，持续天数为３．６±３．５天；对照组持续天数１６．８±７．１天，Ｐ＜０．０５。ＡＮＣ最低值至恢复正常（ＡＮＣ＞２．０×１０９／Ｌ）的天数Ｇ－ＣＳＦ组及对照组分别为２．６±１．３天，８．９±５．３天（Ｐ＜０．０５）。Ｇ－ＣＳＦ组化疗后的第２０天ＡＮＣ均已恢复正常，ＡＮＣ为（９．７±６．８）×１０９／Ｌ故可在第２２天顺利接受第二周期化疗。对照组ＡＮＣ（１．６６±０．８）×１０９／Ｌ（Ｐ＜０．０１）。由此可见，小剂量Ｇ－ＣＳＦ能有效地防治肺癌化疗引起的粒细胞减少症     

MVP和P-MVP方案治疗晚期非小细胞肺癌的效果

①目的　探讨ＭＶＰ和Ｐ－ＭＶＰ方案对晚期非小细胞肺癌（ＮＳＣＬＣ）的效果及免疫功能的影响。②方法　选择４２例晚期ＮＳＣＬＣ分别进行ＭＶＰ及Ｐ－ＭＶＰ方案各３ 周期的化疗,观察疗效、不良反应及免疫学指标、ＡｇＮＯＲｓ变化。③结果　ＭＶＰ组有效率４０．０％ ,Ｐ－ＭＶＰ组５４．５％ ,两组比较差异无显著性（χ２＝ ０．８９８,Ｐ＞ ０．０５）;ＮＳＣＬＣ病人的ＣＤ３,ＣＤ４,ＣＤ４／ＣＤ８ 均低于对照组（ｔ＝ ２．０８２～３．２７６,Ｐ均＜ ０．０５）。ＭＶＰ组治疗后上述指标较治疗前降低（ｔ＝ ２．０４２～３．０１３,Ｐ＜ ０．０５）,而Ｐ－ＭＶＰ组上述指标较治疗前无明显下降（ｔ＝ ０．９７２～１．８７８,Ｐ＞ ０．０５）,Ｐ－ＭＶＰ治疗后ＣＤ３,ＣＤ４ 及ＡｇＮＯＲｓ高于ＭＶＰ组（ｔ＝ ２．１２１～２．９７２,Ｐ＜ ０．０５）;ＭＶＰ组不良反应发生率及强度较Ｐ－ＭＶＰ组稍高。④结论　Ｐ－ＭＶＰ方案与ＭＶＰ方案比较虽然不能提高疗效,但可增强免疫功能。     

扶正保真汤对荷瘤鼠化疗增效实验研究

对荷人肺腺癌（ＳＰＣ－Ａ－１）、肉瘤（Ｓ１８０）ＢＡＬＢ／Ｃ小鼠采用扶正保真汤加环磷酰胺化疗合并治疗，与单用化疗组相比较。结果表明：扶正保真汤加化疗组抑瘤率较高（Ｐ＜０．０１）；且能升高瘤组织内ｃＡＭＰ水平，提高ｃＡＭＰ／ｃＧＭＰ值（Ｐ＜０．０５）；增加Ｇ０＋Ｇ１期细胞，减少Ｓ期细胞（Ｐ＜０．０５）；降低血清ＴＮＦ－α水平及ＭＤＡ含量（Ｐ＜０．０１）；提高Ｔ－ＳＯＤ活力（Ｐ＜０．０１）。提示扶正保真汤能增加化疗疗效     

扶正保真汤对荷瘤鼠化疗增效实验研究

对荷人肺腺瘤（ＳＰＣ－Ａ），肉瘤（Ｓ１８０）ＢＡＬＢ／Ｃ小鼠采用扶正保真汤加环磷酰胺化疗合并治疗，与单用化疗组相比较。结果表明；扶正保真汤加化疗组抑瘤率较高（Ｐ〈０．０１）；且能升高瘤组织内ｃＡＭＰ水平，提高ｃＡＭＰ／ｃＧＭＰ值（Ｐ〈０．０５），增加Ｇ０＋Ｇ１期细胞，减少Ｓ期细胞（Ｐ〈０．０５）；降低血清ＴＮＦ－α水平及ＭＤＡ含量（Ｐ〈０．０１），提高Ｔ－ＳＯＤ活力（Ｐ〈０．０１）。提示扶正保真汤     

急性颅脑损伤患者脑脊液中髓鞘碱蛋白的变化及其意义

目的：为探讨急性颅脑损伤患者脑脊液（ＣＳＦ）中髓鞘碱蛋白（ＭＢＰ）的变化及意义。方法：用放射免疫分析法测定３４例急性颅脑损伤组患者ＣＳＦ中ＭＢＰ。结果：ＣＳＦ中ＭＢＰ在急性颅脑损伤组明显高于对照组（Ｐ＜０．０１）,在ＡＤＣＩ患者明显高于ＡＬＣＩ患者（Ｐ＜０．０１）;ＡＤＣＩ患者入院时ＧＣＳ明显低于ＡＬＣＩ患者,而ＧＯＳ明显差于ＡＬＣＩ患者（Ｐ＜０．０１）;ＭＢＰ与ＧＣＳ和ＧＯＳ均呈明显负相关（ｒ＝－０．６１２,ｒ＝－０．５９８,Ｐ＜０．０１）。结论：急性颅脑损伤患者ＣＳＦ中ＭＢＰ升高,测定ＣＳＦ中ＭＢＰ有助于估计急性颅脑损伤患者病情轻重及预后;有助于ＡＤＣＩ的诊断。     

粒细胞集落刺激因子治疗粒细胞缺乏症28例疗效观察

用重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）治疗粒细胞缺乏症（粒缺）２８例，观察其临床疗效，并与未用ｒｈＧ－ＣＳＦ而其他治疗相同的对照组２０例比较。结果，２３例（８２．１％）中性粒细胞数升至≥０．７×１０９／Ｌ，其中１９例（６７．９％）升至≥１．０×１０９／Ｌ，均显著高于对照组的５５．０％和３５．０％（Ｐ＜０．０５）；ｒｈＧ－ＣＳＦ治疗组并发感染治疗有效率（７５．０％）亦显著优于对照组（Ｐ＜０．０５），且平均发热时间较短（Ｐ＜０．０５）。分析认为，ｒｈＧ－ＣＳＦ治疗粒缺有满意疗效，无明显副反应，可列为首选药物。     

G-CSF和GM-CSF对髓系白血病细胞增殖的影响

目的 了解粒细胞集落刺激因子（Ｇ－ＣＳＦ）和粒细胞－巨噬细胞集落刺激因子（ＧＭ－ＣＳＦ）对髓系白血病细胞增殖的影响。方法 采用甲基纤维素半固体培养法培养白血病细胞集落（ＣＦＵ－Ｌ）,观察Ｇ－ＣＳＦ和ＧＭ－ＣＳＦ对１１例ＡＭＬ和ＣＭＬ患者外周血ＣＦＵ－Ｌ形成的影响。结果 ＣＭ－ＣＳＦ对ＣＦＵ－Ｌ的促进作用明显高于Ｇ－ＣＳＦ（Ｐ＝０．０１２）,而Ｇ－ＣＳＦ对ＣＦＵ－Ｌ形成影响与对照组没有显著性差别（Ｐ＝０．４９５）。结论 Ｇ－ＣＳＦ对髓系白血病细胞体外增殖无明显影响,作为髓系白血病大剂量化疗的支持治疗可能更为安全。     

骨髓增生异常综合征细胞增值活力的研究

用流式细胞仪（ＦＣＭ）ＤＮＡ单参数和ＤＮＡ／膜抗原双参数法对４１例骨髓增生异常综合征（ＭＤＳ）患者和１０例良性血液病病人骨髓细胞的增殖活力进行了研究。ＭＤＳ骨髓细胞Ｇ０／Ｇ１期百分率明显高于对照组（Ｐ＜０．０５），（Ｓ＋Ｇ２）／Ｍ期百分率明显低于对照组（Ｐ＜０．０５），（Ｓ＋Ｇ２）／Ｍ期细胞中ＣＤ２＋细胞比例在原始细胞增多的难治性贫血（ＲＡＥＢ）较难治性贫血（ＲＡ）明显降低（Ｐ＜０．０５）。     

血浆免疫指标变化与糖尿病足部感染

目的:了解机体免疫功能在糖尿病足的变化,探讨糖尿病足的防治办法。方法:以健康志愿者(ＮＣ)和糖尿病(ＳＤＭ)患者为对照,动态观测糖尿病足(ＤＦ)治疗前及治疗过程中可溶性白介素－Ⅱ受体(ｓＩＬ－２Ｒ)、自然杀伤细胞活性(ＮＫＣＡ)、Ｔ淋巴细胞亚群(ＣＤ３、ＣＤ４、ＣＤ８)、免疫球蛋白(ＩｇＧ、ＩｇＭ、ＩｇＡ)、补体(Ｃ３、Ｃ４、ＣＨ５０)及空腹血糖(ＦＰＧ)、餐后２ ｈ血糖(ＰＧ２ｈ)。结果:①ＤＦ和 ＳＤＭ组ｓＩＬ－２Ｒ显著高于 ＮＣ组(Ｐ＜０．０５),ＮＫＣＡ及 ＣＤ４/ＣＤ８显著低于ＮＣ组(Ｐ＜０．０５);同时ＤＦ患者ｓＩＬ－２Ｒ较ＳＤＭ患者显著增高(Ｐ＜０．０５),ＮＫＣＡ及 ＣＤ４/ＣＤ８ 较ＳＤＭ患者显著降低(Ｐ＜０．０５);在 ＤＦ组中溃疡及坏疽患者 ｓＩＬ－２Ｒ显著高于高危足患者,ＮＫＣＡ显著低于高危足患者(均 Ｐ＜０．０５);②２５例 ＤＦ患者治疗后,ｓＩＬ－２Ｒ逐渐下降,ＮＫＣＡ、ＣＤ４/ＣＤ８逐渐升高,至观察终点与治疗前比较,三者差异均有显著性(Ｐ＜０．０５);③在ＤＦ患者,ｓＩＬ－２Ｒ与病情严重性呈显著正相关(ｒ＝０．７３４,Ｐ＜０．０１),与治疗过程中ＰＧ２ｈ变化亦呈显著正相关(ｒ＝０．４６７,Ｐ＜０．０５),ＮＫＣＡ与ＦＰＧ,ＰＧ２ｈ呈显著负相关(ｒ＝     

MVP和P—MVP方案治疗晚期非小细胞肺癌的效果

①目的 探讨ＭＶＰ和Ｐ－ＭＶＰ方案对晚期非小细胞肺癌（ＮＳＣＬＣ）的效果及免疫功 能的影响。②方法选择４２例晚期ＮＳＣＬＣ分别进行ＭＶＰ及Ｐ－ＭＶＰ方案各３周期的化疗、不良反应及免疫学指标、ＡgＮＯＲs变化。③结果ＭＶＰ组有效率４０．０％,Ｐ－ＭＶＰ组５４．５％,两组比较差异无显著性（χ＾２＝０．８９８,Ｐ＞０．０５）;ＮＳＣＬＣ病人的ＣＤ３,ＣＤ４,ＣＳ４/ＣＤ８均低于对照组（t＝２．０８２～３．２７     

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.