超声药物透入治疗联合耳穴压豆对乳腺癌患者化疗后癌因性疲乏症状及生活质量的影响

[摘要] 目的：观察超声药物透入治疗联合耳穴压豆对乳腺癌患者化疗后癌因性疲乏症状及生活质量的影响。方法：采用随机数字表法将符合入选标准的90例乳腺癌化疗后患者分为观察组和对照组,每组均45例,对照组给予常规西医临床干预,观察组在对照组的基础上予超声药物透入联合耳穴压豆治疗治疗,2组连续治疗8周。观察记录两组癌性疲乏程度、多维疲乏症状量表－简短版(Multi-Dimensional Fatigue Symptom Inventory-Short Form, MFSI-SF)评分、单维度疲乏量表-简明疲乏量表(Brief Fatigue Inventory, BFI)评分、生存质量测定量表（Functional Assessment of Cancer Therapy-Breast, FACT-B）评分、匹兹堡睡眠质量指数（Pittsburgh sleep quality index, PSQI）评分改善状况,评估2组生存质量改善状况及不良反应发生状况。结果：观察组治疗前后疲乏程度比较差异有统计学意义（χ2=22.381,P＜0.05）,对照组治疗前后疲乏程度比较差异无统计学意义（χ2=2.496,P＞0.05）;观察组生活质量总改善率为86.7%,明显高于对照组生活质量总改善率68.9%（χ2=4.114,P＜0.05）;治疗后两组MFSI-SF评分和BFI评分均明显低于治疗前（P＜0.05）,且观察组上述评分均低于对照组（P＜0.05）;治疗后观察组FACT-B评分明显高于治疗前（P＜0.05）,PSQI评分明显低于治疗前（P＜0.05）,对照组治疗前后FACT-B评分和PSQI评分无统计学意义（P＞0.05）;两组均未出现明显不良反应。结论 超声药物透入治疗联合耳穴压豆能够有效缓解乳腺癌患者化疗后癌因性疲乏症状,提高患者生活质量,疗效确切,值得临床深入研究和推广。     

胸腹腔内灌注顺铂序贯微波热疗治疗癌性胸腹腔积液的临床观察

目的 观察腔内灌注化疗药物顺铂（DDP）联合热疗治疗癌性胸腹腔积液的疗效。方法 60例癌性胸腹腔积液病人随机分为两组，治疗组27例DDP胸腹腔内注入加热疗，对照组33例单用DDP胸腹腔内注入。结果 胸腹腔积液控制有效率治疗组为88．9％，对照组为60．6％，治疗组明显优于对照组（P＜0．05）。毒副作用无显差异（P＞0．05）。结论 DDP胸腹腔灌注化疗＋热疗有协同作用，能有效提高胸腹腔积液控制率，提高病人生存质量，值得临床推广使用。     

榄香烯注射液联合热疗治疗中度恶性胸腔积液临床观察

[目的] 探讨榄香烯注射液静脉点滴联合热疗治疗中度恶性胸腔积液的临床疗效。[方法] 选取中度恶性胸腔积液患者80例,其中肺癌64例,乳腺癌8例,肝癌5例、卵巢癌2例、前列腺癌1例。随机分为观察组（40例）,对照组（40例）。两组均予胸部高频热疗,隔日1次。观察组同期予静脉点滴榄香烯——0.4G榄香烯注射液加入0.9%氯化钠注射液250 mL中静脉点滴,每日1次,14 d为1个疗程。治疗1个疗程结束后1个月观察两组疗效、临床症状积分改善及功能状态改善情况。[结果] 在客观疗效方面,观察组客观有效率（37.5%）优于对照组（17.5%）,差异有统计学意义（P<0.05）;两组患者在临床症状积分、生活质量方面,差异有统计学意义（P<0.05）。在不良反应方面,观察组表现为发热1例、皮肤灼伤2例,差异无统计学意义（P>0.05）。[结论] 榄香烯注射液静脉点滴联合胸部高频热疗治疗中度恶性胸腔积液疗效较好,患者胸腔积液得到控制,临床症状积分降低,生活质量得到改善,无明显毒副作用,是保守治疗中度恶性胸腔积液较为理想的治疗方案。     

榄香烯与博莱霉素胸腔灌注治疗癌性胸水的短期疗效比较

目的探讨应用榄香烯注射液与博莱霉素胸腔灌注治疗非小细胞肺癌癌性胸水的短期疗效。方法9HD例非小细胞肺癌并发大量胸腔积液患者随机分为两组，榄香烯组45例采用榄香烯注射液400mg、地塞米松注射液10mg、庆大霉素注射液8万U、2％利多卡因注射液100mg溶于30mL生理盐水，经胸闭引流管行胸腔内灌注，灌注后夹管24小时后开放，观察3天后效果不理想重复灌注，最多3次。博莱霉素组45例，采用博莱霉素注射液60mg，以同样的辅助药物配比、同样的灌注方法行胸腔内灌注。结果榄香烯组总灌注87次，平均1．9次／例，总有效率53．3％，博莱霉素组总灌注69次，平均1．5次／例，总有效率80．0％，两组比较差异有统计学意义（P〈0．05）。灌注后不良反应发生率榄香烯组15．5％，博莱霉素组18．8％，两组比较差异无统计学意义（P〉0．05）。结论胸腔灌注榄香烯注射液或博莱莓素均为治疗非小细胞肺癌癌性胸水的有效方法，榄香烯组有效率略差，但不良反应发生率更低，耐受性更好。     

榄香烯注射液联合手术治疗涎腺腺样囊性癌临床观察

目的观察榄香烯注射液联合手术治疗涎腺腺样囊性癌的临床疗效。方法 30例涎腺腺样囊性癌患者随机分为观察组(n=15)与对照组(n=15),2组均采用手术治疗,对照组为单纯手术治疗,观察组术后采用榄香烯注射液300 mg静脉滴注,14 d为1个疗程。结果观察组患者生活质量评价优于对照组(P<0.05),化疗后不良反应少于对照组(P<0.05)。结论榄香烯注射液联合手术治疗涎腺腺样囊性癌疗效优于单纯手术治疗。     

喜炎平注射液联合阿奇霉素序贯治疗支原体肺炎患儿疗效观察

目的：探讨喜炎平注射液联合阿奇霉素序贯治疗支原体肺炎患儿临床疗效观察。方法：将2013年4月至2014年4月109例患儿随机分为对照组（ n＝53）与观察组（ n＝56）。对照组仅采用阿奇霉素序贯治疗,观察组在对照组基础上结合喜炎平注射液治疗。对比分析两组治疗后症状消失时间、住院时间、疗效,治疗前后肺功能和血清炎症因子水平变化。结果：观察组治疗后症状消失时间和住院时间均明显低于对照组（P＜0．05）;观察组总有效率（94．64％）治疗后明显高于对照组（79．25％）（P＜0．05）;两组FEV1、FVC治疗后较治疗前明显上升（P＜0．05）,IL－6、TNF－α治疗后较治疗前明显减少;观察组疗后FEV1、FVC明显高于对照组（ P＜0．05）,IL－6、TNF－α明显低于对照组（ P＜0．05）。结论：喜炎平注射液联合阿奇霉素序贯治疗支原体肺炎患儿临床疗效显著,安全可靠,具有重要临床研究意义。     

榄香烯注射液联合DP方案治疗老年晚期非小细胞肺癌疗效观察

目的探讨榄香烯注射液在老年晚期非小细胞肺癌中的应用价值。方法120例老年晚期非小细胞肺癌患者随机分为2组,治疗组（60例）采用榄香烯注射液联合DP方案治疗,对照组（60例）单纯应用DP方案治疗,21d为一个周期,两个周期后比较2组治疗后的近期疗效,治疗前后的生活质量及白细胞下降程度。结果揽香烯联合DP方案对老年晚期NSCLC的近期疗效显著,有效率60．00％,疾病控制率86．67％。显著高于对照组的41．67％和66．67％,差异具有统计学意义（P〈0．05）;生活质量改善率治疗组60．00％,显著好于对照组38．33％（P〈0．05）;毒副反应,治疗组明显降低了恶心呕吐、白细胞下降、血小板下降和肝功能损害的发生率（P〈0．05）,而在肾功能损害、关节肌肉疼痛和周围神经毒性等方面差异则无统计学意义（P〉0．05）。结论榄香烯注射液联合DP方案治疗老年晚期NSCLC,疗效明显,能明显提高患者生活质量,降低毒副反应,适宜临床推广。     

化疗药胸腔灌注配合深部热疗治疗恶性胸水的护理观察

目的：探讨胸腔灌注化疗药配合深部热疗治疗恶性胸水的护理。方法：68例恶性胸水患者采用随机数字法随机分为2组,治疗组给予胸腔灌注羟喜树碱＋复方苦参注射液配合深部热疗治疗,对照组给予胸腔灌注羟喜树碱＋复方苦参注射液治疗。2组均予以专科护理,治疗组同时给予热疗护理。结果：治疗组有效率为85．71％,对照组有效率66．67％,2组疗效差异有统计学意义（P〈0．05）,2组不良反应差异无统计学意义（P〉0．05）。结论：羟喜树碱＋复方苦参注射液胸腔灌注联合深部热疗治疗恶性胸水疗效确切,不良反应少,正确的护理干预是保证疗效和减少不良反应的基础,值得临床推广应用。     

顺铂5-Fu联合腹腔化疗+热疗与单纯腹腔化疗治疗癌性腹水疗效观察

目的观察顺铂5-Fu腹腔化疗结合微波局部热疗治疗癌性腹水与单纯腹腔化疗的临床疗效。方法41例癌性腹水病人随机分为两组,治疗组21例顺铂＋5-Fu腹腔化疗＋微波热疗,对照组20例,单用顺铂＋5-Fu腹腔灌注。结果治疗组有效率71．4％,KPS评分较对照组明显提高,对照组有效率35％,两组两项指标比较差异有显著意义（P〈0．05）。结论顺铂＋5-Fu腹腔化疗结合微波热疗能显著提高癌性腹水治疗有效率,改善患者生存质量,值得临床推广应用。     

腹腔化疗联合微波热疗治疗腹腔积液临床研究

目的：探讨腹腔化疗联合微波热疗治疗恶性腹腔积液的近期疗效及对患者生活质量的影响。方法：将65例恶性腹腔积液患者,按随机数字表法分为治疗组33例和对照组32例。治疗组腹腔内灌注顺铂40mg-m12＋地塞米松10mg,30min后行全身热疗。对照组只给予腹腔灌注化疗。治疗4周后g-4定临床疗效和生活质量并进行组间比较。结果：治疗后临床疗效比价,治疗组有效率为90．91％,对照组有效率为65．53％,两组比较差异有统计学意义（P〈0．05）。两组生活质量比较,治疗组优于对照组,两组比较差异有统计学意义（P〈0．05）。结论：腹腔化疗联合微波热疗治疗腹腔积液疗效显著。     

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.