参芪扶正注射液配合化疗治疗晚期肺癌的疗效观察

目的 比较参芪扶正注射液加化疗与单纯化疗治疗晚期肺癌患者疗效、毒副反应及生活质量的影响.方法 治疗组NP方案(诺维本 顺铂) 参芪液250 ml,化疗时使用,每天1次,连用6周,对照组单用NP方案.结果 连续2个周期化疗后,治疗组有效率46.7%,对照组36.7%,两组比较差异无显著性(P>0.05).治疗组病变进展率、血液毒副反应明显低于对照组,差异有显著性(P<0.05).生活质量评分治疗组高于对照组,两组间差异有显著性(P<0.05).结论 参芪扶正注射液与化疗联合治疗晚期肺癌可降低化疗对患者的毒副反应,改善患者的生活质量.     

加味补中益气汤对肺癌术后化疗效果的影响

目的：探讨加味补中益气汤对肺癌术后放化疗效果的影响。方法选择2013年3月~2015年12月于本组接受手术治疗的80例肺癌患者,均分为对照组与观察组,术后均采用放化疗干预,观察组在此基础上加用加味补中益气汤治疗,监测两组治疗前后T细胞亚群水平的变化,比较两组毒副反应发生率,监测术后生活质量的改善情况。结果治疗后,观察组CD4、CD4/CD8上升,CD8下降,变化幅度高于对照组(P<0.05);治疗后,观察组中医症状积分降低幅度低于对照组(P<0.05);观察组白细胞、血红蛋白、血小板降低等骨髓抑制以及胃肠道不良反应等的不良事件发生率均低于对照组,但仅胃肠道不良反应发生率对比差异有统计学意义(P<0.05);治疗后,观察组功能、症状、总体健康等维度评分均上升,上升幅度高于对照组(P<0.05)。结论在肺癌术后放化疗中加用加味补中益气汤,可减少毒副作用,改善患者免疫功能,提升术后生存质量。     

艾迪注射液联合XELOX化疗治疗晚期结直肠癌的临床效果

目的探讨艾迪注射液联合XELOX化疗治疗晚期结直肠癌的临床效果。方法选取2017年7月至2019年3月漯河市第六人民医院收治的104例晚期结直肠癌患者,按照随机数表法分为对照组和观察组,各52例。给予对照组XELOX化疗治疗,给予观察组艾迪注射液联合XELOX化疗治疗。对比两组疗效、毒副反应(胃肠道反应、粒细胞减少、血小板下降)及治疗前后生活质量[卡氏功能状态量表(KPS)评分]。结果两组治疗总有效率比较,差异无统计学意义(P>0.05)。治疗后,两组KPS评分均高于治疗前,且观察组KPS评分高于对照组,差异有统计学意义(均P<0.05)。观察组胃肠道反应、粒细胞减少、血小板下降发生率分别为48.08%、44.24%、17.31%,低于对照组的71.15%、67.31%、38.46%,差异有统计学意义(均P<0.05)。结论艾迪注射液联合XELOX化疗治疗晚期结直肠癌,可减少毒副反应发生,提高患者生活质量,效果显著。     

乌苯美司联合OLF方案治疗晚期胃癌临床观察

目的观察乌苯美司联合OLF方案(奥沙利铂+甲酰四氢叶酸钙+氟尿嘧啶)治疗晚期胃癌近期疗效、毒性反应及改善患者生活质量方面的作用。方法将80例晚期胃癌随机分为两组,治疗组(49例)采用乌苯美司加化疗;对照组(31例)采用单纯化疗;两组化疗均采用OLF方案。每两个周期后评价近期疗效和毒副反应,以化疗前、化疗后六个周期后KPS评分和体质量变化来综合评价患者的生活质量。结果治疗后两组有效率分别为61.2%和54.8%,两者比较无显著差异;对照组的白细胞减少发生率高于治疗组;治疗组Karnofsky评分稳定率为63.0%,高于对照组的38.0%(P<0.05);治疗组体质量稳定率为69.0%,亦高于对照组的32.0%(P<0.05)。结论乌苯美司联合OLF方案治疗晚期胃癌疗效肯定,提高了患者的机体免疫功能,减轻了毒副反应,改善了生活质量。     

加味泽漆汤辅助化疗治疗晚期非小细胞肺癌的临床疗效观察

目的:通过观察加味泽漆汤对非小细胞肺癌(NSCLC)化疗后近期疗效、生活质量、毒副作用的影响,分析加味泽漆汤在肺癌中的治疗作用。方法:48例NSCLC患者均采用长春瑞滨+顺铂(NP)方案化疗,其中治疗组24例化疗前3天开始服用加味泽漆汤,对照组24例仅予NP方案治疗,疗程均为2个周期。观察两组近期疗效、化疗后生活质量评分及化疗毒副反应情况。结果:治疗组化疗后生活质量评分优于对照组(P<0.05);治疗组化疗后血液毒性反应及消化道反应明显低于对照组(P<0.05)。结论:中药联合化疗治疗非小细胞肺癌的疗效优于单纯化疗方案,尤其在用药后毒副反应更少,患者更容易耐受。     

复方皂矾丸减轻晚期非小细胞肺癌化疗副反应临床观察

目的观察复方皂矾丸减轻晚期非小细胞肺癌化疗副反应的疗效。方法94例晚期非小细胞肺癌患者随机分为两组,治疗组48例给予TP方案化疗联合复方皂矾丸;对照组46例仅单纯TP方案化疗。观察两组毒副反应、体重变化、KPS评分变化。结果治疗组Ⅲ-Ⅳ度骨髓抑制发生率低于对照组（P〈0．05）。对照组治秀后体重下降及KPS下降发生率与治疗组比较有统计学显著性差异（P〈0．05）。结论复方皂矾丸联合TP方案化疗能减轻晚期非小细胞肺癌患者毒副反应,改善体重及生活质量。     

冬虫夏草联合NP方案治疗晚期非小细胞肺癌的临床观察

[目的]观察冬虫夏草联合NP方案治疗晚期非小细胞肺癌的疗效和毒副反应.[方法]治疗组:NP方案化疗3～4个周期,同时服用冬虫夏草颗粒.冬虫夏草2包/d(225 mg/包),餐前或餐中用水服用.对照组:NP方案化疗方法同治疗组,不服用冬虫夏草颗粒.观察指标:治疗前后CT肿块大小、卡氏评分、T细胞亚群的变化;药物毒副反应情况.[结果]治疗组试验完成情况(化疗通过率):完成12例、中止5例,化疗通过率70.6%;对照组:完成11例、中止5例,化疗通过率68.7%.治疗组CR 2例,PR 4例,SD 4例.有效率35.3%,受益率58.8%.对照组CR 0例,PR 6例,SD 3例.有效率37.5%,受益率56.3%.治疗组2例CR,略好于对照组,但两组统计学处理差异无显著性意义.治疗组卡氏评分变化不大,但对照组有2例明显下降.而在毒副反应方面:对照组病人呕吐、发热、感染的发生率均高于治疗组.[结论]冬虫夏草对肿瘤化疗有一定的辅助作用.     

艾迪注射液联合化疗对晚期胃癌患者临床疗效及癌因性疲乏、生活质量的影响

目的观察艾迪注射液联合化疗治疗晚期胃癌疗效及对癌因性疲乏、生活质量和毒副反应的影响。方法将我院60例晚期胃癌患者随机分为对照组与观察组各30例,对照组予以SOX(替吉奥胶囊+奥沙利铂)化疗方案化疗,观察组在对照组治疗基础上增加艾迪注射液治疗,比较两组客观有效率(ORR)及治疗后肿瘤标志物、中医证候积分、Karnofsky评分、癌因性疲乏(CRF)评分、生活质量核心问卷(QLQ-C30)评分变化,并观察两组毒副反应情况。结果观察组ORR为53.33%,对照组ORR为40.00%,组间比较无统计学差异(0.05);治疗后,观察组血清糖类抗原125(CA125)、癌胚抗原水平明显低于对照组(0.05);中医证候积分、Karnofsky评分明显优于对照组(0.05);CRF总分及行为、躯体、情感、认知各维度评分均明显低于对照组(0.05),且QLQ-C30量表疗效明显优于对照组(0.05);观察组血细胞减少、白细胞减少、血红蛋白下降、恶心呕吐、乏力等毒副反应发生率均明显低于对照组(0.05)。结论艾迪注射液联合化疗治疗晚期胃癌具有增效减毒作用,能够有效降低血清肿瘤标志物水平,减轻化疗毒副反应,改善患者CRF及生活质量。     

艾迪联合紫杉醇+顺铂化疗方案治疗晚期非小细胞肺癌的临床观察

目的:观察艾迪联合紫杉醇+顺铂(TP)方案治疗晚期非小细胞肺癌的临床效果。方法:选取2015年1月-2017年6月本院收治的确诊为非小细胞肺癌晚期患者68例,按照随机数字表法将所有患者分为对照组和观察组,各34例。对照组患者给予TP方案进行治疗,观察组在对照组的基础上给予艾迪注射液。观察治疗4个周期后,两组患者的近期疗效、生活质量Karnofshy评分及毒副反应发生情况。结果:观察组近期临床总有效率为67.65%,虽高于对照组的52.94%,但差异无统计学意义(P0.05);观察组的近期临床收益率为88.24%,明显高于对照组的58.82%,差异有统计学意义(x~2=7.556,P=0.006)。观察组患者治疗后生活质量Karnofsky评分提高率为64.71%,明显高于对照组的38.24%(x~2=4.77,P0.05)。两组患者主要毒副反应为骨髓抑制和胃肠道反应,观察组患者白细胞减少和血小板减少的发生率均明显低于对照组,差异有统计学意义(x~2=8.35、4.87,P0.05)。结论:艾迪联合TP化疗方案治疗晚期非小细胞肺癌可有效提高临床收益率,比单独使用TP方案化疗毒副反应小,可显著改善患者生活质量。     

补中益气汤对癌因性疲乏的影响

目的研究补中益气汤对癌因性疲乏的影响。方法将我院收治的60例癌因性疲乏病例随机分为对照组(n=30,化疗)和实验组(n=30,化疗联合补中益气汤),比较两组治疗前后生活质量、疲乏改善情况及不良反应出现率。结果治疗后两组生活质量评分项目中的社会功能评分对比差异无统计学意义(P>0.05),实验组其他生活质量评分(躯体功能、心理功能、物质生活评分)、生活质量总评分和轻度疲乏率均显著高于对照组(P<0.05或P<0.01),重度疲乏率和消化道不良反应发生率明显低于对照组(P<0.05或P<0.01);骨髓抑制反应出现率两组比较差异无统计学意义(P>0.05)。结论补中益气汤可显著改善癌因性疲乏患者疲乏程度,减少消化系统不良反应,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.     

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.