羟基喜树碱联合化疗治疗晚期胃癌近期疗效观察

目的观察羟基喜树碱(HCPT)联合化疗治疗晚期胃癌的近期疗效和毒性.方法 91例晚期胃癌病人随机分为治疗组和对照组.治疗组46例,接受HCPT 10 mg第1～5天,CF 100 mg第1～5天,5-Fu 500 mg/m2 第1～5天,DDP 30 mg/m2第1～3天;对照组45例接受CF 100 mg第1～5天,5-Fu 500 mg/m2第1～5天,DDP 30 mg/m2第1～3天.以上两个方案21 d为一周期,2周期后评价疗效.结果两组有效率分别为60.9%(28/46),40.0%(18/45),差异有显著性(P＜0.05).两组不良反应差异无显著性(P＞0.05).结论 HCPT联合化疗治疗晚期胃癌有效率高,毒性无明显增加,值得继续研究.     

HVP方案治疗中晚期非小细胞肺癌的疗效

目的　探讨HVP方案治疗中晚期非小细胞肺癌的疗效及副作用。方法　应用HVP方案 (HCPT 6mg/m2 第 1～ 5天 ;VDS 3mg/m2 第 1,8天 ;DDP 2 0mg/m2 第 1～ 5天 )治疗中晚期非小细胞肺癌 ,并且随机分组与MVP方案 (MMC 6mg/m2 第 1天 ;VDS 3mg/m2 第 1,8天 ;DDP 2 0mg/m2 第 1～ 5天 )进行比较。结果　HVP方案组81例 :中位生存期为 10个月 ,CR 10例 (12 . 2 % ) ,PR 32例 (39. 5 % ) ,总有效率为 5 1. 9%。MVP组 80例 :中位生存期为 8个月 ,CR 5例 (6 .3% ) ,PR 2 6例 (32. 5 % ) ,总有效率为 38 8% ,两组有效率差异无显著性 (P >0 .0 5 )。HVP和MVP组的 1年生存率分别为 4 0 . 7%和 31 .3% (P >0 . 0 5 )。两组的副作用相似 ,均可以耐受 ,主要包括骨髓抑制、恶心、呕吐、腹泻、口腔黏膜炎及脱发等 ,两组均为无心电图及肝肾功能改变。结论　HVP方案对中晚期非小细胞肺癌具有较好的疗效 ,副作用轻 ,可以考虑作为中晚期非小细胞肺癌的一线治疗方案。     

NP方案治疗晚期非小细胞肺癌的近期疗效观察

目的观察长春瑞滨(NVB)联合顺铂(DDP)对晚期非小细胞肺癌的近期疗效及毒副反应.方法对57例晚期非小细胞肺癌(NSCLC)患者采用NVB联合DDP治疗:NVB 25 mg/m2,静脉冲入,第1、5天;DDP 30mg/m2,静脉点滴,第1～3天;21天为一周期,至少治疗2周期以上.结果全组CR 0例,PR 27例,总有效率(CR PR)为47 4%(27/57).毒副反应主要为白细胞下降,Ⅰ～Ⅱ度59.6%(34/57),Ⅲ～Ⅳ度17.5%(10/57),其他不良反应较轻微.结论NP方案治疗晚期NSCLC疗效较好,不良反应可以耐受.     

异环磷酰胺、长春酰胺和顺铂联合治疗晚期非小细胞肺癌

目的 :评价异环磷酰胺 (IFO)、长春酰胺 (VDS)和顺铂 (DDP)联合治疗晚期非小细胞肺癌 (NSCLC)的疗效和毒性反应。方法 :5 2例晚期NSCLC给予IFO、VDS和DDP联合化疗 ,第 1～ 5天静脉滴注IFO 1.5～ 2 g/m2 ,美安 (mesna) 4 0 0mg ,在IFO后 0、4、8h静脉推注 ;第 1、8天静脉推注VDS 4mg ;第 1天静脉滴注DDP 6 0mg/m2 。 4周为一个周期 ,两个周期后评价疗效和毒性反应 ,随访生存期。结果 :IFO、VDS和DDP联合化疗总有效率为 4 4 .2 % ,初治和复治病例有效率分别为 4 7.1%和38.9% ,两组间差别无显著性 (P >0 .0 5 )。中位生存期为 8个月。毒性反应主要是骨髓抑制 ,表现为白细胞和血小板的减少较为明显 ,白细胞和血小板下降常出现于给药后第 8～ 12天。结论 :IFO、VDS和DDP联合治疗晚期NSCLC有较好的临床疗效 ,对复发病例也有较好疗效 ,毒性反应耐受性较好 ,如辅以G -CSF防治重度骨髓抑制 ,有较好的临床应用价值     

诺维本联合顺铂治疗非小细胞肺癌45例临床观察

目的 :评价诺维本 (NVB)与顺铂 (DDP)联合治疗非小细胞肺癌 (NSCL C)的近期疗效和不良反应。方法 :对 45例中晚期 NSCLC患者进行 NVB+DDP联合化疗 ,NVB2 5 mg/ m2 d1 、d8,DDP2 0 mg/ m2 d1 ～ d5,每 3～ 4周为 1周期 ,所有患者均完成 2周期以上化疗方可评价疗效。结果 :全组有效率为 2 8.9% ,其中 期患者有效率为 45 % , 期患者有效率为 1 6% ,两者间有显著性差异 ,其不良反应为白细胞降低和静脉炎。结论 :NVB+DDP方案治疗 NSCLC有较好的疗效 ,白细胞降低是其主要的剂量限制性毒性     

羟基喜树碱联合顺铂和足叶乙甙治疗中晚期非小细胞肺癌39例

目的　评价羟基喜树碱 (HCPT)、顺铂 (DDP)、足叶乙甙 (VP - 16 )联合治疗中晚期非小细胞肺癌 (NSCLC)的疗效。方法　 39例中晚期非小细胞肺癌采用HCPT +EP方案化疗 ;HCPT 10mg ,静脉滴注 ,d1～ 5;DDP 30mg ,静脉滴注 ,d1～ 5;VP - 16 0 .1g ,静脉滴注 ,d6～10 ;2 1～ 2 8d为 1周期 ,连用 3个周期后评定疗效。结果　 39例中PR 2 0例 ( 51.2 8% ) ,SD 16例 ( 4 1.0 2 % ) ,PD 3例 ( 7.6 9% ) ;毒副反应为恶心、呕吐、血象下降和脱发。结论　HCPT +EP方案是治疗中晚期非小细胞肺癌较有效的方案     

长春瑞滨同步放疗治疗晚期非小细胞肺癌的近期疗效

目的观察低剂量长春瑞滨(NVB)同步常规分割放射治疗晚期非小细胞肺癌(NSCLC)的近期疗效及毒副反应。方法经病理学或细胞学证实的Ⅲ期或Ⅳ期NSCLC 69例病人分为3组:①同步组20例,采用常规分割胸部放射治疗,2Gy/d,5周,DT60Gy,在放疗的第1、4周的第1、3、5天,放疗前30~60min NVB5mg/m2静脉滴注。②化疗组24例,采用NVB DDP化疗,NVB 25mg/m2第1、8天,静脉滴注;DDP80 mg/m2,第1天静脉滴注,每3周一周期,连用2周期。③放疗组25例,常规分割胸部放射治疗,方法与剂量同同步组。结果同步组、化疗组、放疗组总有效率分别为60.0%、45.8%、52.0%(P>0.05);放射性毒性同步组与放疗组间比较无统计学意义(P>0.05);白细胞下降发生率3组分别为10.0%、58.3%和8.0%(χ2=22.494,P<0.05),血色素下降分别为0、20.8%和0(χ2=10.074,P<0.05),恶心、呕吐分别为15.0%、50.0%和0(χ2=16.905,P<0.05),毒副反应比较均有统计学意义。结论低剂量NVB同步常规分割胸部放射治疗晚期NSCLC有较高的局部控制率,毒副反应可耐受,疗效满意。     

长春瑞滨联合异环磷酰胺和顺铂治疗晚期乳腺癌疗效的初步观察

目的观察长春瑞宾(NVB)联合异环磷酰胺(IFO)和顺铂(DDP)治疗晚期乳腺癌的疗效。方法有明确病理学诊断的晚期乳腺癌患者40例,采用NVB为25 mg/m2,第1、8天静脉滴注;IFO为1.3 g/m2,第1~5天静脉滴注;DDP为20 mg/m2,第1~5天静脉滴注。每21 d为1周期,至少治疗2个周期后评价疗效。结果完全缓解6例,部分缓解16例,总有效率55%;初治者有效率66.6%,复治者有效率40.8%。主要毒副反应为骨髓抑制,以白细胞下降为主(Ⅲ、Ⅳ度抑制率达40%)。结论NVB联合IFO和DDP治疗晚期乳腺癌的疗效较好,且毒副反应可以耐受。     

羟基喜树碱加足叶乙甙和顺铂联合治疗晚期非小细胞肺癌52例观察

目的观察以羟基喜树碱加足叶乙甙和顺铂治疗晚期非小细胞肺癌的疗效和毒副作用.方法52例晚期非小细胞肺癌用10-羟基喜树碱(HCPT)加足叶乙甙(VP-16)和顺铂(DDP)联合化疗(HCPT10mg静脉推注,DDP20mg静脉滴注d1-5或70mg/m2静脉滴注d1,VP-16 100mg静脉滴注d1-5).4周重复,2～3周期后按WHO标准评价疗效.结果52例患者中CR 2例,PR 23例,NC 23例,PD 2例,总有效率48%;主要毒副反应是骨髓抑制和消化道反应.结论羟基喜树碱加足叶乙甙和顺铂治疗晚期非小细胞肺癌疗效较高.     

诺维本加顺铂方案治疗晚期非小细胞肺癌的临床观察

目的 :观察诺维本 (NVB)联合顺铂 (DDP)方案治疗晚期非小细胞肺癌 (NSCL C)的疗效和不良反应。方法 :4 8例晚期NSCL C患者 (包括初治患者 37例 ,复治患者 11例 )接受 NP方案化疗 :NVB2 5 m g/ m2 ,静注 ,第 1、5天或第 1、8天 ;DDP30mg/ m2 ,静注 ,第 1～ 3天。每 2 1或 2 8d为 1周期 ,至少化疗 2个周期。结果 :获 CR4例 ,PR19例 ,SD17例 ,PD8例 ,有效率为4 7.9%。中位生存时间为 9.6个月 ,一年生存率为 38.6 %。初治病例的 RR为 5 1.3% (19/ 37) ,稍高于复治病例的 36 .4 % (4 /11) (P >0 .0 5 )。主要毒性反应为骨髓抑制 ,其中达 ～ 度的反应有 :白细胞减少 2 7.4 % ,贫血和血小板减少均为 5 .6 %。其他反应有恶心、呕吐和外周静脉炎等 ,均较轻微 ,可耐受。结论 :NP方案对晚期 NSCL C有较好疗效 ,主要毒性反应为骨髓抑制 ,可耐受     

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.