54例恶性肿瘤引起的梗阻性黄疸的介入性治疗

对５４例恶性梗阻性黄疸采用经皮穿肝胆管减压引流术，大部分病例在引流后１５￣２０ｄ血清胆红素有明显下降，肝功能恢复正常，故可进行Ｓｅｌｄｉｎｇｅｒ’ｓ插管至肝动脉腹腔动脉灌注化疗或栓塞化疗。３１例经２￣４次灌注化疗或栓塞化疗后，肿瘤缩小，梗阻部位再通率达５７．４％，平均生存期达１０．２个月。     

肝动脉灌注IL—2加化疗栓塞治疗肝癌的临床研究

目的：探讨介入肝动脉灌注白细胞介素－２（ＩＬ－２）加化疗栓塞治疗肝癌的临床疗效。方法：５２例肝癌患者,随机分为２组,对照组３０例直接行单纯肝动脉化疗栓塞,实验组２２例采用ＩＬ－３肝动脉灌注后再行化疗栓塞,治疗前后分别测定外周血Ｔ淋巴细胞亚群、ＮＫ细胞及ＳＩＬ－２Ｒ细胞活性。结果：治疗后对照组与实验组肿块缩小超过５０％分别为６３．３％与７７．３％,１年及２年生存期分别为３０％、４０．９％、２０％及４     

双侧髂内动脉灌注化疗及栓塞治疗盆腔恶性肿瘤的价值：附3 …

目的 探讨髂内动脉灌注化疗及栓塞在治疗盆腔恶性肿瘤中的应用价值。方法 采用双侧髂内动脉插管，根据不同情况，选用动态灌注化疗药物或同时进行动脉栓塞，联合手术或放疗。结果 单侧髂内动脉插管成功率为１００％，双侧插管成功率为８６．８％，总有效率（ＰＲ＋ＣＲ）为１００％，其中ＣＲ２例．无严重并发症。结论 对盆腔恶性肿瘤进行髂内动脉灌注化疗或栓塞，可缩小肿块，控制出血，改善症状，联合手术或放射治疗，可明显提     

肝动脉化疗栓塞治疗原发性肝癌疗效及影响因素分析

目的 探讨肝动脉灌注化疗加栓塞治疗原发性肝癌的临床疗效及影响疗效的因素。方法 对１９９４年９月至１９９８年９月间１０５例不能手术切除的原发性中晚期肝癌患者行选择性肝动脉插管灌注化疗加栓塞治疗。结果 肝动脉灌注化疗加栓塞治疗原发性中晚期肝癌的１,２,３,４ａ累积生存率分别为５５．２％,２２．９％,２．９％。其中１例存活５５个月以上。结论 肝动脉灌注化疗加栓塞是治疗不能手术切除的原发性肝癌的有效方法;     

动脉化疗栓塞术联合膀胱灌注治疗中晚期膀胱癌

目的探讨动脉化疗栓塞术和腔内化疗联合应用在中晚期膀胱癌治疗中的价值。方法对28例经病理证实的膀胱癌患者采用“夹心面包法”同时行双侧膀胱肿瘤供血动脉化疗栓塞,化疗栓塞后7天进行膀胱腔内灌注化疗;对于膀胱癌伴有良性前列腺增生者采用导丝引导4F导管插入法实施膀胱灌注。结果28例患者在化疗栓塞后血尿即减轻或消失;随访24～38个月,平均30个月,其中完全缓解率39．3％(11／28),部分缓解率46．4％(13／28),有效率为85．7％,死亡2例。1、2年带瘤生存率分别达100％、92．9％。结论动脉化疗栓塞术联合膀胱腔内化疗是中晚期膀胱癌安全有效的姑息性治疗方法;对于膀胱癌伴有良性前列腺增生者导丝引导4F导管插入法是实施膀胱灌注的简便易行的新方法。     

宫颈癌介入灌注化疗栓塞的临床应用

目的探讨经导管选择性子宫动脉灌注化疗药物及栓塞治疗宫颈癌的临床效果。方法32例经病理证实的宫颈癌作盆腔动脉选择性插管行灌注栓塞治疗。用DDP40～80mg、5-Fu750～1000mg、VCR2～4mg、THP40～60mg,二联或三联用药。其中单纯动脉内灌注化疗3支,动脉内灌注化疗加碘化油栓塞7支,动脉内灌注化疗加碘化油与明胶海绵颗粒栓塞54支,碘化油用量4ml～8ml,单侧最大量不超过5ml,明胶海绵颗粒大小为1mm×1mm×1mm,用量以供血支动脉栓塞为度。结果总有效率（显效＋有效）87.50%（28/32）,灌注栓塞后12例行广泛性全子宫切除术,15例行放射治疗,2例作全身化疗,1例作姑息性治疗,2例因各种原因放弃继续治疗,其中放疗后7例再行广泛性全子宫切除术。21例伴出血患者灌注栓塞后全部停止出血,9例伴下腹及下肢疼痛症状全部缓解。结论经导管子宫动脉灌注栓塞化疗治疗宫颈癌是安全有效的方法。     

舌动脉超选择性介入化疗舌癌的临床研究

目的：评价舌动脉超选择性灌注栓塞化疗舌癌的临床疗效。方法：对9例临床T2～T4病理诊断为舌鳞癌的患者进行舌动脉超选择性直接动脉灌注顺铂化疗,观察术中反应及术后疗效并随访,评价灌注栓塞化疗的疗效。结果：灌注栓塞化疗1周后肿瘤缩小,局部出现坏死、崩解或液化,无全身性不良反应,术后2年随访,未发现肿瘤复发或转移。结论：对中晚期舌癌患者术前进行舌动脉超选择性灌注栓塞化疗疗效好、不良反应少,可以作为舌鳞癌综合序列治疗的重要组成部分。     

动脉灌注化疗栓塞治疗宫颈癌的效果分析

目的 探讨经动脉灌注化疗栓塞术治疗官颈癌的疗效和意义.方法 对2001年1月-2009年1月住院接受动脉灌注化疗栓塞的101例宫颈癌患者行回顾分析.结果 101例患者经动脉灌注化疗栓塞后临床症状全部得到缓解,症状缓解率100%;79例进行了手术,手术率78.22%;95例动脉灌注化疗栓塞术前、术后B超测量了肿瘤大小,与化疗前相比肿瘤体积缩小(x2=8.796,P=0.012),动脉灌注化疗栓塞总有效率为78.94%.结论 宫颈癌患者在术前或放疗前行动脉灌注化疗栓塞可缩小肿瘤体积,降低临床分期,提高切除率.     

影响中晚期肝癌化疗栓塞疗效的因素分析

目的：探讨中晚期肝癌化疗栓塞治疗疗效及影响疗效的因素。方法：对508例不能切除的原发性肝癌行选择性肝动脉插管灌注化疗和／或栓塞治疗共2025次,其中行选择性肝动脉插管灌注化疗栓塞治疗448例,单纯灌注化疗60例,结果：选择性肝动脉插管灌注化疗栓塞1,2,3年生存率分别为81．3％,38．6％,21．6％;单纯灌注化疗1,2,3年生存率分别为54．3％,21．3％,9．6％,肿瘤分类,栓塞剂及用量,门静脉是否有癌栓,侧支循环的形成,碘油沉积情况以及栓塞技术和方法选择是否是影响疗效的主要因素。结论：选择性肝动脉插管灌注化疗栓塞可作为中晚期肝癌的常规治疗,远期疗效明显优于单纯灌注化疗。     

晚期宫颈癌的动脉灌注化疗

目的：探讨晚期宫颈癌动脉灌注化疗及栓塞的临床价值。方法：14例Ⅱb期以上宫颈癌。所有患者均进行双侧髂内动脉造影，灌注化疗及子宫动脉栓塞，12例治疗后Ⅱ期手术。结果：治疗总有效率达78.6%。灌注化疗后手术的患者1年及3年生存率分别为100%和83.3%(10/12)。结论：动脉灌注化疗及栓塞可为晚期宫颈癌Ⅱ期手术创造条件，其方法简单，损伤小，副作用少，可减少手术中出血，是一项有效的治疗方法。     

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.