多西他赛每周给药联合顺铂治疗晚期非小细胞肺癌

目的：研究多西他赛（泰索帝）每周给药联合顺铂治疗晚期非小细胞肺癌的疗效和不良反应。方法：多西他赛35mg／m^2,每周给药,连用3周休息1周顺铂75mg／m^2,每周期的第1d给药,每28d为1个治疗周期。3周期评价疗效。结果：有16例患者部分缓解,占全部入组病例（45例）的36％,中位生存时间11．3个月（范围5～28个月）;1年生存率51％;Ⅲ-Ⅳ度的粒细胞减少为27％,非血液系统毒副反应为乏力、恶心及液体潴留。结论：多西他赛每周给药联合顺铂治疗初治的晚期非小细胞肺癌疗效较好,骨髓毒性较轻．     

盖诺联合顺铂治疗晚期非小细胞肺癌的护理

目的：观察盖诺联合顺铂治疗晚期非小细胞肺癌的疗效，减轻其毒副作用．方法：对36例晚期非小细胞肺癌采用盖诺联合顺铂治疗。盖诺25mg／m^2加入生理盐水150ml中15min滴完，第1、8天，顺铂20mg／m^2静滴，第1—5天，观察疗效及毒副作用、结果：盖诺联合顺铂治疗晚期非小细胞肺癌36例中PR16例，SD16例，PD4例，有效率为44．4％、36例中发生骨髓抑制8例，恶心呕吐10例，静脉炎9例，脱发5例，周围神经毒性1例，便秘4例。结论：盖诺联合顺铂治疗晚期非小细胞肺癌有效率44．4％主要毒副作用为骨髓抑制、恶心呕吐、静脉炎等，通过各种相应的护理措施，在达到良好疗效的同时，减少了毒副反应的发生。     

紫杉醇联合铂类治疗晚期非小细胞肺癌临床观察

目的探讨紫杉醇联合铂类化疗方案对晚期非小细胞肺癌的疗效和毒性反应。方法37例晚期非小细胞肺癌应用紫杉醇（国产特素）175mg／m^2联合铂类（顺氯氨铂80mg／m^2或卡铂300mg／m^2）化疗。结果总有效率45.95％，其中初治组有效率53．33％，复治组有效率40．9％，用特素加顺铂组28例有效率46．43％，用特素加卡铂组有效率44．44％。中位生存期8．7个月，1年存活率为32．43％。主要不良反应为骨髓抑制及关节或肌肉酸痛。结论紫杉醇联合铂类治疗晚期非小细胞肺癌有较好疗效，不良反应可以耐受。     

长春瑞滨联合顺铂治疗非小细胞肺癌的临床观察

评价长春瑞滨联合顺铂治疗晚期非小细胞肺癌的疗效和不良反应。方法 22例晚期非小细胞肺癌用长春瑞滨25mg/m^2静脉注射，第1、8天，／顺铂75mg／m^2，分三天静脉滴注，28天为一周期，至少完成2个周期。结果 22例患者中CR4．54％，PR36．36％，SD40．9％，PD18．18％，总有效率(RR)40．9％。一年生存率45．45％。不良反应主要为骨髓抑制、消化道反应和静脉炎。没有相关性致死病例。结论 长春瑞滨联合顺铂为治疗晚期非小细胞肺癌有效方案之一，毒副反应能耐受和防治。     

紫杉醇联合顺铂治疗晚期非小细胞肺癌36例临床疗效观察

目的评价紫杉醇（TAX）联合顺铂（DDP）治疗晚期非小细胞肺癌的疗效及毒副反应。方法对36例晚期非小细胞肺癌患者进行TAX＋DDP联合化疗，TAX135mg／m^2，静滴3小时，第一天；DDP30mg／m^2，静滴，第1-3天。每例患者至少完成2周期化疗后评价疗效。结果CR2例，PR15例，sD17例，PD2例，总有效率47．2％，其中初治有效率为68．8％，复治有效率为30．0％。本组病例主要毒副反应为骨髓抑制、胃肠道反应、脱发及肌肉关节痛等。结论紫杉醇联合顺铂是治疗晚期非小细胞肺癌疗效较好方案，毒性可耐受。     

多西紫杉醇联合顺铂治疗晚期非小细胞癌35例的临床观察

目的 观察多西紫彬醇（艾素）联合顺铂治疗晚期非小细胞肺癌的疗效。方法自2003年8月～2008年8月对35例晚期非小细胞肺癌采用多西紫杉醇（艾素）联合顺铂的化疗方案治疗。结果全组35例,部分缓解14例,总有效率为40％。主要毒性反应为骨髓抑制,其中主要为白细胞下降,发生率为76％。结论 多西紫彬醇联合顺铂治疗晚期非小细胞肺癌疗效较好。     

盖诺加顺铂联合治疗晚期非小细胞肺癌疗效观察

目的：观察国产去甲长春花碱(盖诺)与顺铂联合化疗治疗晚期非小细胞肺癌的疗效。方法：NP方案，盖诺25mg／m^2d 1、8，加顺铂40～50mg d 1～3治疗Ⅲ～Ⅳ期非小细胞肺癌24例。结果：部分缓解(PR)8例，稳定(NC)13例，进展(PO)3例，总有效率33．3％。初治有效率40．0％，复治有效率22.2％。主要毒副作用为白细胞减少。结论：盖诺与顺铂联合化疗治疗晚期非小细胞肺癌是一个疗效较好、毒性中等的一线方案。     

紫杉醇联合顺铂治疗晚期非小细胞肺癌的临床观察

目的观察紫杉醇联合顺铂治疗晚期非小细胞肺癌的疗效。方法给予48例晚期非小细胞肺癌患者紫杉醇135mg／m^2第1天给药,顺铂30mg／m^2第1～5天给药,每21天为1周期,完成2周期后评价疗效,有效及稳定病例完成4周期,随访至疾病进展和患者死亡。结果总有效率43.8％,其中初治有效率为50％,复治有效率为40％。不良反应以粒细胞减少、恶心、呕吐、脱发为主,分别为45％、58％、60％。结论紫杉醇联合顺铂治疗晚期NSCLC疗效较好,且耐受性良好。     

多西紫杉醇治疗晚期恶性肿瘤46例临床分析

目的：评价多西紫杉醇（艾素,江苏恒瑞医药股份有限公司产品）＋顺铂或卡铂、阿霉素治疗晚期恶性肿瘤的临床疗效及毒副作用。方法：化疗方案为：多西紫杉醇75mg／m^2,第1天,静脉滴注;联合顺铂30mg／m^2,第1～3天或卡铂300mg／m^2,第1天,静脉滴注,治疗非小细胞肺癌、鼻咽癌;联合阿霉素40mg／m^2,第1～2天,静注,治疗乳腺癌。结果：3组总有效率（CR＋PR）分别为,非小细胞肺癌为49．5％;鼻咽癌为55．6％;乳腺癌为83.3％。其毒性反应主要是骨髓抑制,轻度胃肠道反应。脱发、面色潮红、乏力、肌痛及少数病例末梢神经病变。结论：国产多西紫杉醇联合顺铂或卡铂、阿霉素治疗晚期恶性肿瘤,疗效满意,且毒性可耐受,适合临床应用。     

NP方案治疗晚期非小细胞肺癌39例观察

目的：评价诺维本联合顺铂的化疗方案即NP方案治疗晚期非小细胞肺癌的疗效。方法：有明确的病理和／或细胞学诊断的39例晚期非小细胞肺癌患者，运用诺维本30mg／m^2 dl、8顺铂30mg／m^2 dl—5静滴。每3周1周期，每个患者均化疗2周期以上，然后评价疗效。结果：CR0例，PRl8例，有效率46％(18／39)，不良反应主要为骨髓抑制和消化道反应。结论：NP方案治疗晚期非小细胞肺癌疗效较高且毒副反应可以耐受。     

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.     

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.