羟基喜树碱联用顺铂、5-氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床观察

目的：观察羟基喜树碱联用顺铂、5-氟尿嘧啶、亚叶酸钙治疗62例晚期胃癌疗效。方法：羟基喜树碱10mg／m^2静滴第1～5天，顺铂20mg／m^2静滴第1～5天，亚叶酸钙100mg／d静滴第6～10天，5-氟尿嘧啶750mg／d静滴第6～10天。28天1周期，完成3周期评价疗效。结果：完全缓解(CR)4例，部分缓解(PR)25例，总有效率(CR PR)46．8％。毒副反应主要是骨髓抑制、消化道反应和腹泻。结论：羟基喜树碱联用顺铂、5氟尿嘧啶、亚叶酸钙治疗晚期胃癌疗效好，毒副反应轻，值得临床上进一步观察。     

紫杉醇联合顺铂、醛氢叶酸和氟尿嘧啶治疗晚期胃癌76例

目的观察使用紫杉醇联合顺铂、醛氢叶酸和氟尿嘧啶治疗晚期胃癌的疗效。方法对患晚期胃癌患者76例,采用紫杉醇175ms／m^2,静脉滴注,第1天;顺铂75mg／m^2＋生理盐水1500～2000ml,腹腔内灌注,第2天;醛氢叶酸（CF）200mg/m^2,静脉滴注,第2—4天;氟尿嘧啶250mg／m^2,静脉推注,第2天后1500mg／m^2,72h持续静脉滴注。结果全组CR6例（7．8％）,PR28例（36．8％）,sD32例（42．1％）,PD10例（13．1％）,总有效率（CR＋PR）44．6％。结论紫杉醇联合顺铂、醛氢叶酸和氟尿嘧啶是治疗晚期胃癌患者较好的化疗方法。     

羟基喜树碱联合草酸铂、亚叶酸钙和5-氟尿嘧啶治疗晚期大肠癌的临床观察

目的 观察羟基喜树碱联合草酸铂（艾恒）、亚叶酸钙和5-氟尿嘧啶（5-Fu）组成的HLFO方案治疗晚期大肠癌的疗效和毒副反应。方法 31例晚期大肠癌患者：艾恒150mg／m^2（第1天），亚叶酸钙100mg／m^2，5-Fu 500mg／m^2，羟基喜树碱10mg／m^2，连用5d，21d为1周期，每个病例至少接受2个周期化疗。结果 31例患者中完全缓解（CR）2例（15.5％），部分缓解（PR）10例（32．2％），稳定（SD）11例（35.4％），进展（PD）8例（11．1％），总有效率RR（CR＋PR）12例（47．7％），该方案主要毒性反应为骨髓抑制和神经毒性，白细胞下降（67．7％），其中Ⅲ、Ⅳ度为25．8％，有61．3％出现周围神经病。结论该方案具有较好的疗效和耐受性，能提高患者生活质量。     

多西紫杉醇联合奥沙利铂、甲酰四氢叶酸／5-氟尿嘧啶治疗晚期胃癌疗效分析

目的观察多西紫杉醇（Docetaxel）联合奥沙利铂（Oxaliplatin）、甲酰四氢叶酸（CF）／5-氟尿嘧啶（fluorouracil）治疗晚期胃癌的疗效及耐受性。方法全组32例患者,均经病理确诊。应用Docetaxel 75mg／m^2,静脉滴注1h．第1天,化疗前预处理;Oxaliplati 135mg／m^2,静脉滴注2h,第2天;CF200mg／m^2,静滴2h,第1—5天,后5-Fu 350mg／m^2静滴4—6h,第1—5天,21d为1周期。结果全组CR2例、PR15例、SD10例、PD5例,总有效率53．1％。不良反应主要有骨髓抑制和消化系统反应。结论多西紫杉醇联合奥沙列铂、甲酰四氢叶酸／5-氟尿嘧啶治疗晚期胃癌疗效肯定,不良反应能耐受。     

应用紫杉醇为主方案治疗晚期胃癌疗效观察

目的：观察国产紫杉醇（PTX）联合5-氟脲嘧啶（5-FU）、羟基喜树碱（HCPT）、顺铂（DDP）方案治疗晚期胃癌的疗效和毒副反应。方法：采用PTX135mg／m^2，加入生理盐水静滴3h，第1d；5-FU300mg／m^2，静滴，第1d～第5d；HCPT8mg／m^2，静滴，第1d～第5d；DDP20mg／m^2，静滴，第1d～第5d；3周～4周为1个周期，行2周期治疗后判定疗效。结果：35例可评价疗效，全组无完全缓解（CR）者，部分缓解（PR）15例（42．9％），稳定（NC）13例（37．1％），进展（PD）5例（14．2％），有效率（CR＋PR）42．9％。毒副反应主要为骨髓抑制、脱发和关节肌肉痛，其他毒副反应均较轻微可耐受，无化疗相关死亡。结论：紫杉醇为主方案治疗晚期胃癌疗效肯定，毒副反应能耐受，值得在临床使用。     

周剂量紫杉醇联合氟尿嘧啶顺铂（DF）方案治疗晚期食管癌的临床观察

目的：评价周剂量紫杉醇（PTX）联合氟尿嘧啶（5-Fu）、顺铂（DDP）组成PDF方案治疗晚期食管癌的临床疗效和毒副反应。方法：48例Ⅲ、Ⅳ晚期食管癌患者随机分二组,治疗组：予周剂量即PTX 80mg/m^2ivgttd1,d8,5-Fu750mg/m^2CIVd1-d5,DDP20mg/m^2ivgtt d1-d 5,21天为1周期,对照组：5-Fu 750mg/m^2CIV d1-d 5,DDP 20mg/m^2ivgtt d1-d 5,21天为1周期,2周期后按RECIST标准评价近期疗效和WHO毒副反应评价。结果：治疗组：总有效率70.8%,对照组：总有效率41.7%。治疗组毒副反应主要为Ⅱ度、Ⅲ度骨髓抑制。脱发,周围神经毒性治疗组高于对照组。结论：周剂量紫杉醇联合氟尿嘧啶,顺铂组成PDF方案可能是治疗晚期食管癌较好的化疗方案,值得进一步观察。     

紫杉醇联合顺铂、5-FU治疗进展期胃癌26例

目的探讨紫杉醇联合顺铂及氟尿嘧啶治疗进展期胃癌的客观疗效及安全性。方法紫杉醇135mg／m^2,分第1、8天静滴，顺铂（DDP）20mg／（m^2·d）第1、2、3天静滴，氟尿嘧啶500mg／m^2第1天静滴2h，以后用5-FU2500mg／m^2泵内持续滴注，持续70h，21～28d为1个周期，连用至少2个周期开始评价疗效，获CR、PR患者一个月后确认，不足2个周期的以观察毒性。结果全组CR1例，PR11例，总有效率为50．0％，中位TTP为6．8个月；其中初治有7例，获CR1例，PR3例，总有效率为57．1％，中位TTP为7．2个月；复治患者为19例，可评价疗效的有14例，获CR0例，PR8例，总有效率为47．1％，中位TTP为6．6个月。而且获得CR和PR的病例，部分病例术后也获得病理组织完全缓解和部分缓解。毒副反应主要为血液学毒性及消化道反应，大部分为Ⅰ、Ⅱ度。结论紫杉醇联合顺铂及氟尿嘧啶治疗晚期胃癌疗效肯定，特别对初治患者，毒副反应较轻，患者均能耐受，值得临床进一步扩大研究。     

国产草酸铂联合亚叶酸钙、5-氟尿嘧啶治疗晚期胃癌

目的 观察草酸铂（OXA）联合亚叶酸钙（CF）和5-氟尿嘧啶（5-Fu）组成OLF方案治疗晚期胃癌的临床疗效和不良反应。方法 收治晚期胃癌患者30例，采用OXA130mg／m^2静脉滴注2h，第1天，CF75mg／m^2静脉滴注2h后，5-Fu300mg／m^2（≤500mg／d）静脉滴注4h，1～5d。结果 PR14例、SD11例、PD5例，有效率46．7％（14／30）：主要不良反应为感觉神经毒性、骨髓抑制，无化疗相关死亡。结论 以OXA为主组成OLF方案治疗晚期胃癌疗效较好，耐受性良好。     

多西紫杉醇联合奥沙利铂和5-氟尿嘧啶治疗晚期胃癌33例临床观察

目的考察多西紫杉醇联合奥沙利铂、5-氟尿嘧啶和亚叶酸钙方案治疗晚期胃癌的临床效果。方法33例晚期胃癌患者给予多西紫杉醇35mg／m^2（第1天,第8天,第15天）,奥沙利铂85mg／m^2（第1天,第8天）,5-氟尿嘧啶500mg／m^2（第1天至第5天）,28天为1周期,疗程4周期。结果33例患者中完全缓解3例,部分缓解16例,稳定10例,进展4例,总有效率57．58％;中位疾病进展时间为5.12个月,常见的毒性反应为白细胞和中性粒细胞减低,消化道反应和周围神经毒性反应等。结论多西紫杉醇联合奥沙利铂、5-氟尿嘧啶及亚叶酸钙化疗方案治疗晚期胃癌的疗效显著,毒性反应患者能耐受,可能延长患者生存期。     

紫杉醇联合氟尿嘧啶和顺铂方案治疗晚期胃癌

目的 观察紫杉醇联合氟尿嘧啶及顺铂（PFC）方案治疗1晚期胃癌的临床疗效和毒副反应。方法 晚期胃癌患者20例，给予紫杉醇（PTX）65mg／m^2，静滴4h，第1，8天给药；氟尿嘧啶（5-FU）500mg／m^2，静滴6h，第1～5天；顺铂（CDDP）20mg／m^2，静滴，第1～5天，21d为1周期，至少2个周期后评价疗效和毒副反应。结果 全组20例均可评价疗效，获得CR2例，PR10例，SD5例，PD3例，近期客观有效率60．0％，中位TTP为7．5个月。主要毒副反应为骨髓抑制、恶心呕吐和脱发。结论 PFC方案治疗晚期胃癌疗效较高，毒副反应轻，多数患者耐受良好，值得临床推广运用。     

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.