Ⅲa期非小细胞肺癌手术与术后辅助治疗疗效比较的回顾性分析

目的回顾性分析和比较非手术治疗、单纯手术治疗和手术后化放疗对Ⅲa期非小细胞肺癌患者生存时间的影响，并简要分析影响Ⅲa期非小细胞肺癌预后的因素。方法从1997年1月1日-2004年12月31日北京大学第一医院胸外科病房住院治疗肺部恶性肿瘤的856例患者中，依据相应的入选标准筛选出Ⅲa期非小细胞肺癌患者87例，采用查阅病历、电话以及信件等方式随访，了解患者手术后治疗情况、生存时间及生活质量等资料。获得随访资料的病例50例，随访率57．48％。对于获得随访资料的患者，统计术后1、3及5年生存率；将入选行手术治疗的病例分为单纯手术组和手术＋术后辅助治疗组，使用Kaplan—Meier法进行差异性分析；将未手术患者和单纯手术治疗的患者分组对照，比较各自的生存曲线。结果入选病例术后1、3及5年生存率分别为80．49％、34．62％和29．67％；从单纯手术和术后化放疗组的生存曲线来看，差异无显著性（P=0．0722）。对于非手术治疗患者，手术组患者表现出更高的生存率，差异具有统计学意义（P=0．0073）。结论对于能完全切除的Ⅲa期非小细胞肺癌，手术是其基本治疗手段；对于完全切除的Ⅲa期非小细胞肺癌，手术后辅助化、放疗可能有提高患者术后生存率的倾向。     

女性肺癌外科治疗策略分析

目的 分析女性非小细胞肺癌手术以及术后以放化疗为主的综合治疗对生存期的影响.方法 回顾性研究女性非小细胞肺癌手术治疗患者563例,其中单纯手术者211例,综合治疗者(手术切除+化疗或放疗或两者兼之)326例.结果 女性非小细胞肺癌的1年总生存率为60.4%,5年总生存率为11.3%,Ⅰ期、Ⅱ期及Ⅲb期女性非小细胞肺癌术后的1年和5年生存率均高于同期收治女性非小细胞肺癌的总生存率,而Ⅰ期、Ⅱ期及Ⅲb期女性非小细胞肺癌术后综合治疗患者的1年和5年生存率又均高于同期单纯手术患者的生存率.结论 对于有手术指征的病例,应尽可能手术治疗,术后可辅助以化、放疗等综合治疗,可以不同程度的提高患者的生存率.     

60例Ⅲa期非小细胞肺癌术后放疗加化疗的疗效分析

目的探讨Ⅲa期非小细胞肺癌（NSCLC）患者术后放疗加化疗的临床意义。方法回顾性分析60例Ⅲa期NSCLC患者术后放化疗与单纯手术治疗的生存率及复发情况。其中术后放疗加化疗40例,单纯手术20例。结果术后放化疗组和单纯手术组5年的生存率分别为33%和9.3%,2组比较有显著性差异（P〈0.05）。结论对Ⅲa期非小细胞肺癌术后患者行放疗加化疗,可以提高生存率。     

手术联合放化疗治疗小细胞肺癌42例

目的:探索以手术为主的综合疗法对小细胞肺癌的临床治疗效果。方法:回顾性总结分析42例小细胞肺癌手术治疗的临床资料,其中33例术前化疗2周～4周期,手术后再化疗或(和)放疗;9例手术后病理确诊,进行EP方案化疗或(和)放疗;术后随访,观察1a及3a生存率。结果:42例1a生存率为92.8%;3a生存率为66.7%。结论:外科手术联合放化疗治疗对IIIa期以内的SCLC具有良好的效果。     

Ⅲ期非小细胞肺癌术后放疗可提高局部控制率和生存率

为了观察Ⅲ期非小细胞肺癌术后放疗的远期效果，对１９８７年９月至１９９１年５月间５０例单纯手术治疗和３５例手术加术后放疗的Ⅲ期非小细胞肺癌患者的疗铲进行分析。结果；随访１年，３年和５年，单纯手术组的局部控制率和生存率分别为６０％，２８％，０％和６４％，手术加术后放疗组分别为８０％．６２．８％，１７．９％和７４．２％，３４．３％，１１．４％，经统计学处理，Ｐ〈０．０１有显著差异。     

非小细胞肺癌术后放疗

目的：评价非小细胞肺癌术后放疗的价值。材料与方法：１９９２年１月至１２月１４９例非小细胞肺癌,单纯手术６４例术后放疗８５例,放疗剂量４０～６０Ｇｙ。结果：术后随访５年以上,术后放疗组局部复发率２９．４％,低于手术组４２．２％。１,３,５年生存率单纯手术组６５．６％,３４．８％,９．４％,术后放疗组６７．１％,４２．４％,２２．４％,两组５年生存率差异有显著意义（Ｐ〈０．０５）。结论：术后放疗可降低局部复发率,术后放疗组５年生存率高于单纯手术组。     

区域淋巴结阳性非小细胞肺癌术后放疗与单纯手术的疗效分析

目的 :比较区域淋巴结阳性 (N阳性 )非小细胞肺癌 (NSCL C)术后放疗和单纯手术的疗效 ,探讨术后放疗的指征。方法 :N阳性 NSCLC2 61例行手术治疗 ,其中 112例术后行放疗 ,149例未行放疗。结果 : AB期术后放疗与单纯手术比较 3年和 5年生存率差异无显著性 , A期术后放疗 3年和 5年生存率高于单纯手术 (P<0 .0 5 ,N1期和 N2 期术后放疗与单纯手术比较 3年和 5年生存率差异无显著性。手术后肿瘤残留者术后放疗 3年和 5年生存率高于单纯手术 (P<0 .0 1)。结论 : 期和 N1期患者如手术切除干净不必加放疗 ; A期、术后肿瘤残留者和 N2 期患者术后加放疗可以提高生存率     

区域淋巴结阳性非小细胞肺癌术后放疗与单纯手术的疗效分析

目的：比较区域淋巴结阳性（N阳性）非小细胞肺癌（NSCLC）术后放疗和单纯手术的疗效,探讨术后放疗的指标。方法：N阳性NSCLC 261例行手术治疗,其中112例术后行放疗,149例未行放疗,结果：II AB期术后放疗与单纯手术比较3年和5年生存率差异无显著性,ⅢA期术后放疗年和5年生存率高于单纯手术（P＜0．05,N1期和N2期术后放疗与单纯手术比较3年和5年生存率差异无显著性,手术后肿瘤残留者术后放疗年和5年生存率高于单纯手术（P＜0．01）,结论：II期和N1期患者如手术切除干净不必加放疗,IIIA期,术后肿瘤残留者和N2期患者术后加放疗可以提高生存率。     

手术结合放疗在治疗上颌骨鳞状细胞癌中的作用

目的比较手术前放疗、手术后放疗及单纯手术治疗在上颌骨鳞状细胞癌治疗中的效果。方法上颌骨鳞状细胞癌患者手术前行40~50 Gy放疗,4周后进行手术17例;手术后2周进行放疗16例;单纯手术12例。结果术后5年随访：术前放疗和手术组17例中,1年生存16例,1例失访;3年生存10例,1例死于脑转移,2例死于肺转移,1例死于肺炎,余失访;5年生存5例,3例死于肺转移,余失访。术后放疗和手术组16例中,1年生存14例,1例死于肺转移;3年生存9例,1例死于心肌梗死,1例死于肺转移,余失访;5年生存4例,2例死于肺转移,余失访。单纯手术组12例中,1年生存10例,2例失访;3年生存4例,2例死于肺转移,2例死于脑转移,余失访;5年生存1例,2例死于肺转移,余失访。术前放疗组和术后放疗组3年和5年生存率稍高于单纯手术组。结论手术结合放疗有益于上颌骨鳞状细胞癌患者生存率的提高。     

肾细胞癌术后放疗的远期疗效观察

目的 评价术后放疗在肾细胞癌治疗中的作用。方法 １９８２～１９９３年手术治疗肾细胞癌７１例,其中辅以术后放疗３８例,单纯手术３３例,非随机分组比较２组疗效。结果 随访至１９９８年１２月,随访率９７．２％,术后放疗组５ａ生存率６３．１％,单纯手术组３９．４％,术后放疗组远期疗效优于单纯手术组（Ｐ〈０．０１）。结论 术后放疗可有效地提高肾细胞癌患者的５ａ生存率。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.