L—OHP联合5-Fu和CF治疗结直肠癌的临床观察

目的观察奥沙利铂（L—OHP）联合亚叶酸钙（CF）及氟尿嘧啶（5-Fu）方案治疗晚期结直肠癌的疗效及毒副反应。方法36例晚期结直肠癌患者应用5-Fu500mg/m^2,持续静脉滴注1～5d;CF200mg／m^2,1—5d,L—OHP130mg/m^2静脉滴入持续4h,1d;每3周重复1次。用药4个周期评价疗效。结果36例均可评价疗效。CR3例,PR15例,SD10例,总有效率为（CR＋PR）50％,临床受益率（CR＋PR＋SD）为77．78％;毒副反应主要是末梢神经毒性、恶心、呕吐及骨髓抑制等,多数反应较轻,无严重毒副反应发生。结论L—OHP联合CF及5-Fu治疗晚期结直肠癌疗效确切,毒副反应轻,明显改善生活质量。     

国产奥沙利铂联合亚叶酸钙、5-氟尿嘧啶治疗晚期胃癌的临床观察

目的 观察国产奥沙利铂（L—OHP）联合亚叶酸钙（LV）和5-氟尿嘧啶（5-Fu）持续44小时静滴（双周疗法）治疗晚期胃癌的疗效和毒副反应。方法 对39例晚期胃癌患者采用以奥沙利铂为主的方案进行化疗,评价疗效。结果 39例患者,其中初治者25例,复治者14例;获得总有效率为48．7％。初治（一线）有效率为50．0％,复治（二线）有效率（RR）为28．6％。毒副反应主要为：白细胞减少发生率69．2％,外周神经感觉异常发生率为58．9％。结论 L—OHP合LV和5-FU持续静滴方案治疗晚期胃癌临床疗效较好。     

奥沙利铂联合5-FU、LV方案治疗消化道癌72例临床观察

目的评价奥沙利铂与氟尿嘧啶、亚叶酸钙治疗术后消化道癌的疗效和安全性。方法共收治消化道癌患者72例,术后采用L—OHP 130mg／m^2,静滴2小时。1～5天LV 200mg／m^2,静滴2小时,5-Fu 500mg／m^2,静滴4小时。每月重复1次,治疗3个周期后评价疗效。结果完全缓解（CR）8例（11％）,部分缓解（PR）40例（55．7％）,无变化（NC）24例（33．3％）,总有效率66．7％。副反应主要为感觉神经毒性及恶心、呕吐。结论L-OHP联合5-Fu、LV治疗晚期消化道癌疗效肯定,毒副反应能耐受,值得临床推广应用。     

FOLFOX4方案治疗晚期胃癌临床观察

目的观察FOLFOX4方案治疗晚期胃癌的近期疗效和毒副反应。方法32例晚期胃癌,使用FOLFOX4方案治疗,即奥沙利铂（L—OHP）85mg/m^2加入5％葡萄糖溶液中静滴2小时,第1天;亚叶酸钙（CF）200mg/m^2加入5％葡萄糖溶液中静滴2小时,第1—2天;5-氟尿嘧啶（5-Fu）400mg/m^2静脉推注,然后600mg/m^2加入5％葡萄糖溶液中持续静脉泵入22小时,第1—2天。每2周重复1次。至少使用4个周期评价疗效。结果全组32例均可参加评价,获得CB2例（6．2％）,PR14例（43．8％）,SD10例（31．2％）,PD6例（18．8％）,有效率为50％。毒副反应主要为恶心、呕吐和骨髓抑制,多为Ⅰ-Ⅱ度,一过性的外周感觉神经异常。结论FOLFOX4治疗晚期胃癌,近期有效率较高,毒副反应低,值得临床进一步推广使用。     

草酸铂联合亚叶酸钙及5-Fu治疗晚期胃癌的临床观察

目的观察草酸铂（L—OHP）联合亚叶酸钙（CF）及氟尿嘧啶（5-Fu）方案治疗晚期胃癌的近期疗效和毒副反应。方法41例晚期胃癌患者予L—OHP130mg/m^2，静脉滴入，3h，d1；CF200mg/d，静滴2h，d1-d5；5-Fu500mg/m^2，静脉滴入于CF后用，4—6h，d1-5，21d为一个周期，所有病例2—4个周期后进行临床疗效和不良反应评定。结果完全缓解（CR）2例，部分缓解（PR）17例，稳定（SD）15例，进展（PD）7例，总有效率为46．3％（19／41），18例初治患者有效率50．0％。23例复治患者有效率43．5％。该方案不良反应主要为外周神经毒性，消化道反应及骨髓抑制，其中Ⅰ-Ⅱ度外周神经毒性发生率48．7％（20／41）Ⅰ-Ⅱ度消化道反应发生率51．2％（21／41），其中Ⅲ-Ⅳ度消化道反应26．8％（11／41），Ⅰ-Ⅱ度白细胞减少发生率53．6％（22／41），其中Ⅲ-Ⅳ度白细胞下降发生率24．3％（10／41）结论该方案具有较好的近期疗效和耐受性，可提高患者生活质量。     

奥沙利铂联合氟尿嘧啶、亚叶酸钙治疗晚期胃癌的临床探讨

目的：观察奥沙利铂（oxaliplatin，L-OHP）联合氟尿嘧啶（fluorouracil，5-Fu）、亚叶酸钙（leucovorin，CF）治疗晚期胃癌的近期疗效及毒副反应。方法：入选者为病理证实的晚期胃腺癌患者。化疗方案：L-OHP 100mg/m^2静脉滴注2h．d1，CF200 mg／m^2静脉滴注2h，d1-2，5-Fu 400mg/m^2，静脉滴注2h，d1，5-Fu 600mg/m^2持续静脉泵入22h，d1-2每3周重复，至少完成3个周期后判效，4个周期以上为有效病例。结果：全组54例均可评价疗效及不良反应．治疗总周期221个周期，平均4．1个周期。CR7例（13．0％），PR24例（44．4％），有效率（CR＋PR）59．3％，SD 17例（31．5％），PD6例（11．1％）。主要不良反应为轻度感觉神经毒性，恶心、呕吐及骨髓抑制。结论：L—OHP联合5-Fu、CF治疗晚期胃癌疗效较好，不良反应轻，可耐受，是晚期胃癌化疗的良好选择之一，同样适用于新辅助化疗。     

FOLFOX4方案二线治疗晚期胃癌临床疗效观察

目的观察草酸铂（L—OHP）联合亚叶酸钙（CF），5-氟尿嘧啶（5-Fu）治疗晚期胃癌的近期疗效及毒副反应。方法确诊晚期胃癌患者32例，均为先前行DF、ECF方案治疗失败的患者，治疗方案为：L—OHP 85mg／m^2 iv gtt，h 0-2，d1；CF 200mg／m^2，iv gtt，2h，d1-2；5-Fu 400mg／m^2，iv bolus 2h，d1-2；5-Fu 600mg／m^2，civ gtt，d2-24，d1-2,2周为1个周期，所有患者至少接受3个周期治疗后评价疗效。结果经3个周期以上治疗后，CR1例，PR14例，NC8例，PD9例。总有效率46．9％，主要毒副反应为神经系统毒性、消化道反应、骨髓抑制、肝肾功能轻度损害。结论草酸铂联合亚叶酸钙、5-氟尿嘧啶治疗晚期胃癌疗效较好，不良反应可耐受。     

奥沙利铂氟脲嘧啶和亚叶酸钙联合化疗治疗晚期胃癌

目的研究奥沙利铂（L—OHP）、5-氟脲嘧啶（5-FU）和亚叶酸钙（CF）联合全身化疗治疗晚期胃癌的临床疗效和毒副作用。方法L—OHP100mg／m^2）静脉滴注2h,CF500mg／m^2静脉滴注2h,5-FU400mg/m^2静脉注射,5-FU3mg／m^2持续静脉滴注48h,每2周1次。结果65例晚期胃癌患者中,16例获完全缓解（24．6％）,25例获部分缓解（38．5％）,10例治疗后获稳定,14例病情进展。总缓解率63．1％。毒副反应主要表现为恶心、呕吐、腹泻、静脉炎,其次是神经毒性,包括对冷刺激敏感、握力下降,多数患者耐受良好。结论L—OHP、5-FU和CF联合化疗治疗晚期胃癌疗效显著,且毒副反应轻微,可作为晚期胃癌治疗的首选方案。     

FOLFOX4方案治疗晚期大肠癌前瞻性研究

目的评价FOLFOX4方案治疗晚期大肠癌的临床疗效。方法采用草酸铂（OXA）85mg／m^2静脉滴注2h，第1天；亚叶酸钙（CF）200mg／m^2，静脉滴注2h，第1、2天；5-氟尿嘧啶（5-Fu）400mg／m^2，静脉推注后续以600mg／m^2持续静脉点滴22h，第1、2天的方案治疗32例晚期大肠癌。2周为一周期，重复4周期后间隔1个月评定疗效。结果32例患者平均治疗6．75周期，完全缓解1例（3．13％），部分缓解13例（40．62％），稳定10例（31．25％），有效率43．75％，临床获益率75％，中位无疾病进展时间7个月，中位生存期15．1个月，1年生存率34．6％，治疗有效病例、治疗无效病例中位生存期分别为17．2和9．6个月，二者差异有统计学意义（P〈0．05）。白细胞减少为主要毒副反应（81．2％），其次为胃肠道反应（53．1％），周围神经毒性发生率为37．5％，多数为Ⅰ度，均不影响治疗。结论FOLFOX4方案治疗晚期大肠癌，尤其是肝转移患者有较好疗效，毒副反应可耐受，可作为晚期大肠癌首选化疗方案。     

mFOLFOX6方案治疗26例晚期胃癌

目的观察奥沙利铂联合氟尿嘧啶及亚叶酸钙组成的mFOLFOX6方案治疗晚期胃癌的疗效及毒副反应。方法26例晚期胃癌患者采用mFOLFOX6方案化疗，即：L—OHP100mg/m^2，静脉滴注3h，第1天；CF200mg/m^2，静脉滴注2h，第1天，5-FU2400～2800mg/m^2，46h泵控持续静脉滴注，3周重复1次，每个患者至少接受4个周期化疗。结果全组26例均可评价疗效，完全缓解2例，部分缓解10例，稳定9例，进展5例，总有效率12例（占46．15％）。14例初治患者有效率为50．00％，12例复治患者有效率为41．66％。中位肿瘤进展时间为5．3个月，中位生存时间为10．5个月。毒副反应主要为周围神经炎、骨髓抑制及胃肠道反应等。结论mFOLFOX6方案治疗晚期胃癌近期疗效好，毒副反应可耐受，值得进一步推广。     

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.