多西他赛联合顺铂或希罗达治疗蒽环类耐药晚期乳腺癌的疗效研究

对比分析多西他赛联合顺铂与联合希罗达治疗蒽环类耐药晚期乳腺癌的近期疗效和不良反应.方法 68例经病理证实的晚期乳腺癌患者,分为两组.多西他赛联合顺铂组(A组)与多西他赛联合希罗达组(B组),各34例,均治疗2-4个周期.每完成2个周期进行评价.结果 A组总有效率58.82%(20/34),B组总有效率61.76%(21/34),差异无统计学意义(P＞0.05);两组的不良反应均为可逆性,以Ⅰ-Ⅲ级为主,主要不良反应为骨髓抑制、恶心呕吐、脱发、肌肉关节痛和手足综合征,其中恶心呕吐和手足综合征发生率两组比较差异有统计学意义(P＜0.05).结论 多西他赛联合顺铂与联合希罗达方案治疗蒽环类耐药的晚期乳腺癌,近期疗效相似,不良反应均可耐受,安全性好,但多西他赛联合希罗达方案更适合年老体质差者.     

多西他赛联合替吉奥与奥沙利铂联合替吉奥一线治疗晚期胃癌的疗效分析

目的:评价多西他赛联合替吉奥与奥沙利铂联合替吉奥在晚期胃癌中的疗效和安全性。方法:回顾分析并比较本院2012年1月-2015年1月54例经病理确诊的晚期胃癌患者分别应用多西他赛联合替吉奥与奥沙利铂联合替吉奥方案的疗效和安全性,TS组28例应用多西他赛联合替吉奥方案,OS组26例应用奥沙利铂联合替吉奥方案,比较两组患者的疾病缓解率、疾病控制率和中位无疾病进展时间(median progression-free surviva,PFS),同时比较两组化疗过程中的Ⅲ度和Ⅳ度不良反应的发生率。结果:TS组和OS组的疾病缓解率分别为57.14%和61.54%(P=0.745),疾病控制率分别为85.71%和84.62%(P=0.910),m PFS分别为7.8个月和8.4个月(P=0.531);两组Ⅲ度和Ⅳ度不良反应的发生率分别为14.29%和19.23%(P=0.626),比较差异均无统计学意义(P0.05)。结论:TS方案和OS方案均是胃癌有效的一线化疗方案,不良反应可耐受,疗效和不良反应无明显差异,临床上均可推荐使用。     

吉西他滨与多西他赛联合顺铂治疗晚期NSCLC的临床研究

目的 研究比较吉西他滨与多西他赛联合顺铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效。方法 将 72 例晚期非小细胞肺癌患者随机分成两组,分别接受吉西他滨与多西他赛联合顺铂化疗,每例患者至少接受 2 个周期以上的同一方案治疗,比较两组方案治疗的近期疗效、不良反应及 1 年生存期。结果 吉西他滨联合顺铂化疗组有效率为 47.2％,多西他赛联合顺铂化疗组有效率为 44.5％,吉西他滨联合顺铂化疗组患者中位生存期 11.4 m,1年生存率为 44.5％,多西他赛联合顺铂化疗组患者中位生存期 11.1 m,1 年生存率 41.7％,两组的各项结果比较均无统计学差异（P＞0.05）。结论 吉西他滨与多西他赛联合顺铂方案治疗晚期 NSCLC 疗效相似,可以作为临床一线治疗方案。     

多西他赛联合小剂量铂类与单药化疗治疗老年晚期NSCLC疗效比较

目的 研究70岁以上老年非小细胞肺癌(NSCLC)患者减量联合化疗与单药化疗的有效率与生存期.方法 采用回顾性研究方法,对38例70岁以上老年晚期NSCLC患者采用多西他赛+小剂量顺铂与单药多西他赛化疗的疗效及生存期进行比较.结果 联合方案组和单药方案组有效率分别为20.0％、11.1％ (P＞0.05),中位生存期分别为13.2、11.3个月(P＜0.05),无化疗相关死亡发生.2组化疗的主要不良反应为骨髓抑制及胃肠道反应,给予对症处理后可以恢复,无1例因不良反应中止化疗.结论 多西他赛联合小剂量顺铂化疗治疗一般状况较好的老年晚期NSCLC疗效确切且耐受性较好,中位生存期长于单药多西他赛治疗者.     

多西他赛与奥沙利铂联合氟尿嘧啶类药物治疗晚期胃癌的临床对比研究

目的：分析多西他赛与奥沙利铂联合氟尿嘧啶类药物治疗晚期胃癌的临床效果。方法随机选取符合纳入标准2015年3月-2016年3月期间进入该院的60例晚期胃癌患者随机分为实验组和对照组,每组30例,对照组采用多西他赛联合氟尿嘧啶类药物治疗方式,实验组采用奥沙利铂联合氟尿嘧啶类药物治疗方式,比较两组近期疗效、远期疗效和不良反应。结果两组在近期疗效和远期疗效方面差异无统计学意义(P>0.05),对照组白细胞减少总发生率为86.67%明显高于实验组66.67%,而实验组外周神经毒素发生率66.67%明显高于对照组31.17%,差异有统计学意义(P<0.05)。结论多西他赛与奥沙利铂联合氟尿嘧啶类药物治疗晚期胃癌具有不同的临床应用特点,需要根据患者实际情况进行个性化选择。     

多西他赛和奥沙利铂联合替吉奥三联治疗晚期胃癌的效果观察

目的:观察多西他赛和奥沙利铂联合替吉奥三联治疗晚期胃癌的效果。方法:回顾性分析2015年10月至2016年10月的70例行化疗的晚期胃癌患者的临床资料,根据化疗方案不同将其分为对照组32例与观察组38例。对照组采用奥沙利铂和替吉奥治疗,观察组在对照组治疗方案上加用多西他赛治疗,比较两组临床疗效、生命质量、不良反应发生率及生存率。结果:观察组治疗总有效率为68.4%,显著高于对照组的43.8%,差异有统计学意义(P<0.05);治疗前,两组生命质量评分比较,差异无统计学意义(P>0.05),治疗后,观察组生命质量评分(72.24±6.08)分,显著高于对照组(68.19±5.66)分,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);观察组1年生存率及2年生存率均显著高于对照组,差异有统计学意义(P<0.05)。结论:应用多西他赛和奥沙利铂联合替吉奥治疗晚期胃癌患者的效果优于奥沙利铂联合替吉奥治疗效果,可有效提高患者生命质量,延长患者生存时间。     

多西他赛联合奥沙利铂及替吉奥新辅助化疗对局部晚期胃上部癌的临床价值

目的:探讨多西他赛联合奥沙利铂及替吉奥新辅助化疗对局部晚期胃上部癌的临床效果。方法:选取收治的局部晚期胃上部癌患者44例,患者随机分为对照组和观察组,对照组22例给予多西他赛联合奥沙利铂及氟尿嘧啶治疗,观察组22例则给予多西他赛联合奥沙利铂及替吉奥行新辅助放射治疗。比较两组治疗效果。结果:观察组1年生存率和2年生存率分别为81.8%和68.2%,对照组1年生存率和2年生存率分别为63.6%和45.5%,组间比较差异有统计学意义(P<0.05)。对照组和观察组不良反应发生率分别为36.4%和18.2%,组间比较差异有显著统计学意义(P<0.05)。结论:多西他赛联合奥沙利铂及替吉奥新辅助化疗治疗局部晚期胃上部癌可有效延长患者生存时间,减少不良反应,值得在临床中推广应用。     

多西他赛不同联合用药方案周剂量治疗晚期胃癌的临床疗效分析

目的探讨多西他赛不同联合用药方案周剂量治疗晚期胃癌的临床疗效。方法选取松滋市人民医院2018年8月—2019年8月收治的80例晚期胃癌患者为研究对象,使用随机数字表法将其分为2组,对照组(n=40)给予多西他赛联合顺铂治疗,研究组(n=40)给予多西他赛联合奥沙利铂治疗,以21 d为1个化疗周期,治疗4个周期后评估2组的临床疗效、安全性,记录2组患者的总生存(OS)时间与中位生存时间(MST)。结果对照组患者的治疗有效率为85.00%,研究组为95.00%,差异无统计学意义(P>0.05)。对照组患者的不良反应发生率为20.00%,显著高于研究组的5.00%,差异有统计学意义(P<0.05)。观察组患者的OS时间及MST略长于对照组,但差异无统计学意义(P>0.05)。结论多西他赛联合顺铂及多西他赛联合奥沙利铂治疗晚期胃癌的临床疗效均显著,均可延长患者的生存时间,但多西他赛联合奥沙利铂组的不良反应显著更小,安全性较高。     

国产多西他赛联合顺铂治疗晚期非小细胞肺癌的临床观察

目的 观察国产多西他赛联合顺铂治疗晚期非小细胞肺癌的疗效.方法 58例晚期非小细胞肺癌患者中29例行国产多西他赛联合顺铂(DP方案)治疗,另29例患者行环磷酰胺、阿霉素、顺铂(CAP方案)治疗作为对照组,比较分析两组疗效及不良反应.结果 治疗组有效率为48.28%(14/29),对照组为20.68%(6/29),差异具有非常显著性(P＜0.01),两组不良反应差异无显著性(P＞0.05).结论 国产多西他赛联合顺铂治疗晚期非小细胞肺癌疗效好,且不良反应较轻,安全性好,可作为晚期非小细胞肺癌较为理想的治疗手段.     

奥沙利铂联合多西他赛治疗晚期胃癌37例效果观察

目的:观察奥沙利铂联合多西他赛方案治疗晚期胃癌的疗效及不良反应。方法:37例晚期胃癌患者采用奥沙利铂联合多西他赛的治疗方案,奥沙利铂130 mg/m2第1天静脉滴注,多西他赛75 mg/m2第1、8天静脉滴注,21 d为1个疗程,2个疗程后评价疗效和不良反应。结果:37例晚期胃癌患者中完全缓解3例,部分缓解20例,病情稳定12例,2例病情进展,总有效率达62.16%。全组无治疗相关性死亡者。结论:奥沙利铂联合多西他赛治疗晚期胃癌效果较好,不良反应少,安全性好,值得在临床上推广。     

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.