直线加速器立体定向放射外科治疗颅内病变的研究

用Ｗｉｎｓｔｏｎ－Ｌｕｔｚ法测定Ｘ－刀二次等中心系统的精度，应用仍体头颅模型的特定标记物测定ＣＴ定位的精度，应用不同的扫描方法对颅内病变进行ＣＴ定位，观察效果，并用自身对照方法，随访了经Ｘ－刀治疗后６～２４月的患者，结果显示，Ｘ－刀二次等中心系统误差０．１９ｍｍ，最大误差０．５ｍｍ，ＢＲＷＣＴ头颅定位误差０．６５ｍｍ最大误差１．０９ｍｍ，Ｘ－刀治疗误差为０．６８ｍｍ，最大１．２０ｍｍ，８７例应用Ｃ     

紫杉醇对大肠癌细胞的体外杀伤作用

目的：定量评价紫杉醇对人大肠癌细胞的杀伤作用和药物敏感性。方法：用 Ｍ Ｔ Ｔ 方法检测紫杉醇对体外培养人大肠癌细胞 Ｃ Ｃ Ｌ１８７、 Ｃ Ｃ Ｌ２２９、 Ｃ Ｘ１ 和 Ｃｌｏｎｅ Ａ 的杀伤作用。结果：在最大生理耐受浓度（１×１０－ ７ｍ ｏｌ／ Ｌ）下,药物持续作用７２ ｈ,紫杉醇对４ 种大肠癌细胞的生长抑制率 Ｃ Ｃ Ｌ１８７ 为 ３４５４％ , Ｃ Ｃ Ｌ２２９ 为 ５８７１％ , Ｃ Ｘ１ 为６７４０％ , Ｃｌｏｎｅ Ａ 为７０８７％ 。其中对 Ｃ Ｘ１ 和 Ｃｌｏｎｅ Ａ 呈高度敏感性, Ｉ Ｃ５０分别为９０×１０－ １０ｍ ｏｌ／ Ｌ和４０×１０－ ９ｍ ｏｌ／ Ｌ。紫杉醇对大肠癌细胞的杀伤作用随药物浓度和作用时间的增加而增加。结论：紫杉醇对人大肠癌细胞具有体外敏感性,对 Ｃ Ｘ１ 和 Ｃｌｏｎｅ Ａ 呈高度有效性。药物作用表现出明显的时间和剂量依赖性。     

马蔺子素对~(153)Sm-EDTMP治疗鼻咽癌骨转移瘤的影响

目的：探讨马蔺子素提高钐１５３乙二胺四甲撑膦酸（１５３ＳｍＥＤＴＭＰ）治疗鼻咽癌（ＮＰＣ）骨转移的可能性。方法：ＮＰＣ多发性骨转移瘤４０例，随机分为１５３ＳｍＥＤＴＭＰ内照射治疗组和马蔺子素与１５３ＳｍＥＤＴＭＰ联合治疗组各２０例。结果：单纯内放疗组显效率为３５％，联合治疗组显效率为７５％；肿瘤无进展生存时间分别为（３８±２０）月和（７６±３１）月，２组比较差异有显著性（Ｐ＜０．０５）。血液学毒性和外周血Ｔ淋巴细胞亚群值的差异无统计学意义（Ｐ＞０．０５）。结论：马蔺子素可以提高１５３ＳｍＥＤＴＭＰ治疗ＮＰＣ骨转移的效果，对内照射治疗有增敏作用。     

高浓度二氧化碳致大鼠全身性水肿的机理研究

目的　探讨高碳酸血症时大鼠全身性水肿发生的机理。方法　给大鼠呼吸高浓度二氧化碳气体（８ ％ Ｃ Ｏ２ 、２１ ％ Ｏ２ ,７１ ％ Ｎ２） ,每天７ 小时,连续４ 周。观察高碳酸血症大鼠各项指标的变化,并设对照组。结果　对照组平均肺动脉压（ｍ Ｐ Ａ Ｐ） 为（１９４ ±０２８） ｋ Ｐａ, Ｐａ Ｃ Ｏ２ 为（４６ ±０９） ｋ Ｐａ 。大鼠循环血中１２５ Ｉ牛血清白蛋白半排出时间（ Ｔ１／２） 为（２３８ ±３０） ｍｉｎ ;血浆过氧化脂质（ Ｌ Ｐ Ｏ） 为（３０ ±０６）ｎｍｏｌ／ｍｌ,红细胞超氧化物歧化酶（ Ｓ Ｏ Ｄ） 活性为（１ ０４２ ±１３５） Ｕ／ｇ Ｈｂ 。肺组织中水含量为（７６２ ±１０） ％ ,肌组织为（７４１ ±２８） ％ 。高碳酸血症组ｍ Ｐ Ａ Ｐ 为（２０ ±０４） ｋ Ｐａ 、 Ｐａ Ｃ Ｏ２ 为（７４ ±０４） ｋ Ｐａ 、 Ｔ１／２ 为（１５０ ±２３） ｍｉｎ 、 Ｌ Ｐ Ｏ 为（８８ ±２０） ｎｍｏｌ／ｍｌ、 Ｓ Ｏ Ｄ 为（６８２ ±３４１） Ｕ／ｇ Ｈｂ 、肺组织中水含量为（７８８±１８） ％ 、肌组织为（７６０ ±１０） ％ 。两组比较ｍ Ｐ Ａ Ｐ 差异无显著意义（ Ｐ＞ ００５） ; Ｐａ Ｃ Ｏ２ 、     

喉癌癌变过程中P21~(WAFI/CIP1)表达及临床病理学意义

目的　探讨喉癌癌变过程中 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 表达的临床病理学意义。方法　用免疫组化检测２０ 例正常粘膜、４０ 例不典型增生病变和６０ 例喉癌组织中 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 表达。结果　 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 和阳性表达定位于细胞核。在喉癌癌变过程中,喉正常粘膜、不典型增生病变和喉癌中 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 阳性表达率分别为９５０ ％ ,７５０ ％ 和６３３ ％ （ Ｐ＜ ００５） 。 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 在高、中、低分化的喉癌中阳性表达率分别为７６２ ％ ,６５５ ％ 和３００ ％ （ Ｐ＜ ００５） 。 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１阳性表达与其它临床病理参数无相关性（ Ｐ＜ ００５） 。结论　 Ｐ２１ Ｗ Ａ Ｆ Ｉ／ Ｃ Ｉ Ｐ１ 异常表达对喉癌发展起重要作用。     

内皮素-1及其基因在早期STZ糖尿病大鼠肾组织中的表达及其意义

为探讨内皮素１（ Ｅ Ｔ１）及其基因在早期链脲　菌素 （ Ｓ Ｔ Ｚ） 糖尿病大鼠肾脏组织中的表达及其意义,作者采用免疫组化 Ａ Ｂ Ｃ法和原位杂交技术检测了２４只早期 Ｓ Ｔ Ｚ糖尿病大鼠肾组织中 Ｅ Ｔ１及 Ｅ Ｔ１ ｍ Ｒ Ｎ Ａ 的定位及半定量表达。实验分为４组,每组６只。结果： Ｅ Ｔ１和 Ｅ Ｔ１ ｍ Ｒ Ｎ Ａ 的分布一致,主要分布于肾小球内皮细胞、系膜细胞、血管内皮细胞、平滑肌细胞及肾小管上皮细胞之中。髓质中 Ｅ Ｔ１和 Ｅ Ｔ１ ｍ Ｒ Ｎ Ａ 的表达高于皮质, 在糖尿病发生后１～２周, 二者在肾小球内均明显减少 （ Ｐ＜ ００５）, 但在４周时开始增高 （ Ｐ＜ ００５）, 而且在髓质中持续性增高。上述结果表明, Ｅ Ｔ１及 Ｅ Ｔ１ ｍ Ｒ Ｎ Ａ 参与了早期 Ｓ Ｔ Ｚ糖尿病大鼠肾小球高灌注及有关小管间质损伤。     

普罗布考调脂效应的临床观察

为评价普罗布考调脂作用,将７２例原发性高脂血症者随机分为２组,每组３６例,Ｐ组服普罗布考（Ｐｒｏｂｕｃｏｌ）１．０ｇ／ｄ;Ｆ组服非诺贝特（Ｆｅｎｏｆｉｂｒａｔｅ）０．３ｇ／ｄ,疗程均为３个月。治疗结束时Ｐ组和Ｆ组服药前后比较,血清总蛋固醇（ＴＣ）降低３７１％和２７３％,低密度脂蛋白胆固醇（ＬＤＬＣ）降低３９４％和３２６％,甘油三酯降低１７５％和４８６％,高密度脂蛋白胆固醇（ＨＤＬＣ）Ｐ组降低２８０％,Ｆ组升高１９７％,Ｆ组降低脂蛋白（ａ）１９３％。结果表明,Ｐ组调脂作用ＴＣ,ＬＤＬＣ优于Ｆ组,ＴＧ及ＨＤＬＣ逊于Ｆ组。两组副反应情况类似,但Ｐ组程度较轻     

温热联合细胞周期特异性药物对恶性胸膜间皮瘤细胞的影响

通过体外实验研究温热联合细胞周期特异性药物羟基喜树碱（ＯＰＴ）对ＳＭＣ１ 恶性胸膜间皮瘤细胞株的影响。结果显示：经０１ μｇ／ｍ ｌ、１０ μｇ／ｍ ｌ、１００ μｇ／ｍ ｌＯＰＴ 处理４８ ｈ 对ＳＭＣ１ 细胞增殖有抑制作用,其抑制作用具有药物浓度依赖性,流式细胞仪测定显示经ＯＰＴ处理后细胞周期出现改变,Ｓ期细胞下降,Ｇ２＋ Ｍ 期细胞增加（Ｐ＜ ００５ 或Ｐ＜ ００１）;单独加温３９℃、４１℃、４３℃６０ ｍ ｉｎ 对ＳＭＣ１ 细胞增殖同样具有抑制作用,并有温度依赖性;温热联合ＯＰＴ 对ＳＭＣ１ 细胞增殖具有最佳抑制效果,该效果显现出温度药物浓度依赖性。该实验为临床应用提供了一定的理论依据     

COPD和CPHD患者血浆ET—1变化及L—Arg对其影响的研究

采用放免分析法测定了ＣＯＰＤ、ＣＰＨＤ患者急性发作期血浆中ＥＴ１含量及应用盐酸精氨酸治疗前后血浆ＥＴ１水平变化。结果提示，ＣＯＰＤ、ＣＰＨＤ急性发作期外周静脉血ＥＴ１水平较正常组显著升高（Ｐ＜０００１），且ＣＰＨＤ急性发作期ＥＴ１水平较ＣＯＰＤ患者显著增高（Ｐ＜０００１）。急性发作期患者ＥＴ１含量与ＰａＣＯ２呈显著正相关，与ＰａＯ２、ｐＨ值呈显著负相关。ＬＡｒｇ组和对照组治疗前血浆ＥＴ１含量无显著差异，而治疗后ＬＡｒｇ组ＥＴ１水平较对照组有显著降低（Ｐ＜０００１）。提示ＥＴ１可能参与了ＣＯＰＤ、ＣＰＨＤ的发病过程，测定血浆ＥＴ１的水平变化可望作为判定病情严重程度的一个指标。ＬＡｒｇ可能作为ＮＯ供体通过增加ＮＯ的生成而拮抗ＥＴ１的产生，有可能成为ＣＯＰＤ、ＣＰＨＤ治疗的一个新途径     

硝普钠治疗难治性心衰及其对血浆一氧化氮、内皮素-1的影响

为探讨硝普钠治疗难治性心衰后血浆一氧化氮（ＮＯ）及内皮素１（ＥＴ１）的变化。在综合治疗的基础上加用硝普钠治疗难治性心衰５８例，应用分光光度法及放免法测定治疗前后血浆ＮＯ及ＥＴ１的变化。结果：与治疗前相比，有效组血浆ＮＯ水平明显升高（Ｐ＜００１），ＥＴ１明显下降（Ｐ＜００１）；无效组ＮＯ、ＥＴ１无明显变化（Ｐ＞００５）；心功能明显改善总有效率８７９３％。结果提示：ＮＯ、ＥＴ１是观察心衰治疗效果的重要指标之一。     

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.