粒细胞集落刺激因子治疗中性粒细胞减少症临床观察

目的观察中粒细胞减少症(neutropenia)用粒细胞集落刺激因子(G-CSF)治疗后白细胞(WBC)变化情况。方法对本院2002～2004年血液肿瘤科WBC减少住院病人200例和门诊病人4例,均已进行G-CSF治疗作为治疗组,对照组50例。结果治疗组总有效率为92.6%,时间3～14d不等,WBC数量从(2.39±1.20)×109/L上升到(8.60±2.86)×109/L,中性粒细胞(ANC)数量从(1.10±0.80)×109/L上升到(3.60±1.16)×109/L;对照组上升率为58.0%。治疗组和对照组WBC和ANC变化比较差异有显著性,P<0.01。血红蛋白、血小板其数量无明显变化。结论用G-CSF治疗白细胞减少症WBC和ANC上升显著。     

小剂量G—CSF对化疗引起的粒细胞减少症的治疗作用

应用小剂量（２μｇ／ｋｇ）粒细胞集落刺激因子（Ｇ－ＣＳＦ）于１８例肺癌患者化疗中，以观察预防发生中性粒细胞减少症的疗效。其中小细胞肺癌５例，非小细胞肺癌１３例，随机分成Ｇ－ＣＳＦ组及对照组各９例，化疗方案为ＣＥ（卡铂－ＶＰ１６）。结果Ｇ－ＣＳＦ组粒细胞绝对计数（ＡＮＣ）＜２．０×１０９／Ｌ，发生例数５例，持续天数为３．６±３．５天；对照组持续天数１６．８±７．１天，Ｐ＜０．０５。ＡＮＣ最低值至恢复正常（ＡＮＣ＞２．０×１０９／Ｌ）的天数Ｇ－ＣＳＦ组及对照组分别为２．６±１．３天，８．９±５．３天（Ｐ＜０．０５）。Ｇ－ＣＳＦ组化疗后的第２０天ＡＮＣ均已恢复正常，ＡＮＣ为（９．７±６．８）×１０９／Ｌ故可在第２２天顺利接受第二周期化疗。对照组ＡＮＣ（１．６６±０．８）×１０９／Ｌ（Ｐ＜０．０１）。由此可见，小剂量Ｇ－ＣＳＦ能有效地防治肺癌化疗引起的粒细胞减少症     

小剂量阿糖胞苷加粒细胞集落刺激因子治疗老年急性髓细胞白血病10例临床观察

目的探患者讨小剂量阿糖胞苷（Ara-C）加粒细胞集落刺激因子（G-CSF）治疗老年急性髓细胞白血病（AML患者）的临床疗效。方法对10例初发的老年AML采用小剂量Ara—C加G-CSF治疗，具体方案：粒细胞集落刺激因子G—CSF[100μg／（m^2&#183;d）皮下注射，在第一次注射阿糖胞苷（Ara-C）之前开始使用，至最后一次注射Ara—C之前停用，当中性粒细胞〉30&#215;10^9／L时减少G-CSF的剂量或暂时停用]联合小剂量Ara—C（10mg／m^2皮下注射每12h 1次，连用14～21d）诱导化疗，如1疗程未获缓解，可接受第二疗程治疗。结果1疗程完全缓解（CIL）率为40％，2疗程CIL率60％；化疗后外周血白细胞最低值平均为0．95&#215;10^9／L，中性粒细胞绝对值（NAP）〈0.5&#215;10^9／L的中住时间为10d，血小板（PLT）平均输注量为3个治疗量；非造血系统毒副反应低；感染发生率为60%，无治疗相关死亡率。结论小剂量Ara—C加G-CSF治疗老年急性髓细胞白血病的疗效肯定。不良反应小。     

小剂量粒细胞集落刺激因子治疗粒细胞减少

为观察小剂量粒细胞集落刺激因子 (rhG CSF)治疗非化疗药品所致粒细胞减少症或粒细胞缺乏症的疗效 ,选择 30例粒减或粒缺患者 ,其中应用小剂量rhG CSF(治疗组 ) 15例 ,对照组 15例。结果 :治疗组外周血中性粒细胞计数上升至 2 0× 10 9/L的时间比对照组明显缩短 ,用 2个样本均数差异的t检验方法 ,P <0 0 5。表明非化疗药品所致粒减或粒缺使用rhG CSF能加快周围血粒细胞上升至正常计数值 ,帮助患者加快度过骨髓抑制期 ,且无明显副作用。     

粒细胞集落刺激因子治疗肿瘤化疗所致粒细胞减少15例报告

粒细胞集落刺激因子（G－CSF）是一组糖蛋白、多肽激素。由DNA重组技术产生，可刺激正常中性粒细胞的增生和成熟[1]。目前作为肿瘤化疗的辅助治疗已推广应用于临床。我们采用G－CSF治疗肿瘤化疗所致粒细胞减少症，效果满意。现将结果报道如下。临床资料一、病例选择：所有病例均经病理证实为恶性肿瘤。肝肾功能正常；ECOG活动状态0～2级。化疗前粒细胞绝对数≥2×109/L外地血小板≥100×109/L外地。本组中男11例，女4例，年龄最大63岁，最小18岁。其中：非何杰金氏淋巴瘤（NHL）10例；小细胞肺癌（SCL）3例；结肠癌1例；食道癌1例…     

粒细胞集落刺激因子联合地榆升白片治疗白细胞减少25例

目的：观察粒细胞集落刺激因子联合地榆升白片治疗白细胞减少的疗效。方法：将48例病人随机分成治疗组25例,对照组23例,治疗组口服地榆升白片同时用粒细胞集落刺激因子,对照组口服碳酸锂、维生素B4片,单用粒细胞集落刺激因子治疗。结果：治疗组升高白细胞明显优于对照组,两组比较有显著性差异（P〈0.05）。结论：粒细胞集落刺激因子联合地榆升白片治疗白细胞减少,升高白细胞疗效稳定、显著。     

脱氧核苷酸钠注射治疗急性白血病化疗后粒细胞缺乏效果观察

目的：观察静脉注射脱氧核苷酸钠注射液治疗急性白血病（AL）化疗后粒细胞缺乏的临床效果。方法选取收治的61例化疗后的急性白血病患者为研究对象,随机分为实验组与对照组,实验组31例患者每日予重组人粒细胞集刺激因子200μg＋脱氧核苷酸钠150 mg;对照组30例患者仅每日予重组人粒细胞集落刺激因子200μg,至连续2次复查中性粒细胞绝对值大于0.5＆#215;109/L后停药。结果实验组感染发生率为25.8%,粒细胞缺乏纠正时间为（3.2＆#177;1.4）d,对照组发生率为60%,粒细胞缺乏纠正时间（5.4＆#177;2.3）d。两组感染发生率及粒细胞缺乏纠正时间比较差异有统计学意义（P＜0.05）。结论脱氧核苷酸钠注射液对急性白血病化疗后中性粒细胞的恢复具有较好的临床疗效。     

小剂量粒细胞集落刺激因子联合叶酸治疗粒细胞减少症的护理

粒细胞减少症（外周血中性粒细胞绝对数低于１．５×１０９／Ｌ时）是临床常见的病症，大多由药物或化学毒物通过免疫反应引起，发病率高，病情较重，传统的升粒细胞药物起效慢、疗效差，而大剂量粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）疗效虽可靠，但其价格较昂贵，特别是...     

粒细胞集落刺激因子治疗粒细胞缺乏症28例疗效观察

用重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）治疗粒细胞缺乏症（粒缺）２８例，观察其临床疗效，并与未用ｒｈＧ－ＣＳＦ而其他治疗相同的对照组２０例比较。结果，２３例（８２．１％）中性粒细胞数升至≥０．７×１０９／Ｌ，其中１９例（６７．９％）升至≥１．０×１０９／Ｌ，均显著高于对照组的５５．０％和３５．０％（Ｐ＜０．０５）；ｒｈＧ－ＣＳＦ治疗组并发感染治疗有效率（７５．０％）亦显著优于对照组（Ｐ＜０．０５），且平均发热时间较短（Ｐ＜０．０５）。分析认为，ｒｈＧ－ＣＳＦ治疗粒缺有满意疗效，无明显副反应，可列为首选药物。     

孟鲁司特对反复呼吸道感染患者炎症相关指标水平的影响

目的观察孟鲁司特对反复呼吸道感染患者鼻咽抽吸物及血清炎症指标的影响。方法选择2012年7月至2015年6月周口市中心医院收治的82例反复呼吸道感染患者,按照随机数字表法分为观察组与对照组,各41例。两组患者均给予常规基础治疗,观察组加用孟鲁司特治疗,监测治疗前后两组患者免疫球蛋白指标IgA、IgE、IgG,炎症因子IL－2、IL－4、IL－5、肿瘤坏死因子－α（ TNF－α）、干扰素－γ（ IFN－γ）及中性粒细胞、淋巴细胞、单核巨噬细胞、嗜酸性粒细胞、白三烯D4（ LTD4）水平,比较两组免疫功能的改善及炎症水平的变化。结果①治疗后,观察组中性粒细胞、嗜酸性粒细胞、LTD4低于对照组[（3.78±0.16）×109／L、（0.52±0.71）×109／L、（190.32±92.14）pg／mL vs （4.14±1.13）×109／L、（0.83±0.66）×109／L、（234.62±88.43）pg／mL],单核巨噬细胞高于对照组[（2.25±0.93）×109／L vs （1.86±0.79）×109／L],差异均有统计学意义（P＜0.05）;②治疗后,观察组IgA、IgG高于对照组[（0.76±0.10） g／L、（0.39±0.06） g／L vs （0.69±0.11） g／L、（0.31±0.04） g／L],IgE低于对照组[（0.17±0.03） g／L vs （0.21±0.03）g／L],差异均有统计学意义（P＜0.05）;③治疗后,观察组IL－2、IFN－γ高于对照组[（260.71±18.62）pg／mL、（22.06±2.33）pg／mL vs （220.55±20.41）pg／mL、（15.38±5.98）pg／mL],IL－4、IL－5、TNF－α低于对照组[（11.06±8.06）pg／mL、（13.42±7.55）pg／mL、（7.55±1.02）pg／mL vs （20.04±12.22）pg／mL、（24.52±11.23）pg／mL、（14.33±2.18）pg／mL],差异均有统计学意义（ P＜0.05）;④观察组治疗总有效率为78.05％,高于对照组的56.10％（ P＜0.05）。结论采用孟鲁司特治疗反复呼吸道感染患者,治疗有效率高,患者血清炎症因子改善显著。     

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.     

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.     

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.