手术去势间断联合抗雄激素治疗晚期前列腺癌

目的：探讨手术去势间断联合抗雄激素药物治疗晚期前列腺癌的临床疗效。方法选择我院2008年1月至2012年8月收治的60例晚期前列腺癌患者作为研究对象,分成研究组与对照组各30例,研究组采用手术去势间断联合抗雄激素药物进行治疗,对照组采用抗雄激素药物进行治疗,对比分析两组的治疗效果。结果两组患者治疗后的前列腺特异性抗原（ PSA）水平与生活质量均有改善,但研究组改善更为明显,差异具有统计学意义（P＜0.01）;研究组患者的疾病无进展,生存时间（PFS time）和总生存时间（Os time）均比对照组时间长,差异具有统计学意义（P＜0.05）;研究组患者中出现性欲缺乏人数多于对照组（P＜0.01）;两组患者中出现潮热、骨质疏松与贫血的差异不具有统计学意义（ P＞0.05）。结论采用手术去势间断联合抗雄激素药物治疗晚期前列腺癌的临床疗效较好,能有效提高患者的生活质量以及 PFStime、Ostime。     

手术去势间断联合抗雄激素药物治疗晚期前列腺癌临床研究

目的:探讨手术去势间断联合抗雄激素药物治疗晚期前列腺癌的临床疗效。方法:选择2014年2月~2016年2月收治于我院的30例晚期前列腺癌患者作为研究对象,将其随机分组,分为对照组(15例)和研究组(15例),对照组患者采用抗雄激素药物进行治疗,研究组采用手术去势间断联合抗雄激素药物进行治疗,对比研究组和对照组两组患者的治疗效果。结果:比较研究组和对照组治疗前后PSA水平,治疗前期两组患者PSA水平无显著差异(P0.05),不具有统计学意义;治疗后实验组患者PSA水平明显低于对照组,差异具有统计学意义(P0.05);比较研究组和对照组患者的疾病无进展生存时间(PFS time)和总生存时间(Os time),研究组均优于对照组,差异具有统计学意义(P0.05)。结论:手术去势间断联合抗雄激素药物治疗晚期前列腺癌的临床效果较好,值得临床推广。     

手术去势联合间歇雄激素全阻断疗法治疗晚期前列腺癌的作用观察

目的：探讨手术去势联合间歇性雄激素全阻断疗法治疗局部进展期前列腺癌（ PCA）的临床价值。方法：选取我院2009年1月至2013年1月间收治的失去根治手术机会的晚期前列腺癌患者44例,随机分为观察组与对照组,观察组采用手术去势联合间歇性雄激素全阻断疗法治疗,对照组患者采用药物去势治疗,给予黄体生成素释放激素类似物（醋酸戈舍瑞林缓释植入剂）联合抗雄激素药物（比卡鲁胺）治疗,观察两组患者治疗前后EORTCQLQ-C30及QLQ-PR25评分,以评价患者生活质量评分改善情况,并对比两组患者疾病无进展生存时间（ PFStime）、总生存时间（ OS time）情况。结果：两组患者治疗后前列腺特-异性抗原（ PSA）均显著下降,但组间比较无统计学差异（ P＞0．05）;观察组患者生活质量改善较对照组更为显著（ P＜0．05）;观察组患者PFStime、OS time较对照组显著提高（ P＜0．05）。结论：手术去势联合间歇性雄激素全阻断疗法治疗局部进展期PCA安全、有效,能显著提高患者PFStime、OS time及生活质量,是老年患者及贫困地区PCA患者较好治疗选择。     

药物去势和手术去势联合TURP治疗前列腺癌疗效分析

目的研究前列腺癌患者药物去势与手术去势联合经尿道前列腺电切术后患者前列腺特异性抗原(PSA)水平与国际前列腺症状评分(IPSS)的变化。方法 60例研究对象,其中28例行药物去势,32例行手术去势联合经尿道前列腺电切。对比治疗前后PSA及IPSS变化。结果治疗后3个月,两组患者PSA均有明显下降,但组间差异无统计学意义(P>0.05),IPSS评分手术组较药物组下降明显(P<0.01)。结论前列腺癌合并下尿路梗阻的患者更适合行手术去势联合经尿道前列腺电切及抗雄激素药物治疗。     

微创经尿道前列腺等离子电切术联合手术去势或药物去势治疗高龄晚期前列腺癌合并尿潴留的疗效和安全性分析

目的探讨微创经尿道前列腺等离子电切术联合手术去势或药物去势治疗高龄晚期前列腺癌合并尿潴留的疗效和安全性。方法选取医院于2017年1月ZHI 2019年3月期间收治的45例高龄晚期前列腺癌合并尿潴留患者作为研究对象,采用随机数字表法分为对照组、手术去势组、药物去势组各15例。三组均行微创经尿道前列腺等离子电切术,在此基础上手术去势组联合手术去势治疗,药物去势组联合药物去势治疗。比较三组患者治疗前后的治疗有效率、生活质量评分及IPSS评分。结果治疗后,药物去势组的疾病控制率、生活质量评分明显高于手术去势组和对照组,且不良反应发生率、IPSS评分明显低于手术去势组和对照组,比较差异显著(P0.05)。结论微创经尿道前列腺等离子电切术联合药物去势治疗高龄晚期前列腺癌合并尿潴留患者的疗效优于手术去势及单纯电切治疗,能提升患者的生活质量,有效改善尿潴留,具有较高的安全性,值得应用。     

药物去势联合手术去势治疗前列腺癌的疗效评价

目的讨论药物去势治疗结合双侧睾丸切除联合前列腺电切治疗前列腺癌的临床有效性。方法病例分2组,治疗组采用药物去势结合双侧睾丸切除联合前列腺电切手术治疗前列腺癌,对照组采用双侧睾丸切除结合去势药物治疗,对2组结果进行统计分析。结果 2组IPSS、PSA术前（P〉0.05）不具有统计学意义,2组IPSS、PSA术后3个月（P〈0.05）差异显著,有统计学意义。结论采用药物去势结合双侧睾丸切除联合前列腺电切手术治疗前列腺癌有一定的临床有效率。     

晚期前列腺癌药物去势中Gleason评分、血清PSA与疗效相关性研究

目的：探讨晚期前列腺癌（Pca）患者药物去势治疗过程中疗效与Gleason评分及血清前列腺特异性抗原（PSA）的相关性。方法：选择33例晚期Pca患者，给予黄体激素释放激素类似物（LHRH—A）＋抗雄激素药物进行药物去势治疗，根据Gleason评分分为2～5分组、6～7分组、8～10分组，对3组血清PSA变化进行分析。结呆：Gleason评分6～7分组的病人在治疗后3个月内血清PSA值下降最快，治疗后6个月时Gleason评分2～5分组病人血清PSA值恢复正常，而Gleason评分6～7分组与8～10分组病人血清PSA值则接近正常值范围。不同Gleason评分组间血清PSA水平差异有统计学意义（F=5．396，P〈O．05）。结论：（1）Gleason评分、血清PSA水平与晚期Pca患者行药物去势疗法疗效有密切关系。（2）血清PSA变化是监测Pca复发与评价疗效的可靠瘤标。     

TUVP联合间歇性和持续性雄激素去势对改善晚期前列腺癌患者生活质量和总生存率的影响

目的：探讨TUVP联合间歇性和持续性雄激素去势对改善晚期前列腺癌患者生活质量和总生存率的影响.方法：随机抽取我院136例晚期前列腺癌患者,将其分为两组,对照组69例,采用TUVP联合持续性雄激素去势治疗,观察组67例,采用TUVP联合间歇性雄激素去势治疗,比较两组治疗3个月后的国际前列腺症状评分、生活质量评分及随访一年后总生存率之间的差异.结果：治疗3个月后,观察组患者在国际前列腺评分、生活质量评分及随访一年后的总生存率分别为1.85±0.48,1.85±0.48,89.55％,明显优于对照组,差异有统计学意义（P＜0.05）.结论：对晚期前列腺癌患者来说,TUVP联合间歇性雄激素去势治疗是安全有效的治疗方法,能明显改善患者的临床症状,提高生活质量,提高癌症患者的总生存率.     

氟他胺联合抑那通间歇性治疗手术去势后前列腺癌的临床观察

目的探讨晚期前列腺癌手术去势后间歇性雄激素阻断治疗的临床疗效。方法选取2003年1月至2010年1月晚期前列腺癌患者24例（C1、C2、D1、D2期分别为2、6、10、6例）,做睾丸去势手术后,采用间歇性内分泌治疗：氟他胺服用3～6个月,当前列腺特异性抗原（PSA）下降达到相对稳定水平（0.2～13μg/L）并维持2个月后停药,停药期间定期影像学检查及PSA监测,当PSA水平超过稳态水平2～3倍时进入下一周期氟他胺治疗,以此类推;抑那通在手术去势后18～24个月,当PSA大于稳态水平2～3倍时开始使用,1次/月,3次/疗程,以后每3年1疗程。结果 24例患者平均随访时间（38.7±14.3）月,22例生存,生存率91.7%;3例氟他胺耐药。停药间歇期〉9个月,87.5%患者重复用药后仍能有效控制,重复用药后平均治疗时间（5.0±1.1）月。与单纯手术去势或持续内分泌药物治疗比较,间歇性内分泌治疗可明显延长肿瘤对雄激素依赖的时间。结论手术去势后联合间歇性内分泌治疗,可延缓患者向雄激素难治性前列腺癌的进展,是治疗晚期前列腺癌的有效方法     

药物去势联合放疗对前列腺癌患者的效果评估

目的 探讨药物去势治疗联合根治性放射治疗前列腺癌患者的效果和安全性研究。方法 选取2014年1月—2016年1月禹城市人民医院收治且年龄超过70岁的前列腺癌患者89例作为研究对象。随机分为药物去势联合根治性放疗组（观察组44例）和单纯根治性放疗组（对照组45例）,观察临床疗效及不良反应发生情况,随访观察疾病中位无进展生存时间（mPFS）。结果 两组客观缓解率和疾病控制率（客观缓解率61.4% VS 33.3%,疾病控制率95.5% VS 55.6%）比较,差异有统计学意义（P?<0.05）,观察组均高于对照组;观察组的mPFS为（36.5±3.7）个月,对照组为（19.8±2.4）个月,差异有统计学意义（P?<0.05）。观察组总生存时间（OS）为（39.8± 3.8）个月,对照组为（25.4±2.7）个月,差异有统计学意义（P?<0.05）。多因素分析发现前列腺癌患者KPS 70～80分、淋巴结转移阳性患者、Gleason评分G8～10及单纯放疗是前列腺癌患者PFS和OD的影响因素;药物去势联合根治性放疗同样与患者OS相关。结论 药物去势联合根治性放射治疗高龄前列腺癌患者有较好的生存获益,值得临床推广应用。     

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.