浸润性膀胱癌经导管双侧髂内动脉灌注化疗的临床疗效观察

目的探讨浸润性膀胱癌经导管双侧髂内动脉灌注化疗的临床疗效。方法选取我院收治的55例行经导管双侧髂内动脉灌注化疗的浸润性膀胱癌患者,对其临床资料进行回顾性分析。结果本组55例患者双侧髂内动脉插管均成功,术后3例患者出现发热现象,12例患者出现恶心、呕吐现象,4例患者出现厌食现象,2例患者出现穿刺点血肿现象,1例患者出现白细胞降低现象。经导管灌注化疗后,2例患者完全缓解,22例患者部分缓解,1例患者病情稳定。术后给予患者为期6个月的随访,3例患者肿瘤复发。结论经导管双侧髂内动脉灌注化疗治疗是一种安全、有效的治疗方式,值得推广和应用。     

肝癌行介入化疗加栓塞疗法的观察与护理

肝癌经皮穿刺行股动脉介入化疗 +栓塞疗法越来越多地被人们采用。近年 ,我们对 3 0例肝癌患者进行介入化疗加栓塞治疗 ,现将护理体会报告如下。1 临床资料本组肝癌 3 0例 ,男 2 7例 ,女 3例 ,年龄 3 8～ 72岁。2 5例未经手术。 1 0例已行介入术 2～ 3次 ,患者均在Ｘ线电视监视下采用经皮穿刺股动脉途径插管至肝总动脉 ,注入抗癌药后 ,将病变血管栓塞。一般均采用 1次注入较大剂量的抗癌药物 ,定期复查 ,观察疗效 ,决定是否继续介入术。2 术前准备心理准备　术前向患者讲解介入疗法的优点、方法和适应证 ,并请做过介入治疗的患者现身说法 ,…     

髂内动脉化疗栓塞和药泵植入联合手术治疗浸润性膀胱癌

目的:寻求浸润性膀胱癌的有效治疗方法.方法:回顾性总结经手术、病理证实并获随访的40例浸润性膀胱癌患者资料.40例患者分为髂内动脉化疗栓塞和药泵植入联合手术治疗组(A组)20例和单纯手术治疗组(B组)20例,了解介入治疗对浸润性膀胱癌的效应,分析比较两组术后复发率、生存率的差异.结果:A组患者术前经髂内动脉化疗栓塞后,能使大部分膀胱肿瘤病灶缩小,控制严重血尿,提高手术中肿瘤的切除率,术后经药泵穿刺注射抗癌药物能更有效地清除残留肿瘤病灶和杀灭盆腔内转移病灶,预防肿瘤复发,提高病人生存率和生活质量.结论:髂内动脉化疗栓塞和药泵植入联合手术治疗膀胱癌安全有效,可以显著提高浸润性膀胱癌的治疗效果.     

泌尿系统疾病的介入栓塞治疗(附63例报告)

目的：探讨介入栓塞治疗泌尿系统疾病的疗效,提高介入栓塞治疗系统疾病的水平。方法：采用Seldinger进行经皮穿刺股动脉插管,以无水乙醇碘油混合剂、明胶海绵为主要栓塞物,用选择性或和超选择性插管技术栓塞治疗肾癌40例、肾血管动静脉畸形5例、中晚期膀胱癌18例。结果：33例肾癌患者栓塞术后肿瘤体积缩小、肾周水肿带明显,手术时出血减少;1例栓塞术后肿块无改变,1月后改行手术治疗;6例Ⅳ期病人行治疗性栓塞,术后存活6～18月,未再出现血尿;1例切除术后肿瘤复发患者,行肿块栓塞术后并发截瘫。5例血管动静脉畸形行栓塞术后随访12～24月余,无血尿,无复发。18例膀胱癌,14例浸润性膀胱癌患者在采用超选择性髂内动脉化疗栓塞术治疗后,保留了部分膀胱,其中晚期膀胱癌（t4期）4例,行栓塞治疗后出血停止。结论：介入栓塞治疗泌尿系统疾病是一种有效的方法,能提高手术成功率,能最大程度保留正常肾和膀胱组织或显著改善生存质量。其并发症较少,但发生后其后果极其严重,应引起高度重视。     

恶性肿瘤病人介入化疗前后的监护

目前 ,在Ｘ线监测下行股动脉介入化疗法是治疗恶性肿瘤中、晚期和复发癌的一种新途径。它直接栓塞肿瘤血供的主要动脉血管 ,使肿瘤缺血坏死而达到控制肿瘤发展的目的。在介入化疗工作中 ,监护程序十分重要 ,现将我科 1999年 1月至 1999年12月对 2 7例肿瘤患者行介入治疗时所进行的监护工作 ,总结如下 :1　临床资料及方法1 1　临床资料我科对 2 7例患者行介入治疗。介入前经ＣＴ ,病理学确诊为癌症。介入治疗后经ＣＴ、超声显像测量肿瘤明显缩小。1 2　方法在Ｘ线引导下 ,局麻后经股动脉穿刺 ,将导管选择性送入髂内动脉 ,待造形证实后 ,将丝…     

动脉化疗配合TURBt治疗浸润性膀胱癌

目的评价动脉灌注化疗配合经尿道膀胱肿瘤切除术(TURBt)治疗膀胱癌的临床效果。方法对TURBt联合髂内动脉化疗的12例浸润性膀胱癌患者临床资料进行回顾性分析。结果2年内死亡1例，余均存活，没有明显的并发症。结论TURBt联合髂内动脉化疗为晚期浸润性膀胱癌提供了一有效治疗方法。     

中晚期胃癌介入治疗的临床体会

目的探讨中晚期胃癌癌体供血动脉灌注化疗栓塞术的疗效.方法采用改良Seldginger法穿刺股动脉插管胃癌癌体供血动脉灌注化疗药物加明胶海绵碎沫、碘化油栓塞.结果54例病人经3～6次治疗,临床症状明显改善,14例经2次治疗后接受手术治疗,平均生存14.44月.结论中晚期胃癌癌体供血动脉灌注化疗栓塞术是安全、有效、可行的,有临床推广价值.     

脑多发转移瘤与胶质瘤介入治疗

目的 :研究局部化疗对颅内多发肿瘤的疗效。方法 :经股动脉Seldinger法插管 ,将化疗药物注入肿瘤供血动脉 ,呈持续、缓注 0 5～ 2h ,使药物对肿瘤呈“浸泡”作用。结果 :2 4例一月左右症状基本消失 ,复查CT肿瘤均有不同程度地缩小 ,术后全身反应轻微。介入后生存期 6个月～ 2年不等 ,目前尚有 13例已治疗 3年仍存活。结论 :介入化疗治疗多发脑瘤 ,确有使肿瘤缩小 ,可靠持久降颅压作用 ,明显提高生存质量 ,延长生命     

经尿道膀胱肿瘤电切术联合髂内动脉栓塞化疗治疗晚期浸润性膀胱癌16例

目的：探讨经尿道膀胱肿瘤电切术联合髂内动脉栓塞化疗在晚期浸润性膀胱癌治疗中的临床应用价值。方法：16例晚期浸润性膀胱癌患者行髂内动脉化疗栓塞联合经尿道膀胱肿瘤电切（TURBt）治疗。结果：5例连续随访1年以上无肿瘤复发;7例随访半年至1年后发现肿瘤复发,其中2例拒绝再次治疗死亡,其余再次行上述治疗,至近期随访元复发;3例因心血管疾患死亡;1例随访3个月后失访。结论：对于晚期膀胱癌,尤其是不能或不愿行膀胱全切术的患者,TURBt联合髂内动脉化疗是一种相对安全、有效的治疗方法。     

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.