胸腔内注入顺铂和白细胞介素-2联合治疗恶性胸腔积液

目的　探讨胸腔内注入顺铂 (DDP)和白细胞介素 2 (IL 2 )联合治疗恶性胸腔积液的效果。方法　病理确诊的恶性胸腔积液 62例 ,经胸腔插管引流术排尽胸液后 ,按随机化原则分为两组 :治疗组 ( 3 2例 )在胸腔内注入DDP 40mg·m-2 、IL 2 2 0 0万U ;对照组 ( 3 0例 )在胸腔内注入DDP 40mg·m-2 。 1周后重复 1次 ,观察疗效、生活质量、生存率以及毒副反应。结果　治疗组总有效率 81%、病变进展率 6% ,与对照组的 5 0 %、3 0 %比较差异有显著性 (P <0 .0 5 )。Karnofsky评分大于 70分 ,治疗组较对照组有显著提高 (P <0 .0 5 )。治疗组 0 .5年、1年、1.5年、2年的生存率为 97%、5 6%、41%、6% ,分别高于对照组的 70 %、43 %、13 %、3 % ,其中 0 .5、1.5年的生存率比较差异有显著性 (P <0 .0 5 )。结论　胸腔内注入DDP和IL 2联合治疗恶性胸腔积液是一种有效、副反应小、可耐受的治疗方法     

胸管注入滑石粉联合顺铂治疗恶性胸腔积液的研究

目的 探讨胸腔内注入灭菌滑石粉联合顺铂治疗恶性胸腔积液的疗效.方法 病理确诊的恶性胸腔积液患者98例,经胸腔闭式引流术尽量排除胸水后,随机分为2组.滑石粉联合顺铂治疗组55例,在胸腔内注入生理盐水20mL+顺铂(40mg/m2)+医用滑石粉混悬液(灭菌滑石粉5g+生理盐水40mL).对照组43例,胸内注入生理盐水20mL+顺铂(40mg/m2),注药后夹管并嘱患者变换体位.4h后重新放开引流,待引流液体量少于50mL/d则考虑拔管.观察疗效、生活质量、生存率及不良反应.结果 治疗组总有效率72.7%,较对照组51.2%,差异有统计学意义(P<0.05).治疗组0.5、1.0年生存率高于对照组,差异有统计学意义(P<0.05).结论 胸腔内注入灭菌滑石粉联合顺铂治疗恶性胸腔积液是一种有效、经济、不良反应轻、患者可耐受的方法.     

中药健脾利水方联合胸腔内注入顺铂治疗恶性胸腔积液的疗效观察

目的:探讨中药健脾利水方联合胸腔内注入顺铂治疗恶性胸腔积液的疗效观察。方法:病理诊断的恶性胸腔积液60例,经胸腔插管引流术排尽胸液后,按随机化原则分为2组,治疗组(34例)在胸腔内注入DDP 40mg/m2,并加服中药健脾利水方加减,水煎服,每日1剂早晚分服;对照组(26例)在胸腔内注入DDP 40mg/m2。3d后重复1次。观察疗效、生活质量、生存率以及毒副反应。结果:治疗组总有效率94.1%,病变进展率2.9%,较对照组50.0%、26.5%差异有显著性(P<0.05)。Kamofshky的评分>70分,治疗组较对照组有显著提高(P<0.05)。治疗组0.5、1、1.5、2年的生存率为94.12%、67.65%、55.88%、8.82%,分别高于对照组的76.92%、34.62%、19.23%、3.85%,其中0.5、1.5年的生存率差异有显著性(P<0.05)。结论:中药健脾利水方联合胸腔内注入顺铂治疗恶性胸腔积液。安全有效,副作用低,是治疗恶性胸腔积液的理想药物。     

沙培林联合顺铂胸腔内注入治疗恶性胸腔积液疗效观察

目的探讨胸腔注入顺铂（DDP）联合沙培林治疗恶性胸腔积液的疗效。方法病理诊断恶性胸腔积液80例,经胸腔插管引流术排尽胸液后,按随机化原则分为两组,治疗组42例,对照组38例。治疗组在胸腔内注入沙培林＋DDP,对照组胸腔注入顺铂。观察疗效、毒副反应,生活质量及生存率。结果治疗组总有效率88％,病变进展率4．7％,较对照组（37％、28％）差异有统计学意义（P〈0．05）。Kamofshky的平分〉70分,治疗组较对照组有显著提高（P〈0．05）。治疗组0．5、1、1．5、2年的生存率为95％、66％、52％、9％,分别高于对照组76％、37％、16％、3％,其中0．5、1．5年后生存率差异有统计学意义（P〈0．05）。结论应用沙培林和顺铂治疗恶性胸腔积液安全有效,副作用低,是治疗恶性胸腔积液的理想药物。     

重组白介素-2与顺铂联合胸腔内注射治疗恶性胸水的疗效观察

目的 观察重组白介素-2(IL-2)与顺铂(DDP)胸腔内注射治疗恶性胸水的疗效.方法 对40例恶性胸水患者随机分为两组:治疗组20例患者应用IL-2与DDP胸腔内注射;对照组20例患者应用DDP胸腔内注射.两组对比疗效.结果 治疗组治疗恶性胸水总有效率90%.DDP对照组治疗恶性胸水总有效率65%.结论 IL-2与DDP联合应用治疗恶性胸水有显著的协同作用(P<0.05),毒副反应小,见效快,能及时减轻患者的痛苦,是安全有效的方法.     

干扰素联合顺铂治疗恶性胸腔积液疗效观察

目的　观察干扰素联合顺铂治疗恶性胸腔积液的近期疗效和毒副反应。方法　 5 4例恶性胸腔积液病人 ,其中治疗组 2 8例 ,对照组 2 6例 ,均经 B超定位后 ,选择较易穿刺的部位 ,尽量排净胸水。治疗组胸腔内注入干扰素 4 0 0万 U,顺铂 30～ 6 0 mg;对照组胸腔单纯注入顺铂 30～ 6 0 mg,每周 1次 ,连用 1～ 4次。结果　治疗组 CR8例 ,占 2 9% ,PR16例 ,占 5 7% ,总有效率 (CR+PR) 86 % ;对照组 CR5例 ,占 19% ,PR10例 ,占 38% ,总有效率 (CR+PR) 5 7%。毒副反应主要表现在治疗组中 ,发热 5例 ,最高温度 38.7℃ ,恶心呕吐 5例 ,其中 °3例 , °2例 ,白细胞下降 8例 ,其中 °6例 , °2例。对照组中恶心呕吐 4例 , °3例 , °1例 ,白细胞下降 5例 , °4例 , °1例。除治疗组发热较对照组明显外 ,恶心呕吐 ,白细胞下降均无显著差异。结论　干扰素联合顺铂治疗恶性胸水 ,疗效肯定 ,安全有效 ,毒副反应低 ,病人均能耐受 ,可作为临床上控制恶性胸腔积液的一种方法     

重组白细胞介素2治疗恶性胸腔积液的前瞻性研究

目的 :探讨重组白细胞介素 2 (rIL - 2 )治疗恶性胸腔积液的临床应用价值。方法 :1998年 3月～ 2 0 0 1年8月收治的 79例癌性胸腔积液患者随机分为rIL - 2治疗组和顺铂 (DDP)对照组 ,rIL - 2治疗组 4 0例采用rIL - 2胸腔内给药 ,每次 10 0～ 16 0万u ,每周 2次 ,2～ 4周为一疗程。DDP对照组采用DDP胸腔内给药 ,每次 80～ 10 0mg ,每周 1次 ,2～ 4周为一疗程。结果 :rIL - 2治疗组总有效率 85 % ,与DDP对照组 84 .6 %比较无显著差异 (P >0 .0 5 )。胸痛、骨髓抑制、消化道反应的发生率rIL - 2组显著低于DDP组 (P <0 .0 5 )。生活质量改善rIL - 2组显著高于DDP组 (P <0 .0 5 )。结论 :rIL - 2对癌性胸水有显著的疗效 ,与化疗药物有相等的控制胸水的作用 ,能显著提高患者生活质量 ,且毒副作用小 ,患者易于接受。     

羟基喜树碱配合中药治疗恶性胸腔积液的临床观察

目的 :观察羟基喜树碱配合中药治疗恶性胸腔积液的疗效。方法 :6 4例恶性胸腔积液患者随机分为治疗组和对照组。两组患者先将胸水尽量抽尽 ,之后 ,予以羟基喜树碱 2 0 mg+地塞米松 10 m g胸腔内注射。治疗组同时予以中药苓桂术甘汤和葶苈大枣泻肺汤加减。结果 :治疗组有效率为 87.5 % ,对照组为 :5 0 % (P<0 .0 1) ;治疗组毒副反应发生率为 3.75 0 % ,对照组为 2 3.12 5 % (P<0 .0 1) ;胸水复发中位时间治疗组为 76 d,对照组为 4 2 d(P<0 .0 5 )。结论 :羟基喜树碱配合中药治疗恶性胸腔积液疗效好 ,毒副作用小 ,经济合理 ,乐于为患者接受 ,值得推广。     

白细胞介素-2联合顺铂治疗恶性胸腔积液的短期疗效

目的观察白细胞介素-2(IL-2)、顺铂经胸腔内注入治疗恶性胸腔积液的疗效和毒副反应。方法将40例恶性胸腔积液患者随机分成两组,治疗组抽胸液后依次注入IL-2和顺铂;对照组抽胸液后只注入顺铂,治疗1个月评价疗效。结果治疗组完全缓解率为60%,总有效率85%;对照组完全缓解率为20%,总有效率45%,治疗组疗效优于对照组,两组毒副作用相似。结论IL-2联合顺铂经胸腔内注入治疗恶性胸腔积液疗效较好,毒副反应较轻,是一种安全有效的方法。     

卡介菌多糖核酸治疗恶性胸腔积液的历史对照研究

目的　观察胸腔内注射卡介菌多糖核酸治疗恶性胸腔积液的疗效和毒副反应。方法　 67例恶性胸腔积液的患者 ,其中选择 2 0 0 0年 1月至 2 0 0 3年 8月住院的患者 2 2例为治疗组 ,1996年 1月至 1999年 12月住院的患者 45例为对照组。治疗组患者在胸腔抽液后 ,注入稀释过的卡介菌多糖核酸 12ml,每周 1次 ,连用 1～ 4次。对照组给予常规治疗。结果　治疗组 2 2例中 ,总有效率 81 8% ,明显高于对照组的总有效率 3 7 8% (P <0 0 5 )。毒副反应以对照组较多 ,主要存在于对照组进行胸腔内化疗药物注射的患者。治疗组不良反应主要为发热 4例 ,最高温度 3 8 8℃。两组比较 ,治疗组不良反应 <对照组。结论　卡介菌多糖核酸胸腔内注射治疗恶性胸水 ,疗效肯定 ,安全有效 ,毒副反应低 ,病人能良好耐受 ,可作为临床上控制恶性胸腔积液的一种有效的治疗措施     

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.