晚期非小细胞肺癌患者化疗前后T细胞亚群临床观察

目的：检测晚期非小细胞肺癌（NSCLC）患者化疗前后T细胞亚群（CD3＋、CD3＋CD4＋、CD3＋CD8＋、CD4/CD8）的变化,观察细胞免疫状态并探讨免疫治疗的意义。方法对25例晚期NSCLC患者化疗前后检测外周血T细胞亚群,并进行分析。结果25例化疗前与1,2个周期化疗后对照比较差异均无统计学意义。化疗有效组12例,化疗后免疫功能有升高趋势,但无统计学差异;化疗无效组13例,与化疗前T细胞亚群比较无统计学差异。结论晚期NSCLC患者免疫功能可能降低,但化疗无论有无疗效,细胞免疫功能无明显抑制,提示化疗过程中免疫治疗并非必要。     

34例肺癌患者化疗前后红细胞免疫功能测定对比分析

目的：探讨化疗对肺癌患者红细胞免疫功能影响的临床意义;方法：应用肿瘤红细胞Ｃ３ｂ受体花环、红细胞免疫粘附肿瘤细胞花环和红细胞免疫复合物花环测定３４例肺癌患者化疗前后的红细胞免疫功能;结果：肺癌患者化疗前红细胞Ｃ３ｂ受体花环、红细胞免疫粘附肿瘤细胞花环明显低于正常组（Ｐ〈０．０１）;经化疗后进一步下降,化疗前后有显著差异（Ｐ〈０．０５）,而红细胞免疫复合物花环则相反;结论：化疗对肺癌患者免疫功能有抑     

非小细胞肺癌化疗前后机体免疫指标的相关研究

目的探讨非小细胞肺癌患者化疗前后机体细胞免疫及体液免疫指标的变化情况。方法对40例健康对照者（对照组）及40例采取化疗的非小细胞肺癌患者（观察组）化疗前后检测并比较CD3、CD4、CD8、IgG、IgA、IgM水平。结果观察组化疗前CD3、CD4、CD4／CD8下降（P〈0．05）、CD8无差异（P〉0．05）。化疗后较化疗前CD3、CD4、CD8下降（P〈0．05）。CD4/CD8升高（P〈0．05）。观察组化疗前IgG、IgA和IgM升高（P〈0．05），而化疗后与化疗前比较无显著性差异（P〉0．05）。结论非小细胞肺癌患者化疗前细胞免疫功能下降，体液免疫功能升高，化疗后与化疗前相比细胞免疫功能下降，体液免疫功能无变化。     

中晚期肺癌化疗前后免疫功能状态的临床观察

目的 探讨中晚期肺癌患者免疫功能状态及化疗对其的影响。方法 用碱性磷酸酶－抗碱性磷酸酶（APAAP）法测定T淋巴细胞亚群，琼脂扩散法测定免疫球蛋白。结果 化疗组化疗前外周血CD4^ 、CD4^ ／CD8^ 较对照组显著下降（P＜0.05），化疗后与化疗前比较也有显著降低（P＜0.01）；而化疗前CD8^ 较对照组显著增高（P＜0.05），化疗后较化疗前显著升高（P＜0.05）。化疗组化疗前IgA、IgM与对照组无显著差异（P＞0.05），化疗后较化疗前显著降低（P＜0.05）；化疗前IgG与对照组比较增高（P＜0.05），化疗后与化疗前比较有显著降低（P＜0.05）。结论 中晚期肺癌患者细胞免疫功能明显下降，体液免疫功能下降，化疗后细胞免疫功能、体液免疫功能均较化疗前明显下降。     

支气管动脉灌注化疗对肺癌患者T细胞亚群及NK细胞的临床意义

目的探讨肺癌患者支气管动脉灌注（BAI）化疗前后T细胞亚群及NK细胞的变化及临床意义。方法选择30例肺癌患者,于支气管动脉灌注化疗前、化疗后2周、4周,采用碱性磷酶抗碱性磷酶（APAAP）法检测T细胞亚群及NK细胞的变化,并与30例健康者作对比分析。结果肺癌患者CD8＋细胞显著高于健康者,同时CD3＋细胞、CD4＋细胞、CD4＋/CD8＋比值、NK细胞低于健康对照组（P〈0.01）。BAI治疗后2周T细胞亚群、NK细胞与治疗前比较未见明显变化（P〉0.05）,治疗后4周CD3＋细胞、CD4＋细胞、CD1＋/CD8＋比值、NK细胞升高,CD8＋细胞下降（P〈0.01）。结论肺癌患者免疫功能较正常人低下,BAI治疗后4周有可能使肺癌患者免疫水平得到一定程度恢复,临床上观察细胞免疫功能对肺癌患者的BAI治疗和预后有一定的监测作用;接受BAI治疗的患者间隔4周后进行第二次治疗较为恰当。     

青光眼、白内障、葡萄膜炎患者外周血T、B淋巴细胞免疫功能的研究

目的：研究青光眼、白内障、葡萄膜炎患者外周血T、B淋巴细胞免疫状态。方法：用同位素（^14C-TdR,^3H-TdR)掺入法测定淋巴细胞转化能力以反映机体免疫功能。结果：青光眼，葡萄膜炎患者细胞免疫功能较正常人低而白内障患者细胞免疫功能较正常人显著增高，青光眼，葡萄膜炎患者体液免疫功能较正常人高而白内障患者体液免疫功能则与正常人无显著差异。结论：青光眼、白内障、葡萄膜炎患者存在有与正常人不同的免疫状态。     

大肠癌患者免疫功能检测的临床意义

目的 探讨大肠癌患者免疫功能与分期的关系。方法 采用免疫荧光法和透射比浊法测定60例大肠癌患者和20例正常人的细胞免疫及体液免疫功能。结果 大肠癌患者CD3^＋、CD4^＋、INK、C3、C4、IgG、IgA、IgM、CD4^＋／CD4^＋比值降低，CD4^＋高于正常对照组，这种变化随临床分期的增高更加显著（P＜0．05）。结论 大肠癌患者存在免疫功能抑制，随临床分期的增高而加重。测定大肠癌患者的免疫功能可以判断肿瘤发展情况与预后。根治性切除肿瘤，行免疫化疗是必要的。     

肺癌患者化疗前后免疫功能的研究

目的 临床观察肺癌患者化疗前后免疫功能状态,了解肺癌患者免疫功能情况及化疗对患者免疫功能的影响.方法 用免疫细胞化学法检测46例肺癌患者化疗前后及22例健康人的细胞免疫功能(CD3、CD4、CD8和CD56);比较肺癌患者化疗前后免疫指标的变化,并比较其与健康人群免疫指标的差异.结果 化疗前后肺癌患者的CD3、CD4和CD4/CD8明显低于健康对照组,CD8和CD56明显高于健康对照组,但患者化疗前后差异无显著性(P＞0.05).结论 肺癌患者细胞免疫功能低下;化疗对患者免疫功能有一定影响,但差异无显著性.     

肺癌患者红细胞免疫功能研究

目的：观察肺癌患者红细胞免疫功能异常在肺癌发生中的作用。方法：采用刘景田改进的微量全血法检测45例肺癌患者的红细胞免疫功能，并与37例正常人对照分析。结果：肺癌患者红细胞C3b受体花环率（RCR），红细胞C3b受体花环促进率（RFER），自然肿瘤红细胞免疫花环率（），自然肿瘤红细胞免疫花环率（NTER）和直向肿瘤红细胞免疫花环率（DTER）明显低于正常人（P＜0．01），促肿瘤红细胞免疫环花率（ETER），协同肿瘤红细胞免疫花环率（ATER）低于正常人（P＜0．05），而红细胞免疫复合物花环率（RICR）和红细胞C3b受体花环抑制率（RFIR）则明显高于正常人（P＜0．01）。结论：肺癌患者红细胞免疫功能低下，检测其红细胞免疫功能有助于肺癌的诊断和治疗。     

中医扶正固本治疗对乳腺癌新辅助化疗者免疫功能的影响

目的：观察中医扶正固本治疗对乳腺癌新辅助化疗患者细胞免疫功能的影响。方法：66例乳腺癌初治患者按治疗方式分成A组（单纯新辅助化疗）34例,B组（新辅助化疗＋扶正固本治疗）32例,在治疗前后检测患者细胞免疫功能的变化。结论：新辅助化疗使乳腺癌患者细胞免疫功能明显下降,联合扶正固本治疗能使细胞免疫功能明显改善。     

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.