艾迪注射液联合GP方案对晚期非小细胞肺癌患者的疗效及对血清VEGF表达的影响

目的探讨艾迪注射液联合吉西他滨和顺铂（GP）方案治疗晚期非小细胞肺癌（NSCLC）的近期疗效,以及对患者血清血管内皮生长因子（VEGF）水平的影响。方法将80例晚期NSCLC患者随机分为观察组（40例）和对照组（40例）,观察组给予艾迪注射液联合GP方案治疗,对照组患者则仅给予GP方案化疗;观察并对比两组患者近期疗效和血清VEGF水平的变化。结果经两周期全身化疗后,观察组临床获益率（CBR）为87.5%,明显高于对照组的67.5%,差异有统计学意义（P〈0.05）;两组患者血清VEGF水平均较治疗前明显降低,差异有统计学意义（P〈0.05）,其中以观察组患者降低更为明显,两组比较差异有统计学意义（P〈0.05）。结论艾迪注射液联合GP方案可以有效提高晚期NSCLC患者的临床获益率,并且显著降低其血清VEGF水平,从而提高化疗效果。     

吉西他滨与顺铂联合化疗对晚期非小细胞肺癌患者CYFRA21-1、IGF-1及VEGF的影响

目的:探讨吉西他滨与顺铂联合化疗对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者血清细胞角蛋白19片段(CYFRA21-1)、胰岛素样生长因子-1(insulin-like growth factors-1,IGF-1)与血管内皮生长因子(vascular endothelial growth factor,VEGF)水平的影响。方法:分析2015年1月至2016年12月在本院接受治疗的78例晚期非小细胞肺癌患者的临床资料,观察组78例采用吉西他滨及顺铂联合化疗,另选取82名健康人群为对照组。结果:观察组患者治疗后血清CYFRA21-1、IGF-1水平明显低于治疗前水平,且高于对照组;观察组患者治疗后血清VEGF水平高于治疗前水平,且高于对照组,差异均具有统计学意义(P<0.05)。经过治疗后,观察组患者总缓解率为29.49%(23/78);部分缓解(PR)患者治疗后血清CYFRA21-1、IGF-1及VEGF水平明显低于稳定+进展(SD+PD)患者,PR患者血清CYFRA21-1、IGF-1明显低于治疗前水平,PR组患者血清VEGF水平则高于治疗前水平,SD+PD组患者治疗后血清VEGF水平高于治疗前水平,差异具有统计学意义(P<0.05)。结论:吉西他滨与顺铂联合化疗可使晚期NSCLC患者血清CYFRA21-1、IGF-1表达下调,VEGF水平上调,对化疗疗效的评价具有临床价值。     

进展期卵巢癌细胞减灭术后腹腔热灌注重组人血管内皮抑素联合TP方案的疗效分析

目的探讨进展期卵巢癌细胞减灭术后在紫杉醇与顺铂联合化疗方案（TP）基础上腹腔热灌注重组人血管内皮抑素的临床疗效与安全性。方法选取进展期卵巢癌患者69例,采用随机数字表法分为对照组34例和观察组35例。两组患者均在进展期卵巢癌细胞减灭术后接受TP方案化疗,共4个疗程。在此基础上,观察组患者在进展期卵巢癌细胞减灭术后第1、8天将60mg/m2重组人血管内皮抑素与0.9%氯化钠溶液混合至3000ml,进行腹腔热灌注治疗;对照组患者接受腹腔热灌注等量0.9%氯化钠溶液治疗。化疗4个疗程结束后,比较两组患者血管内皮生长因子（VEGF）水平、治疗有效率、不良反应发生情况和2年生存率。结果4个疗程结束后,观察组患者血清VEGF水平低于对照组,且两组患者血清VEGF水平均较治疗前降低,差异均有统计学意义（均P＜0.05）。观察组患者治疗有效率为51.43%,高于对照组的26.47%,差异有统计学意义（P＜0.05）。两组患者心血管毒性、骨髓抑制、胃肠道反应、脱发、肌肉或关节酸痛等不良反应发生情况比较差异均无统计学意义（均P＞0.05）。观察组患者2年生存率为82.86%,高于对照组患者的61.76%,差异有统计学意义（P＜0.05）。结论在TP方案基础上,给予进展期卵巢癌术后患者腹腔热灌注重组人血管内皮抑素治疗,能够有效抑制肿瘤生长,降低VEGF水平,提高近期疗效和生存率,且不良反应发生率并未升高,具有较高的安全性和较好的临床效果。     

膀胱癌患者血清IGF-I、IGFBP-3 水平及其临床意义

目的 探讨膀胱癌患者血清胰岛素样生长因子- Ⅰ（IGF- Ⅰ）、胰岛素样生长因子结合蛋白-3 （IGFBP-3）水平,及其与膀胱癌病理特征的关系。方法 选取在该院泌尿外科行手术治疗的膀胱癌患者200 例 作为膀胱癌组,同期健康体检者200 例作为对照组,测定血清IGF- Ⅰ、IGFBP-3 水平。结果 膀胱癌组患 者血清IGF- Ⅰ、IGFBP-3 水平低于对照组（P <0.05）,IGF- Ⅰ /IGFBP-3 比值高于对照组（P <0.05）。膀 胱癌患者术后血清IGF- Ⅰ、IGFBP-3 水平高于术前（P <0.05）,IGF- Ⅰ /IGFBP-3 比值低于术前（P <0.05）。 低级别膀胱癌患者血清IGF- Ⅰ、IGFBP-3 水平高于高级别（P <0.05）;高、低级别胱癌患者IGF- Ⅰ / IGFBP-3 比值比较,差异无统计学意义（P >0.05）。肌层浸润性膀胱癌患者血清IGF- Ⅰ、IGFBP-3 水平低 于非肌层浸润性（P <0.05）;肌层浸润性与非肌层浸润性膀胱癌患者IGF- Ⅰ /IGFBP-3 比值比较,差异无 统计学意义（P >0.05）。T3、T4 期患者血清IGF- Ⅰ、IGFBP-3 水平低于Ta ～ T2 期（P <0.05）;淋巴结转 移患者血清IGF- Ⅰ、IGFBP-3 水平低于无淋巴结转移患者（P <0.05）。结论 膀胱癌患者血清IGF- Ⅰ、 IGFBP-3 水平下降,血清IGF- Ⅰ、IGFBP-3 水平有望成为膀胱癌诊断和预后评价的检测指标。     

血清中内皮抑素水平和小细胞肺癌的关系

目的 探讨小细胞肺癌患者化疗前、后血清中内皮抑素的动态变化规律及其与小细胞肺癌（SCLC）患者化疗疗效的关系。方法 用ELISA法检测35例小细胞肺癌患者化疗前、化疗后3d、21d血清中内皮抑素水平和35例健康体检者血清内皮抑素水平。结果 （1）SCLC患者血清中内皮抑素水平均显著高于正常对照组（P〈0．001）；（2）临床受益组SCLC患者化疗后3d血清内皮抑素水平显著高于化疗前和化疗结束后（P〈O．001），化疗前血清内皮抑素水平虽然比化疗结束后21d稍高，但无统计学意义（P〉0．05）。而化疗无效组化疗前、化疗结束后3d、21d三者间血清内皮抑素水平无显著性差异（P〉o．05）。结论 对可疑病例进行血清内皮抑素水平的动态观察有利于小细胞肺癌的早期诊断，SCLC患者血清中内皮抑素水平可作为评估化疗疗效及预后的参考指标。     

非小细胞肺癌患者化疗前后血清肿瘤标志物、HIF-1α、VEGF的变化及相关性研究

目的 探讨非小细胞肺癌（NSCLC）患者化疗前后血清肿瘤标志物、缺氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）的变化及其相关性.方法 选择本院收治的40例NSCLC患者为观察组,来本院体检的40名健康正常人为对照组.检测两组血清中HIF-1α、VEGF水平;检测观察组血清中癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、鳞状上皮细胞癌抗原（SCC）水平.评价观察组的临床疗效和生存质量改善情况.结果 观察组临床总有效率为30％,治疗后NSCLC患者生存质量改善率为32.5％.对照组血清HIF-1α、VEGF水平均明显低于观察组,经比较差异有显著统计学意义（P＜0.01）.观察组治疗后血清HIF-1α、VEGF水平明显高于治疗前,经比较差异有显著统计学意义（P＜0.01）.观察组治疗后血清CEA、NSE、SCC水平均显著低于治疗前,经比较差异有显著统计学意义（P＜0.01）.观察组患者血清HIF-1α水平与VEGF水平呈显著正相关（P＜0.01）;与CEA、NSE、SCC水平均呈显著负相关（P＜0.01）.结论 NSCLC患者化疗后血清HIF-1α、VEGF水平明显升高,血液学肿瘤标志物相关指标明显下降,且以上指标存在显著相关性.     

恩度联合同步放化疗治疗非小细胞肺癌疗效及对外周血CTC、VEGF和3年生存期的影响

目的 探讨恩度联合同步放化疗治疗非小细胞肺癌（NSCLC）疗效及对外周血循环肿瘤细胞（CTC）、血管内皮生长因子（VEGF）水平和3年生存期的影响。方法 选取我院2015年6月～2017年9月诊治的104例NSCLC患者为研究对象,根据治疗方案分为两组,将接受同步放化疗的49例患者纳入对照组,接受恩度联合同步放化疗治疗的55例患者纳入治疗组。比较两组患者治疗前后外周血CTC、VEGF、血清肿瘤标志物水平,并观察肿瘤细胞增殖转移情况以及不良反应。化疗后随访3年,统计生存情况。结果 治疗前两组外周血CTC阳性率和VEGF水平比较,差异无统计学意义（P＞0.05）,治疗后治疗组上述指标低于对照组（P＜0.05）;治疗前两组患者血清肿瘤标志物水平比较,差异无统计学意义（P＞0.05）,治疗后治疗组水平显著低于对照组（P＜0.05）;两组患者治疗前高迁移率族蛋白AT-hook2（HMGA2）、HMGBI和程序化细胞死亡分子5（PDCD5）水平比较,差异无统计学意义（P＞0.05）,治疗后治疗组HMGA2、HMGBJ水平显著低于对照组,PDCD5水平显著高于对照组（P＜0.05）;治疗组3年生存率以及生存时间高于对照组（均P＜0.05）;两组患者不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 恩度联合同步放化疗应用于NSCLC患者中可降低外周血CTC、VEGF水平,抑制肿瘤细胞增殖转移,提高治疗效果,且不增加不良反应,可延长3年生存期。     

IGF-1和IGFBP-3在非小细胞肺癌患者血清和肺癌组织中的表达及意义

目的检测胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)在非小细胞肺癌(non-small cell lung cancer,NSCLC)患者外周血清中的含量和肺癌组织局部的表达情况,探讨IGF-1和IGFBP-3与NSCLC发生发展的关系及其在NSCLC辅助诊断、危险性预测和治疗中的临床意义。方法运用酶联免疫吸附法(ELISA)检测肺癌组和对照组患者外周血血清中IGF-1、IGFBP-3的水平;运用免疫组化方法检测肺癌组和对照组患者肺组织标本的IGF-1与IGFBP-3表达情况。结果肺癌组血清中IGF-1表达高于对照组(P<0.05),肺癌组血清中IGFBP-3的表达显著低于对照组(P<0.05),IGF-1在肺癌组织中的表达强于对照组(P<0.05),IGFBP-3在肺癌组织中的表达弱于对照组(P<0.05)。结论 NSCLC患者血清IGF-1、IGFBP-3表达在非小细胞肺癌的发生、发展及远处转移中有重要作用,检测其水平变化对肺癌的诊断、判断预后有重要意义。     

血清IGF-1、IGFBP-3、VEGF及多项白介素在结直肠癌转移监测中的意义

目的:探讨血清人胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)、血管内皮细胞生长因子(VEGF)及多项白介素在结直肠癌转移中的监测意义。方法:选取2008年5月～2011年10月于本院进行治疗的60例结直肠癌患者为观察组,同期进行健康体检的60例健康人员为对照组,将两组人员的血清IGF-1、IGFBP-3、VEGF及白介素中的促炎性细胞因子、抗炎性细胞因子水平进行检测及比较,并将观察组中复发、转移患者的上述检测指标与未复发、转移者进行比较。结果:观察组的血清IGF-1、VEGF-C及VEGF-D高于对照组,IGFBP-3低于对照组,血清IL-2低于对照组,其他白介素均高于对照组,同时观察组患者中存在复发、转移者则变化幅度更大,差异均有统计学意义(P均<0.05)。结论:血清IGF-1、IGFBP-3、VEGF及多项白介素在结直肠癌转移中的监测价值较高,有助于了解肿瘤复发转移情况。     

IGF-1与IGFBP-3在未青春发育特发性矮小儿童生长激素治疗中的意义

目的探讨血清胰岛素样生长闵子-1（IGF-1）和胰岛素样生长因子结合蛋闩-3（IGFBP-3）在未青春发育特发性身材矮小（ISS）患儿重组人生长激素（rhGH）治疗过程中的变化及意义。方法观察组50例ISS患儿行周产rhGH治疗,采用酶联免疫分析技术测定其治疗前及治疗7d、1个月及6个月时的血清IGF-1和IGFBP-3水平。对照组为20例正常儿童。结果观察组治疗前血清IGF-1、IGFBP-3水平均低于对照组（P〈0．01或P〈0．05）;观察组治疗7d时血清IGF-1、IGFBP-3水平高于治疗前（P〈0．01）：治疗1个月时接近高峰。治疗前血清IGF-1水平与治疗6个月后的△GV、△、△HtSDSBA呈负相关。治疗1个月时的AIGF-1与治疗6个月后的△GV、aHtSDSCA、△HtSDSBA呈正相火。结论m清IGF-1可以作为判断和预测GH对未青春发育ISS儿童疗效的指标。     

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.