Natural changes in peritoneal equilibration test results in continuous ambulatory peritoneal dialysis patients: a retrospective, seven year cohort survey

We conducted a retrospective, 7 year cohort survey to examine the natural changes in peritoneal equilibration test (PET) results in patients with long-term uneventful continuous ambulatory peritoneal dialysis (CAPD). Thirty-two (17 males, 15 females) patients on CAPD with two or more standard PETs performed more than 6 months apart, in the absence of peritoneal insult, were included. Changes and pattern of PET results were evaluated by the dialysate to plasma ratio of creatinine (D:P-cre), the fourth h dialysate to instilled glucose ratio (D4:Do) and ultrafiltration volume (UF, ml). The subgroups included high (H), high-average (HA), low-average (LA), or low (L) transporters with the dividing ratios (D:P-cre) of >0.81, >0. 65 to 0.81, >0.5 to 0.65, and <0.5, respectively. The median D:P-cre significantly decreased (p = 0.04), but neither the D4:Do nor the final median UF significantly decreased. The change in D:P-cre was strongly and inversely correlated with the initial D:P-cre value (r = -0.68; p < 0.05). A similar relationship was found between the change in the final D4:Do and the initial D4:Do (r = -0.752; p < 0. 01) and between the change in the final UF and the initial UF (r = -0.875; p < 0.01). No correlation was found between the change in D:P-cre and the age of the patient, the time interval between PETs, monthly dialysate glucose exposure, or underlying diabetes/non-diabetes. The final peritoneal transport pattern was altered with 5 (15.6%) patients remaining in the extreme subgroups (H or L) and, by contrast, 84.4% (27/32) of the patients now in the averaged (HA or LA) groups (p < 0.01, chi2 test). We demonstrated a natural "centralization" migration of PET results after long-term uneventful CAPD, which may help to explain why patients with extreme PET characteristics, that is, H or L, continued to do well on CAPD.     

腹腔灌注联合射频透热治疗28例晚期卵巢癌

[目的]探讨晚期卵巢癌腹腔转移的治疗方法。[方法]以顺铂 卡铂 依托泊甙为主的联合方案行腹腔持续热灌注化疗并腹腔射频透热治疗28例晚期卵巢上皮癌，观察其疗效及毒副反应。[结果]完全缓解(CR)5例，部分缓解(PR)16例，稳定（NC）5例，进展（PD）2例，总有效率75.0%。主要毒副反应为骨髓抑制。[结论]双铂联合依托泊甙腹腔热灌注并射频透热治疗对中晚期卵巢癌疗效较好，毒副反应少。     

Prognostic factors for patients with advanced stage serous borderline tumours of the ovary.

BACKGROUND: The aim of this study was to determine the prognostic factors for patients with advanced stage, low malignant potential ovarian tumour (LMPOT). PATIENTS AND METHODS: A retrospective review of 80 patients with serous LMPOT and peritoneal implants treated at or referred to our institution was carried out. RESULTS: Sixty-five patients had non-invasive implants. Fifteen patients had invasive implants. Twenty-nine patients had stage II and 51 patients had stage III disease. Three patients died of evolutive invasive disease and four of complications of treatment. The only prognostic factor of progression to 'evolutive invasive disease' is the pathologic subtype of peritoneal implants. The 5-year rates of evolutive invasive disease in patients with non-invasive implants and invasive implants were 2% and 31%, respectively (P <0.002). CONCLUSIONS: In this series, the only prognostic factor for patients with advanced stage borderline tumour is the type of peritoneal implant. More patients died of the treatment's complications than of the disease itself. The patients' prognosis with non-invasive implants seems to be excellent, and conservative management could be discussed in younger patients.     

腹腔巨噬细胞产生一氧化氮对腹膜透析失超滤的作用

目的 研究腹腔巨噬细胞产生的一氧化氮（ＮＯ）对腹膜淋巴孔的作用,探讨腹膜淋巴孔的淋巴重吸收对长期腹膜透析失超滤的影响。方法 应用腹透液建立腹宁的小鼠模型,用全自动酶标仪动态测定怛,用扫描电镜观察不同时间点腹膜间皮超微病理变化,使用计算机与扫描电镜联机的图象处理系统,测定不同腹膜透析时间点腹膜淋巴孔的变化。结果 腹腹膜管析时程延长,透析组有大量巨噬细胞从腹膜淋巴孔游出,在腹膜表面形成许多乳斑。巨噬细     

Primary carcinoma of the pelvic peritoneum intercepted by screening for ovarian cancer

An asymptomatic woman found to have primary pelvic peritoneal carcinoma following serum CA125 assay and ultrasound examination is reported. The close proximity of this screen detected tumor to the normal ovary supports the possibility that an extra ovarian primary origin of carcinoma with subsequent involvement of the ovary may be more common than has previously been recorded.     

保肾乙丸对延缓腹膜透析患者残余肾功能的临床观察

本研究对行腹膜透析患者予口服中药保肾乙丸治疗,以观察其对残余肾功能的影响。将54例尿毒症行腹膜透析的患者随机分为两组,透析3个月后,对照组患者尿量(UV)、残余肾功能(RRF)、尿素KT/V、肌酐清除率(Ccr)均较治疗组有明显降低(P<0.01),而治疗组血尿素氮(BUN)、血肌酐(Cr)明显比对照组降低(P<0.01)。     

聚氯乙烯软袋对腹膜透析液中川芎嗪的吸附

 目的：考察聚氯乙烯（PVC）软袋装川芎嗪在腹膜透析液中的稳定性。方法：含川芎嗪0．04mg·ml^－1和0．20mg·ml^－1的腹膜透析液分别置于4℃，25℃和37℃，定时取样以HPLC测定含量，药物浓度降低≤5％为稳定性指标。结果：由于PVC软袋的吸附作用，各浓度在25℃ 6h后均有显著性降低，12h后降至95％以下；37℃ 4h即均有显著性降低，8h后降至95％以下。0．20mg·ml^－1（4℃）在24h后浓度明显下降，但10d后浓度下降未超过5％，0．04mg·ml^－1（4℃）在观察期间浓度略有升高。结论：PVC软袋可吸附川芎嗪，随温度的升高，吸附作用亦增强。川芎嗪溶于腹膜透析液后室温贮放不宜超过6h，温度升至37℃后尽快使用。     

热休克对H22细胞膜HSP70蛋白及其mRNA水平的影响

将IL-2或/和IFN-γ基因体内转染腹腔巨噬细胞(MΦ),其表达的基因产物能提高MΦ的细胞毒活性,并诱导MΦ分泌TNF、IL-1和NO等抗肿瘤免疫介质.激发机体的非特异性免疫功能而产生抗肿瘤效应,特别是IL-2和IFN-γ基因联合转染MΦ,其表达的基因产物既能使MΦ产生更强的细胞毒活性并分泌高水平的TNF、IL-1和NO,又能激活脾CTL细胞,从而激发机体的非特异性和特异性免疫功能,产生更强的快同抗肿瘤效应.结果表明,IL-2和IFN-γ基因转染MΦ较单基因转染具有更强的抗瘤效应     

Tissue Inhibitor of Metalloproteinase-1 Concentrations are Attenuated in Peritoneal Fluid and Sera of Women with Endometriosis and Restored in Sera by Gonadotropin-Releasing Hormone Agonist Therapy

Objective: To establish tissue inhibitor of metalloproteinase-1 (TIMP-1) concentrations in peritoneal fluid (PF) and sera of women with endometriosis and compare them to disease-free controls.

Design: Prospective randomized study.

Setting: Academic medical center.

Patient(s): Women with laparoscopically documented endometriosis and disease-free women of reproductive age.

Intervention(s): Peritoneal fluid and sera were collected, and some women received gonadotropin-releasing hormone agonist (GnRH-a) therapy for endometriosis.

Main Outcome Measure(s): Peritoneal fluid and sera TIMP-1 concentrations were measured with a specific RIA.

Result(s): The TIMP-1 concentrations were significantly lower in PF and sera of women with endometriosis compared with disease-free women. The GnRH-a therapy restored serum TIMP-1 concentrations.

Conclusion(s): Aberrant expression and localization of TIMP-1 may derange the proteolytic milieu of the peritoneal cavity and contribute to the etiology and underlying physiologic sequelae associated with endometriosis. Measurement of TIMP-1 in serum may aid in diagnosing endometriosis and assist with monitoring treatment efficacy in women with this disease.     

尿毒症患者血清甲状腺功能测定分析

目的 探讨尿毒症患者体内血清甲状腺激素的变化以及血液透析对其的影响，为临床的诊治提供依据。方法 尿毒症患者分为非血液透析组(A组，30例)和血液透析组(B组，20例)，用化学发光的方法测定其血清甲状腺激素包括TT3、TT4、FT3、FT4、TSH；在血液透析组中有10例患者(C组)血液透析前后测定其血清甲状腺激素；并测定了20例年龄、性别相匹配的健康人群的血清甲状腺功能作为对照组(CG)。结果 尿毒症患者与对照组比较，TT4、FT3、FT4均下降，两组数据比较，差异有显著意义，其余差异无显著意义。血液透析前后比较甲状腺激素各项指标差异无显著意义。非血液透析组中BUN、Scr与FT3、FT4呈负相关，与TSH无相关性。结论 在尿毒症患者有较高频率的甲状腺功能减退，在终末期肾脏疾病的患者中检测甲状腺功能应作为常规。