顺铂腹腔化疗在治疗卵巢恶性卵黄囊瘤中的价值探讨

目的：探讨顺铂腹腔化疗在治疗卵巢恶性卵黄囊瘤中的价值。方法：回顾性分析本科治疗的卵巢恶性卵黄囊瘤５４例，分为术后单纯用ＶＡＣ方案静脉化疗２６例（单纯组）和术后顺铂腹腔化疗联合ＶＡＣ方案静脉化疗２８例（联合组）。对两组持续缓解情况进行分析对比。结果：单纯组持续缓解率为５７．７％，联合组为７８．６％，两组差异无显著性（Ｐ＞０．０５）。联合组有１３例行保留子宫及健侧附件手术，有１１例获持续缓解，与全子宫双附件切除差异无显著性（Ｐ＞０．０５）。结论：在ＶＡＣ静脉化疗联合顺铂腹腔化疗基础上，行保留子宫及健侧附件手术不影响持续缓解的疗效，可为要求保留生育机能患者较理想的联合化疗方法。     

卵巢未成熟畸胎瘤患者保留生育功能的初步探讨

本文对７例卵巢未成熟畸胎瘤进行临床分析。根据ＰＩＧＯ分期标准Ⅰ期４例，Ⅲ期３例。采用手术为主，辅以化疗的综合疗法，化疗方案为长春新碱、更生霉素和环磷酰胺联合用药，即ＶＡＣ方案，接受保留生育机能治疗。除１例患者病时已有小孩，２例尚未婚配，有生育要求者４例，均已妊娠，足月分娩２例（１例孕＿２产＿１人流一次，１例孕＿２产＿２），所生的３个小孩均健康，无畸形，尚有两例正在妊娠中。作者认为对年轻未成熟畸胎瘤患者，进行保留生育机能的治疗是安全可行的。     

卵巢恶性畸胎瘤临床与预后

目的分析卵巢恶性畸胎瘤的临床、病理特点及预后相关因素.方法以本院1954年1月～2001年12月收治的84例卵巢恶性畸胎瘤患者为研究对象,所有患者均行手术治疗,中位随访146个月.以患者术后5、10及15年生存率为评价预后的指标,分析患者年龄、婚育状况、临床表现、临床分期、病理类型、组织学分级、肿块大小、手术方式及术后是否辅助化疗等因素与预后的关系.结果卵巢恶性畸胎瘤患者的平均年龄为(33.5±16.1)岁,主要临床症状为腹痛、腹胀,占86.9%.卵巢畸胎瘤恶变37例,卵巢未成熟畸胎瘤47例.单因素分析和多因素分析均显示临床分期为影响卵巢恶性畸胎瘤预后的主要因素,Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的5年生存率分别为(87.20±4.52)%、(50.00±35.36)%、(30.55±9.43)%和0.00%(P=0.00).组织学分级1、2与3级患者的5年生存率逐渐下降,分别为(90.48±6.41)%、(68.75±11.59)%和(57.14±16.38)%,但差异无统计学意义(P=0.08).在31例死亡患者中27例(87.1%)于术后2～17个月内死亡.结论卵巢未成熟畸胎瘤在临床特点和生物学特性等方面不同于卵巢畸胎瘤恶变.对卵巢畸胎瘤恶变总的治疗原则是施行全面分期手术和肿瘤细胞减灭术,术后辅助PVB方案为主的足量化疗;对年轻的卵巢未成熟畸胎瘤患者应尽量保留生育功能以期提高患者生活质量,术后2年内应密切随访.     

118例卵巢恶性肿瘤临床分析

我院1981年1月到1995年12月共收治卵巢恶性肿瘤118例．均经病理检查确诊。其中,浆液性囊腺癌38例,粘液性囊腺癌22例,颗粒细胞瘤8例,内胚窦癌6例．卵巢内膜样痛、胚胎性癌各3例．恶性淋巴瘤2例．恶性卵泡膜细胞瘤、透明细胞癌、卵巢间质肉瘤、低分化支持一间质细胞瘤各1例,卵巢转移性腺癌8例。本组病例均行以手术为主的综合治疗,术后根据卵巢肿瘤的病理类型,采用相应的化疗方案进行长期、多疗程的化疗。118例中先访4例,随访率96．61％．随访至1996年12月。生存期1年以内者12例,临床分期为IV期,拒绝化疗1例．合并肠扭转及肠穿孔2例…     

骶尾部畸胎瘤的病理与治疗的探讨

目的：骶尾部畸胎瘤是否有恶变成为决定手术方式与价值的讨论中心，本文试图加以探讨，以指导临床治疗方案。方法：本院1984～1999年收治30例患儿治疗情况及随诊结果，对照病检结果按WHO分类分析。结果：18例分化型，未分化型8例，随访2月～8年，复发恶变2例，恶性4倒，存活1例。结论：骰尾部畸胎瘤因存在未分化细胞，有恶变可能，故提倡产前超声检查，早期诊断，早期手术切除，据病检结果术后加强随访、复查、恶性者坚持联合化疗。     

卵巢畸胎瘤的CT表现

目的：研究卵巢畸胎瘤的CT表现。方法：经病理证实卵巢畸胎瘤13例，均为女性，平均年龄34.9岁。良性囊性畸胎瘤11例，恶性未成熟畸胎瘤2例，全部病例作了CT扫描。结果：11例良性囊性畸胎瘤均见脂质密度，2例恶性未见，7例显示壁结节，10例显示瘤壁钙化或骨化，3例有脂液平面．结论：发生于卵巢的含有脂质成分和钙化者应考虑本病。     

卵巢恶性畸胎瘤20例诊治分析

目的探讨卵巢恶性畸胎瘤的临床病理特点及诊治方法。方法对笔者所在医院1997年5月-2012年5月收治的20例卵巢恶性畸胎瘤患者的临床资料进行回顾性分析。结果（1）诊断：成熟畸胎瘤恶变（MT）12例,未成熟畸胎瘤（IM）8例。（2）临床特征：患者年龄16-67岁,9例MT≥50岁（75％）,6例IM≤20岁（75％）;肿块直径≥10cm有18例（90％）,以囊实性包块为主,部分可探及血流信号;MT多见CA125或CA199升高,IM多见CA125、CEA或AFP升高。（3）治疗及随访：20例均行手术治疗,二次手术6例,保留生育功能手术8例;术中冷冻病理18例,误诊4例;术后化疗12例,放疗2例。术后随访18例,其中2例复发,3例死亡,14例无瘤生存至今。结论疑为卵巢畸胎瘤患者,年龄（≥50岁或≤20岁）、肿块直径≥10cm、血清肿瘤标志物指标升高和腹腔积液是恶性的信号,应尽早手术,送术中冷冻病理,如恶性应术后及时化疗,降低复发率,提高患者生存率。     

卵巢恶性生殖细胞瘤保留生育功能治疗(附84例报告)

目的：总结84例卵巢恶性生殖细胞瘤保留生育功能的治疗。方法：回顾性分析收治的116例卵巢恶性生殖细胞瘤,其中84例（Ⅰ期57例,Ⅱ期14例,Ⅲ期13例）保留对侧卵巢及子宫,术后联合化疗。结果：全组5年生存率74.9%,65例存活,19例死亡,62例月经周期正常,2例闭经,13例已足月分娩14个孩子,孩子生长正常。结论：卵巢恶性生殖细胞瘤对化疗十分敏感。为幼女、少女、年轻的患者保留生育功能是可行的。     

脑肿瘤术后应用VM－26的治疗体会

为了进一步探讨恶性脑肿瘤术后的治疗方法，我们对６例幕上恶性脑肿瘤术后进行ＶＭ－２６化疗，随访一年，未见肿瘤复发和新的脑内转移灶，全部病例均存活，说明ＶＭ－２６对恶性肿瘤细胞起到了细胞毒作用和预防性脑部化疗，表明ＶＭ－２６是恶性脑肿瘤化疗的有效药物之一。     

卵巢恶性生殖细胞瘤116例临床分析

目的 回顾性总结１１６例卵巢恶性生殖细胞瘤的治疗。方法 １９８６年１月至１９９８年１月，我院共收治卵巢恶性生殖细胞瘤１１６例，占同期卵巢恶性肿瘤总数的１６．６％。其中Ⅰ期６６例，Ⅱ期１９例，Ⅲ期２８例，Ⅳ期３例。采用以下手术为主，辅以化疗和效疗。结果 全组５年生存７６例，占６０．２４％，其中无性细胞瘤２９例，占８１．８％，未成熟畸胎瘤２２例，占６４．１％，内胚窦瘤２１例，占５２．８％，混合性生殖细     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.