国产多西他赛联合卡培他滨治疗转移性乳腺癌24例临床观察

目的:研究多西他赛(Docetaxel)联合卡培他滨(Capecitabine/Xeloda)治疗蒽环类、紫杉醇或氟尿嘧啶类化疗失败的复发转移乳腺癌的疗效及可行性。方法:对24例复发转移性乳腺癌患者均给予多西他赛75mg/m2,第1天;口服卡培他滨2次/d,餐后服用,每次1250mg/m2,连续服用14d,治疗周期为21d,至少治疗2个周期。结果:本组完全缓解(CR)4例,部分缓解(PR)10例,稳定(SD)8例,疾病进展(PD)2例,总有效率(CR+PR)58.3%,肿瘤控制率(CR+PR+SD)为93.3%.不良反应主要表现为骨髓抑制、胃肠道反应和手足综合征,均可耐受,无治疗相关死亡患者。结论:国产多西他赛联合卡培他滨治疗复发转移性乳腺癌近期能取得较好的疗效,且毒副反应可以耐受,符合晚期肿瘤的治疗目的。     

多西他赛联合卡培他滨治疗老年转移乳腺癌的临床观察

目的:探讨多西他赛联合卡培他滨治疗老年患者耐药性转移乳腺癌的临床疗效。方法:选择我院收治的经过蒽环类治疗后转移的78例老年女性乳腺癌患者,均分为治疗组和对照组,治疗组采用多西他赛+卡培他滨,对照组单用多西他赛治疗,评价两组的临床疗效及不良反应。结果:两组在有效率,疾病控制率,中位生存期方面比较差异显著(P<0.05)。两组在白细胞下降,骨髓抑制,胃肠道反应,脱发等毒副反应比较,P<0.05。结论:多西他赛联合卡培他滨是治疗老年转移性乳腺癌的临床有效方案,安全性好,可以成为治疗转移乳腺癌的有效救治方案,值得临床进一步深入研究。     

多西他赛不同给药方案联合卡培他滨治疗转移性乳腺癌的临床观察

目的:观察多西他赛不同给药方案联合卡培他滨治疗转移性乳腺癌的疗效和毒副反应。方法:26例转移性乳腺癌患者均接受多西他赛联合卡培他滨方案治疗1,2例多西他赛每周给药剂量为25mg/m2,d18,1,5;卡培他滨1 000mg,2次/d,d1～14。14例多西他赛三周给药剂量为75mg/m2,d1;卡培他滨1000mg,2次/d,d1～14,每3周为1周期。评价两组的有效率及毒副反应。结果:每周组12例患者完全缓解(CR)1例,部分缓解(PR)3例,有效率(CR+PR)33.3%(4/12)。三周组14例患者完全缓解(CR)1例,部分缓解(PR)4例,有效率(CR+PR)35.7%(5/14)。三周组的III～IV度血液学毒性及胃肠道反应均较每周组高,而三周组的周围神经炎较每周组低。结论:多西他赛联合卡培他滨是治疗转移性乳腺癌的有效方案之一,不同给药方案耐受性不同。     

多西紫杉醇联合卡培他滨治疗蒽环类耐药性晚期乳腺癌的效果观察

目的 观察多西紫杉醇联合卡培他滨方案治疗蒽环类耐药性晚期乳腺癌的疗效与不良反应.方法 以多西紫杉醇联合卡培他滨方案治疗蒽环类耐药性晚期乳腺癌27例.多西紫杉醇75 mg/m2,静脉滴注,第1天;卡培他滨1 000 mg/m2,分早晚2次餐后口服,第1～14天;21 d为一周期.每例患者治疗2个周期以上.结果 完全缓解(CR)2例(7.4%),部分缓解(PR)13例(48.2%),稳定(SD)7例(25.9%),进展(PD)5例(18.5%),总有效率(CR+PR)55.6%,肿瘤进展时间2～17个月,中位时间为6个月,1年生存率63.0%.主要不良反应为骨髓抑制、恶心呕吐和手足综合征,骨髓抑制以白细胞减少为主,Ⅲ～Ⅳ度白细胞减少发生率仅为14.8%.所有毒性均可耐受.结论 多西紫杉醇和卡培他滨联合方案治疗蒽环类耐药性晚期乳腺癌有效率较高,使用方便,不良反应可耐受,可做为使用蒽环类后耐药乳腺癌的理想治疗方案.     

多西他赛联合卡培他滨姑息治疗晚期转移性乳腺癌的疗效评价（附26例病例分析）

目的评价多西他赛联合卡培他滨治疗晚期转移性乳腺癌的临床疗效。方法 26例晚期转移性乳腺癌患者采用多西他赛35mg/m2,静脉滴注,第1、8天。卡培他滨每日2000mg/m2,分2次服用,连服14d,每3周重复,完成2个周期后判定疗效。结果全组26例,CR2例,PR14例,SD5例,PD5例,总有效率（CR＋PR）61.5%,临床控制率（CR＋PR＋SD）80.8%。不良反应主要为白细胞减少。结论多西他赛联合卡培他滨治疗晚期乳腺癌疗效肯定,安全性好。     

多西他赛联合卡培他滨治疗转移性乳腺癌的临床观察

目的：观察多西他赛联合卡培他滨（希罗达）治疗转移乳性腺癌的疗效及不良反应。方法：56例乳腺癌患者采用多西他赛联合卡培他滨治疗,第1天静脉滴注多西他赛75mg／m^2;第1-14天口服卡培他滨900mg／m^2,每天2次,21d为1周期,4周期后评价疗效。结果：56例患者治疗后均取得较好疗效,不良反应主要为胃肠道反应、骨髓抑制和肝功能损害。均可经过对症支持治疗可逆性恢复,无治疗相关死亡患者。结论：多西他赛联合卡培他滨治疗转移性乳腺癌疗效较好,不良反应可耐受。     

多西他赛联合卡培他滨治疗耐药性晚期乳腺癌疗效观察

目的观察及评价周剂量多西他赛联合卡培他滨治疗蒽环类药物耐药晚期乳腺癌的疗效和不良反应。方法46例经病理证实的蒽环类耐药性晚期乳腺癌患者,采用多西他赛联合卡培他滨方案化疗,多西他赛35mg／m^2、静脉滴注、d1、d8,卡培他滨1250mg／（m^2·d）,分2次口服、d1～d14,21d为1个周期,化疗周期数为2～8个周期,中位周期数4个,直至病情进展或不良反应无法耐受。结果46例患者中,完全缓解6例（13．0％）,部分缓解23例（50．0％）,稳定13例（28．9％）,疾病进展4例（8．7％）,有效率为63．0％。不良反应主要为胃肠道反应、骨髓抑制和手足综合征,患者均可耐受。结论周剂量多西他赛联合卡培他滨治疗蒽环类耐药性晚期乳腺癌的疗效确切及毒副反应轻,患者耐受性好,值得临床推广。     

枸橼酸他莫昔芬联合卡培他滨治疗绝经前晚期乳腺癌疗效观察

目的观察枸橼酸他莫昔芬（tamoxifen）联合卡培他滨治疗蒽环类及紫杉类耐药的绝经前乳腺癌的疗效。方法 40例绝经前蒽环类及紫杉类耐药晚期乳腺癌患者随机分为两组,联合组20例,用药方案：Tamoxifen联合卡培他滨。对照组20例,Tamoxifen单药组。治疗2疗程后,评价疗效。结果联合组有效率（CR＋PR）为40%,对照组有效率为30%。差异无统计学意义（P〉0.05）。主要不良反应有手足综合征、胃肠道反应及骨髓造血抑制,但均以Ⅰ～Ⅱ度为主,毒性反应较轻。结论本研究Tamoxifen＋卡培他滨方案与单药方案相比无统计学意义,可能与样本量有关,但联合方案取得了可观的有效率,可作为葸环类和紫杉类耐药的绝经前乳腺癌患者的选择方案。     

多西他赛联合卡培他滨治疗转移性乳腺癌临床观察

目的:评价多西他赛联合卡培他滨治疗转移性乳腺癌临床疗效;方法:选择有可评价病灶的转移性乳腺癌患者34例,以多西他赛75mg/m2,卡培他滨(希罗达)1.0/m2bid d1～14,q3w,化疗4～6周期.结果:有效率70.6%,中位无进展生存期(PFS)为7.6个月.主要毒副反应为骨髓抑制、消化道反应及手足综合征.结论:多西他赛联合卡培他滨为转移性乳腺癌行之有效化疗方案.     

吉西他滨联合卡培他滨治疗耐药性乳腺癌的临床观察

目的观察吉西他滨联合卡培他滨治疗蒽环类耐药性晚期乳腺癌的疗效与毒性反应。方法2003年6月~2006年3月应用吉西他滨联合卡培他滨治疗蒽环类药物耐药的晚期乳腺癌32例。结果CR4例,PR14例,SD8例,PD6例,总有效率(CR PR)56.2%。全组中位缓解期5个月(2~14个月)。主要毒性为骨髓抑制,胃肠道反应和手足综合征,其中骨髓抑制主要以白细胞减少为主,Ⅲ~Ⅳ度白细胞减少发生率18.7%。结论吉西他滨联合卡培他滨对蒽环类药物耐药的转移性乳腺癌有较好疗效,且毒性可以耐受。     

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.     

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.     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.