比较恩丹西酮与胃复安治疗大剂量顺铂诱发恶心,呕吐的疗效

目的：比较恩丹西酮和胃复安治疗大剂量顺铂诱发恶心、呕吐的疗效。方法：Ａ组：２６例,第１天用恩丹西酮２４ｍｇ静滴化疗前３０分钟或８ｍｇｉｖ缓推化疗前３０分钟及化疗后２ｈ。Ｂ组：２２例,第１天用胃复安２０ｍｇ肌注化疗前３０分钟,地塞米松１０ｍｇ静脉缓推化疗前１５分钟。结果：恩丹西酮和胃复安对大剂量顺铂引起的即发和迟发恶心、呕吐的止吐率分别为８８．５％、９２．３％和５０％、７７．２％。结论：恩丹西酮对大剂量顺铂引起的即发恶心、呕吐优于胃复安。     

恩丹西酮对顺铂致吐的治疗作用

恩丹西酮治疗抗癌药物顺铂引起的恶心、呕吐反应５０例，分两组观察。单用组：注射用顺铂前２０ｍｉｎ、后４ｈ各静注恩丹西酮８ｍｇ。联用组：注射用顺铂前４０ｍｉｎ静注地塞米松１０ｍｇ，前２０ｍｉｎ静注恩丹西酮８ｍｇ。两组停用顺铂后均改为口服恩丹西酮４ｍｇ，１日２次，连用２天。单用组对恶心呕吐控制率分别为８８％、９２％。２～５ｄ为７６％～９２％。联用组对恶心呕吐控制率分别为９２％、９６％。２～５ｄ为８０％～９６％。两组之间无统计学差异（Ｐ＞００５）。结果表明恩丹西酮疗效确切，联用组药量减半疗效不变。     

恩丹西酮预防老年恶性肿瘤化疗致恶心呕吐的临床分析

对４０例老年癌症化疗患者采用自身随机交替对照法，观察了恩丹西酮的止吐作用。顺铂剂量为４０ｍｇ／次×３ｄ，第１～３天给药，患者在第１周期随机接受恩丹西酮和胃复安止吐方案，第２周期交替使用止吐方案。结果显示：恩丹西酮控制急性恶性呕吐优于胃复安，有效率达８７．５％，而胃复安仅４７．５％，两组间有显著性差异（Ｐ＜０．０１），对迟发性呕吐两组差异无显著性（Ｐ＞０．０５），恩丹西酮无锥体外系症状，而胃复安组有２例出现锥体外系症状。     

恩丹西酮联用地塞米松治疗化疗后恶心呕吐的临床观察

目的：观察恩丹西酮和胃复安分别联用地塞米松控制化疗所致的胃肠道反应的疗效。方法：对６８例接受阿霉素、顺铂化疗患者随机分组,恩丹西酮组,联合化疗前静点地塞米松１０ｍｇ,静注恩丹西酮８ｍｇ;胃复安组联合化疗前地塞米松１０ｍｇ静点,胃复安３０ｍｇ化疗前后肌注。结果：恩丹西酮联用地塞米松对化疗所致的急性呕吐及恶心的有效率分别为８５．３％、８８．２４％,明显优于胃复安联用地塞米松组。（Ｐ＜０．００１,Ｐ＜０     

恩丹西酮防治顺铂引起恶心呕吐的临床观察

为进一步观察恩丹西酮对化疗期间顺铂引起恶心呕吐的控制效果及使用剂量,采用自身对照方法观察３４例不同治疗周期用康泉与恩丹西酮控制顺铂所致的恶心呕吐,结果,恶心控制率：康泉为８５．２％,恩丹西酮为８２．３％;呕吐控制率;康泉为８５．３％,恩丹西酮为７９．４％。两组结果的差异无显著性（Ｐ均〉０．０５）。认为恩丹西酮是一种强效止吐剂,且副反应轻微,每日８ｍｇ剂量配合价廉的辅助药即可控制顺铂所致的恶心呕吐。     

低剂量恩丹西酮预防顺铂所致呕吐的临床研究

目的：评价低剂量恩丹西酮预防顺铂所致呕吐的效果和不良反应。采用随机自身对照方法，将48例接受联合化疗（舍顺铂）的患者随机分为A、B两组，均接受两个周期相同方案的化疗，A组第1周期用恩丹西酮4mg，第2周期用恩丹西酮8mg止吐；B组第1周期用恩丹西酮8mg，第2周期用恩丹西酮4mg止吐。结果4mg和8mg恩丹西酮急性恶心有效率分别为72．9％（35／48）和79．21％（38／48），对急性呕吐有效分别为87．5％（42／48）和93．8％（45／48），中位呕吐次数为3．5和3次。经统计学处理两组差异无显著性。对迟发性呕吐的疗效相似，结论：低剂恩丹西酮对预防顺铂所致呕吐疗效突出，改进的方案用法简便，可减少用药少用药量。     

国产恩丹西酮与进口恩丹西酮用于预防顺铂呕吐的疗效比较

恩丹西酮是５－ＨＴ３受体拮抗剂，在预防化疗呕吐方面有确切疗效，比较国产恩凡西酮与进口恩丹西酮在小剂量顺铂化疗中的止吐疗效，以了解国产恩丹西酮的止吐作用及副反应。方法：在每日使用顺铂前１５￣２０分钟随机应用枢丹针剂或枢复宁针剂８ｍｇ，同时静注地塞米松１０ｍｇ，结果两组控制恶心的有效率分别为６９．６％和６７．５％，止吐的有效率分别为７６％和８２％。便秘为主要的副反应，均无椎体外系症状，提示，国产恩丹西     

恩丹西酮预防化疗所致呕吐Ⅲ期临床研究

观察了经顺铂类和非顺铂类药物化疗的９５例患者应用恩丹西酮的止吐作用。顺铂组共６８例，顺铂４０ｍｇ／次×３天（２３例），５０ｍｇ／次×３天（２７例），８０ｍｇ／次×２天（１８例）；非顺铂组２７例，均系接受含环磷酰胺和／或阿霉素联合方案化疗用胃复安后出现呕吐患者，入组后接受同一方案治疗。结果显示，恩丹西酮对控制顺铂不同剂量组所致急性呕吐的ＣＲ率依次为８７．０％，８５．２％和６６．７％，总有效率分别为９１．３％，９６．３％和９４．４％；而对非顺铂组控制急性呕吐的ＣＲ率为８８．９％，有效率９６．３％。上述结果表明恩丹西酮对控制顺铂类和非顺铂药物所致的呕吐反应均有较强的止吐作用     

恩丹西酮与氯丙嗪联用预防顺铂引起的恶心、呕吐58例临床观察

本文观察了恩丹西酮（ｏｎｕａｎｓｅｔｒｏｎ）与盐酸氯丙嗪（ｃｈｏｒｐｒｏｍａｚｉｎｉＨｇｕｒａ－ｃｈｉｏｒｉｄｕｍ）联用预防化学药顺氯铵铂（ＤＤＰ）引起恶心、呕吐反应５８例，分两组观察，第一组２８例单用恩丹西酮静冲８ｍｇ，每日一次，其疗效为一天６７．８６％，第２天７５．００％，第３天８５．７７％。第二组３０例加用盐酸氯丙嗪２５ｍｇ肌注，每日一次，其疗效为第一天９３．３２％，第２天９６．６７％，第３天９６．６７％。结果联用盐酸氯丙嗪组优于单用恩丹西酮组（Ｐ＜０．０５）。     

恩丹西酮加地塞米松对化疗性呕吐的预防

为观察恩丹西酮加地塞米松对化疗性呕吐的预防作用，治疗组静注或口服恩丹西酮加地塞米松，对照组肌注胃复安，结果：治疗组正常进食者占５３．３％，对照组为１３％（Ｐ＜０．０１）；治疗组１～５ｄ呕吐控制率为８３．３％，对照组为１３％（Ｐ＜０．０１），治疗效果明显优于对照组。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.