术前用惠若舒治疗食管癌患者化疗后白细胞减少症及手术的临床随机对比研究

目的　观察惠若舒对化疗后有白细胞减少但仍有手术指征的食管癌患者实施手术治疗及术后并发症影响。方法　将 3 7例化疗后食管癌患者 (外周血WBC <4.0× 10 9/L)随机地分为A、B两组 :A组 (惠若舒组 ,共 10例 )患者化疗后 1周立即给予惠若舒肌注 ( 5 0 μg/d× 14d) ,B组 (鲨肝醇组 ,共 2 7例 )患者则立即给予鲨肝醇口服 ( 0 .1tid× 14d) ,每隔 3天查 1次患者外周血WBC ;14d后A、B两组患者均接受手术治疗 (均为左6肋间开胸 ,食管癌切除加胃—食管左胸顶器械吻合术 ) ,并观察A、B两组患者吻合口瘘、脓胸和切口感染等并发症的发生率及术后平均住院日。结果　A、B两组患者在用药后外周血WBC平均升高数 (A :( 3 .2± 0 .2 )× 10 9/L ,B :( 1.5± 0 .1)× 10 9/L ;P <0 .0 1)、外周血白细胞上升至 4.0× 10 9/L所需要的时间 (A :7± 1.1d ,B :14± 2 .3d ;P <0 .0 1)及平均住院日 (A :7± 1.5d ,B :11± 2 .8d ;P=0 .0 0 0 1) ,差异有显著性 ,而术后总并发症 (含 :吻合口瘘、脓胸及切口感染等 )发生率 (A :0 .0 0 %,B :14 .81%;P =0 .5 5 71)和治愈率 (A :10 0 .0 %,B :92 .6;P =0 .99)方面差异均无显著性 (可能均与样本数较少有关 )。结论　一部分化疗后白细胞减少而又能接受手术切除的患者 ,使用惠若舒治?     

心肌梗死患者白细胞增多临床意义的探讨

目的 :探讨白细胞计数与急性心肌梗死 (AMI)的关系。方法 :测定 4 3例AMI患者白细胞计数及中性粒细胞数 ,并与 4 3例健康对照组作比较。结果 :AMI组白细胞计数明显高于对照组〔(9 77± 8 4 1 )× 1 0 9/L比 (7 1 8± 5 2 7)× 1 0 9/L ,P <0 0 1〕 ;AMI组的中性粒细胞数也明显高于对照组〔(6 2 4± 2 4 5 )× 1 0 9/L比 (3 81± 1 36 )× 1 0 9/L ,P <0 0 1〕。结论 :白细胞增多与AMI关系密切。动态观察白细胞的变化 ,可能成为AMI患者病情监测及预后判断的辅助指标     

急性心肌梗塞患者外周血白细胞计数与近期预后的关系

目的　说明白细胞参与阻塞血管及产生自由基的病理机制以利于更好地有重点地观察高危患者 ,降低心梗死亡率。方法　对 80例AMI患者入院后 4 8h近期内的外周血WBC计数进行检测。结果　WBC计数 >10 .0× 10 9/L患者的死亡率 ( 2 3.0 8% )与WBC计数 <10 0× 10 9/L患者的近期死亡率 ( 4 .88% )比较有显著性差异 (P <0 .0 1)。结论　大量白细胞导致Ca2 超负荷 ,加速心肌死亡 ,因此在急性心梗早期应设法降低白细胞数量及功能     

高砷水地区人群末梢血象分析

目的 :探讨饮用高砷水对人体末梢血象的影响。方法 :采用日本产 F- 82 0自动血球计数仪测定红细胞(RBC)、白细胞 (WBC)、血小板 (PL T)数及血红蛋白 (Hb)含量。结果 :水砷暴露组男性 RBC4.74× 10 1 2 /L ,WBC5 .75×10 9/L,PL T149.6× 10 9/L,Hb133.9g/L;女性 RBC4.2 2× 10 1 2 /L,WBC5 .5 7× 10 9/L,PL T141.4× 10 9/L,Hb12 4.2 g/L。对照组男性 RBC5 .10× 10 1 2 /L,WBC6 .5 0× 10 9/L,PL T187.0× 10 9/L,Hb15 8.6 g/L;女性 RBC4.5 6× 10 1 2 /L,WBC6 .10×10 9/L ,PL T191.6× 10 9/L ,Hb135 .4g/L。暴露组均低于对照组 ,差异具有统计学意义 (P <0 .0 1)。结论 :饮用高砷水可引起红细胞、白细胞、血小板及血红蛋白含量下降     

大剂量丙种免疫球蛋白治疗特发性血小板减少性紫癜效果观察

目的 :探讨大剂量丙种免疫球蛋白 ( HDIVIg)治疗特发性血小板减少性紫癜 ( ITP)的临床疗效。方法 :将 ITP病人 2 9例随机分为 3组 :A组 ( 12例 )单纯 HDIVIg治疗 ,B组 ( 7例 )使用 HDIVIg加强的松治疗 ,对照组 ( 10例 )使用强的松治疗。结果 :总有效率 A、B两组分别为 91.7%和 10 0 % ,与对照组总有效率 5 0 %相比 ,差异均有显著性 ( P<0 .0 5 ) ;血小板计数对照组为 ( 5 2 .8± 3 5 .1)× 10 9/L,低于 A组 ( 76.9± 42 .6)× 10 9/L( P<0 .0 5 ) ,也低于 B组 ( 118.0± 78.75 )× 10 9/L ( P<0 .0 1) ;A、B两组间相比 ,后者高于前者 ( P<0 .0 5 )。结论 :HDIVIg治疗 ITP疗效优于强的松治疗 ,HDIVIg加强的松联合治疗 ITP对疗效的保持与巩固优于 HDIVIg组 ,是一种较佳的治疗方案     

不同性别之间急性心肌梗死的临床特点分析

目的 :探讨不同性别之间急性心肌梗死 ( AMI)的临床特点。方法 :将 2 0 3例AMI患者按性别分为两组 :男性组 1 43例 ,女性组 60例 ,回顾性分析两组在年龄、心功能、白细胞计数 ( WBC)、心肌酶谱和血脂的差别。结果 :1男性组较女性组天门冬酸氨基转氨酶( AST)和肌酸激酶 ( CK)高 ,分别为 1 5 8.9± 1 45 .9U/L和 95 5 .5± 863.7U/L;83.9± 68.9U/L和 441 .8± 482 .2 U/L。两组比较有高度显著性差异 ( P<0 .0 0 1 ) ;2女性组较男性组发病平均年龄晚 1 0年 ( 73.4± 8.3vs62 .8± 1 2 .5岁 ) ,心功能差 ( 2 .2± 0 .8vs1 .8± 0 .8级 )、WBC增加 ( 1 0 .8± 4.5 vs8.9± 3.7× 1 0 9/L)、血脂紊乱明显。结论 :与男性相比 ,女性AMI患者一般年龄大 ,心功能差 ,WBC增加和血脂紊乱明显 ;而男性组较女性组心肌酶谱增高明显。     

低氧照射腹盆部对肿瘤病人骨髓及免疫功能的影响

①目的　探讨低氧放疗对肿瘤病人骨髓及细胞免疫功能的保护作用。②方法　将 14 6例腹盆部恶性肿瘤病人分为两组。低氧放疗组 (A组 ) 70例 ,常规放疗组 (B组 ) 76例作为对照。A组病人在放疗的同时吸入体积分数为 0 .10 5的低氧气体 ,B组病人仅常规放疗。③结果　A组WBC平均下降 (1.38± 1.2 9)× 10 9/L ,B组下降(2 .87± 1.30 )× 10 9/L ,两组比较差异有显著性 (t=2 .315 ,P <0 .0 5 )。E花环试验的变化 :A组平均上升 6 .0 0 %±2 .39% (t=2 .2 71,P <0 .0 5 ) ,B组平均下降 3.97%± 1.88% (t=1.997,P <0 .0 5 ) ;淋巴细胞转化率的变化 :A组平均上升 3.78%± 1.83% ,B组平均下降 4 .4 7%± 1.73% (t=2 .2 71,P <0 .0 5 ) ,A与B组上述两项免疫指标治疗前后差值比较 ,差异非常显著 (t=3.316 ,3.2 16 ,P <0 .0 5 )。④结论　与常规放疗相比 ,低氧放疗可保护腹盆部肿瘤病人的骨髓和细胞免疫功能。     

血小板计数异常与疾病关系的探讨

目的　探讨血小板计数 (PC)在炎性疾病中的消长规律以及与预后的关系。方法　回顾性调查自 2 0 0 1年 6月至 2 0 0 2年 12月入住江西省儿童医院PICU的 78例测定二次以上的血小板计数异常儿 ,把PC <10 0× 10 9/L归入PC减少组 ,PC >35 0× 10 9/L归入PC增高组 ,调查其原发病 ,了解PC异常与病程以及预后的关系 ,观察PC与WBC、RBC三者之间的关系。结果　 78例中 6 5例为PC升高组 ,最高为 2 0 0 0× 10 9/L ,13例为PC减少组 ,最低为 2 0× 10 9/L ,二组各死亡 2例 ,死亡率分别为 3.0 7%和 30 .76 % ,有非常显著差异 (P <0 .0 1)。PC升高组的死亡儿均死于不可逆的原发病 ,似于PC升高的炎性反应无关 ;PC减少组均死于多器官功能障碍 (MODS) ,2例在短时间内下降 >5 0 % ,而存活儿的PC均升至 10 0× 10 9/L以上。未见PC、WBC和RBC三者之间的消长规律。结论　PC升高提示炎性反应 ,在危重儿中PC常降低 ,猜测下降的原因主要是因为DIC时消耗增加以及在内脏器官中扣押 ,其下降的程度和速度以及再次升高的快慢与预后有关 ,PC易监测、价廉 ,可作为监测危重儿疾病趋势和预后的指标     

原发性高血压病人白细胞计数分析

为探讨原发性高血压病人与自身血循环中白细胞计数的关系 ,设原发性高血压组和正常对照组 ,均采静脉血进行白细胞计数分析。原发性高血压组白细胞计数 (6 .84± 1.38)× 10 9/L与对照组 (4.70± 1.6 5 )× 10 9/L ,有显著差异 (P <0 .0 1)。提示原发性高血压病人血循环中白细胞计数较正常人偏高。     

里亚尔预防肿瘤化疗所致白细胞减少的临床研究

目的　评价国产基因重组人粒细胞 /巨噬细胞集落刺激因子 (rhGM CSF ,里亚尔 )防治实体瘤化疗所致白细胞(WBC)和中性粒细胞 (ANC)减少的临床效果及不良反应。方法　 5 0例恶性肿瘤患者随机分入AB和BA两组。A为研究周期 ,即化疗结束 4 8h开始 ,rhGM CSF(里亚尔 ) 15 0 μg、SCqd× 3～ 10d ;B为空白对照周期。自化疗开始隔日查血常规 1次 ,观察WBC及ANC的变化。结果　研究周期于rhGM CSF注射 2 4h后 ,WBC及ANC绝对值迅速上升 ,4 8～ 72h出现第 1高峰 ,第 8～ 10天出现第 2高峰。而对照周期化疗后WBC和ANC绝对值逐渐下降 ,始终低于治疗周期。WBC和ANC的最低值 (WBC <4 .0×10 9/L及ANC <2 .0× 10 9/L)的持续时间及化疗后第 2 8天WBC <4 .0× 10 9/L的病例数在研究周期和对照周期间差异有显著意义 (P <0 .0 1) ,感染发生率和严重程度亦明显降低。乏力、骨痛和流涕发生率分别为 2 6 %、2 2 %和 16 %。发热、局部反应、皮疹和消化道反应少见。结论　里亚尔是一种有价值的化疗辅助药物。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.