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蛋白质组学生物标志物预测补救性宫颈环扎术的临床成功率

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世界核心医学期刊文摘（妇产科学分册） 2005年第7期1卷 6-7页

作者： Weiner C.P. Lee K.-Y. BuhimschiC.S. 张剑萍 Dept. Physiol. Obstet. Gynecol. R. University of Maryland School of Medicine 655 W Baltimore St Baltimore MD 21201- 1559 United States Dr

Objective: The origin of incompetent cervix is multifactorial, and the success of rescue cerclage is unpredictable. We tested amniotic fluid from women who were preparing to undergo rescue cerclage for proteomic biomarkers and correlated their presence with clinical outcome. Study design: Amniocentesis was performed to facilitate rescue cerclage in 37 consecutive women with painless dilation (>2 cm) and no detectable uterine activity for 4 hours (range, 1- 24 hours) before cerclage. Thirty- nine consecutive women with a sonographically normal pregnancy and cervix who underwent amniocentesis for chromosomal testing during the same study interval at the same clinical site provided the control samples. A proteomic fingerprint was generated with the discarded sample and the Mass- Restricted score (MR score) for inflammation calculated. Peaks corresponding to free hemoglobin chains were sought as evidence of decidual hemorrhage or intra- amniotic bleeding. Results: Amniocentesis was performed at 23.5 weeks in cerclage (mean dilation, 4 cm) versus 19.5 weeks in control subjects. Cerclage subjects were delivered at 28.8 weeks; control subjects were delivered at 39.2 weeks. Thirty- two of 37 of cerclage subjects (86% ) were delivered prematurely. Ten of 37 of cerclage subjects (27% ), but no control subject, had a MR score that was indicative of inflammation (P <. 001). Hemoglobin peaks were present in 12 of 37 of cerclage subject (32% ), but no control subjects. Among cerclage subjects, those with a MR score of 3 to 4 were delivered earlier than those with a MR score of 0 to 2 (P <. 001). Women with a MR score of 3 to 4 had a shorter latency period (days from amniocentesis to delivery; 3 days) and a shorter percentage of prolongation (1.8% ) than women with a MR score of 0 to 2 (35 days; P <. 05; 17.9% ; P <. 05). Women with hemoglobin had a shorter latency period (6 days) and a shorter percentage of prolongation (3.8% ) than women without hemoglobin (38 days; P <. 05; 21.

关键词：宫颈环扎术补救性蛋白质组学生物标志物临床成功率宫颈机能不全羊膜腔穿刺游离血红蛋白宫口扩张正常妊娠

减少卵子老化对于补救性卵母细胞单精子显微注射结局的影响

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世界核心医学期刊文摘（妇产科学分册） 2006年第9期2卷 43-44页

作者： Nagy Z.P. Rienzi L.F. Ubaldi F.M. 朱亮 Reproductive Biology Associates 1150 Lake Hearn DriveAtlanta GA 30342 United States Dr

Objective: To evaluate the results of a novel protocol that allows to rescue IVF unfertilized oocytes by intracytoplasmic sperm injection (ICSI).Design: Prospective clinical ***: Private reproductive medical ***(s): Thirty patients undergoing ***(s): Controlled ovarian stimulation (COS), conventional IVF, rescue ICSI, embryo culture, and embryo *** Outcome Measure(s): Identification of unfertilized IVF oocytes 6 hours after insemination and fertilization, and developmental rates of those oocytes after rescue microinjection, as well implantation and pregnancy rates (PR).Result(s): All oocytes (392) from 30 patients were inseminated with standard IVF 3 hours after ovum pick- *** body (PB) status was checked at decumulation and rechecked 3 hours ***- two oocytes were fertilized after IVF alone and 184 nonactivated oocytes (failed fertilization) were rescue microinjected and 166 of them fertilized (20 patients).Cleavage stage on day 2 was significantly more advanced and embryo grade was higher after standard IVF fertilization than after rescue *** of the 30 embryos transferred were implanted in the IVF- only patients (27% )- and 8 of 68 embryos in the rescue ICSI patients (12% ).Conclusion(s): Rescue ICSI of unfertilized IVF oocytes 6 hours after insemination (9 hours after egg retrieval) can provide normal fertilization, embryo development, and pregnancy; however, corresponding outcome parameters tend to be impaired in comparison to the standard IVF fertilization results.

关键词：卵母细胞单精子显微注射卵子老化补救性补救ICSI 未受精卵胚胎移植 IVF 卵子受精

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足叶乙甙加顺铂用于小细胞肺癌的补救性化疗

国外医学(肿瘤学分册) 1986年第5期 308-309页

作者：陈黎

小细胞肺癌约占全部肺癌20%。近五年来研究的重点放在发现更完善的联合用药方案上,以提高完全缓解率,改善生存率。业已证明,许多抗癌药单用或联合用药对小细胞肺癌有效,其中足叶乙甙(Etoposide)可能是最有希望的一种。美国和欧洲的经... 详细信息

小细胞肺癌约占全部肺癌20%。近五年来研究的重点放在发现更完善的联合用药方案上,以提高完全缓解率,改善生存率。业已证明,许多抗癌药单用或联合用药对小细胞肺癌有效,其中足叶乙甙(Etoposide)可能是最有希望的一种。美国和欧洲的经验表明单用鬼臼脂素(Prodophllotoxin)的缓解率在20～51%。顺铂对小细胞肺癌的疗效较差,缓解率在0～12%之间。联合使用足叶乙甙和顺铂对P388白血病和B16恶性黑色素瘤显示抗肿瘤协同作用。Sierocki等用足叶乙甙加顺铂初治小细胞肺癌取得显著疗效(缓解率95%)。作者研究了该联合方案对常规治疗后复发或进展的小细胞肺癌的疗效。材料和方法:30例经组织学证实的晚期小细胞肺

关键词：小细胞肺癌足叶乙甙抗肿瘤协同作用联合用药方案补救性恶性黑色素瘤完全缓解率联合方案鬼臼脂抗癌药

二次剖腹探查术或二次肿瘤细胞减灭术后补救性全腹放疗对卵巢癌患者的疗效

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世界核心医学期刊文摘（妇产科学分册） 2005年第6期1卷 46-47页

作者： Dowdy S.C. Metzinger D.S. Gebhart J.B. K.C. Podratz 侯巍 Section of Gynecologic Surgery Mayo Clinic 200 First Street SW Rochester MN 55905 United States

Our aim was to determine the outcomes associated with use of whole- abdominal radiation therapy (WART) in women with ovarian cancer, to identify predictors of response, and to assess associated toxicity. From 1981 through 2000, 171 women received WART at our institution after ovarian cancer surgery. Relevant clinical information was extracted through retrospective chart review. One hundred nine patients received WART after positive second- look laparotomy (SLL), and 62 were treated after secondary debulking (SD) for recurrent disease. The median dose to the whole abdomen was 25.5 Gy (range, 1.0- 30.5 Gy). Therapy included a pelvic boost in 120 patients (70% ) and a para- aortic boost in 21 patients (12% ). The planned radiation course was completed in 123 patients (72% ). In the SLL group, 5- year survival was 29% with a median follow- up of 98.4 months. The 5- year progression- free survival (PFS)was 41% in those with microscopic disease. There was one treatment- related death (1% ). For the SD group, median PFS was 11 months and associated with treatment- related mortality in 5% . Overall, treatment- related small bowel obstruction occurred in 26 patients (15% ). In patients with a positive SLL, WART should be considered only for those with microscopic residual disease. Treatment- related small bowel obstruction can be expected in 15% of these patients. Use of WART for recurrent disease appears to be related to serious bowel toxicity in 5% with an associated short disease- free interval; the therapeutic index of WART may not be acceptable in patients with recurrent disease regardless of the degree of cytoreduction.

关键词：剖腹探查术补救性复发性卵巢癌肿瘤细胞减灭术微小肿瘤小肠梗阻放射疗法放射剂量微小病灶临床信息

肛管表皮癌保守治疗失败后的补救性经腹会阴切除术

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世界核心医学期刊文摘（胃肠病学分册） 2005年第10期1卷 12-13页

作者： Ghouti L. Houvenaeghel G. Moutardier V. 郝筱倩 Institut Paoli-Calmettes 232 Bd de Sainte Marguerite 13009 Marseille France Dr.

PURPOSE: Radiotherapy alone or with combined chemot-herapy is the first therapeutic option for epidermoid carcinoma of the anal canal. Failure of this conservative treatment may benefit of salvage abdominoperineal resection. This study was designed to analyze postoperative outcome and oncologic results in a single anticancer institution. METHODS: Medical charts of 36 patients (median age, 57.9 years) who underwent salvage abdominoperineal resection after failure of conservative treatment between 1987 and 2002 were reviewed retrospectively. There were 15 patients treated for immediate failure (Group I) and 21 patients for recurrence (Group II). Twenty-two patients have undergone primary use of flap reconstruction of the perineal wound. There were ten rectus abdominis myocutaneous flaps, nine omental flaps, two gracilis muscular flaps, and one combined flap. RESULTS: There was no postoperative mortality. Median follow-up was 67 (range, 15-155) months. Primary closure of the perineum was obtained in 33 patients (92 percent). Secondary wound breakdown occurred in 23 of 33 patients (70 percent). Complications unrelated to the perineal wound occurred in 13 patients. The overall crude five-year survival after salvage abdominoperineal resection was 69.4 percent. The crude five-year survival in Group I and Group II was 60.7 and 71.5 percent respectively (P = 0.28). The crude five-year, disease-free survival in Groups I and II was 31.1 and 48.2 percent respectively (P = 0.10). Twenty-three patients experienced recurrences after salvage abdominoperineal resection (64 percent) with a mean delay of 30 months. CONCLUSIONS: Despite high incidence of perineal morbidity, salvage abdominoperineal resection for epidermoid carcinomas of the anal canal has a high long-term survival rate.

关键词：表皮癌补救性切除术经腹会阴切除联合化疗无病生存率总体生存率股薄肌再造术腹直肌

急性心梗溶栓后补救性经皮冠状动脉介入治疗的临床观察

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贵州医药 2005年第3期29卷 216-217页

作者：徐敏李芝峰袁正强李杰张文辉刘霞洪刘丹聂鹏遵义医院心内科 563002

急性心肌梗死(AMI)治疗学的重要进展之一是再灌注治疗.作为再灌注治疗主要手段的溶栓治疗可明显降低病死率并改善存活者的心功能.但溶栓治疗有许多限制:在全部患者中仅1/3适于并接受溶栓治疗,不论使用何种溶栓剂,其再通率均有一定限制(... 详细信息

急性心肌梗死(AMI)治疗学的重要进展之一是再灌注治疗.作为再灌注治疗主要手段的溶栓治疗可明显降低病死率并改善存活者的心功能.但溶栓治疗有许多限制:在全部患者中仅1/3适于并接受溶栓治疗,不论使用何种溶栓剂,其再通率均有一定限制(60%～80%),且残余狭窄,再闭塞发生率高.八十年代初期,直接经皮冠状动脉腔内成形术(PTCA)作为机械性再灌注手段应用于AMI患者,并逐渐推广.它能使梗塞相关血管(IRA)迅速、完全的开通,明显降低AMI病死率.但由于其设备和人员要求较高,费用昂贵,仅在国内少数医院开展.我院于2002年10月开展冠状动脉介入治疗以来,结合本地区条件(病人经济能力有限,对介入治疗了解较少),我们采用急性心肌梗死入院后,在积极向病人家属交代冠状动脉介入治疗的同时,对具备溶栓条件的患者争分夺秒进行溶栓治疗,以尽可能挽救存活心肌.从2002年12月至2004年5月对20例AMI患者进行溶栓后补救性经皮冠状动脉介入治疗,现报告如下.

关键词：经皮冠状动脉介入治疗经皮冠状动脉腔内成形术(PTCA) 临床观察急性心梗急性心肌梗死(AMI) 补救性溶栓后再灌注治疗溶栓治疗残余狭窄治疗学心功能存活者病死率溶栓剂再通率发生率再闭塞机械性患者限制

急性心肌梗死溶栓失败后补救性PTCA的评价

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岭南心血管病杂志 2003年第2期9卷 80-82页

作者：黄体钢天津医科大学第二医院天津市天津心脏病学研究所300211

溶栓失败后立即PTCA即补救性或挽救性(res-cue或salvage)PTCA.

关键词： PTCA 溶栓急性心肌梗死补救性失败评价挽救

应用依替巴肽是治疗严重动脉夹层的补救性措施

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 28-29页

作者： Latsch A. Suselbeck T. Muth N. 王永兴 Department of Medicine University Hospital of Mannheim Theodor-Ku tzer-Ufer 1-3 D-68167 Mannheim GermanyI.

Background: It has been shown in several large trials that the inhibiti on of g lycoprotein(GP) IIb/IIIa receptors of platelets can reduce the rate of ischemic complications following percutaneous transluminal coronary angioplasty (PTCA).We sought to determine the efficacy of eptifibatide in patients with severe dissec tions or threatened vessel closure after PTCA in small coronary arteries (< 2.5 mm). Methods: Eptifibatide was used in 51 patients after conventional balloon an gioplasty complicated by severe dissections with or without threatened vessel oc clusion. Eptifibatide was administered as a double-bolus of 180 μg/kg bodyweig ht, followed by a continuous infusion at a dosage of 2.0 μg/kg min over a time period of 20 h. In this situation, the implantation of a coronary stent was avoi ded if a prompt antegrade flow of contrast dye could be maintained. Results: Usi ng the GP IIb/IIIa antagonist eptifibatide, it was possible to increase or to ma intain antegrade blood flow in 28(55%) patients. In 45%of the patient populati on, however, repeat PTCA was needed, and in four patients (7.8%) an intracorona ry stent had to be implanted. During hospitalization three (6%) patients underw ent target lesion revascularization (two Re-PTCAs, one coronary bypass graft op eration). There were no myocardial infarctions and there was no intrahospital de ath. The cumulative event rate including acute and long term events was 25%. Co nclusions: The findings of our study indicate that eptifibatide is able to preve nt vessel occlusion after PTCA complicated by severe dissections with or without threatened vessel occlusion associated with a low-in-hospital complication ra te.

关键词：依替巴肽动脉夹层补救性血管闭塞血小板糖蛋白血管再通术事件率球囊扩张成形受体拮抗剂大型试验

放疗后复发的前列腺癌患者在补救性前列腺癌根治术后的勃起功能康复

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现代泌尿外科杂志 2007年第2期12卷 132-133页

作者：王健北京宣武医院泌尿外科 100053