中药复方硬肝复康治疗乙型肝炎和肝硬化临床疗效

目的研究硬肝复康临床治疗肝炎和肝硬化的效果。方法将四川省部分市、地、县及军队医院临床应用硬肝复康的资料进行小结和分析。结果应用硬肝复康治疗乙型病毒性肝炎44例，总有效率93．2％，明显高于甘草甜素对照组的85．0％（P〈0．05）；且硬肝复康组HBV标志改善率、化验指标和临床症状改善率均明显高于对照组（P〈0．05）。多家医院临床应用硬肝复康治疗各种肝硬化共459例，总有效率92．4％；治疗三月后，大多患者临床症状和体征、化验指标等显著改善。结论硬肝复康对乙型肝炎和各种肝硬化具有显著临床疗效。     

薄层扫描法测定新新肝康片中五味子甲素和丹参酮ⅡA的含量

目的：对新新肝康片进行质量控制,对其主要药物进行定性鉴别,并建立了五味子甲素、丹参酮ⅡＡ的定量测定方法。方法：采用ＴＬＣ法对五味子、丹参、进行定性鉴别,并用薄层双波长锯齿与线性扫描法分别测定了五味子甲素、丹参酮ⅡＡ的含量。结果：五味子甲素、丹参酮ⅡＡ的含量分别为０．６０２、０．３７６ｍｇ．ｇ＾－１,回收率为９６．９８％、９６．６８％。结论：本法稳定可靠,可作为该制剂质量控制指标。     

肝巨大占位性病变肝三叶切除23例治疗分析

目的：探讨肝巨大占位性病变的外科治疗,提高肝三叶切除治疗水平。方法：回顾分析肝三叶切除治疗肝巨大占位性病变２３例（肝肿瘤５例,肝包虫病１８例）治疗过程。结果：手术死亡率（１／２３）４．３５％,术后并发症（４／２３）１７．４％,临床治愈率（２２／２３）９５．６５％。临床治愈出院２２例,随访１、３、５年的生存率分别为９０．９５％、８６．４％和８１．８％。肝癌与肝包虫病的临床治愈率相当,５年生存率前者明显低于后者,与癌复发有关。结论：严格手术指征,围手术期处理,注重手术操作技巧,可提高临床治愈率和术后疗效。     

肝动脉化疗、栓塞治疗原发性肝癌的临床研究（附188例分析）

目的：研究原发性肝癌肝动脉化疗、栓塞的疗效及其影响因素。材料与方法：回顾性分析１８８例肝癌肝动脉化疗、栓塞的临床随访资料。结果：总疗效为症状缓解占５９．６％，肿瘤缩小占５５％，ＡＦＰ下降占３７．８％，半年及１、２、３年生存率分别为７５．４％、４６％、２３．５％、１４．７％，平均生存期１２．２月，最长已存活５０月，获二步手术切除１８例，对比分析了７个影响疗效的有关因素。结论：无或轻度肝硬化、早中期、单个肿瘤、直径＜１０ｃｍ、无门脉癌栓或肝动－静脉瘘、行栓塞治疗、治疗次数在３次以上者，其中远期疗效明显优于对应组。克服有关影响因素及综合治疗将会进一步提高肝癌化疗栓塞的疗效     

肝动脉化疗,栓塞治疗原发性肝癌的临床观察

目的：研究原发性肝癌肝动脉化疗、栓塞的疗效及其影响因素。材料与方法：Ｌ回顾性分析１８８例肝癌肝动脉化疗、栓塞的临床随访资料。结果：总疗效为症状缓解占５９．６％，肿瘤缩小占５５％，ＡＦＰ下降占３７．８％，半年及１、２、３年生存率分别为７５．４％、４６％、２３．５％、１４．７％，平均生存期１２．２月，最长已存活５０月，获二步手术切除１８例，对比分析了７个影响疗效的有关因素。结论：无或轻度肝硬化、早中期     

小肝癌栓塞化疗的效果观察

目的：探讨小肝癌经导管肝动脉注射碘油抗癌药栓塞化疗（ＴＯＣＥ）的疗效及影响预后的因素。材料与方法：小肝癌３０例,全部接受ＴＯＣＥ治疗后随访３￣５年以上,其中２４例单纯行ＴＯＣＥ治疗,作为Ａ组;另６例ＴＯＣＥ后４￣６周行手术切除,作为Ｂ组。两组分别统计和生存率和死亡原因。结果：Ａ组１、３、５年生存率分别为７９．３％、３７．５％和２２．２％;Ｂ组则为１００％、６６．７％和２５％。生存≥３年的患者主要死     

硫普罗宁联合甘草酸二铵治疗药物性肝损害临床观察

目的：观察硫普罗宁（凯西莱）联合甘草酸二铵（甘利欣）治疗药物性肝损害的临床疗效。方法：将40例药物性肝损害患者随机分为观察组和对照组各20例,分别给予硫普罗宁联合甘草酸二铵治疗和单用甘草酸二铵治疗。结果：肝功能指标恢复总有效率、γ-谷氨酰转肽酶恢复总有效率、临床症状改善率,观察组分别为90％、75％、90%,对照组分别为60%、30％、50％;两组比较,差异显著（P〈0．05）。结论：硫普罗宁联合甘草酸二铵治疗药物性肝损害疗效显著,谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酰转肽酶（γ-GT）恢复早,效果优于单用甘草酸二铵。     

恶性肝肿瘤术前肝动脉栓塞疗效评价——37例手术病理与随访研究

目的：通过３７例巨大肝脏恶性肿瘤手术标本病理学研究及生存率随访，对术前肝动脉化疗栓塞（ＴＡＥ）的疗效和意义做出评价。材料与方法：３７例肿瘤直径５～２４ｃｍ（平均１１．２ｃｍ）。术前进行了１～４次ＴＡＥ治疗。栓塞治疗后平均２５天做了外科手术切除。对手术标本进行了大体和显微镜下组织学研究。本组病例进行了长期随访，统计生存率。结果：ＴＡＥ使瘤体平均由１１．２ｃｍ缩小至８．５ｃｍ。９２％的病理标本显示肿瘤４０％～１００％的范围坏死。随访１、２、３和５年生存率分别为８０．０％、６６．７％、５５．３％和２３．０％。结论：术前ＴＡＥ能够提高巨大肝肿瘤的切除率，改善患者的预后。     

Budd-Chiari综合征的介入治疗

目的：研究和评价Ｂｕｄｄ－Ｃｈｉａｒｉ（ＢＣＳ）综合征的介入治疗结果。材料与方法：对２３例各型ＢＣＳ患者在Ｂ超及透视监视下采用闭塞部位穿刺，球囊扩张及支撑架技术进行治疗。结果：２２例成功，无严重手术并发症，术后患者症状明显缓解，腔静脉压差由２．４±１．１ｋＰａ降为０．７±０．２ｋＰａ，肝静脉压差的２．８±０．９ｋＰａ和为０．５±０．３ｋＰａ，经过６个月－４年随访，通畅率８２％，复发病例经再次治疗均     

下腔静脉阻塞类型和病程对PTA治疗的影响

下腔静脉阻塞类型和病程对ＰＴＡ 治疗的影响目的　评价单纯ＰＴＡ 对治疗肝段下腔静脉阻塞综合征的长期疗效和相关因素分析。方法　１９９３～１９９７ 年间,１６ 例肝段下腔静脉阻塞患者实施下腔静脉血管成形术。术前对所有患者进行病史调查,常规临床体验,超声及下腔静脉造影,造影结果按Ｓｕｇｉｕｒａ 法分类。术后随访分为Ａ 组（ 症状复发组） 和Ｂ组（症状未复发组） 。结果　１６ 例患者中,Ａ 组７ 例,Ｂ 组９ 例,术前平均病程分别为（７ ．７１ ±３．０４） 年（４ ～１２ 年） 和（２．３３ ±１ ．５） 年（１ ～５ 年）。主要临床表现为腹胀,肝脾大,双下肢及胸腹壁静脉曲张。下腔静脉造影Ｓｕｒｇｉｕｒａ 分类：Ａ组：Ⅰａ、Ⅰｂ 、Ⅲ型各１ 例,Ⅱ型４ 例（ 肝静脉开放２ 例,闭塞５ 例）。Ｂ组：Ⅰａ、Ⅲ型各３ 例,Ⅰｂ 型２ 例,未能归类１ 例（肝静脉开放６ 例,闭塞３ 例） 。１６ 例ＰＴＡ 均获成功,除１ 例术后发生右髂股静脉血形成并发轻度的肺栓塞外,无其它并发症发生。Ａ 组症状复发平均时间（２２ ．５７ ±１２ ．８５）个月。Ｂ组无症状复发平均时间（４１．５５ ±６．２）１ 个月。结论：ＰＴＡ 对病程短,至少有１支肝静脉开放的下腔静脉梗阻患者有较好的长期     

Carcinoma of the rectum: 508 patients with failure analysis and implication for adjuvant therapy

Five hundred and eight patients with carcinoma of the rectum, seen between 1970 and 1980, were reviewed. The numbers of patients in each of the Astler-Coller stages were: stage A: 86; B1: B2: 145; C1: 19; C2: 116; and D (those with metastatic disease): 78. Resection was possible in 92.4% of the patients and operative mortality was 2.3%. Excluding stage D patients, the 5- and 10-year actuarial survivals were 56.9% and 43.7% respectively. When adjusted for deaths from intercurrent disease the 5- and 10-year survivals were 66.8% and 56.3%. Frequency of local recurrence by stage at five years was as follows: stage A: 5.8%; B1: 14%; B2: 20%; C1: 31.5%; and C2: 33.6%. An isolated local recurrence was seen in 5.8% of stage A patients, 12.5% of B1, 13.1% of B2, 15.8% of C1 and 2.6% of C2 staged patients. Histological grade was an important prognostic factor independent of stage. Distance of the tumor above the anus and presence of venous invasion1 could not be assessed. Among stage C patients, survival was 57% when there was one node involved, but this figure fell to approximately 30% with involvement of two or more nodes. Analysis of failure rates suggests that adjuvant radiation treatment is of potential benefit in patients with stages B2, C1, or C2 disease and in stage B1 patients with additional risk factors. The data indicate that adjuvant local treatment is unlikely to increase survival in stage C2 patients, since almost all recurrences in this stage are accompanied by distant metastases.     

CT demonstration of dilated thoracoabdominal veins in patients with arteriovenous fistulas or grafts for hemodialysis

PURPOSE: The purpose of this article was to describe the CT finding of dilated thoracoabdominal veins in patients with renal failure who have arteriovenous fistulas or grafts (AVF/G) for hemodialysis. MATERIALS AND METHODS: The authors retrospectively identified nine women and nine men on hemodialysis with a mean age of 62 (range, 20-88) years. Inclusion criteria for the series were functioning AVF/G, imaging with chest or abdominal CT, and access to clinical charts. Each clinical chart was evaluated for AVF/G function, diagnosis of cirrhosis or central venous obstruction, hepatitis B and C serology, and liver function as reflected by serum SGOT/SGPT. Each CT was reviewed for evidence of cirrhosis as follows: nodular liver contour, prominent left and caudate lobes, splenomegaly, and ascites. The CT scans were also evaluated for the presence of dilated thoracic or abdominal veins. The contrast-enhanced scans were evaluated for obstruction of the visualized central veins. RESULTS: Fifty percent (9 of 18) of patients had dilated thoracoabdominal veins involving the following sites: chest wall, internal mammary, inferior phrenic, left gastric, gastric, portal, periportal, preaortic, mesenteric, splenorenal, periumbilical, and omental. None of these patients had clinical or CT evidence of cirrhosis. Eighty-nine percent (eight of nine patients) had normal serum SGOT/SGPT. Hepatitis B serology was normal in all seven patients tested, and hepatitis C serology was normal in 86% (six of seven patients). Eighty-nine percent (eight of nine patients) had no clinical or CT evidence of central venous obstruction. Among the nine patients without dilated veins, none had the clinical diagnosis of cirrhosis, although 56% (five of nine) had one or more CT findings associated with cirrhosis. None was diagnosed with central venous obstruction. Sixty-seven percent (six of nine patients) of those tested had normal serum SGOT/SGPT. Hepatitis B serology was normal in 88% (seven of eight) and 63% (five of eight) of patients tested, respectively. The authors did not find statistically significant differences between the patients with and without dilated veins with respect to the above parameters. CONCLUSION: Dilated thoracoabdominal veins were present in 50% of patients on hemodialysis with functioning AVF/G in this series. The venous dilatation appears to be independent of cirrhosis and central venous obstruction and is likely related to complex physiologic changes that are known to occur in patients on hemodialysis with functioning AVF/G.     

超短波和音频以及中药外敷治疗输卵管阻塞的疗效分析

目的 探讨超短波+音频+中药外敷治疗输卵管阻塞的疗效.方法 对240例患者输卵管(角部或伞端)阻塞在治疗时随机分为3组:A组用超短波+音频渗透+中药外敷联合治疗80例;B组超短波+音频渗透治疗80例;C组中药外敷治疗80例.治疗后进行选择性输卵管造影(selective salpingography,SSG)判断疗效、3～24月随访并进行比较.结果 输卵管再通率,受孕率:A组86.5%(135/156),63.8%(51/80);B组64.3%(101/157),51.3%(41/80);C组57.1%(88/154),48.8%(39/80);A组治疗后再通率和受孕率明显高于B组和C组(P<0.01、P<0.05).所有患者无1例并发症.结论 超短波+音频渗透+中药外敷联合治疗输卵管(角部或伞端粘连)阻塞的治疗效果非常显著.     

Sexually transmitted infection and blood-borne virus screening in juvenile correctional facilities: a review of the literature and recommendations for Australian centres

BACKGROUND: Juveniles in custody are disproportionately affected by sexually transmitted infections (STI) and blood-borne viruses (BBV) due to high rates of risk behaviours. METHODS: A literature review was undertaken with the aim of providing evidence-based recommendations on STI/BBV screening in Australian juvenile correctional facilities. Relevant research was identified using Premedline and Medline databases, followed by a manual search of reference lists in relevant articles identified in the database search. A total of 36 relevant publications were identified and reviewed. RESULTS: STI/BBV knowledge in incarcerated youth is poor and accompanied by high rates of sexual and blood-borne risk behaviours. The prevalence of these infections is considerable. High rates of asymptomatic gonococcal and chlamydial infections exist, which can be easily diagnosed on self-collected specimens using new nucleic acid amplification technology. HIV infections are rare although continued vigilance is needed in view of substantial risk factors for infection. Hepatitis C prevalence is high, although much lower than that of adult prisoners, signifying a possible window of opportunity for Hepatitis C prevention. Many remain at risk of Hepatitis B, and it is important to assess the need for vaccination in this group. CONCLUSION: Screening for STI/BBV in incarcerated juveniles is of major public health importance and all individuals should be offered screening in conjunction with risk-reduction education during their admission to juvenile detention centres.     

腰池持续引流联合高压氧对重型颅脑损伤术后并发慢性脑积水的影响

目的 探讨重型颅脑损伤(severe craniocerebral injury,SCI)术后早期行腰池持续引流(continuous lumbar drainage,CLD)联合高压氧(hyperbaric oxygen,HBO)治疗对患者慢性脑积水(chronic hydrocephalus,CH)的影响.方法 将我院390例SCI术后患者分为3组:A组130例早期HBO联合CLD治疗,B组130例CLD治疗,C组130例常规药物治疗.比较1年内患者发生CH的差异.结果 3组病例1年内发生CH的比例(例数)分别为:A组5.38%(7例),B组12.31%(16例),C组21.54%(28例),采用x2检验比较3组发病率差异性,A、B组比较x2=3.864,P<0.05;B、C组比较x2=3.939,P<0.05;A、C组比较x2=14.560,P<0.01.结论 CLD可以有效降低SCI术后CH的发生率,若联合HBO治疗效果更明显.     

消渴化瘀片干预治疗糖耐量减低的临床观察

目的　评价消渴化瘀片对糖耐量减低 (IGT)的干预治疗作用。方法　选择 16 8例已确诊的IGT患者 ,随机分为治疗组 (86例)与对照组 (82例 ) ,两组患者在观察期间均采用适当的饮食控制和体育运动加以干预 ,治疗组加服消渴化瘀片 (2个月为 1个疗程 ) ,对照组不服药。采用自身对照及组间对照方法对比观察 ,分析两组干预治疗前后的空腹血糖、餐后 2h血糖、糖化血红蛋白、胆固醇及甘油三酯等指标的变化。结果　两组干预治疗前后自身比较差异有统计学意义 (P <0 0 1) ,干预治疗后两组间比较 ,治疗组优于对照组 ,差异有统计学意义 (P <0 0 1)。1年后随访 ,综合评定疗效 ,治疗组总有效率为 91 8% ,而对照组为 6 8 3% ,两组间比较差异有统计学意义 (P <0 0 1)。结论　中药消渴化瘀片对IGT有明显的改善作用     

Prostatic cancer therapy: comparison of external-beam radiation and I- 125 seed implantation treatment of stages B and C neoplasms

Of 179 patients with stage B or C adenocarcinoma of the prostate, 106 underwent iodine-125 seed-implant therapy (I-125 SI) and 73 received external-beam radiation therapy (EB). A retrospective analysis determined disease-free survival rate, local tumor control, and complication rate for each treatment group. The 5-year disease-free survival rates for SI-treated patients were 75% for stage B and 30% for stage C groups. Corresponding rates for EB-treated patients were 75% and 40%, respectively. The rate of local tumor control for stage B patients was 85% for SI-treated and 88% for EB-treated patients. The corresponding rates for stage C tumors were 75% for SI-treated and 92% for EB-treated patients. The rate of long-term complications in each group was approximately 10%. For stage B cancer of the prostate, I-125 SI treatment is an acceptable alternative to EB therapy; our data are inconclusive regarding stage C treatment, but EB therapy is preferred.     

膦甲酸钠治疗重度黄疸型乙型肝炎的研究

目的 :探讨膦甲酸钠对重度黄疸型乙型肝炎的抗病毒作用。方法 :用膦甲酸钠治疗 11例轻中度慢性乙型肝炎和2 0例重度黄疸型乙型肝炎 ,并选择同期的 11例轻中度慢性乙型肝炎和 2 0例重度黄疸型乙型肝炎不进行抗病毒治疗作对照。结果 :治疗结束时 ,膦甲酸钠治疗组HBeAg和HBVDNA阴转率分别为 4 2 1%和 6 1 3% ,显著高于对照组 (5 3%和12 9% ) ;重度黄疸型乙型肝炎患者血清HBeAg、HBVDNA阴转率 (75 0 %和 80 0 % )均显著高于轻中度慢性乙型肝炎患者 (18 2 3%和 2 7 3% ) ;治疗结束后 3个月膦甲酸钠治疗组HBeAg和HBVDNA阴转率分别为 2 9 4 %和 4 0 7%。结论 :膦甲酸钠对重度黄疸型乙型肝炎具有较好的抗病毒作用     

脾动脉部分栓塞术联合肝康Ⅱ号治疗乙肝肝硬化并脾功能亢进临床观察

目的观察脾动脉部分栓塞术（partial splenic embolization,PSE）联合肝康Ⅱ号（GankangⅡ）治疗乙肝肝硬化并脾功能亢进的临床疗效。方法 28例住院治疗乙肝肝硬化并脾功能亢进的患者,采用Seldinger技术进行PSE,手术前后给予肝康Ⅱ号辨证治疗,术后1 w、1个月、3个月观察白细胞（WBC）、血小板（PLT）、红细胞（RBC）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、凝血酶原活动度（PT）变化。结果术后WBC、PLT明显增加（P〈0.01）,凝血酶原时间缩短（P〈0.05）,术后1 w ALT、TBIL轻度升高,但无显著差异（P〉0.05）。随访过程中ALT、TBIL有下降趋势,但无统计学差异（P〉0.05）。结论 PSE联合肝康Ⅱ号对乙肝肝硬化并脾功能亢进有明显预防作用。     

左旋咪唑搽剂联合拉咪夫啶治疗慢性乙型肝炎对HBeAg血清转换率的影响

 目的观察左旋咪唑搽剂联合拉咪夫啶治疗慢性乙型肝炎对HBeAg血清转换率的影响.方法108例慢性乙型肝炎患者根据治疗前血清ALT水平,分为A、B、C 3组,各组随机分为两组,用药方式:(1)联合用药组:左旋咪唑搽剂(LL)5ml均匀涂于四肢皮肤上,2/周,拉咪夫啶(LMI)100mg口服,1/d,连续用药6个月.(2)单一用药组:拉咪夫啶(LMI)100mg口服,1/d,连续用药6个月.结果在A、B、C 3组中联合用药组HBeAg血清转换率明显高于单-用药组(P＜0.05);治疗前血清ALT＞ULN(正常上限)2～5倍者HBeAg血清转换率明显高于ALT在ULN＜2倍或正常者.结论联合用药可提高HBeAg血清转换率;治疗前ALT水平也是影响HBeAg血清转换率的一个重要因素.