36例桥本病合并甲状腺癌临床分析

目的 探讨慢性淋巴细胞性甲状腺炎(桥本病)合并甲状腺癌的诊断与治疗方法.方法 回顾性分析2004-2008年118例桥本病并发甲状腺癌36例资料.结果 本组桥本病并发甲状腺癌发病率为30.51%(36/118).全组出现甲状腺结节的患者均进行了手术治疗,桥本病合并甲状腺癌36例平均随访4.5年元死亡及复发,预后好.结论 对于并发甲状腺结节的桥本病应考虑手术治疗.桥本病并发甲状腺癌临床诊断较困难.术前常规测血抗甲状腺球蛋白抗体(ATGA)、抗微粒体抗体(MCA)、细针穿刺、术中快速冰冻切片,有利于术前、术中确诊及正确的手术方式选择.     

桥本病合并甲状腺癌(附17例报告)

目的：总结桥本病合并甲状腺癌的诊治经验。方法：回顾我院1984年1月～2001年6月间138例桥本病合并甲状腺癌17例，分析两者之间的发病机制和诊治经验。结果：本组发病率为12．32％(17／138)，全组病人均出现甲状腺结节，17例桥本病病人术后随访平均6．8年，无死亡及复发。预后好。结论：桥本病临床常见，但并发甲状腺癌诊断困难，易误诊，术前常规测血TGA、MCA、甲状腺核素显影、细针穿刺、术中快速冰冻切片．有利于术前、术中确诊．并选择正确的手术方式。使治疗合理有效。     

桥本病的诊断与外科治疗

目的总结桥本病的外科诊治经验。方法回顾分析1999年至2005年收治的39例桥本病发病情况、诊断和治疗。结果10例经B超穿刺活检确诊，29例经手术治疗。与病理检查对照，术前误诊率明显下降。并发甲状腺癌5例（占％），恶性淋巴瘤1例（占％）。结论桥本病是常见病；正确掌握其临床特征、常规测血清抗体（TCA、TMA）、B超、有选择地作FNAC检查、注意与其他甲状腺疾病鉴别可降低术前误诊率；重视并发恶性肿瘤；术中常规作冷冻切片检查，其手术方式、切除范围及术后药物治疗应个体化，尽可能避免术后甲状腺机能减退的发生。     

桥本病外科治疗106例分析

目的：总结桥本病外科治疗的临床情况及影响诊断的相关原因，方法：1995年8月－2000年2月外科治疗桥本病106例，参照病理结果对诊断、手术加以分析。结果106例病理诊断为单纯桥本病30例（28．3％），余76例均并存其他甲状腺疾病，其中并发甲状腺癌15例（14．1％），术前诊断本病仅9例，主要原因是大多并存其他甲状腺病而误导医生考虑临床上常见病，甚或警惕甲状腺癌的存在。结论：本病已不再少见。提高临床医生对本病的认识，掌握其特点，可降低术前误诊率。提倡细针穿刺细胞学检查。重视术中可疑病变作快速切片，有利于选择正确，合理的手术方式。     

桥本病合并甲状腺结节的诊断和治疗

目的总结桥本病合并甲状腺结节的诊断和治疗的经验。方法分析该院1991年1月～2006年1月外科手术治疗的31例桥本病合并甲状腺结节的临床资料。结果31例均并发有甲状腺结节,其中合并甲状腺癌4例(12.90%),甲状腺腺瘤2例(6.45%),结节性甲状腺肿6例(19.35%),甲状腺功能亢进1例(3.22%),其余均为淋巴滤泡样结节。术前29例诊断为其他的甲状腺疾病,误诊率为93.5%。均行手术治疗,手术中根据快速病理检查采取了不同范围的手术方式。26例获得随访,随访率为83.87%;术后发生甲状腺功能减退1例。结论合并其他甲状腺疾病的桥本病临床上诊断困难,易误诊,对于并发甲状腺结节的桥本病应考虑手术治疗,手术中应尽量保留正常的甲状腺组织,以防止甲状腺功能减低。     

桥本病合并甲状腺结节的外科治疗

目的探讨桥本病（HD）并存甲状腺结节的诊治经验。方法回顾分析我院1995年至2008年手术治疗的,以结节形式为主要症状的187例HD的临床资料。结果HD并存甲状腺癌21例（11．2％）,结节性甲状腺肿50例（26．7％）,甲状腺滤泡性腺瘤28例（15％）,淋巴瘤3例（1．6％）,采取了不同范围的手术方式,术后均服用甲状腺素片。结论对于HD并存甲状腺结节尤其单结节患者,如临床资料不能除外恶性肿瘤均应积极手术。B超及细胞学穿刺有助于术前诊断,而术中快速病理检查是确诊的有效方法,并指导手术方案的制定。     

桥本病合并甲状腺癌的诊断与治疗

目的分析桥本病合并甲状腺癌的临床特征、诊断、治疗及预后。方法回顾性分析1998年1月至2008年1月经病理证实为桥本病合并甲状腺癌10例的临床资料。结果术后病理诊断桥本病合并乳头状癌8例,滤泡状癌2例。术后声音嘶哑1例,有不同程度的甲状腺功能减退9例,术后均常规行甲状腺素抑制／替代治疗。结论桥本病合并甲状腺癌术前诊断困难,以手术治疗最有效,掌握其手术探查指征很重要并应按甲状腺癌根治性手术的原则施术,术后常规应用甲状腺素治疗。     

甲状腺癌的诊治63例报告

目的 总结甲状腺癌的诊治经验。方法 分析我院1988－2000年间手术治疗并经病理证实的63例甲状腺癌的临床资料。结果 男16例，女47例，平均年龄43．5岁（年龄范围：9－78岁），甲状腺乳头状癌，滤泡癌，髓样癌发病率分别为71％（45例），14．3％（9例），11％（7例），无手术死亡，术后声音嘶哑2例，因气管压迫行气管切开2例，伴桥本病2例，经病理证实再次手术5例。结论 甲状腺癌以PTC常见，且预后较好，MTC及未分化癌手术应以全甲状腺切除术加颈淋巴结清扫术。早期诊断，早期治疗，适当的手术方法，是提高疗效的关键。     

外科治疗36例合并甲状腺结节的桥本病结果分析

目的 :探讨合并甲状腺结节的桥本病外科手术必要性及手术处理方式。方法 :总结 1997～ 2 0 0 3年 6月我院外科手术治疗并经病理证实的合并结节的桥本病 36例 ,分析其术前诊断困难性及桥本病与甲状腺癌发生相关性。结果 :术前临床拟诊断桥本病者仅 4例 ,误诊率 88.9%。B超检查对诊断效果差 ;36例中合并甲状腺癌 4例 (全部为乳头状隐性癌 )其占 11.1%。结论 ::合并甲状腺结节的桥本病应予手术诊治 ,手术处理方式视情况而定     

甲状腺病变常见超声误诊原因分析

目的 分析甲状腺病变的超声表现,探讨各种甲状腺病变超声诊断要点、漏诊、误诊原因。方法回顾性分析72例经临床和手术病理证实的甲状腺病变的超声资料。结果超声诊断病理符合60例（符合率为83.33％）,误诊8例（误诊率为11.11％）,漏诊4例（漏诊事为5．56％）。7例误诊包括：结节性甲状腺肿（24例）误诊2例（2／24）．其中1例误诊为甲状腺癌,1例误诊为甲状腺瘤;甲状腺癌（32例）误诊为甲状腺瘤3例（3／32）,桥本病（I例）误诊为甲状腺癌1例;甲状腺瘤（12例）误诊为甲状腺癌1例（1／12）;Graves病（3例）误诊为桥本病1例。4例漏诊：结节性甲状腺肿1例,甲状腺癌2例,甲状腺瘤1例,原因分别为缺乏对临床资料的了解和经验不足、结节声像图表现不典型、多源性结节并存。结论甲状腺病变与正常腺组织及周围结构的关系,以及有无淋巴结肿大、转移是甲状腺病变定性诊断的主要依据,仔细观察甲状腺结节的二维及彩色多谱勒超声征象．并结合临床分析可以减少漏、误诊的发生。     

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…     

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.     

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     

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.     

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.