男性乳腺癌的临床分析

目的 探讨男性乳腺癌的临床特征及合理的临床治疗和预后因素.方法 对25例男性乳腺癌的临床资料进行回顾性分析.结果 中位随访68个月,5年总生存率为60%,无瘤生存率为52%,Ⅱ期5年生存率为72%,Ⅲ期5年生存率为42.9%,Ⅳ期为0,腋淋巴结阴性5年生存率为83.3%,腋淋巴结阳性5年生存率为47.4%,在预后指标单因素分析中,发现腋淋巴结转移为唯一临床预后指标,未能发现年龄、肿瘤大小等因素对预后产生影响.结论 男性乳腺癌的治疗应采取手术、化疗,放射和内分泌治疗相结合的综合治疗措施.     

男性乳腺癌的诊治探讨

目的 探讨男性乳腺癌的诊断和治疗方法.方法 对1978年2月～1999年6月收治的38例男性乳腺癌的临床资料进行回顾性分析.结果 38例男性乳腺癌患者全部表现为乳晕附近肿块,钼靶照像、彩超可作为辅助检查,细胞学及病理学可作为确诊手段.临床Ⅰ期9例,Ⅱ期18例,Ⅲ期10例,Ⅳ期1例.5年生存率分别为100%、64.3%、42.8%、0%.总5年生存率为52.6%,根治术与改良根治术5年生存率分别为66.7%及62.5%,腋淋巴结阴性与阳性5年生存率分别为91.7%及50%.结论 首选改良根治术,辅以化疗,放疗,内分泌等综合治疗是男性乳腺癌治疗的理想方法.     

隐性乳腺癌的诊治（附6例报告）

原发病灶不详的腋淋巴结转移性癌的诊断和治疗常是临床工作中引起争议的问题。隐性乳癌是指乳房内未扪及肿块而已有腋淋巴结转移或其它部位远处转移的乳癌[1] ,由于腋淋巴结接受 75%的乳房淋巴液 ,故隐性乳癌最常见的首发症状为腋淋巴结转移。我院从 1983年至 1999年共诊治乳腺癌 980例 ,其中隐性乳癌 6例 ,占 0 .61% ,现分析如下。1　临床资料1.1　一般资料　 6例均为女性 ,年龄 34～ 68ａ ,平均52ａ。1.2　临床表现　 6例首发症状均是腋淋巴结肿大 ,病程最短 10ｄ ,最长 5个月 ,均在半年内就诊。 1例在外院做淋巴结活检 ,证实为转移性腺癌…     

乳腺癌病人行乳房切除并腋淋巴结清扫术治疗的疗效随访评价

目的对乳房切除并腋淋巴结清扫术的乳腺癌患者的治疗效果进行评价。方法选择2004年1月至2005年1月来我院就诊的196例符合试验标准的患者为研究对象,所有患者行乳房切除并腋淋巴结清扫,在进行手术后实施放化疗。结果为患者实施为期10年的随访,总随访率为81.63%,患者1年生存率96.87%,5年生存率95.00%。10年内生存率为81.25%。结论对于乳腺癌患者实施乳房切除并腋淋巴结清扫术,1年和5年内的生存率不存在统计学意义,并发症少,值得进一步推广。     

副乳癌的诊断和治疗

目的 探讨副乳癌的发病特点和治疗。方法 对1978～2004年经治疗的副乳癌20例的临床和病理资料进行回顾性分析。结果 20例副乳癌占同期收治的乳腺癌1203例的1．13％。20例中男性副乳癌2例，占同期收治男性乳癌35例的5．71％。20例副乳癌中18例发生在腋下，2例发生在腹股沟区。本组患者术后5年生存率为36．37％，明显低于乳癌术后5年生存率45．38％（P〈0．05）。结论 副乳癌多发生在腋下或腹股沟区，这些区域淋巴结丰富，发生转移早，预后差。     

乳腺癌外科治疗的预后问题

报告乳腺癌手术治疗经随访5年以上的病人239例,5年生存率为76.2％。手术预后与肺瘤的病理类型,肿瘤的大小,有无腋窝淋巴结的转移及转移淋巴结数目的多少有关。关于术式的选择,由于早期乳癌各种手术的疗效无大区别,我们认为临床检查无腋窝淋巴结转移,肿块直径<5cm时,可采用仿根治术。腋窝淋巴结阳性,肿块直径>5cm者,宜采用根治术。     

94例早期乳腺癌前哨淋巴结阴性的术后放疗研究

目的 分析94例早期乳腺癌保乳治疗前哨淋巴结活检阴性患者术后单纯乳腺放疗的疗效及并发症情况.方法 2003年1月～2006年1月间94例早期乳腺癌前哨淋巴结活检阴性患者未行腋窝淋巴结清扫手术,放射治疗时单纯行乳腺放疗,观察其淋巴结转移情况及患者生存率.结果 94例患者5年生存率为96%,局部控制率为93%.全组无腋窝淋巴结转移情况,无上肢水肿、活动受限等副作用发生.结论 早期乳腺癌前哨淋巴结活检阴性患者术后单纯乳腺放疗安全可行,可减少治疗的并发症.     

错配修复基因hMLH1在胃癌的表达及与胃癌临床进展的关系

目的 探讨错配修复基因hMLH1在胃癌的表达及其与胃癌临床进展的关系.方法 收集咸宁市中心医院普外科于2000年1月至2005年12月行胃癌根治术的胃癌石蜡标本66例,采用免疫组化SP法检测这66例胃癌组织中hMLH1的表达情况,结合病理资料分析hMLH1的表达与病理特征间的关系,并且对这66例胃癌病人进行随访,观察hMLH1的表达与胃癌病人无瘤生存期、5年生存率的关系.结果 66例标本中阳性表达的有31例,占46.9%.其中高中分化癌和低分化癌的阳性比例分别为36.9%和10.0%,差异有统计学意义,P＜0.05;无淋巴结转移和有淋巴结转移的阳性比例分别为33.3%和13.6%,差异有统计学意义,P＜0.05.随访结果 表明：31例阳性表达的病人术后5年内无瘤生存期平均为27.2个月,5年生存率为58.6%,35例阴性表达的病人术后5年内无瘤生存期平均为10.6个月,5年生存率为29.7%,组间比较差异有显著性,P＜0.05.结论 hMLH1在胃癌的表达与癌的分化状况和有无淋巴结转移及临床进展有关.     

4例副乳癌的诊断和治疗及预后

目的:探讨副乳癌的发病特点和治疗。方法:对1995~2010年经治疗的副乳癌4例患者的临床和病理资料,治疗及预后进行回顾性分析。结果:4例副乳癌占同期收治的乳腺癌3 332例的0.12%。4例副乳癌均发生在腋下。均行经典改良根治术,术后辅以放疗和化疗。本组患者术后5年生存率为25%,明显低于乳癌术后5年生存率45.38%(P<0.05)。结论:副乳癌多发生在腋下或腹股沟区,这些区域淋巴结丰富,发生转移早,预后差。     

两种术式治疗Ⅱ期乳腺癌的远期疗效分析

目的　探讨采用改良根治切除术治疗Ⅱ期乳腺癌的远期效果。方法　按TNM分期诊断标准诊断为Ⅱ期乳腺癌的病人 2 5 8例 ,采用改良根治术 1 2 7例 ,其中行Auchincloss手术 5 4例 ,行Patey手术 73例 ;标准根治术 1 31例。治疗后随访 1 0年以上 ,比较各种手术术式与病人生存率的关系。结果　改良组和标准组 5年生存率分别为 87 1 %和 89 8% ,差异无显著性 (P>0 5 ) ,1 0年生存率分别为 70 %和 6 8 5 % ,无显著性差异 (P >0 75 ) ;Auchincloss术和Patey术 5年生存率分别为 85 1 %和88 7% ,1 0年生存率分别为 6 6 0 %和 72 6 % ,差异均无显著性 (P >0 2 5 )。结论　Ⅱ期乳腺癌采用改良根治切除术治疗 ,远期效果同Halsted根治切除术 ,对腋淋巴结有转移者宜采用改良根治术Ⅱ式     

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.