喉部分切除术81例的疗效分析

目的：探讨喉部分切除术的疗效及修复方法。方法：回顾分析1980年1999年施行喉部分切除术81例的临床资料,其中声门上型喉癌22例、声门型喉癌59例。结果：声门上型喉癌3、5年生存率分别为66．7％、63．2％,声门型喉癌3、5年生存率分别为87．2％、80．5％。拔管率声门上型喉癌为77．2％（17／22）,声门型喉癌为93．2％（55／59）。结论：喉部分切除术能保留大部分患者喉的呼吸及发声功能,是根治喉癌的有效术式。     

22例小儿过敏性紫癜（HSP）临床病例分析报告

对我院2004年1月至2006年4月住院的22例小儿过敏性紫癜进行临床病例分析回顾：其中男15例，女7例（男：女=2．1：1）；发病年龄2～8岁13例，10岁以上9例；合并肾病（肾炎）综合征5例（占22．7％），关节肿痛8例（占36．4％），胰腺炎2例（占9．1％），肠套叠1例（占4．5％），神经糸统表现1例（占4．5％）。     

46例皮肌炎临床分析

我院1988年一1997年共收治皮肌炎46例，现分析报告如下。1临床资料1．1一般资料男18例，女28例，男：女为1：1．6。发病年龄最小8岁，最大76岁，平均38岁。＜15岁5例，15-40岁18例，＞40岁23例。Ⅰ型皮肌炎29例，Ⅱ型多发性皮肌炎6例，Ⅲ型皮肌炎伴发恶性肿瘤4例，Ⅳ型儿童皮肌炎5例，Ⅴ型皮肌炎重叠结缔组织病（SLE）2例。1．2初发症状皮炎先发生25例（54．3％），皮炎与肌炎同时发生9例（l．6％），肌炎先发生6例，仅发生肌炎6例。1．3皮肤症状上眼脸浮肿性紫红斑28例（60．9％），前胸V型区红斑四例（40．0％），G0tbon丘疹8例（17．4…     

声门上型喉癌N0～2颈部淋巴结的治疗方法

目的：对声门上型喉癌N0～2颈部淋巴结的治疗方法进行讨论。方法：对64例声门上型喉癌颈部淋巴结N0～2行改良颈清术与改良颈清术加放疗两种治疗方法，并进行分析。结果：64例声门上型喉癌中，改良颈清术32例38侧，改是颈清术加术后放疗32例34侧，N0～N1 32例34侧，N2 32例38侧。3年总生存率64．06％，5年总生存率57．81％。N3行根治性颈清术，在此不作讨论。结论：对N01N病例，改良颈清术与改良颈清术加放疗一样有效（P〉0．05）。对于N2病例，改良颈清术加放疗明显优于单纯改良性颈清术（P〈0．05）     

幽门功能不全与伴发疾病──附565例胃镜诊断分析

幽门功能不全（PIS）及其伴发疾病临床并不少见，它们的发生、发展有着一定的因果关系。近2年来我科内镜检出PIS565例，现分析如下。1材料与方法1．1一般资料1995年1月～1996年1月我院2061例同期胃镜受检者中，检出PIS共565例，检出率27.36％。其中男385例（68.14％），女180例（31．86％），男：女为人1：1。年龄13～86岁，平均年龄39．84岁。其中≤45岁最多见，共394例，占69．7％，为好发年龄。1．2材料日本产OlympusGIF－XQ20型和GIF－XQ30型内镜。1．3方法轻柔、熟练地把内镜插入胃腔后立即观察幽门，再撤镜渐次观察其它部位。…     

手足口病406例临床观察和护理

资料与方法 2009年1～6月收治406例手足口病患儿,其中男286例（70．44％）,女120例（29．56％）,男：女=2．38：1;〈1岁35例（8．62％）,1～5岁324例（79．8％）,〉5岁47例（11．58％）。     

扩张型心肌病36例诊疗体会

资料与方法10年来收治资料较为完整的住院扩张型心肌病（DCM）病例36例,男28例,女8例,男：女=3．5：1,年龄17～65岁,平均41．5±2．3岁。首发症状为活动后心悸、气短、不能平卧睡眠等心功能不全者25例（69．4％）;心律失常6例（16．7％）,胸闷、心前区疼痛3例（8．3％）;     

开展功能性喉癌手术的体会

为最大限度地提高患者术后生活质量，在行喉癌根治性术中保留或重建喉的发音、呼吸和吞咽防御功能十分重要。近年我们施行功能性喉癌手术３０例，疗效满意。现报告如下。１临床资料本组３０例，男２８例，女２例，２４～７２岁。病变部位及术式：（１）声门上型喉癌（Ｔ３...     

鞭炮爆炸眼伤42例临床分析

鞭炮爆炸眼伤一般伤势重、合并症多、致盲率高．我院1980年1月至1994年3月共收治住院鞭炮爆炸眼伤42例45眼。现分析报告如下。1临床资料1.1一般资料42例鞭炮爆炸眼伤占同期眼科住院总数的0．82％，占眼外伤住院总数的15．9％。其中男39例（92．8％）．女3例（7．2％），男：女=     

声门上型喉癌颈部淋巴转移的诊断及治疗

目的 探讨声门上型喉癌颈淋巴转移灶诊断及治疗对策。方法 对我科2000—08-2003—03收治的声门上型喉癌61例，按1997 UICC TNM分类及分期进行诊断，其中CN0的诊断标准定义为体格检查（PE）阴性，且CT所见淋巴结最大轴径〈10mm。将所有病例分为三组：Ⅰ组PE及CT均为阳性的CN1病例及全部CN2—3病例；Ⅱ组PE阴性、CT为阳性的CN，病例；Ⅲ组PE阴性，CT所见淋巴结最大轴径〈10mm的CN0病例，分别选择不同范围的颈淋巴结清扫术。CN0病例术中行前哨淋巴结（SN）检测，确定清扫范围，据术后病理及3年、5年颈部控制率评价颈部转移癌疗效。结果Ⅰ组病例17例，颈转移率58．8％，淋巴转移分布于Ⅱ-Ⅳ区；Ⅱ组病例21例，颈转移率38．1％，分布于Ⅱ-Ⅲ区；Ⅲ组病例23例，行SN检测，成功率69．6％，术中冰冻阳性1例，术后连续切片观察阳性转移3例，颈转移率13．0％，分布于Ⅱ区淋巴结。行不同区域颈淋巴结清扫术，其中3年颈部复发率16．3％，5年颈部复发率26．2％。与不同时期声门上型喉癌临床资料为对照，统计学处理有明显差异。结论　CN0病例影像学指标淋巴结最大轴径〈10mm可合理指导临床，术中SN检测可指导颈清扫范围。CN0及CN1病例可行双侧分区性颈清扫术替代传统术式，疗效满意。     

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.