不同年龄乳腺癌的对比分析

目的　比较不同年龄阶段乳腺癌患者在临床及病理特征等方面的差别 ,以期探讨各年龄段之间的患病特点。方法　将 15 1例乳腺癌患者分为青年组 (≤ 3 5岁 ) ,中年组 ( 3 6～ 5 9岁 ) ,老年组 (≥ 60岁 )。比较不同年龄段患者的病程 ,肿瘤的大小、组织学类型、分级与分期、淋巴结转移及雌、孕激素受体 (ER、PR)表达等临床病理特点。结果　在ER、PR阳性率、病程方面 ,青年组和老年组明显低于中年组 (P <0 0 5 ) ;在肿瘤大小 ,组织学分级、TNM分期及淋巴结转移率方面 ,青年组明显高于中年组 (P <0 0 5 ) ,而老年组与青年组和中年组之间差异无显著性 (P >0 0 5 )。结论　青年人和老年人以非激素依赖性乳腺癌为主 ,病程短 ,而且青年人乳腺癌还具有生长快 ,恶性度高 ,转移早 ,病期晚的特点 ;中年人以激素依赖性乳腺癌多见 ,且病程长 ,恶性度低 ,转移晚 ,病期早。     

不同年龄段乳腺癌临床病理特征分析

目的比较不同年龄段乳腺癌患者临床病理方面的特点,以探讨各年龄段之间的病理差异。方法将454例浸润性乳腺癌患者分为青年组（≤35岁）,中年组（36-59岁）,老年组（≥60岁）,比较不同年龄段患者的病理分期、淋巴结转移及雌、孕激素受体（ER、PR）表达等临床病理特点。结果3组乳腺癌的淋巴结转移率青年组明显高于中老年组,差异有显著性（P〈0.05）。病理分期青年组乳腺癌Ⅲ期病例明显高于中老年组,有统计学意义（P〈0.05）。在激素受体方面,青年组ER、PR阳性率明显低于中老年组,而Cer-b-2表达明显高于中老年组,差异有统计学意义（P〈0.05）。中年组和老年组间的各项观察指标比较差异无统计学意义。结论青年乳腺癌具有侵袭性强、生长快、恶性度高、易转移、病期晚的特点。     

不同年龄段女性乳腺癌患者临床病理特征的回顾性分析

目的：分析不同年龄段女性乳腺癌患者的临床病理特征。方法：回顾性分析该院在2013年12月至2015年12月中所收治的100例女性乳腺癌患者资料作为研究对象,将其按照不同年龄段分为青年组（20例）、中年组（45例）、老年组（35例）,对三组患者临床资料进行分析的同时观察不同年龄段女性乳腺癌患者的临床病理特征。结果：经临床资料分析后发现,中年组女性患上乳腺癌的总体几率要明显高于青年组和老年组女性,组件对比差异明显（P ＜0.05）;另外,在女性乳腺癌患者的淋巴转移率上,其中年组的转移发生率要显著高于青年组和老年组女性,组件对比差异明显（P ＜0.05）。结论：经本文研究结果可以发现,中年女性相较于青年及老年女性具有更高的乳腺癌病发率,且在淋巴侵袭几率上中年组女性所占比例更大,这对不同年龄段女性乳腺癌患者的临床治疗有着重大的意义。     

不同年龄段乳腺癌患者临床病理特点分析

目的 探讨不同年龄段女性乳腺癌患者的临床病理特点.方法 选取该院经病理确诊的女性乳腺癌患者89例,按照其年龄段进行分组,将其分为青年组、中年组以及老年组,对其临床资料进行回顾性分析,分析各组的临床病理特点.结果 青年组36~60岁女性乳腺癌患者的发病率明显高于青年组和老年组,侵润性癌所在的比例最高,病理分期Ⅱ期所占比例明显高于其他分期,青年组Ⅲ期病例明显多于中年组和老年组,中年组淋巴转移发生率明显高于青年组和老年组.结论 乳腺癌发病以Ⅱ期患者居多,中年组36~60岁女性具有更高的淋巴侵袭性,浸润性病变的发生率较高,对于乳腺癌患者诊治及预后判断具有重要指导意义.     

76例不同年龄段女性乳腺癌的临床和病理特点分析

目的分析女性乳腺癌不同年龄段患者的临床及病理特点。方法对2009年12月～2011年12月病理确诊的女性乳腺癌患者进行年龄段分组,分为青年组、中年组、老年组。分析各组的病理类型、发病比例、临床特点等。结果中年组的发病比例最高,青年组的发病比例最低。浸润性病变患者比例最高,各组间比较差异无统计学意义（P〉0.05）。Ⅱ期患者比例最高,各组Ⅰ期患者比例差异有统计学意义（P〈0.05）。结论女性乳腺癌的高发年龄为36～60岁,浸润性病变的发生率相对较高,以Ⅱ期患者居多。     

青年与老年结直肠癌临床特点比较

目的:比较青年与老年结直肠癌临床特点。方法:回顾性分析2014年10月至2017年9月期间的141例青年(年龄<40岁结直肠癌和同期确诊的542例老年(年龄≥60岁且<80岁)结直肠癌患者的临床资料。比较两组癌胚抗原检出率、首发症状、家族史、误诊率、行根治性手术的例数、发病部位、分化程度、TNM分期、淋巴结转移和癌变类型等临床特点。结果:两组性别及癌胚抗原检出率比较,差异无统计学意义(P>0.05);首发症状,青年组以便血最多见,老年组以腹痛最多见,无症状患者明显多于青年组,差异均有统计学意义(P<0.05);青年组有家族史、误诊率、行根治性手术的例数均明显高于老年组,差异均有统计学意义(P<0.05)。两组的肿瘤分型及肿块直径比较,差异无统计学意义(P>0.05)。青年组发病部位最多的是直肠,老年组最多的是左半结肠;青年组最多的是中分化癌,老年组最多的是高分化癌;青年组TNM分期最多的是Ⅱ期,老年组最多的是Ⅰ期;两组无淋巴结转移和远处转移的患者均较多,且老年组明显多于青年组;组织学类型上,老年组更多的是腺癌,青年组更多的是印戒或黏液癌,以上数据差异均有统计学意义(P<0.05)。结论:青年结直肠癌患者误诊率高、恶性程度高,易早期淋巴结转移及远处转移;老年结直肠癌患者早期症状不明显,最终行根治性手术比例相对青年组低。     

宁夏某院不同年龄大肠息肉检出率及临床特征分析

目的 探讨宁夏医科大学总医院不同年龄组大肠息肉特点,为临床诊治提供客观依据.方法 收集2002～2012年该院收治的经内镜及病理证实的大肠息肉患者837例,按患者年龄不同分为青年组(＜45岁)、中年组(45～59岁)、老年组(≥60岁),回顾性分析各组检出率、性别结构、临床表现、内镜特征、病理类型.结果 各组检出率均呈逐年上升趋势且老年组高于青、中年组,发病年龄向年轻化发展,差异有统计学意义(P＜0.05);青、中年组男性大肠息肉检出率明显高于女性,老年组性别构成差异无统计学意义(P＞0.05),青、中组男性检出率高于老年组男性,老年组女性检出率高于青、中年组女性,差异有统计学意义(P＜0.05);青年组临床表现以无症状为主,中、老年组以大便性质改变为主;老年组大于或等于1 cm、无蒂、多发息肉的构成比显著高于青、中年组,差异有统计学意义(P＜0.05);3组均非腺瘤性息肉多于腺瘤性息肉,青、中年组非腺瘤性息肉构成比高于老年组,老年组腺瘤性息肉构成比、癌变率均高于青、中年组,差异有统计学意义(P＜0.05).结论 老年人患大肠息肉、发生癌变风险均高于青、中年,近年大肠息肉的发病有年轻化趋势,临床上应根据不同年龄组大肠息肉的特点制订筛查策略.     

青年乳腺癌与中老年乳腺癌超声影像学对比研究

目的 探讨青年乳腺癌与中年、老年乳腺癌在超声影像学、病理及免疫组化表现方面的差异.方法 共收集乳腺癌患者162例,按年龄分为青年组(≤40岁)、中年组(41 ～ 59岁)和老年组(≥60岁)各54例.回顾分析三组乳腺癌在超声影像学、病理及免疫组化表现方面的差异.结果 青年组超声恶性征象“边缘毛刺征”、“周围高回声晕环”、“微小钙化灶”、“后发回声衰减”、“腋窝异常肿大淋巴结”的比率均高于中年组和老年组(JP＜0.05).青年组浸润性非特殊性癌Ⅲ级、肿瘤大小T3+T4、腋下淋巴结转移的比率均高于中年组和老年组(P＜0.05).青年组ER、PR阳性表达比率均低于中年组和老年组(P＜0.05).结论 青年乳腺癌与中老年乳腺癌相比具有恶性度高、侵袭性强及超声典型恶性征象发生率高的特点.     

食管癌根治术后综合治疗的临床研究

目的评价食管癌根治术后综合治疗的临床价值.方法对614例食管癌根治术后病理分期Ⅱ、Ⅲ期患者进行了随机分组,综合治疗组308例,N0期采用5-FU+DDP方案化疗,N1期进行同步放化疗,对照组206例采用单纯手术治疗.结果综合治疗组与对照组术后1年生存率无显著性差异(P＞0.05),两组3年生存率差异有显著性(P＜0.05),5年生存率综合治疗组明显高于对照组,差异有极显著性(P＜0.01),术后区域淋巴结转移率两组有显著性差异(P＜0.05),术后血性转移率两组差异无显著性(P＞0.05).结论食管癌根治术后Ⅱ、Ⅲ期患者进行综合治疗可提高远期生存率,降低区域淋巴结转移率.     

青年ST段抬高型心肌梗死患者的临床、冠状动脉造影特点及预后

目的 探讨年龄≤40岁青年ST段抬高型心肌梗死(STEMI)患者的临床发病、危险因素、冠状动脉病变特点及预后.方法 回顾性分析2005年5月-2010年5月在复旦大学附属中山医院心内科行经皮冠状动脉介入治疗(PCI)的STEMI患者,按年龄段分组:青年组(≤40岁),中年组(≥41岁且≤59岁组),老年组(≥60岁).分析各组的危险因素、冠状动脉造影特点、PCI治疗情况,并随访患者12个月的预后.结果 接受直接PCI的青年STEMI患者占所有STEMI患者的2.2％.青年组的男性构成比最高(95.0％);青年组的吸烟构成比为85.0％,显著高于老年组的64.8％(P＜0.05);青年组有冠状动脉性心脏病家族史的构成比也显著高于中、老年组(P值均＜0.05).青年组单支病变构成比为65.0％,显著高于中年组的24.8％和老年组的20.6％(P值均＜0.05);罪犯血管以左前降支最为多见,在青年组达到70.0％,显著高于中年组的57.5％和老年组的45.1％(P值均＜0.05).3组间PCI治疗成功率的差异均无统计学意义(P值均＞0.05).青年组在住院期间及随访12个月时严重心力衰竭发生率显著低于老年组;虽然3组间病死率的差异无统计学意义(P＞0.05),但随访12个月时青年组主要心血管不良事件发生率显著低于中、老年组(P值均＜0.05).结论 青年心肌梗死患者的临床危险因素特征、冠状动脉病变特点及预后与老年患者均存在较大的差异,心脏功能及主要心血管不良事件等远期预后较好.     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.