咳嗽,气短,心慌,心界扩大

咳嗽、气短、心慌、心界扩大许平分副主任医师解放军４３７医院病理科（７３００７０）病历摘要：患者男性，２８岁，某部干部。于１９９１年６月２３日因间歇性咳嗽、气短１月余而入院，病人入院前１个月因咽痛、周身不适而在某卫生队就诊，诊断：＂急性扁机体炎＂，给青...     

胸闷,气促,乏力,消瘦6个月

胸闷，气促，乏力，消瘦６个月李应珍整理作者单位：新疆医学院第一附属医院（乌鲁木齐８３００５４）病历摘要患者女性，５０岁，于１９９１年８月胸闷，气促，乏力，逐渐消瘦已６个月，偶感头晕，鼻塞，咽喉部干燥按鼻炎治疗无好转，近数月间断牙龈出血，鼻衄，胸闷，气...     

Viagra, cialis, impase--which of them, to whom, when and how?

The study has been performed of the efficacy in the treatment of erectile dysfunction (ED) of oral drugs affecting nitric oxide: impase and phosphodiesterase-5 (PDE-5) inhibitors--sildenafil citrate (viagra), tadalafil (sialis)--alone and in combination with impase. A total of 218 ED patients aged 21-73 years (mean age 58.1 +/- 13.2 years) were divided into 3 groups comparable by the number of the patients, age, suspected etiology, pathogenesis and ED severity. Group 1 (n = 81) took viagra in the individually adjusted dose for 6 months; group 2 (n = 64) received sialis in a dose 20 mg for 6 months; group 3 (n = 73) took impase 1 tablet each other day sublingually for 6 months. Overall efficacy made up 77.8, 81.3 and 56.2% for viagra, sialis and impase, respectively. In view of different mechanism of action of PDE-5 inhibitors (viagra, sialis) and impase we combined the drugs in those who failed monotherapy or had drastic side effects. The combination raised efficacy of pharmacotherapy from 56.2 to 92.2%. We came to the conclusion that in psychogenic, isolated neurogenic, compensated and subcompensated arteriogenic ED of a mild or moderate degree, the treatment can be started with impase. If it was uneffective, in severe ED or moderate venoocclusive ED it is better to use PDE-5 inhibitors (viagra, sialis). If one of the latter fails, the other should be administered. If the inhibitors have low efficacy or in side effects, it is indicated to use their combination with impase.     

胃癌,胰腺癌肝转移,低血糖

病史摘要患者，女，６４岁，因确诊“胃癌肝转移”２年，黑便１周于１９９７年７月２日入院。患者于１９９５年７月体检时Ｂ超发现肝脏多发性占位，后经ＣＴ、ＭＲＩ证实，于１９９５年９月在北京某医院胃镜检查，病理提示胃体低分化腺癌。当时无腹痛、恶心、呕吐、便血等...     

卵巢肿瘤LDH,铁蛋白,CEA,AFP测定的临床意义

为寻求卵巢癌较特异的标记物,目前血清学检查方法已有数十种之多。临床上广泛应用的有乳酸脱氢酶(LDH)及其同功酶、铁蛋白、癌胚抗原(CEA)及胎甲球(AFP)等。现将我科(1982—1989)卵巢肿瘤119例检测结果分析如下。     

Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, black, Hispanic, and white residents of the San Francisco Bay Area, 1988–92 (United States)

Background: To date only eight US studies have simultaneously examined cancer incidence in relation to social class and race/ethnicity; all but one included only black and white Americans. To address gaps in knowledge we thus investigated socioeconomic gradients in cancer incidence among four mutually exclusive US racial/ethnic groups – Asian and Pacific Islander, black, Hispanic, and white – for five major cancer sites: breast, cervix, colon, lung, and prostate cancer.Methods: We generated age-adjusted cancer incidence rates stratified by socioeconomic position using: (a) geocoded cancer registry records, (b) census population counts, and (c) 1990 census block-group socioeconomic measures. Cases (n=70,899) were diagnosed between 1988 and 1992 and lived in seven counties located in California's San Francisco Bay Area.Results: Incidence rates varied as much if not more by socioeconomic position than by race/ethnicity, and for each site the magnitude – and in some cases direction – of the socioeconomic gradient differed by race/ethnicity and, where applicable, by gender. Breast cancer incidence increased with affluence only among Hispanic women. Incidence of cervical cancer increased with socioeconomic deprivation among all four racial/ethnic groups, with trends strongest among white women. Lung cancer incidence increased with socioeconomic deprivation among all but Hispanics, for whom incidence increased with affluence. Colon and prostate cancer incidence were inconsistently associated with socioeconomic position.Conclusions: These complex patterns defy easy generalization and illustrate why US cancer data should be stratified by socioeconomic position, along with race/ethnicity and gender, so as to improve cancer surveillance, research, and control.     

肠多发性,弥漫性,海绵状血管,淋巴管瘤1例

患者男,37岁,以反复黑便,贫血1年半,于1990年9月6日入院。患者于1年半前,因腰部摔伤始出现黑便,后反复发作。大便呈果酱样,稀薄。量较大,曾先后4次发生虚脱,住院治疗,曾诊为结节性多动脉炎,经用消炎、止血及激素等药物治疗无效。入院后查体:慢性消耗病容,重度贫血貌,无黄染,浅表淋巴结不肿大。心肺无异常,腹部轻度膨隆,无明显压痛,肝脾未触及,腹水征( ),肠鸣音活跃。RBC1.8×10~12/L,Hgb56g/L,大便潜血持续( ),血     

症,证,征的用法

症:用于症状、并发症。例如:临床症状、症状鉴别诊断、手术并发症等。证:用于适用证、禁忌证。例如:手术适应证、手术禁忌证等。征:用于综合征、征象、体征、指征。例如:唐氏综合征、临床证象、手术指征等。     

连续,超分割,加速放射治疗

在放射治疗中,主要的变量是照射次数、每次剂量、总剂量和总的治疗时间。放射治疗学家力图用综合治疗方法使肿瘤得到最大限度的控制,而对正常组织的损伤很小。在英国,每个中心所用的有效治疗方案都是根据临床经验、实际情况和当地习惯制定的。几乎所有治