晚期上皮性卵巢癌综合治疗效果分析

目的探讨晚期上皮性卵巢癌的有效治疗方法。方法回顾性分析154例晚期上皮性卵巢癌患者的临床资料,就手术和化疗对预后的影响进行评价。结果154例患者均接受手术治疗,其中104例达到理想的肿瘤细胞减灭术。术后有149例患者接受了化疗,其中完成初次6~8个疗程者有111例,使用化疗方案为PT和PAC。分析表明,理想的肿瘤细胞减灭术、足量的化疗与患者的预后都有着良好的相关性(P<0.01,P<0.01)。PT方案组的5年生存率显著高于PAC方案组(P<0.01),复发率显著低于PAC组。结论理想的肿瘤细胞减灭术加正规化疗是当前治疗晚期上皮性卵巢癌的有效方法。     

卵巢上皮性癌的治疗现状及存在的热点问题

目前卵巢癌缺乏早期筛查手段,治疗方面也缺乏有效的治疗手段,预后差。卵巢上皮性癌的初次治疗原则是手术为主,早期应行全面分期手术,晚期行肿瘤细胞减灭术或中间型肿瘤细胞减灭术,辅以化疗、放疗等综合治疗,但临床上卵巢癌的治疗过程中仍存在一些问题(如理想的肿瘤细胞减灭术如何定义、中间型肿瘤细胞减灭术对患者生存率的影响如何等)。该文就卵巢上皮性癌的治疗现状及存在的热点问题予以综述。     

晚期上皮性卵巢癌新辅助化疗的疗效观察

目的:探讨晚期上皮性卵巢癌患者采用新辅助化疗(NAC)治疗的可行性,评价新辅助化疗在晚期上皮性卵巢癌治疗中的临床意义.方法:回顾性分析我科2003～2007年实施新辅助化疗的晚期上皮性卵巢癌共29例(NAC组).选取同期住院晚期上皮性卵巢癌35例为对照(对照组),对照组常规行肿瘤细胞减灭术,分别对两组患者进行疗效评价分析.结果:新辅助化疗组中,晚期上皮性卵巢癌患者有效率为55.17%,手术基本切净率为82.76%,对照组中,手术基本切净率为51.43%,相比较差异有统计学意义(P<0.05).结论:新辅助化疗在晚期上皮性卵巢癌的治疗中能明显缓解症状,改善患者术前状况,增加手术耐受性,增加手术的切净率,提高疗效.     

积极的肿瘤细胞减灭术对于晚期卵巢癌患者生存率的影响(德)

目的:本研究旨在评价接受广泛初次肿瘤细胞减灭术的晚期上皮性卵巢癌患者,影响其术后生存率的预后因子(减瘤)。材料与方法:对1996—2001年,德国H am burg-Eppendorf大学妇科就诊的99例行肿瘤细胞减灭术的原发卵巢癌(FIGOⅢ/Ⅳ期)患者的资料进行分析。结果:在开始全身化疗前(92%     

新辅助化疗联合间歇型肿瘤细胞减灭术治疗34例晚期卵巢癌的疗效及预后分析

[背景]观察新辅助化疗(NACT)联合间歇型肿瘤细胞减灭术治疗晚期卵巢癌的疗效及预后.[病例报告]选择自2005年1月至2015年12月间的113例晚期卵巢癌患者,其中观察组34例,采用NACT联合间歇型肿瘤细胞减灭术治疗;对照组79例,先行肿瘤细胞减灭术再行辅助化疗;两组化疗方案均为紫杉醇联合卡铂.比较两组患者的手术情况、临床疗效及生存率.结果见,观察组患者行NACT后的腹水量、CA125水平及原发肿瘤的最大直径与接受NACT前比较均明显下降(P<0.05).观察组的平均手术时间、术中平均出血量、CA125水平、理想减灭率以及临床疗效均明显优于对照组(P<0.05),而两组复发情况与生存率间无明显差异(P>0.05).[讨论] NACT联合间歇型肿瘤细胞减灭术在晚期卵巢癌治疗上具有较好的效果,但在控制复发及提高生存率方面无明显优势.     

术前新辅助化疗联合洛铂术中腹腔灌注化疗对晚期卵巢癌患者VEGF、HE4水平及预后的影响

目的 探讨术前新辅助化疗联合洛铂术中腹腔灌注化疗对晚期卵巢癌患者血清血管内皮生长因子(VEGF)、人附睾蛋白4(HE4)水平及预后的影响。方法 选取我院自2014年6月～2016年7月收治的80例晚期卵巢癌患者,按随机数字表法分为两组,各40例。观察组实施术前新辅助化疗+肿瘤细胞减灭术+洛铂术中腹腔灌注化疗+术后TP方案化疗,对照组实施常规肿瘤细胞减灭术+术后TP方案化疗,比较两组手术情况、短期疗效、血清VEGF与HE4水平变化情况,并随访1、3年生存率。结果 观察组的手术时间、术中出血量、腹水量及住院时间均少于对照组(P0.05);观察组临床总有效率为80.00%,高于对照组的57.50%(P0.05);治疗后,观察组血清VEGF、HE4水平均较治疗前降低且低于对照组(P0.05);观察组3年生存率高于对照组(P0.05)。结论 术前新辅助化疗联合洛铂术中腹腔灌注化疗可明显缩短手术时间、减少术中出血量,提升晚期卵巢癌患者短期疗效,且有利于下调血清VEGF、HE4水平,改善预后。     

TP方案治疗晚期上皮性卵巢癌92例临床分析

上皮性卵巢癌的发病率居卵巢恶性肿瘤的首位。70%～80%的上皮性卵巢癌在确诊时已属晚期,致使手术不能完全切净,术后复发率高,5年生存率低。目前对于晚期上皮性卵巢癌的治疗,首选的方法仍是肿瘤细胞减灭术加术后辅助化疗。化疗在晚期上皮性卵巢癌的治疗中     

新辅助化疗联合肿瘤细胞减灭术中热灌注治疗晚期卵巢癌疗效观察

目的 :探讨新辅助化疗联合肿瘤细胞减少灭术中热灌注治疗晚期卵巢癌的临床疗效。方法 :针对我院从2012年4月~2013年7月收治的120例晚期卵巢癌的患者,随机分为两组,观察组患者术前采取腹腔内热灌注辅助化疗(以铂类为基础)进行处理,对照组采取常规的新辅助化疗进行处理,两组患者随后采取合肿瘤细胞减灭术进行手术,比较两组患者在手术时间、出血量、腹水量、术后的住院时间、并发症、疗效、复发与死亡、生存率等数据的差异。结果 :观察组患者在术中的各项疗效和术后的各种恢复表现均优于对照组,且具有显著的统计学差异。结论 :在临床上对于晚期卵巢癌患者采取术前的热灌注辅助化疗联合肿瘤细胞减灭术,对于患者的预后和疗效较常规的方法有较大的提高,值得在临床上进行推广。     

辅助化疗联合肿瘤细胞减灭术治疗卵巢癌的临床体会

目的 探讨新辅助化疗结合间隔肿瘤减灭术治疗晚期卵巢癌的效果.方法 对我院在2000年1月至2005年12月间收治的69例晚期卵巢癌进行回顾性分析,先行新辅助化疗,全身化疗3疗程后行间隔肿瘤减灭术,术后继续化疗6疗程,分析3年及5 年生存率.结果 明显提高肿瘤细胞减灭术的满意率,3年生存率81.1%,5年生存率55.1%.结论 新辅助化疗结合间隔减瘤术治疗晚期卵巢癌可以明显提高晚期卵巢癌患者手术满意率和生存率.     

新辅助化疗在晚期卵巢癌治疗中应用措施

目的 探讨新辅助化疗在晚期卵巢癌治疗中应用,毒副作用,临床适应症.方法 我院自2000年10月至20008年12月, 共收治卵巢癌并施行肿瘤细胞减灭患者96例, 根据化疗时间分为新辅助化疗组(术前化疗组)46例, 术前未化疗组50例,进行治疗观察.结果 新辅助化疗组与术前未化疗组手术情况最佳减灭,非最佳减灭,手术时间,术中出血量经统计学分析两组手术情况比较 P＜0.05,有统计学意义.结论 新辅助化疗在晚期卵巢癌治疗中掌握临床适应症,选择合理的化疗方案,正确的认识毒副作用,能够提高晚期卵巢癌治疗效果.     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…