年轻妇女宫颈癌临床特征与预后分析

目的探讨年轻妇女(≤35岁)宫颈癌的临床病理特征及预后。方法对36例年轻妇女宫颈癌(研究组)进行了回顾性分析,并与同期56例中老年妇女宫颈癌(对照组)进行对照。结果研究组以接触性出血为主占77.78%,较对照组的46.43%明显为高,差异有统计学意义(<0.01)。两组均以外生型为主,分别为47.2%及62.5%;病理类型均以鳞癌为主,分别为72.2%、87.5%,差异无统计学意义(>0.05)。研究组淋巴转移阳性率高于对照组,分别为22.2%、5.4%,差异有统计学意义(<0.05);研究组I期、Ⅱ期和Ⅲ期宫颈癌2年生存率分别为72.7%、65.0%和40.0%,对照组分别为88.2%、87.5%和57.1%,两组差异有统计学意义(<0.05)。研究组2年复发转移率为58.3%,高于对照组的35.7%(<0.05)。结论接触性阴道流血为年轻妇女宫颈癌的危险信号。应提高对年轻妇女宫颈癌的警惕性,避免漏诊或误诊。年轻妇女宫颈癌患者预后差可能与盆腔淋巴结转移率高有关。     

84例女性子宫内膜癌临床病理特点的研究

目的 分析不同年龄子宫内膜癌患者的临床病理特点及预后,探讨年轻患者的理想治疗方案.方法 对比分析本院1998年～2007年诊治的34例(年龄<40岁)子宫内膜癌患者(研究组)和50例(年龄≥60岁)子宫内膜癌患者(对照组)的临床病理资料及预后.结果 研究组患者有高血压、糖尿病占2.9%,有子宫内膜癌家族史者占29.4%,均明显低于对照组(P<0.05).研究组早期(Ⅰ期)病例较多(88.2%),高于对照组(P<0.05).组织病理类型以子宫内膜样腺癌为主(94.1%),非子宫内膜样腺癌少见,与对照组相比差异有显著性(P<0.05).组织学分级为高中分化者占94.1%,浸润肌层深度<1/2或局限于内膜内者占72.4%,均高于对照组(P<0.05).然而,研究组淋巴结转移率低于对照组,但5年生存率为93.7%,明显高于对照组(P<0.05).结论 子宫内膜癌年轻患者以子宫内膜样腺癌为主,临床分期早、预后好,多数患者能够长期生存.治疗应遵循个体化、人性化的原则,可以尝试保留其生育功能的手术.     

年轻妇女子宫颈癌的临床特征和预后分析

目的探讨年轻妇女子宫颈癌的临床特征及预后。方法回顾性分析2008年2月-2011年2月间我院收治的138例年轻妇女子宫颈癌患者（观察组）的临床资料,与同期162例中老年宫颈癌患者（对照组）相对照,观察两组的临床特征及预后。结果年轻妇女子宫颈癌发病率呈逐年上升趋势。观察组临床表现以接触性阴道流血最显著,占59.4%（82/138）,明显高于对照组的15.4%（25/162）（P〈0.05）;观察组腺癌发生率38.4%（53/138）高于对照组的12.3%（20/162）（P〈0.05）;观察组Ⅰ、Ⅱ、Ⅲ期三年生存率分别为75.0%、61.2%、32.7%,明显低于对照组的88.1%、81.3%、68.7%（P〈0.05）。手术切除是治疗年轻妇女子宫颈癌的首选方式。结论年轻妇女子宫颈癌发病呈上升趋势,可能与性传播有关。接触性阴道出血是年轻妇女子宫颈癌的主要临床症状,可能与患者处于性活跃期性生活较频繁有关。年轻妇女子宫颈癌腺癌比例增高及淋巴结转移率高是影响患者预后的重要因素。采取子宫切除术联合卵巢移位术对治疗年轻妇女子宫颈癌疗效显著,且并发症少、预后好,值得临床推广。     

年轻宫颈癌68例临床分析

目的:探讨我院收治的宫颈癌患者是否出现年轻化的趋势,年轻宫颈癌患者的临床以及诊断和治疗特点。方法:对1996年1月～2006年12月我院收治的年龄≤35岁宫颈癌患者68例的临床资料进行回顾性分析(研究组),并随机与同时期>35岁宫颈癌患者110例作对照研究(对照组)。结果:年轻宫颈癌发病有明显上升趋势,临床分期上,研究组以早期癌(临床分期≤Ⅱa期)居多,占80.88%(55/68),与对照组相比差异有显著性;病理类型及组织学分级二组差异无显著性,均以鳞癌为主要病理类型,但研究组中盆腔淋巴结转移率明显高于对照组,差异有显著性;术后5年存活率,≤Ⅱa期患者两组比较差异无显著性(P>0.05),≥Ⅱb期患者研究组5年存活率明显低于对照组,差异有显著性(P<0.05)。结论:宫颈癌患者发病有明显年轻化趋势;年轻组患者临床分期以早期癌(≤Ⅱa期)所占比例高,接触性阴道流血为年轻妇女宫颈癌的危险信号,诊断上应提高对年轻妇女宫颈癌的警惕性,尽量做到早期诊断和治疗,提高年轻患者的5年存活率,主张提倡对已婚妇女的普查,及时发现及诊疗癌前病变和早期癌。     

影响宫颈癌发病的相关因素和临床病理特征

目的 对280 例宫颈癌的病例进行回顾性分析,追踪目前宫颈癌发病的相关因素、临床特征、病理特征以及预后的相互关系.方法 对本院2006年12月～2011年12月的280例宫颈癌患者进行回顾分析,分为青年组(年龄≤35 岁)40 例,中老年组(年龄＞35 岁)240例,并且对临床资料进行对比分析.结果 青年组与中老年组的构成比在2006～2008年为19.33%(23/139),2009～2011年为12.06(17/141),比较差异无统计学意义(P＞0.05).根据怀孕次数的调查发现,中老年宫颈癌中孕次＞3次占53.75%(129/240),产次＞3次占55.42%(133/240),与青年组比较差异有统计学意义(P＜0.05).临床表现青年组中主要为接触性阴道出血67.50%(54/80),较中老年组多,差异有统计学意义(P＜0.05).临床分期青年组中原位癌占10%(4/40),Ⅰ期占40%(16/40),两者的比例达50%与中老年组比较差异有统计学意义(P＜0.05).组织病理学类型、组织学分级、宫颈形态、统计学分析青年组和中老年组无统计学意义(P＞0.05).青年组总生存率低于中老年组,但差异无显著性(P＞0.05).结论 临床表现年轻宫颈癌患者的特点主要为接触性阴道出血,临床分期以早期为主.而中老年宫颈癌患者则以孕次和产次为特异性的发病因素.分析比较年轻宫颈癌总生存率无明显下降,年轻并不是宫颈癌预后恢复的不良因素.     

ⅠB1期宫颈腺癌和鳞癌患者保留卵巢的临床病理特征比较

目的：探讨ⅠB1期宫颈腺癌患者保留卵巢的风险及预后。方法：回顾性分析1994年8月至2015年4月北京大学第一医院妇产科收治的139例ⅠB1期浸润性宫颈癌的临床资料,其中宫颈腺癌38例、宫颈鳞癌101例,按是否保留卵巢分为两组,分析比较卵巢转移的风险及保留卵巢的预后。结果：38例ⅠB1期宫颈腺癌的平均5年累计生存率为89.1%,101例同期宫颈鳞癌为92.9%,两组相比差异有统计学意义（P=0.034）。宫颈腺癌患者中32例行卵巢切除,病理证实的卵巢转移率为3.1%（1/32）,而宫颈鳞癌患者中54例行卵巢切除,病理证实的卵巢转移率为1.8 %(1/54),两组间差异无统计学意义（P=0.574）。宫颈腺癌中6例保留卵巢患者的平均5年累计生存率为80.1%,而宫颈鳞癌中47例保留卵巢患者的平均5年累计生存率为94.6%（P=0.127）,两组间的生存曲线差异无统计学意义。结论：ⅠB1期宫颈腺癌相比同期的宫颈鳞癌预后稍差,但对于年轻的、无明显高危因素的ⅠB1期宫颈腺癌患者可以考虑保留卵巢。     

年轻妇女宫颈癌38例临床分析

目的探讨年轻妇女宫颈癌的发病趋势、临床表现、病理特征和治疗特点。方法对2003-01～2008-12我院收治的年龄435岁宫颈癌患者38例（研究组）的临床资料进行回顾性分析,并随机与同时期〉35岁宫颈癌患者34例（对照组）作对照分析。结果年轻妇女宫颈癌发病率有明显上升趋势;研究组孕次、产次均较对照组低,但无统计学意义;临床表现研究组与对照组均以接触性出血为主,其次为不规则阴道流血;在肿瘤类型方面,两组均以外生型为主,但是研究组以巨块型为主,占63．1％,与对照组相比差异有统计学意义（P〈0．05）;临床分期上,研究组和对照组均以早期癌（临床分期≤Ⅱa期）居多,分别占94．7％（36／38）、91％（31／34）,两者相比差异无统计学意义（P〉0．05）;病理类型、组织学分级、淋巴结转移与对照组相比差异无统计学意义（P〉0．05）,均以中分化鳞癌为主要病理类型。研究组38例,予手术治疗34例,30例保留一侧或双侧卵巢并移位于同侧上腹部（P〈0．05）,34例行盆腔淋巴结清扫,淋巴结转移率为20．6％,以闭孔淋巴结为最常见。对照组34例,予手术治疗31例,10例保留一侧或双侧卵巢并移位于同侧上腹部（P〈0．05）,31例行盆腔淋巴结清扫,7例有淋巴结转移,淋巴结转移率为22．5％,以闭孔淋巴结为最常见,两组淋巴结转移率比较差异无统计学意义（P〉0．05）。结论宫颈癌患者发病有明显年轻化趋势;研究组患者临床分期以早期癌为主,接触性出血为年轻妇女宫颈癌的危险信号,淋巴结转移较少见,诊断上应提高对年轻妇女宫颈癌的警惕性,尽量做到早期诊断和治疗,主张提倡对已婚妇女的普查,及时发现及诊疗癌前病变和早期癌。治疗时应注意保留早期患者的卵巢功能,提高生活质量。     

D2胃切除术中行No.14v淋巴结清扫对局部进展期远端胃癌患者预后的影响

目的:探讨D2胃切除术中行No.14v淋巴结清扫对局部进展期远端胃癌患者预后的影响。方法:选取50例局部进展期远端胃癌患者为受试对象,按照随机数表法分为研究组与对照组,各25例。对照组采用D2胃切除术,研究组在对照组基础上行No.14v淋巴结清扫。比较两组患者手术相关指标(手术时间、术中出血量、平均淋巴结清扫数量)评估差异;比较术前及术后3年时,两组患者血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)199、CA724]水平变化;比较术后1个月内,两组患者并发症发生情况差异;比较术后1年时及术后3年时,两组患者生存率(总生存率、无进展生存率)及淋巴结转移率情况变化。结果:两组患者手术时间、术中出血量比较无统计学意义(P>0.05),研究组患者平均淋巴结清扫数量明显多于对照组(P<0.05);术后3年时,两组患者CEA、CA199、CA724水平均较术前显著降低(P<0.05),且研究组明显低于同一时间对照组(P<0.05);术后1个月内,两组患者肺部感染、胸腔积液、吻合口瘘、肠梗阻发生率比较无统计学意义(P>0.05);术后3年时,研究组患者总生存率、无进展生存率均明显高于同一时间对照组(P<0.05),且淋巴结转移率均明显低于同一时间对照组(P<0.05)。结论:D2胃切除术中行No.14v淋巴结清扫应用于局部进展期远端胃癌患者,可增加淋巴结清扫数量,改善血清肿瘤标志物水平,提高患者术后生存率,降低淋巴结转移率。     

近50年宫颈癌的发病趋势和临床特点分析

目的分析近50年宫颈癌的发病趋势和临床特点,探讨合理的治疗方案。方法对1955年1月至2004年12月收治的1557例浸润性宫颈癌的临床和病理资料进行回顾性分析。结果近50年来宫颈癌的平均发病年龄逐渐降低,由1955~1964年的(56.27±8.45)岁降至1995~2004的(43.81±8.90)岁;年轻宫颈癌(≤35岁)的构成比由3.42%升至24.91%。同时,临床早期(Ⅰ~Ⅱ期)的比例和非鳞癌的比例则逐步升高,差异均有统计学意义(P<0.05)。不同年龄组病例的临床分期、病理类型及淋巴结转移率比较,差异均有统计学意义(P<0.05),尤其是年轻人宫颈癌与其他年龄组比较,具有非鳞癌比例高、淋巴结转移率高和临床晚期(Ⅲ~Ⅳ期)比例高等显著特点。针对宫颈癌发病的新趋势和临床特点,改变传统的治疗模式、探索相应的治疗新方法十分必要。结论近50年宫颈癌的发病具有明显年轻化、及临床早期比例和非鳞癌比例逐步升高的趋势。与其他年龄组比较,年轻人宫颈癌具有显著不同的临床和病理特点。对于生育年龄宫颈癌的治疗应充分考虑其生殖内分泌功能的保留问题。新辅助动脉化疗是现代宫颈癌治疗的有效手段之一。     

宫颈癌临床病理特征与盆腔淋巴结转移的相关性分析

目的 分析宫颈癌临床病理特征与盆腔淋巴结转移之间的关系。 方法 回顾性分析温州市中西医结合医院2015年3月-2017年3月收治的宫颈癌患者102例,其中有盆腔淋巴结转移者共22例(21.57%),作为观察组,其余80例无盆腔淋巴结转移者为对照组,观察并探讨2组患者肿瘤分期、组织学类型、生长类型等与盆腔淋巴结转移之间的关系。 结果 观察组患者中有绝经期9例,占40.91%(9/22),对照组22例,占27.50%(22/80),2组差异有统计学意义(P<0.05)。观察组高危型HPV阳性22例,占100%;Ⅰb 14例,占63.64% (14/22),Ⅱa 8例,占36.36%(8/22);14例肿瘤直径 ≥ 4 cm,占63.64%(14/22)。观察组10例宫颈肌层癌浸润深度>2/3(45.45%),对照组17例(21.25%),2组差异有统计学意义(P<0.05);观察组内生型17例,外生型5例,没有溃疡型及颈管型,与对照组比较差异有统计学意义(P<0.05)。盆腔淋巴结转移与年龄、组织学分型等无明显相关。 结论 宫颈癌患者有高危型HPV、临床分期、肿瘤大小与盆腔淋巴结转移有关,且宫颈肌层癌浸润深度>2/3、内生型的宫颈癌患者,其盆腔淋巴结转移率较高。      

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.