351例老年原发性肺癌临床特征分析

目的:探讨老年原发性肺癌的临床特点及病理特征。方法:收集2008—2013年经病理证实为肺癌的老年组病例351例以及非老年组病例174例,分析两组间肿瘤大小与部位、病理类型、分期、临床特征以及治疗方法。结果:(1)两组间肿瘤大小以大于等于3 cm多见,部位以左上及左下为主,两组间差异无统计学意义(P0.05)。(2)老年组病理类型以鳞癌多见(亚组分析男性以鳞癌多见,女性则以腺癌多见),而非老年组以腺癌较多见。(3)在分期上,两组均以晚期(IIIb~IV期)多见,而老年组肺内及脑转移少于非老年组,老年组Ⅰ期发现率高于非老年组,两组间相比差异有统计学意义(P0.05)。(4)两组常见临床表现以咳嗽为主要症状,但老年组中较多病人表现为胸闷气急,非老年组则较常见胸痛,两组相比,差异有统计学意义(P0.05)。(5)老年组多采用以化疗为主的综合治疗,与非老年组比较差异性有显著性(P0.05)。结论:老年原发性肺癌以鳞癌多见,临床表现以咳嗽最常见,多有胸闷气急,常并发COPD及肺部感染,尽管与非老年相比,老年组Ⅰ期发现率高,肺内及脑转移较少,但因并发症多,耐受性差,治疗仍以化疗为主。     

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。     

老年肺癌患者血清CEA、NSE、CYFRA21-1检测的临床意义

目的 探讨血清癌胚抗原(CEA) 、神经元特异性烯醇化酶(NSE)、 细胞角蛋白(CYFRA21-1)检测在老年肺癌辅助诊断中的临床意义.方法 测定455例肺癌、382例肺部良性疾病患者的三项指标,并分析其在不同年龄组、不同病理类型、不同TNM分期的特点.结果 肺癌患者血清三项指标水平明显高于肺部良性疾病患者(P<0.01),其中肺癌老年组CYFRA21-1水平高于肺癌非老年组(P<0.01).同年龄腺癌组、鳞癌组、小细胞癌分别以血清CEA、CYFRA21-1、NSE检测水平较高(P<0.05);CEA在腺癌老年组的表达高于腺癌非老年组,CYFRA21-1在鳞癌老年组的表达高于鳞癌非老年组,差异有统计学意义(P<0.05).不同年龄组三项联合检测肺癌的诊断效率较单项检测显著提高(P<0.01),年龄组之间无差异.同年龄组肿瘤标志物阳性率均随着临床分期的升高而升高,Ⅳ期血清CEA 、NSE阳性率明显高于Ⅰ+Ⅱ期,差异有统计学意义(P<0.05),联合检测较单项检测高,差异有统计学意义(P<0.01),CYFRA21-1及联合检测在Ⅲ期年龄组之间差异有统计学意义(P<0.05).结论 血清肿瘤标志物CEA、NSE、CYFRA21-1的联合检测对老年肺癌患者的早期诊断、组织学分型、临床分期具有重要应用价值.     

老年消化性溃疡221例临床与内镜特点分析

目的 探讨老年消化性溃疡的临床特点及内镜下病变特点.方法 总结我院近4年来经胃镜及病理检查确诊的221例老年消化性溃疡患者(老年组)及823例中青年消化性溃疡患者(中青年组)的临床资料,分析两组人群的临床特点及内镜下病变特点.结果 老年组患者中有饮酒史者及非甾体抗炎药应用史者所占比例显著高于中青年组,差异有统计学意义(P<0.01);老年组上腹节律性疼痛、压痛及嗳气反酸发生率均显著低于中青年组,差异有统计学意义(P<0.05);老年患者中大溃疡与巨大溃疡者所占比例显著高于中青年组,差异有统计学意义(P<0.05);老年患者梗阻、出血、癌变的发生率及并发症总发生率均显著高于中青年组,差异有统计学意义(P<0.05).结论 老年消化性溃疡具有发病危险因素多、临床症状体征不典型、溃疡大和并发症相对较多的特点.     

青年肺癌与老年肺癌手术患者的临床病理特征对照

目的:对比青年肺癌与老年肺癌手术患者的临床病理特征。方法:选取青年肺癌与老年肺癌手术患者各50例,分别为本研究的青年组和老年组,分析比较两组患者的临床病理特点。结果:青年组患者病理类型以腺癌为主,比例明显多于老年组;青年组患者TNM分期主要为Ⅲb-IV期,老年组患者TNM分期主要为Ⅰ-Ⅲa期,组间差异有显著统计学意义(P<0.01);青年组患者治疗方式以全肺切除为主,而老年组则以肺叶切除方式为主,差异有显著统计学意义(P<0.01);两组5年生存率差异无统计学意义(P>0.05)。结论:青年肺癌患者和老年肺癌患者相比,临床症状表现复杂但无特异性,早期容易误诊。患病后青年患者的病情往往发展迅速,手术治疗效果不理想且治疗预后较差。因此,需要通过各种诊断方式综合分析患者的病情,根据其具体情况合理选择正确的治疗方式,提高青年肺癌确诊率和生存率,改善疾病的治疗效果,提高患者的生存质量和生命安全。     

周围型肺癌的CT特点临床分析

目的：探讨周围型肺癌的CT表现特点。方法随机选取该医院放射科CT室2014年1月—2015年12月期间的100例周围型肺癌患者,所有患者均经过病理学确诊,根据不同的病理类型与不同的病理分化程度进行分组,统计不同患者的CT表现特点。结果不同病理类型患者在CT上出现胸膜凹陷征的比率不同,腺癌出现胸膜凹陷征的几率最大,鳞癌出现的几率最小,3组比较差异有统计学意义(P<0.05);在纵膈淋巴结转移方面,小细胞癌出现纵膈淋巴结转移几率最高,与腺癌相当,鳞癌相对出现纵膈淋巴结转移几率最低,3组比较差异有统计学意义(P<0.05)。结论周围型肺癌患者的不同病理类型及不同分化患者的CT表现有其特殊的表现形式,CT诊断对于临床病理分型与病理分化程度有一定的指导价值。     

老年与中青年消化性溃疡临床特点比较

目的 探讨老年消化性溃疡(PU)与中青年消化性溃疡的临床特点及其异同,为临床医师诊治该病提供帮助.方法 回顾性分析2010年1月至2013年1月在昆明医科大学第一附属医院经胃镜或手术病理确诊的老年消化性溃疡351例(老年组)与中青年消化性溃疡351例(中青年组)的临床资料,比较2组的临床症状、并发症、溃疡部位、性状、大小、伴发疾病及治疗与转归等因素.结果 (1)临床症状:与青年组相比,老年消化性溃疡症状不典型(80.3%vs 73.0%),常以并发症为首发症状(46.7%vs 29.6%),2组间差异有统计学意义(P<0.001);典型上腹痛者低于中青年组(19.7%vs 37.0%),2组间差异有统计学意义(P<0.001);(2)常见并发症:老年组患者出现并发症明显高于中青年组(46.7%vs 29.6%),以出血、穿孔和幽门梗阻常见,差异有统计学意义(P<0.05);(3)溃疡灶部位:老年组胃溃疡、高位溃疡较中青年组增多(P<0.05);(4)溃疡性状与大小:老年组巨大溃疡(≥2.0 cm)患者多于中青年组(15.1%vs 4.3%,P<0.05);但HP感染无明显差异(90.3%vs 90.9%,P>0.05);(5)伴发病:老年组患者伴发糖尿病、心血管疾病、胆结石、胆囊炎、痛风等慢性疾病者较中青年组多见(47.0%vs 15.7%,P<0.05);(6)治疗与转归:老年组因并发症死亡者明显高于中青年组(14.0%vs 3.8%,P<0.05).结论 老年消化性溃疡较中青年消化性溃疡具有症状不典型、发病部位高、并发症多、死亡率高等特点,早确诊、早治疗对改善预后、降低病死率至关重要.     

老年胃癌患者临床表现､病理特征和预后分析

目的 :探讨老年胃癌患者的临床病理特征及其预后相关因素。方法 :回顾性收集南京医科大学第一附属医院2006年8月~2008年8月收治的155例老年胃癌患者(年龄≥60岁)的临床病理资料,并与同时期收治的40岁以下的89例中青年胃癌患者的临床表现、病理特征及预后进行对比分析。结果:老年组以男性更为多见,而中青年组男女比例基本相似,两组患者的常见临床表现中,以腹痛、呕血、黑便及贫血较为常见。部分老年胃癌患者有胸骨后不适、吞咽困难、消瘦,其比例明显高于中青年组,而中青年组上腹部不规律疼痛高于老年组。老年组胃癌发生在中上部的比例要明显高于中青年组,老年组多为BorrmannⅡ型和Ⅲ型,而中青年组以Ⅲ型和Ⅳ型多见,并且老年组低分化型患者的比例显著低于中青年组;但两组在肿瘤大小、淋巴结转移、TNM分期及根治性切除率等方面的差异均无统计学差异(P>0.05)。单因素和多因素预后分析显示,TNM分期(P=0.004)和手术方式(P=0.036)是影响老年胃癌患者预后的独立因素。结论:老年胃癌患者在临床表现、病理特征和预后影响因素方面与中青年组存在差异,TNM分期和手术方式是影响老年胃癌患者预后的独立因素,根治性手术仍是获得长期疗效的有效方法。     

老年与青年肺癌患者临床特点对比分析

目的探讨老年与青年肺癌的临床特征及预后的差异。方法选取2012年1月至2015年1月漯河市郾城区人民医院收治的经病理学证实的肺癌患者130例,其中老年组(年龄≥60岁)85例,青年组(年龄≤40岁)45例。对130例患者的临床资料进行回顾性分析,观察比较老年组与青年组患者的性别分布、有无吸烟史、是否伴有胸痛、病理组织类型及生存率等临床资料。结果两组患者均以男性居多,青年组女性患病比例及吸烟比例高于老年组,差异具有统计学意义(P<0.05)。老年组合并肺部疾病患者比例明显高于青年组,胸痛史患者比例显著低于青年组,差异具有统计学意义(P<0.05)。老年组患者鳞癌比例高于青年组,腺癌比例低于青年组,半年、1年、2年生存率均低于青年组,差异具有统计学意义(P<0.05)。结论老年人肺癌相比于青年人肺癌以男性、鳞癌比例较高;而青年人则以腺癌为主,半数伴有胸部疼痛及吸烟史。对所有的肺癌患者来说,早期诊断、积极治疗是提高疗效的唯一方法。     

115例年轻女性乳腺癌患者临床特点分析

目的探讨年轻女性乳腺癌患者的临床特点及治疗方法。方法回顾性分析郑州大学人民医院2010年1月至2014年3月收治的115例年轻(≤35岁)女性乳腺癌患者的临床资料,随机选取同期老年(≥60岁)女性乳腺癌患者115例作为对照组,对比分析两组患者肿瘤分期、淋巴结转移情况、病理类型、免疫组化指标、分子分型、手术方式等。结果年轻组中晚期乳腺癌患者比例高于老年组(P<0.05)。年轻组淋巴结转移75例(65.2%),老年组淋巴结转移43例(42.6%),两组差异具有统计学意义(P<0.05)。两组病理类型分布差异无统计学意义(P>0.05)。年轻组ER阳性率低于老年组(P<0.05),PR、HER2阳性率组间差异无统计学意义(P>0.05)。年轻组中Luminal A型乳腺癌患者所占比例低于老年组,但三阴性乳腺癌所占比例高于老年组(P<0.05)。年轻组患者保乳手术率高于老年组(P<0.05)。结论年轻乳腺癌分期晚、淋巴结转移多见;ER阳性率高;Luminal A型及三阴性乳腺癌所占比例较高。年轻患者更倾向于保乳手术治疗。     

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.