直肠癌淋巴结转移的相关因素分析

目的探讨直肠癌淋巴结转移的影响因素。方法将671例手术治疗的直肠癌患者的临床病理资料，采用SPSS 10．0统计软件，分析各临床病理因素对直肠癌淋巴结转移的影响。结果全组病例淋巴结转移率为53.2％；患者不同性别和肿瘤位置其淋巴结转移率的差异无统计学意义（均P〉0.05），不同年龄、肿瘤大小、大体类型、组织学类型、分化程度及浸润深度者淋巴结转移率的差异有统计学意义（均P〈O01）。上述多因素回归分析得出相关因素与淋巴结转移的密切程度依次为：浸润深度〉大体类型〉分化程度〉组织类型〉肿瘤大小〉年龄。结论直肠癌淋巴结转移与患者的年龄、肿瘤的大小、大体类型、组织学类型、分化程度及浸润深度相关，浸润深度是影响转移发生的最主要因素。肿瘤越大、浸润越深、分化越差其淋巴结转移率越高。     

直肠癌淋巴结转移的多因素分析

目的探讨直肠癌淋巴结转移的相关临床病理因素。方法回顾性分析手术治疗的151例直肠癌患者的临床资料,采用单因素和logistic多因素回归分析方法,研究直肠癌淋巴结转移与临床病理因素之间的关系。结果单因素分析显示,性别、年龄、肿瘤部位、肿瘤大小、大体类型、组织类型、术前血癌胚抗原（CEA）水平与直肠癌淋巴结转移无关,而肿瘤占肠腔周径、肿瘤分化程度、肠壁浸润深度与淋巴结转移有关。logistic多因素回归分析显示,肿瘤分化程度和肠壁浸润深度与淋巴结转移有关。结论肿瘤分化程度和肠壁浸润深度是影响直肠癌淋巴结转移的重要危险因素。     

直肠癌患者淋巴结转移的相关因素分析

目的探讨各临床病理因素对直肠癌淋巴结转移的影响。方法采用SPSS 10.0 for windows统计软件，运用单因素及多因素Logistic回归对671例手术切除的直肠癌患者的临床病理资料进行分析。结果全组病例淋巴结转移率53.2％；单因素分析显示患者性别、肿瘤位置与淋巴结转移差异无统计学意义（X^2=0．362、0．138，均P〉0．05），年龄、肿瘤大小、大体类型、组织学类型、分化程度、浸润深度与淋巴结转移差异有统计学意义（X^2=24．121、37．422、87．154、69.451、75．894、163．004，均P〈0．01）。Logistic多因素回归分析得出相关因素与淋巴结转移的密切程度依次为：浸润深度〉大体类型〉分化程度〉组织类型〉肿瘤大小〉年龄。结论直肠癌淋巴结转移与患者的年龄、肿瘤的大小、大体类型、组织类型、分化程度、浸润深度有关，浸润深度是转移发生的最主要因素。肿瘤越大、浸润越深、分化越差其淋巴结转移率越高。     

直肠癌淋巴结转移分析

目的:探讨直肠癌淋巴结转移与诸多临床因素及预后之间的关系。方法:统计85例行全直肠系膜切除术的患者的各个临床因素、生存情况和术后淋巴结病检转移情况,分析后者与前两者之间的关系。结果:单因素分析中肿瘤大体类型、浸润深度、组织学类型、分化程度、血清CEA水平与淋巴结转移相关;多因素分析中肿瘤大体类型、浸润深度与淋巴结转移相关;无淋巴结转移组5年生存率明显高于有淋巴结转移组,淋巴结转移个数<3个组5年生存率明显高于淋巴结转移个数≥3个组。结论:直肠癌的临床特征与淋巴结转移之间存在联系,了解这些联系有利于对直肠癌淋巴结转移的判断,以及制定治疗方案和进行预后判断。     

胃癌淋巴结转移的病理因素及各因素间相关性分析

目的:探讨影响胃癌淋巴结转移的病理因素及各病理因素间的相关性,为合理的胃癌根治术提供依据.方法:收集切除胃癌原发灶的222例患者的病历资料,对切除标本原发部位、大体形态、细胞类型、分化程度、肿瘤直径以及浸润深度与淋巴结转移之间的相互关系进行统计学分析,并分析各病理因素间的相关性.结果:单因素分析发现肿瘤直径、浸润深度、分化程度与淋巴结转移相关,而多因素分析则显示分化程度不是胃癌发生淋巴结转移的独立危险因素.原发部位、大体形态、细胞类型与淋巴结转移无关.肿瘤浸润深度与肿瘤直径和分化程度相关,分化程度与胃癌的细胞类型有关.结论:胃癌根治术时应根据肿瘤直径与浸润深度选择合理的淋巴结清扫范围.     

结直肠癌淋巴结转移的多因素回归分析

目的探讨结直肠癌淋巴结转移规律及其影响因素，为临床诊断、治疗和预后评估提供参考。方法分类整理武汉大学中南医院1990年1月-2006年12月手术治疗的1127例结直肠癌病人的病历资料，采用χ^2检验及Logistic多因素回归分析方法，研究淋巴结转移与临床病理参数之间的相关性。结果单因素分析显示，患者的性别、肿瘤部位与淋巴结转移无明显相关性。影响淋巴结转移的因素有患者的年龄、肿瘤的大小、肿瘤浸润肠壁的深度、病理组织学类型和分化程度。40岁以下的结直肠癌患者淋巴结转移率明显高于40岁以上者（P〈0．01）；淋巴结转移率随肿瘤直径的增大而增加（P〈0．001）；肿瘤浸润肠壁的深度增加，淋巴结转移率增加（P〈0．001）；肿瘤的分化程度越低，淋巴结转移率越高（P〈0．001）。Logistic回归分析显示，结直肠癌淋巴结转移与病人的年龄、肿瘤的大小、肿瘤浸润肠壁的深度、肿瘤的分化程度相关，影响淋巴结转移的相关因素由强到弱依次为肿瘤浸润肠壁的深度、肿瘤的分化程度，在所选因素中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。结论结直肠癌淋巴结转移与病人的年龄、肿瘤的大小、肿瘤浸润肠壁的深度、病理组织学类型及分化程度相关，其中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。     

直肠癌淋巴结转移分析

目的：探讨直肠癌淋巴结转移与诸多临床因素及预后之间的关系。方法：统计85例行全直肠系膜切除术的患者的各个临床因素、生存情况和术后淋巴结病检转移情况，分析后者与前两者之间的关系。结果：单因素分析中肿瘤大体类型、浸润深度、组织学类型、分化程度、血清CEA水平与淋巴结转移相关；多因素分析中肿瘤大体类型、浸润深度与淋巴结转移相关：无淋巴结转移组5年生存率明显高于有淋巴结转移组，淋巴结转移个数〈3个组5年生存率明显高于淋巴结转移个数≥3个组。结论：直肠癌的临床特征与淋巴结转移之间存在联系，了解这些联系有利于对直肠癌淋巴结转移的判断，以及制定治疗方案和进行预后判断。     

结直肠癌淋巴结转移规律的多因素回归分析

目的:探讨结直肠癌淋巴结转移规律及其影响因素。方法:分类整理武汉大学中南医院1990年1月-2007年12月手术治疗的结直肠癌病人的病历资料1 127例,采用卡方检验及Logistic多因素回归分析方法研究淋巴结转移与临床病理参数之间的相关性。结果:单因素分析显示,患者的性别、肿瘤部位与淋巴结转移无明显相关性。影响淋巴结转移的因素有患者的年龄、肿瘤的大小、肿瘤浸润肠壁的深度和分化程度。40岁以下的年轻结直肠癌患者淋巴结转移率明显高于40岁以上者(P<0.01)。淋巴结转移率随肿瘤直径的增大而增高(P<0.001)。肿瘤浸润肠壁的深度增加,淋巴结转移率增加(P<0.001)。肿瘤的分化程度越低,淋巴结转移率越高(P<0.001)。Logistic多因素回归分析显示,结直肠癌淋巴结转移与肿瘤浸润肠壁的深度和肿瘤的分化程度相关,相关因素与淋巴结转移的程度依次为肿瘤浸润肠壁的深度>肿瘤的分化程度,在所选因素中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。结论:结直肠癌淋巴结转移与肿瘤浸润肠壁的深度和分化程度相关,其中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。     

结肠癌淋巴结转移的多因素回归分析

目的：探讨影响结肠癌淋巴结转移的相关因素。方弦：收集233例结肠癌患者临床病理资料进行回顾性分析。结果：单因素分析发现肿瘤浸润深度和分化程度与淋巴结转移相关（P〈O．01）,性别、年龄、原发部位、肿瘤直径、大体类型、组织学类型与淋巴结转移无关（P〉0．05）,多因素分析进一步证实浸润深度和分化程度是影响结肠癌发生淋巴结转移的独立因素（P〈O．01）。结论：肿瘤浸润深度与分化程度是影响结肠癌淋巴结转移的独立因素,对于指导结肠癌手术时淋巴结清扫范围具有重要作用。     

直肠癌向直肠系膜远端微转移规律研究

目的研究直肠癌向直肠系膜远端微转移与临床病理间的关系,为选择直肠癌手术方式提供必要的依据。方法收集46例直肠癌手术后标本,沿肿瘤下缘纵向切取宽约2cm的远端直肠系膜组织,用脂溶法处理后,计数其中淋巴结,随后按每1cm距离切成组织块,行HE染色,取HE检查阴性的切片,再用细胞角蛋白(CK)20为标记的免疫组织化学方法检查,观察显微镜下肿瘤远端直肠系膜中微转移的情况,并进行转移规律分析。结果直肠远端系膜中共检出有淋巴结微转移10例(其中合并有癌结节播散有3例),仅有1例癌结节播散,远端系膜总转移率为23.9%,癌结节微转移率为6.5%,淋巴结微转移率为19.6%;转移最远距离为4cm。直肠癌系膜远端微转移在肿瘤大体类型、浸润深度、分化程度等因素间差异有统计学意义(P0.05);而在年龄、性别、肿瘤部位和大小等因素间差异无统计学意义(P0.05)。结论直肠系膜远端的微转移主要表现为淋巴结的微转移和癌结节的形成;转移发生与肿瘤大体类型、浸润深度、分化程度等因素显著相关。     

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.     

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.     

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.