子宫颈癌疾病与手术分类

目的解决子宫颈癌疾病与手术编码问题。方法根据子宫颈癌具体部位进行疾病分类。根据手术范围、入路、方式、伴随的其他操作决定手术编码。结果介绍了子宫颈癌疾病和手术分类原则,以及查找编码方法。结论子宫颈癌疾病编码应结合手术记录明确病变部位、手术编码应按手术切除的范围和是否伴随有盆腔淋巴结清扫,决定是根治性与非根治性子宫全切手术。     

非脱垂大子宫经阴道切除术128例临床分析

目的 探讨非脱垂大子宫经阴道子宫全切除术的可行性及临床效果.方法 回顾性分析128例大子宫经阴道全子宫切除术的临床资料,与同期经腹子宫全切除术105例进行比较.结果 128例大子宫经阴道子宫全切除术均成功完成,无中转开腹手术.手术时间经阴道子宫切除组较经腹子宫切除组略长,差异有显著性(P＜0.05),术中出血量阴式组少于腹式组,差异有显著性(P＜0.05),而术后下床活动时间、术后排气、术后住院时间比较,阴式组均较腹式组短,差异有显著性(P＜0.01).结论 非脱垂大子宫经阴道切除是安全可行的.     

经阴道子宫切除术的疗效观察

目的:探讨经阴道子宫切除术的可行性及临床应用价值。方法:改良经阴道子宫切除手术步骤,对18例有子宫切除手术适应症者行经阴道子宫切除术,取同期经腹切除子宫18例作对比分析。结果:阴式组较腹式组手术时间长、术中出血稍多(P<0.05),而术后肛门排气时间、术后镇痛例数、术后住院日阴式组少于腹式组(P<0.01);术后病人满意度阴式组明显高于腹式组(P<0.01);两者术后性生活满意度无差别。结论:阴式全子宫切除术具有术后疼痛轻,恢复快,住院日缩短,病人满意度高等优点,是一种安全、手术效果好、副反应少的手术方式。     

内凝棒在改良腹式横切口子宫切除术中应用

目的 探讨内凝棒在全子宫切除中经阴道宫颈鞘内挖空术后电凝止血与传统全子宫切除，宫颈楔形切除术方法优点。方法 通过对26例腹式横切口经腹及阴道联合子宫切除术与对照组子宫全切宫颈楔形切除术进行观察分析。结果 腹式横切口经腹及阴道联合子宫切除术明显优于传统术式。结论 腹式横切口经腹及阴道联合手术方法具有宫颈外形完整，移行带切除彻底，不易发生残端癌等优点。     

经阴道子宫全切除术临床观察

目的 探讨经阴道子宫切除术的可行性及临床应用价值.方法 改良经阴道子宫切除手术步骤,对120例有子宫切除手术适应证者行经阴道子宫切除术,取同期经腹切除子宫120例作对比分析.结果 阴式组较腹式组手术时间长,术中出血稍多(P<0.05),而术后肛门排气时间、术后镇痛例数、术后住院时间阴式组少于腹式组(P<0.01);术后患者满意度阴式组明显高于腹式组(P<0.01);两者术后性生活满意度无差别.结论 阴式全子宫切除术具有创伤小,术后疼痛轻,恢复快,住院日短,患者满意度高等优点,是一种安全、微创、手术效果好、副反应少的手术方式.     

24例经阴道子宫切除术的临床观察

目的探讨经阴道子宫切除术的可行性及临床应用价值。方法改良经阴道子宫切除手术步骤,对12例有子宫切除手术适应症者行经阴道子宫切除术,取同期经腹切除子宫12例作对比分析。结果阴式组较腹式组手术时间长,术中出血稍多（P〈0．05）,而术后肛门排气时间,术后镇痛例数、术后住院日阴式组少于腹式组（P〈0．01）;术后病人满意度阴式组明显高于腹式组（P〈0．01）;两者术后性生活满意度无差别。结论阴式全子宫切除术具有术后疼痛轻,恢复快,住院日缩短,病人满意度高等优点,是一种安全,手术效果好、副反应少的手术方式。     

非脱垂全子宫切除两种微创术式对比分析

临床上子宫切除术的术式选择多种多样,常见的有经腹子宫切除(TAH)、经阴道子宫切除(TVH)及腹腔镜下子宫切除(TLH)术。近年报道相同指征的手术切除TVH优于TAH。而随着阴式手术适应     

子宫切除术四种不同入路方式比较

目前常用的子宫切除术有经腹全子宫切除术（TAH）、阴式全子宫切除术（TVH）、腹腔镜全子宫切除术（LTH）、腹腔镜辅助下阴式全子宫切除术（LAVH）,但如何合理选择手术入路,哪种术式更有优势,是临床上不断探讨、研究、总结的问题,本文回顾性分析了本院行子宫切除术患者的临床资料,总结了四种不同入路子宫切除方式的优缺点。     

新式非脱垂子宫经阴道全切术与经腹全子宫切除术的临床效果观察

目的:比较新式非脱垂子宫经阴道全切除术与经腹全子宫切除术的临床效果。方法:对有全子宫切除指征的,非脱垂的经阴道全切除术42例和经腹全子宫切除术40例的资料进行回顾性分析,比较两种术式的手术时间、术中出血量、术后排气时间、住院时间等情况。结果:与经腹全子宫切除术比较,经阴道全切除术术中出血量少,手术时间、术后排气时间短、住院时间短,差异有统计学意义(P<0.05)。结论:新式非脱垂子宫经阴道全切除术具有创伤小、手术时间短、术中出血量少、恢复快、腹腔内环境干扰小等优点,是一种值得推广的微创手术。     

非脱垂子宫阴式全子宫切除术的临床观察

目的 探讨非脱垂子宫经阴道全子宫切除术的手术效果.方法 对需行子宫切除的行经阴道全子宫切除术21PJ患者与经腹全子宫切除术20例患者就手术时间、手术中出血量、术后病率、术后肛门排气时间、术后住院天数进行观察比较.结杲阴道全子宫切除术在手术时间、术后病率、术后肛门排气时问、等方面均少于腹式全子宫切除术,有统计学意义.术中出血量,两种方式没有统计学意义.结论 非脱垂子宫经阴道全子宫切除术是一种低创伤,效果好的手术方式.具有临床推广价值.     

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…