卵巢癌和原发性腹膜癌患者直结肠切除术

目的:本研究调查卵巢癌和原发性腹膜癌患者直结肠切除术的手术细节和并发症。研究设计:在手术资料数据库中筛选1998—2002年因卵巢癌和原发性腹膜癌行直结肠切除术的患者。结果:筛选出125例患者,其中73%接受初次肿瘤细胞减灭术;18%进行二次肿瘤细胞减灭术;7%进行间期细胞减灭术     

卵巢癌手术中肠道病灶处理对预后影响的循证评价

目的:评价卵巢癌肿瘤细胞减灭术中肠道病灶处理的安全性及对预后的影响.方法:收集2000年1月1日至2010年12月31日发表的,关于卵巢癌肿瘤细胞减灭术中肠道转移病灶处理的文献进行复习,评价肠道病灶处理的临床价值.结果:27篇文献符合纳入标准.多数学者认为肠切除可提高理想减瘤的概率并有改善患者生存的趋势,肠切除理想减瘤患者较不理想减瘤患者预后好.而肠管浸润深度可能对患者的无瘤生存有影响,但对于总的生存无影响.最常见的术后并发症为感染,发生率平均20.7%.而与肠道手术直接相关的最常见并发症为肠梗阻发生率平均10.6%.其次为肠漏及吻合口漏的发生,平均2.7%.术中出血量100～8 500 mL.住院时间4～79 d.术后肛门排气时间1周左右.结论:卵巢癌肿瘤细胞减灭术中肠道病灶处理是安全可行的,可提高理想减瘤的概率,肠切除后达到理想减瘤患者预后好,但其对预后的影响仍需更多相关研究以进一步证实.     

新辅助化疗、肿瘤细胞减灭术联合热灌注治疗晚期卵巢癌疗效分析

目的:探讨新辅助化疗联合肿瘤细胞减灭术术中、术后热灌注疗法治疗晚期卵巢癌的临床价值.方法:2015年6月至2017年3月来我院就诊的晚期卵巢癌患者178例随机分为两组,对照组(n=88)和观察组(n=90).其中对照组给予新辅助化疗(紫杉醇+顺铂/卡铂)联合肿瘤细胞减灭术治疗,观察组给予新辅助化疗联合肿瘤细胞减灭术术中、术后热灌注疗法治疗.比较两组患者术中出血量、术后住院时间,以及治疗效果、出院后6个月的复发率和死亡率.结果:观察组患者术中出血量与对照组比较,差异无统计学意义(P＞0.05);观察组患者术后住院时间明显短于对照组,出院6个月的复发率和死亡率明显低于对照组,组间比较差异具有统计学意义(P＜0.05).结论:新辅助化疗联合肿瘤细胞减灭术术中、术后热灌注疗法治疗晚期卵巢癌效果明显,值得推广应用.     

宫颈癌根治术的危险因素分析

目的:调查与宫颈癌根治术有关的危险因素.方法:收集2000年1月～2006年5月入院的416例行宫颈癌根治术的病人临床资料,统计分析可能导致手术并发症的因素.结果:年龄＞55岁、ρ(白蛋白)≤35 g·L-1、ρ(血红蛋白)≤8 g·L-1、术前放化疗和腹主动脉淋巴结清扫等5个因素是宫颈癌根治术的危险因素.结论:在准备行宫颈癌根治术时,对以上危险因素应仔细考虑,有目的地控制相关因素可以降低宫颈癌根治术有关的并发症发生.     

卵巢癌中间型肿瘤细胞减灭术手术时机的探讨

目的:探讨卵巢癌中间型肿瘤细胞减灭术手术时机。方法 :分析34例卵巢癌首次手术未达到理想的肿瘤细胞减灭术,行2～4疗程的化疗后通过妇检、血CA125、CT或MRI来评估再行中间型肿瘤细胞减灭术的时机。结果:34例中29例(85.3%)行中间型肿瘤细胞减灭术手术达到满意的效果。结论:晚期卵巢癌,首次手术常无法达到理想的肿瘤细胞减灭术,经化疗2～4疗程后通过妇科检查、血CA125、CT/MRI进行评估的使中间型减瘤术达到理想的效果,提高病人的生存率。     

45例复发性卵巢癌综合治疗的临床分析

目的 探讨复发性卵巢癌治疗的意义和方法 .方法 45例复发性卵巢癌患者,16例采用二次肿瘤细胞减灭术联合化疗,15例采用单纯化疗,7例化疗与放疗联合应用.14例化疗＜6疗程,24例化疗≥6疗程.结果 二次肿瘤细胞减灭术联合化疗的患者的总生存时间,较单纯化疗患者明显延长(P＜0.05);二次肿瘤减灭术残留病灶≤2 cm患者的复发后生存时间,较病灶＞2 cm者延长;二线化疗≥6疗程者的复发后生存时间,较＜6疗程者明显延长(P＜0.05).结论 复发性卵巢癌的治疗强调个体化,二次肿瘤减灭术联合化疗可延长生存时间,手术中残留病灶大小对预后有影响.     

动脉介入化疗栓塞在晚期上皮性卵巢癌中的应用

目的:探讨动脉介入化疗栓塞在晚期上皮性卵巢癌治疗中的意义。方法:1999年12月1日至2012年5月31日在我院实施肿瘤细胞减灭术的晚期上皮性卵巢癌患者共100例,按术前是否行动脉介入化疗栓塞分为2组,即动脉介入化疗栓塞组(治疗组)和初次肿瘤细胞减灭术组(对照组)。治疗组27例,对照组73例,治疗组术前予1~2疗程动脉介入化疗栓塞后再行肿瘤细胞减灭术,对照组行初次肿瘤细胞减灭术,对其进行回顾性分析,比较2组患者临床各项指标、相关预后因素及累积生存率。结果:治疗组分级高、期别晚者所占比例高,但达到满意的肿瘤细胞减灭术者所占比例比对照组高,两者比较差异无统计学意义(P>0.05)。多因素生存分析显示手术病理分期及手术满意度是影响患者总的生存率的独立预后因素(P=0.010及P=0.011)。治疗组3年和5年累积生存率分别为64%和48%,对照组为62%和40%,差异无统计学意义(P>0.05)。结论:术前估计难以达到满意的肿瘤细胞减灭术的晚期上皮性卵巢癌患者,行动脉介入化疗栓塞可能提高手术的成功率,但不能提高患者总的生存率。     

晚期卵巢癌新辅助化疗与手术治疗的临床研究

目的探讨晚期卵巢癌新辅助化疗与手术治疗的疗效及相关影响因素。方法回顾性分析新辅助化疗结合间隔细胞减灭术（或称中间减瘤术,即给予新辅助化疗后进行的瘤细胞减灭术）治疗的52例晚期卵巢癌病例。结果根治性切除及肿瘤细胞减灭术38例（73.1%）,姑息性切除14例（26.9%）。术后并发症22例（42.3%）,围手术期死亡2例,病死率3.8%。结论手术治疗是晚期卵巢癌患者的首选治疗,新辅助化疗有助于达到满意的肿瘤细胞减灭术,对提高患者生活质量并且延长生存时间具有一定价值。     

晚期卵巢癌的先期化疗20例临床分析

目曲探讨先期化疗在晚期卵巢癌治疗中的临床意义。方法分析我院48例曾行肿瘤细胞减灭术的晚期卵巢癌患者，其中20例行先期化疗，术前行1～3个疗程以铂类为主的化疗；28例未行先期化疗，直接手术，比较两组患者疗效及2年生存率。结果行先期化疗组20例患者，化疗总有效率达85％，胸腹水的控制率达88．2％，满意肿瘤细胞减灭术达85％，术后并发症发生率100k；术前未行化疗组满意肿瘤细胞减灭术的53．6％，术后并发症发生率42．9％，两组比较差异有显著性（P〈0．05）。结论先期化疗能控制胸腹水，缩小瘤体，增加满意肿瘤细胞减灭术的成功率，降低手术并发症的发生率。     

卵巢癌二次肿瘤细胞减灭术的效果:哈斯特帕大学经验

目的:本研究旨在评价复发性卵巢癌患者接受二次肿瘤细胞减灭术的效果。研究设计:对接受二次肿瘤细胞减灭术患者的临床病理特点进行回顾性分析。结果:共分析64例患者资料。多因素分析显示以下3个因素有显著性作用:初次手术时达到满意的肿瘤细胞减灭(P=0.003,O R0.30,95%CI0.14～     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.