双侧子宫动脉栓塞术治疗子宫肌瘤109例

目的 总结经导管双侧子宫动脉栓塞术的临床处理和介入操作经验，探讨该治疗方法在子宫肌瘤治疗中的应用价值。方法 采用股动脉入路，行双侧子宫动脉超选择性插管和栓塞治疗109例子宫肌瘤患者，栓塞剂为聚乙烯醇（PVA）和明胶海绵。结果 栓塞治疗成功率99．1％，造影 表现为子宫动脉增粗改变及肿瘤染色。57例月经增多症状均有不同程度改善。肌瘤有缩小。结论 经导管动脉栓塞术治疗子宫肌瘤是临床上一种有效和安全的治疗手段。     

子宫动脉栓塞术治疗子宫肌瘤50例临床观察

目的研究子宫动脉栓塞（Uterine arterial embolization,UAE）治疗子宫肌瘤的临床效果、不良反应及并发症。方法采用Seldinger技术对50例子宫肌瘤患者用PVA颗粒（500～700pm）行超选择性子宫动脉栓塞治疗,术后3～12个月随访复空,观察临床症状改善、肌瘤体积变化厦并发症等情况。结果超选择插管及栓塞成功率均为100％,无严重并发症。随访3～12个月,所有患者临床症状改善,术后6个月子宫体积平均缩小38．5％,肌瘤平均缩小62％。结论子宫动脉栓塞术治疗子宫肌瘤是一种微创性的治疗手段．能保留患者的子宫。对控制症状、缩小肌瘤体积有显著的作用,是一种安全、有效的治疗子宫肌瘤的方法。     

双侧子宫动脉栓塞治疗子宫肌瘤的临床应用

目的评价双侧子宫动脉栓塞术（UAE）治疗子宫肌瘤的疗效。方法48例症状性子宫肌瘤患者行超选择性子宫动脉插管，使用明胶海绵颗粒进行双侧子宫动脉栓塞。术后分别于3、6个月随访复查，观察临床症状及肌瘤体积变化情况。结果UAE后临床症状明显改善。尤其以子宫出血症状改善最为明显；栓塞后3个月复查子宫肌瘤体积平均缩小38．4％，6个月子宫肌瘤体积平均缩小56．2％；2例肌瘤大小无明显变化。总有效率：勾95％。术前18例有不同程度贫血，血红蛋白为68～103g／L；术后6个月复查血红蛋白均达到正常范围。结论使用明胶海绵颗粒行双侧子宫动脉栓塞治疗子宫肌瘤是一种安全、有效的治疗方法.     

介入性子宫动脉栓塞术治疗子宫肌瘤的疗效观察

目的 探讨应用介入性子宫动脉栓塞术(UAE)治疗子宫肌瘤的疗效及安全性。方法 26例子宫肌瘤患者均采用经皮股动脉穿刺，行腹主动脉、髂内动脉、子宫动脉造影并应用超液态碘化油、聚乙烯醇颗粒(PVA)355～500μm 5．0μm真丝线段、PVA355～500μm 500～710μm行子宫动脉栓塞，治疗子宫肌瘤。结果子宫肌瘤造影表现:小肌瘤无特异性表现；大肌瘤血供丰富，部分肌瘤双侧子宫动脉供血，部分肌瘤血供来自同侧子宫动脉；术后6个月随访，B超显示肌瘤萎缩明显、临床有效率达100％，无1例复发。结论 PVA并真丝线段栓塞子宫动脉治疗子宫肌瘤是一种疗效高、创伤小、安全而且经济的新方法，值得临床应用推广。     

子宫肌瘤介入治疗在临床应用中的价值

目的探讨子宫动脉栓塞治疗子宫肌瘤的方法,了解其临床效果、不良反应及并发症。材料和方法对28例以月经过多、经期延长为主要症状的子宫肌瘤患者,通过超选择性双侧子宫动脉插管,用直径300～500μm的PVA微粒或500～700μmEmbosphere微球将子宫动脉栓塞。结果27例均栓塞成功,无严重并发症。随访3～12个月,所有病例月经恢复正常,贫血病例,血红蛋白升至正常范围,术后6个月肿瘤平均缩小60％。结论子宫动脉栓塞术是创伤小,保留子宫,并发症少,临床效果好的一种治疗方法。     

经子宫动脉栓塞治疗子宫肌瘤14例疗效观察

目的：探讨经子宫动脉栓塞治疗子宫肌瘤的临床疗效、不良反应、并发症及在基层医院开展的可行性。方法：对14例以月经过多、经期延长为主要症状的子宫肌瘤患者，通过行超选择双侧子宫动脉插管，用500-700μm的PVA颗粒进行栓塞治疗。结果：栓塞成功率100％，无严重并发症。随访病例月经恢复正常，临床症状明显改善，肌瘤明显缩小。结论：子宫肌瘤的动脉栓塞治疗是创伤小、疗效好、保留子宫、并发症少的治疗方法。     

子宫肌瘤介入栓塞术临床价值

目的探讨超选择性子宫动脉血管栓塞术治疗子宫肌瘤的临床价值,了解其临床不良反应及并发症。方法我院对52例以月经过多、经期延长为主要症状,经B超、CT、MRI扫描确诊的子宫肌瘤患者,子宫肌瘤平均大小约8.45cm,经股动脉穿刺,用5F导管及超滑导丝引入至髂内动脉并行髂内动脉造影,了解子宫动脉开口,通过超选择性双侧或单侧子宫动脉插管,用直径300～500μm的PVA微粒或平阳霉素碘化油乳剂8mg左右（PLE）将子宫动脉栓塞。结果 51例栓塞成功,无严重并发症。随访3～12个月,所有病例月经恢复正常,贫血病例,血红蛋白升至正常范围。术后6个月经B超、CT扫描复查,肿瘤平均缩小致2.35cm（72.2%）,其中肌瘤大小经测量（与术前比较）缩小62.5%以上者22例,缩小45.6%者19例,基本消失的10例,1例出现栓塞反应,经药物治疗后栓塞反应消失。结论子宫动脉栓塞术治疗子宫肌瘤是一种操作简单、创伤小、能保留子宫生育功能、并发症少、临床效果好的治疗方法。     

选择性子宫动脉栓塞术治疗子宫肌瘤

目的探讨选择性子宫动脉栓塞术治疗子宫肌瘤的临床效果。方法97例子宫肌瘤，采用双侧子宫动脉插管栓塞治疗，术后1、3、6个月复查患者瘤体大小及临床症状改善情况。结果97例子宫肌瘤均表现为双侧子宫动脉供血，行双侧子宫动脉栓塞后，肌瘤直径明显缩小，临床症状大部分缓解，无严重并发症。结论超选择双例子宫动脉栓塞治疗子宫肌瘤是一种安全、有效的治疗方法。     

超选择性子宫动脉栓塞治疗子宫肌瘤的临床应用研究

目的 评价用10号真丝线段及聚乙烯醇（PVA）颗粒超选择性子官动脉栓塞治疗子宫肌瘤的临床效果。方法 12例子宫肌瘤患者均采用经皮股动脉穿刺，双侧子宫动脉插管，其中超选至双侧子宫动脉10例，单侧2例，4例用10号真丝线段栓塞，8例用聚乙烯醇（PVA）颗粒栓塞。结果 所有病例随访4～16个月，8例用聚乙烯醇栓塞，6例临床症状消失，2例明显改善；4例用10号真丝线段栓塞，其中3例临床症状消失，1例有所改善。B超示瘤体缩小40％～90％。无1例严重并发症发生。结论 超选择性子官动脉栓塞治疗子宫肌瘤是1种创伤小、安全、有效的治疗方法。     

海藻酸钠微球经导管栓塞治疗子宫肌瘤38例临床观察

[目的]观察海藻酸钠微球栓塞剂（KMG）经导管栓塞子宫动脉治疗子宫肌瘤的疗效。[方法]选择子宫肌瘤患者38例，采用Seldinger技术，所有病例均采用右侧股动脉入路、RCU导管双侧子宫动脉插管技术，造影确认后注入KMG（直径500-700μm）和3-5条明胶海绵条块，阻断肌瘤血液供应。分别于栓塞后3个月、6个月、12个月观察疗效。[结果]超选择插管及栓塞成功率均为100％，肌瘤体积缩小，月经恢复正常，贫血、压迫症状改善。[结论]海藻酸钠微球经导管栓塞治疗子宫肌瘤是一种疗效显著的微创性治疗方法。     

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.