42例宫颈癌的临床疗效分析

目的 观察宫颈癌的临床疗效.方法 Ⅰa1期行全子宫切除;Ⅰ a2～Ⅱ b1期宫颈癌行广泛性子宫全切术+盆腔淋巴结清扫木,术后加放疗或化疗治疗,Ⅱb.期～Ⅲ期以上放疗+化疗(Ⅰ期宫颈癌行子宫次广泛切除术,术后加放射治疗.Ⅱ期宫颈癌行广泛性子宫全切术+盆腔淋巴结清扫术,术后加治疗).结果 42例中,Ⅰ期宫颈癌术后生活满10年以上者5例.满5年以上者18例,生存率100%;Ⅱ期宫颈癌术后12例中5年生存率33%,Ⅲ期宫颈癌5年内生存牟为0.结论 宫颈癌的治疗,转归及预后与宫颈癌的分期,分型、分化有着及其密切的联系,分期越早,疗效越好,生存率越高;分化越高,疗效越好,生存率越高.按病理分类,鳞癌明显高于腺癌生存率.     

宫颈癌术后放射治疗37例的临床分析

目的:研究探讨体外照射放疗对于宫颈癌术后患者的临床效果以及并发症,为临床宫颈癌患者的术后治疗提供理论参考依据。方法:对37例宫颈癌患者的临床资料进行回顾性分析。临床资料显示对该37例宫颈癌患者手术后进行放射治疗,并对其进行随访,持续3年以上。观察患者经手术后放射治疗的临床效果以及治疗后并发症。本研究中患者手术后接受放疗,放疗的方式一般包括单纯体外照射(11例),单纯腔内照射治疗(10例),腔内、体外配合放射治疗(16例)。根据不同病情的宫颈癌患者的5年生存率以及术后放疗并发症评价手术后放疗的临床疗效。结果:上述37例患者中,5年总生存率为75.68%,其中Ⅰa期患者5例,Ⅰb期患者8例,Ⅱa期患者8例,Ⅱb期患者7例。治疗后盆腔复发4例,阴道残端病灶复发3例,远端转移5例,有6例患者出现术后放疗并发症。结论:危险系数较高的出现,Ⅰ期、Ⅱ期宫颈癌,在患者手术后进行放射治疗,有一定程度的治疗效果欠理想。尤其是当患者手术时并未完全清除病灶的情况下,放疗效果无法对患者的5年生存率有较为显著的提高。但具有不良预后的宫颈癌患者在手术后接受放射治疗,可以起到一定的临床效果,提高其生存概率以及患者的生活质量。肿瘤往远处进行转移是该治疗方式无法达到预期效果的主要原因。     

宫颈癌不同治疗方法比较及合并贫血治疗效果观察

目的总结Ⅰa～Ⅲb期宫颈癌患者不同治疗方式后生存状态,探讨合并贫血患者预后的相关因素。方法对417例患者进行统计分析。按FIGO临床标准分期:Ⅰ期21例,Ⅰb期165例,Ⅱa期24例,Ⅱb期99例,Ⅲa期24例,Ⅲb期84例。主要观察不同治疗方式,是否伴有中度贫血与预后关系。结果Ⅰa期患者5年生存率为100%,Ⅰb期为89.1%,Ⅱa期为87.5%,Ⅱb期为48.4%,Ⅲa期为50%,Ⅲb期为39.3%。手术患者为82.1%,非手术患者为52.5%。中度以上贫血(Hb≤90 g/L)患者72例,正常或轻度贫血(Hb>90 g/L)患者345例,两者5年生存率差异有统计学意义,Ⅱb期后中度以上贫血患者51例,正常或轻度贫血患者156例,两者5年生存率差异无统计学意义。结论宫颈癌因早期的治疗方式以单纯手术为主,越晚期采用辅助放疗及化疗手段增多,在数字上显示生存率较手术治疗低,符合分期越晚,疗效越差的结论。晚期患者出现中度以上贫血较多见,其生存率情况比宫颈癌早期明显差,与临床分期有一致性;贫血患者在治疗时及时止血、输血、升血等处理,如贫血得到缓解,对预后无明显影响。     

改良Ivor-Lewis手术联合术后放疗治疗胸段食管鳞癌的疗效及预后COX回归分析

目的回顾性评价改良Ivor-Lewis手术联合术后放疗治疗胸段食管鳞癌的疗效及预后危险因素。方法选择368例胸段食管鳞癌患者,其中Ⅰ期51例,Ⅱ期及以上317例。Ⅱ期及以上患者按治疗方式分为两组:单纯手术组(141例)采用单纯改良Ivor-Lewis手术治疗,手术+放疗组(176例)在改良Ivor-Lewis手术后补充术后放疗。采用Kaplan-Meier法计算总生存率l,og-rank检验比较两组的生存差异,COX回归分析预后相关危险因素。结果全部患者1、3、5年生存率分别为87.2%、59.2%、37.5%。单纯手术组总体5年生存率为26.2%,手术+放疗组为35.5%,两组差异有统计学意义(P=0.025),Ⅲ期及以上患者手术+放疗组生存率较单纯手术组改善更明显(P=0.001)。COX回归分析结果显示,年龄≥60岁、低分化及以下、切端阳性、瘤栓阳性、T3以上浸润、更多的阳性淋巴结数、UICCⅢa期以上均为预后相关危险因素(P<0.05)。结论改良Ivor-Lewis术对Ⅰ、Ⅱ期胸段食管鳞癌疗效较好,对于Ⅲ期及以上患者,应结合术后补充放疗改善总生存率。     

大菜花型宫颈癌的放疗效果及预后分析

目的回顾性分析大菜花型宫颈癌的放疗效果及预后因素.方法64例经病理证实的大菜花型宫颈癌,肿瘤最大直径5～8 cm(平均6.5 cm),按FIGO新分期标准放疗前临床分期:ⅡA期9例,ⅡB期19例,ⅢA期5例,ⅢB期31例. 采用外照射、肿瘤组织间插植及腔内照射综合手段进行根治性放疗.根据放疗第4周妇检记录进行“放疗中再分期”. 采用Kaplan-Meier法计算生存率,并将年龄、病理类型与分化程度、肿瘤最大径、放疗前分期和“放疗中再分期”等因素纳入Cox模型进行预后的多因素分析.结果放疗中再分期结果:Ⅰ期9例,ⅡA期28例,ⅡB期13例,ⅢA期5例,ⅢB期9例.全组累计5年生存率和无瘤生存率分别为81%和75.8%.一系列因素中,只有“放疗中再分期”是影响生存率的重要和独立的预后因素(P＜0.01).结论大菜花型宫颈癌根治性放疗效果较好;放疗前分期不准确,对估计预后无价值;“放疗中再分期”是影响预后的主要因素.     

宫颈癌治疗63例临床观察

目的观察宫颈癌的临床疗效。方法对于Ⅰ期宫颈癌行子宫次广泛切除术，术后加放射治疗；Ⅱ期官颈癌行广泛性子宫全切术＋盆腔淋巴结清扫术，术后加放疗；Ⅲ期以上者行放疗＋化疗。结果63例中，Ⅰ期宫颈癌术后生活满lo年以上者5例，满5年以上者18例，生存率100％；Ⅱ期宫颈癌术后12例中5年生存率33％，Ⅲ期宫颈癌5年内生存率为0。结论宫颈癌的治疗、转归及预后与宫颈癌的分期、分型、分化有着极其密切的联系，分期越早，疗效越好，生存率越高；分化越高，疗效越好．生存率越高。按病理分类，鳞癌明显高于腺癌生存率。     

影响Ⅰ～Ⅱa期宫颈癌术后预后因素的分析

目的 探讨影响Ⅰ～Ⅱa期宫颈癌行广泛子宫切除和盆腔淋巴结清扫术后的预后因素.方法 比较分析115例宫颈癌患者的临床病理和随访资料,回顾性分析影响预后的单因素和多因素.结果 115例Ⅰ～Ⅱa期宫颈癌根治术后的5年累积生存率为82.95%,年轻组和中老年组分别为70.27%和89.31%,两者比较差别有统计学意义(P=0.0386).单因素分析提示,年龄、临床分期、宫颈肌层浸润程度、血管或淋巴管累及情况和盆腔淋巴结转移情况与早期宫颈癌预后有关.COX模型多因素分析表明,宫颈肌层浸润程度、血管或淋巴管累及情况和盆腔淋巴结转移个数是影响早期宫颈癌的独立预后因素.有≥2个高危因素者,术后放疗或化疗与未治疗者生存率分别为83.33%和16.67%,两者比较差别有统计学意义(P<0.05).结论 Ⅰ～Ⅱa期宫颈癌预后年轻患者比中老年患者差.宫颈肌层浸润程度、血管或淋巴管累及情况和盆腔淋巴结转移情况是影响早期宫颈癌的独立预后因素.有≥2个高危因素者术后辅助治疗,可以明显提高疗效.     

宫颈癌Ⅰ,Ⅱ期的淋巴结转移及治疗与预后的关系--附45例临床病例分析

目的探讨宫颈癌Ⅰ,Ⅱ期的淋巴结转移及治疗与预后关系。方法回顾性分析45例淋巴结转移患者,全部行广泛性子宫切除和盆腔淋巴结清扫术,其中IB22例,ⅡA 5例,ⅡB期18例,术前放疗32例,术后放疗31例,1个淋巴结转移25例,2个或2个以上淋巴结转移20例。结果淋巴结转移率12.30%(45/366),45例患者五年生存率68.89%。转移淋巴结<1.5 cm者,5年生存率84.62%,转移淋巴结≥1.5 cm者,5年生存率47.36%;1个淋巴结转移者5年生存率84.00%,2个或2个以上淋巴结转移者5年生存率50.00%。结论淋巴结状态可作为估计预后指标,术前术后放疗有助于降低局部复发率及远处转移率。     

年轻宫颈癌误诊病例分析

目的:探讨年轻宫颈癌常见误诊原因及其治疗方式对预后及生活质量的影响,对年轻宫颈癌有预警作用.方法:回顾性分析我院妇科收治的33例年轻宫颈癌患者的临床资料,年龄20～35岁.病理确诊前按月经不调或其他疾病治疗而延误诊断的11例患者为研究组,首次就诊时明确诊断的22例患者为对照组,分析两组之间的临床期别、治疗方式、淋巴结转移率及误诊时治疗方式对临床分期及预后的影响.结果:研究组11例患者首次就诊时,7例按"重度宫颈糜烂"行激光治疗,Ⅱb期4例,Ⅲa期1例,Ⅲb期2例,4例Ⅱb期患者介入化疗后行宫颈癌根治术,术后病理报告均伴有盆腔淋巴结转移,3例行根治性放疗;4例患者按"功能失调性子宫出血"治疗,Ⅱa期3例,Ⅱb期1例;介入化疗后均行宫颈癌根治术,1例Ⅱb期伴有盆腔淋巴结转移.对照组:Ⅰa期3例,Ⅰb1期3例,Ⅰb2期6例,Ⅱa期4例,Ⅱb期6例,3例保留生育功能,19例行根治术,3例盆腔淋巴结转移术后辅助放疗.结论:年轻宫颈癌易误诊为功能失调性子宫出血或者慢性宫颈炎,误诊时治疗方式将影响到盆腔淋巴结的转移率;宫颈癌的诊断时间将影响肿瘤期别及生存率,诊断越早预后越好.     

子宫恶性苗勒氏管混合瘤的临床病理特征及预后

目的探讨子宫恶性苗勒氏管混合瘤的临床特征、治疗方法及预后。方法收集汕头大学医学院附属肿瘤医院2003年3月 ~2015年6月收治的16例子宫恶性苗勒氏管混合瘤的临床资料进行回顾性分析。结果16例患者诊断时中位年龄58岁,其中 13例为绝经后患者。按FIGO分期（2009年）,Ⅰa期7例,Ⅰb期3例,Ⅱ期1例,Ⅲa期3例,Ⅲc2期1例,Ⅳ期1例。15例患者术 前行子宫分段诊刮术,病理均取得恶性证据。13例患者入院时查血CA125,2例升高。16例患者总生存率75.0%,无复发生存率 68.8%,随访期超过3年的患者11例,3年生存率72.7%。行腹膜后淋巴结清扫术12例,2例复发;未行腹膜后淋巴结清扫术4例, 3例复发。术后接受化疗者13例,3例复发;未接受化疗3例,2例复发。接受术后放疗6例,1例复发;未接受术后放疗10例,4例 复发。Ⅰ~Ⅱ期11例,复发率18.2%;Ⅲ~Ⅳ期5例,复发率60%。结论术前行子宫分段诊刮术对子宫恶性苗勒氏管混合瘤有较 大的诊断价值,手术病理分期是重要预后因子。早期诊断、完整的手术分期、术后以铂类为基础的化疗联合放疗可提高子宫恶 性苗勒氏管混合瘤的生存率。     

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.