神经系统副肿瘤综合征的临床表现分析

目的：分析22例神经系统副肿瘤综合征患者的临床特点。方法：将我院收治的22例神经系统副肿瘤综合征患者的临床资料进行回顾性分析。结果：癌性感觉性周围神经病（PSN）12例,肌无力综合征8例,脊髓压迫症6例,脑干脑炎4例,亚急性小脑变性3例。3例在出现神经系统症状后1周内确诊,3例在1月内确诊,其余16例均在神经病变持续存在数月至数年后经多次检查确诊为肿瘤。结论：神经系统副肿瘤综合征临床表现形式多样,容易误诊,临床早期确诊对于肿瘤的发现和治疗非常重要。     

副肿瘤综合征临床分析

目的:了解神经系统副肿瘤综合征患者的临床特点.方法:收集神经系统副肿瘤综合征患者12例,对其临床资料进行回顾性分析.结果:12例患者在出现副肿瘤症状后才发现肿瘤,副肿瘤综合征的临床类型有周围神经损害占7例(58.3%),肌无力综合征2例(16.7%),亚急性小脑变性1例(8.3%),边缘叶脑炎1例(8.3%),皮肌炎1例(8.3%).结论:神经系统副肿瘤综合征临床表现形式多样,容易误诊,临床早期确诊对于隐匿肿瘤的发现和治疗非常重要.     

副癌性小脑变性三例报告

副癌性小脑变性是一种少见的神经系统副肿瘤综合征,临床容易误诊,易延误肿瘤的诊断而错过最佳治疗时期.现将本院收治的3例副癌性小脑变性报告如下.     

副肿瘤性小脑变性的回顾性研究

目的了解神经系统副肿瘤性小脑变性患者的临床特点。方法收集神经系统副肿瘤小脑变性患者共16例,对其临床资料进行回顾性分析。结果①本组患者男性6例,女性10例,年龄37-73岁,病程15天-2年,急性起病7例,亚急性起病8例,慢性起病1例;②以步态不稳为首发症状者10例,头晕伴视物旋转者6例;③9例为先出现神经症状后发现肿瘤,查出肺癌5例（小细胞肺癌2例）,多发腹膜后占位1例,腹膜后淋巴结转移癌（盆腔恶性肿瘤可能性大）1例,胃癌1例,卵巢癌1例,甲状腺癌1例,弥漫性大B细胞淋巴瘤1例,乳腺癌1例。④检查血液抗-Yo抗体阳性1例,脑脊液抗-Hu抗体阳性1例。结论副肿瘤性小脑变性临床表现形式多样,容易误诊,临床早期确诊对于隐匿肿瘤的发现和治疗非常重要。     

26例副肿瘤综合征误诊分析

目的浅析26例副肿瘤综合征误诊情况及症状特点。方法回顾性分析我院2000年1月-2011年1月间收治的26例经病理细胞学确诊肺癌合并副肿瘤综合征患者临床误诊资料。结果副肿瘤综合征临床误诊病理类型有肌肉萎缩硬化病变7例,弥漫性灰质四肢僵硬4例,小脑损伤变性2例,亚急性小脑功能性障碍5例,边缘性脑膜炎2例,Lambert-Eaton多发性肌无力2例,坏死性脊髓炎4例。结论副肿瘤综合征临床表现形式多样化、复杂化,难以分辨具体病因而增加误诊、漏诊概率,临床早期加强重视对加深病症了解及确诊隐匿病变尤为重要。     

神经系统副肿瘤综合征18例临床分析

目的分析神经系统副肿瘤综合征（PNS）的临床特点和诊断方法。方法对18例确诊的PNS类型、临床特点及其他辅助检查进行分析。结果 18例均以神经系统症状为首发,临床类型有癌性周围神经病变10例;LAMBERT-Eaton肌无力综合征3例;亚急性小脑变性2例;边缘性脑炎1例;皮肌炎和自主神经病1例。18例患者经检查确诊为肺癌12例,乳腺癌2例,非霍奇金淋巴瘤1例,胃癌、结肠癌和前列腺癌各1例。结论癌性周围神经病变是最常见的PNS,原发肿瘤以肺癌居多,对高度怀疑PNS者,应密切观察和随访。     

肺癌所致神经系统副肿瘤综合征15例临床分析

目的对肺癌所致神经系统副肿瘤综合征予以分析和探讨。方法对2015年1月至2015年12月期间于我院进行治疗的肺癌所致神经系统副肿瘤综合征患者15例进行回顾性分析,对患者的临床资料进行观察并记录。结果肺癌所致神经系统副肿瘤综合征的15例患者中出现肌无力综合征的有3例,周围神经病3例,多发性肌炎5例,边缘叶脑炎1例,脑干脑炎3例。结论:因为肺癌所导致的神经系统副肿瘤综合征往往形成的原因较为多,临床上的表现出来的情况也较多,对诊断造成较为严重的影响,很容易出现误诊、漏诊的情况,对患者的生活质量和生命安全造成了较为严重的影响。     

副肿瘤性神经系统综合征的临床分型、相关肿瘤及免疫学研究

目的:将430例副肿瘤性神经系统综合征(PNS)临床分型、相关癌肿及免疫学进行一次对照研究.方法:采用亲合免疫细胞组织化学和免疫印迹技术测定430例PNS患者血清及脑脊液中的特异性神经元抗体.结果:430例PNS患者的临床表现类型主要有副肿瘤性感觉神经元病、副肿瘤性脑脊髓炎、副肿瘤性小脑变性、副肿瘤性边缘叶脑炎及副肿瘤性眼阵挛-肌阵挛综合征,相关肿瘤主要见于小细胞肺癌、乳腺癌、卵巢癌、霍奇金淋巴瘤等,其中281例患者血清中存在特异性神经元抗体.结论:因PNS患者体内存在多种自身特异性神经元抗体,提示PNS是一种癌肿导致的自身免疫性疾病,检测这些抗体有助于PNS及伴随肿瘤的早期诊断.     

17例神经系统副肿瘤综合征临床分析

目的 分析神经系统副肿瘤综合征(paraneoplastic syndrome of nervous system,PNSNS)的临床特点,以提高对该病的早期诊断和治疗效果。 方法 回顾性分析中国科学技术大学附属第一医院神经内科2016年9月—2019年10月收治的17例PNSNS患者的临床表现、实验室检查结果和治疗效果,并作文献复习。 结果 17例患者中14例(82.4%)在肿瘤之前出现神经系统症状,3例(17.6%)在肿瘤之后出现神经系统症状。抗Hu抗体、抗Yo抗体;抗Amphiphysin抗体、抗recoverin抗体、抗Titin抗体、抗Ma2抗体、抗SOX-1抗体、抗Zic4抗体阳性例数分别为4(23.5%)、3(17.6%)、2(11.8%)、2(11.8%)、2(11.8%)、2(11.8%)、2(11.8%)、1(5.9%)例。抗Hu抗体、抗Zic4抗体同时阳性者1例(5.9%)。神经系统病变表现为亚急性小脑变性6例(35.2%);感觉运动性周围神经病3例(17.6%);边缘性脑炎2例(11.8%);Lambert-Eaton综合征2例(11.8%);运动神经元病1例(5.9%);多发性肌炎(5.9%)1例;脑干脑炎1例(5.9%);亚急性感觉神经元病1例(5.9%)。 结论 多数诊断为神经系统副肿瘤综合征的患者神经系统损害症状早于原发肿瘤临床表现,需要对患者进行肿瘤筛查以及长期随访。激素及丙种球蛋白治疗有效。      

副肿瘤性小脑变性临床分析

目的分析副肿瘤性小脑变性患者的临床特点。方法回顾性分析13例副肿瘤性小脑变性患者的起病方式、临床表现、相关检查结果、肿瘤来源、误诊情况、治疗效果、愈后等临床资料。结果临床诊断小脑病变,应考虑到副肿瘤性小脑变性;原发肿瘤以小细胞肺癌、肠癌、乳腺癌、卵巢癌、何杰金病等多见;明确原发肿瘤病灶后,行原发肿瘤综合治疗后,小脑症状有明显改善。结论临床如遇成年、小脑症状、突然起病、进行性加重、不符合原发神经病变规律,排除小脑卒中、感染、肿瘤、中毒性小脑病变、遗传性小脑变性等,应考虑到副肿瘤性小脑变性,需行全身详细的体检及影像学检查,避免原发灶的漏诊,早期明确诊断为及时治疗提供条件。     

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…