乙型病毒肝炎的临床治疗研究

乙肝是一种严重危害人类健康的传染性疾病,也是我国当前流行最为广泛、危害性最严重的一种传染病.据调查,全世界约有3.5亿慢性乙肝携带者,其中25%的人有很大可能死于乙肝或其相关并发症.实际上,全球范围内,每年约有一百万人死于HBV感染,乙肝已成为排名第九的致死痍病.乙肝具有传播快、不易察觉、影响范围广等特点,由于目前医学上对慢性乙型肝炎的抗病毒治疗还没有有效根治的治疗方法,因此研制有效治疗药物及临床治疗方法显得尤为重要.本文先阐述了乙型肝炎的分类、发病原理等基础知识,然后通过临床诊断、治疗目标等展开探讨,研究目前乙型肝炎的治疗方法手段,并提出一些治疗上的合理化建议,旨在为乙型肝炎的临床治疗提供第一手资料,早日攻克这一医学难题.     

β受体阻滞剂在慢性心力衰竭治疗中的应用

慢性心力衰竭(Chronic Heart Failure,CHF)是由于各种病因导致的心肌损害而引起心脏结构和功能的改变,最终导致心脏泵功能衰竭所形成的一组严重的临床综合征,是各种器质性心脏病终末阶段的主要临床表现.它正在成为21世纪最重要的心血管病症.其发病率在逐年快速增长,且预后差,有临床症状的患者5年存活率与恶性肿瘤相仿[1].     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.     

小儿手足口病45例临床分析

[目的]总结分析小儿手足口病临床流行特点,探讨防治措施.[方法]对2003年8月～2008年5月住院的小儿手足口病患儿进行分析.[结果]本组45例中,<5岁者有44例,占97.8%,集中在每年3～5月发病有39例,占86.7%,心肌酶谱检查25例中,CK,CK-MB升高者5例,占20.O%.E结论]春季也是小儿手足口病的好发i季节,防治措施主要是发现并隔离患儿,流行期间幼托机构落实晨检制度非常重要.     

清代医籍《医学传灯》临床用药配伍规律的文献研究

目的:对清代名医陈德求所撰《医学传灯》中医药治疗内科杂病用药配伍规律进行文献研究。方法:将清代名医陈德求撰《医学传灯》治疗疾病的中医内服方药录入计算机,建立数据库,运用统计学方法分析其用药规律。结果:整理中药复方135首,涉及中药131种,总用药次数1 306次。结论:临床治疗核心单味药依次为甘草、黄芩、陈皮、半夏、柴胡、茯苓、白芍药、枳壳、桔梗、当归、人参等。药类以补虚药、清热药、化痰止咳平喘药、理气药、利水渗湿药、解表药等为主。     

Yap1蛋白在前列腺癌中的表达及其临床病理学意义

目的 探讨Yap1蛋白在前列腺癌中的表达及临床病理学意义.方法 应用免疫组织化学方法检测Yap1在35例前列腺癌组织和16例良性前列腺增生组织中的表达,用平均吸光度值(积分吸光度/面积,IA/area)代表阳性细胞的表达水平;并探讨Yap1与前列腺癌临床病理参数之间的关系.结果 Yap1在良性前列腺增生组的表达水平(IA/area =0.1867 ±0.0753)明显高于前列腺癌组(IA/area=0.0782 ±0.0614),两组差异有统计学意义(P＜0.01,F=16.942);Yap1蛋白主要表达在细胞质.Yap1蛋白表达程度与前列腺癌的Gleason评分无明显相关(P＞0.05),但Yapl在Gleason 7分组(IA/area =0.0548±0.0441)的表达强度高于Gleason 9分组(IA/area=0.1296±0.0957) (P ＜0.05).结论 前列腺癌中Yap1蛋白低表达可能与前列腺的发生、发展有关.     

翁沥通治疗慢性前列腺炎:多中心随机双盲安慰剂对照试验

前列腺炎是泌尿科临床上最常见的炎症性疾病之一。高达25％～50％的男性曾经或正在受到前列腺炎的困扰[1]。我们通过多中心随机双盲安慰剂对照的方法，评估翁沥通治疗慢性前列腺炎的安全性和有效性。