以左乳包块为首发症状的胃癌乳腺转移一例

正患者女,44岁,因"发现左乳包块伴红肿疼痛1月余"于2019年5月22日入院。查体:左乳较右乳体积明显增大,皮肤呈橘皮样改变,乳头稍内陷、固定,中央区扪及巨大包块,约10 cm×8 cm×6 cm,质硬,边界不清,触痛阳性,左腋窝扪及多个肿大淋巴结并融合成团。乳腺B超:左乳外上、外下及内下象限皮下软组织水肿,腺体内不规则低回声区。乳腺     

重症超声在低血容量休克评估及指导临床治疗中的应用研究#

目的:探讨重症超声在低血容量休克精细化容量管理中的临床价值.方法:选取66例ICU低血容量休克患者随机分成两组,均予常规ICU监测治疗和容量复苏,观察组在重症超声动态评估下予以适时扩容补液-限制性液体复苏-负向液体复苏.观察两组病人6 h、24 h复苏达标率及乳酸清除率差异;比较ICU留置时间及并发肺水肿、多器官功能障碍综合征(Multiple organ dysfunction syndrome,MODS)的差异.结果:两组复苏达标率、乳酸清除率6 h无统计学差异(P>0.05),24 h有统计学差异(P<0.05),且ICU留置时间、并发肺水肿和M0DS例数也有统计学差异(P<0.05).结论:重症超声可视化动态评估,实现精细化容量管理,指导滴定式治疗,提高复苏达标率和救治效率,缩短ICU留置时间,减少盲目液体复苏并发症.     

中医分时辨治糖尿病合并抑郁症患者临床疗效观察

目的:研究分析中医分时辨治糖尿病合并抑郁症患者的临床效果。方法:随机抽取135例糖尿病合并抑郁症患者,根据治疗方法将其分为中药组、西药组和基础治疗组各45例,中药组患者于寅时采用调气降糖丸、巳时采用益脾降糖丸、酉时采用糖肾康进行治疗;西药组患者口服盐酸氟西汀胶囊进行治疗,基础治疗组患者采用降糖药物进行基础治疗。三组患者均治疗12周,比较其治疗前后汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分情况,分析三组患者中医症状改善程度,对其血糖指标、糖化血红蛋白指标和血脂指标等进行测定。结果:经过治疗,中药组和西药组患者HAMD、HAMA评分均较治疗前明显下降,且中药组患者下降程度更为显著,差异具有统计学意义(P0.05);中药组和西药组患者EPG、2hPG、HbAlc、TG、TC水平均较治疗前明显下降(P0.05,P0.01),HDL-C水平较治疗前明显升高(P0.01),且中药组患者各项指标改善程度明显优于西药组,差异具有统计学意义(P0.05)。基础治疗组患者治疗前后各项指标均无明显变化。结论:采用中医分时辨治糖尿病合并抑郁症患者能明显改善其血糖和血脂水平,减轻患者抑郁症状,值得临床推广应用。     

EMD-PLGA NPs延缓5/6肾切除大鼠诱发慢性肾功能衰竭

目的探讨大黄素-聚乳酸/羟基乙酸共聚物纳米粒(EMD-PLGA NPs)对5/6肾切除大鼠残余肾组织的保护作用及可能的机制。方法大鼠随机分为假手术组8只(sham组),造模成功24只后随机分为模型组8只(model组)、大黄素组8只(EMD组)、纳米粒组8只(NPs组),期间检测大鼠24 h尿蛋白定量、血尿素氮(BUN)和血肌酐(SCr),光镜下观察肾组织病理变化,分别用RT-PCR法和免疫组织化学法检测肾组织转化生长因子-β1(TGF-β1)及结缔组织生长因子(CTGF)mRNA及蛋白表达。结果药物干预后,与sham组比较,model组24 h尿蛋白定量、BUN、SCr及TGF-β1和CTGF mRNA及蛋白水平上升(P0.01);与model组比较,EMD组、NPs组24 h尿蛋白定量、BUN、SCr、TGF-β1、CTGF mRNA及蛋白水平下降(P0.01);与EMD组比较,NPs组24 h尿蛋白定量、BUN、SCr、TGF-β1和CTGF mRNA及蛋白水平下降(P0.01)。结论与普通EMD比较,EMD-PLGA NPs能更好地延缓肾病慢性进展。     

论广西中医药外向型、复合型人才的培养

中草药贸易长期以来是中国与东盟贸易的重要组成部分。近年来,中国和东盟国家医药贸易发展迅速,呈加深态势。与此同时,医药类投资也已成为中国与东盟各国交流合作的重头戏之一。广西是中国唯一一个与东盟国家既有陆地接壤,又有海域相连的省区,其区位优势有利于与东盟国家开展传统医药深度合作。     

癌症需要早发现早治疗——访北京市健安医院院长谢继增

为什么癌症很难早期发现?北京市健安医院院长谢继增说:“漫长的诊断占用了很长时间,同时也失去了治疗的最佳时机。这需要我们医务工作者对此多加研究,找出癌症的发生、发展规律,对临床的治疗提供依据。”但是,对癌症早期发现的研究人员目前并不多。1974年,在部队从事中西医结合     

弥散张量成像对胶质瘤手术风险的评估

Objective To elucidate the clinical significance of diffusion tensor imaging (DTI) mainly used for protecting neurological functions in patients with gliomas. Methods Thirty - eight patients with gliomas were recruited to undergo DTI test and assess the status of neurological functions before and after surgery. According to the relationships between gliomas and adjacent white matter(WM) tracts, DTI can be classfied as the following types : type Ⅰ - displacement; type Ⅱ - Infiltration; type Ⅲ - Disruption. The neurological functions before surgery were compared in three groups,as well as the change of neurological functions after surgery was also compared in three groups. Results There were 14 cases in type Ⅰ , 16 cases in type Ⅱ, and 8 cases in type Ⅲ. There were significant difference between DTI types and preoperative neurological functions, as well as between DTI types and the change of postoperative neurological functions ( P < 0. 05 ). Conclusions DTI allows to visualizate the relationships of gliomas and adjacent WM tracts, which represent the different growth patterns of gliomas. It is useful for neurosurgeons to select suitable surgical approaches and determine appropriate extent of resection.     

横切口不缝皮输卵管结扎术5000例体会

本文介绍了横切口不缝皮输卵管绝育术5000例进行了临床效果观察，结果表明已婚生育过子女的育龄妇女下腹部腹纹横向，不缝皮，愈合快，疤痕小，不用拆线，无线结反应，感染机会小等优点，农村广大育龄妇女更容易接受，确实是一种简便、安全、可靠、经济的绝育方法之一，值得推广使用。     

弥散张量成像对胶质瘤手术风险的评估

Objective To elucidate the clinical significance of diffusion tensor imaging (DTI) mainly used for protecting neurological functions in patients with gliomas. Methods Thirty - eight patients with gliomas were recruited to undergo DTI test and assess the status of neurological functions before and after surgery. According to the relationships between gliomas and adjacent white matter(WM) tracts, DTI can be classfied as the following types : type Ⅰ - displacement; type Ⅱ - Infiltration; type Ⅲ - Disruption. The neurological functions before surgery were compared in three groups,as well as the change of neurological functions after surgery was also compared in three groups. Results There were 14 cases in type Ⅰ , 16 cases in type Ⅱ, and 8 cases in type Ⅲ. There were significant difference between DTI types and preoperative neurological functions, as well as between DTI types and the change of postoperative neurological functions ( P < 0. 05 ). Conclusions DTI allows to visualizate the relationships of gliomas and adjacent WM tracts, which represent the different growth patterns of gliomas. It is useful for neurosurgeons to select suitable surgical approaches and determine appropriate extent of resection.     

乌骨藤对裸鼠胶质瘤作用的实验研究

目的:观察乌骨藤对裸鼠皮下胶质瘤的抑制效应。方法:建立裸鼠胶质瘤移植模型,随机分为5组,每组10只,空白对照组(生理盐水组)、乌骨藤组、莪术组、猫爪草组和阳性对照组(替莫唑胺组)。观察裸鼠的生存状况,计算肿瘤体积,计算肿瘤抑制率。结果:给药治疗后,抑瘤率乌骨藤组38.3%、莪术组41.7%、猫爪草组34.2%,增殖率乌骨藤组58.4%、莪术组57.2%、猫爪草组60.7%,乌骨藤抗肿瘤效果介于莪术和猫爪草之间,但各组中药在抗胶质瘤方面无明显差异(P>0.05)。各组裸鼠体重组间比较,差异无显著性意义(P>0.01)。结论:乌骨藤对裸鼠皮下胶质瘤的有显著的抑制作用。