A suggested clinical score to predict the severity of adenoid obstruction in children

Chronic nasal obstruction in children is a very common disorder. Obstructing adenoid is usually the first to blame. Though the clinical assessment is essential, it is often considered unreliable or insufficient. We conducted a prospective clinical study to validate a clinical score predicting the severity of adenoid obstruction in symptomatic children. The clinical score (CS) included mouth breathing, snoring, restless sleep, frequent waking-up at night and obstructive breathing during sleep. Each item received a score of 0 or 1. The palatal airway was evaluated on a lateral nasopharyngeal x-ray. The degree of obstruction was assessed intra-operatively by a laryngeal mirror using a 3-grade scale. The volume of each adenoid specimen was measured. Eighty-six patients were enrolled, 51 boys and 35 girls, aged 13–181 months (mean 52, median 45). The CS correlated very well with the intra-operative findings (p < 0.01) and with the degree of palatal airway obstruction (p < 0.05) but not with the volume of the adenoid removed (p > 0.05). The CS was higher in children younger than 3 years (CS > 3 in 85.7% vs. 29.2%), having more frequent obstructive breathing during sleep (71.43% vs. 21.54%). A CS of three or higher, predicted severe obstruction in 96.5% of patients, as detected intra-operatively. The suggested CS is simple to use and is highly reliable in identifying children in need for adenoidectomy, in the context of normal anterior rhinoscopy and tonsils less than grade three.This work was presented at the podium of the XVIII IFOS in Rome, Italy on June 26, 2005.     

复方金荞麦颗粒治疗肺癌1000例临床疗效观察

目的 总结复方金荞麦颗粒治疗肺癌的疗效。方法 对1000例各种类型的肺癌患者采用复方金荞麦颗粒5g，3次·d^-1 口服，同时辅以中药汤剂治疗，3mo为1疗程，病情稳定后逐渐减量维持。结果本组1000例患者经3mo～15a以上治疗，基本治愈181例（18．1％），显效518例（51．8％），有效204例（20．4％），无效97例（9．7％），总有效率为90．3％。结论 复方金荞麦颗粒为抗肿瘤的纯中药制剂，具有明显抑制肿瘤细胞生长、增强免疫功能、提高患者生存质量等功效，尤其是对失去手术治疗机会、不能接受化疗和放疗的肺癌患者具有较好疗效。     

从“治未病”思想探讨中医药防治EH相关子宫内膜癌的研究意义

子宫内膜癌为女性生殖道三大恶性肿瘤之一。子宫内膜增生症(endometrial hyperplasia,EH)乃子宫内膜癌的癌前病变,因而早期诊断和治疗EH非常必要。中医药防治EH相关子宫内膜癌有其应用简便、价格低廉、有效安全等优势,符合中医"治未病"的思想。由此推理,中医药防治EH相关子宫内膜癌有着广阔前景,值得深入研究。     

癌痛从痰论治探讨

癌痛是晚期癌症患者的主要症状之一,属于中医痛证范畴。痰是产生癌痛的重要中医病机,消痰法是治疗癌痛的重要方法。     

New sonographic techniques for the diagnosis and treatment of hepatocellular carcinoma

Ultrasound (US) contrast agents such as Levovist and Sonazoid are now commercially available in Japan. Innovative contrast agents and ultrasound technologies have dramatically changed both diagnostic and treatment strategies for hepatocellular carcinoma (HCC). Contrast-enhanced US is extremely useful in the differential diagnosis of hepatic tumors as well as in evaluation of post-treatment response of HCC after lipiodol transarterial chemoembolization and radio frequency ablation. Harmonic US sensitively detects residual cancer cells in HCC patients after treatment, to facilitate accurate guidance for needle insertion for US monitoring; no other imaging modalities, including computed tomography (CT) or magnetic resonance imaging (MRI), have such capability. In 2005, the breakthrough technology of pure arterial phase imaging, which depicts only intranodular arterial accumulated maximum intensity projection images, was developed from advanced raw data storing and accumulation technologies. This technique can clearly identify whether blood supplyin the tumor is of arterial or portal origin, to facilitate the non-invasive characterization of nodular lesions associated with liver cirrhosis. Again, CT or MRI do not have such capabilities. This innovative technique can help differentiate premalignant lesions from overt HCC. Concurrent real-time imaging of multi-detector CT and US, known as real-time virtual sonography, has recently become available. This technique greatly facilitates the treatment guidance for HCC. These newly introduced sonographic techniques are dramatically changing the diagnostic and therapeutic strategies for HCC, which are expected to improve the prognosis of HCC patients.     

肝移植术后缺血型胆道病变的再移植治疗策略

目的探讨肝移植术后缺血型胆道病变的再移植的指征、手术时机的选择及免疫治疗策略。方法回顾性分析我中心自1999年7月至2007年2月10例肝移植术后缺血型胆道病变再移植治疗的病例。供肝植入均采用改良背驮式原位肝移植术,手术当天及第四天给予IL-2受体拮抗剂（舒莱）,术中不用激素冲击,术后采用他克莫司（FK506）,麦考酚酸酯（MMF）和激素（Pred）的常规三联或FK506和MMF两联免疫抑制治疗方案。结果10例病人中8例术后肝功能恢复良好,顺利痊愈出院,最长已存活42个月。2例死亡,分别于术后34、69 d死于严重的混合感染。术前MELD小于25分的7例患者无一例死亡,术前MELD大于25分的3例患者中2例死亡。结论肝移植术后发生缺血型胆道病变行再次肝移植是有效的治疗方法。术前对患者病情的准确评估,尽可能在MELD评分小于25分时进行再次肝移植治疗,有助于提高再移植的疗效。     

体表面积、体质量指数对老年骨质疏松的影响

目的探讨体表面积（BS）、体质量、体质量指数（BMI）对老年人骨密度（BMD）的影响。方法用双能X线骨密度仪测定1794例老年人腰椎、髋关节的BMD值，并对其与BS等指标进行相关回归分析。结果BS大的老年人其BMD大于BS小者，有显著性差异。在各种指标与BMD的相关性比较中，BS与BMD的相关性最好，其后依次为：体质量、身高、OSTA得分（亚洲人自我骨质疏松筛查工具）、BMI。结论BS比BMI等指标更能反映出人体体型对老年人BMD的影响。     

溃疡散预防消化性溃疡复发临床观察

目的 :观察溃疡散对消化性溃疡的抗复发治疗的临床效果。方法 :随机将 80例患者分成溃疡散治疗组 (4 2例 )和雷尼替丁对照组 (38例 )并同时观察两组患者治疗前后溃疡复发情况。结果 :治疗后治疗组溃疡复发率明显低于对照组 ,P <0 .0 1,两组对比有非常显著性差异。结论 :治疗组能明显的改善患者临床症状和降低消化性溃疡复发率。