厚朴温中汤加减治疗功能性消化不良36例

目的:观察厚朴温中汤治疗功能性消化不良临床疗效。方法:门诊随机选取66例病人分为两组,分别给予厚朴温中汤和吗叮啉,28d后,对比疗效。结果:有效率:吗叮啉组70.0%,厚朴温中汤组97.2%,两组比较差异有显著性意义。结论:厚朴温中汤治疗功能性消化不良有良效。     

再生障碍性贫血治疗中若干问题的管见

再生障碍性贫血不同地区、不同学者的不同治疗方法,反映了人们对疾病的不同的认识,主流意见一是从肾辨证立论,二是综合脏腑、阴阳、气血、病因辨证用药.急慢性再障病理特点和临床表现的不同是中医辨证治疗的基础.治用四联生血汤补肾益肾,健脾资料,清热解毒,活血化瘀.     

吸入麻醉药预处理对心肌缺血“第二保护窗”的作用机制

吸入麻醉药预处理对心肌缺血侑罐注损伤具有急性期和“第二保护窗”两个时间段的保护作用。“第二保护窗”起效缓慢而持久,临床上有充分的时间在手术前给予,能更方便有效地预防围术期心肌缺血的并发症。它可诱导一些触发因子如腺苷、一氧化氮的产生,通过信号转导通路蛋白激酶C、核因子-κB等,作用于ATP敏感性钾通道及活性氧族等终末效应离子通道或保护蛋白而发挥迟发性心肌保护。现就近年来关于吸入麻醉药预处理对心肌“第二保护窗”的作用机制作一综述。     

医学检验专业第二课堂活动的实践与思考

本文结合广东医学院医学检验专业第二课堂活动的实践,从设计原则、组织形式、探索和思考几方面阐述了第二课堂教育的模式,探讨了第二课堂活动在医学检验专业学生综合素质培养中的作用,旨在促进医学检验专业教学改革,提高学生的社会适应能力。     

消瘅汤治疗糖耐量降低32例临床疗效观察

目的观察消瘅汤治疗糖耐量减低（IGT）的临床疗效。方法将62例IGT患者随机分为治疗组（32例）和对照组（30例）。两组患者均给予一般的饮食及运动干预治疗,在此常规治疗的基础上对照组患者采用维生素B1治疗;治疗组采用消瘅汤治疗。观察两组患者治疗后临床疗效及治疗前后体重指数（BMI）、血糖、胰岛素、血脂、血压、胰岛素敏感指数（IAI）等指标的变化情况。结果两组患者治疗后,对照组总有效率为43.3%,治疗组为87.5%,两组比较有显著性差异（P〈0.01）。治疗组治疗后血糖、胰岛素、IAI、血脂（除高密度脂蛋白）及血压情况与对照组比较,有显著性差异（P〈0.05）。结论消瘅汤能明显增加胰岛素敏感性,可逆转糖耐量减低,对机体进行多方面综合调节,且无明显毒副作用,值得进一步推广。     

补阳还五汤对急性脑梗塞患者血清VEGF含量的影响

目的:观察补阳还五汤对急性脑梗塞患者血清VEGF含量的影响。方法:将66例急性脑梗塞患者随机分为补阳还五汤治疗组33例和对照组33例,分别治疗14天后比较其血清VEGF含量。结果:治疗组治疗后血清VEGF含量较治疗前明显提高(P<0.05),而对照组无改善(P>0.05)。且治疗组治疗后血清VEGF含量明显高于对照组(P<0.05),差异有统计学意义。结论:补阳还五汤能有效提高急性脑梗塞患者血清VEGF含量,促进血管新生。     

Second-Look Operation for Unresectable Pancreatic Ductal Adenocarcinoma at a High-Volume Center

Background The value of re-exploration for pancreatic ductal adenocarcinoma after the initial diagnosis of unresectability is unclear. Methods In this study, we analyzed 33 patients who were re-explored after an initial diagnosis of unresectability. Results At the time of reoperation, a resectable tumor was found in 18 patients: therefore, 15 pancreaticoduodenectomies, two total pancreatectomies and one left resection were performed with three vascular resections. Morbidity and mortality rates for the cohort were 6/33 and 1/33, without significant differences between resectable and nonresectable patients. Length of stay, duration of operation, and blood loss were significantly increased in the resection group. Kaplan–Meier survival analysis demonstrated increased median survival for resected patients (1078 days after the initial operation versus 547 days in the group of unresectable patients; p = 0.018). Analysis of the reasons against initial resection showed that, if the patients had been sent to a tertiary referral center for pancreatic surgery, a different decision in favor of resection would probably have been made in 14 out of 33 patients. A review of 10 published reports on reoperation for pancreatic cancer revealed results comparable to our study in terms of low morbidity and mortality as well as a survival benefit. Conclusions Reoperation for pancreatic ductal adenocarcinoma that is initially deemed unresectable can be safely performed in a selected group of patients by experienced surgeons, supporting the concept of patient centralization in pancreatic surgery. Resection at the second operation may confer a survival benefit even when the initial findings preclude a potentially curative approach.     

养心汤对同型半胱氨酸致大鼠血管内皮功能障碍的影响

目的 通过高蛋氨酸饲料喂养SD大鼠建立血管内皮功能障碍模型,观察中药养心汤对血管内皮功能障碍的影响并对其相关机制进行探讨.方法 SD雄性大鼠40只,按随机数字表法分为空白组、模型组、叶酸组、养心汤组,每组10只.空白组喂养常规普通饲料,模型组、叶酸组、养心汤组喂养含3％ L-蛋氨酸的常规普通饲料,共12周,建立血管功能...     

Long-term survival and risk of second cancers after radiotherapy for cervical cancer

PURPOSE: To evaluate the risk of second cancers after cervical cancer treated with radiotherapy for Asian populations. METHODS AND MATERIALS: We reviewed 2,167 patients with cervical cancer undergoing radiotherapy between 1961 and 1986. Intracavitary brachytherapy was performed with high-dose rate source (82%) or low-dose rate source (12%). Relative risk (RR), absolute excess risk (AR), and cumulative risk of second cancer were calculated using the Japanese disease expectancy table. For 1,031 patients, the impact of smoking habit on the increasing risk of second cancer was also evaluated. RESULTS: The total number of person-years of follow-up was 25,771, with 60 patients being lost to follow-up. Among the 2,167 patients, 1,063 (49%) survived more than 10 years. Second cancers were observed in 210 patients, representing a significant 1.2-fold risk (95% confidence interval [CI], 1.1-1.4) of developing second cancer compared with the general population, 1.6% excess risk per person per decade of follow-up, and elevating cumulative risk up to 23.8% (95% CI, 20.3-27.3) at 30 years after radiotherapy. The RR of second cancer was 1.6-fold for patients with the smoking habit and 1.4-fold for those without. CONCLUSIONS: Small but significant increased risk of second cancer was observed among Japanese women with cervical cancer mainly treated with high-dose rate brachytherapy. Considering the fact that about half of the patients survived more than 10 years, the benefit of radiotherapy outweighs the risk of developing second cancer.     

Risk of second malignancies after adjuvant radiotherapy for breast cancer: a large-scale, single-institution review

PURPOSE: The aim of this study was to estimate the risk of second malignancies (SM) after radiation therapy (RT) for breast cancer (BC) in a large, institutional, homogeneous cohort of patients. METHODS AND MATERIALS: We retrospectively studied 16,705 patients with nonmetastatic BC treated at the Institut Curie in Paris between 1981 and 1997. Adjuvant RT was given to 13,472 of these patients, and no RT was given to 3,233. The SM included all first nonBCs occurring during follow-up. Cumulative risks for each group were calculated using Kaplan-Meier estimates, censoring for contralateral cancer or death. RESULTS: Median patient age at diagnosis of BC was 55 years for the whole population, and 53 and 60 years for patients who had and had not undergone irradiation, respectively. At the 10.5-year median follow-up, 709 patients were diagnosed with SM (113 in the non-RT and 596 in the RT group). There was a significant increase in the rate of sarcomas and lung cancers in the RT group compared with non-RT group (p 0.02). Treatment with RT was not found to increase the risk of other types of cancers such as thyroid cancer, malignant melanoma, gastrointestinal or genitourinary, and hematologic SM. CONCLUSIONS: This study suggests that adjuvant RT increased the rate of sarcomas and lung cancers, whereas it did not increase the rate of other malignancies.