人工流产漏吸10例临床分析

我院1993～1998年共治疗人工流产术漏吸患者10例,现将漏吸原因及处理讨论如下。1 临床资料 10例均为妇科门诊病人,其中本院漏吸1例,其余9例均来自卫生院,年龄19～32岁,平均25岁。未产妇4例,经产妇6例,其中3例有剖宫产史,3例为自然分娩。1.1 第1次人工流产情况 停经35～47d,其中6例少于40d。检查尿妊娠试验均阳性,10例患者均未行B超检查。本院1例漏吸者术后未见典型绒毛组织,其余例术中及术后情况均不详,术后患者分别在6～45d就诊,7例术后有明显早孕反应,3例术后1个月无月经来潮,B超提示宫内早孕,发现双子宫1例,子宫不完全纵隔1例。临床诊断:早孕或人工流产漏吸。     

特定体位下损伤方式1例法医分析

1 案例资料 死者,女,24岁,与嫌疑人(男,30岁,173 cm)发生争执时被刺伤,送医院抢救无效死亡.尸体检验:尸长163 cm,发育正常.上身穿红色毛衣,其右侧领口下28 cm、距中线5 cm处有一1.7 cm长的破裂口,创角外钝内锐;内穿粉红色秋衣,其左衣领下16 cm、距中线2 cm处有一1.8 cm长的破裂口,创角外钝内锐,破口周围均有血迹.     

胸段食管癌切除术患者的预后分析

Objective To investigate the prognostic factors and influence of the number of lymph node metastases on survival and UICC-TNM classification in patients with thoracic esophageal cancer after curative resection. Methods From 1985 to 1990, 1224 patients were surgically treated for thoracic esophageal cancer. The patients who died within 30 days after operation were not included in this study. Fifteen factors possibly influencing survival of these patients were selected and analyzed. A multivariate analysis of these individual variables was performed by Cox proportional hazard model. According to the n, mher of lymph node metastases (0, 1 and ≥ 2), a new modification of the TNM classification was suggested: stage Ⅱ a (T2N0M0 and T3N0M0), stage Ⅱb [T1N1M0 and T2N1 (1) M0], stage Ⅲ a [T2N1 (2)M0 and T3N1 (1)M0] and stage Ⅲ b [T3N1 (2)M0 and T4NanyMO]. Results According to multivariate analysis, lymph node metastases, depth of invasion, location of tumor, histological classification and length of the tumor were of prognostic significance (P < 0.01). There was obvious correlation between the rate of lymph node metastasis and the depth of invasion, length of tumor and grade of differentiation. The 5-year survival rate of the patients with 0, 1 and ≥2 positive metastatic lymph nodes was 59.1%, 32.0% and 8.9%, respectively. The 5-year survival rate of the patients with stage T2N1M0 and stage T3N1M0 was significantly higher in those with only one lymph node involved than in those with two or more lymph nodes involved (43.1% vs. 18.0% and 28.0% vs. 9.6%, P<0.01). The 5-year survival rate of the modified stage Ⅱa, Ⅱb, Ⅲa and Ⅲb was56.5%, 43.9%, 25.6% and 11.1%, respectively, with a statistically significant difference among different stages (P < 0. 01). Conclusion The lymph node metastasis is the most important prognostic factor for thoracic esophageal cancer after resection. The major influencing factors of lymph node metastasis are the depth of invasion, length of tumor and grade of differentiation. Therefore, the lymphadenectomy along with esophngectomy and subsequently combined modality therapy against lymph node metastasis is necessary to improve the S-year survival rate. Our proposed new classification based on number of lymph node metastases (0, 1, ≥2 positive nodes) is more applicable because it can well reflect the correlation between lymph node metastasis and the survival, and provides evidence for the modification of the currently used UICC TNM staging system for surgically treated thoracic esophageal cancer.     

智障清口服液抗记忆损伤作用的研究

采用跳台法和电迷路法对智障清口服液抗记忆损伤作用进行研究，结果表明该药对东度莨菪碱造成的记忆损伤具有明显的保护和改善作用。     

儿童胰岛素依赖型糖尿病几项凝血指标的研究

用放射免疫法测定２４例ＩＤＤＭ患者血浆６－酮－前列腺素Ｆ１α及血栓素Ｂ２含量，用ＢｅｃｋｍａｎＩＣＳⅡ型手动速率散射比浊法检测血浆纤维结合蛋白含量，并于正常对照组进行比较，其结果为正常对照组６－酮－前列腺素Ｆ１α、血栓素Ｂ２、纤维结合蛋白值分别为２４．９６±４．０９ｐｇ／ｍｌ、８８．４７±９．０５ｐｇ／ｍｌ、０．３０５±０．０４２ｇ／Ｌ；ＬＤＤＭ组上述各项指标分别为２６．８４±１．５８ｐｇ／ｍｌ、１９１±２．８５ｐｇ／ｍｌ、０．２６±０．１１ｇ／Ｌ。本文结果表明ＩＤＤＭ组血浆血栓素Ｂ２（ＴＸＢ２）值明显高于对照组（Ｐ＜０．０１）、Ｆｎ值低于对照组，但无显著性差异（Ｐ＞０．０５），ＴＸＢ２升高与血糖、血脂有正相关倾向，提示儿童ＩＤＤＭ存在发生慢性血管并发症的危险因素。     

乌司他丁治疗急性轻症胰腺炎的疗效观察

目的评价乌司他丁治疗急性轻症胰腺炎临床疗效。方法将58例急性轻症胰腺炎患者随机分成两组,治疗组30例,对照组28例。对照组予禁食、胃肠减压、抗炎、抑制胃酸分泌及支持对症等常规治疗,治疗组除常规治疗外,加用乌司他丁,每次10万U,静脉滴注,每天1次,疗程7天。观察记录患者腹部症状、体征及血尿淀粉酶变化情况等并进行统计学处理。结果治疗组在5天后症状、体征的缓解率及5天内患者血、尿淀粉酶下降水平均明显优于对照组(P<0.05)。结论乌司他丁对急性轻症胰腺炎有较好的疗效。     

腹腔镜下十二指肠吻合术治疗新生儿十二指肠梗阻

Objective To evaluate the feasibility and indication of laparoscopie duodenoduoden-ostorny for neonates with congenital duodenal obstruction- Methods From May 2004 to Feburary 2008,6 newborns with duodenal obstruction underwent exploratory laparoscopy. With a lower-pressure pneumoperitoneum of 5～8 mmHg and a suspending suture for right liver elevator, the procedure was performed using 3 cannulas of 3.3 mm to 5.5 mm diameter. Under the laparoscopic vision, the cause of duodenal obstruction was diagnosed and a sutured anastomosis was performed after the duodenum mo-bilized. Results Findings at laparoscopy included duodenal diaphragm in 3 cases,annular pancreas in 2 cases, and preduodenal portal vein in 1 case. Three cases with duodenal diaphragmatic stenosis were en-countered a partial excision of the diaphragm after vertical incision of the anterior part of duodenum followed laparoscopically by a transverse suture. A diamond-shaped side-to-side duodenoduodenal anas-tomosis was successfully carried out in 2 cases of annular pancreas through a laparoseopic approach, but a duodenojejunostomy was converted to mini-laparotomy during the laparoscopic course of a predu-odenal portal vein. The average operative time was 102 16.5 min (85～135 min). Visualization was ex-cellent, and there were no intraoperative complications. Feedings were started on postoperative day 3 to 5. All cases were on full feedings after 8 to 10 days. Follow-up upper gastrointestinal tests showed no evidence of stricture or obstruction. Conclusions The duodenoduodenostomy with laparoseopy can be performed in neonates securely and appropriated for a full-term newborn with tolerance CO2 pneumo-peritoneum. It provides an excellent and micro-invasive way to evaluate and treat congenital duodenal obstruction.     

胸段食管癌切除术患者的预后分析

Objective To investigate the prognostic factors and influence of the number of lymph node metastases on survival and UICC-TNM classification in patients with thoracic esophageal cancer after curative resection. Methods From 1985 to 1990, 1224 patients were surgically treated for thoracic esophageal cancer. The patients who died within 30 days after operation were not included in this study. Fifteen factors possibly influencing survival of these patients were selected and analyzed. A multivariate analysis of these individual variables was performed by Cox proportional hazard model. According to the n, mher of lymph node metastases (0, 1 and ≥ 2), a new modification of the TNM classification was suggested: stage Ⅱ a (T2N0M0 and T3N0M0), stage Ⅱb [T1N1M0 and T2N1 (1) M0], stage Ⅲ a [T2N1 (2)M0 and T3N1 (1)M0] and stage Ⅲ b [T3N1 (2)M0 and T4NanyMO]. Results According to multivariate analysis, lymph node metastases, depth of invasion, location of tumor, histological classification and length of the tumor were of prognostic significance (P < 0.01). There was obvious correlation between the rate of lymph node metastasis and the depth of invasion, length of tumor and grade of differentiation. The 5-year survival rate of the patients with 0, 1 and ≥2 positive metastatic lymph nodes was 59.1%, 32.0% and 8.9%, respectively. The 5-year survival rate of the patients with stage T2N1M0 and stage T3N1M0 was significantly higher in those with only one lymph node involved than in those with two or more lymph nodes involved (43.1% vs. 18.0% and 28.0% vs. 9.6%, P<0.01). The 5-year survival rate of the modified stage Ⅱa, Ⅱb, Ⅲa and Ⅲb was56.5%, 43.9%, 25.6% and 11.1%, respectively, with a statistically significant difference among different stages (P < 0. 01). Conclusion The lymph node metastasis is the most important prognostic factor for thoracic esophageal cancer after resection. The major influencing factors of lymph node metastasis are the depth of invasion, length of tumor and grade of differentiation. Therefore, the lymphadenectomy along with esophngectomy and subsequently combined modality therapy against lymph node metastasis is necessary to improve the S-year survival rate. Our proposed new classification based on number of lymph node metastases (0, 1, ≥2 positive nodes) is more applicable because it can well reflect the correlation between lymph node metastasis and the survival, and provides evidence for the modification of the currently used UICC TNM staging system for surgically treated thoracic esophageal cancer.     

前列腺小细胞癌2例报告及文献复习

目的:探讨前列腺小细胞癌的临床病理特征,提高其临床诊治水平。方法:通过2例前列腺癌治疗后转化为前列腺小细胞癌的病例报告并复习相关文献。结果:2例患者因PSA升高行前列腺穿刺,病理诊断均为前列腺癌,均行最大限度雄激素阻断治疗,治疗后PSA降至正常水平;后因排尿困难行前列腺电切术,术后病理诊断为前列腺小细胞癌,行化疗或放疗,于发现小细胞癌后8～9个月死亡。结论:前列腺小细胞癌可由前列腺腺癌治疗后转化而来,病理转化最可能的机制是长期内分泌治疗所诱发突变。前列腺小细胞癌较前列腺腺癌恶性程度高,预后差。     

平阳霉素对阴茎癌组织c-myc及Ras-P21蛋白表达影响的研究

目的 探讨应用平阳霉素化疗对阴茎癌组织蛋白c-myc、Ras-P21表达的影响及意义。方法 收集1995—2005年间阴茎鳞状细胞癌患者100例,按照术前是否进行化疗分为两组,其中化疗组50例,术前应用平阳霉素化疗7天,并在化疗后行阴茎部分切除术+改良方法的腹股沟淋巴结清扫术;对照组50例,未进行化疗而直接行阴茎部分切除术改良方法的腹股沟淋巴结清扫术。应用免疫组化法(SP)对两组的100例阴茎癌组织标本进行c-myc、Ras-P21蛋白产物检测。应用χ²检验对数据进行统计分析。结果 化疗组50例阴茎癌标本中c-myc、Ras-P21表达阳性率分别为30%、27%。对照组50例阴茎癌标本中,c-myc、Ras-P21表达阳性率分别为52%、48%。经χ²检验,化疗组与对照组的c-myc、Ras-P21表达阳性率的差异具有统计学意义(P＜0.05)。结论 应用平阳霉素化疗后阴茎癌组织中c-myc、Ras-P21蛋白的表达明显下降。