中药外敷治疗肝癌腹水28例

我院自1988年8月至1991年12月间,采用中药外敷腹部,治疗肝癌并腹水28例。现将治疗情况报道如次.一、临床资料本组28例肝癌中,男性23例,女性5例,年龄28岁～51岁,平均39.5岁;原发性肝癌27例,转移性肝癌1例.患者均符合1978年全国杭州会议统一诊断标准,腹水检查呈血性进行性增加。均属无条件作手术的Ⅱ、Ⅲ期中晚期肝癌病人.28例中,曾常规口服双氢克尿噻平均28.7天,     

肺结核手术治疗53例临床分析

肺结核是一种较常见的肺部疾病,我院自1996年1月至1997年12月经手术和病理证实的肺结核53例。本文对53例肺结核的临床资料作一分析。这些病例在术前均诊断不明确,手术后才明确诊断及治疗,对其临床特点及手术价值进行讨论。 1 临床资料 1.1 一般资料:本组男性36例,年龄18～81岁,平均46.5岁;女性17例,年龄14～70岁,平均43.2岁。 1.2 临床症状:最常见的症状是咳嗽,为40例(占     

甲状腺癌外科手术方式的选择

本文报告1977年5月～1991年11月间经手术治疗的甲状腺癌155例,均经病理证实。通过本资料分析,对甲状腺癌外科治疗手术方式的选择作一探讨。一、临床资料分析1.性别:男性36例(23.2%),女性119例(76.8%),男女比例1:3.3(36/119)。2.年龄:<30岁44例(28.4%),31～40岁42例(27.1%),41～50岁27例(17.4%),     

冰红汀剂外用治疗肝癌疼痛42例

疼痛是肝癌的常见症状,1994年～1997年笔者采用自制复方中药汀剂——冰红汀剂。治疗肝癌疼痛42例,取得较好疗 本组42例肝痛伴疼痛患者中原发性肝癌35例,继发性肝癌7例,均为晚期患者。其中男性37例,女性5例,年龄31～68岁,平均47.2岁。疼痛性质:隐痛2例,胀痛35例,刺痛5例。按WHO疼痛分级标准,Ⅰ级疼痛4例,Ⅱ级疼痛27例,Ⅲ级疼痛11例。 2 治疗方法 2.1 冰红汀剂的制作 每1000m170％酒精加红花60g,浸泡7日,用医用纱布过滤过渣后加冰片90g,蟾酥40g浸泡7日后分     

天化丸治疗中晚期肝癌89例

1987～1997年10年间,我院选用具有健脾和胃、疏肝理气、清热利湿、活血化瘀、软坚散结作用的中药验方天化殪癌细胞更新丸(简称“天化丸”)治疗中、晚期肝癌,现报道如下。 1 临床资料 1.1 一般情况 共收治中、晚期肝癌89例,均为门诊病例,其中原发性肝癌73例,转移性肝癌16例;男性72例,女性17例,年龄23～71岁,35～55岁     

西沙必利、吗丁啉治疗64例功能性消化不良的疗效观察

资料和方法一、资料:功能性消化不良(FD)64例均符合1987年美国芝加哥会议提出的诊断标准。其中:男性46例,女性18例,年龄18—72岁。病程均为2个月至12年。全部病例经临床全面检查包括胃镜、B 超、肝功等,部分经 CT 检查,均排除器质性消化不良的诊断。患者分2组,西沙必利组36例。男性26例,女性10例;吗丁啉组28例,男性22例,女性6例。     

474例晚期血吸虫病并发肝癌51例临床分析

本院1989~1999年共收治腹水型晚期血吸虫病(晚血)474例,其中并发肝癌51例,报告如下。1临床资料1.1对象474例晚血患者,男性418例,女性56例;年龄8~76岁,平均47.4岁。患者均经病史、临床和实验室检查确诊。对照组470例,为随机抽样慢性血吸虫病患者,其中男性415例,女性55例;年龄19~     

肝动脉栓塞化疗加(32)~P内照射治疗原发性肝癌

为提高晚期肝癌非手术治疗效果,我们从93年8月开始,探索肝动脉栓塞化疗加用同位素~(32)P内照射治疗晚期不能手术原发性肝癌,现报道如下。材料和方法一、病例分组同期住院原发性肝癌患者,分为两组:(1)肝动脉栓塞化疗(非同位素组),共28例,其中男性24例,女性4例,平均年龄45.6岁,肝脏肿瘤直径8.5±1.6cm;出现肺转移者3例,出现腹水者6例,AFP增高25例、正常者3例。(2)肝动脉栓塞化疗加同位素~(32)P     

胸腺肽α1联合肝动脉化学栓塞治疗晚期肝癌

我们采用美国赛生公司生产的胸腺肽α1 ,即Ｔα1 (商品名日达仙 )联合肝动脉化学栓塞 (ＴＡＣＥ)治疗 1 0例晚期肝癌患者 ,取得较好疗效 ,现报告如下。材料与方法一、临床资料1 0例原发性肝癌患者为 1 998年 7月至 1 999年 6月我院所收治。男性 8例、女性 2例 ,平均年龄 54岁 (     

晚期肝癌的TNF与5—Fu联合疗法

从1990年1月～1993年12月我们采用TNF(Tumor Necrosis Factor即肿瘤坏死因子)和5—Fu(5—氟脲嘧啶)联合治疗晚期肝癌12例,取得了明显的疗效,兹报道如下。 临床资料 病例 12例晚期肝癌患者中,原发性肝癌9例,转移性肝癌3例;男性9例,女性3例;年龄40～50岁者7例,40岁以下者1例,50岁以上者4例。 诊断 12例晚期肝癌均为B超和CT所证实。α—FP在300μg儿以下者8例,在300μg/L以上者4例;伴腹水者6例;伴黄疸者5例;肝功能异常者3例。均有上腹不适或疼痛、食欲降低、饮食减少、消瘦等症状。 治疗方法 5—Fu 1000mg加入5％葡萄糖溶液1000ml中静脉点滴,每日1次,连用10天;同时用TNF 10万国际单位,肌肉注射,每日1次,连用     

砂冰莪术酊治疗晚期原发性肝癌疼痛的研究

探讨中药外敷缓解中晚期肝癌疼痛的临床疗效。将142例中晚期肝癌患者随机分为中药组(86例)及度冷丁组(56例),两组止痛效果比较,相差非常显著,P<0.01;中药外敷缓解肝癌疼痛止痛效果确切可靠,无损伤,不增加痛苦,可重复用药,价廉,无成瘾,患者乐于接受。     

Predictive Factors of Palliative Radiotherapy Response and Survival in Patients with Spinal Metastases from Hepatocellular Carcinoma

Background/Aims

Spinal metastases often severely limit the quality of life by causing severe pain and neurological deficits. The purpose of this study was to evaluate the palliative effect of radiotherapy (RT) for spinal metastases from hepatocellular carcinoma (HCC) and to identify factors predictive of survival in HCC patients with spinal metastases who received RT.

Methods

A retrospective analysis was performed on 192 patients with spinal metastases from HCC who received RT.

Results

Of 192 patients with spinal metastases from HCC, an overall pain response to palliative RT occurred in 187 patients (97.4%), with a complete pain response (CR) in 41 patients (21.4%) and a partial response in 151 patients (78.6%). A higher biologically effective dose (BED) and more advanced RT techniques were identified as predictive factors for a CR. The 1- and 2-year overall survival (OS) rates were 18.1% and 6.3%, respectively, and the median survival time was 4.5 months. A long OS was associated with good performance status, controlled primary HCC, absence of extrahepatic metastases, and a higher BED.

Conclusions

RT provided effective palliation for patients with painful spinal metastases from HCC. Our results provide information regarding pain control, survival outcomes, and predictive factors for the prognosis of HCC patients with spinal metastases treated with RT.     

黑黄胶囊治疗上消化道出血的临床与实验研究

以中药黑黄胶囊（中药组）治疗上消化道出血92例，西药雷尼替丁加止血剂对照（西药组）治疗69例。治疗结果显示，中药组的治愈率明显优于西药组（P＜0．05）；中药组4种中医证型的治疗结果比较，差异无显著意义（P＞0．05），表明黑黄胶囊能够快速止血，缩短病程，适于各种上消化道出血患者的治疗。药理实验结果显示，黑黄胶囊有缩短出血、凝血时间，促进瘀血吸收，抑制应激性溃疡，提高痛阈值等作用，表明黑黄胶囊治疗上消化道出血的作用机制，与活血止血、抗溃疡、镇痛等作用有关。     

Pseudoaneurysm of the popliteal artery: a rare sequela of acupuncture

Acupuncture is an ancient Chinese treatment that has proved effective in relieving pain of various origins. Pseudoaneurysm resulting from acupuncture is an extremely rare event. Only 4 patients treated surgically for such a condition have previously been reported in the world medical literature. We present the case of a patient who had a pseudoaneurysm of the popliteal artery that resulted from acupuncture therapy for osteoarthritis of the knee. The patient was successfully treated by direct repair of the pseudoaneurysm.     

Slow-wave photic stimulation relieves patient discomfort during esophagogastroduodenoscopy

Background and Aim: Although pretreatment with a sedative drug is effective in relieving pain during esophagogastroduodenoscopy (EGD), such drugs can cause significant side‐effects. The aim of this study was to examine the effect of slow‐wave photic stimulation on discomfort and/or pain felt during EGD. Methods: Forty consecutive patients (25 men and 15 women) who underwent diagnostic EGD in our hospital were included in the study. Twenty patients received photic stimulation for 25 min, and underwent electroencephalographic recording, in addition to the usual premedications. Twenty control patients received the same treatment but without photic stimulation. All patients evaluated the discomfort/pain felt during endoscopy against a five‐grade scale in comparison with what they had experienced in their previous examination. Results: Patients with an improved discomfort/pain score were 18/20 and 3/20 in the treated and control groups, respectively. Overall comparison of pain scores between both groups was significant (P < 0.0001). The proportion of slow‐wave activity recorded in patients’ electroencephalograms significantly increased in the treated group compared to control values (36.6 ± 6.8% vs 29.1 ± 3.4%, P < 0.001). There was a close correlation between the degree of discomfort/pain felt during endoscopy and the proportion of slow‐wave activity (P < 0.001). Conclusion: Slow‐wave photic stimulation shows promise as a treatment for relieving the discomfort and/or pain felt by patients undergoing EGD.     

Radiotherapy for painful bone metastases from hepatocellular carcinoma.

BACKGROUND: Painful bone metastases are one of the distressing clinical situations in patients with hepatocellular carcinoma (HCC). The purpose of the study was to evaluate the palliative effect of radiotherapy for painful bone metastases from HCC. PATIENTS AND METHODS: A retrospective analysis was performed upon 51 patients, who were treated with radiotherapy for painful bone metastases from HCC at 77 sites, from January 1991 to June 2000. Twenty patients (39%) presented synchronous metastases, and the remaining 31 patients (61%) showed metachronous metastases. In addition to bone pain, neurologic symptoms and a palpable mass were presented in 13 (25%) and seven (13%) patients, respectively. Twenty-one patients (41%) had a solitary metastasis and the most frequent site was the vertebra. The total dose of radiotherapy ranged from 12.5 to 50 Gy (median 30 Gy). RESULTS: On the Wisconsin Brief Pain Questionnaire, relief of pain was achieved at 56 sites (73%). The overall survival rate at 2 years was 4% and the median survival time was 5 months. Univariate analysis showed that tumor stage within the liver and the presence of metastases to organs, other than bones, were significant prognostic factors for survival (P < 0.05). CONCLUSION: In conclusion, radiotherapy provides effective palliation for patients with painful bone metastases from HCC during the substantial median survival time.     

Treatment with cimetidine, antacid, or placebo in patients with dyspepsia of unknown origin

Patients with dyspepsia of unknown origin were randomly allocated to a controlled double-blind study to examine the symptomatic effect of cimetidine and antacid especially on the relief of pain, nausea, and bloating. Two hundred and twenty-two patients with no previous history of peptic ulcer disease and no evidence of other organic causes of dyspepsia were treated for 6 weeks with placebo, cimetidine, or antacid. The results showed that cimetidine was superior to both placebo and antacid in relieving pain and nausea but not bloating. Certain background factors, such as epigastric pain and symptoms relieved by solid food, had a significant positive influence on the outcome of treatment. When the impact of background factors was taken into account, cimetidine was found to be more effective than both placebo and antacid also with regard to the number of patients who improved in general well-being.     

Hepatocellular carcinoma in primary biliary cirrhosis: similar incidence to that in hepatitis C virus-related cirrhosis

OBJECTIVES: The prevalence of hepatocellular carcinoma (HCC) in primary biliary cirrhosis (PBC) is not well established, as some reports suggest a low risk, whereas others indicate that HCC may be no less frequent than in other types of cirrhosis. METHODS: We compared the incidence of HCC in a series of 140 patients with PBC (five men, 135 women, mean age 54 +/- 1.6 yr) followed-up for a mean of period of 5.6 +/- 0.4 yr with a group of patients with cirrhosis related to hepatitis C virus (HCV) who were matched for age, sex, and follow-up period. In all patients, HCC was prospectively screened by clinical, laboratory, and ultrasound procedures. RESULTS: Five patients with PBC (3.6%) developed HCC. All were in stage IV of the disease. The incidence of HCC in the 45 patients with late stages of the disease (III or IV) was 11.1%, similar to that found in patients with HCV-related cirrhosis, which was 15.0%. The relative risk for HCC in late stages of PBC was of 0.812 (95% CI, 0.229-2.883) with respect to HCV-related cirrhosis. The probability for developing HCC was significantly higher in patients with HCV-related cirrhosis than in PBC patients overall (p = 0.001), but was similar in patients with HCV-related cirrhosis and in patients with PBC in stages III and IV (p = ns). CONCLUSION: The risk for HCC in patients with late stages of PBC is similar to that in patients with HCV-related cirrhosis.     

Transforming growth factor-beta gene expression signature in mouse hepatocytes predicts clinical outcome in human cancer

Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. The clinical heterogeneity of HCC, and the lack of good diagnostic markers and treatment strategies, has rendered the disease a major challenge. Patients with HCC have a highly variable clinical course, indicating that HCC comprises several biologically distinctive subgroups reflecting a molecular heterogeneity of the tumors. Transforming growth factor beta (TGF-beta) is known to exhibit tumor stage dependent suppressive (that is, growth inhibition) and oncogenic (that is, invasiveness) properties. Here, we asked if a TGF-beta specific gene expression signature could refine the classification and prognostic predictions for HCC patients. Applying a comparative functional genomics approach we demonstrated that a temporal TGF-beta gene expression signature established in mouse primary hepatocytes successfully discriminated distinct subgroups of HCC. The TGF-beta positive cluster included two novel homogeneous groups of HCC associated with early and late TGF-beta signatures. Kaplan-Meier plots and log-rank statistics indicated that the patients with a late TGF-beta signature showed significantly (P < 0.005) shortened mean survival time (16.2 +/- 5.3 months) compared to the patients with an early (60.7 +/- 16.1 months) TGF-beta signature. Also, tumors expressing late TGF-beta-responsive genes displayed invasive phenotype and increased tumor recurrence. We also showed that the late TGF-beta signature accurately predicted liver metastasis and discriminated HCC cell lines by degree of invasiveness. Finally, we established that the TGF-beta gene expression signature possessed a predictive value for tumors other than HCC. CONCLUSION: These data demonstrate the clinical significance of the genes embedded in TGF-beta expression signature for the molecular classification of HCC.     

Losec治疗食管源胸痛止痛效果的评价

应用洛赛克（Ｌｏｓｅｃ２０ｍｇ／ｄ）对７８例食管源胸痛进行了止痛效果的临床观察，全部患者经内镜，食管测压，酸反流试验等形态学和动力学检查诊断。研究结果表明：Ｌｏｓｅｃ对各种原因引起的食管源胸痛均有明显的止痛效果，总有效率为８２．１％；与硝苯啶联合服用对由高张力型食管运动障碍引起的胸痛止痛有效率为７４．１％，明显高于单用硝苯啶组３６．８％（Ｐ＜０．０５）。