卵巢肿瘤患者术后化疗对其生殖功能及子代的影响

作者对该院1972年7月至1989年8月间收治的卵巢肿瘤病例中,经保留生育功能手术及术后化疗1～12个疗程患者30例进行研究。结果:化疗后,月经正常者65.5％(19/29)。化疗后的月经改变与接受化疗时患者的年龄显著相关,接受化疗时,年龄≥25岁,导致月经异常的机率高于年龄<25岁的患者。要求生育     

心脏肿瘤附74例临床经验及外科手术效果

原发性心脏肿瘤占所有心脏及心包肿瘤的5％～10％,尸解则占0.0001％～0.05％。心脏及心包转移性肿瘤较常见,尸解则占癌瘤的21％。大约75％良性肿瘤,其中40％为粘液瘤,20％为横纹肌瘤,其他为中胚层混合瘤。大多数恶性肿瘤为肉瘤,其他为淋巴瘤、胸腺瘤及浆细胞瘤。本文总结了外科治疗良性和恶性心脏肿瘤及其远期效果。 1 材料和方法在法国拉陪(La Pitie)医院心血管外科从1972年到1989年5月外科治疗心脏     

急性早幼粒细胞白血病217例长期生存因素分析

目的探讨影响急性早幼粒细胞白血病（APL）患者长期生存的主要因素,为改善预后、延长患者生存期提供临床依据。方法对1978—1989年和1990—2003年分别收治的99例、118例初发APL患者的资料进行回顾性队列研究和生存分析。结果217例APL患者中72例患者达到5年以上长期生存。1978—1989年与1990—2003年患者5年总体生存率分别为4．0％和56．0％,完全缓解（CR）及CR后长期生存率分别为56．6％和89．0％、7．1％和64．8％。年龄、白细胞、血小板、骨髓异常早幼粒细胞、免疫表型、染色体核型、诱导方案、达CR1时间、CR后治疗时间是影响长期生存的重要预后因素;性别、发热、出血、肝脾淋巴结肿大、血清铁蛋白、乳酸脱氢酶对长期生存无影响。结论骨髓异常早幼粒细胞〉70％、达CR1时间〉30d、CD34阳性表型、非典型染色体核型者是不利于长期生存的独立危险因素;血小板≥30．0×10^9／L、使用ATRA＋CH诱导方案、CR后治疗时间≥3年则有利于长期生存。     

慢性肺原性心脏病诊断、治疗及病理的研究

1964～1966年和1972年以来,与有关科室相互协作,进行了肺心病的诊断,治疗和病理研究,取得了较多的进展。慢性阻塞性肺疾病(COPD)性肺心病住院病死率由1972年的26.5％下降到近三年平均8.8％(6.1～12.9％),肺性脑病由1972年的66.7％下降到近三年平均12.6％(0～28.6％),均达到1973和1977年全国肺心病专业会议提出的规划要求。     

放射治疗恶性肿瘤骨转移128例临床观察

本文观察自1997～2003年8月应用放射治疗128例608个病灶，止痛的总有效率（CR＋PR）97．2％。取得良好的近期临床疗效，现报道如下。     

计算机X线摄影与传统X线摄影对比分析

随着医学技术的迅猛发展 ,传统X线摄影已远不能适应临床的需求 ,计算机X线摄影 (Computedradiography ,CR)应运而生。本院 2 0 0 2年 8月引进美国柯达公司研制的 90 0型CR ,至 2 0 0 3年 3月 ,已完成 2 4 0 0 0例摄影。现对CR摄影的图像质量与传统X线片的图像质量进行对比分析 ,并报告如下。1　材料与方法一般资料 :本院 2 0 0 2年 8月～ 12月所摄CR片中按顺序抽取 10 0 0例作为研究组。其中男 6 79例 ,女 32 1例。年龄 5～ 85岁。胸片 5 6 4张 ,头颅四肢片 2 36张 ,其他及特殊造影片 2 0 0张。本院 2 0 0 1年 8月～ 12月所摄的传统X…     

溃疡性结肠炎及Crohn病发病频度的国际比较

溃疡性结肠炎(UC)及Crohn病(CD)是病因未完全搞清的有代表性的炎症性肠道疾病(IBD)。日本的频度明显低于欧美各国,1975、1976年日本厚生省分别将UC、CD定为特定疾病,近年来此类患者激增,对其流行病学的关注也日益增加。作者调查了世界各国UC和CD频度的已有文献,并与日本的状况加以对比。检索1972～1989年8月收录的英文报告两种疾病的论文,提取249篇论文中记有以地区为基础     

黑面神合剂新复方治疗慢性气管炎262例疗效总结

黑面神合剂的药物和组成,是从综合验证的8个处方,50多味中草药中筛选出来的,经过3年6个月,总共治疗观察慢性气管炎1329例。其中: 1971年3月～1972年5月以黑面神合剂治疗验证1067例,二个疗程总有效率91.28％,临床控制率28.12％,临床控制及显效率61.76％(本方临床验证情况1972年5月已作专题总结报告,本文略)。 1972年6月～1974年9月,用经过改进的     

276例成人社会获得性肺炎临床分析

<正>社会获得性肺炎(Community Aequirel Pneumor,简称CAP)的患者,虽然大多数在门诊治疗,但仍是住院的常见病。1989年8月～1995年8月住我院内科治疗的社会获得性肺炎276例,占我院同期内科住院患者的2.4％,占呼吸内科住院患者的10.3％。本文对276例CAP患者的临床特征,实验检查及治疗情况作一回顾性分析。     

堵塞性肠梗阻20例分析

1989年8月～2007年1月我们共收治各类肠梗阻465例，其中堵塞性肠梗阻20例，约占4．30％，均经手术证实，现报告如下。[第一段]     

Trends in mortality, morbidity, and risk factor levels for stroke from 1960 through 1990. The Minnesota Heart Survey.

OBJECTIVE--The Minnesota Heart Survey is a population-based study designed to monitor and explain trends in cardiovascular mortality, morbidity, and risk factors. DESIGN--Surveillance time-trends study. METHODS--The following trends were examined among men and women aged 25 to 74 years living in Minneapolis-St Paul, Minn: (1) stroke mortality from 1960 through 1990; (2) risk factors in population-based surveys conducted in 1973 through 1974, 1980 through 1982, and 1985 through 1987; and (3) morbidity in a 50% sample of hospitalized discharges for acute-stroke in 1970, 1980, and 1985. RESULTS--Stroke mortality in Minneapolis-St Paul declined slowly from 1960 through 1972 (average fall, 2.4% per year), dropped sharply from 1972 through 1984 (average fall, 6.5% per year), but exhibited little change thereafter (average fall, 1.5% per year). The average level of cardiovascular disease risk factors fell from 1973-1974 to 1985-1987, with the exception of body mass index. In particular, hypertension diagnosis, treatment, and control levels improved substantially between 1973-1974 and 1980-1982, although there was little improvement after 1980-1982. While discharge rates for hospital-coded acute stroke declined substantially between 1970 and 1985 in both sexes, no clear trend was observed in definite stroke rates as validated using standard clinical criteria. Twenty-eight-day case fatality rates of definite stroke improved significantly from 1970 to 1985. CONCLUSIONS--The substantial decline in stroke mortality of more than 50% from 1960 through 1990 appears to have been attributable to both primary and secondary prevention. These data suggest that the long decline in stroke mortality and morbidity in Minneapolis-St Paul has plateaued, although improved detection of stroke with computed tomography prevents an unequivocal conclusion.     

Surgical Treatment of Recurrent Hepatocellular Carcinoma (A report of 112 cases)

GreatprogresshastakenplaceinthetreatmentofHCC.Hepaticresection,asamaintreatment,makespatientssurvivalmarkedlyimproved,butpostoperationrecurrenceisstillaproblemtobesolved.Inourdepartment,among112patientswithrecurrenthepatocellularcarcinomatreatedsurgically,58patientshadsecondaryhepaticresection.Theaimofthisstudywastoevaluatethelong-termresultsoftreatmentandprognositicfactorsinpatientswithrecurrenthepatocellularcarcinomaaftercurativeresectionofhepatocellularcarcinomaandtoclarifytheoptimaltreatm…     

~(60)钴外照射加高剂量率腔内后装治疗鼻咽癌的临床研究

目的 :探讨60 Co外照射加腔内后装放射治疗鼻咽癌的疗效及并发症。方法 :对我院 1985年 7月～ 1993年8月采用60 Co外照射加高剂量率后装腔内放射治疗 5 8例鼻咽癌回顾性分析 ,本组病例随访 5年以上 ,失访按死亡统计。结果 :本组病例 5年局部控制率 84.5 % ( 4 9/5 8) ,5年生存率和无瘤生存率分别为 75 .9% ( 4 4/5 8)和 6 8.9%( 4 0 /5 8)。结论 :外照射加腔内放射治疗可适当减少外照射剂量和放射损伤 ,提高鼻咽早期原发肿瘤和鼻咽癌外照射后鼻咽腔内残瘤病灶的局部控制率     

Ⅰ型精神分裂症患者治疗的远期效果观察

目的了解Ⅰ型精神分裂症患者远期疗效。方法应用BPRS、SDSS、ADL和自编量表等对398例Ⅰ型精神分裂症加以随访3年。分析对治疗依从性、社会功能恢复情况等远期疗效。结果随时间延长，其患者完全依从率从出院时的73．1％降至第3年时的34．9％，完全不依从比例从随访1年时10．8％升到第3年时的15，6％；随访1年复发或恶化率的32．1％，到3年时为45．O％。远期社会功能缺陷率较高。男性性功能障碍率达69．3％。结论Ⅰ型精神分裂症远期依从性差，社会功能严重缺陷率高，复发率也高，应注意药源性性功能障碍等不良反应引起依从性差。     

Ascertainment and natural history of treated acromegaly in Northern Ireland.

The prevalence of known cases of acromegaly in Northern Ireland in 1984 was 6.3 per 100,000 population. The incidence of newly-diagnosed cases over the preceding 25 years was 5.5 patients per year, or 0.4 patients per 100,000 population per year. This rate would be equivalent to about 200 new cases per year in the United Kingdom. Four options have been available to most of these patients--surgical hypophysectomy (transfrontal or transsphenoidal), pituitary radiotherapy (usually external cobalt beam), drug treatment with bromocriptine, or no treatment. Choice of treatment has been mainly influenced by tumour size, with the larger pituitary adenomas having surgery initially. No single form of treatment has been successful in achieving a clinical remission or cure in more than a minority of cases. The most successful outcome has been where total pituitary ablation has been achieved. Life-table analysis for the whole group shows life expectancy which is not markedly different for that of an age-matched population from Northern Ireland. Morbidity related to long term osteoarthritis and treatment complications remain a major problem. The incidence of malignant tumours is higher than would be expected.     

Long term outcome of renal transplantation in the pre cyclosporin era: One centre’s experience

The number of renal transplants has been increasing steadily over the last twenty years. This increase has been associated with a significant improvement in the one year graft and patient survival. However, as survival improves, long term complications are becoming more clinically important. We, therefore, retrospectively reviewed our experience of renal transplantation in 165 patients between January 1970 and December 1980, and describe in detail the complications experienced by those whose grafts functioned for 10 years or longer. The 10 year patient survival rate was 47% and graft survival rate was 30%. The graft survival rate for living related grafts was superior to that of cadaveric grafts. The major cause of mortality in the first year following renal transplantation was infection and in subsequent years, cardiovascular disease predominated. Patients whose grafts functioned for 10 years or more developed a variety of complications including infection, skin cancer and hepatic dysfunction. Clinicians involved in the long term care of the patients need to be aware of these problems and skilled in their management.     

Early gastric cancer: the case for long term surveillance

Thirty five patients with early gastric cancer have been treated at the Bristol Royal Infirmary since 1965. The number of cases diagnosed has doubled in the last 10 years. Epigastric pain (74%), loss of weight (63%), and gastrointestinal bleeding (43%) were the most common presenting symptoms, with a median length of history of 12 months (range five days to 72 months). Life table survival curves showed a crude five year survival of 71% (age adjusted 92%) and a crude 10 year survival of 63% (age adjusted 85%). Sixteen patients have been followed up clinically, endoscopically, and by scintigraphy with technetium-99m p-butyl iminodiacetic acid to assess the risk of recurrent disease. Of seven patients with pronounced bile reflux, two had moderate dysplasia of the gastric remnant, and one patient was found to have developed a metachronous tumour nine years after surgery. Partial resection seems to be the best choice of treatment for early gastric cancer, giving good functional results. Consideration should, however, be given to Roux en Y diversion, and long term surveillance of the gastric remnant is recommended.     

老年人食管癌贲门癌患者手术治疗的临床评估(附62例报告)

目的：评估老年人食管癌、贲门癌患者的手术治疗及手术效果。方法：将62例年龄≥70岁（老年组）和62例年龄＜70岁（非老年组）已行食管癌、贲门癌切除手术患者的临床特征、术后并发症、术后早期死亡率及近、远期临床随访结果进行回顾性对照分析。结果：术后并发症发生率：老年组29．03％（18／62），非老年组32．26％（20／62）；术后早期死亡率：老年组3．23％（2／62），非老年组1．6％（1／62）；近、远期效果：老年组1年生存率74．19％（46／62），2年生存率54．84％（34／62），3年生存率38．71％（24／62）；非老年组1年生存率80．64％（50／62），2年生存率67．74％（42／62），3年生存率32．26％（20／62）。结论：经严格选择病人，恰当及时的术前术后处理，老年组与非老年组术后并发症发生率、早期死亡率及近、无期效果无明显差异。对70岁以上食管癌、贲门癌患者积极行手术治疗是可行的。     

Nursing dependency in registered nursing homes and long term care geriatric wards in Edinburgh

There has been growing interest and public investment in registered nursing homes, apparently based on the assumption that these homes are the private equivalent of hospital long term care. We have tested this hypothesis in a survey comparing 400 patients in 18 registered nursing homes with 217 patients in 11 geriatric long term care wards in Edinburgh. The nursing home patients formed a distinct and separate group: 362 (92%) were women, 392 (98%) were single or widowed, and 358 (90%) were self financing, whereas in the geriatric long term care group 148 (68%) were women and 35 (16%) were still married. Patients in nursing homes were also far less dependent than those in geriatric long term care wards (p less than 0.005). This study suggests that there may be large differences between the patients in these two types of institution, particularly with regard to nursing dependency. This finding has important implications in the future planning of long term places for the dependent elderly.