环孢素A,强的松和抗凝联合治疗特发性膜性肾炎的回顾性分析

目的 比较单用强的松，强的松＋环磷酰胺，强的松＋环孢素Ａ３种不同方法治疗特发性膜性肾炎的疗效，进行３～１０ａ的随访总结。方法 测定患者的２４ｈ尿蛋白定量及血清肌酐值以评定治疗效果。结果 单用强的松治疗组３０例，完全缓解１１例（３７％）部分缓解７例（２３％）有效率６０％，强的松＋环磷酰胺组２４例，完全缓解１０例（４２％）部分缓解４例（１６％）有效率５８．３％；强的松＋环孢素Ａ组２６例完全缓解１９例（     

达那唑和泼尼松治疗特发性血小板减少性紫癜

达那唑与泼尼松合用治疗复发性特发性血小板减少性紫癜患者４２例，显效２４例，良效７例，进步４例，有效率８３．３％。对照组单用泼尼松治疗３６例，显效７例，良效３例，进步４例，有效率３８．８％。两组间有效率差异有高度显著性（Ｐ＜０．０１）。说明达那唑与泼尼松合用有协同作用，可减少泼尼松用量及毒副作用，显效快，有效率高，停药后不易复发。提示达那唑的主要毒副作用为肝功能损害及雄性化作用，应予重视。     

小剂量强的松加“益气活血壮腰利湿”方治疗难治性肾病综合征

１１例经正规强的松治疗８周无效之肾病综合征。用小一强的松加中药“益气活血壮腰利湿”方治疗，获完全缓解４例（３６．３６％），基本缓解３例（２７．２７％），部分缓解２例（１８．１８％）。无效２例（１８．１８％），总有效率８１．８２％。     

毛细血管内增生性肾炎致肾病综合征12例激素治疗疗效分析

对１２例毛细血管内增生性肾炎（ＥＰＧＮ）致肾病综合征（ＮＳ）治疗４周无好转的病人,给予大剂量激素标准疗程治疗,治疗结果与常规治疗组进行对比。强的松组１２例中,治疗２个月后８倒获得完全缓解（６６．７％）,１２个月后１２例完全缓解（１００％）。常规治疗组 １２例中,在 ２个月和 １０个月观察到完全缓解人数分别为 ２例（１６． ７％）和 ６例（５０． ０％）,两组间同一时期完全缓解率均有显著性差异（Ｐ＜０．０５）。对于ＥＰＧＮ性ＮＳ,使用强的松治疗可以有效地减少蛋白尿,使患者早日达到完全缓解。     

甲酰四氢中酸和干扰素,氟尿嘧啶联合治闻晚期大肠癌60例

采用甲酰四氢叶酸和干扰素，５－氟尿嘧啶联合治疗结肠癌２８例，直肠癌３１例，结直肠癌１例，总有效率（ＣＲ＋ＰＲ）达４１．７％，稳定（ＮＣ）达２１例（３５％），进展（ＰＤ）１４例（２３．３％），有效者缓解者期１～２４月，总的在位生存时间１０．４月，缓解者中位生存期１８．１月。研究结果三者合用是目前治疗肠癌最有生物化学根据的方案。     

狼疮性肾炎3种治疗方案临床疗效比较

观察３种不同方案治疗狼疮性肾炎的疗效。方法８１例患者分为３组，Ａ组以甲基强的松龙＋强的松，Ｂ组以环磷酰胺＋强的松，Ｃ组以ＭＰ＋ＣＴＸ＋强的松治疗。结果：组间近期缓解率有显著差异，其中Ｃ组解率最高，其次为Ａ组，Ｂ组略低。感染为最常见和严重的并发症。结论：在治疗症狼疮性肾炎中，联用ＭＰ及ＣＴＸ冲击治疗，辅以中等量强的松能提高临床疗效。     

大剂量甲地孕酮治疗晚期也腺癌

了解加大孕酮剂量疗效，以期成为进展期也腺癌的第二线内分泌治疗药物。方法：对２４例晚期乳腺癌患者服用醋酸甲地孕酮（ＭＡ），每日用量１０００－１２００ｍｇ，分３次口服。结果：口服甲地孕酮治疗二周后，观察其疗效，有效率达５４．２％，完全缓解（ＤＲ）１例，部分缓解（ＰＲ）１２例，稳定（ＳＤ）者占２５．０％，短期内进展（ＰＤ）５例，占２０．８％，１３例有效率者平均稳定期为１０．４个月，６个稳定者为９．０９个     

他巴唑与强的松合用对Graves病甲状腺功能及自身抗体的影响

目的：探讨他巴唑与强的松合用对Ｇｒａｖｅｓ病（ＧＤ）甲状腺功能及自身抗体的影响。方法：选择初诊的ＧＤ６７例,随机分成两组。治疗组给予他巴唑和强的松各 １５ ｍｇ／ｄ,对照组他巴唑 １５ ｍｇ／ｄ,均于上午８时顿服。结果：治疗４周及８周后Ｔ３、Ｔ４同时正常者：治疗组分别为２７例和３５例（７７．１４％、１００％）;对照组分别为１５例和２４例（４７％、７５％）,差异显著（Ｘ２＝６．５４７,Ｐ＜０．０２５; Ｘ２＝９．９３６,Ｐ＜０．００５）。Ｔ３、Ｔ４恢复正常所需时间治疗组为４．９１±１．７０周;对照组为７．０１±３．３２周,两组比较差异显著（Ｐ＜０．００５）。治疗３个月及１２个月后,ＴＧＡｂ、ＴＭＡｂ及ＴＲＡｂ抑制率明显高于对照组（ Ｐ均＜ ０． ０５）。结论：他巴唑与强的松联合应用疗效优于单用他巴唑。     

仙蝥抗癌片治疗恶性肿瘤近期疗效观察

用自制仙蝥抗癌片治疗恶性肿瘤４２例，取得了较好的疗效，完全缓解（ＣＲ）７例，部分缓解（ＰＲ）１８例，总缓解率（ＣＲ＋ＰＲ）为５９．４％。部分病例可出现类似环磷酰胺的泌尿系统反应，停药后可自行消失。并对其抗癌机理作了初步探讨     

DA方案治疗慢性粒细胞白血病

目的：为探讨联合化疗治疗慢性粒细胞白血病的疗效。方法：１９８８年１月～１９９６年１月，以柔红霉素（ＤＮＲ）和阿糖胞苷（Ａｒａ－Ｃ）组成的ＤＡ方案治疗慢性粒细胞白血病２４例。结果：完全缓解率９１．７％，缩脾效果好，Ｐｈ＋细胞率下降５２．４±１１．３％，中数生存期５４．６月，同期用马利兰治疗１８例，完全缓解率８３．３％，Ｐｈ＋细胞率下降１２．８±４．２％，中数生存期３２．８月。结论：ＤＡ方案是治疗慢性粒细胞白血病有效的联合化疗方案。     

PAROXYSMAL HEMOGLOBINURIA WITH A REPORT OF A CASE IN A CHINESE

Paroxysmal hemoglobinuria is an uncommon disease: Up to date there have been hardly 300 cases reported in the literature. The disease has appeared to have been relatively more common in Japan than elsewhere in this part of the world. So far, there is no record of its occurrence among the.Chinese. S. Inamori(11 and N. Ito (2) report- ed two cases from Mukden Medical College Hospital in Manchuria, but the nationality of these two patients was not mentioned.     

A Recurrent Ectopic Pregnancy within A Previous Caesarean Scar: A Case Report

Objective To investigate the clinical diagnosis and treatment of caesarean scar pregnancy (CSP). Methods We reported here a case of recurrent ectopic pregnancy within a previous cesarean scar and reviewed the literature. Results Surgical evacuation of a CSP was a small side effect and effective treatment of CSP. Conclusion Early and accurate diagnosis, timeliness and effective treatment were extremely important in saving patients?life and retaining their fertility.     

CHOLECYSTECTOMY THROUGH A MINI-LAPAROTOMY A PRELIMINARY REPORT

Cholecystectomy through a small subcostal incision (mini-lap cholecystectomy), has recently been introduced as an alternative to conventional cholecystectomy in an effort to reduce its attendant morbidity. A trial was conducted to assess the morbidity of cholecystectomy performed through a small subcostal incision. Eighteen consecutive patients posted for elective cholecystectomy were operated through such an incision. In 2 [11%], the incision had to be extended. The records of these patients were retrospectively compared with an equal number of consecutive cholecystectomies previously performed by the same surgeon through a conventional incision. There was no significant difference in the average operating time, incidence of wound infection or the number of post-operative complications between the conventional and the mini-laparotomy group. However, the number of doses of post operative analgesic required, the duration of post-operative ileus, hospitalisation and convalescence needed was nearly halved. Thus mini-lap cholecystectomy has much lesser morbidity and is considered to be a safe and viable alternative to conventional cholecystectomy.KEY WORDS: Cholecystectomy, Mini-laparotomy, Post-operative morbidity     

大胆假设,小心求证——培养研究生的几点体会

研究生培养应该是全方位的,通过学习,使综合素质得到提高,为将来的可持续发展打下一坚实的基础,其中能力的培养尤为重要.     

维生素A中毒1例

患儿 ,女 ,3岁 ,因“发热、头痛、呕吐伴咳嗽 2ｄ”入院 ,近 1个月来患儿全身皮肤反复出现皮疹 ,瘙痒明显 ,纳差。查体 :生命体征平稳 ,精神较差 ,全身皮肤粗糙 ,可见散在红色丘疹及新旧抓痕和血迹 ,口唇红 ,略干 ,咽部充血 ,双侧扁桃体ＩＩ度肿大 ,未见脓性分泌物 ,心、肺、腹部及神经系统检查无异常 ,拟诊“上呼吸道感染”予抗感染及对症治疗 ,患儿上呼吸道症状消失 ,而头痛、呕吐、皮肤瘙痒未见好转 ,并出现全身非凹陷性肿胀 ,以颜面、四肢为主 ,触痛明显 ,且口唇干燥、皲裂和鼻粘膜出血 ,怀疑维生素Ａ中毒。经详细追问病史 ,发现患儿自 …