30例Ⅱ＿b期子宫颈鳞癌术前放疗前后的临床病理检查对照

Ⅱｂ期子宫颈鳞癌３０例，术前给予１／２根治剂量的放射治疗，休息２～３周后行广泛性子宫切除术和盆腔淋巴结清扫术，手术均能顺利完成。术后病理检查宫颈局部肿瘤均有不同程度的缩小或消失，宫旁变软增宽，宫旁均未见癌，因此Ⅱｂ期子宫颈鳞癌给予１／２根治剂量的术前放疗，可以选择性的行子宫颈癌根治术。     

子宫颈癌术前放疗211例临床观察

我院1985～1992年共行子宫颈癌广泛切除和盆腔淋巴结清扫手术754例,其中211例行术前放射治疗。145例临床诊断为Ⅱb期。随着手术技术的提高和术前放射治疗的配合,子宫颈癌的手术适应症的选择,可以扩大到Ⅱb期,不增加手术的并发症,并具有一定的优点。     

胸腔镜在肺癌分期中的应用

目的 探讨胸腔镜在肺癌分期中的应用价值。方法 应用胸腔镜对拟手术的肺癌患者进行胸内探查，作胸膜胸膜、肺门大血管、肺门和纵隔淋巴取材病理学检查，以确定肺癌患者病理分期。结果 全组患者术前准确病理分期４８例，其中Ⅰ期１２例，Ⅱａ期８例，Ⅱｂ期１５例，Ⅲａ期５例，Ⅲｂ８例；术前胸腔镜分期后开胸术中发现不相符肺癌分期２例，均为Ⅲｂ期。结论 胸腔镜对拟行手术的肺癌患者进行胸内探查，可以明显地提高术前分期的准     

50例Ⅱb期宫颈癌患者术前放射治疗的护理干预

目的 解除患者对放射治疗的恐惧心理,正确了解放射治疗术前作用,减少手术时对正常组织的损伤及术后并发症发生,保证手术按时顺利完成.方法 对我院2008年3月-2009年4月50例Ⅱb期宫颈癌患者,进行术前放射治疗的护理干预,了解患者心理需求,进行针对性的术前干预.结果 50例患者中2例出现Ⅰ-Ⅱ骨髓抑制,1例发生Ⅱ度皮炎,1例发生直肠炎,经过治疗与护理,术前恢复正常.未其它并发症的发生.结论 全面了解患者的疾病及心理反应,合理运用医学知识结合熟练临床技术,进行系统规范的护理措施,使患者顺利完成术前放疗,保证手术按时顺利进行.     

33例肾母细胞瘤的放射治疗——远期疗效观察

本院1965年6月至1981年11月放射治疗肾母细胞瘤33例。按NWTS-Ⅲ分期,Ⅰ期12例,Ⅱ期8例,Ⅲ期12例,Ⅳ期1例。术前放射5例,术前放射加术后放射4例,术后放射24例,五年无瘤存活率52%(17/33),十年无瘤存活率42%(9/21),手术加放射的五年存活率45%(9/20),手术加放射及化疗的五年存活率62%(8/13)。讨论了远期疗效及有关肾母细胞瘤的放射治疗问题     

Ebstein心脏畸形的外科治疗

目的：总结Ｅｂｓｔｅｉｎ心脏畸形（Ｅｂｓｔｅｉｔ ａｎｏｍａｌｙ）手术治疗的经验,以提高临床治疗水平。方法：１９９０年５月至１９９８年１０月外科治疗Ｅｂｓｔｅｉｎｔ心脏畸形２７例,其中合并预激综合征６例。年龄４．５￣４３岁,平均２６．５岁。按ＮＹＨＡ推荐标准分级,术前功能Ⅰ组者２例,Ⅱ级者１２例,Ⅲ级者９例,Ⅳ级者４例。手术采用改良Ｄａｎｉｅｌｓｏｎ房化心室折叠术２２例,三尖瓣置换术５例,其中６例     

宫颈癌Ⅱb期27例手术疗效分析

宫颈癌Ⅱｂ期２７例均行广泛性全子宫＋双侧附件＋盆腔淋巴清扫术，５年随访结果，存活２０例（７４．１％），死亡７例，结果显示Ⅱｂ期宫颈癌的手术疗效与单纯放疗１或放疗后手术疗效接近，可成为无放疗设备医院治疗宫颈癌Ⅱｂ期的有效途径。     

老年妇女子宫颈癌手术与放射治疗的疗效分析

子宫颈癌是老年妇女（６０岁以上）妇科恶性肿瘤中最常见的疾病。我院１９９１年１月至１９９５年１０月共收治子宫颈癌６３０例,其中老年妇女宫颈癌Ⅰｂ～Ⅱｂ期９３例,占１５％。现将临床资料进行分析,以探讨Ⅰｂ～Ⅱｂ期子宫颈癌手术与放疗的疗效及影响预后的高危因...     

术前放射治疗对中晚期胃癌的临床疗效研究

目的探讨术前放射治疗对中晚期胃癌患者临床疗效的影响。方法选取2008年10月至2013年10月福建医科大学附属南平市第一医院收治的167例中晚期胃癌患者,根据有无进行术前放射治疗将患者分为两组:非放射治疗组(79例),患者均未进行术前放射治疗仅进行单纯手术切除;放射治疗组(88例),患者均先进行放射治疗再进行手术切除。分析两组患者的治疗有效率、根治手术切除率、手术病死率、并发症发生率及5年生存率。结果放射治疗组的治疗有效率(67.4%)、根治手术切除率(92.3%)、5年生存率(35.7%)均高于非放射治疗组的50.3%、82.0%、20.8%,差异有统计学意义(χ2=5.04,4.02,4.52,均P<0.05);放射治疗组手术病死率(2.5%)和非放射治疗组的1.4%比较,差异无统计学意义(P>0.05);放射治疗组并发症发生率(7.8%)和非放射治疗组的7.4%比较,差异无统计学意义(P>0.05)。结论中晚期胃癌患者手术前进行放谢治疗可提高根治手术切除率、治疗有效率和5年生存率,但对并发症发生率和手术病死率影响不大。     

提高晚期宫颈癌手术切除率的研究进展

宫颈癌是妇女常见的恶性肿瘤之。病死率居癌症的第2位，是危害妇女健康与生命的重要疾病。对宫颈癌是选择手术治疗还是放射治疗是多年来一直争论的问题，但大多数专家赞成早期病例(Ⅰ—Ⅱ)选择手术治疗，而对晚期(Ⅱh—Ⅳa)和局部晚期(局部肿瘤≥4cm)患者则采用放射治疗。近年来部分学者采用术前放疗、术前化疗和术前放化疗等综     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.