冷冻联合激光加重组人干扰素α-2b软膏治疗尖锐湿疣的疗效研究

目的探讨液氮冷冻联合CO2激光加重组人干扰素α-2b软膏治疗尖锐湿疣的疗效和不良反应。方法多发性尖锐湿疣患者180例,女性。随机分为3组,每组各60例患者。治疗组采用液氮冷冻联合CO2激光加重组人干扰素α-2b软膏治疗;激光组单纯采用CO2激光治疗,输出功率13～15 W;冷冻组单纯采用液氮冷冻治疗。术后15 d,1、2、3和6个月随访,观察并记录不良反应。结果三组的治愈率分别为96.7%、73.3%和70.0%,治疗组和激光组比较、治疗组和冷冻组比较差异均有显著意义(P<0.05),激光组与冷冻组比较,差异无显著意义(P>0.05)结论液氮冷冻联合CO2激光加重组人干扰素α-2b软膏治疗尖锐湿疣可提高治愈率,有效降低复发率。     

激光与液氮冷冻治疗脂溢性角化病对比观察

目的：对比激光与液氮冷冻治疗脂溢性角化病的疗效。方法：将脂溢性角化病128例随机分为观察组和对照组各64例,观察组采用调Q开关激光,波长532nm,脉冲频率1～5Hz,光斑直径2～3mm,根据患者年龄、部位、皮损厚度调能量密度1.0～4.3J对皮损均匀照射;对照组采用液氮冷冻治疗,治疗1个月后比较两组疗效。结果：治疗后对照组痊愈率为53.1%,色沉率30.2%,观察组痊愈率85.6%,色沉率5.0%,两组比较,差异均非常显著（P〈0.01）。结论：采用激光治疗脂溢性角化病,一次性治愈率高,色沉发生率低,具有较好的美容效果。     

卡介菌多糖核酸联合液氮冷冻治疗扁平疣的疗效观察

目的：观察卡介菌多糖核酸联合液氮冷冻治疗扁平疣的临床疗效、复发情况及不良反应。方法：75例扁平疣患者随机分为两组,对照组（n=37例）：仅采用液氮冷冻治疗,观察组（n=38例）采用卡介菌多糖核酸联合液氮冷冻治疗。比较两组临床疗效、不良反应发生率及治疗1年后复发率。结果：观察组治疗总有效率（92.1%）明显高于对照组（75.7%）,而复发率（7.9%）明显低于对照组（24.3%）（P〈0.05）;两组不良反应发生率比较无显著差异性（P〉0.05）。结论：卡介菌多糖核酸联合液氮冷冻治疗扁平疣疗效显著,复发率低,无明显不良反应,值得临床推广应用。     

局部氨基酮戊酸-光动力疗法联合CO_2激光治疗跖疣

目的比较CO2激光与局部氨基酮戊酸-光动力疗法(ALA-PDT)联合CO2激光治疗跖疣的疗效。方法跖疣患者70例,随机分成两组,每组35例。治疗组采用ALA-PDT联合CO2激光治疗,对照组仅采用CO2激光治疗。随访6个月,观察疗效和不良反应。结果治疗组痊愈17例、显效13例、进步4例、无效1例;对照组痊愈7例、显效14例、进步10例、无效4例。两组痊愈率和有效率比较差异有显著意义(P0.05)。随访6个月,治疗组复发2例(5.7%),对照组复发11例(31.4%),差异有非常显著意义(P0.01)。治疗组较对照组不良反应较轻。结论 ALA-PDT联合CO2激光治疗跖疣疗效优于单纯CO2激光治疗,不良反应轻,而且复发率明显降低。     

单独或联合Nd:YAG激光、CO2激光治疗化脓性肉芽肿的疗效比较

目的探求简单,安全,效果较好的治疗化脓性肉芽肿的激光手术方法.方法化脓性肉芽肿患者65例分为3组:Nd:YAG激光联合CO2激光治疗组(A组,22例)、CO2激光治疗组(B组,22例)和Nd:YAG激光治疗组(C组,21例),比较3组的手术中失血量、术后伤口愈合及瘢痕形成情况及一次性治愈率.结果一次性治愈率A组为100%,而B组和C组分别为95.5%和85.7%;A组患者术中出血少,手术时间短于B组,而伤口恢复快于C组患者;A组患者术后愈合良好,瘢痕表浅,明显轻于B、C组(P＜0.05);随访均无复发.结论Nd:YAG激光联合CO2激光治疗化脓性肉芽肿效果良好,无明显副作用,操作简单,值得推广.     

钬激光治疗多发性表浅膀胱肿瘤

目的 探讨钬激光治疗多发性表浅膀胱肿瘤的临床效果.方法 对43例多发性表浅膀胱肿瘤进行钬激光治疗,激光能量1.0～1.4 J,功率10～14 W,频率10 Hz.术后配合化疗药物或卡介苗灌注,观察其疗效.结果 41例应用钬激光将肿瘤顺利切除,2例改行开放手术.操作时间20～160 min,平均55 min.术后对38例进行了随访,随访时间6～24个月,3例复发.结论 钬激光治疗多发性表浅膀胱肿瘤操作较简单、对病人损伤小、疗效可靠.     

595 nm脉冲染料激光治疗儿童化脓性肉芽肿疗效观察

目的评价595 nm脉冲染料激光治疗儿童化脓性肉芽肿的疗效及安全性。方法采用595 nm脉冲染料激光治疗化脓性肉芽肿76例,治疗直径3 mm的化脓性肉芽肿,采用小光斑、大能量的治疗方法,光斑直径3 mm,脉宽1.5～3 ms,能量密度15～21 J/cm~2;1个月后复查,疗效不佳者进行二次治疗直到皮损消失。结果 595 nm脉冲染料激光治疗化脓性肉芽肿的1次治愈率为60例(78.95%),总治愈率为76例(100.0%),出现轻度色素沉着者4例(5.26%),色素减退者2例(2.63%)。无一例浅表瘢痕、凹陷性瘢痕,随访3个月无复发。结论 595 nm脉冲染料激光治疗儿童化脓性肉芽肿安全有效。     

火针联合 308 nm 准分子激光治疗白癜风疗效分析

【摘要】 目的 研究分析火针联合 308 nm 准分子激光治疗白癜风的临床疗效。方法 选取2018年10月至2020年10月台前县夹河中心乡卫生院收治的85例白癜风患者 (255处皮损)作为研究对象,按照随机数表法将其随机分为观察组42例 (123处皮损) 和对照组43例(132处皮损),观察组患者采用火针联合308 nm 准分子激光治疗,对照组患者单纯采用308 nm 准分子激光治疗,对比观察两组患者皮损面积、复色率、见效时间、临床疗效以及不良反应发生情况。结果 治疗结束后,观察组患者皮损面积明显小于对照组 (t = 27.030,P <0.001),复色率明显高于对照组 (Z = - 17.691,P < 0.001),见效时间明显短于对照组 (Z = - 6.554,P <0.001); 观察组患者中皮损痊愈36处、显效46处、好转19处、无效22处,明显优于对照组患者的皮损痊愈25处、显效41处、好转32处、无效34处 (Z = - 2.623,P = 0.009)。其间,观察组患者不良反应发生率为1.63%,与对照组患者的不良反应发生率 0.76%无明显差异 (χ2 =0.413,P =0.520)。结论 与单纯应用308 nm准分子激光治疗相比,火针联合 308 nm 准分子激光可明显缩短白癜风皮损处肤色恢复时间,缩小皮损面积,提高复色率,疗效显著。     

单独或联合Nd∶YAG激光、CO_2激光治疗化脓性肉芽肿的疗效比较

目的探求简单,安全,效果较好的治疗化脓性肉芽肿的激光手术方法。方法化脓性肉芽肿患者65例分为3组:Nd∶YAG激光联合CO2激光治疗组(A组,22例)、CO2激光治疗组(B组,22例)和Nd∶YAG激光治疗组(C组,21例),比较3组的手术中失血量、术后伤口愈合及瘢痕形成情况及一次性治愈率。结果一次性治愈率A组为100%,而B组和C组分别为95.5%和85.7%;A组患者术中出血少,手术时间短于B组,而伤口恢复快于C组患者;A组患者术后愈合良好,瘢痕表浅,明显轻于B、C组(P<0.05);随访均无复发。结论Nd∶YAG激光联合CO2激光治疗化脓性肉芽肿效果良好,无明显副作用,操作简单,值得推广。     

复方樟柳碱治疗继发性缺血性眼底病临床疗效

目的:探讨复方樟柳碱治疗继发性缺血性眼底病的有效性及安全性.方法:自2012年1月～2014年10月我科共收治125例(146眼)继发性缺血性眼底病患者为研究对象,按照入院顺序随机分为对照组(73眼)和观察组(73眼).对照组给予维生素、路丁、肌苷等常规治疗;观察组在对照组基础上给予复方樟柳碱皮下注射,2mL/次,1次/天.14d为一疗程.治疗3个疗程,观察比较两组患者治疗前后视力变化情况.比较两组患者临床疗效及不良反应发生率.结果:治疗前两组患者视力情况比较差异无统计学意义(P＞0.05);治疗后,观察组患者视力恢复情况显著优于对照组(P＜0.05).观察组有效率显著高于对照组(97.3％ VS82.2％,x2=8.990,P=0.003),不良反应发生率高于对照组(4.1％VS 2.7％),但差异无统计学意义(x2=0.000,P=1.000).结论:复方樟柳碱对于继发性缺血性眼底病的治疗具有良好的疗效,对改善患者预后具有正向意义,值得在临床上推广应用.     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.