利多卡因联合地塞米松治疗甘露醇外渗损伤的实验研究

目的 探讨利多卡因联合地塞米松局部封闭治疗20%甘露醇外渗4 h后局部损伤的效果.方法 将7只小白鼠四肢内侧制成20%甘露醇外渗模型.4 h后,随机抽取1只小白鼠于四肢注射部位取材(E组),观察甘露醇外渗致局部组织损伤情况;其余6只按模型部位分为A组(左上肢),B组(左下肢)、C组(右上肢)及D组(右下肢).A组予2%利多卡因2 ml加地塞米松1 mg局部封闭,B组予2%利多卡因2 ml局部封闭,C组予生理盐水局部封闭,D组为空白对照.处理24 h后取材进行病理学观察.结果 光学显微镜观察显示,E组局部组织损伤呈重度表现;A组呈无或轻度表现,轻于B组、C组、D组和E组;B组以中度为主,轻于C组、D组(均呈重度)和E组.结论 甘露醇外渗后4 h组织损伤严重,外渗后需及时采取有效措施,避免组织损伤加重;利多卡因联合地塞米松封闭治疗甘露醇外渗4 h形成的局部组织损伤快速、简便并安全有效.     

低浓度5-FU与糖皮质激素联合治疗胸骨前瘢痕疙瘩的疗效分析

目的 探讨低浓度(0.25%)5-氟尿嘧啶(5-FU)与糖皮质激素混合注射治疗胸骨前瘢痕疙瘩的效果.方法 将本组的98例患者(共有167个胸骨前瘢痕疙瘩,病史1～42年)分成A、B、C三组,均行瘢痕疙瘩全层注射.对A组的22例患者行单纯5-FU(2.5% 5-FU 0.6 ml 2%利多卡因5.4 ml)注射,对B组的22例患者行单纯5-FU和糖皮质激素(1%曲安奈德5 ml 2%利多卡因1 ml)交替注射,对C组的54例患者行5-FU与糖皮质激素的混合液注射(2.5% 5-FU 0.6 ml 1%曲安奈德5 ml 2%利多卡因0.4 ml).在瘢痕疙瘩完全萎缩后,逐渐降低药物浓度,并延长注射间隔期.治疗次数为6～22次,治疗3～36个月,随访6～26个月.结果 局部注射低浓度5-FU,能够减轻瘢痕的充血程度和痛痒症状(有效率均为95.5%),但只有在与糖皮质激素交替或联合使用后,才能促使瘢痕明显萎缩(P＜0.05),而联合使用比交替使用更为有效(P＜0.05).结论 低浓度5-FU与糖皮质激素联合治疗胸骨前瘢痕疙瘩,具有较良好的疗效.     

中老年女性尿道综合征合并精神症状的治疗

目的：探索中老年女性尿道综合征合并精神症状的治疗方法。方法：对103例合并精神症状的尿道综合征患者随机分为A、B两组。A组口服尼尔雌醇2mg/2 周;B组除口服尼尔雌醇2mg/2周外,加服镇静抗抑郁药：奋乃静2mg,tid,非那根25mg,tid;分别于第4、8周观察比较。对两组中精神症状缓解不明者转第二阶段,除上述抗抑郁药外,每晚加用安定10mg肌注,尿道局部封闭及利多卡因灌注,同时给予精神暗示等综合治疗,于第1、2、3、4周观察疗效。统计学方法采用X^2检验。结果：A组仅2例缓解（2／46）,B组49例缓解（49／57）,两组相比差异有显著性意义（P＜0．01）。第二阶段综合治疗前后对比,52例中49例缓解（P＜0．01）。结论 加用镇静及抗抑郁药对缓解中老年女性尿道综合征并精神症状效果明显,采用综合治疗对症状严重者更有效。     

冷敷联合表面麻醉预处理在透明质酸注射填充鼻唇沟中的应用

目的探讨冷敷联合表面麻醉在透明质酸注射填充鼻唇沟中对求美者疼痛缓解情况和舒适度的影响。方法自2018年10月至2019年1月,对60例透明质酸注射填充鼻唇沟的求美者,采用随机数字表法分为冷敷联合表面麻醉组(A组)和表面麻醉组(B组),每组各30例。A组先在注射区域外敷复方利多卡因乳膏20 min,接着冷敷5 min,之后进行注射治疗,治疗结束后继续冷敷5 min;B组仅于治疗前外敷复方利多卡因乳膏20 min。在注射治疗穿刺即刻(T0)、穿刺1 min(T1)、结束即刻(T2)及结束后10 min(T3),采用疼痛数字评分法(numerical rating scale, NRS)对两组求美者进行疼痛评分。术后30 min评估注射点出血、淤青及注射区肿胀等皮肤出现的症状,并随访求美者的满意度。结果 A组和B组在T0、T1、T2、T3时注射点NRS评分差异均有统计学意义。A组的NRS评分低(P0.05);皮肤症状发生率低(χ2=5.079,P=0.024);求美者满意度高(Z=-2.752,P=0.006)。结论采用冷敷联合表面麻醉可以缓解透明质酸注射填充鼻唇沟治疗时的疼痛,并减轻注射后局部并发症。求美者满意度和接受度均较高。     

关节内注射富血小板血浆与玻璃酸钠治疗膝关节骨关节炎的对比研究

目的比较富血小板血浆(platelet-rich plasma,PRP)与玻璃酸钠(hyaluronic acid sodium,HA)治疗膝关节骨关节炎(knee osteoarthritis,KOA)的近期疗效。方法 2013年3月~2014年1月,将60例KOA按就诊顺序依次分至A、B、C组,每组20例。A组膝关节内注射自体PRP 5 ml,B组膝关节内注射HA 2 ml,C组膝关节内先注射PRP 5 ml,10 min后注射HA 2ml。每周一次,连续5周。治疗结束后4周采用Lysholm膝关节评分系统进行评价。结果 A组、C组各1例注射PRP后出现短暂膝关节炎症反跳,其余患者均未出现并发症。3组治疗后4周Lysholm膝关节评分较治疗前均有明显提高(A组42.3±10.5 vs.54.3±10.4,t=-7.086,P=0.000;B组41.6±10.0 vs.54.2±9.1,t=-5.450,P=0.000;C组41.8±10.4 vs.66.8±7.2,t=-12.887,P=0.000),且C组明显高于A、B组(F=12.982,P=0.000)。C组有效率(60%,12/20)明显高于A组(20%,4/20)和B组(20%,4/20)(χ2=9.600,P=0.008)。治疗前后血常规和肝、肾功能均未出现异常。结论膝关节腔注射PRP联合HA可以迅速控制疼痛并改善患者膝关节功能,具有显著的近期疗效,是治疗KOA的一种安全有效的方法,长期疗效有待继续观察。     

小针刀基础上联合改良骶管注射治疗腰椎间盘突出症的临床观察

目的探讨小针刀联合改良骶管注射药物治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法自2014-09-2016-09,纳入90例保守治疗的LDH患者,采用随机数字表法将其分为三组各30例:A组均采用改良骶管注射疗法治疗,B组均采用小针刀治疗,C组均采用改良骶管注射疗法联合小针刀治疗。三组均为7 d治疗1次,共3次为一个疗程。3次后进行疗效观察及组间对比。结果三组治疗后,其VAS评分、M-JOA评分均较治疗前显著改善,差异均有统计学意义(P0.05);但C组治疗后的两项评分显著优于A、B两组(均为P0.05),A、B组间无统计学差异(P0.05)。1个疗程后,A组总有效率为76.7%,B组为80%,C组为90%;A、B两组总有效率均显著低于C组(P0.05)。结论小针刀与骶管注射药物治疗LDH均可取得良好疗效;将两者联合应用,可进一步降低患者疼痛、改善日常活动能力,提高总体疗效。     

尿道旁注射治疗女性尿道周围腺炎所致顽固性尿道痛初步探讨

目的 探讨尿道旁注射(利多卡因+头孢曲松钠+地塞米松)治疗对抗生素无效的女性尿道周围腺炎所致顽固性尿道痛的可行性及临床疗效.方法 本组12例患者,女性,已婚,年龄38～ 72岁,病史最短4年,最长30年.金属尿道探条引导下,于尿道旁5、7点位置注射生理盐水5ml+碳酸利多卡因5ml+头孢曲松钠1g+地塞米松5mg,一周两次,两周为一个疗程.结果 12例患者都能顺利完成尿道旁注射,无不良反应发生.10例患者注射一个疗程后疼痛完全缓解;2例注射两个疗程后较注射前疼痛明显改善,主诉满意.平均随访6(2 ～12)个月,患者顽固性尿道痛都明显缓解,无一例复发.结论 尿道旁注射能安全、快速、有效缓解女性尿道周围腺炎所致顽固性尿道痛,提高生活质量,是治疗女性顽固性尿道疼痛一种简单有效的方法,值得临床推广.     

肛肠病手术超前镇痛联合术后局部注射镇痛效果的临床研究

为观察高乌甲素超前镇痛加亚甲蓝长效止痛剂局部注射对肛肠病患者进行术后镇痛的效果,将300例拟行手术治疗的肛肠病患者随机分为A、B、C三组,各100例,镇痛方式：A组术前3h肌肉注射氢溴酸高乌甲素8mg,术后于创面局部点状注射亚甲蓝长效止痛剂（亚甲蓝20mg、2％利多卡因5ml、注射用水10ml的混合液）;B组仅术后于创面局部点状注射亚甲蓝长效止痛剂;C组仅术后口服曲马多缓释片。对比观察三组患者的术后镇痛效果。结果显示,（1）肛门疼痛VAS评分：A组患者术后6～72h几乎无痛。术后6h、24h肛门疼痛VAS评分A组均低于B、c组,P〈0．05或P〈0．01。术后72h肛门疼痛VAS评分A组与B组比较差异无统计学意义,P〉0．05;但A组、B组均明显低于C组,P〈0．01。（2）镇痛效果：A组患者术后6～72h镇痛效果均为优。术后6h、24h镇痛效果A组均明显优于B、c组,P〈0．01。术后72h镇痛效果A组与B组比较差异无统计学意义,P〉0．05;但A组、B组均明显优于C组,P〈0．01。结果表明,高乌甲素超前镇痛加亚甲蓝长效止痛剂局部注射对肛肠病患者进行术后镇痛操作简单,安全,效果满意。     

曲安奈德皮损内注射联合CO_2点阵激光治疗增生性瘢痕的临床观察

目的探讨曲安奈德皮损内注射联合CO_2点阵激光治疗增生性瘢痕的临床效果。方法选取2015年1~9月收治的增生性瘢痕患者135例,依据随机数字表法随机分为观察组、对照组A和对照组B,每组45例。对照组A:给予曲安奈德与利多卡因混合液0.2ml/cm~2;对照组B:给予CO_2点阵激光治疗,每4周治疗1次,一个疗程6次;观察组:采用曲安奈德皮损内注射联合CO_2点阵激光治疗。同时评估3组临床治疗后效果,记录并比较患者治疗前后的瘢痕厚度、VSS评分变化以及治疗后不良反应的发生情况。结果治疗后,观察组、对照组A、对照组B的临床总有效率分别为97.78%、86.67%、82.22%;观察组的临床显效率显著高于对照组A、对照组B,其组问差异具有统计学意义(P0.05);观察组患者的瘢痕厚度、VSS评分改善优于对照组A和对照组B,组间差异具有统计学意义(P0.05)。观察组与对照组B的不良反应发生率显著低于对照组A,其组间差异具有统计学意义(P0.05)。结论增生性瘢痕患者行曲安奈德皮损内注射联合CO_2点阵激光治疗,能够降低患者的瘢痕厚度以及VSS评分,提高治疗有效率,且不良反应发生率低,值得临床推广应用。     

不同方法治疗肩周炎90例临床观察

目的　探讨用不同方法治疗肩周炎并观察其疗效。方法　选择 90 例肩周炎患者,随机分成三组,每组30例。采用三种不同方法,进行临床观察:A组口服芬必得每次 0 6 g,每日 2 次,盘龙七每次0 6 g,每日3次,10 d为1疗程;汽化药热疗,每日1次,10 d为1疗程;功能锻炼,每日数次。B组肩胛上神经阻滞(1%利多卡因 10 ml+醋酸强的松龙 25 mg+ VitB1 100 mg+ VitB12 500μg),口服盘龙七+汽化药热疗+功能锻炼。C组肌间沟臂丛神经阻滞(1%利多卡因 10 ml),待阻滞完善后行手法松解肩关节的粘连,松解粘连后采用痛点阻滞(2%利多卡因 2 ml+醋酸强的松龙 25mg+VitB1 100 mg+VitB12 500μg),口服盘龙七+功能锻炼。结果　三组治愈率:A组 13%,B组66%,C组93%。C组明显优于A、B组(P<0 .05)。结论　综合疗法是治疗肩周炎较理想的治疗方法。     

尿动力学检查在女性尿道综合征的应用（附160例分析报告）

为探讨尿动力学检查(UDS)在女性尿道综合征(FUS)的临床价值,应用Laborie公司Encore 5.7尿动力分析仪检查FUS160例。结果发现剩余尿>50ml者占34.4％,初尿意尿量<60ml者28.1％,60～100ml者25.4％,由于有剩余尿和产生初尿意的尿量较少,产生初尿意的实际增加尿量更少,这些都可能是产生尿道综合征症状的部分原因。本组膀胱逼尿肌收缩无力或减弱55例,占34.4％,单纯使用平滑肌兴奋剂,如新斯的明和加兰他敏等提高了疗效。认为尿动力学检查女性尿道综合征患者,有助于了解其病因,分类治疗能提高疗效。     

Management of diverticular fistulae to the female genital tract

OBJECTIVE: Fistulae to the female genital tract are an infrequent but severe complication of diverticular disease. The purpose of this study was to evaluate treatment and outcome in patients with diverticular colo-genital fistulae. METHOD: Sixty women treated for diverticular fistulae (DF) to the female genital tract during 1992-2004 were identified. Clinic and operative charts were reviewed. Mean age was 70 years and mean follow-up time after surgery was 1 year. RESULTS: Most common presenting symptoms were vaginal discharge of faeces or gas (95% of patients) and abdominal pain (43%). About 75% of patients had undergone a hysterectomy. Forty-six patients underwent at least one radiological contrast study and the fistula was demonstrated in 35 (76%) patients. Fifty-seven patients had surgery, and findings included colo-vaginal fistulae (n = 47), colo-uterine fistulae (n = 2) and multiple fistulae involving vagina and other organs (n = 8). A sigmoid resection and primary anastomosis was performed in 51 and a Hartmann procedure with colostomy in six patients. Sixteen (28%) patients experienced morbidity after surgery, including anastomotic dehiscence (n = 4) and ureteric injury (n = 3). There was no mortality. CONCLUSION: Diverticular fistulae to the female genital tract usually occur in elderly patients with a prior hysterectomy. Radiological contrast studies demonstrate the fistulous tract in most cases. Sigmoid resection and primary anastomosis results in a satisfactory outcome in the majority of patients.     

Local anaesthetic and steroid combined injection therapy in the management of non-cyclical mastalgia

AIMS: We aimed to assess the effectiveness of a local anaesthetic and steroid combination injection therapy in the management of non-cyclical mastalgia. METHODS: Patients with non-cyclical mastalgia were assessed for rib tenderness (lateral chest wall tenderness-LCWT). The tenderest spot was injected with a combined preparation of 1 ml 2% lignocaine and 1 ml 40 mg depomedrone. Those who declined injection therapy were advised on topical or oral NSAIDs or reassurance. All patients were reassessed 6 weeks later. A successful outcome was taken as either a complete response (CR) or partial response (PR), i.e. pain although present is tolerated. RESULTS: One hundred and thirty eight women were diagnosed with LCWT. One hundred and four women were injected. Thirty-four women declined and were managed appropriately. At assessment 83 injected cases were successful (83%; CR n = 61, PR n = 22) compared to 13 non-injected cases (44.8%; CR n = 5, PR n = 8, P < 0.0001). No side effects were recorded. Sixteen cases recurred and were successfully re-injected. CONCLUSIONS: A steroid and local anaesthetic injection is an effective and safe treatment for LCWT.     

The comparison of artificial urinary sphincter implantation and endourethral macroplastique injection for the treatment of postprostatectomy incontinence

OBJECTIVES: To compare the effectiveness of macroplastique injection with artificial urinary sphincter implantation (AUS) for treatment of postprostatectomy incontinence (PPI). METHODS: A prospective randomized clinical trial including 45 patients with PPI was performed secondary to radical retropubic prostatectomy (RRP), transvesical prostatectomy (TVP), transurethral prostatectomy (TURP), and TURP with TVP, in 12, 16, 16, 1 patients respectively. Patients were divided into two groups as minimal (group I) and total incontinence (group II) according to the severity of incontinence. Respectively, Group I (n = 21) and group II (n = 24) patients were randomized as AUS implantation (n = 11, n = 11) and macroplastique injection (n = 10, n = 13). Follow-up period was 48 (6-84) months in patients with macroplastique injection and 60 (8-120) months in AUS implantation. The success of the treatment was evaluated by calculating the average number of pads used by the patient per day, the weight of the pads and score of quality of life survey scale for each group both in the preoperative and in the postoperative period. RESULTS: There were statistically significant differences between preoperative and postoperative average pad weight, average number of pads and quality of life scores, both in patients with minimal and total incontinence. In group I there was no statistically significant difference between the two techniques. However, in group II there was a significant difference favoring AUS implantation. CONCLUSIONS: Endourethral injection should be the treatment of choice for patients with minimal incontinence, whereas AUS implantation as the first choice for patients with total incontinence.     

The utility of fluorescence in situ hybridization (FISH) in the diagnosis of myxoid soft tissue neoplasms

Diagnosing myxoid soft tissue neoplasms can be challenging because of overlapping histologic features. Distinct chromosomal translocations have been identified in several myxoid sarcomas, including t(12;16)(q13;p11) FUS-DDIT3 in myxoid liposarcoma, t(7;16)(q34;p11) FUS-CREB3L2 in low-grade fibromyxoid sarcoma, and t(9;22)(q31;q12) EWSR1-NR4A3 in extraskeletal myxoid chondrosarcoma. These recurrent chromosomal alterations are attractive targets for diagnostic studies. To that end, dual-color, break-apart fluorescence in situ hybridization (FISH) probes spanning the genomic regions of EWSR1 (22q12), DDIT3 (12q13), and FUS (16p11) (Vysis, Downer's Grove, IL) were evaluated in formalin-fixed, paraffin-embedded tissues from myxoid neoplasms, including intramuscular myxoma (n=10), myxoid liposarcoma (n=18), low-grade fibromyxoid sarcoma (n=10), extraskeletal myxoid chondrosarcoma (n=13), and myxofibrosarcoma (n=8). Of the myxoid liposarcomas, 18/18 cases had a rearrangement of the DDIT3 gene, with 17/18 (94.4%) showing both DDIT3 and FUS gene rearrangements. A FUS gene rearrangement was identified in 7/10 (70%) of low-grade fibromyxoid sarcomas, with no changes involving EWSR1 or DDIT3. An EWSR1 translocation was seen in 6/13 (46.2%) of extraskeletal myxoid chondrosarcomas, without changes in DDIT3 or FUS genes. The remaining neoplasms studied showed no rearrangements involving DDIT3, FUS, or EWSR1 genes. In conclusion, interphase FISH using DDIT3 and FUS probes identifies the characteristic translocation in myxoid liposarcoma. FUS and EWSR1 probes are useful in confirming the diagnosis of low-grade fibromyxoid sarcoma and extraskeletal myxoid chondrosarcoma, respectively. The specificity of the probes is documented as none of the non-translocation-associated myxoid tumors showed genomic abnormalities with the probes tested. FISH is capable of providing specific ancillary information useful in this often difficult differential diagnosis.     

Ultrasound-guided thrombin injection of iatrogenic femoral pseudoaneurysms: a prospective analysis

An adverse consequence of the use of the femoral artery for the endovascular evaluation and treatment of arterial disease is the increased incidence of iatrogenic femoral pseudoaneurysms. Although surgical repair has traditionally been used to treat such aneurysms, less invasive modalities have emerged. The purpose of this study is to prospectively evaluate ultrasound-guided thrombin injection (UGTI) for the treatment of iatrogenic femoral pseudoaneurysms. A treatment protocol was approved and 30 stable patients (21 female; age range 43-85 years; mean 67 years) were prospectively enrolled from December 1997 through June 1999 to undergo UGTI on 30 iatrogenic femoral pseudoaneurysms. Pseudoaneurysms occurred after cardiac intervention (n = 22, 73%), peripheral intervention (n = 7, 23%), and after a femoral line placement (n = 1, 3%). They ranged in size from one to 5 cm with a time interval from intervention until UGTI of one to 132 days (median 3 days). Eleven patients (37%) were systematically anticoagulated at the time of UGTI. All pseudoaneurysms were treated using sterile technique and local anesthesia with ultrasound-guided injection via a 20-gauge spinal needle of 0.1 to 2 cm3 (median 0.6 cm3) of 1000 units/cm3 topical thrombin solution administered by one of six physicians. A period of bedrest for 4 to 6 hours after injection was followed by repeat groin duplex scan at 24 hours and a clinical follow-up at 30 days. There were no procedural deaths or nonvascular complications. Twenty-seven (90%) UGTIs resulted in successful pseudoaneurysm ablation with no recurrences at 24 hours or 30 days. Two (7%) UGTIs failed and one (3%) femoral artery embolic complication occurred; all were successfully treated with surgery. Success appeared to be independent of anticoagulation status, pseudoaneurysm age, size, or operator experience. We conclude that UGTI is a safe, easy, well-tolerated and effective noninvasive method for treatment of iatrogenic femoral pseudoaneurysms and should be considered in all stable patients before operative repair.     

The role of tumor ablation in bridging patients to liver transplantation

HYPOTHESIS: Treatment of hepatocellular carcinoma before liver transplantation can curb local tumor progression and thereby prolong patients' transplantation eligibility. DESIGN: Retrospective case-control pilot study. Twelve of 39 patients receiving liver transplantation for hepatocellular carcinoma had treatment before transplantation. Pretreatment included radiofrequency ablation (n = 8), percutaneous ethanol injection (n = 2), both modalities (n = 1), and tumor resection (n = 1). Twelve control subjects without pretreatment who were age-, sex-, and score-matched on the Model for End-stage Liver Disease and Child-Turcotte-Pugh classification were selected. The primary outcome measure was the waiting period for transplantation. RESULTS: Patients with pretreatment waited on the transplant list significantly longer than their counterparts without pretreatment (median, 484 vs 253 days; P =.03). CONCLUSIONS: Treatment before transplantation with tumor ablation or resection is associated with a longer waiting period on the transplant list. This enables patients who might otherwise be removed from the list because of tumor progression to receive transplantation.     

女性尿道综合征的诊断与治疗(附36例报告)

目的探讨女性尿道综合征的可能病因与最佳治疗方式。方法对36例临床诊断女性尿道综合征的患者,进行尿流率、尿动力学检查。除应用一般解痉、镇静、a-受体阻滞剂等治疗外,根据检查有针对性地加用尼尔雌醇片,少数患者应用尿道扩张,尿道口成形术。结果所有患者未发现尿路器质性病变。更年期(12例)与绝经后(20例),加用尼尔雌醇,症状改善,达到治愈;育龄期治疗困难,加用尿道扩张,尿道口阴道口间距延长术,3例获治愈,1例效果不佳,仍在诊治中。结论女性尿道综合征病因复杂,尿道高压,不稳定膀胱占绝大多数。雌激素下降,阴道、尿道粘膜萎缩是老年女性尿道综合征的主要病因,治疗上宜加用尼尔雌醇;育龄期女性尿道综合征治疗困难,必要时行尿道扩张或尿道整形,才能收到满意效果。     

A prospective phase II trial of ONYX-015 adenovirus and chemotherapy in recurrent squamous cell carcinoma of the head and neck (the baylor experience)

Background: The E1-b attenuated adenovirus, ONYX-015 (Onyx Pharmaceuticals, Richmond, CA), has demonstrated antitumoral activity in patients with recurrent squamous cell carcinoma of the head and neck. This study evaluated the effects of intratumoral ONYX-015 injection combined with systemic chemotherapy. Methods: Inclusion criteria included: (1) recurrent squamous cell carcinoma of the head and neck, not surgically salvageable, (2) target tumor amenable to direct injection, and (3) no prior chemotherapy for recurrent disease. Patients received ONYX-015 (10¹⁰ plaque-forming units) intratumorally for 5 days, cisplatin (80 mg/m²) on day 1, and 5-fluorouracil (800–1000 mg/m²) on days 1–5. This cycle was repeated every 3 weeks. Serial physical examination and computed tomography were used to assess tumor size and treatment response. Results: Fourteen patients were enrolled, and nine patients were evaluable for response at the time of enrollment. The mean age of the evaluable patients was 60.8 years (range, 46–71 years). Mean maximum tumor diameter was 4.8 cm (range, 1.9–10.5 cm). Treatment-related toxicity included nausea (n=7, 77.8%), vomiting (n=5, 55.6%), mucositis (n=5, 55.6%), pain at the injection site (n=5, 55.6%), constipation (n=4, 44.4%), and fatigue (n=4, 44.4%). Locoregional tumor control was obtained in all nine patients (100%) (mean observation time, 157 days). Complete clinical response was seen in three patients (33.3%), partial response was seen in three patients (33.3%), minor response was seen in one patient (11.1%), and two patients (22.2%) had stable disease. Median time to local progression of disease has not been reached (range, 35–356 days). Conclusions: ONYX-015 adenovirus plus systemic cisplatin and 5-fluorouracil provides antitumor activity and local tumor control in patients with recurrent squamous cell carcinoma of the head and neck. This novel treatment approach offers hope for patients with limited treatment alternatives and provides the foundation for a phase III clinical trial. Presented at the 53rd Annual Meeting of the Society of Surgical Oncology, New Orleans, Louisiana, March 16–19, 2000.     

血液透析病人透析器首次使用综合征预处理的探讨

目的探讨减少血液透析病人出现透析器首次使用综合征 (FUS)的护理方法。方法将首次使用透析器的 10 8例病人随机分为治疗组与对照组各 5 4例。治疗组在血液透析前予地塞米松 5mg加入 0 .9%氯化钠注射液 5 0 0ml中循管 10min ;对照组仅用 0 .9%氯化钠注射液 5 0 0ml循管 10min。结果治疗组FUS发生率 3.7% ,对照组31.5 % ,两组比较 ,差异有显著性意义 (P <0 .0 1) ;两组均无出血征象 ,透析开始后 1、2hAPTT值比较 ,差异均无显著性意义 (P >0 .0 5 )。结论血液透析病人第 1次透析或更换不同类型透析器时使用地塞米松 5mg加入 0 .9%氯化钠注射液 5 0 0ml中循管 10min的预处理方式能减少FUS的发生 ,且不增加出血风险。