麝甲消痛膏治疗乳腺增生症疗效观察

目的观察外用贴敷麝甲消痛膏治疗乳腺增生的临床疗效。方法将76例乳腺增生症患者随机分为两组,麝甲消痛膏组40例（观察组）,口服乳癖消对照组36例。结果观察组痊愈18例,显效15例,有效7例,总有效率为100％;对照组痊愈2例,显效3例,有效26例,无效5例,总有效率为86．2％;两组差异有显著性（P〈0．05）。结论麝甲消痛膏治疗乳腺增生症疗效好于口服乳癖消组。     

韭菜子治疗顽固性呃逆疗效观察

目的观察口服韭菜子煎剂治疗顽固性呃逆的临床疗效。方法将60例顽固性呃逆患者随机分为韭菜子治疗组（A组）和山莨菪碱治疗组（B组）,每组各30例。A组予口服韭菜子煎剂100ml,3次／d;B组予肌肉注射山莨菪碱10mg,3次／d。两组均治疗2d,观察疗效。结果A组总有效率为93．3％,B组总有效率为56．7％。A组疗效优于B组（P〈0．05）。结论口服韭菜子煎剂治疗顽固性呃逆有较好的临床疗效。     

思密达山莨菪碱治疗呼吸衰竭并发上消化道出血的临床疗效观察

目的观察应用思密达与山莨菪碱治疗呼吸衰竭并发的上消化道出血的临床疗效。方法83例病人分为三组。A组口服或鼻饲思密达和山莨菪碱混合剂；B组鼻饲或口服奥美拉唑胶囊。C组静脉滴注雷尼替丁。结果A组治疗总有效率89．66％与B组（96，15％）比较疗效相近，P〉0.05，B组药有加重气道阻塞副作用。A组与C组（总有效率67．86％）比较A组明显好于C组，P〈0．05。结论思密达与山莨菪碱混合剂是治疗呼吸衰竭并发的上消化道出血有效药物之一，副反应小。     

马来酸曲美布汀联合双歧四联活菌治疗肠易激综合征的临床疗效观察

目的观察马来酸曲美布汀联用双歧四联活菌对肠易激综合征（IBS）的疗效。方法85例IBS患者，随机分成2组：马来酸曲美布汀＋双歧四联活菌组（治疗组A组）45例及复合维生素B＋多酶片组（对照组B组）40例。马来酸曲美布汀0．1，每日三次，联用双歧四联活菌1．5，每日三次，治疗两周；复合维生素B2片，每日三次，联用多酶片3片，每日三次，治疗两周。记录治疗前后症状和不良反应并进行评分。结果A组的总有效率93．3％，B组的总有效率22．5％。无1例严重的不良反应发生。A组与B组间存在显著性差异（P〈0．005）。结论马来酸曲美布汀联用双歧四联活菌治疗IBS近期疗效确切，病人依从性好，值得推广应用。     

维生素B2联合葡萄糖酸锌治疗复发性口腔溃疡疗效观察

目的：观察维生素岛联合葡萄糖酸锌治疗复发性口腔溃疡（ROU）的临床疗效。方法：选择ROU90例,随机分为观察组与对照组各45例。观察组采用口服维生素B2片和葡萄糖酸锌片治疗,对照组口服维生索B2片和维生素C片,比较两组疗效。结果：观察组显效32例,有效11例,无效2例,总有效率为95．6％;对照组显效9例,有效14例,无效22例,总有效率为51．1％。两组总有效率比较,差异非常显著（P〈0．01）。结论：维生素B2联合葡萄糖酸锌治疗ROU疗效显著。     

复方甘草甜素联合地氯雷他定治疗慢性荨麻疹疗效观察

目的观察复方甘草甜素片联合地氯雷他定治疗慢性荨麻疹的临床疗效。方法选择本院门诊慢性荨麻疹患者，随机分为治疗组37例，对照组33例，治疗组口服复方甘草甜素片50mg，3次／日，地氟雷他定5mg，1次／日，对照组仅口服地氟雷他定，疗程均为4周。结果治疗组有效率83．78％，对照组57．58％，两种有效率比较有显著性差异（P〈0．001）。结论复方甘草甜素片联合地氯雷他定治疗慢性荨麻疹的疗效确切。     

曲安奈德局部注射治疗糜烂型口腔扁平苔藓疗效观察

目的：观察曲安奈德局部注射治疗糜烂型口腔扁平苔藓的效果。方法：将糜烂型口腔扁平苔藓（OLP）68例分为两组，治疗组（46例）采用醋酸曲安奈德与利多卡因混合液于病损区基底部分点注射；对照组（22例）采用口服泼尼松片疗法。比较两组疗效、用药后不良反应及1年后随访复发率。结果：治疗组痊愈率21．7％，总有效率91．3％，药物不良反应率4．4％及1年随访复发率63．0％；对照组痊愈率13．6％，总有效率72．7％，药物不良反应率77．3％及1年随访复发率68．2％。两组治疗总有效率比较，差异显著（P〈0．05）；药物不良反应率比较，差异非常显著（P〈0．01）；1年随访复发率比较，差异不显著（P〉0．05）。结论：本疗法为治疗糜烂型OLP的一种有效、安全、近期疗效肯定的方法。     

莫沙必利联合兰索拉唑治疗功能性消化不良临床分析

目的：评价兰索拉唑与莫沙必利联合治疗功能性消化不良的疗效。方法：将70例患者随机分为3组。A组（20例）口服兰索拉唑30mg,1次／d,B组20例,口服莫沙必利5mg,1次／d,C组30例,口服兰索拉唑30mgl次／d,和莫沙必利5mgl;k／d,疗程均为2周。结果：C组总有效率为83．3％,治愈率为60．0％,均明显优于A组和B组,且有显著性差异（P〈0．05,P〈0．01）。结论：兰索拉唑与莫沙必利联合治疗能有效缓解功能性消化不良的症状,疗效明显,安全可靠。     

上消化道炎性病变伴幽门螺杆菌感染再生修复疗效观察

目的：观察美宝胃肠胶囊对上消化道炎症病变（消化性溃疡、炎症）实施再生修复疗法的治疗效果及对伴幽门螺杆菌（HP）感染的清除作用，寻找伴幽门螺杆菌感染的上消化道炎性病变的理想治疗方法。方法：选择经胃镜检查诊断为伴幽门螺杆菌感染的上消化道溃疡、炎症性病变病例22例，根据自愿原则，其中15例单独服用美宝胃肠胶囊（A组），7例服用美宝胃肠胶囊同时加服内科常规治疗用药（B组），观察比较胃肠胶囊治疗一个月对上消化道溃疡、炎症性病变的再生修复作用及清除幽门螺杆菌（HP）的疗效。结果：治疗10天，两组病人自觉症状改善率均为100％，治疗20天的症状消失率：A组为93．3％，B组为100％，治疗一月胃镜复查结果，HP转阴率：A组为53．3％，B组为42．9％；好转率：A组为40．0％，B组为42．9％；无效率：A组为6．7％，B组为14．3％；溃疡治愈率：A组为100％，B组为100％，其中瘢痕愈合率分别为：A组6．7％、B组14．3％；炎症性病变明显改善率：A组100％，B组100％。结论：美宝胃肠胶囊具有控制幽门螺杆菌（HP）感染的治疗作用，能够缓解早期上消化道溃疡、炎症性病变病人的自觉症状和促使上消化道溃疡、炎症性病变的再生修复。     

动静脉联合化疗加口服VP-16治疗中晚期肺癌临床研究

目的：研究动静脉联合化疗加口服VP—16治疗中晚期肺癌的临床价值。方法：对临床经影像学及组织细胞学确诊为中晚期肺癌的78例患者随机分为动、静脉联合化疗加口服VP-16治疗组（A组）40例和动、静脉联合给药治疗组（B组）38例。两组采取的动静脉联合化疗方案相同，A组在动静脉联合化疗后口服VP-16，每一疗程后定期复查，测量肿瘤大小，行Kamo fsky评分及毒性反应计量评定。结果：近期疗效观察A组有效率优于B组（x^2=4．493，P羽．05），远期疗效比较A组2年生存率优于B组（x^2=6．627，P〈0．05），两组病例药物毒副反应比较统计无显著差异（P〉0．05）。结论：动静脉联合化疗加口服小剂量VP-16治疗中晚期肺癌．能确切延长中位生存期，全身毒副怍用发生率低，明显提高患者的生活质量，是治疗中晚期肺癌的最有效方法之一。     

Significance of follow-up mammography in estimating the effect of tamoxifen in breast cancer patients who have undergone surgery.

OBJECTIVE: We evaluated mammographic changes to assess the effect of tamoxifen in breast cancer patients who had undergone surgery. MATERIALS AND METHODS: We reviewed the mammograms of 102 breast cancer patients treated with tamoxifen (20 mg per day); these patients were subgrouped into tamoxifen-only patients and patients treated with tamoxifen in combination with another therapy (chemotherapy, radiotherapy, or both). The control group was made up of 50 breast cancer patients who did not undergo tamoxifen therapy and 20 healthy women who had an age distribution and menstruation status similar to those of the breast cancer patients. Two radiologists evaluated parenchymal patterns on mammograms of the contralateral breast in the breast cancer patients and of the left breast in the healthy women. Parenchymal changes before and after surgery were also analyzed. RESULTS: Follow-up mammography showed decreased breast parenchyma in 59.8% of the tamoxifen group, 87.0% of the premenopausal tamoxifen-treated women, 36.0% of the nontamoxifen patients, and 10.0% of the healthy women. CONCLUSION: On follow-up mammography of breast cancer patients, breast parenchyma was shown to be decreased after tamoxifen therapy. Mammography can be a useful method for evaluating breast parenchymal changes after tamoxifen treatment.     

醋酸甲地孕酮联合他莫昔芬治疗子宫内膜癌的疗效及其对血清TSGF、PRL、HE4的影响

 

目的 探讨醋酸甲地孕酮联合他莫昔芬治疗子宫内膜癌的疗效及其对血清TSGF、PRL、HE4的影响。方法 选择大连大学附属中山医院2016-03至2018-12收治的105例子宫内膜癌患者,随机分成2组。对照组50例,给予口服醋酸甲地孕酮片治疗;观察组55例,给予口服醋酸甲地孕酮片联合枸橼酸他莫昔芬片,治疗12周后,观察两组近期治疗效果及不良反应发生的情况,并采用酶联免疫吸附试验(ELISA法)分别检测两组患者治疗前后血清中TSGF、PRL、HE4表达水平。结果 治疗12周后,对照组有效率为42.00%,临床获益率为68.00%;观察组有效率为65.45%,临床获益率为85.45%;两组治疗的有效率及临床获益率的差异均有统计学意义(P＜0.05);两组患者血清TSGF、PRL、HE4表达水平均较治疗前明显降低,差异有统计学意义(P＜0.01),两组间比较发现,观察组患者血清TSGF、PRL、HE4表达水平明显低于对照组,两组差异均有统计学意义(P＜0.05);观察组不良反应发生率明显低于对照组,差异有统计学意义(P＜0.05)。结论 醋酸甲地孕酮与他莫昔芬联合治疗有助于提高子宫内膜癌临床治疗效果,降低患者血清TSGF、PRL、HE4表达水平,其发挥临床疗效可能与血清TSGF、PRL、HE4的表达有关。

     

Remission Rates Following Preoperative Chemotherapy and Radiation Therapy in Patients with Breast Cancer

PURPOSE: To evaluate remission and breast-conservation rates after preoperative chemotherapy or chemo-radiotherapy (CT-RT). PATIENTS AND METHODS: Seventy-three patients with 74 biopsy-proven invasive breast cancers prospectively entered the protocol. Eighteen patients were treated by neoadjuvant chemotherapy followed by surgery and adjuvant irradiation (chemotherapy group). Fifty-five patients with 56 tumors were treated with combined neoadjuvant chemo-radiotherapy, followed by surgery (chemo-radiotherapy group). Most patients of both treatment groups received 4 cycles of EC chemotherapy. In some patients with large tumors 3 cycles of CMF were added. Chemotherapy was followed by hormonal treatment with tamoxifen or LHRH agonists in case of positive hormone-receptor status. Preoperative radiotherapy was administered using 2 Gy fractions up to a total dose of 50 Gy, followed by a tumor boost of 6 to 11 Gy. The median overall treatment time was 41 days (range: 35 to 55 days). The median time interval between end of neoadjuvant therapy and surgery was 11 weeks (range: 10 to 22 weeks) and 27 weeks (range: 11 to 41 weeks) for the chemotherapy- and chemo-radiotherapy group. The median time interval between end of chemotherapy and the beginning of irradiation ranged between 2 and 8 weeks (median 4 weeks) in the chemo-radiotherapy group. RESULTS: Side-effects due to chemo- or radiotherapy were moderate and reversible. In the chemotherapy group 17/18 patients (94%) achieved a partial (pPR) and 1/18 patients (6%) a complete histopathological response (pCR). In the chemo-radiotherapy group 32/56 (57%) showed a pPR and 24/56 (43%) a pCR. The difference in complete remission is significant (Fisher's Exact Test: p = 0.004). In 45/74 cases (61%) the breast was preserved, immediate breast reconstructions with rectus myocutaneous flaps (TRAM) after mastectomy were performed in 8/74 cases (11%) and modified radical mastectomies without reconstruction were required in 21/74 cases (28%). The breast conservation rates were similar in both treatment groups. CONCLUSIONS: Even though the small number of patients in the present protocol does not permit definite conclusions, the results of combined modality treatment seem promising with regard to tumor remission within the treated breast and as a tool for breast conservation in advanced stage disease. On the basis of these encouraging data a prospective Phase-III study has been initiated.     

乳腺癌钼靶X线表现与雌激素受体表达相关性的研究

目的:探讨乳腺癌钼靶X线表现与雌激素受体(ER)表达之间的相关性。方法:将180例乳腺癌患者X线征象中钙化、毛刺、结构紊乱、病变密度增高、边缘浸润及是否同时合并乳腺囊性增生症与经免疫组织化学染色测定ER表达进行对照研究。结果:180例乳腺癌患者中,有钙化者98例,占54.4%;出现毛刺征75例,占41.7%;结构紊乱72例,占40%;病变区表现为高密度90例,占50%;有边缘浸润者96例,占53.5%;乳腺癌同时合并乳腺囊性增生症91例,占50.6%。ER表达阳性100例,占55.6%。毛刺征、边缘浸润征组及同时合并乳腺囊性增生症者ER阳性表达率高;结构紊乱、病变区高密度ER阳性表达率低,钙化征与ER表达无关。结论:乳腺癌钼靶X线征象在一定程度上反映了ER表达状态。     

小金片治疗乳腺增生症的临床疗效

 目的 观察小金片治疗乳腺增生症的临床疗效,从而为小金片的临床应用提供证据。方法 选择武警总医院2016-02至2017-03乳腺增生症患者97例,按治疗情况分为小金片治疗组60例,其他药物(逍遥丸、乳癖消片、祛瘀散结胶囊)对照组37例,统计分析两组患者治疗前后乳腺结节的大小及疼痛改善情况,进一步评估两组患者临床疗效情况。结果 治疗前,两组患者乳腺结节最大直径[治疗组:(4.21±1.15)cm;对照组:(4.24±1.07)cm]以及疼痛评分[治疗组:(6.91±1.78)cm;对照组:(7.56±1.93)cm],未见明显差异。治疗后两组结节最大直径[治疗组:(0.93±0.35)cm;对照组:(2.23±0.58)cm],以及疼痛评分[治疗组:(2.07±0.68)cm;对照组:(3.88±1.41)cm]较治疗前明显改善(P<0.05)。相比于其他药物对照组,小金片治疗组患者乳腺结节最大直径(治疗前:4.21±1.15;治疗后:0.93±0.35)以及疼痛评分(治疗前:6.91±1.78;治疗后:2.07±0.68)都有明显下降,差异有统计学意义(P<0.05)。结论 小金片治疗乳腺增生症临床疗效显著。     

寻常性银屑病85例心理治疗观察

目的探究心理治疗对银屑病疗效的影响。方法将85例寻常性银屑病患者随机分为心理治疗组及对照组,比较8周后两组的治疗效果。采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)及抑郁自评量表(Self-rating depression scale,SDS)分别测定治疗前后患者的心理健康状况并进行比较。结果治疗后两组患者的病情指数(PASI)分值均较治疗前有所下降,尤以心理治疗组分值的降低更为显著(P<0.05)。心理治疗组的治愈率及总有效率分别为60.47%、88.37%,对照组为35.71%、57.14%,心理治疗组的治疗效果优于对照组(P<0.05)。此外,治疗后两组患者SAS及SDS分值均较治疗前明显下降,尤以心理治疗组患者显著(P<0.05)。结论心理治疗对于寻常性银屑病的治疗具有正面影响。     

乳康口服液对大鼠乳腺增生及性激素水平的影响

目的探讨乳康口服液对大鼠乳腺增生及性激素的影响。方法实验分为6组：正常对照组、模型对照组、三苯氧胺（3 mg·kg-1）组和乳康口服液低、中、高（3.5、7、14 mg·kg-1）剂量组,用苯甲酸雌二醇注射液和黄体酮注射液制备大鼠乳腺增生模型后再予相应药物治疗。实验结束后测定血清雌二醇、孕酮及催乳素浓度和乳头直径,HE染色观察乳腺组织病理形态。结果乳康口服液能降低雌激素刺激所致的雌二醇、催乳素的升高,并升高雌激素刺激所致的孕酮的降低,也能缩小乳腺增生引起的乳头增大,并改善乳腺组织增生情况。乳康口服液组乳腺增生程度随剂量增高逐渐降低,高剂量组改善情况与三苯氧胺组相似。结论乳康口服液能明显改善大鼠乳腺增生情况,并将相关血清激素水平恢复至正常。     

三阴性乳腺癌三线化疗治疗方案分析

目的 分析三阴性乳腺癌患者的三线化疗治疗方案及治疗效果.方法 选取2016年4月-2017年4月收治的90例三阴性乳腺癌患者,随机分组发将患者分为研究组、对照组各45例.对照组采用一线化疗方案治疗,研究组采用三线化疗治疗方案治疗.随访3年,比较两组治疗总有效率、毒副反应发生率、3年生存率.结果 研究组治疗总有效率(71...     

Distinctive FDG and FES accumulation pattern of two tamoxifen-treated patients with endometrial hyperplasia

16α-[¹⁸F]Fluoro-17β-estradiol (FES) is an estrogen receptor (ER) ligand used for the detection of ER-positive malignant tumors such as breast cancer. We recently reported the feasibility of combined FES-and 2-[¹⁸F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) scans for the differential diagnosis of endometrial tumors. ER expression measured by FES-PET was preserved in endometrial hyperplasia, whereas ERs were assumed to be reduced in endometrial carcinoma with accelerated glucose metabolism measured by FDG-PET. We report two postmenopausal patients under suspicion of endometrial carcinoma on the basis of cytology and/or magnetic resonance imaging (MRI), who were on tamoxifen treatment since undergoing surgery for breast cancer. Pelvic MRI suggested endometrial carcinomas, whereas FDG-and FES-PET showed no abnormal tracer accumulation. A postoperative histopathologic examination revealed that the lesions were endometrial hyperplasias with no malignant findings. FES-PET enables us to evaluate the ERα expression of endometrium noninvasively, whereas the evaluation of ER expression using FES-PET requires careful attention regarding the influence of hormonal therapy because tamoxifen greatly affects FES accumulation of even endometrial hyperplasia, which should be an FES-avid lesion.     

食管静脉曲张套扎术后的护理体会

目的探讨食管静脉曲张患者套扎术后的护理方法。方法对58例食管静脉曲张患者实施针对性的治疗及护理措施,积极预防并发症。结果所有食管静脉曲张套扎术后患者预后良好,减少了出血、胸骨后疼痛及吞咽困难等并发症的发生,曲张根除30例,减轻26例,无效2例,无死亡病例。结论对食管静脉曲张套扎术后患者实行针对性护理,可以促进患者早日康复。