年轻宫颈癌患者临床病理及预后特点

目的：探讨年轻（≤35岁）宫颈癌患者临床、病理及预后特点。方法回顾性分析2005年1月-2008年9月我院≤35岁65例宫颈癌患者的临床、病理及随访资料。结果≤35岁宫颈癌患者占同期住院治疗的宫颈癌患者的17.0%（65/382）。年轻宫颈癌患者以低分化鳞癌为多见,非鳞癌患者淋巴结转移率高于鳞癌患者（P =0.000）。FIGO早期患者鳞癌的5年生存率较非鳞癌为高,差异有统计学意义（P =0.001）。FIGO晚期患者中,鳞癌的5年生存率与非鳞癌类似,差异无统计学意义（P =0.176）。存在高危病理因素患者5年生存率较无高危病理因素患者为低（P 〈0.05）。结论伴有高危病理因素的年轻宫颈癌患者应加强随访,给予积极的辅助治疗,以期提高生存率。     

宫颈癌发病年龄与预后的关系(附93例分析)

目的 探讨宫颈癌发病年龄与临床预后的关系。方法 回顾南方医院1997年1月~2002年12月收治的宫颈癌93例,分为年轻组(≤35岁)和中老年组(>35岁),进行临床分期、病理组织学、细胞分化等临床资料对比分析。结果 两组患者在临床分期、组织学上有统计学差异。≤35岁组:≤Ⅱa期占82.61%,≥Ⅱb期占17.39%,磷癌占86.67%,腺癌占13.39%;而>35岁组:≤Ⅱa期占便51.43%,≥Ⅱb期占48.73%,磷癌占82.98%,腺癌占17.02%。细胞分化程度分析,≤35岁组和>35岁组经统计学处理无显著性差异。结论 >35岁组宫颈癌患者具有临床期别较高、腺癌较多的不良预后因素。年轻宫颈癌患者预后较好。     

中老年宫颈癌患者临床病理特征及预后分析

目的分析宫颈癌患者的临床病理特征和预后特点,比较年轻患者与中老年患者的差异,探讨中老年宫颈癌患者的病理特征和预后。方法回顾性分析安徽医科大学附属省立医院于2006年10月至2012年8月诊治的110侧宫颈癌患者的临床资料。将年龄≤35岁的患者作为年轻组,年龄〉35岁的患者作为中老年组,分析患者的临床病理特征以及可能的预后差异。结果两组患者都以接触性出血及不规则阴道出血为主,但年轻患者因处于性活跃期,有出血症状表现的比例比中老年患者高,中老年组的无症状确诊病例比年轻组高（P〈0．05）。病理特点两组在癌变种类方面无明显差异,鳞癌及腺癌占的比例类型两组差异不显著（P〉0．05）,中老年组Ia患者明显少于年轻组,差异有统计学意义（x2=5．88,P〈0．05）。结论中老年患者的宫颈癌分期比年轻患者高,病情发展情况较严重。     

年轻宫颈癌患者预后因素分析

目的研究年轻宫颈癌患者的发病趋势以及影响预后的相关因素。方法回顾性分析年轻宫颈癌患者67例,与同期收治的大于35岁的对照组患者进行比较,分析两组患者的发病趋势、预后以及影响预后的相关因素。结果年轻宫颈癌患者的发病率、复发率明显增高,复发时间明显缩短;无瘤生存期年轻组低于对照组;5年生存率和中位生存期年轻组低于对照组;分析显示,年龄、临床分期、肿瘤大小和淋巴转移因素是影响年轻宫颈癌患者预后的相对独立性因素。结论年轻宫颈癌患者的发病率呈升高趋势;年轻组患者较对照组容易复发而且复发时间早、5年生存率低,预后差。     

潍坊地区213例子宫颈癌临床分析

目的 回顾性分析潍坊地区213例宫颈癌患者的临床资料,探讨近期子宫颈癌的临床特点及治疗方法.方法 回顾性分析213例宫颈癌患者的发病年龄、HPV感染情况、临床分期、治疗方式及术后病理结果.结果 213例患者年龄(45.32±11.2)岁,中位数年龄为44岁.年轻宫颈癌(≤35岁)的构成比为22.07%.≤35岁宫颈癌患者的HPV 阳性率为65%,较>35岁者明显升高,后者为32%.Ⅱ期、Ⅲ期及Ⅰ期、Ⅲ期间患者的平均年龄均有显著性差异(P＜0.05).213例患者中,12例患者未行手术,其余患者均经手术治疗.结论 潍坊地区近5年宫颈癌具有明显年轻化、临床分期早的趋势,且与HPV感染有相关性.提倡对所有有性生活3年以上的女性进行普查,加强对HPV感染高危人群的监测、随访,以便及时预防癌前病变和早期宫颈癌.对已确诊的年轻宫颈癌患者进行预后估计,并采取相应的综合治疗措施以改善患者的预后和生活质量.     

乳腺癌骨转移的危险因素及放疗效果分析

目的：探讨乳腺癌骨转移的危险因素及放疗的效果。方法本组乳腺癌骨转移患者40例,均为我院2013年5月—2014年5月收治,分析其危险因素,并观察放疗效果。结果疼痛完全缓解率为80%,总有效率为87.5%,治疗后1年生存率为65%,2年生存率为30%,3年生存率为10%,平均生存期为（15.2±1.7）个月。影响乳腺癌骨转移的危险因素主要为临床分期,风险比为1.904;腋窝淋巴结转移数,风险比为1.042;确诊时年龄35岁~50岁,风险比为2.133;确诊时年龄>50岁,风险比为2.921。结论乳腺癌骨转移患者,采用放疗,可明显减轻疼痛,改善生活质量,还需采取放射性同位素内照射治疗方式,也可应用综合方案,包括内分泌治疗、化疗、针对骨膦治疗等。对于乳腺癌,需重视骨转移的影响因素,以便早期发现,尽快制定治疗措施,以改善预后,提高患者生存质量。     

1004例宫颈癌临床及病理分析

目的探讨年轻宫颈癌和绝经期宫颈癌的临床及病理学特征。方法回顾性分析1004名宫颈癌患者的年龄分布、临床分期、病理分型及淋巴结转移情况。结果患者的年龄范围为22~77岁,平均（46.56±9.76）岁,患病高峰41~50岁。临床表现以不规则阴道出血（50.80%）和接触性出血（28.49%）为主。绝经期宫颈癌以绝经后阴道不规则出血（73.84%）为主要临床表现。病理分型以鳞癌为主（89.74%）。病理诊断浸润癌占88.94%,年轻患者原位癌与早期浸润癌比例高于中老年患者,绝经期宫颈癌与之相反（P〈0.05）。盆腔淋巴结转移率为21.50%。年轻组和绝经组分别与对照组比较无统计学差异（P〉0.05）。结论年轻组和绝经期组宫颈癌在临床表现和分期上分别与其他患者有所差异,在病理类型和淋巴结转移方面没有差异。应该重视这两类人群的发病特征,做到早期诊断、早期治疗,提高患者的生活质量及预后。     

53例年轻宫颈癌患者临床分析

目的分析35岁以下年轻宫颈癌妇女的发病趋势、临床特点、治疗方法。方法对宁夏医科大学总医院2009年1月-2013年1月收治的53例年轻宫颈癌≤35岁（研究组）患者的临床资料进行回顾性分析,将同期收住的420例中老年宫颈癌（〉35岁）作为对照组,对比分析二者的临床分期及病理类型。结果 2009年1月-2013年1月我院年轻宫颈癌构成比逐年上升。年轻宫颈癌临床分期中早期所占比例（I~IIa期）高于对照组,肿瘤病理类型两组存在差异,年轻宫颈癌非鳞癌患者所占比例大于对照组,差异均具有统计学意义。年轻宫颈癌4年内复发率高于对照组,差异具有显著性。结论年轻宫颈癌发病有年轻化的趋势。年轻宫颈癌病理类型发生变化,短期内复发率较高,需采取综合治疗改善预后。     

年轻宫颈癌临床分析

目的回顾北京大学深圳医院近10年间153例35岁以下年轻妇女宫颈癌住院患者完整的临床随访资料,探讨年轻宫颈癌的临床病理特点与预后的相关因素,以指导年轻宫颈癌的临床处理及随访。方法收集2000年12月31日-2010年12月31日间北京大学深圳医院收治确诊为年轻宫颈癌的患者153例,采用SPSS19．O统计软件分析,P〈O．05认为有统计学意义。结果年轻宫颈癌患者和〉35岁宫颈癌患者在5年生存率方面无统计学差异。年轻宫颈癌患者预后与多种因素有关。结论年轻宫颈癌患者预后与多种因素相关,其中临床分期是独立危险因素。     

青年宫颈癌放射治疗效果分析(附42例报告)

目的探讨 35岁以下青年妇女宫颈癌放射治疗 (简称放疗 )疗效及影响预后的因素。方法回顾性总结分析 4 2例经放疗的青年妇女宫颈癌的临床特点及预后。结果本组青年妇女宫颈癌放疗后 5年生存率为5 7.1% (2 4 / 4 2 ) ,Ⅲ期和Ⅳ期患者 5年生存率低于Ⅱ期患者 (P <0 .0 5 ) ;肿瘤 >4cm者疗效低于≤ 4cm者 (P <0 .0 5 ) ;结节型和溃疡型 5年生存率低于菜花型 (P <0 .0 5 )。结论青年妇女宫颈癌 5年生存率较低 ,临床分期为Ⅲ期和Ⅳ期、宫颈局部肿瘤 >4cm者及结节型和溃疡型患者预后差     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.