宫腔镜电切术致TURP综合征2例分析

TURP综合征即过度水化综合征,亦称稀释性低钠血症,主要是由灌流液在短时间内快速大量被吸收所致。此症已被人们认识,且随着双极电刀的应用,此症发生率减少,但如对此并发症早期认识不足,常可贻误治疗而导致死亡。我科曾发生此症2例,现报道如下:1临床资料1.1资料来源2例患者均为子宫粘膜下肌瘤(IV型),分别于2006及2012年入住我科行宫腔镜下肌瘤电切术。     

中医对衰老的认识及益寿方法

延缓衰老,是人们所追求的愿望,也是医学研究的重要课题,中医学对此积累了丰富的理论与实践经验。本文就中医学对衰老的认识及益寿方法浅谈如下。 一、对衰老的认识 “蜉蝣朝生夕死,松柏万年长青”,每种生物都有一定的寿限,人也不能超脱这一自然规律。《尚书·洪范》说:“一日寿,百二十岁也”,明确指出了人的自然寿限。《素问·上古天真论》称人的自然寿限为“天年”,指出“终其天年,度百岁乃去”。     

FOLFOX-6与肝动脉灌注化疗对结直肠癌肝转移治疗效果的比较

Objective To compare the efficacy and side effects between systemic chemotherapy and hepatic arterial infusion by combination of oxaliplatin and 5-fluorouracil (FOLFOX-6) with 5-fluorouracil in the patients who have developed hepatic metastasis after colorectal cancer operation. The factors that would affect the prognosis without operational treatment were also analyzed. Methods 46patients who had signed the informed consents were allocated into two groups: the group with general chemotherapy (Trial Group includes 26 cases) and the one with hepatic arterial infusion chemotherapy (Control Group includes 20 cases). The total effective rate, the prognosis, the cytoxicitic side effects,quality of life, the total survival rate and the responses were the main parameters determined. Kaplan-Meier was used to analyze Mono-factor to the prognostic responses and the Cox mode was used to analyze poly-factor to the prognostic responses. Results The overall survival rate was significantly higher by using systemic treatment versus HAI(median, 15. 0 v 11.2 months;P＜0.05). The difference in overall responsive rate (CR+PR) between the two groups was statistically significant (50% v 10%;P=0. 011). No significant difference was found in PS scale during the treatment. (P=0. 126). Except for myelosuppression and abdominal pain, no significant difference was found in the other side effects. Univariate analysis revealed that the invasive lesions to serosa, the distribution of liver metastases, the size and number of liver metastases, primary carcinoma involving lymph nodes and the treatment were correlated with prognoses. Cox regression analysis showed that the larger diameter of liver metastases, the number of liver lesions, primary carcinomas involved in serosal layer and the treatment modules were independent prognostic factors. Conclusions The oxaliplatin-based FOLFOX-6 chemotherapy regiment has a better responsive rate and survival rate than the traditional infusion with 5-fluorouracil to the main hepatic artery for interventional therapy. The diameter of the hepatic metastasis larger than 5em, multiple hepatic metastasis and the primary lesions penetrating serosal layer suggest the poor prognosis. The oxaliplatin-based systematic chemotherapy has a better prognosis. Therefore,it is worth carrying on further study on modification of traditional hepatic arterial infusion and on evaluation of therapy by combination of the hepatic arterial infusion with the systematic chemotherapy.     

腹腔镜在治疗输卵管妊娠中的应用体会

目的:探讨腹腔镜在治疗输卵管妊娠中的临床价值。方法:35例不同类型的输卵管妊娠采用不同方法治疗。结果:诊断治疗成功率100％,腹腔镜下行根治性手术,效果可靠,接受保守手术者,术后输卵管复通率及妊娠率高。结论:腹腔镜治疗输卵管妊娠,达到了微创和保留输卵管功能的良好效果。随着手术器械的改进,操作技术的提高,手术适应证将进一步拓宽。异位妊娠手术结束前,无需彻底清洗腹腔,既能避免反复冲洗的痛苦,又利于纠正贫血。     

血尿酸与急性冠状动脉综合征367例的相关性研究

目的探讨血清尿酸（SUA）水平与急性冠状动脉综合征（ACS）的相关性。方法经临床确诊的冠心病（CHD）患者182例[其中慢性稳定型（A组）94例,ACS（B组）88例]与对照组185例。分别测定SUA及血脂。结果ACS组SUA水平显著高于对照组（P〈O．01）,Logistic回归分析显示,SUA增高与ACS明显相关。结论高尿酸血症是ACS的主要危险因素之一。     

HPV E6/E7mRNA原位杂交技术在HPV分型检测阴性的子宫颈腺癌中的研究

目的:探讨人乳头瘤病毒(HPV)分型检测阴性的子宫颈腺癌中HPV E6/E7mRNA的表达情况,为子宫颈腺癌的早期筛查提供新思路。方法:选择2019年1月至2021年6月于潍坊医学院附属医院和山东大学齐鲁医院就诊的HPV分型检测阴性的15例子宫颈腺癌患者为研究组,同期HPV分型检测阳性的15例子宫颈腺癌患者为对照组。采用高危型HPV E6/E7mRNA原位杂交(RISH)检测两组患者病变组织中HPV E6/E7mRNA的表达情况,同时采用免疫组化法(IHC)检测p16和Ki-67的表达情况。结果:与对照组比较,研究组HPV E6/E7 mRNA的阳性表达(73.3%vs.100.0%)、p16的阳性表达(80.0%vs.100.0%)及Ki-67的阳性表达(86.7%vs.100.0%),差异均无统计学意义(P>0.05)。研究组中HPV E6/E7mRNA表达阴性的4例患者病理类型均属于非HPV相关子宫颈腺癌(胃型腺癌2例,微偏腺癌2例),HPV E6/E7mRNA在HPV相关和非HPV相关中的阳性占比分别为100.0%(26/26)和0(0/4);其中1例普通浸润型腺癌HPV...     

从《内经》谈肺主气

《素问·五脏生成篇》指出 :“诸气者 ,皆属于肺”。肺主气 ,是指肺有化生、调节人体宗气、营卫之气、清阳之气等后天之气的功能 ,在人体生命活动中发挥着重要的作用 ,所谓 :“肺主气 ,气调则营卫脏腑无所不治”(《类经·藏象类》)。《内经》对此论述颇多 ,本文就此谈谈自己的看法。1　主宗气《灵枢·邪客》:“宗气者 ,积于胸中 ,出于喉咙 ,以贯心脉而行呼吸焉”。肺主宗气 ,主要表现在两个方面 :1 .1　主宗气的生成宗气由清气和谷气汇聚而成 ,肺在其过程中起着关键性作用。一方面 ,自然界清气进入肺脏 ,通过肺肃降透肺进胸 ,正如《医学衷中…     

游泳和抚触对婴儿的综合影响

目的 探讨游泳与抚触对婴儿的综合影响.方法 对2006 年6月-2008 年6月在本院产科出生的510名足月新生儿,定期进行游泳和抚触,与对照组进行胎粪初排时间、转黄时间及黄疸消退时间进行比较,并比较42d、3、6、9、12月龄时的身长、体重、头围值、智能、运动发展指数及各发育指标.结果 研究组胎粪初排时间早、转黄时间快、黄疸指数下降快于对照组,差异均有统计学意义(P<0.05);两组婴儿42 d、3、6、9、12月龄时的身长、体重、头围值、智力发展指数及发育指标比较,差异均有统计学意义(P<0.05).结论 游泳与抚触对婴儿黄疸消退、智能及体能发展均有影响.     

宫腔镜电切术治疗子宫内息肉26例临床分析

目的探讨宫腔镜电切术治疗子宫内膜息肉的临床应用。方法采用宫腔镜下经宫颈电切术切除息肉,将切除组织标本送病理检查。结果宫腔镜电切术治疗子宫内膜息肉一次成功率100%,且手术时间短、手术范围小、损伤小、出血少、无并发症发生、可提供子宫内膜病变部位的病理标本。结论宫腔镜电切术对早期诊断子宫内膜癌及子宫内膜息肉癌变具有高精的临床意义,深受患者好评,充分体现了微创治疗技术在治疗子宫内膜增生症上的优势及功效。