手辅式腹腔镜治疗肾恶性肿瘤(附10例报告)

目的：探讨手辅式腹腔镜技术在肾恶性肿瘤手术中的应用。方法：采用手辅式腹腔镜技术进行肾癌根治术及肾盂癌根治术共10例。其中肾癌6例，肾盂癌4例。8例经腹腔入路，2例经腹膜后入路。结果：手术全部获得成功，没有严重的并发症，手术效果良好。患者随访6个月～3年。未见局部复发和远处转移。结论：手辅式腹腔镜肾癌根治术和肾盂癌根治术不仅保留了腹腔镜技术创伤少、恢复快的优点，还克服了常规腹腔镜手术的许多局限性，糅合了开放手术和腹腔镜技术的优势，提高了手术的安全性、根治性和操作的灵巧性．缩短了手术时间和手术者的培训时间。     

益生菌与益生元在结直肠癌预防中的作用

结直肠癌(CRC)是一种常见的胃肠道肿瘤.在中国,CRC的发病率仅次于胃癌和食管癌,居胃肠道肿瘤的第三位,而在国外,CRC的发病率是消化道恶性肿瘤的首位.有效的预防和治疗CRC成为了医疗工作者面临的一个严峻课题.近年来,越来越多的研究显示益生菌和益生元有可能影响CRC的发生和发展,并可能在CRC的预防中发挥作用,为CRC的预防和治疗提供了一个新的研究方向.此文就肠道益生菌和益生元与CRC的预防和治疗的关系的研究进展作一综述.     

TUVP治疗高龄高危良性前列腺增生59例报告

目的：探讨经尿道前列腺电汽化（TUVP）术治疗高龄、高危良性前列腺增生症（BPH）患者的安全性及有效性。方法：2004年7月至2006年6月，对59例高龄且合并心、肺、脑、肾等重要脏器疾病的高危患者施行TUVP术。充分的个体化术前准备后，均行连续硬膜外麻，25．5F连续灌注式气化电切镜，冲洗液为4％甘露醇，肾功能不全患者使用5％葡萄糖，液面高度60cm，如腺体460g，则彻底切除；如腺体〉60g，年龄〉80岁，则作一椭圆形通道切除。观察手术效果并行．IPSS评分。结果：全部病例均安全耐受手术。手术时间25～126min，平均57min，切除前列腺组织平均重量37g，无输血病例，未出现电切综合症，3～5d拔除导尿管，均排尿通畅，术后IPSS平均12.1分。结论：TUVP治疗高龄、高危BPH患者安全、有效。     

我院诊断学2003年教学效果评价与分析

诊断学是运用基本理论、基本知识和基本技能对疾病进行诊断的一门科学.是为医学生基础医学各门学科过渡到学习临床医学各科而设立的一门必修课[1].但随着学校办学规模的扩大,教学层次逐渐增多,教学人员和临床基地的缺乏,使诊断学教学面临许多困难.为了较全面地了解诊断学的教学情况,我们于2003年对我院2001级本科同学进行问卷调查,并对结果进行分析.     

老年病人的心理特点及护理对策

老年病人的病种有心脑血管系统疾患后遗症，老年痴呆，晚期癌症等疾病，其疾病特点有其独特的规律性，尤其应注意的是老年人敏感多疑，情绪不稳定，医护人员对这种现象应该充分重视。现就老年患者的心理特点及护理对策作一分析探讨。1老年患者的心理特点老年病人由于社会环境，人际关系等变化而导致心身疾病，老年病人因病情变化而产生惆怅、忧烦、苦恼、失眠、焦虑等反应属于心身疾病的一种表现。1．1不同的情绪可以使机体各个系统引起相应的变化。研究证实，心理活动是通过神经、体液和免疫三个环节密切联系对健康产生影响消极的心理活动…     

心律平对闭式胸腔麻醉犬心脏电生理效应

本文采用心脏程序电刺激方法观察心律平(propafenone)对闭式胸腔麻醉犬的心脏电生理效应,结果示该药抑制犬窦房结功能,抑制冲动在心房、房室结内传导以及延长心房及房室结不应期,尤其显著地抑制室房逆向传导。     

辽吉冰凉花总甙对心功能影响的实验研究

辽吉冰凉花总甙(APAW)1.0mg/kg iv,能使麻醉家兔正常心脏的P-dP/dt环体面积(LO),LV-dP/dt_max,Vpm及LVSP比药前增大,HR减慢。APAW和冰凉花(AAR)及毒毛旋花子甙K(SK)一样,能明显改善衰竭兔心的心功能。静脉恒速输入0.5 mg/ml APAW,25min后,心衰家兔的LVSP,LV—dP/dt max,LO均明显回升,LVEDP降低,t-dP/dt max缩短。三种强心甙的最大强心效力无显著性差异。但APAW的治疗宽度和治疗指数均较AAR和SK为大,而AAR和SK间则无显著性差异。     

颈动脉炎引起双眼视神经萎缩1例

大动脉炎是一种比较少见的慢性血管病,多见于青年女性,因颈动脉炎引起双侧视神经萎缩较为罕见。患者党××女20岁学生双眼视力逐渐下降10个月。近2个月头晕、嗜睡、间歇性左颞部麻木及四肢发冷发麻。双眼视力指数/眼前,双眼瞳孔等大,约3mm,直接间接对光反射迟钝。双眼屈光间质正常,双眼视乳头边界整齐,颞侧色苍白,黄斑区     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.