会阴侧切口皮内缝合100例分析

在以往，产妇会阴侧切缝合常采用肠线缝合粘膜、肌层，丝线缝合皮下脂肪、皮肤。由于丝线缝合过紧易导致组织水肿，甚至缝线嵌入组织内，给产妇带来很大痛苦。我院自1998年采用了肠线皮内缝合法。现将2001年5月-2002年1月100例行侧切的产妇皮肤，采用0号可吸收肠线行皮内连续缝合，效果满意，报道如下。     

钙化型腰椎间盘突出症手术体会

钙化型腰椎间盘突出是一种特殊类型的腰椎间盘突出症，在病程较长或年龄较大的患者中并不少见。其临床表现及治疗都有一定特殊性，本文介绍作者近年来手术治疗钙化型腰椎间盘突出症的体会。     

鼻-鼻内窥镜外科围手术期的护理

我科自开展鼻-鼻内窥镜外科手术以来，特别注重整体性治疗。并更大的关注于围手术处理，降低了鼻窦炎、鼻息肉病术后复发率，我们认为在护理方面围绕围手术期，配合医师进行以下护理。     

Quantitative methylation-specific polymerase chain reaction gene patterns in urine sediment distinguish prostate cancer patients from control subjects.

PURPOSE: Aberrant promoter hypermethylation of several known or putative tumor suppressor genes occurs frequently during the pathogenesis of prostate cancers and is a promising marker for cancer detection. We sought to develop a test for prostate cancer based on a quantitative methylation-specific polymerase chain reaction (QMSP) of multiple genes in urine sediment DNA. PATIENTS AND METHODS: We tested urine sediment DNA for aberrant methylation of nine gene promoters (p16INK4a, p14(ARF), MGMT, GSTP1, RARbeta2, CDH1 [E-cadherin], TIMP3, Rassf1A, and APC) from 52 patients with prostate cancer and 21 matched primary tumors by quantitative fluorogenic real-time polymerase chain reaction. We also analyzed urine sediments from 91 age-matched individuals without any history of genitourinary malignancy as controls. RESULTS: Promoter hypermethylation of at least one of the genes studied was detected in urine samples from all 52 prostate cancer patients. Urine samples from the 91 controls without evidence of genitourinary cancer revealed no methylation of the p16, ARF, MGMT, and GSTP1 gene promoters, whereas methylation of RARbeta2, TIMP3, CDH1, Rassf1A, and APC was detected at low levels. CONCLUSION: Overall, methylation found in urine samples matched the methylation status in the primary tumor. A combination of only four genes (p16, ARF, MGMT, and GSTP1) would theoretically allow us to detect 87% of prostate cancers with 100% specificity. Our data support further development of the noninvasive QMSP assay in urine DNA for early detection and surveillance of prostate cancer.     

Phase I study of gefitinib plus celecoxib in recurrent or metastatic squamous cell carcinoma of the head and neck.

PURPOSE: Effective and tolerable palliative treatments are needed for patients with incurable squamous cell carcinoma of the head and neck (SCCHN). Single-agent targeted therapies have limited activity in this setting. The feasibility of adding celecoxib to gefitinib for the treatment of incurable SCCHN is unknown. PATIENTS AND METHODS: Nineteen patients with unresectable recurrent locoregional and/or distant metastatic SCCHN with progressive disease after at least one prior chemotherapy or chemoradiotherapy regimen were enrolled onto this single-institution phase I study. Three dose levels were explored: (1) celecoxib 200 mg twice daily plus gefitinib 250 mg daily; (2) celecoxib 400 mg twice daily plus gefitinib 250 mg daily; and (3) celecoxib 400 mg twice daily plus gefitinib 500 mg daily. RESULTS: No dose-limiting toxicities were encountered at any dose level. The most common toxicities were acneiform rash, diarrhea, hand reaction, dyspepsia, and anemia. Four of 18 patients assessable for response (22%; 95% CI, 2% to 42%) achieved a confirmed partial response. CONCLUSION: The combination of gefitinib 500 mg daily plus celecoxib 400 mg twice daily is well-tolerated. The encouraging responses seen in this early study suggest further evaluation of epidermal growth factor receptor and cyclooxygenase-2 inhibitors in SCCHN is warranted.     

Radiologically placed temporary hepatic artery catheter for treatment of liver cancer

Hepatic artery infusion (HAI) chemotherapy is associated with higher response rates compared to systemic chemotherapy in those patients with unresectable liver malignancies. Operative hepatic artery catheter (HAC) insertion has significant morbidity and mortality, especially in patients with high‐volume disease, some of whom may not respond to HAI chemotherapy. We report our experience in 45 patients with high‐volume liver disease who were initially treated with HAI chemotherapy via a radiologically placed temporary HAC to try to select the responders who then went on to have an operative HAC. In these 45 patients who had 62 radiologically placed HAC, we found very few major complications, and certainly no complications such as cholecystitis, vascular or malperfusion problems.     

基于PDCA循环的质量管理体系在我科ISO9001贯标中的应用

目的:在药剂科推行ISO9001标准质量管理体系。方法:将PDCA循环(策划-实施-检查-改进)的程序和方法应用于我科ISO9001质量认证贯标工作中。结果:基于PDCA循环的ISO9001标准在我科贯标中的应用获得成功。结论:遵循PDCA循环进行ISO9001质量认证行之有效。     

超负荷心肌肥厚心肌细胞的凋亡和增殖

在超负荷心肌肥厚过程中存在心肌细胞的凋亡和增殖,心肌细胞的凋亡可能是代偿性肥厚向心衰转变的决定因素,凋亡的发生机制涉及外在因素和一些内源性细胞通路。另一方面,心肌肥厚中既有心肌细胞的肥大,亦存在心肌细胞的增殖,心肌细胞的增殖与细胞周期素(Cyclin)、细胞周期依赖激酶(Cdk)、Cdk抑制因子(CdkI)、bcl2、p53及端粒等因子有关,心肌细胞的凋亡和增殖通过一些因子相关联。     

地红霉素治疗男性非淋菌性尿道炎疗效观察

目的:比较地红霉素和红霉素治疗非淋茵性尿道炎的疗效和安全性.方法:选择男性支原体和衣原体无合并症尿道炎患者129例为研究对象,试验组67例给予地红霉素250 mg,po qd,对照组62例给予红霉素片500mg,po qid,均连续服用14 d.结果:地红霉素组的治愈率为76.1%,有效率为89.6%,病原茵清除率为76.1%;红霉素组治愈率为48.4%,有效率为66.1%,病原茵清除率为48.4%.结论:地红霉素治疗非淋茵性尿道炎安全有效.     

膝关节类风湿性关节炎的MRI诊断

目的探讨磁共振成像(MRI)技术在类风湿性关节炎(RA)患者膝关节病变临床诊断中的应用价值.方法对32例51个膝关节进行磁共振检查,并分析其表现.结果MRI显示了RA患者膝关节的滑膜增生及血管翳形成、关节软骨破坏、骨质受侵、关节囊积液及周围邻近软组织的改变,并可通过血管翳的信号和强化程度判断疾病的时期.结论MRI能直接显示RA患者膝关节的各种改变,与X线及CT比较有明显优势,有助于疾病的早期诊断和临床分期.