联合内分泌治疗对前列腺和睾丸的影响

目的 探讨抑那通和缓退瘤联合治疗对正常前列腺,增生的前列腺（ＢＰＨ）和前列腺癌以及睾丸的作用。方法 对１６例接受联合内分泌治疗至少３个月且有治疗前后病理资料的前列腺癌患者的标本进行了系统的病理学检查。对内分泌治疗后的睾丸标本与同龄未接受治疗的进行对照研究。结果 １４例内分泌治疗后的前列腺标本２例未见残存癌灶,９例对治疗有明显的反应;３例对治疗反应差,治疗并未降低前列腺癌的病理分期。３例内分泌治疗后     

我国烧伤外科的进展与展望

一、烧伤外科光辉的４１年与兄弟学科相比,烧伤外科起步相对较晚,刚刚度过“不惑之年”。虽然学科年轻,但发展迅速,临床治疗达到世界领先水平,基础研究亦跻身于世界先进行列。我国烧伤专业的发展大体经历了三个阶段［１］。１９５８年由于土法上马全民大炼钢铁,致使烧伤患者骤然增多。北京、上海、重庆、西安等大城市率先在几个大医院成立了烧伤专科。上海瑞金医院成功地救治了烧伤面积８９％,Ⅲ度烧伤２３％的钢铁工人邱财康。这一史无前例的医学奇迹,震惊了世界,也鼓舞了国人。进入６０年代全国各地先后成立了烧伤科或组建了烧伤…     

Improved immunogenicity of a core-coated tetanus toxoid delivery system.

A new microparticulate delivery system composed of a stabilizing gelatin/poloxamer microcore surrounded by a PLGA coat was designed to improve the stability of tetanus toxoid (TT) encapsulated in PLGA microspheres. Microcores were prepared by a spray-congealing technique and encapsulated within PLGA using an oil-in-oil (o/o) solvent evaporation technique. SEM analysis of the cross-sections of the microcapsules revealed the adequate encapsulation of the cores, showing an intimate contact between the core and the coating. This structure was responsible for an osmotic phenomenon observed in vitro, which led to the release of the encapsulated TT in a short period of time. Nevertheless, it was observed that the release was affected by the presence of the poloxamer in the core: microspheres without poloxamer in the core exhibit a faster release (2 h) than those that incorporate the surfactant (24 h). The in vivo evaluation of this system showed that the encapsulated toxoid induced a low but continuous levels of neutralizing antibodies (Nt), whereas those obtained for the control (aluminum phosphate-adsorbed toxoid) decreased after reaching the maximum level at 14 weeks. Moreover, the administration of a mixture of encapsulated and adsorbed TT led to significant higher and more prolonged Nt levels than those measured for the adsorbed toxoid.     

四甲基偶氮唑盐法用于非小细胞肺癌药敏试验条件的筛选

目的筛选非小细胞肺癌药敏试验的条件。方法取25例非小细胞肺癌患者的瘤细胞,用四甲基偶氮唑盐（MTT）法观察9种化疗药物,在不同浓度、不同时间对瘤细胞的敏感性。结果9种化疗药物对瘤细胞的敏感性,有随着药物浓度的增加、作用时间的延长而增高的趋势,但每个药物都有各自的特点。结论非小细胞肺癌细胞MTT法药敏试验的浓度应为临床用药量的计算值,药物作用时间应以48h为宜。     

张景岳中医精神病学思想初探

明代张景岳在中国医学史上是位卓有成就的医学大家,他对中医理论及临床各科的发展颇多建树。本文将对其在中医精神病学方面的认识分七个方面作一探讨。１．对癫证病因病机的发挥;２．对狂证病因病机的认识;３．对中医一些特殊精神病证病因的认识;４．有关痫证的认识;５．有关痴呆病的认识;６．对郁证的认识;７．有关精神疾病的真伪鉴别     

双上斜肌麻痹的临床特征与治疗

双眼上斜肌同时麻痹称为双上斜肌麻痹,近年来受到国内外眼科学者的重视。本文报告13例,均是我科近年来手术治疗并在术后观察3个月以上者。13例病人都无明显外伤史,发病在出生时及出生后早期,为先天性病变。手术次数1～2次。临床特征:不对称病变以单眼上斜视,代偿头位为主要表现,其中有一部分病人为潜在型双侧病变。对称型以两侧同向注视时的反向上斜视为主要表现,双侧Bielschowsky征为阳性。不少病人同时有V型斜视。需要手术治疗的病人一般应做双眼手术。可根据病情决定是同时做双侧手术,还是分次做,以及术式、术量。术后大部分病人能获得满意的头位及眼位。     

Incidence of dementia in relation to stroke and the apolipoprotein E epsilon4 allele in the very old. Findings from a population-based longitudinal study

BACKGROUND AND PURPOSE: Both stroke and the apolipoprotein E (APOE) epsilon4 allele increase the risk of dementia. However, the interaction between stroke and APOE on dementia is still unclear. We addressed this topic by using a longitudinal design. METHODS: We followed up a community cohort of 1301 subjects aged >/=75 years, who did not have dementia at baseline. Among them, 92 subjects had a history of stroke (from 3 months to 16 years before baseline interview). After the 3-year follow-up, 224 dementia cases had been diagnosed. During the period of follow-up, 91 subjects had a first occurrence of stroke (incident stroke). The APOE genotype was known for 985 subjects. Cox proportional hazards regression models were constructed to estimate the risk for dementia in terms of relative risks (RRs) for stroke and the APOE epsilon4 allele, with adjustment for age, sex, education, systolic blood pressure, antihypertensive medication use, and heart disease. RESULTS: In the entire study population, RRs for dementia related to history of stroke and incident stroke were 1.7 (95% CI, 1.1 to 2.6) and 2.4 (95% CI, 1.6 to 3.5), respectively, after adjustment for all potential confounders. Subjects with stroke that occurred within 3 years before baseline had RR of 2.4 (95% CI, 1.4 to 4.2), whereas those with stroke occurring >3 years before baseline had RR of dementia of 1.1 (95% CI, 0.6 to 2.3). Among those with APOE information, individuals with only history of stroke (that occurred within 3 years before baseline) had RR of 3.1 (95% CI, 1.4 to 6.6), individuals with only the APOE epsilon4 allele had RR of 1.7 (95% CI, 1.1 to 2.5), and individuals with both factors had RR of 5.3 (95% CI, 2.1 to 13.4). The corresponding figures when incident stroke was examined instead of history of stroke were 2.3 (95% CI, 1.3 to 4.1), 1.7 (95% CI, 1.1 to 2.4), and 4.6 (95% CI, 2.0 to 10.6), respectively. The RR of interaction term for history of stroke and APOE epsilon4 was 1.1 (95% CI, 0.3 to 3.8; P=0.8). The corresponding figure was 1.2 (95% CI, 0.4 to 4.4; P=0.7) for incident stroke and APOE epsilon4. Furthermore, the RRs of dementia without any stroke and dementia with stroke in relation to APOE epsilon4 were 1.6 (95% CI, 1.1 to 2.3) and 1.2 (95% CI, 0.6 to 2.4), respectively. In addition, the APOE epsilon4 allele was not significantly related to the occurrence of stroke (RR=0.8; 95% CI, 0.5 to 1.5). CONCLUSIONS: A relatively fresh stroke is a risk factor for dementia. APOE epsilon4 increases the risk of dementia without stroke but not dementia with stroke. Our data do not support a multiplicative effect of stroke and the APOE epsilon4 allele on the risk of dementia. However, both factors seem to have an additive effect on the risk of dementia. The APOE epsilon4 allele does not increase the risk of stroke in this Swedish elderly population.     

Evaluation of combined therapy with chemoembolization and irradiation for large hepatocellular carcinoma

The effects of combined transcatheter arterial chemoembolization (TACE) and radiotherapy in patients with large hepatocellular carcinoma (HCC) were analysed retrospectively. A total of 107 patients with large unresectable HCC was treated with TACE followed by external beam irradiation. The largest dimension of the tumours ranged from 5 cm to 18 cm. Acute effects, survival rates, toxicity and prognostic factors were analysed. Follow-up ranged from 4 months to 98 months (median 24 months). An objective response, i.e. reduction of tumour area greater than 50%, was achieved in 48.6% of cases. In 64.9% of the cases with increased alpha-feto protein (AFP) values, AFP level underwent a reduction of more than 25%. The cumulative survival rates at 1, 3 and 5 years were 59.4%, 28.4% and 15.8%, respectively (median survival 18 months). The combination therapy was generally well tolerated. Only two patients died from liver failure or variceal bleeding associated with therapy. The Cox proportional hazards model showed that the number of tumours and the irradiation dose were independent prognostic factors. The results indicate that combined TACE with radiotherapy is a promising therapeutic approach for large unresectable HCC. Prospective controlled trials to ascertain the real potential benefit of this approach are required.     

经皮电刺激与电针治疗纤维肌痛综合征疗效对比

目的 :对比经皮电刺激与电针治疗纤维肌痛综合征 (FS)的疗效差异。方法 :将 66例患者随机分为经皮电刺激治疗组 (A组 )、电针治疗组 (B组 )、药物对照组 (C组 )进行临床疗效的对比研究。其中A组和B组均采用以FS常见的 1 8个压痛点邻近穴位为刺激点 ,C组采用口服阿米替林为主的西药。结果 :A组及B组的有效率及痊愈显效者 6个月、1 2个月及 2 4个月随访结果同C组比较 ,其差异具有非常显著性意义 (P <0 0 1 ) ,但A组同B组比较 ,差异无显著性意义 (P >0 0 5)。结论 :经皮电刺激或电针刺激穴位治疗纤维肌痛综合征的疗效优于药物组 ,而经皮电刺激是一种无创痛且被患者乐于接受的方法