脑肿瘤意识障碍临床分析

本文观察502例脑肿瘤中,有47例出现意识障碍(9.4%)。其发生机制主要有:①脑疝形成;②普遍性颅内压增高引起脑缺氧;③肿瘤内出血;④肿瘤部位如额、颞叶、上脑干等的直接损害;⑤癫痫发作。脑疝形成是主要死亡原因。简要讨论了脑肿瘤意识障碍的临床特点、预后因素以及脑中心性疝的早期诊断。     

Long-term results of first-line sequential high-dose carboplatin, etoposide and ifosfamide chemotherapy with peripheral blood stem cell support for patients with advanced testicular germ cell tumor

OBJECTIVE: Standard chemotherapy shows relatively low long-term survival in patients with poor-risk testicular germ cell tumor (GCT). First-line high-dose chemotherapy (HD-CT) may improve the result. High-dose carboplatin, etoposide, ifosfamide chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) was investigated as first-line chemotherapy in patients with advanced testicular GCT. METHODS: Fifty-five previously untreated testicular GCT patients with Indiana 'advanced disease' criteria received three cycles of bleomycin, etoposide and cisplatin (BEP) followed by one cycle of HD-CT plus PBSCT, if elevated serum tumor markers were observed after three cycles of the BEP regimen. RESULTS: Thirty patients were treated with BEP alone, because the tumor marker(s) declined to normal range. Twenty-five patients received BEP and HD-CT. One patient died of rhabdomyolysis due to HD-CT. Three and six (13% and 25%) out of 24 patients treated with BEP and HD-CT achieved marker-negative and marker-positive partial responses, respectively. The other patients achieved no change. Fifteen (63%) are alive and 14 (58%) are free of disease at a median follow-up time of 54 months. Severe toxicity included treatment-related death (4%). CONCLUSIONS: HD-CT with peripheral stem cell support can be successfully applied in a multicenter setting. HD-CT demonstrated modest anticancer activity for Japanese patients with advanced testicular GCT and was well tolerated. This regimen might be examined for further investigation in randomized trials in first-line chemotherapy for patients with poor-risk testicular GCT.     

间接免疫荧光法检测婴幼儿急性下呼吸道合胞病毒感染的特异性IgM

本文对1984年1～3月和1985年3～8月共107例急性下呼吸道感染的住院患儿,采用间接免疫荧光法检测其急性期血清抗RSV特异性IgM抗体,并与病毒分离和/或中和试验比较,敏感性为82.1％,特异性为71.8％。RSV感染患儿发病后3天内大多数病例即可从血清中检测出RSV-IgM,因此该法具有早期诊断价值。     

“肠梗”治疗粘连性肠梗阻425例

本文对采用自行研制的中草药浓缩剂“肠梗”治疗的粘连性肠梗阻４２５例进行临床分析。根据不同的病理及临床特征将其分为三种类型，其中广泛粘连型是“肠梗”治疗的最佳适应症，粘连扭转型是其禁忌证。并对中转手术的指征、时间等问题进行了讨论。认为该方法具有简单易行、安全可靠、成功率高的特点，是一种易于推广的治疗粘连性肠梗阻的有效方法，具有较高的临床实际应用价值     

胫骨延长术后的功能康复程序初探

胫骨延长术是矫治小儿麻痹后遗症下肢短缩最常见的术式，但如何恢复或改善术后的功能，目前尚无一套系统的程序。本文作者根据自行设计的胫骨延长休后功能康复的临床观察，作较系统地介绍，并就该程序的合理性，进行了讨论与论证。     

蝮蛇抗栓酶与肝素抗凝治疗小儿肾病的疗效比较

本文对60例小儿肾病患儿随机分为3组,蝮蛇抗栓酶治疗组,肝素治疗组,常规治疗组(对照组),结果总有效率分别为95％,90％,60％。蝮蛇抗栓酶组与对照组比较,差异有极显著性(P<0.01),肝素组与对照组比较,差异有显著性(P<0.05)。结果提示抗凝治疗对小儿肾病高凝状态有明显改善作用,能增加临床疗效。蝮蛇抗栓酶抗凝效果优于肝素。     

重视药物利用评价研究,开展药物利用评价活动

药物利用评价是当前医院合理用药的深入发展的重要体现,也是临床药学的重要工作之一。本文论述了药物利用评价的目的、意义、方法和进展,以及药物利用评价在医院药房中的应用,以期引起有关人员的重视。     

HCV的检测方法

从发现丙型肝炎病毒以来 ,丙肝的检测技术发展迅速 ,灵敏度和特异性都有明显的提高 ,方法学在不断改进完善。笔者就近年来丙型肝炎的实验室检测方法作简要的综述