急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

以抑郁症症状为首发症状的癫痫发作

文献报道,抑郁症症状可以成为癫痫的发作症状,但是不是癫痫独立的或首发的尚不清楚。我们回顾性分析了5例以抑郁为首发症状的单纯癫痫。所有患者的神经系统检查、脑脊液检查、磁共振检查均正常,可排除脑部器质性病变。全部患者首诊经精神科医生诊断为抑郁症,其中3例为中度抑郁,1例为重度抑郁。所有患者的随机脑电图检查均显示轻度异常,后经24小时动态脑电图监测,确诊为癫痫的复杂部分发作。予以卡马西平或者拉莫三嗪治疗后情绪正常,也无其它形式癫痫发作,多次脑电图检查显示恢复正常。随访8～18月无发作。因此,我们认为抑郁症症状可以是癫痫发作的首发表现,而诊断"功能性的"抑郁症则一定要排除以抑郁症状为首发症状的癫痫发作。     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

健脾益肾中药配合化疗治疗中晚期非小细胞肺癌临床观察

目的:观察健脾益肾中药对中晚期非小细胞肺癌患者化疗副反应、生活质量、免疫功能等方面的影响.方法:将70例中晚期肺癌患者随机分为两组,治疗组(36例)采用化疗同时配合健脾益肾法立方辨证治疗.对照组仅以单纯化疗,21天为1周期.连用2周期为1疗程.通过观察患者治疗前后症状改善、生活质量、外周血细胞变化、近期疗效、T细胞亚群变化等指标进行评定.结果:治疗后症状改善治疗组有效率为86.11%,对照组有效率为61.76%,两组有效率比较,差异有显著性意义(P<0.05).治疗后治疗组卡氏评分有效率为83.33%,对照组有效率为58.82%,组间比较具有显著性差异(P<0.05).两组治疗前血象各指标比较(P>0.05),治疗后组内比较(P<0.05),两组治疗后血象各指标均下降,但对照组下降更明显,组间比较有统计学意义(P<0.05).治疗后治疗组CD4/CD8比值与对照组相比增高明显,具有显著性差异(P<0.05).治疗后治疗组瘤体有效率为27.78%.对照组瘤体有效率为20.59%,两组瘸体有效率比较无明显差异(P>0.05).结论:中晚期肺癌患者化疗期间予以健脾益肾中药干预可改善患者症状、减轻化疗副反应、提高患者免疫功能及生活质量.     

健脾补肾方减轻脾肾两虚证乳腺癌患者术后化疗心脏毒性及提高生活质量的临床研究

目的:探讨健脾补肾方对乳腺癌术后TEC方案化疗不良反应的影响,为健脾补肾方能更好的应用于临床提供依据.方法:依据标准,共收集60例,随机分为治疗组(健脾补肾方联合化疗组)和对照组(单纯西医化疗组),每组各30例.比较两组患者的心电图、心肌肌钙蛋白I、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、中医证候积分、卡氏评分.结果:1)两组患者化疗后心电图、CK、CK-MB异常率比较发现,第一周期化疗前后及第二周期化疗前比较均无明显差异,无统计学意义.在第二周期化疗后心电图、CK、CK-MB异常率比较,差异有统计学意义.说明健脾补肾方可降低第二周期化疗后心电图、CK、CK-MB异常率.2)化疗后治疗组中医证候积分有效率86.67%,高于对照组有效率53.33%,差异有显著统计学意义;治疗组卡式评分有效率93.33%,高于对照组有效率53.33%,治疗组高于对照组,差异有显著统计学意义.结论:健脾补肾方应用于脾肾两虚证乳腺癌患者术后化疗后,能减轻心脏毒副反应,并提高患者的生活质量.     

益气化瘀法治疗慢性盆腔炎30例临床观察

目的 :观察益气瘀法对慢性盆腔炎的治疗效果。方法 :运用以黄芪、党参、当归、红藤等药组成的盆炎Ⅰ号方和上方减去黄芪、党参组成的盆炎Ⅱ号方治疗慢性盆腔炎各 30例 ,以观察其临床疗效及其对血液流变学及免疫功能的影响。结果 :盆炎Ⅰ号方总有效率 93 33% ,明显高于对照方 (总有效率 76 6 7% )(P <0 0 5 ) ,检测结果表明 ,两组对血液流变学都有明显改善 (P <0 0 5 ) ,治疗组对免疫功能也有明显的改善 (P <0 0 5 ) ,而对照组无明显改善 (P >0 0 5 )。结论 :盆炎Ⅰ号方能降低血液粘稠度 ,改善微循环 ,提高免疫功能 ,从而提高临床疗效     

中药单体逆转肺癌多药耐药的研究进展

正一直以来,肺癌严重危害着人类的健康,其发病率高并呈逐年上升趋势。在中国,肺癌的总发病率已占到男性恶性肿瘤之首,预计到2025年我国肺癌总患病人数将超过100万[1]。临床上75%的肺癌患者就诊时已是晚期。当肺癌进入中晚期,化疗则为当前最主要的治疗手段,因为多药耐药     

黎月恒运用中医药治疗食管癌经验

从病因病机、分期论治、用药特色3个方面介绍黎月恒教授治疗食管癌的经验。黎教授认为,食管癌的基本病机为痰、气、瘀、毒交阻于食道,临床分为4个阶段进行治疗。术前阶段治以四物消瘰汤加减;术后阶段,在手术过程及术后早期恢复过程中,常用八珍汤加减,术后出现吻合口瘘、胸腔感染则以活血化瘀、消热解毒之品治之,术后出现反流性食管炎及胃排空障碍则以六君子汤合半夏厚朴汤加减治之;放疗阶段,方选六君子汤合沙参麦冬汤加减;化疗阶段,自拟脾肾方加减治疗。临床随症加减,疗效显著。     

乳腺癌骨转移74例临床病理分析

【目的】探讨乳腺癌骨转移的临床病理特点。【方法】回顾性分析306例乳腺癌病例中74例发生骨转移患者的临床资料。探讨骨转移与不同乳腺癌病理分型的关系。【结果】乳腺癌骨转移发生率26．5％（74／306）。乳腺癌非浸润性癌和早期浸润性癌不发生骨转移。以胸部骨转移（58．11％）多见。乳腺癌骨转移患者中,浸润性导管癌最为常见,单纯性癌、印戒细胞癌、髓样癌较少见,浸润性小叶癌、粘液癌很少见,非浸润性癌、早期浸润性癌、硬癌,腺癌临床基本不出现骨转移。【结论】乳腺癌以胸部骨转移发生率高,乳腺浸润性导管癌发生转移最为常见,其他类型较少见。