无呼吸道症状肺癌35例临床分析

目的：探讨完全无症状或无呼吸道症状肺癌的早期诊断。方法：随机抽取1995年2月至2001年3月经临床及病理诊断为肺癌的380例,其中“无症状”肺癌35例进行分析。结果：由于“无症状”肺癌的异位内分泌等作用,致使患者表现为神经科,骨科,皮肤科,消化科,内分泌科学等多学科病变。结论：为了提高“无症状”肺癌的早期确诊率,及早行胸片,CT片,支行镜等相关检查相当重要,定期体检对于早期发现肺癌有重要的意义。     

饮食服务业从业人员乙型肝炎病毒感染动态研究

目的为了解泰安市饮食服务业从业人员乙型肝炎病毒感染状况。方法应用ELISA方法在1995～1999年对53434名饮食服务业从业人员进行了血清HBsAg、抗-HBc、HBeAg和抗-HBe检测。结果1995～1999年饮食服务业从业人员血清HBsAg、抗-HBc、HBeAg和抗-HBe总阳性率呈逐年下降趋势,依次为4.41%、3.88%、3.46%、2.86%和2.50%,其差异有显著意义（χ     

肾综合征出血热多尿期肾图的变化及意义

目的 :研究肾综合征出血热 (HFRS)多尿期肾图的变化及其意义。方法 :静脉注射 1 31 I-邻碘马尿酸钠 (1 31 I- OIH) 3.7×10 9Bq(10 μCi) ,用闪烁照相法描记 15 min,通过电子计算机自动处理 ,得出肾图的各项参数。结果 :2 0例受检者均已进入多尿期 ,2 4h尿量在 2 0 0 0 ml以上 ,血尿素氮 (BUN)已正常或接近正常 ,但肾图却明显异常 ,表现为半排时间 (TC1 /2 )延长 (>8min) ,15min残留率 (C1 5 /b)超过 5 0 % ,肾脏指数大多低于 45 % ;同期作尿β2 -微球蛋白 (β2 - m )测定 ,也明显高于正常 ;8例作发射型电子计算机扫描 (ECT)检查 ,肾小球滤过率 (GFR)和有效肾血浆流量 (ERPF)分别为 (4 0 .8± 2 1.2 ) ml/min和 (35 0 .8± 10 2 .1) ml/min,均明显低于正常 (P<0 .0 1)。结论 :HFRS患者多尿期肾图大多呈排出不良和功能受损的图形 ,表明该期肾功能以及肾血流量尚未恢复正常 ,对症治疗仍需继续。     

胰岛素泵治疗继发性失效2型糖尿病临床研究

目的 比较磺脲类药物失效（ｓｕｌｆｏｎｙｌｕｒｅａ ｆａｉｌｕｒｅ,ＳＦ）的 ２型糖尿病患者胰岛素泵连续皮下输注治疗（ｃｏｎｔｉｎｕ－ｏｕｓ　ｓｕｂｃｕｔａｎｅｏｕｓ　ｉｎｓｕｌｉｎ　ｉｎｆｕｓｉｏｎ,ＣＳⅡ）组和多次注射胰岛素组（ｍｕｌｔｉｐｌｅ ｓｕｂｃｕｔａｎｅｏｕｓ　ｉｎｓｕｌｉｎ　ｉｎｊｅｃｔｉｏｎ,ＭＳⅡ）血糖控制的疗效和安全性。方法 采用对照研究方法探讨ＣＳⅡ和ＭＳⅡ两种治疗方法在控制血糖、胰岛素剂量、低血糖的发生率的差异。结果 ＧＤⅡ组治疗达到理想血糖控制的疗效和所需的时间明显短于ＭＳⅡ组（Ｐ＜０．０１）;ＧＳⅡ组治疗达到理想血糖控制所需的胰岛素量明显少于ＭＳⅡ组（Ｐ＜０。０１）;ＣＳⅡ组低血糖发生率低于ＭＳⅡ组。结论ＣＳⅡ治疗能缩短达到理想血糖控制的时间,有效地降低餐后２小时血糖;减少了胰岛素用量;减少了低血糖的发生。囚此,ＣＳⅡ疗法对ＳＦ的２型糖尿病患者理想血搪控制比ＭＳⅡ疗法更快、更有效,且使用胰岛素剂量更小,更安全。     

妊娠合并登革热35例临床分析

目的 探讨登革热对妊娠的影响。方法 对35例妊娠合并登革热进行回顾性分析。结果 35例患有27例出现不正常分娩及产后大出血,有22例出现流产、死胎、早产及畸胎。结论 妊娠合并登革热在妊娠早期可出现流产或死胎,中期可引起早产,晚期可出现产后大出血。     

Surgical Treatment and Proposed Modified Classification for Harrington Class III Periacetabular Metastases

ObjectivesThis study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.MethodsThis study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2‐year recurrence‐free survival (RFS). Owing to the limited sample size, we considered P < 0.1 as significant.ResultsIn phase 1, the mean surgical time was 273.1 (180 to 390) min and the mean intraoperative hemorrhage was 2425.0 (400.0 to 8000.0) mL, respectively. The mean follow‐up time was 18.5 (2 to 54) months. Recurrence was found in 4 patients and the 2‐year RFS rate was 62.4% (95% confidence interval [CI] 31.6% to 93.2%). The mean postoperative MSTS93 score was 56.5% (20% to 90%). Based on the periacetabular bone destruction, we categorized the lesions into two subgroups: with the bone destruction distal to or around the inferior border of the sacroiliac joint (IIIa) and the bone destruction extended proximal to inferior border of the sacroiliac joint (IIIb). Six patients with IIIb lesions had significant prolonged surgical time (313.3 vs 249.0 min, P = 0.022), massive intraoperative hemorrhage (3533.3 vs 1760.0 mL, P = 0.093), poor functional outcome (46.7% vs 62.3%, P = 0.093), and unfavorable local control (31.3% vs 80.0%, P = 0.037) compared to the 10 patients with IIIa lesions. We then modified the surgical strategy for two subgroup of class III lesions: Harrington/modified Harrington procedure for IIIa lesions and en bloc resection followed by modular hemipelvic endoprosthesis replacement for IIIb lesions. Using the proposed modified surgical classification, 62 patients in the phase 2 study demonstrated improved surgical time (245.3 min, P = 0.086), intraoperative hemorrhage (1466.0 mL, P = 0.092), postoperative MSTS 93 scores (65.3%, P = 0.067), and 2‐year RFS rate (91.3%, P = 0.002) during a mean follow‐up time of 19.9 (1 to 60) months compared to those in the phase 1 study.ConclusionThe Harrington surgical classification is insufficient for class III lesions. We proposed modification of the classification for Harrington class III lesions by adding two subgroups and corresponding surgical strategies according to the involvement of bone destruction. Our proposed modified classification showed significant improvement in functional outcome and local control, along with acceptable surgical complexity in surgical management for Harrington class III lesions.     

顽固性复发性气胸胸膜腔造影及硬化治疗后追踪

对32例顽固性复发性气胸患者用60%泛影葡胺进行胸膜腔造影,确定裂口后作硬化剂治疗,并作复张后胸部CT对照及手术追踪对照,取得满意效果。     

肝硬化患者肾脏血液动力学的研究

目的 研究肝硬化患者肾脏血液动力学的改变。方法 应用多普勒超声测定４２例肝硬化患者肾脏血液动力学指标。并分析这些指标与肝功能及平均动脉压之间的关系。结果 不同阶段的肝硬化患者肾内血管收缩程度有明显的差异。结论 肝硬化早期即有肾血管的收缩,肝功越差肾血管收缩越明显。肾血管的收缩是全身血液动力学改变的一部分。     

中药肛滴在治疗消化道恶性肿瘤中的应用

探讨中药肛滴在治疗消化道恶性肿瘤中的应用。通过对６例典型病例的回顾分析,观察中药肛滴在缓解癌性粘连性肠梗阻、缓解消化道恶性肿瘤患者症状、提高晚期消化道恶性肿瘤患者生存质量的作用。应用中医理论“通则不痛”之说,对消化道恶性肿瘤患者进行中药肛滴治疗．认为有较好的临床效果。     

综合医院确诊的39例肺结核患者转诊结果随访调查

目的;了解并评价综合医院内科确诊的活动性肺结核病例转诊结果。方法：对我院呼吸内科１９９５年８月－１９９８年８月确认的３９例活动性肺结核患者（不包括结核性胸膜炎）转往结构防治专业机构的结果进行信访和电话随访。结果：仍的３９例活动性肺结核患者中有３５例在确诊后１周内结核病接受０．５ａ－１ａ的全地化疗,３３例获得良好效果,２例死亡,死因分别为肺间质纤维化合并感染肺心病及呼吸衰竭。３例慢性纤维空洞型肺结核