咪唑安定在椎管内麻醉和手术中的镇静作用观察

麻醉和手术对于患者来说无疑是一种可怕的经历，许多患者往往因为惧怕而不能很好地配合麻醉和手术，这种强烈的应激刺激常常引起各种生理指标的紊乱，甚至可以导致麻醉和手术的失败，因而术前和术中保持患者的安全十分必要。本试验旨在研究安定和不同剂量的咪唑安定在硬膜外阻滞和术中的镇静效果以及对呼吸和循环的影响。     

头颈部副神经瘤

随着病理学，影像诊断学，颅底外科及血管显微外科技术的发展，学者们对头颈部副神经节瘤有了新的认识。现就其发病情况，命名，病理与免疫组化，临床表现，诊断及治疗进行综述。     

浅谈心脏病人的心理护理

心理护理是现代护理模式的重要组成部分,是影响治疗和康复的重要因素,古人云“善医者必先医其心,而后医其身”,可见心理对身体的影响已早为人们所认识。 心脏病人的心理护理尤为重要,因为心脏病人往往病程长,心律失常难以纠正,胸闷,心悸等不适感使病人受到濒死的威胁,故易引起紧张、焦虑、绝望感。这种不良的心理状态,可使交感肾上腺系统兴奋性增加,而进一步加重心脏负担,形成恶性循环。良好的心理护理能消除病人的各种不良心理因素,使其身心处于有利于病情恢复的最佳状态。在护理上应注意以下几点:     

糖尿病及肥胖患者血浆Leptin的相关性分析

目的　探讨非肥胖正常人与肥胖患者及糖尿病患者血浆Leptin(瘦素 )的关系。方法　采用放射免疫分析法测定了 2 1例非肥胖正常人 ,2 4例肥胖患者及 2 0例肥胖伴糖尿病患者血浆Leptin水平。 结果　肥胖患者血浆Leptin水平 (1 0 9.1± 1 6 .4pg/ml)及肥胖伴糖尿病患者血浆Leptin水平 (81 .0± 1 7.5pg/ml)显著低于非肥胖正常人 (1 94.3± 1 7.7pg/ml)。 结论　非肥胖正常人及肥胖患者血浆Leptin水平与体重指数、血糖、胆固醇及甘油三脂呈显著负相关 ,表明人的Leptin在调节体重及内分泌代谢方面起一定的作用。     

胆脂瘤骨吸收免疫反应机理探讨

用免疫组化技术在接近骨皮质的胆脂瘤基质中观察到大量Langerhans细胞,将此接触骨片作组织学检查可发现成排的破     

胸段食管癌切除术患者的预后分析

Objective To investigate the prognostic factors and influence of the number of lymph node metastases on survival and UICC-TNM classification in patients with thoracic esophageal cancer after curative resection. Methods From 1985 to 1990, 1224 patients were surgically treated for thoracic esophageal cancer. The patients who died within 30 days after operation were not included in this study. Fifteen factors possibly influencing survival of these patients were selected and analyzed. A multivariate analysis of these individual variables was performed by Cox proportional hazard model. According to the n, mher of lymph node metastases (0, 1 and ≥ 2), a new modification of the TNM classification was suggested: stage Ⅱ a (T2N0M0 and T3N0M0), stage Ⅱb [T1N1M0 and T2N1 (1) M0], stage Ⅲ a [T2N1 (2)M0 and T3N1 (1)M0] and stage Ⅲ b [T3N1 (2)M0 and T4NanyMO]. Results According to multivariate analysis, lymph node metastases, depth of invasion, location of tumor, histological classification and length of the tumor were of prognostic significance (P < 0.01). There was obvious correlation between the rate of lymph node metastasis and the depth of invasion, length of tumor and grade of differentiation. The 5-year survival rate of the patients with 0, 1 and ≥2 positive metastatic lymph nodes was 59.1%, 32.0% and 8.9%, respectively. The 5-year survival rate of the patients with stage T2N1M0 and stage T3N1M0 was significantly higher in those with only one lymph node involved than in those with two or more lymph nodes involved (43.1% vs. 18.0% and 28.0% vs. 9.6%, P<0.01). The 5-year survival rate of the modified stage Ⅱa, Ⅱb, Ⅲa and Ⅲb was56.5%, 43.9%, 25.6% and 11.1%, respectively, with a statistically significant difference among different stages (P < 0. 01). Conclusion The lymph node metastasis is the most important prognostic factor for thoracic esophageal cancer after resection. The major influencing factors of lymph node metastasis are the depth of invasion, length of tumor and grade of differentiation. Therefore, the lymphadenectomy along with esophngectomy and subsequently combined modality therapy against lymph node metastasis is necessary to improve the S-year survival rate. Our proposed new classification based on number of lymph node metastases (0, 1, ≥2 positive nodes) is more applicable because it can well reflect the correlation between lymph node metastasis and the survival, and provides evidence for the modification of the currently used UICC TNM staging system for surgically treated thoracic esophageal cancer.     

李赛美教授运用经方经验介绍

李赛美是广州中医药大学教授、主任医师、博士研究生号师、《伤寒论》教研室主任。擅用经方治疗糖尿病、甲亢、朋病等疑难病症，积累了丰富的临床经验。笔者有幸随师侍诊，受益良多。兹择二三，以飨读者。     

李赛美教授治疗甲状腺机能亢进症经验介绍

李赛美教授是广州中医药大学第一临床医学院伤寒论教研室主任,博士研究生导师,主任医师,学验俱丰,擅长用中医药治疗内分泌及代谢疾病。笔者跟师随诊,现将其治疗甲状腺机能亢进症(甲亢)的经验介绍如下。     

耳科手术中使用电钻引起的噪声声级

近代文献中,有不少作者报导有关鼓室成形术后发生耳蜗感音性聋的文章,其发生率约为3—5％。这些作者认为:引起听力障碍的原因可能是术中进行听骨链的处理所造成。术中使用电钻的时间较长,耳蜗长期暴露于通过“骨导”传入的高声级噪声中,致使耳蜗造成损伤。噪声通过骨     

纤维支气管镜在临床的应用

1860年已开始有人研究纤维光学,40年前对于光学纤维传送影像的原理已经明确,但应用到临床则是最近15年的事。1966年日人池田(Ikeda)首先设制了光学纤维支气管镜,其主要优点是扩大了对支气管观察检查的范围,对于肺部疾患特别是肺癌的诊断,提供了有利条件。1969年在美国已开始使用。