益气托邪汤对眼肌型重症肌无力复发率的影响

目的：观察益气托邪汤对眼肌型重症肌无力复发率的影响。方法：治疗组71例服用益气托邪汤,对照组36例服用补中益气汤,两组均配合低剂量泼尼松短期治疗,观察两组患者治疗2个月后的临床疗效,以及2年内复发率的情况。结果 ：治疗组有效率87.32%,对照组有效率86.11%;治疗组复发率（例数）25.35%,对照组为55.56%;治疗组复发率（次数）32.39%,对照组97.22%,两组比较差异有统计学意义。结论：应用益气托邪汤治疗眼肌型重症肌无力复发率明显降低,明显优于对照组。     

妊娠期脊柱结核一例并文献复习

【目的】提高对妊娠期脊柱结核的认识及诊断、治疗水平。【方法】报告1例以妊娠期腰腿痛为临床表现的脊柱结核病例并进行相关文献复习。【结果】患者,女,26岁。因腰骶部疼痛8个月加重伴右下肢疼痛5个月入住本院。患者于孕后约2个月始出现腰骶部疼痛,因担心X线对胎儿发育的影响,未行影像学检查及相应治疗,逐渐出现行走困难。足月剖腹产腰痛及右下肢疼痛无缓解,行影像学检查考虑腰椎结核,予以抗结核治疗两周后,于产褥期后行腰椎病灶清除＋腰椎钉棒系统内固定术,并继续抗结核治疗,术后患者疼痛逐渐缓解。通过PubMed数据库以“妊娠期”和“影像学检查”为主题词检索到关于妊娠期可行MRI检查的报告。【结论】妊娠期腰腿痛可根据病情行MRI检查,以避免不可逆的神经功能障碍,直接影响母体和胎儿的健康。如考虑脊柱结核,妊娠时间在3个月内可根据情况考虑终止妊娠。若大于3个月,应选择适当的抗结核治疗并维持妊娠,一般在妊娠34～36周可考虑行剖宫产术,并根据病情可考虑是否同时行脊柱结核的手术治疗。     

参鹿益髓汤治疗多发性硬化症41例

多发性硬化症是神经系统常见的中枢神经系统脱髓鞘疾病,目前其病因及发病机制尚未明确,此病难以治愈,容易复发。我们运用参鹿益髓汤治疗多发性硬化症41例,现报道如下。1临床资料1.1诊断标准与中医辨证标准参照《多发性硬化的诊断和分类标准》[1]及1983     

非小细胞肺癌患者呼出气冷凝液中p53蛋白检测的临床意义

Objective To study the clinical significance of the detection of p53 protein in exhaled breath condensate (EBC) of patients with non-small cell lung cancer (NSCLC). Methods EBC and plasma of 98 patients with NSCLC were collected,p53 protein expression in EBC and plasma was detected by enzyme-linked immunosorbent assay,and the data were compared with those of 98 healthy controls. p53 protein expression in cancer tissue of 98 patients with NSCLC was detected by immunohistochemistry. p53 protein expression in EBC and plasma and positive expression rate of p53 protein in cancer tissue were compared among patients with different lung cancer type,stage,histologic type,tumor size,and lymph node metastasis,smoking history. The specificity and sensitivity of diagnosis of p53 protein in patients with NSCLC were analyzed by ROC curve. Results ① The level of p53 protein in EBC of patients with NSCLC was significantly higher than that in healthy control group [(233.99±7.91) ng/L vs ( 130. 26 ± 4. 73) ng/L,P ＜0. 01]. The level of p53 protein in serum of patients with NSCI.C was significantly higher than that in healthy control group [(292. 58 ± 8. 79) ng/L vs (141. 66±3. 33) ng/L,P ＜0. 01]. ② The level of p53 protein in EBC of patients with central lung cancer was higher than that in patients with peripheral lung cancer [(248. 22 ± 8. 58) ng/L vs (215. 78 ± 6.61) ng/L,P＜0. 01]. ③The level of p53 protein in EBC of patients with positive immunostaining group was higher than that in negative group [(249.77 ± 8.07) ng/L vs (216.86 ± 7.44) ng/L,P ＜ 0. 05]. ④The level of p53 protein in serum of smokers was significantly higher than that in non-smokers [(310.18 ± 9.04) ng/L vs (254. 55 ± 6. 91) ng/L,P ＜0. 01]. ⑤The positive expression rate of p53 protein in cancer tissue was 47. 96% (47/98). ⑥The sensitivity and specificity of diagnosis of p53 protein were 95. 90% and 90. 04% in plasma,and those were 92. 90% and 79. 59% in EBC. The cut off values of p53 protein were respectively 175. 68 ng/L and 166. 26 ng/L in EBC and serum. Conclusions The detection of p53 protein in EBC of patients with NSCLC is helpful for the diagnosis of lung cancer.     

络病理论与肺纤维化关系探析

肺间质纤维化根据病因可分为特发性和继发性两类,均是以慢性肺泡类和肺泡结构紊乱最终导致肺间质纤维化为特征的疾病.笔者运用络病理论为指导,分析探讨其病因病机,通过长期的临床观察和理论总结,提出肺纤维化可归属于中医络病范畴,认为肺气虚弱,络气不足,易致肺络瘀阻、绌急,痰瘀交互,阻滞肺络是肺纤维化的基本病机.     

从肾督络理论探讨脊髓病发病机制

脊髓病是神经内科中与脊髓有关的一类疾病的总称,督脉循行路线与脊髓解剖部位密切相关,其功能反映了脊髓的绝大部分功能,肾、督脉、络脉密不可分。故提出脊髓病的发病机制为肾督亏虚,气血瘀滞;肾督亏虚,邪毒络瘀;肾督亏虚,气络虚滞。     

冷冻消融联合免疫治疗在非小细胞肺癌治疗中的应用进展

冷冻消融在非小细胞肺癌（non-small cell lung cancer,NSCLC）的治疗中除了通过低温使肿瘤细胞脱水、破裂、坏死外，还可通过产生抗肿瘤免疫应答来发挥作用的。而近年来免疫治疗在NSCLC的治疗方面效果显著。那么冷冻消融和免疫治疗在NSCLC治疗方面是否具有协同作用呢？本文就冷冻治疗、免疫治疗及两种联合治疗在NSCLC治疗中的应用进展作一综述。