心理社会因素与手术康复（二）：气功的干预作用

目的探索气功放松训练在外科心理应激及术后心身康复中的干预作用。方法随机选取择期上腹部手术病人42例为气功放松训练干预组,与之相匹配的另40例为对照组。术前1天进行认知、行为、状态焦虑等的测量,术前1小时测定心率、收缩血压均值及与入院时的差值,术后则测量或记录疼痛程度、肠道排气时间等多种心身康复指标,在SPSS支持下作统计分析。结果干预组术前对手术的消极认知较少,焦虑较轻,睡眠差、食欲减退等心身症状也较不明显;手术后疼痛体验较轻,焦虑较少。但在肠道排气时间、止痛剂用量等康复指标上,两组的差异无显著性。结论气功放松训练有助于病人术前、术后的心理适应,可作为有效的心理行为干预措施应用于外科临床。     

会厌在喉部分切除喉功能重建术中的应用

目的 探讨会厌在喉部分切除喉功能重建术中的应用价值。方法 １９９２年１２月－１９９６年１月３２例不同分期的声门型,声门上型喉癌行喉部分切除术,将残存会厌下移保留喉功能。结果 ２１例声门型喉癌术后１９例拔除气管套管恢复喉的全部功能,１１例声门上型喉癌５例恢复喉全部功能,并于术后１４－１８ｄ恢复吞咽功能,无１例出现误吸收起严重并发症。３年生存率８７．５％（２８／３２）,５年生存率５８．３％（７／１２）     

鼻咽癌组织中微血管的分布

目的：观察鼻咽癌组织中微血管的分布及存在状况,探讨其与鼻咽癌的临床病理联系。方法：采用免疫组织化学Ｓ－Ｐ法,检测血栓调节蛋白在鼻咽癌血管内皮细胞的表达,进行微血管的定性半定量研究。结果：鼻咽癌组织中微血管的分布不均匀。极性消失。血管呈分支芽状弥漫分布于癌组织中,或呈条索状围绕癌细胞团。微血管的数目与癌细胞的增殖指数屯预后正相关。结论：鼻咽癌组织中微血管数与患者的生存期有关。     

直接经皮冠脉内支架植入术治疗急性心肌梗死

目的：评价直接冠脉内支架植入术治疗急性心肌梗死的临床疗效。方法：１７例急性心肌梗死患者于症状发作后２～１４小时施行冠脉内支架术。结果：所有患者冠脉再通均获成功。ＴＩＭＩ血流均达到３级。无残余狭窄,血管再通距症状发作时间平均５．７小时,所有患者胸痛均在术后２小时内明显缓解;除２例ＳＴ段持续抬高外,其余病例均在术后２小时ＳＴ段下降〉５０％;心肌酶峰明显提前。１例左主干病变于术后１周发生严重泵衰竭死亡;     

严重烧伤病人早期肾功能损害与早期糖尿症的相关性研究

目的 :通过对严重烧伤病人进行应激性糖尿症和早期肾功能损害等并发症观察研究 ,进一步了解其发病机制。方法 :对重度烧伤病人进行血 BS、BUN、Cr、UA、TNFα、INS、β2 - MG及尿糖、尿 PRO、尿 p H、尿β2 - MG等进行监测。结果 :发现 5例病人在血糖不高的情况下出现糖尿和不同程度的肾功能损害。结论 :部分严重烧伤病人早期糖尿是由肾脏近曲小管吸收障碍引起。     

99mTc-MIBI scan in mammary Pagets disease: a case report

Technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) uptake is known to be increased in breast cancer because of increased blood flow from angiogenesis and heightened metabolism. We performed a 99mTc-MIBI scan in a patient with mammary Paget's disease. The patient had underlying invasive cancer in the same side of the breast. 99mTc-MIBI scan exhibited a scintigraphic image of the uptake from the invasive cancer lesion located deeply in the breast toward the epidermis. 99mTc-MIBI showed an uptake in the deeply located invasive cancer lesion as well as nipple lesion. Especially, the delayed phase of Tc-MIBI scan demonstrated the tumor site more accurately. In conclusion, 99mTc-MIBI scan could be a useful adjunct to clinical decision making in the management of Paget's disease of the breast.     

Undetectable serum thyroglobulin in a patient with metastatic follicular thyroid cancer

The case of a 54-year-old woman with metastatic follicular thyroid cancer and undetectable serum thyroglobulin is presented. Many years after the patient had a subtotal thyroidectomy for a large goiter that had no clear evidence of malignancy, metastatic bone disease developed. When the bone metastases were detected and during the follow-up period, serum thyroglobulin values remained undetectable, but radioiodine uptake in the metastases was abundant. This case indicates that the combination of 1-131 scintigraphy and serum thyroglobulin values is superior to the measurement of serum thyroglobulin alone in detecting well-differentiated, metastatic thyroid cancer.     

Tea preparations protect against DMBA-induced oral carcinogenesis in hamsters

The preventive effects of green tea, tea pigments, and mixed tea (a composite of whole water extract of green tea, tea polyphenols, and tea pigments) on 7,12-dimethyl-benz[a]anthracene (DMBA)-induced oral carcinogenesis in golden Syrian hamsters were studied. The right buccal pouches of animals were topically treated with 0.5% DMBA three times per week for 15 weeks. Animals were killed separately after 6, 10, and 15 weeks of DMBA treatment. Oral tumors were counted and measured, and mean tumor burden was calculated. The incidence of preneoplastic lesions and micronucleated cells, the number and volume of silver-stained nucleolar organizer regions (AgNOR), the labeling index of proliferating cell nuclear antigen, and the level of epidermal growth factor receptor expression were studied. The results showed that oral administration of 1.5% green tea, 0.1% tea pigments, and 0.5% mixed tea as the sole source of drinking water for two weeks before initiation of the DMBA treatment and until the end of the experiment significantly reduced the mean tumor burden and the incidence of dysplasia and oral carcinoma (p < 0.01). The frequency of micronucleated cells, the number of AgNOR, the total volume of AgNORs, the labeling index of proliferating cell nuclear antigen, and the level of epidermal growth factor receptor expression in the oral mucosal cells were also significantly reduced (p < 0.01). These results clearly indicated that tea preparations could effectively inhibit DMBA-induced oral carcinogenesis in hamsters. Protection from DNA damage and suppression of cell proliferation could be important mechanisms of the anticarcinogenic effects of the tea preparations.