中西医结合治疗糖尿病足并发酮症酸中毒22例临床观察

目的：观察中西医结合疗法治疗糖尿病足合并酮症酸中毒的临床疗效。方法：22例分别给予静脉滴注胰岛素、抗生素、复方丹参注射液，口服中药汤剂，伤口局部外用湿润烧伤膏等治疗。结果：临床治愈14例，好转6例，无效2例。结论：中西医结合治疗糖尿病足并发酮症酸中毒疗效较好。     

46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

EXPRESSION OF PHOSPHO-b-CATENIN AND ITS SIGNIFICANCE IN NON-SMALL CELL LUNG CANCER

b-catenin is a 92kDa soluble protein and arecognized component of a cell-cell adhesion regulator when coupled with cadherin[1] and is also considered to play an important role as a member in the Wingless/Wnt signal transduction pathway[2]. Combined type b-catenin combines with plasma zone of E-cad and mediatehomotypic cell-cell adhesion; free cytoplasmic typeb-catenin, Wnt protein, GSK-3b, APC and Axin etc.form Wnt signal transduction pathway. Cytoplasmic type b-catenin forms multiprotein …     

CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines.

BACKGROUND AND PURPOSE: The appropriate application of 3-D CRT and IMRT for HNSCC requires a standardization of the procedures for the delineation of the target volumes. Over the past few years, two proposals--the so-called Brussels guidelines from Grégoire et al., and the so-called Rotterdam guidelines from Nowak et al.--emerged from the literature for the delineation of the neck node levels. Detailed examination of these proposals however revealed some important discrepancies. MATERIALS AND METHODS: Within this framework, the Brussels and Rotterdam groups decided to review their guidelines and derive a common set of recommendations for delineation of neck node levels. This proposal was then discussed with representatives of major cooperative groups in Europe (DAHANCA, EORTC, GORTEC) and in North America (NCIC, RTOG), which, after some additional refinements, have endorsed them. The objective of the present article is to present the consensus guidelines for the delineation of the node levels in the node-negative neck. RESULTS AND CONCLUSIONS: First a short discussion of the discrepancies between the previous Brussels and the Rotterdam guidelines is presented. The general philosophy of the consensus guidelines and the methodology used to resolve the various discrepancies are then described. The consensus proposal is then presented and representative CTVs that are consistent with these guidelines are illustrated on CT sections. Last, the limitations of the consensus guidelines are discussed and some concerns about the direct applications of these guidelines to the node-positive neck and the post-operative neck are described.     

深圳市区学龄前儿童异位性皮炎现况调查

目的了解深圳市区3～6，5岁儿童异位性皮炎(AD)的发病情况。方法对深圳市区3～6，5岁学龄前儿童进行调查，调查以问卷的方式进行。结果调查总数2450名。符合AD诊断标准者共53例，总患病率为2.16％。结论深圳市区3～6．5岁儿童异位性皮炎患病率与全国的患病率相近。     

原发性小肠肿瘤86例临床分析

目的探讨原发性小肠肿瘤(PIT)的外科诊治经验，以提高对PIT的诊治水平。方法回顾性分析1988-2003年收治的86例PIT的临床资料。结果86例中，良性肿瘤占20．9％(18虑6)，恶性肿瘤占79．1％(68/86)。恶性肿瘤以腺癌多见，占41．2％(28/88)。X线检查是主要诊断手段，B超、CT、内镜、肠系膜血管造影也有助于诊断。全组均行手术治疗，其中急诊手术率为34．9％(30/86)。本组无手术死亡。恶性肿瘤1、3、5年生存率分别为73．5％、49．0％、24．5％。结论PIT术前诊断困难，误诊率与急诊手术率高。一经诊断，手术治疗是最佳选择。     

子痫前期与子痫终止妊娠时机及方式的探讨

目的探讨子痫前期与子痫终止妊娠的时机和方式对母婴的影响。方法对42例患者进行了回顾性分析，观察新生儿的窒息率和死亡率。结果产前子痫5例，产时子痫4例，产后子痫2例，子痫前期30例，母亲全部存活，剖官产率86．70％，新生儿窒息率92．85％，围生儿死亡率5．8％。结论治疗子痫前期与子痫适时终止妊娠是极重要的方法，终止妊娠的方式首选剖宫产。     

人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折

目的评价骨水泥型人工股骨头置换术治疗老年股骨粗隆间不稳定型骨折的临床效果。方法总结应用本术式治疗的高龄、有明显骨质疏松的20例股骨粗隆间不稳定型骨折患者临床资料，并与传统内固定术进行比较。结果18例术后随访2～24个月，髋关节功能接近或恢复到受伤前水平，无一例因手术并发症死亡，术后开始负重行走时间7～30d。结论该手术方法具有功能恢复好，并发症少，能早期离床活动等优点，手术危险性不比其他内固定术大。     

急性肠系膜静脉血栓形成临床分析

目的探讨急性肠系膜静脉血栓形成(AMVT)的诊断与治疗方法。方法对8例AMVT患者资料进行回顾性分析。结果6例手术治疗，2例非手术治疗，其中1例死于术后中毒性休克。结论早期诊断，早期抗凝、缓解血管痉挛和及时的手术干预是改善AMVT患者预后的主要措施。CT和彩色多普勒对该病的诊断有很大帮助，选择性血管造影可明确诊断。     

复方甘草酸苷对SARS患者激素撤药综合征的影响

目的 :探讨复方甘草酸苷 (GL)在SARS患者减激素治疗过程中的作用。方法 :采用回顾性分析方法 ,观察GL对SARS患者的激素撤药综合征 (HWS)相关症状和指标的影响。结果 :应用GL后可使HWS症状发生率降低 ,其中SARS患者的主要症状气短、胸闷的发生率分别由24 5 %和22 6 %降低至3 6 %(P≤0 01)和7 1 %(P≤0 05) ;乏力、肌肉关节痛、头痛的发生率分别由13 2 %、15 1 %、10 4 %降至7 2 %、14 3 %、0 %;SARS患者ALT升高例数减少 (P≤0 01)。结论 :激素撤药过程中应用GL ,可以降低HWS的发生率。