改进微波幅射器探头治疗宫颈糜烂疗效观察

目的：探讨改进的微波辐射器探头治疗宫颈糜烂的疗效。方法：将微波辐射器探头由双直线形、双针形、单针形等点线状改进成为“单舌形”和“双舌形”两种弧形平面探头，用于治疗宫颈糜烂。分析1999-2002年450例宫颈糜烂治疗资料，其中300例经微波治疗(A组)，150例经C02—激光治疗(B组)，随访1—3个月。结果：两组治疗后3个月内A组治愈率明显高于B组(P＜0．005)，总有效率A组明显高于B组(P＜0．025)。两组术中、术后不良反应比较：术中宫颈创面出血A组明显低于B组(P＜0．005)，术中腹痛、脱痂期出血量、术后局部感染率方面两组相似。结论：所改进的微波辐射器探头治疗宫颈糜烂治愈率高，操作安全，术后并发症少，医患乐于接受。     

宫颈鳞癌中erbB3、erbB4基因蛋白表达与细胞凋亡和增殖的相关性研究

目的　探讨原癌基因erbB3、erbB4与细胞凋亡和增殖的关系 ,为该基因作用机制提供新线索。方法　分别采用免疫组化、DNA末端标记技术 (TUNEL法 )和HE染色检测 5 0例宫颈鳞癌中erbB3、erbB4基因蛋白表达及凋亡指数 (AI)和增殖指数 (MI)。结果　宫颈鳞癌中erbB3、erbB4表达率分别为 5 2 .5 %、44 .0 % ,AI、MI值分别为 5 .5 0± 4.10和 4.18± 3 .63 ,随着宫颈癌恶性程度增高、FIGO分期进展、肿瘤体积的增大和淋巴结转移组 ,erbB3、erbB4表达率增加 ,AI、MI值也增高 ,但差异仅在分化程度上有显著性 (P <0 .0 5 )。双变量相关分析显示erbB3、erbB4表达与AI、MI间无相关性 (r3=0 .10 98、0 .12 3 6,r4 =0 .2 15 1、0 .2 5 5 8,P >0 .0 5 )。结论　erbB3、erbB4和AI、MI预示着宫颈癌恶性潜能 ,但不能作为预后有用指标。erbB3、erbB4的作用机制可能不是通过细胞凋亡或增殖起作用     

颈椎脱位的闭合复位

1985年5月～1996年3月,我们经治34例单纯颈椎脱位患者,30例行Crutchfield颅骨牵引闭合复位,20例成功,占66.6％。在成功组中,牵引重量最大为18kg,无一例出现神经损害加重。不全瘫均有不同程度恢复。尸体头颅标本测定,Crutchfield颅骨牵引承受的最大抗拨出力为60.3kg,在治疗颈椎脱位时,颅骨牵引是安全有效的闭合复位方法。     

DNA flow cytometry in stage IB and II cervical carcinoma

In a retrospective study the prognostic significance of nuclear DNA content was investigated, as measured by flow cytometry, of the tumor specimens from 212 women with nonpretreated FIGO stage IB and II cervical cancer. One-hundred and thirty cases (62%) were found to be diploid, whereas 82 (38%) were aneuploid. Univariate analysis of the follow-up data showed an increased relative risk (RR) for recurrence free survival (RFS) for stage II tumors (RR = 1.87, 95% CI: 1.13–3.10, P = 0.015) and for age (RR = 1.52, 95% CI: 0.66–3.52 and RR = 2.35, 95% CI: 1.19–4.65, P = 0.032). Ploidy showed a relative risk of 1.33 (95% CI: 0.83–2.13, NS). In addition, univariate analysis of overall survival (OS) revealed similar results. For the subgroup of patients with primary surgery ( n = 151), positive pelvic nodes (RR = 5.38, 95% CI: 2.70–10.71, P = 0.0001) and parametrial extension (RR = 2.53, 95% CI: 1.24–5.17, P = 0.011) were significant factors for OS after univariate analysis, the estimated effects on RFS were slightly smaller. Multivariate analysis of RFS for the whole study population showed age, histologic grade and stage with a slightly increased risk, but no effect was significant. Ploidy with an RR of 0.97 (95% CI: 0.58–1.62) seems to have no influence on prognosis. For the subgroup with primary surgery, ploidy again failed statistical significance with an RR of 1.20 (95% CI: 0.58–2.49). Our results suggest that abnormalities of the nuclear DNA content in this homogeneous group of patients are associated with clinical and morphological prognosticators, however, ploidy is not an independent prognostic factor for RFS, or for the whole study population or for the subgroup with primary surgery.     

对神经根型颈椎病CT扫描的价值探讨

对50例神经根型颈椎病的CT征象进行了分析,并与X线平片加以比较。认为CT不仅在神经根型颈椎病的诊断中具有独特作用,而且在确定手术方法和手术途径的选择上也很有意义。作者认为在CT机还没有普及的情况下,摄一张良好的钩椎关节放大斜位片或椎间孔断层片对诊断神经根型颈椎病应是首选的。CT和X线平片相结合,综合分析,更有价值。     

Surgical results of performing R4 gastrectomy for gastric cancer located in the upper third of the stomach

Because gastric cancers located in the upper third of the stomach are difficult to detect at an early stage, the surgical results remain poor. We performed R4 gastrectomy as a radical procedure for 25 patients, involving complete resection of the latero-aortic and interaorticovenous lymph modes above and below the left renal vein, in combination with the ordinary R2 or R3 gastrectomy (the R4 group). These patients were compared with 156 others who underwent R2 gastrectomy alone (the R2 group). There were no significant differences in operation time, blood loss, or the incidence of complications between the two groups; however, when the survival rates of the patients with tumors invading beyond the subserosa were compared, the 5-year survival rate was found to be significantly higher in the R4 group than in the R2 group. Furthermore, in patients with para-aortic nodal involvement, a significant survival advantage was observed in the R4 group, as compared with the R2 group. These results suggest that the R4 gastrectomy is a rational approach for patients with advanced gastric cancer located in the upper third of the stomach.     

宫腔镜电切术治疗宫颈肌瘤的临床应用

目的 :探讨应用宫腔镜电切术治疗宫颈肌瘤的临床应用价值。方法 :用宫腔镜电切术切除宫颈肌瘤3 7例 ,其中有蒂宫颈肌瘤 2 1例 ,无蒂内突型宫颈肌瘤 16例 ,术后随访 3～ 3 1个月。结果 :平均手术时间2 0 7min ,术中平均出血 2 0 5ml ,一次性治愈率达 10 0 % ,无 1例子宫穿孔、低钠血症、周围脏器损伤、感染及宫颈管粘连等并发症发生。结论 :治疗宫颈肌瘤首选宫腔镜电切术 ,它具有治愈率高、创伤小、恢复快、并发症少的特点。     

颈椎损伤合并截瘫100例总结

本文回顾我院20年来所收治的100例颈椎损伤合并截瘫伤员,试图对诊断和处理方法上若干主要问题提出探讨。