用金樱根治疗老年性尿失禁的临床研究

[目的]观察金樱根与中药缩泉丸治疗老年尿失禁的作用。[方法]选择53例患者，随机分为两组，观察组27例，用金樱根汤剂治疗；对照组26例，用目前治疗尿失禁的代表中药缩泉丸治疗。观察期为20d，10d为1个疗程，观察患者临床症状及各项指标的变化。[结果]观察组和对照组患者的临床症状及各项指标均明显改善，但金樱根的疗效要优于缩泉丸。[结论]金樱根是临床上治疗老年尿失禁较为理想的药物，值得进一步研究推广。     

医学高职教育的不可行性分析

医学高等教育,是一种生命科学理论、人体科学技术与自然科学知识相结合的超综合性教育活动,是关于人与人服务的社会特点而开展的知识传授、技术传递、思维培训、个人社会技术引导的"人"的教育过程.由此赋予该专业的课程门类众多、专业理论纵深、知识技术要求娴熟、医德意识最大唤醒等多重功能,不仅基础课程课时量大,而且知识链条关系十分紧密,课程的排列与进度只能是递进式的,因而长时间周期是实施医学教学的第一保证.     

对高等中医药院校人才培养的几点看法

高等中医药院校担负着人才培养、科学研究、社会服务的三大职能.对高等中医药院校人才培养要求必须具有必要的西医学基础知识及临床诊疗技能;具有一定的社会人文科学知识和自然科学基础知识;不是单纯的培养中医治疗人才,而是培养为中医药行业服务的各类人才;培养目标与模式应是多样化、多元化.对人才培养应重视以人为本的思想,招生应采取按类招生模式,以充分调动学生的兴趣,发挥学生的个性;减轻学生负担,给其更多的自由空间、更多的课程选择机会;坚持主辅修,为学生开拓发展的空间.人才培养应强调动手能力、创新意识,使学生学会学习,应注重课内与课外相结合;教师的授课要多样化;应重视临床实践能力.     

防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用

为探讨自制防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用效果.选择需行下肢骨牵引的病人100例,随机分成实验组和对照组各50例.实验组采用自制防滑钢针及Y形酒精滴管;对照组采用传统钢针及酒精点滴.观察2组病人钢针滑动、压疮、针道感染情况.结果实验组钢针牵引滑动率显著低于对照组(P＜0.01).针道感染率明显低于对照组(P＜0.01).表明应用自制防滑钢针及Y形酒精滴管效果确切,经济实用,使用方便,可有效避免并发症的发生.     

老年直肠癌临床特征及治疗的变迁

目的 了解近年来老年直肠癌临床特征及治疗的变迁。方法 回顾性分析10年间313例老年直肠癌患者的临床特征及治疗情况，对比第一个5年和第二个5年的临床特征及治疗方法的变迁。结果发病年龄后延，误诊率降低，早期病例增多；Dixon手术增多，辅助治疗由简单变为综合治疗方法；5年生存率明显提高，术后的复发率明显减低。结论 老年直肠癌发病年龄后延，误诊率降低，早期病例逐渐增多；治疗上更趋有效、合理。     

A trial-based cost-effectiveness analysis of letrozole followed by tamoxifen versus tamoxifen followed by letrozole for postmenopausal advanced breast cancer.

BACKGROUND: Third-generation aromatase inhibitors are being considered as an alternative to tamoxifen as first-line therapy for advanced breast cancer. These newer therapies are more expensive, and will gain greater acceptance if they can demonstrate cost-effectiveness. METHODS: Life table analyses are used to compare the costs and benefits [life years gained and quality-adjusted life years (QALYs) gained] of treating postmenopausal women with advanced breast cancer with first-line letrozole (with the option of second-line tamoxifen) compared with first-line tamoxifen (with the option of second-line letrozole). Patient-level data from a large clinical trial describes the effectiveness of the therapy options, clinicians estimate resource usage and utility values are obtained from the literature. RESULTS: The mean cost of providing first- and second-line hormonal therapy is pound 4765 if letrozole is the first-line therapy and pound 3418 if tamoxifen is provided first (a difference of pound 1347). However, patients receiving letrozole as first-line therapy gain an additional 0.228 life years, or 0.158 QALYs. The cost-effectiveness analysis found that first-line hormonal therapy with letrozole gains additional life years at a cost of pound 5917, whilst the cost per additional QALY gained is pound 8514. CONCLUSION: The strategy of letrozole as first-line hormonal therapy not only provides an opportunity for extending and improving patient's quality of life, but also is highly cost-effective compared with other generally accepted medical treatments.     

老年原发性非小细胞性肺癌临床特征

[目的]明确老年原发性非小细胞性肺癌临床及肿瘤生物学特征,为其早期诊断和治疗提供理论指导。[方法]分析安徽医科大学第一附属医院1996年至1998年3年间经病理或(和)细胞学确诊的原发性非小细胞性肺癌病例,将其中大于70岁(老年组)和小于40岁(青年组)作为研究对象,按照临床症状、组织学类型、临床分期、治疗方式和生存率等跟踪随访3年并将相关资料进行统计分析。[结果]在3年间确诊为原发性非小细胞性肺癌病例中,老年组148例,青年组104例。老年组以男性为主,青年组以女性为主,差异分别具有显著性(P<0.05);老年组鳞癌多见,青年组腺癌多见,差异分别具有显著性(P<0.05);老年组多采用以支持和化疗为主的综合治疗,青年组采用以手术为主的综合治疗方案;老年组3年累计生存率为17.5%,中位生存数为14个月;青年组3年累计生存率是28.6%,其中位生存数为18.2个月,差异具有显著性(P=0.018)。[结论]老年原发性非小细胞性肺癌患者主要是男性和鳞癌;老年组的总的生存率和预后较青年组差。     

基于小波变换极大模的多模医学图像融合

多模态医学图像融合由于其对医学临床诊断的意义已引起广泛的关注,基于图像边缘特性的融合方法逐渐成为研究的重点。本文提出了一种基于离散二进小波变换的多尺度边缘检测和图像融合的方法,实现了特征级图像融合。不同于以往的从极大模值点直接重建图像,本文的算法利用极大模值点建立有效的融合规则,然后从融合的小波系数重构信号。融合图像的交互信息和峰值信噪比等检测指标表明此方法优于传统融合算法。     

临床肿瘤学的现状和展望

由于肿瘤发病率和在居民死亡原因中所占比例越来越高,肿瘤防治一直是各国卫生领域内的重点课题之一。本文对近年来肿瘤预防和治疗的新观点和新资料做了介绍,并指出循证医学、规范化和个体化在新时代的重要性。而在高发区开展研究和通过现代科学方法阐明中医药的作用是对我们民族对世界医学做出贡献的重要途径。     

Common Challenges and Problems in Clinical Trials of Boron Neutron Capture Therapy of Brain Tumors

Clinical trials for binary therapies, like boron neutron capture therapy (BNCT), pose a number of unique problems and challenges in design, performance, and interpretation of results. In neutron beam development, different groups use different optimization parameters, resulting in beams being considerably different from each other. The design, development, testing, execution of patient pharmacokinetics and the evaluation of results from these studies differ widely. Finally, the clinical trials involving patient treatments vary in many aspects such as their dose escalation strategies, treatment planning methodologies, and the reporting of data. The implications of these differences in the data accrued from these trials are discussed. The BNCT community needs to standardize each aspect of the design, implementation, and reporting of clinical trials so that the data can be used meaningfully.