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.     

中药治疗乳腺癌的临床和实验研究进展

综合近年来有关文献可知：中医治疗乳腺癌方面取得了一定进展。主要从临床研究和实验研究两个方面进行研究，中医药治疗本病，不但能控制病情发展，而且能改善近期症状，对巩固病情有较大帮助。但也有不足之处，需充分应用现代医学科学技术和手段，对中药治疗乳腺癌术后的综合治疗、抗乳腺癌转移复发等方面进行深入研究，充分发挥中医药治疗优势，取长补短，共同提高其生存率。     

广东省中医院治疗非典型肺炎临床经验

[目的]观察中西医结合治疗严重急性呼吸综合症(SARS)的临床疗效。[方法]对103例确诊SARS患者采用中西医结合的治疗方案。中医采用卫气营血和三焦辨证 ,按病情分为早期、中期、极期 (高峰期 )、恢复期4期 ;西医方案主要采取营养支持、吸氧、呼吸机辅助通气、抗感染、免疫增强、激光抗炎及对症处理等措施。[结果]103例中治愈96例 (93.21 % ) ,死亡7例 (6.79 % ) ;退热时间为 (6.72±3.95)d ;肺部病灶完全消失94例 (91.26 % ) ,胸部X片显示病灶吸收时间为(18.13±8.99)d;2例呈纤维索条状改变。[结论]采用中西医结合治疗在干预病程、减轻中毒症状、缩短发热时间和住院时间、减少后遗症、减轻并发症和西药副作用方面有明显的作用     

运用《金匮要略》方、法治疗泌尿系疾病

《金匮要略》在现代医学泌尿系感梁的临床运用较广，笔者将泌尿系疾病的辨证分型及《金匮要略》中的相关方或法加以整理归纳为8个方面，以利于临床运用。     

循证医学与中医学关系及设想初探

循证医学主要研究内容是提供证据和应用证据，其与中医相同之处是重视证据，重视整体观。中医辩证是通过四诊收集证据，将诊查结果作为辩证、立法、用药的依据。循证医学的核心思想是寻求证据，应用证据。前者用于诊断、后者注重对诊断和治疗结果的分析评价。中医重视整体观，重视从局部与整体有机的联系上分析疾病的病机变化。治疗上重视人体整体 功能状态的调整和改善。而循证医学也具有整体观，突破以往以疾病为中心的模式，倡导临床措施和医疗决策以病人为中心。为促进循证中医药学的发展，建议制作中医药的系统评价；进行循证中医药学在临床实践中的应用研究；组织评价方法研究小组；建立中医临床评价研究资料库。     

加替沙星治疗急性细菌性呼吸道和泌尿道感染

目的: 评价国产加替沙星注射液治疗急性细菌性呼吸道和泌尿道感染的有效性与安全性.方法: 采用区组随机、平行对照、多中心研究设计,加替沙星注射液与左氧氟沙星注射液均为200 mg,ivd, q12 h, 疗程5～14 d.结果: 本项试验实际入组49例,其中加替沙星组27例,左氧氟沙星组22例,治疗结果加替沙星与左氧氟沙星组临床有效率分别为96.30%与95.45%,细菌清除率分别为95.24%与100%,不良反应发生率分别为7.41%与4.55%,上述结果均无统计学差异.结论: 加替沙星与左氧氟沙星在治疗临床常见的敏感细菌引起的呼吸道、泌尿道感染均是安全、有效的抗菌药物.     

来氟米特的作用机制及临床应用进展

来氟米特是一种新型的免疫抑制剂，主要用于类风湿性关节炎的治疗。近年的一些临床研究提示，该药物对其他自身免疫性疾病也有一定的疗效。本文综述来氟米特的作用机制和临床研究进展，阐述其最新研究动态和发展趋向。     

PRIMARY INTRACRANIAL GERM CELL TUMORS: Clinicopathologic Review of 32 Cases

Primary intracranial germ cell neoplasms are rare tumors and constitute a heterogeneous group. We have reviewed 32 cases, over a 21-year period, from the University of Florida. The cases include 22 germinomas, 6 mixed germ cell tumors, and 4 teratomas. The clinical presentations in these cases were more closely related to the location of the tumor, that is, pineal or suprasellar, rather than the histologic subtype. Neuroimaging evaluation was useful in distinguishing between germinomas, teratomas, and other mixed germ cell tumors (MGCTs), primarily by evaluation of cystic versus solid lesions (teratoma versus germinoma), contents of cysts (teratoma versus MGCT), and infiltrative nature of the tumors (MGCT), although cytologic-histopathologic confirmation remains necessary. Germinomas responded favorably to radiation therapy with survival periods of over 16 years; MGCTs were treated with combination chemotherapy and radiation, with a markedly poorer prognosis. This study underlines the critical significance of histopathologic evaluation of the tumor in determining therapeutic interventions as well as prognosis.     

Infant influenza

Reports on the symptoms of infant influenza (less than 1 year of age) are very few. From 1989 to 1996, 105 infants with influenza were examined. The symptoms, nutrition and source of infection of the 105 patients were investigated in Sakuma Pediatric Clinic and viral studies were performed at the Kitakyushu City Institute of Environmental Sciences. The symptoms of patients under 6 months old are very mild, with a low maximum body temperature and a short duration of fever. Other complications are few. The symptoms gradually become more severe with each month of age. The ratio of patients displaying a diphasic fever with two peak temperatures increases with each month of age. Over 50% of patients over 9 months old have this diphasic fever with two peak temperatures. It is inconclusive whether an anti-infective factor in human milk exists or not. Of the 105 patients in this study, 28 were under 4 months of age; of these 28, all but 3 were infected by family members.