Postoperative adjuvant radiotherapy and 5-fluorouracil chemotherapy for rectal carcinoma

Postoperative combined modality therapy with radiotherapy and 5-fluorouracil (5FU) chemotherapy is an effective adjuvant approach that reduces locoregional and distant metastatic disease in patients with high-risk rectal carcinoma. However, this approach results in a treatment regimen of at least 6 months’duration. The present prospective study investigates the integration of radiotherapy and 5FU chemotherapy in a protocol designed to minimize toxicity and reduce the overall treatment time. A total of 40 patients with TNM stage II or III disease received postoperative radiotherapy at four fractions per week with weekly 5FU bolus injections delivered on the fifth non-radiotherapy day. Patients also received systemic chemotherapy with leucovorin both before and after pelvic irradiation, with the total treatment duration extending for only 18 weeks. Patients were able to complete radiotherapy in 90% of cases, while the delivery of full-dose chemotherapy was achievable in the vast majority. The incidence of haematologic and gastrointestinal toxicities requiring the cessation of treatment was acceptable. With a median follow-up of 20.9 months among surviving patients, the estimated progression-free and overall survival at 2 years were 71 % and 79%, respectively.     

中西医结合治疗活动期溃疡性结肠炎42例疗效观察

目的:观察中西医结合治疗活动期溃疡性结肠炎(UC)的临床疗效。方法:将72例活动期UC患者随机分为2组。治疗组42例,用溃结合剂(处方:白头翁、败酱草、地榆、苦参、白及、白芍、木香)加柳氮磺胺吡啶保留灌肠治疗;对照组30例,单纯用柳氮磺胺吡啶保留灌肠治疗。2组均以2周为1疗程,连续治疗2疗程后观察疗效。结果:近期治愈率治疗组73.81％,对照组36.67％;总有效率治疗组95.24％,对照组80.00％。2组近期治愈率及总有效率比较,差异均有显著性意义(P<0.05)。结论:中西医结合保留灌肠治疗活动期UC较单纯西医治疗疗效好。     

放疗联合肝动脉化疗栓塞治疗肝癌的研究进展

对于不能手术的原发性肝癌患者，放射治疗配合肝动脉栓塞化疗（TACE）的疗效明显好于单纯放疗或单纯化疗，治疗并发症的发生率和程度可以接受，大多数患者可以耐受。放疗配合动脉栓塞化疗是治疗不能手术的原发性肝癌患者的非常有发展前途的治疗方法。现综述这二种治疗方法的技术特点、疗效和协同作用研究的现状及最新进展。     

双途径化疗治疗晚期肺癌并胸腔积液33例报道

目的观察双途径化疗对晚期非小细胞肺癌合并胸腔积液的疗效.方法采用胸腔穿刺、CVP管植入灌注顺铂＋地塞米松与长春瑞宾（NVB）＋顺铂（DDP）联合静脉化疗相结合的方法治疗33例肺癌.结果治疗胸腔积液的有效率为93.94%,肺部病灶治疗有效率为48.48%.结论双途径给药为临床上值得推广的方法.     

盖诺加吡柔比星治疗晚期乳腺癌的临床观察

目的观察盖诺联合吡柔比星治疗晚期乳腺癌的疗效及安全性。方法对28例晚期乳腺癌患者,盖诺25mg/m2,静脉滴入,第1、8天;吡柔比星40mg/m2,静脉注射第1天,21天为一周期,全组化疗共86周期。结果有效率71.4%(20/28),CRO例,PR20例。结论盖诺加吡柔比星治疗晚期乳腺癌,疗效较好,且毒性可耐受,值得临床使用。     

中西医结合治疗溃疡病穿孔远期疗效观察

目的：观察中西医结合治疗溃疡病穿孔的远期疗效。方法：采用自拟问卷对126例经中西医结合治疗痊愈出院的胃、十二指肠溃疡急性穿孔患者进行远期疗效随访。结果：良好89例（70．6％），尚好28例（22．2％），不良9例（7．2％），总有效率92．8％。结论：中西医结合治疗溃疡病穿孔远期疗效肯定，但是否坚持服药治疗可直接影响到远期疗效。     

Comparison of combined spinal epidural anesthesia and epidural anesthesia for cesarean section

BACKGROUND: Epidural anesthesia (EA) is popular for cesarean section, but has some drawbacks such as incomplete block, inadequate muscle relaxation and delayed onset. Combined spinal epidural anesthesia (CSEA) has gained increasing interest as it combines the reliability of a spinal block and the flexibility of an epidural block. We investigated the efficacy of CSEA that combines the main spinal and the supporting epidural anesthesia, comparing with pH-adjusted EA, for cesarean section. METHODS: Sixty-four pregnant women at full term were divided into two groups. Patients in the CSEA group (n=32) were given 1.5-1.6 ml of 0.5% hyperbaric bupivacaine intrathecally, followed by 10 ml of 0.25% plain bupivacaine through the epidural catheter 10 min later. Patients in the EA group (n=32) received 20-25 ml of 2% lidocaine which was already mixed with 0.1 ml of 0.1% epinephrine, 100 g of fentanyl and 1.5 ml of 8.4% sodium bicarbonate. The quality and side effects of surgical anesthesia, neonatal state, and postoperative course were compared between the two groups. RESULTS: In the EA group, 22% (7 cases) complained of intraoperative pain but none in the CSEA group (P=0.011). Muscle relaxation and motor block were much better in the CSEA group (P<0.001 and P=0.011 each). Significantly more women in the EA group had shivering (P=0.001). They also had more nausea and vomiting but the differences were not significant. Not only the time to T4 block (9.7 vs. 18.3 min, mean, P<0.001) but also the stay in the postanesthesia care unit, recovery of sensory and motor block and start of postoperative pain were all significantly shorter in the CSEA group. No one in either group had postdural puncture headache (PDPH). CONCLUSION: We can conclude that, when combining the main spinal and the supporting epidural anesthesia, CSEA has greater efficacy and fewer side effects than the pH-adjusted EA in cesarean sections.     

蚕蚀性角膜溃疡的综合治疗

目的:探讨蚕蚀性角膜溃疡的最佳有效治疗方案。方法:将连续治疗的蚕蚀性角膜溃疡患者54例(77眼),按治疗方案的不同分为3组,单纯角膜溃疡切除联合板层角膜移植组21眼,角膜溃疡及邻近球结膜切除联合板层角膜移植组19眼,板层角膜移植术后联合应用地塞米松、环孢霉素A组37眼,对其疗效进行回顾性分析。结果:单纯角膜溃疡切除联合板层角膜移植术组一次性手术治愈率为48%,复发率为33%。角膜溃疡联合临近球结膜切除板层角膜移植术组一次性手术治愈率为68%,复发率为26%。板层角膜移植联合应用免疫抑制剂组一次性治愈率为76%,复发率为24%。结论:角膜溃疡及邻近球结膜切除联合板层角膜移植术后应用地塞米松及环孢霉素A眼液是目前治疗蚕蚀性角膜溃疡的最佳有效方法。     

三联术治疗先天性睑裂狭小综合征

目的探讨先天性睑裂狭小综合征的手术方法。方法13例行内眦成形、外眦成形和上睑下垂矫正三联手术。结果术后全部13例(26眼)睑裂宽度≥6mm，重睑线美观自然，眼睑闭合良好。结论三联术治疗先天性睑裂狭小综合征术式简便，效果确切。     

国产甲乙型肝炎联合疫苗的安全性和免疫原性初步研究

目的评价国产甲、乙肝联合疫苗的安全性和免疫原性。方法对278名健康儿童和312名健康成人接种国产甲、乙肝联合疫苗，并与单价甲肝灭活疫苗和乙肝灭活疫苗进行对照，观察其免疫后的副反应和检测抗体阳转率。结果接种国产甲、乙肝联合疫苗成人和儿童中均未观察到严重全身反应和局部反应。首针免疫后7个月，儿童组甲肝抗体和乙肝抗体阳转率分别达到100％和96．88％，GMT达到29144mIU／ml和102mlU／ml；成人组甲肝抗体和乙肝抗体阳转率也达到100％和98．84％，GMT达到21891mIU／ml和112mlU／ml。儿童和成人接种甲乙肝联合疫苗后，甲肝和乙肝抗体阳转率和GMT均高于单价疫苗。结论国产甲、乙型肝炎联合疫苗是安全的，并可诱导较高的甲肝抗体和乙肝抗体应答。