卵巢癌脑转移8例临床分析

卵巢癌的扩散以腹、盆腔种植为主要转移途径,血行扩散、脑转移极少见。我院1982～1998年共收治卵巢癌患者818例,其中8例出现脑转移。总结报告如下。1　临床资料1.1　一般情况　初治时期2例,期4例,期1例,外院治疗后复发1例。浆液性囊腺癌5例,粘液性囊腺癌2例,透明细胞癌1例。1.2　脑转移发生时间　诊断卵巢癌至脑转移的时间9～94.8个月,中位30.2个月。1.3　治疗　发生脑转移前8例均行全子宫双附件、大网膜、阑尾切除术,术后6例行含顺铂方案化疗,1例行米尔法兰口服加盆腔放射治疗,1例行非顺铂方案化疗。发生转移后,4例行化疗或化疗 全脑放疗,4…     

SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

ＳＥＡＲＣＨＦＯＲＨＥＲＰＥＳＳＩＭＰＬＥＸＶＩＲＵＳＴＹＰＥ２（ＨＳＶ－２）ＡＮＤＨＵＭＡＮＰＡＰＩＬＬＯＭＡＶＩＲＵＳ（ＨＰＶ）ＩＮＴＨＥＮＯＲＭＡＬＡＮＤＡＢＮＯＲＭＡＬＣＥＲＶＩＣＡＬＳＡＭＰＬＥＳＺｈａｎｇＷｅｉ;张伟;ＪｉｎＳｈｕｎｑｉａ...     

经内镜高频治疗食管癌狭窄12例疗效观察

食管癌可导致患者进食困难，生活质量严重下降。对于已经失去手术机会的晚期食管癌狭窄或合并食管瘘的患者，采用支架置入后放射治疗可取得满意效果。但因种种原因，部分患者不能接受带支架放疗而再次出现的癌性狭窄，对此笔者采用内镜下高频治疗取得满意效果，现报道如下。     

CLINICAL ANALYSIS OF EXTRAMAMMARY PAGET’S DISEASE OF VULVA

Paget'sdiseasewasfirstlydescribedbyJamesPagetin1874asabreastlesion.ItwasalsoseenatotherplacesandgenerallycalledextramammaryPagetsdisease,76%ofwhichwaspredominantlyfoundonthevulva[1].Pagetsdiseaseofthevulvaremainsarareconditionthataccountsforlessthan1%ofvulvarneoplasms[2].Thelesionusuallyappearsaseczemaandmaybemisdiagnosed.However,invasivediseaseoradenocarcinomamaybepresentwithPagetsdisease.Andrecurrenceishighaftertreatment.TheaimofthisstudywastoreviewcasesofPagetsdiseaseinourhospitalandanal…     

高危型人乳头瘤病毒载量与子宫颈病变的关系

Objective To determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN). Methods Cervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00),low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load 100. 00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression. Results The HR-HPV infection rate of the population was 14. 51% (2515/17 334). 100. 00% (29/29) of SCC,97. 63% (206/211) of CIN 3,93.43% (199/213) of CIN 2,75.04% (421/ 561) of CIN 1 and 10. 17% (1660/16 320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC,CIN 3,CIN 2,CIN I and normal were 320. 85,158. 05, 143. 70,125.34 and 9. 64, respectively. There were significant differences among the distributions of viral loads in each lesion (X2=6190. 40,P<0. 01). The severity of CIN increased with the viral load (X2=5493. 35 ,P<0. 01). Compared with the risks of CINs in HR-HPV negative population,the risks of CINs in low,moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9. 01 (6. 31 -12. 87), 24.96(18.23 -34. 17) and 68.42(51.40 -91.08); CIN 2:26.44(12.07 -57.95),98. 53 (49. 54 -195.98) and 322. 88(168.62 -618. 27) ; CIN 3 + : 72. 89(24.02 -221.18) ; 343. 58(121.81 -969.09) Was 3115.05,2413.95 and 3098.57, respectively. P<0.01) . In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95%CI):<35: 4. 71(1.23-18.09) and 15.06(4.40-51.49); 35-: 4.01 (1.62-9.90) and 14.09(6. 15 -32.28); 40-: 3.06(1.52 -6. 16) and 7.78(4.05 -14.95); ≥45: 3. 50(1.36 -9. 01) and 7. 57 (3. 13 -18. 30)], and there was a positive correlation between the risk of CIN 2 + and the viral load (Xtrend2was 51. 33,66. 28,53. 64 and 51.00,respectively. P<0. 01). The risk of CIN 2 + was highest among the women aged 40 -with high viral load [0R(95% CI):2.02 (1.15 -3. 52)]. Conclusion There is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3,and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively.     

液基细胞学结合阴道镜检查在北京市社区妇女宫颈病变筛查中的意义

目的探讨宫颈液基细胞学及阴道镜检查在北京市社区妇女宫颈病变筛查中的临床意义。方法2006年6月至2007年6月对北京市展览路社区的795位20～54岁有性生活的妇女进行筛查。筛查对象接受妇科检查时,留取宫颈超柏氏薄层液基细胞学检测标本,并对宫颈细胞学异常者行阴道镜检查及活组织检查。结果宫颈细胞学阳性[≥ASC-US（不能明确意义的不典型鳞状细胞）]45例,占5．7％（45／795）。其中ASC-US33例,占73．3％（33／45）;低度鳞状上皮内病变8例;高度鳞状上皮内病变3例;不典型腺细胞1例。细胞学阴性750例,占94．3％（750／795）。宫颈细胞学阳性的45例中,5例拒绝行阴道镜检查,占11．1％（5／45）。在行阴道镜活组织病理检查的40例中,慢性宫颈炎11例（27．5％）;宫颈湿疣14例（35．0％）;宫颈上皮内瘤样病变（CIN）1为7例（17．5％）;CIN2为3例（7．5％）;CIN3为4例（10．0％）;早期浸润癌1例（2．5％）。细胞学阴性的750例中,宫颈湿疣2例（0．3％）;CIN1为5例（0．7％）;宫颈低级别腺上皮内病变1例（0．1％）。宫颈液基细胞学筛查CIN1及以上宫颈病变和宫颈癌的敏感度71．4％,特异度94．2％,阳性预测值37．5％,阴性预测值99．2％;筛查CIN2及以上宫颈病变和宫颈癌的敏感度100．0％,特异度96．0％,阳性预测值20．5％,阴性预测值100．0％。结论应重视并及时进行北京市社区人群宫颈病变的早期筛查,薄层液基细胞学结合阴道镜活组织检查及病理学检查,对提高早期宫颈癌筛查的准确性效果明显。     

缺血性结肠炎患者的血黏度及血脂分析

目的：分析缺血性结肠炎（IC）患者的血黏度及血脂状况，为防治IC提供依据。方法确诊为IC患者（观察组）与健康者（对照组）各43例，测定高切变率下的全血黏度、低切变率下的全血黏度、D-二聚体、总胆固醇（CHOL）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（Apo-A1）、载脂蛋白B（Apo-B）。结果观察组高切变率全血黏度、低切变率全血黏度、D-二聚体、CHOL、TG、LDL-C、Apo-B 水平，均高于对照组，HDL-C、Apo-A1低于对照组，差异均有统计学意义。结论缺血性结肠炎患者血黏度及血脂明显异常，血管栓塞风险高，积极改善微循环与合理的调脂治疗，可预防和减缓缺血性结肠炎的发生及进展。     

Detection of sentinel lymph node in early cervical cancer

CervicalcancerwasoncerankedinsecondpositionamongthemostcommonmalignanttumorinChinesewomen.Theincidencerateofthecervicalcancerwasremarkablyreducedduetothenewlydevelopedmedicaltechniquesandthesocalledthethreeearly?po1icy:earlyprevention,earlydiagnosisandearlytreatment.Thedeathrateofcervicalcancerdescendedby10.3/100000in1970to3.3/1000001990.However,thetrendoftheincidencerateofear1ycervica1cancerissignificantlyincreasedamongtheyoungerwomenpopulation.Thestandardtechniqueofthesurgicaltreatmentforea…     

35岁以下妇女宫颈癌

目的探讨宫颈癌的发病趋势和年轻宫颈癌的预后因素。方法回顾分析自1970～1994年我院收治125例年轻宫颈癌（＜35岁）的临床资料。结果＜35岁妇女宫颈癌在我院治疗的全部宫颈癌中所占比例自70年代的1．22％上升至80年代的1．42％及90年代初的5．01％。根治性治疗的116例中22例宫颈原位癌和早期浸润癌的5年生存率为100％,94例浸润性宫颈癌的总5年生存率为56．4％,复发（或未控）和转移率为36．2％（34／94）。结论本组提示宫颈癌发病有年轻化趋势,＜35岁年轻宫颈癌的预后较差,临床期别、宫颈肿瘤大小、组织学类型是影响预后的重要因素。     

泮托拉唑钠肠溶片与泮托拉唑钠胶囊治疗消化性溃疡的临床随机对照研究

目的:比较泮托拉唑钠肠溶片与泮托拉唑钠胶囊治疗消化性溃疡的临床疗效及评价其不良反应。方法:采用随机对照和开放试验的方法治疗胃镜检查确诊的消化性溃疡病人共162例,其中泮托拉唑钠肠溶片组(试验组)62例,其中胃溃疡18例,十二指肠溃疡44例;泮托拉唑钠胶囊组(对照组)60例,其中胃溃疡16例,十二指肠溃疡44例;开放组40例,其中胃溃疡12例,十二指肠溃疡28例。结果:试验组中胃溃疡的愈合率和总有效率分别为83.3%和100.0%,十二指肠溃疡的愈合率和总有效率分别为88.6%和97.7%;对照组中胃溃疡的愈合率和总有效率分别为81.3%和100.0%,十二指肠溃疡的愈合率和总有效率分别为84.1%和97.7%;开放组中胃溃疡的愈合率和总有效率分别为91.7%和100.0%,十二指肠溃疡的愈合率和总有效率分别为85.7%和100.0%。试验组中疼痛消失率和其他消化道症状的消失率在胃溃疡为94.4%和92.3%,在十二指肠溃疡则为97.7%和98.0%。对照组中疼痛消失率和其他消化道症状的消失率在胃溃疡为93.8%和93.6%,在十二指肠溃疡则为97.7%和97.3%。两组在愈合率、总有效率、疼痛消失率和其他消化...