贲门癌误诊为贲门失驰症一例报告

贲门癌误诊为贲门失驰症一例报告戈烽李秉潞李单青张志庸李泽坚患者，女，７５岁。因“间歇性”吞咽困难８个月门诊入院。入院前的钡餐检查显示食管下段鸟嘴样改变，诊为“贲门失弛症”。此后在２个月内连续做４次胃镜检查（包括两次食管下段气囊扩张术），均通过贲门困难...     

经皮冠状动脉腔内成形术失败后急诊冠状动脉旁路移植术二例

经皮冠状动脉腔内成形术失败后急诊冠状动脉旁路移植术二例中国医学科学院中国协和医科大学北京协和医院＊胸心外科于洪泉任华苗齐张志庸孙成孚李泽坚经皮冠状动脉腔内成形术（ＰＴＣＡ）已成为对一些冠状动脉粥样硬化性心脏病（冠心病）患者的首选治疗方法。但这项有创治...     

胸腺瘤伴随的消化系统异常

目的探讨胸腺瘤中消化系统异常的发生率及可能的发生机制。方法结合文献,对北京协和医院1985年1月至2002年6月138例胸腺瘤的临床资料进行回顾性分析。结果138例胸腺瘤患者中消化系统症状总发生率12．3％（17／138）,其中以慢性腹泻最多（7．2％,10／138）,大多数腹泻原因不明确。胸腺瘤患者具有突出的自身免疫倾向,可检测到多种自身抗体;10例慢性腹泻患者中7例检测出自身抗体。胸腺瘤切除后有6例慢性腹泻症状基本缓解。结论胸腺瘤伴随消化系统异常比较常见,其中原因不明的慢性腹泻最多。胸腺瘤患者具有突出的自身免疫倾向,推测自身免疫性肠病可能是此类慢性腹泻的主要病因之一。     

心脏手术中经食管超声心动图监测的应用

１９９４年１月～１９９７年５月,对１４６例心脏手术患者行经食管超声心动图（ＴＥＥ）术中监测,现分析如下。１临床资料与方法１．１一般资料本组共１４６例,男７０例,女７６例。年龄１３～７３岁,平均３４．６岁。手术病种包括先天性心脏病（房、室间隔缺损、法洛...     

EARLY AND LATE RESULTS OF TOTAL GASTRECTOMY IN TREATMENT OF ADVANCED ADENOCARCINOMA OF THE CARDIA

Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomybetween 1978 and 1986.The operative morbidity rate was 7.5% and the hospital mortalityrate (1 month) was 1.5%.The postoperative 1,3,4,and 5 year survival rates were 69%.50.7%,20% and 13.8% respectively.The quality of life after surgery was improved.Patho-logical type,lymph node metastasis,completeness of resectionand postoperative chemotherapywere the main factors influencing postoperative survival time.Indications for total gastrec-tomy and the advantages of transthoracic total gastrectomy are discussed.     

E-cadherin在非小细胞肺癌组织中的表达及临床意义

目的探讨非小细胞肺癌(NSCLC)组织中的E-cadherin(E-cad)表达情况与NSCLC临床病理特征的关系及其对预测肿瘤转移的意义。方法利用SP免疫组化法检测北京协和医院胸外科2009年6月至2010年6月收治的69例NSCLC患者的肿瘤标本的E-cad表达情况,并对患者治疗后进行为期一年的随访。结果 E-cad在患者肿瘤组织中的表达与患者组织学类型、年龄、性别无关(P分别为0.277、0.281、0.378),而低分化、晚期或淋巴结转移者E-cad表达率较低(P分别为0.001、0.049、0.040)。治疗后的E-cad(-)的Ⅰ~Ⅲ期患者比E-cad(+)患者更易发生转移(16.7%vs0,P=0.018)。结论 E-cad表达与NSCLC的侵袭和转移性有关,可以作为预测NSCLC转移的分子标志之一。     

FACTORS AFFECTING REMOVAL AND PROGNOSIS OF THYMIC TUMORS

One hundred and ten cases of thymic tumors were intervened surgically, including 92 thymoma, 8 thymie earcinoid, and 10 thymic carcinoma. In this series, 50. 9 % of the cases were complicated with various syndromes, 44. 5 % with myasthenia gravis (MG). Resection rate was correlated with the size and invasion of the tumor. There was significant difference in resection rate among thymoma, thymic carcinoid and thymic carcinoma. The degree of invasiorl undoubtely influenced on resection. The 3-, 5- and 10- year suvival rate of the thymoma were 82. 7 %, 68. 1 % and 40. 0 %, respectively. The prognosis depended on the pathoioglcal classification and the severity of the neighbouring invasion, but MG had no sianificant effect on prognosis. Recurrence and metastasis of the tumor were the main cause of late death.