补充与替代疗法治疗肠易激综合征的研究进展

肠易激综合征是临床常见的功能性胃肠病之一。由于多数患者的症状经过一线药物治疗后仍不能得到较好改善，许多患者为获得更好的治疗效果，转向选择补充与替代疗法进行治疗。然而，由于研究质量和数量的限制，大部分治疗肠易激综合征的补充与替代疗法并未被相关共识和指南所推荐。本文从补充与替代疗法的分类入手，从天然产品、身心治疗、传统医药3个方面就目前国内外常用的补充与替代疗法治疗肠易激综合征的研究进行概述，以期为临床工作者和患者更好地了解和应用提供帮助。     

Group Similarities in Beliefs Concerning the Causes of Alcohol Problems and the Effectiveness of Means of Overcoming Problem Alcohol Use

Four hundred and eight respondents, who did or did not know persons close to themselves with alcohol problems, from four different racial/ethnic groups (with one group, Filipinos, categorized in terms of whether they were born in the Philippines or in the US.) rated the importance of 19 different causes of problem alcohol use and 22 different means of overcoming problem alcohol use. Rank-order correlations across sexes, persons differing in exposure to problem drinkers, and ethnic groups were nearly all in the 0.90's regarding causation. Correlations of Caucasians' ratings with those of other groups were high, but only in the 0.60's and 0.70'9, chiefly because Caucasians were more prone to regard problem alcohol use as hereditary and as a disease, and less likely to believe problem use to result from social factors. All across-group correlations concerning beliefs about the effectiveness of means of overcoming problems were in the 0.90's. Some of the means of treatment regarded most highly by all groups have not been demonstrated to be effective.     

573例乳腺癌临床资料分析

目的探讨乳腺癌的临床特点以及台疗方法的评价.方法收集1989年～1992年共573例完整的病例资料.按治疗方法分为手术组、手术+放疗、手术+化疗、手术+放疗+化疗、非手术组.对病例的一般临床特点及生存率进行统计学分析.结果年龄35岁～55岁者占408例,发病部位外上象限为333例,病理实性癌占375例.不同治疗方法的生存率分5年和10年如下手术组78%、62%,手术+化疗72%、45%,手术+放疗57%、40%,手术+放疗+化疗60%、45%,非手术组35%.结论乳腺癌高发病率年龄组为中年,病变多位于外上象限,病理多为浸润性非特殊性癌.治疗方法仍以手术治疗为首选,适当地配合放、化疗等.     

结肠镜下无创治疗急性阑尾炎30例临床观察

目的：探讨结肠镜下无创治疗急性阑尾炎的临床疗效及安全性。方法选择60例急性阑尾炎患者，按治疗方法的不同随机均分为实验组和对照组（n=30）。实验组采用内镜逆行治疗，对照组采用腹腔镜阑尾切除，比较2组患者的临床疗效及不良反应。结果实验组住院时间、术后肛门排气时间、治疗费用均明显低于对照组，2组比较差异具有统计学意义（P＜0.05）；实验组腹痛解除天数平均（1.5±0.5）d，对照组腹痛解除天数平均（4.1±0.7）d，2组比较差异具有统计学意义（P＜0.05）；实验组无1例发生并发症，对照组术后发生切口感染2例，1例发生粘连性肠梗阻。结论结肠镜下无创治疗急性阑尾炎疗效好、恢复快、费用低，无明显不良反应，值得临床推广应用。     

幼年特发性关节炎诊疗规范

幼年特发性关节炎(JIA)临床上常见亚型包括全身型JIA、少关节型/多关节型JIA和幼年脊柱关节炎。本病无特异性诊断指标, 需与感染性疾病和恶性病相鉴别。全身型JIA起病多急骤, 病情进展快, 易合并巨噬细胞活化综合征而危及生命。儿童风湿科医生对JIA的诊断及治疗经验仍不足, 规范化诊疗水平有待进一步提高。中华医学会风湿病学分会组织有关专家, 在借鉴国内外诊疗规范和分类标准的基础上, 制定本规范, 旨在规范JIA各亚型及全身型JIA合并巨噬细胞活化综合征的诊断和治疗方案, 以降低致死率和严重并发症的发生率, 从而改善患儿预后。     

Overview of high-risk HPV's 16 and 18 infected cervical cancer: Pathogenesis to prevention

As general, the Human papillomavirus (HPV) causes the most sexually transmitted diseases. Among well categorized 80 types, the high-risk types HPV's 16 and 18 are highly involved in 70% of cervical cancer. The virulence of HPV is mainly exhibited by E5, E6 and E7 encoded oncoproteins that cause low to high-grade cervical lesions (CIN-1, 2, 3), leading to form 99.7% of squamous cell and 89% of adenocarcinomas cervical cancer worldwide. This study mainly encircles the major role of E5, E6 and E7 oncoproteins in HPV 16 and 18. Further discussed the uprising of significant biomarkers and their cellular process in different stages of cervical cancer with current prevention and treatment regimens. Hence, this integration will evoke novel markers, potential vaccination and various treatments approaches with special reference for HPV16 and 18 infected cervical cancers.     

旴江医家论痰饮

"百病多由痰作祟",痰是人体水液代谢障碍所形成的病理产物,又是导致众多病证的致病因素。旴江医学著作宏富,内容丰厚,其中包括许多关于痰饮的精辟论述。对旴江主要医家有关痰饮病因、病机、辨证及防治的论述进行总结。     

出口梗阻型便秘的认识及治疗进展

出口梗阻型便秘是临床中常见的功能性便秘类型,严重困扰着患者生活,近年逐渐引起临床医生的重视。通过多年临床,笔者对出口梗阻型便秘的发病机制有了初步的认识,治疗手段也趋于多样化,但总体疗效都不太满意,仍值得进一步探索改进。本文通过复习相关文献,就出口梗阻型便秘的最新认识及主要治疗手段研究进展作一综述。     

腹腔镜下经括约肌间切除联合结肠拖出术在低位直肠癌保肛术中的应用

目的:探讨腹腔镜下改良经括约肌间切除(ISR)联合结肠肠管拖出术在低位直肠癌保肛术中的应用效果。方法:回顾性分析2016年4月—2017年6月11例行腹腔镜下改良ISR联合结肠拖出术的低位直肠癌患者临床资料。结果:11例均成功完成手术,平均手术时间215(185～320)min,术中平均出血量52(30～250)mL,术后平均住院11.6(9～15)d。无吻合口瘘、骶前感染、肛门狭窄、术后出血等并发症。单个标本获取淋巴结数12～26枚,平均15枚。11例随访4～16个月,平均10个月,未发现与手术相关并发症,无局部复发及转移。术后6个月肛门功能均恢复满意。结论:腹腔镜下改良ISR联合结肠拖出术是治疗低位直肠癌保留肛门较理想的一种手术方式,肛门功能和治疗效果满意,不需要预防性造口,可以完全避免吻合口瘘的发生,同时具有创伤小、恢复快、费用低等优点。