原发性胃恶性淋巴瘤31例临床分析

本文对1978～1987年收冶的31例原发性胃恶性淋巴瘤进行临床分析。原发性胃恶性淋巴瘤和胃癌在临床表现及胃钡餐X线检查方面很难区分,但两者的手术切除率及预后不同,因而其鉴别有重要临床意义。为此,我们提出以下几点供临床鉴别:1.原发性胃恶性淋巴瘤发病年龄较胃癌轻。2.原发性胃恶性淋巴瘤患者全身状况较胃癌好,低蛋白血症和恶液质少见。3.原发性胃恶性淋巴瘤转移较胃癌晚。4.胃镜下活检要达到粘膜下层,阳性率较高。5.术中可见原发性胃恶性淋巴瘤瘤体较胃癌软,切面偏红,较易分离切除。     

青年人原发性胃恶性肿瘤462例分析

目的:探讨青年人原发性胃恶性肿瘤临床病理特点及诊治方法。方法:对462例患者临床病理资料进行系统性回顾。结果:青年人原发性恶性肿瘤主要为胃癌,少数为原发性淋巴瘤、平滑肌肉瘤等。青年人胃癌组织分化差的类型居多,易发生浸润和转移,远端胃为好发部位;常规胃镜加活检低于中老年人胃癌的诊断水平,超声内镜、胃镜结合超声诊断符合率明显高于常规胃镜检查;根治性切除术者1年、2年、5年生存率明显高于姑息性手术者,早期胃癌根治性切除效果更佳。青年人原发性胃淋巴瘤诊断时以中晚期居多,根治性切除术亦有较好的疗效。结论:青年人原发性胃恶性肿瘤恶性程度高,预后差;早期发现和早期手术切除是提高生存率的关键;胃镜是诊断胃恶性肿瘤的主要方法,超声内镜、胃镜结合超声可提高诊断率,尤其是对于胃壁浸润者。     

残胃癌的临床病理特点和诊治

目的 探讨残胃癌临床特点及合理的外科治疗方法.方法 回顾性总结本院收治的19例残胃癌患者的临床资料,分析残胃癌临床表现特点及治疗与转归.结果 残胃癌平均潜伏期24.3年.全组19例患者均接受了剖腹探查,手术切除9例(47.4%).根治性切除7例(36.8%),包括残胃全切除3例,行联合器官切除术4例:残胃加左半肝切除1例,残胃加横结肠切除1例,残胃加脾切除1例,残胃加脾、胰尾切除1例;姑息性残胃切除、残胃空肠吻合2例,空肠造瘘5例; 4例剖腹探查加置化疗泵;1例诊断性探查与活检.消化道重建术式均为Roux-en-Y吻合术.本组无住院死亡病例.14例患者获得随访,1、3、5年生存率分别为64.3%、42.9%、21.4%; 7例根治性切除患者1、3、5年生存率分别为100%、85.7%、42.9%.姑息性切除患者生存时间平均为20(15～25)个月.残胃病灶未切除者生存时间平均为6.8(3～11)个月.结论 胃大部分切除术后要定期进行内镜检查,可早期发现残胃癌,及时行残胃癌根治术或联合脏器切除术,可改善患者生活质量和延长患者生存期.     

胃淋巴瘤的X线影像分析

原发性胃恶性淋巴瘤(primary gastric malignant lym-phoma,PGML)发病率低,只占消化道肿瘤的1%~4%,但是为最常见原发于淋巴结外的恶性淋巴瘤[1]。本病临床表现缺乏特异性,术前钡餐造影及胃镜易漏诊或误诊为胃癌[2,3],而两者的预后和治疗方案完全不同。本文总结了7例原发性胃恶性淋巴瘤的胃肠气钡双对比造影(double-contrast upper gastrointestinal examination,GI)表现,以提高其术前诊断水平。1资料与方法1·1临床资料7例经胃镜活检和手术证实为原发性胃淋巴瘤患者,其中男性5例,女性2例,年龄23~73岁,平均53岁。行GI检查7例,临床表现均…     

胃癌合并胃原发性恶性淋巴瘤的组织病理学及组织化学研究

胃的恶性淋巴瘤少见,约占胃恶性肿瘤的1%～4%。胃癌合并胃原发性恶性淋巴瘤则罕见。本文对1例胃癌合并胃恶性淋巴瘤的病例进行了较系统的组织病理学和组织化学研究,并对恶性淋巴瘤、瘤样淋巴组织增生与胃癌关系进行了讨论。     

残胃癌11例临床诊疗分析

残胃癌(gastric stump cancer,GSC)是胃十二指肠溃疡行胃大部切除术5年后残胃发生的原发性癌[1],由Balfour于1922年首次提出,由于其早期诊断率低,其根治性手术率和生存率均明显低于原发性胃癌。近年来残胃癌的发生率有日渐增高的趋势。我院2003年5月至2009年4月共诊治11例残胃癌患者,占我院同期收治胃癌总数的1.5%(11/716),现总结如下。1临床资料1.1一般资料11例中男10例,女1例。年龄48~79岁,平均年龄58.6岁。距胃部分切除时间6~37年,平均21.4年,其中间隔>20年者占54.5%(6/11)。胃部分切除原因:胃溃疡或伴穿孔、出血、梗阻7     

原发性胃恶性淋巴瘤11例

原发性胃恶性淋巴瘤是胃内最常见的非上皮性恶性肿瘤。本文收集我科1981～1997年间11例原发性胃恶性淋巴瘤,均经手术病理证实。现报道如下。　1　临床资料一般资料　本组11例,男6例,女5例,男女之比为12∶1。年龄22～59岁,平均401岁,35岁以下患者4例,占36%。从发病到就诊平均13ｍｏ。临床表现为上腹不同性质疼痛10例;腹部明显包块8例;均占全组70%以上。柏油便3例。明显消瘦2例。恶心呕吐1例。合并胃穿孔2例。Ｘ线钡餐造影和纤维内镜检查各9例。前者诊断胃癌5例,胃恶性淋巴瘤4例;后者诊断胃癌4例,胃恶性淋巴瘤5例。两项检查的诊断符合率前者为…     

胃原发性恶性淋巴瘤12例临床分析

<正>胃原发性恶性淋巴瘤是非癌性胃恶性肿瘤中较常见的类型,其临床和内镜表现缺乏特异性,常被误诊为胃癌。由于在治疗方法上与胃癌不尽相同,其预后较胃癌好。现将我院近10年来确诊的12例胃原发性恶性淋巴瘤分析报告如下。 1.临床资料 本组12例中,男7例,女5例;年龄12～81岁,平均45岁;病史最长3年,最短12天,平均8.4个月。 主要症状 上腹痛10例,消化道出血6例,上腹     

原发性胃恶性淋巴瘤37例临床分析

原发性胃恶性淋巴瘤(Primary gastric malignantlymphoma)又被命名为粘膜相关淋巴瘤(Mucosa-associatedlymphoid tissue-lymphoma,MALT-L),占胃非上皮性恶性肿瘤首位,文献报道,约占胃恶性肿瘤的5%~11%,且逐年呈上升趋势[1,2]。本文现将我院1995至2005年来确诊的37例原发性胃淋巴瘤的临床特征、治疗和预后进行分析。临床资料1一般资料本组37例原发性胃淋巴瘤37例,其中男21例,女16例,年龄14~74岁,平均46岁。诊断标准[3]为术后病理组织学证实,同时有以下条件:1全身无病理性浅表淋巴结肿大;2胸片无纵隔淋巴结肿大;3白细胞计数及分类正常;4手术证实病变局限于胃及引流区域淋巴结;5肝脾正常。临床分期按Naqivi分期[4]:期4例,病灶在胃内;a期9例,淋巴结受累仅限于临近胃内原发性的引流淋巴结;b期13例,有腹腔内非临近区淋巴结的受累;期9例,有胃周围脏器的直接侵犯;期2例,肝、脾、骨髓受累,或有其他腹腔外病灶。2临床表现临床表现无特殊,半数以上表现与消化性溃疡相似。其中腹痛30例(81.1%),腹胀14例(37.8%)...     

脾脏原发性肿瘤诊治体会(附17例报告)

目的 探讨原发性脾脏肿瘤的诊断与治疗规律.方法 回顾性分析我院1991年以来收治的原发性脾脏肿瘤患者17例,其中良性7例,恶性10例,全部行脾切除术,2例联合切除胰尾,2例联合行胃部分切除.恶性肿瘤术后均给予化疗及放疗.结果 全组无手术死亡.良性病例预后良好.本组7例恶性淋巴瘤分别于术后5个月至12个月死亡;3例血管内皮肉瘤手术后3个月至8个月死亡,死因均为肿瘤复发.结论 脾脏原发性肿瘤早期诊断至关重要,脾脏切除是主要的治疗手段,恶性病例术后均辅以化疗及放疗.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.