乳腺癌保乳手术治疗进展

随着"乳腺癌是一全身性疾病"的提出以及循证医学的发展,乳腺癌的治疗模式从以往的单纯依靠手术治疗转变为多学科的综合治疗。乳腺癌的外科治疗理念从一个多世纪前的"可以耐受的最大治疗"转变为综合治疗保障下的"最小有效治疗"。保乳术及术后综合治疗已成为治疗早期乳腺癌的主要方法之一。本文就近年来关于乳腺癌保乳术手术方式、手术技术问题、适应证及禁忌证、治疗效果、存在的问题等方面作一综述。     

从"肝肾-经筋"理论探讨骨性关节炎的综合治疗

目的:依据"肝肾-经筋"理论,探讨骨性关节炎的中医分期综合治疗.方法:通过文献研究方法,以<内经>藏象、经筋理论为指导,根据"治未病"、"杂合以治"为依据,探讨骨性关节炎的分期综合治疗.结果与结论:骨性关节炎早期以局部经筋病变为主,中后期除经筋病变外,尚有脏腑病变尤其以肝、肾为主.辨证治疗在分期的基础上,采用经筋辨证和脏腑辨证,早期以外治推拿、针灸等方法为主,中后期当辩证论治内服汤药综合配合外治两种方法.通过分期综合治疗,提高治疗该病的临床疗效.     

乳腺癌保乳手术治疗研究进展

在发展循证医学临床提出"乳腺癌属于全身性疾病"时,治疗乳腺癌的模式也从之前单一手术治疗变成综合性治疗。外科治疗乳腺癌的理念也由"可以耐受的最大治疗"变成综合治疗基础保障下的"最小有效治疗"。综合治疗以及保乳术逐渐变成早期乳腺癌的主要治疗方法之一。本文探析了乳腺癌保乳手术治疗研究进展。     

乳腺癌保乳手术治疗进展

随着研究的深入、医疗科技的进步以及基于分子生物学为基础的个体化治理方案的实施,乳腺癌的治疗已从过去的单纯手术治疗模式向多学科综合治疗模式、个体化治理模式转变。乳腺癌的外科治疗理念从最初的"可以耐受的最大治疗"转变为综合治疗保障下的"最小有效治疗"。保乳术及术后综合治疗已成为治疗早期乳腺癌的主要方法之一。该文就近年来关于乳腺癌保乳术的理论基础、适应证和禁忌证、手术方式及术后辅助治疗等问题进行综述。     

医本家整体治疗策略在肿瘤治疗设计中的作用

临床医学处于快速发展期,对恶性肿瘤的治疗正在经历从传统的单项专科治疗向联合治疗,再向多学科综合治疗的转变。对恶性肿瘤治疗的最终目的是提高生活质量和延长生存期,而通常的治疗原则是"早期、积极和综合"治疗,这些治疗原则太笼统,对     

“清肺化痰颗粒”治疗急性气管—支气管炎及慢性支气管炎急性发作129例临床观察

[目的]观察"清肺化痰颗粒"对急性气管—支气管炎及慢性支气管炎急性发作的疗效。[方法]将199例观察对象随机分为两组,治疗组129例给予"清肺化痰颗粒",3次/d,每次1袋,1周为1个疗程;对照组70例给予"羚羊清肺丸",3次/d,每次1丸,2周为1个疗程。观察两药的综合疗效以及对咳嗽、咳痰的疗效。[结果]治疗组与对照组对慢性支气管炎急性发作综合疗效上无统计学差异,但在咳痰的治疗方面,治疗组明显好于对照组。对急性气管—支气管炎的治疗,治疗组在综合疗效和咳痰的治疗上明显优于对照组。[结论]"清肺化痰颗粒"疗效明确.对于两病的综合疗效以及咳嗽、咳痰的疗效均优于"羚羊清肺丸"。     

基于TOPSIS法的江西省农村中医适宜技术推广绩效评估

目的对3项中医适宜技术在江西农村推广的绩效进行综合评价。方法采用TOPSIS法对中医适宜技术在江西省县、乡、村推广的供、需双方进行综合评价,并对推广绩效进行排序。结果 3项中医适宜技术中,"隔物灸治疗寒湿凝滞型原发性痛经"的推广绩效排在首位,其次为"经皮穴位电刺激治疗瘀滞型肩周炎"和"热敏灸治疗颈椎病"。结论 "隔物灸治疗寒湿凝滞型原发性痛经"的综合绩效位列第一,适合进一步推广使用。     

认识恶性肿瘤才会合理治疗

倡导恶性肿瘤多学科综合治疗的理念已有半个世纪,得到了我国广大临床肿瘤学工作者的认同,但是目前我国恶性肿瘤综合治疗的现状不尽人意。中国抗癌协会肺癌专业委员会的主任委员吴一龙教授在本刊2008年第一期上发表了题为《恶性肿瘤多学科综合治疗的困境》的述评,剖析了多学科综合治疗的困境及原因。中国医学科学院肿瘤医院头颈外科专家屠规益教授近期著文《恶性肿瘤的综合治疗,实证和行动一致?》,分析了目前我国的恶性肿瘤多学科综合治疗存在的问题并提出了一些改进肿瘤综合治疗的建议。为了进一步推动恶性肿瘤多学科综合治疗的发展和提高,我刊请中国抗癌协会肺癌专业委员会和中国抗癌协会临床肿瘤学协作专业委员会的专家对"恶性肿瘤多学科综合治疗"谈谈各自的看法。本刊将专家们的意见陆续刊登在综合治疗论坛栏目中,请大家关注,更敬请全国各位同行发表自己的看法。     

恶性肿瘤综合治疗的思考

倡导恶性肿瘤多学科综合治疗的理念已有半个世纪,得到了我国广大临床肿瘤学工作者的认同,但是目前我国恶性肿瘤综合治疗的现状不尽人意。中国抗癌协会肺癌专业委员会的主任委员吴一龙教授在本刊2008年第一期上发表了题为《恶性肿瘤多学科综合治疗的困境》的述评,剖析了多学科综合治疗的困境及原因。中国医学科学院肿瘤医院头颈外科专家屠规益教授近期著文《恶性肿瘤的综合治疗,实证和行动一致?》,分析了目前我国的恶性肿瘤多学科综合治疗存在的问题并提出了一些改进肿瘤综合治疗的建议。为了进一步推动恶性肿瘤多学科综合治疗的发展和提高,我刊请中国抗癌协会肺癌专业委员会和中国抗癌协会临床肿瘤学协作专业委员会的专家对"恶性肿瘤多学科综合治疗"谈谈各自的看法。本刊将专家们的意见陆续刊登在综合治疗论坛栏目中,请大家关注,更敬请全国各位同行发表自己的看法。     

肿瘤综合治疗—我们迫切需要

倡导恶性肿瘤多学科综合治疗的理念已有半个世纪,得到了我国广大临床肿瘤学工作者的认同,但是目前我国恶性肿瘤综合治疗的现状不尽人意。中国抗癌协会肺癌专业委员会的主任委员吴一龙教授在本刊2008年第一期上发表了题为《恶性肿瘤多学科综合治疗的困境》的述评,剖析了多学科综合治疗的困境及原因。中国医学科学院肿瘤医院头颈外科专家屠规益教授近期著文《恶性肿瘤的综合治疗,实证和行动一致?》,分析了目前我国的恶性肿瘤多学科综合治疗存在的问题并提出了一些改进肿瘤综合治疗的建议。为了进一步推动恶性肿瘤多学科综合治疗的发展和提高,我刊请中国抗癌协会肺癌专业委员会和中国抗癌协会临床肿瘤学协作专业委员会的专家对"恶性肿瘤多学科综合治疗"谈谈各自的看法。本刊将专家们的意见陆续刊登在综合治疗论坛栏目中,请大家关注,更敬请全国各位同行发表自己的看法。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.