乳腺浸润性导管癌中医分型与微血管密度关系分析

目的 探讨乳腺浸润性导管癌2种证型与微血管密度(MVD)的关系,为乳腺癌辨证分型提供病理学证据. 方法 60例患者随机分为肝郁痰凝型组30例,冲任失调型组30例,应用免疫组化法检测手术后肿瘤标本MVD. 结果 肝郁痰凝型乳腺癌患者肿瘤MVD高于冲任失调型患者,有显著性差异(P<0.05). 结论 2证型乳腺癌患者肿瘤MVD的差异性可能作为乳腺癌临床辨证分型的客观指标之一.     

乳腺癌中医证型与生物学指标相关性研究

目的:探讨乳腺癌中医辨证分型与生物学指标的相关性。方法:对364例乳腺癌患者进行术前辨证分型,术后收集免疫组化结果,探索证型与生物学指标是否相关。结果:364例患者中,肝郁痰凝证198例,占54.4%,冲任失调证150例,占41.2%,正虚毒炽证16例,占4.4%。正虚毒炽证ER、PR阴性率和p53、Ki-67阳性率高于肝郁痰凝证和冲任失调证,差异有统计学意义(P0.0125),Cerb B-2表达与中医证型无相关性,差异无统计学意义(P0.05)。结论:乳腺癌中医证型与生物学指标存在相关性,正虚毒炽证预后较差。     

早、中期乳腺癌中医证型与腋窝淋巴结阳性数量的临床研究

目的探讨早、中期乳腺癌中医证型与腋窝淋巴结阳性数量的相关性。方法对46例乳腺癌患者术前进行辨证分型;结合超声造影得出淋巴结数量、临床分期、肿块大小等数据。结果早、中期乳腺癌有肝郁痰凝及冲任失调2种证型,肝郁痰凝型淋巴结阳性率较冲任失调证阳性率高(P<0.05),间接反映肝郁痰凝型临床预后较差。结论中医证型指导预后具有影像学的依据。     

乳腺癌中医分型与血流动力学特征的关系

[目的] 探索乳腺癌血流动力学特点与乳腺癌患者中医辨证分型之间的关系,从肿瘤血管微观特征方面为中医辨证提供科学的、客观的定量分析指标.[方法] 通过超声造影技术联合常规彩色多普勒超声技术,对58例不同中医证型(分为3型)且,临床确诊为乳腺癌的患者的血流动力学特点进行比较分析.[结果] 乳腺癌肝郁痰凝与正虚毒炽证型间的血流峰速比较,差异有显著性意义(P<0.05).起始增强时间比较:冲任失调与肝郁痰凝证型间差异有显著性意义(P<0.05).达峰时间比较:冲任失调与肝郁痰凝证型间比较,差异有显著性意义(P<0.05);冲任失调与正虚毒炽证型间差异也有显著性意义(P<0.05).在曲线斜率方面,肝郁痰凝与正虚毒炽证型间差异有显著性意义(P<0.05).乳腺癌患者中医证型分级与各血流动力学指标的相关性分析提示,证型分级仅与血流峰速呈正相关(r=0.245,P<0.05),与其他血流动力学指标无明显相关性.[结论] 乳腺癌血流动力学指标在各中医分型中的分布有一定差异;乳腺癌患者证型分级与部分血流动力学指标存在相关性,血流动力学指标可以为中医辨证提供科学的定量分析指标.     

乳腺癌中医证型与临床分期及分子标志物关系

目的：探讨乳腺癌中医证型与临床分期及雌激素受体（estrogen receptor,ER）、孕激素受体（progeste ronereceptor,PR）和癌蛋白C-erbB-2关系。方法：选择经病理证实、有完整资料的乳腺癌病例95例,辨证分为肝郁痰凝、冲任失调、正虚毒炽3种中医证型,采用免疫组织化学法对各证型的,临床分期及其分子标志物ER、PR、CerbB-2表达进行分析。结果：95例中,肝郁痰凝型为71例,占74．74％,冲任失调型为9例,占9．47％,正虚毒炽型为15例,占15．79％。Ⅰ期、Ⅱ期乳腺癌中以肝郁痰凝型居多,而Ⅲ期、Ⅳ期中正虚毒炽型所占比例高于肝郁痰凝型和冲任失调型。肝郁痰凝型ER阳性率与正虚毒炽型比较,差异无显著性（P=0．074）;肝郁痰凝型ER阳性率与冲任失调型比较,差异有显著性（P=0．022）。各证型PR、C-erbB-2阳性率比较,差异无显著性。结论：乳腺癌早期多为肝郁痰凝型,后期以正虚毒炽型为主。肝郁痰凝型ER表达水平高于冲任失调型,而PR、C-erbB-2的表达与中医证型无明显相关性。     

乳腺癌中医证型与高频彩超检查特点相关性研究

目的 探讨乳腺癌患者肿瘤中医辨证分型与高频彩超血流分布特点之间的相关性.方法 回顾性分析178例乳腺癌患者的术前超声检查特点及中医辨证分型,并分析彩色血流分布与中医证型之间的关系.结果 178例乳腺癌患者中肝郁痰凝型91例（51.1％）、冲任失调型63例（35.4％）、正虚毒炽型24例（13.5％）.彩色多普勒血流特点与肿瘤临床分期呈正相关.正虚毒炽型者血流多,血流阻力指数高.结论 乳腺癌彩色多普勒血流特点与中医证型之间存在一定的相关性.肿瘤的彩色血流分布从一定程度上反映了癌细胞的生物行为和预后,为中医辨证论治和临床治疗方案的选择提供客观依据.     

乳腺癌不同病理阶段超声弹性成像与中医辨证分型相关性研究

目的研究乳腺浸润性导管癌（IDC）及其前期病变乳腺导管原位癌（DCIS）、微小浸润癌（MA）的超声弹性成像（UE）与中医证型特点及相关性,并探讨其病理基础。方法60例乳腺癌患者,按CK5／6、P63不同表达分为A组（DCIS及MA,n=10）、B组（IDC与DCIS混合的导管癌,n=29）和C组（完全为IDC或仅有肿物周边小灶DCIS残留的IDC,n=21）,所有患者术前均行UE评分及中医辩证分型。结果A组UE评分低于B、C组（LSD,P为0．019、0．008）;各组间中医证型分型构成差异有统计学意义（P=0．049）。不同中医证型患者UE评分差异有统计学意义（P=0．000）,由肝郁痰凝型到冲任失调型到正虚毒炽型,UE评分呈上升趋势（rs=0．538,P=0．000）。结论乳腺癌不同病理阶段UE评分及中医证型不同,二者间存在相关性,推测与疾病的分子病理学基础有关。     

乳腺癌辨证分型与核磁共振动态增强扫描相关性研究

目的:探索乳腺癌MRI动态增强扫描征象与乳腺癌患者中医辨证分型之间的关系。方法:通过MRI动态增强扫描技术对61例不同中医证型(分为3型)且临床确诊为乳腺癌的患者的MRI图像特点进行比较分析。结果:乳腺癌肝郁痰凝与正虚毒炽证型间的时间-动态增强曲线,差异有显著性意义(P<0.05)。乳腺癌患者中医证型分级与MRI形态学和血流动力学的相关性分析提示,证型分级与形态学及增强曲线间存在相关性。结论:乳腺癌患者证型分级与MRI形态学和血流动力学存在相关性,血流动力学指标可以为中医辨证提供科学的定量分析指标。     

乳腺癌辨证分型与核磁共振动态增强扫描相关性研究

目的：探索乳腺癌MRI动态增强扫描征象与乳腺癌患者中医辨证分型之间的关系。方法：通过MRI动态增强扫描技术对61例不同中医证型（分为3型）且临床确诊为乳腺癌的患者的MRI图像特点进行比较分析。结果：乳腺癌肝郁痰凝与正虚毒炽证型间的时间-动态增强曲线,差异有显著性意义（P〈0.05）。乳腺癌患者中医证型分级与MRI形态学和血流动力学的相关性分析提示,证型分级与形态学及增强曲线间存在相关性。结论：乳腺癌患者证型分级与MRI形态学和血流动力学存在相关性,血流动力学指标可以为中医辨证提供科学的定量分析指标。     

82例乳腺囊性增生症中医辨证分型研究

目的通过对82例乳腺囊性增生症临床资料分析探讨中医辨证分型规律。方法82例乳腺囊性增生症均有手术活检病理支持,通过分析其临床症状、血清泌乳素(PRL)水平、彩超诊断、病理类型与中医证型的相关性,总结中医证型规律。结果肝郁血瘀型、冲任失调型、脾胃虚弱型是乳腺囊性增生症的常见证型。结论临床应重视对脾胃虚弱型乳腺囊性增生症的论治。      

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…