雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.     

333例儿童临床使用痰热清注射液的安全性分析

目的:了解痰热清注射液儿科临床使用的安全性。方法:用SPSS13.0软件统计分析哈尔滨市儿童医院2011年1月至2012年9月使用痰热清注射液的儿科住院患儿临床使用该药品安全性的主动集中监测数据。结果:使用痰热清注射液的333例患儿均有合并用药现象,其中98%与抗菌药合并使用。痰热清注射液的不良反应均发生在3岁以下的儿童,发生率为1.2%,未见与其不良反应肯定的关联性。结论:3岁以下患儿临床使用痰热清注射液应慎重。     

雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.     

白头翁汤保留灌肠辅助治疗细菌性痢疾的护理体会

细菌性痢疾(简称菌痢)是由于痢疾杆菌引起的急性肠道传染病,目前因耐药菌增多,对抗生素治疗效果不满意。2002年—2004年我院对25例菌痢病人采取白头翁汤保留灌肠辅助治疗,收到了满意的效果,现报道如下。     

单纯胆囊切除术后早期黄疸处理

单纯胆囊切除术后早期黄疸的出现,是临床外科的一个棘手问题,须尽早查明原因及时正确处理,以便获得良好的预后.我院自1990年5月至1994年5月剖腹单纯胆囊切除561例,术后早期不同原因黄疸5例,占0.94%;腹腔镜胆囊切除术108例,早期黄疸1例,占0.92%.6例术前均无黄疸史.现将术后早期黄疸病例报告及处理的有关问题加以讨论.     

原发性乳腺恶性淋巴瘤

原发性乳腺恶性淋巴瘤２例报告，并复习自１９８８年至１９９４年国内文献共１２９例资料。其中男性３例，女性１２６例，平均年龄４１岁；在完整的临床和病理资料８９例中，单侧７０例（７８．７％），其右左之比为３７：３３；双侧１９例（２１．３％）。在有随访资料的１１５例中，１、３、５年存活率分别为５８．３％、２７．８％和１４％，预后非常恶劣。在国内的原发性乳腺恶性淋巴瘤与乳癌临床上甚难鉴别，对此有关问题作一讨论。     

乳腺癌术后皮下积液139例采用细管引流的体会

目的：探讨乳腺癌术后皮下积液采用细管引流方法及疗效。方法：回顾1990年2月至2002年2月我院腺癌术后发生皮下积液139例，采用细管引流，就其疗效进行同顾性总结和分析。结果：139例经处理后2～3天皮下积液均消失，皮瓣与胸壁粘连良好，无1例出现皮瓣坏死。结论：腺癌术后皮下积液采用细管引流操作简单，创伤小，疗效显。     

磺达肝癸钠和低分子肝素治疗创伤感染患者高凝状态的比较研究

目的：比较磺达肝癸钠与低分子肝素对于创伤感染患者高凝状态的治疗作用和不良反应。方法2012年2月～2013年2月我院重症监护治疗中心收治创伤感染合并高凝状态者36例,随机分成2组,一组患者采用磺达肝癸钠进行抗凝治疗（F组,18例）,剂量为2.5mg,1次/d;另一组采用低分子肝素进行抗凝治疗（L组,18例）,剂量为4100U/次,1次/12h,两组疗程均为11d。采用血凝分析仪测定纤维蛋白原、D-二聚体含量以及抗凝血酶Ⅲ（ AT-Ⅲ）活性;比较两组患者用药后深静脉血栓发生率、出血事件发生率、多器官功能障碍综合征（ MODS）发生率以及死亡率。结果抗凝治疗后两组患者AT-Ⅲ总体呈现上升趋势,第5d和11d F组数值较L组高,有统计学差异（P＜0.05）。纤维蛋白原含量逐步上升,两组间无统计学差异（P＞0.05）。两组患者D-二聚体自抗凝治疗后第5d出现明显下降（P＜0.01）,且第5d和第7d两组间比较有统计学差异（P＜0.05）,第11d数值比较无统计学差异（P＞0.05）;两组患者深静脉血栓发生率、MODS发生率以及死亡率无统计学差异,F组出血事件发生率低于L组（P＜0.05）。结论低分子量肝素和磺达肝癸钠均可有效改善创伤感染患者合并的高凝状态。与低分子量肝素相比,磺达肝癸钠可降低创伤感染合并高凝状态患者出血风险。