经内镜高频治疗食管癌狭窄12例疗效观察

食管癌可导致患者进食困难，生活质量严重下降。对于已经失去手术机会的晚期食管癌狭窄或合并食管瘘的患者，采用支架置入后放射治疗可取得满意效果。但因种种原因，部分患者不能接受带支架放疗而再次出现的癌性狭窄，对此笔者采用内镜下高频治疗取得满意效果，现报道如下。     

72例慢性心力衰竭临床分析

目的 分析慢性心力衰竭的病因、诱因及住院和门诊治疗情况,提高临床诊治水平,改善预后.方法 查阅72份慢性心力衰竭住院病历和门诊病历,统计病因、诱因和药物治疗情况.结果 基本病因以冠心病和高血压性心脏病为主,占73.6％,合并两种以上基础心脏病占47.1％.诱因以快速房颤和血压升高为主,占78.5％.72例住院患者药物使用率：氢氯噻嗪75％,卡托普利71％,地高辛44％、参麦41％,螺内酯41％,美托洛尔和呋塞米均是13.7％,毛花苷C 8％,显效18例（25％）,其中：有效22例（30.5％）,无效32例（44.5％）,其中有3例住院1天自动出院.出院治疗后3个月门诊随访：显效44例（81.5％）,有效8例（14.8％）,死亡2例（3.7％）.结论 本组慢性心力衰竭患者多种基础心脏病并存,以冠心病和高血压性心脏病引起的心力衰竭最多见,发病以快速房颤和高血压为主要诱因.基层医院大部分患者住院时间短,治疗不彻底,门诊随访继续给予规范有效的治疗,效果理想,预后好.     

Detection of sentinel lymph node in early cervical cancer

CervicalcancerwasoncerankedinsecondpositionamongthemostcommonmalignanttumorinChinesewomen.Theincidencerateofthecervicalcancerwasremarkablyreducedduetothenewlydevelopedmedicaltechniquesandthesocalledthethreeearly?po1icy:earlyprevention,earlydiagnosisandearlytreatment.Thedeathrateofcervicalcancerdescendedby10.3/100000in1970to3.3/1000001990.However,thetrendoftheincidencerateofear1ycervica1cancerissignificantlyincreasedamongtheyoungerwomenpopulation.Thestandardtechniqueofthesurgicaltreatmentforea…     

高危型人乳头瘤病毒载量与子宫颈病变的关系

Objective To determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN). Methods Cervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00),low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load 100. 00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression. Results The HR-HPV infection rate of the population was 14. 51% (2515/17 334). 100. 00% (29/29) of SCC,97. 63% (206/211) of CIN 3,93.43% (199/213) of CIN 2,75.04% (421/ 561) of CIN 1 and 10. 17% (1660/16 320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC,CIN 3,CIN 2,CIN I and normal were 320. 85,158. 05, 143. 70,125.34 and 9. 64, respectively. There were significant differences among the distributions of viral loads in each lesion (X2=6190. 40,P<0. 01). The severity of CIN increased with the viral load (X2=5493. 35 ,P<0. 01). Compared with the risks of CINs in HR-HPV negative population,the risks of CINs in low,moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9. 01 (6. 31 -12. 87), 24.96(18.23 -34. 17) and 68.42(51.40 -91.08); CIN 2:26.44(12.07 -57.95),98. 53 (49. 54 -195.98) and 322. 88(168.62 -618. 27) ; CIN 3 + : 72. 89(24.02 -221.18) ; 343. 58(121.81 -969.09) Was 3115.05,2413.95 and 3098.57, respectively. P<0.01) . In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95%CI):<35: 4. 71(1.23-18.09) and 15.06(4.40-51.49); 35-: 4.01 (1.62-9.90) and 14.09(6. 15 -32.28); 40-: 3.06(1.52 -6. 16) and 7.78(4.05 -14.95); ≥45: 3. 50(1.36 -9. 01) and 7. 57 (3. 13 -18. 30)], and there was a positive correlation between the risk of CIN 2 + and the viral load (Xtrend2was 51. 33,66. 28,53. 64 and 51.00,respectively. P<0. 01). The risk of CIN 2 + was highest among the women aged 40 -with high viral load [0R(95% CI):2.02 (1.15 -3. 52)]. Conclusion There is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3,and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively.     

缺血性结肠炎患者的血黏度及血脂分析

目的：分析缺血性结肠炎（IC）患者的血黏度及血脂状况,为防治IC提供依据。方法确诊为IC患者（观察组）与健康者（对照组）各43例,测定高切变率下的全血黏度、低切变率下的全血黏度、D-二聚体、总胆固醇（CHOL）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（Apo-A1）、载脂蛋白B（Apo-B）。结果观察组高切变率全血黏度、低切变率全血黏度、D-二聚体、CHOL、TG、LDL-C、Apo-B 水平,均高于对照组,HDL-C、Apo-A1低于对照组,差异均有统计学意义。结论缺血性结肠炎患者血黏度及血脂明显异常,血管栓塞风险高,积极改善微循环与合理的调脂治疗,可预防和减缓缺血性结肠炎的发生及进展。     

35岁以下妇女宫颈癌

目的探讨宫颈癌的发病趋势和年轻宫颈癌的预后因素。方法回顾分析自1970～1994年我院收治125例年轻宫颈癌（＜35岁）的临床资料。结果＜35岁妇女宫颈癌在我院治疗的全部宫颈癌中所占比例自70年代的1．22％上升至80年代的1．42％及90年代初的5．01％。根治性治疗的116例中22例宫颈原位癌和早期浸润癌的5年生存率为100％,94例浸润性宫颈癌的总5年生存率为56．4％,复发（或未控）和转移率为36．2％（34／94）。结论本组提示宫颈癌发病有年轻化趋势,＜35岁年轻宫颈癌的预后较差,临床期别、宫颈肿瘤大小、组织学类型是影响预后的重要因素。     

SEARCH FOR HERPES SIMPLEX VIRUS TYPE2（HSV－2）AND HUMAN PAPILLOMAVIRUS（HPV）IN THE NORMAL AND ABNORMAL CERVICAL SAMPLES

ＳＥＡＲＣＨＦＯＲＨＥＲＰＥＳＳＩＭＰＬＥＸＶＩＲＵＳＴＹＰＥ２（ＨＳＶ－２）ＡＮＤＨＵＭＡＮＰＡＰＩＬＬＯＭＡＶＩＲＵＳ（ＨＰＶ）ＩＮＴＨＥＮＯＲＭＡＬＡＮＤＡＢＮＯＲＭＡＬＣＥＲＶＩＣＡＬＳＡＭＰＬＥＳＺｈａｎｇＷｅｉ;张伟;ＪｉｎＳｈｕｎｑｉａ...     

卵巢癌脑转移8例临床分析

卵巢癌的扩散以腹、盆腔种植为主要转移途径,血行扩散、脑转移极少见。我院1982～1998年共收治卵巢癌患者818例,其中8例出现脑转移。总结报告如下。1　临床资料1.1　一般情况　初治时期2例,期4例,期1例,外院治疗后复发1例。浆液性囊腺癌5例,粘液性囊腺癌2例,透明细胞癌1例。1.2　脑转移发生时间　诊断卵巢癌至脑转移的时间9～94.8个月,中位30.2个月。1.3　治疗　发生脑转移前8例均行全子宫双附件、大网膜、阑尾切除术,术后6例行含顺铂方案化疗,1例行米尔法兰口服加盆腔放射治疗,1例行非顺铂方案化疗。发生转移后,4例行化疗或化疗 全脑放疗,4…