Objective It is to investigate the curative effect of“package” minimally invasive surgery in primary liver canc-er, and observe its influence on the serum T lymphocyte subsets ( CD3+, CD4 +, CD8 +, CD4 +/CD8 +ratio) and NK cells (CD56 +), matrix metalloproteinase 9 (MMP-9) and vascular endothelial growth factor (VEGF).Methods 85 patients with primary liver cancer were selected and divided into 3 groups according to the wishes of the patients:35 cases in group A were treated with transcatheter arterial chemoembolization ( TACE) , 30 cases in group B were treated with TACE +argon helium knife, 20 cases in group C were treated with TACE +argon helium knife frozen+125 I radioactive seed implantation; the changes of serum T lymphocyte subsets, CD56 +, MMP-9 and VEGF levels were observed before and after treatment, and the postoperative tumor shrinkage rate and recurrence rate and survival rate follow-up 16, 12 months were recorded in 3 groups. Results After 2 weeks of treatment, the serum levels of CD3 +, CD4 +, CD4 +/CD8 +and NK were significantly increased, and the levels of CD8 +, MMP-9 and VEGF were significantly reduced in the 3 groups (all P<0.05).After 5 weeks and 7 weeks treatment, the indexes of group B and C were significantly better than those after 2 weeks and those of group A in the same time (all P<0.05);at 7 weeks after operation, the improvement of the indexes of group C was significantly better than those at 5 weeks and those of group B in the same time (all P<0.05);at 12 weeks after operation, the tumor shrinkage rate of group B and C were significantly higher than that of group A ( P<0.05) , and group C was significantly higher than that of group B (P<0.05).The recurrence rate in group B and C was significantly lower, and the survival rates were significantly higher than that in the group A at 16 months follow-up (all P<0.05);and the recurrence rate of group C was significantly lower, survival rate was significantly higher than that of group B (all P<0.05).Conclusion The curative effect of“package”minimally invasive surgery in primary liver cancer is better, it can obviously improve the immune function of the body, inhibit tumor angiogenesis , reduce the recurrence rate and mortality, it is worthy of clinical popularization and application.

Objective To observe the clinical effect of self - made traditional prescription on premature coronary heart disease diagnosed as TCM syndrome of phlegm turbidity and blood stasis. Methods From January 2014 to January 2016,a total of 150 premature coronary heart disease patients diagnosed as TCM syndrome of phlegm turbidity and blood stasis were selected in&nbsp;the Department of Cardiology,the First Hospital of Handan,in the Department of Cardiology,the Central Hospital of Handan, and they were divided into control group(n = 74)and treatment group(n = 76)according to random number table. Based on conventional treatment,patients of control group were given placebo,while patients of treatment group were given self - made traditional prescription;both groups continuously treated for two courses(2 weeks as a course). Curative effects of angina pectoris and electrocardiogram,blood lipids index(including TG,TC,HDL-C and LDL-C)and traditional clinical symptoms (including chest distress,chest pain,duration and attack frequency of chest distress/ chest pain,shortness of breath,fatigue, palpitation and spontaneous perspiration)score before and after treatment were compared between the two groups,and incidence of adverse reactions during the treatment was observed. Results The curative effects of angina pectoris and electrocardiogram of treatment group were statistically significantly better than those of control group ( P < 0. 05 ). No statistically significantly differences of TG,TC,HDL-C or LDL-C was found between the two groups before treatment(P > 0. 05);after treatment,TG, TC and LDL-C of treatment group were statistically significantly lower than those of control group,while HDL-C of treatment group was statistically significantly higher than that of control group(P < 0. 05). No statistically significant differences of chest distress score,chest pain score,duration of chest distress/ chest pain score,attack frequency of chest distress/ chest pain score, shortness of breath score,fatigue score,palpitation score,spontaneous perspiration score or total score was found between the two groups before treatment( P > 0. 05),while chest distress score,chest pain score,duration of chest distress/ chest pain score,attack frequency of chest distress/ chest pain score, shortness of breath score, fatigue score, palpitation score, spontaneous perspiration score and total score of treatment group were statistically significantly lower than those of control group after treatment(P < 0. 05). During the treatment,two cases of control group occurred nausea and vomiting,three cases of treatment group occurred gastrointestinal discomfort. Conclusion Self - made traditional prescription has certain clinical effect in treating premature coronary heart disease diagnosed as TCM syndrome of phlegm turbidity and blood stasis,can effectively adjust the blood lipid metabolism and relieve the chest distress/ chest pain,with less adverse reactions.

The invention relates to a medicine for treating pericarditis. The medicine is prepared from the following medicinal raw materials in parts by weight: 6 parts of cassia twigs, 9 parts of poria cocos, 8 parts of pepperweed seeds decocted in a wrapped manner and 8 parts of radix codonopsis pilosulae. The cassia twig in the formula of the medicine is pungent, sweet and warm, can take effect on the heart, lung and bladder meridians, and has the efficacies of inducing sweat, dispelling exogenous evils, warming and dredging collaterals, enhancing yang, regulating qi, depressing ascending qi and inducing diuresis; the poria cocos is sweet and mild, can take effect on the heart, lung, spleen and kidney meridians, and has the efficacies of inducing diuresis, clearing damp, invigorating the spleen and calming the heart; the pepperweed seed can take effect on the lung and bladder meridians, and has the efficacies of removing heat from the lung, relieving asthma, inducing diuresis and alleviating edema; and the radix codonopsis pilosulae can take effect on the spleen and lung meridians, and has the efficacies of tonifying middle-jiao and qi, strengthening the spleen and tonifying the lung. The medicinal raw materials are combined together to take the effects of warming yang, promoting the circulation of qi, inducing diuresis and eliminating phlegm synergistically to cure pericarditis basically. Clinical experiments show that the medicine provided by the invention can be used for treating pericarditis safely and effectively.

无精症细胞是指在所射出的精粹检查中,连续3次找不到一个正常形成的精子,关于精子细胞形态与男性生育关系的研究一直是专家学者不断探寻的一个重点.本文通过梳理前人对精子形态、染色分析方法、精子形态与精子功能、精于形态与辅助生殖四个方面研究,旨在从精子细胞形态入手,探讨如何为患者提供生育的可能性.

目的:探讨无精症精液脱落细胞形态特征.方法:观察分析89例无精症患者的精液其生精细胞的形态种类,分析其检查结果.结果:89例无精症的精液中,25例有生精细胞.其中17例主要是精子细胞占68％,5例是次级精母细胞占20％,2例是初级精母细胞占8％,1例精原细占4％胞.结论:观察精液生精细胞的形态及分类,对非梗阻性无精症的诊断有价值,建议临床常规开展精液的脱落细胞检查.

目的:通过对三家系Gardner综合征患者十余年的追踪观察,了解该病的动态变化,及不同家系临床表现的差异.方法:对三家系成员采用咨询、查体和多种物理检查方法进行观察.结果:三家系共有患者17人,观察期间死亡5例.死于结肠息肉癌变4例,死于心脏病1例.三联症10例,二联症7例.结论:Gardner综合征不同家族其临床表现差别较大,在发病年龄、死亡年龄出现软组织肿瘤、骨瘤的时间均有差别.

目的:探讨精液白细胞与男性不育的关系.方法:检测64例不育者精液白细胞,观察其与精液常规分析参数,精浆果糖含量的关东.结果:64例不育者精液白细胞＞5个/HP为29.69％.白细胞＞5个/HP组精液量、精子密度、精子存活率a,b级活力精子率均明显低于精液白细胞≤5个/HP组(P＜0.05).精液白细胞＞5个/HP组畸形精子率、精液粘度增高率明显高于白细胞≤5个/HP组口＜0.05).结论:精液白细胞可影响精液质量.

目的:探讨无精症精液脱落细胞的DNA含量与形态之间的关系及临床应用价值；方法:选择48例无精症男性不育患者,利用染色检测原理,定量分析DNA含量及细胞形态,观察其DNA积分光度、细胞结构、细胞形态；结果:48例无精症男性不育患者中,DNA积分光密度1.38±0.28,明显低于正常组(P＜0.05);正常细胞形态比例为42.02％,与正常组(81.01％)比较有统计学意义(P＜0.05)；其中头部异常与尾部异常表现出显著性差异(P＜0.05)；结论:无精症精液脱落细胞DNA积分光密度明显降低,可能与精子异常障碍有关.

目的 观察黄芪党参蘑菇煎在大肠癌患者化疗时的协同作用.方法 将51例大肠癌病人随机分为实验组(黄芪党参蘑菇煎加LFP方案)和对照组(单纯LFP方案),将两组的疗效、毒性、对化疗的耐受性、生活质量改善情况进行对比.结果 提高生存质量,提高KPS评分,提高率、稳定以上率分别是55.6%,92.6%.一般症状改善,尤其食欲增加、睡眠改善实验组更为明显.增加化疗药物的疗效,受益率(CR+PR+SD)比较有意义.保护骨髓,维护造血功能,治疗后白细胞的数量为(4.19±0.45)×109/L,治疗前后白细胞的数量增长的比较有意义.结论 黄芪党参蘑菇煎治疗大肠癌,可以抵御化疗的副作用,增加食欲改善体质、保护脏器功能.缓解肿瘤的不适症状等.

目的观察黄芪党参蘑菇煎在晚期食管癌胃癌患者化疗时协同作用免疫功能变化。方法将50例肿瘤病人,分为试验组和对照组,均使用羟喜树碱、氟脲嘧啶、顺铂;实验组加用中药煎剂。观察病人免疫功能:淋巴细胞活性(Ag-NoRS)、自然杀伤细胞活性(NK)、T淋巴细胞亚群(CD3,CD4,CD8,CD4/CD8)。结果实验组近期疗效好于对照组;免疫功能方面,T淋巴细胞活性(AgNoRS)、NK细胞活性、提高免疫细胞亚群数量,试验组优于对照组,且差异有显著性意义(P<0.05)。结论黄芪党参蘑菇煎配合化疗治疗晚期食管癌胃癌可以提高免疫功能。

于尔辛教授经长期研究,提出了“肝癌的‘本’是脾虚”的论点,使西医的肝癌与中医的“脾虚”相对应,建立肝癌脾虚辨证为主、治疗健脾为主肝癌的治疗新方法。笔者将此演译为“中心辨证”。所谓“中心”,指将西医诊断的某一病名冠以中医的一个证,并且认为此证就是该病的根本—即中心;在这个“中心”基础上,再分不同的类型,施以相应的治疗;由此,提出了所有恶性肿瘤都应有“中心辨证”,乃至形成所有西医病的皆有相应的“中心辨证”和中心施治思路,使中西医结合更进一步。

舌诊是中医诊断观察疾病的重要手段,舌象可以判断正气盛衰,病邪的性质,病势的进退,尤其在脾胃疾病的诊治中更占有重要地位.我们于2001～2004年对200例次恶性肿瘤患者应用抗肿瘤药物前后的舌象进行了观察并作了总结分析,以期探索舌象变化对肿瘤临床用药的指导意义.

食用菌多糖是目前被认为临床效果较为确切的一类低毒而免疫活性强的物质.食用菌包含能够食用的真菌,常见的有蘑菇、香菇、平菇、金针菇、草菇、口蘑、银耳、木耳、大刺猴头、灵芝、云芝、茯苓、猪苓等.其中蘑菇多糖的抗肿瘤作用研究较少,本文就食用菌多糖抗肿瘤的作用机理及蘑菇多糖的抗肿瘤作用讨论如下:

中医在血液病的诊治范畴中,补益气血、健脾补肾、益气养阴、清热解毒、清营止血、活血化淤治疗各种血液病以及再生障碍性贫血、难治性白血病,都有较高的疗效[1～4],作为中西医结合工作者,现将在临床实践中经验,撰一短文,抛砖引玉,告知同行,共同探讨提高,利与血液病患者的诊疗和康复.

目的探讨黄芪党参蘑菇煎在食管癌胃癌患者化疗中辅助治疗临床研究。方法黄芪党参蘑菇煎组和化疗组,均使用羟喜树碱、氟脲嘧啶、顺铂,连用5 d,间隔4周,再连用5 d。黄芪党参蘑菇煎组1剂/d,2次/剂,口服,连服2个月为1个疗程。观察疗效、免疫功能、血常规及一般状况。结果近期疗效、远期疗效、生活质量、体重、血常规、免疫功能,黄芪党参蘑菇煎组均优于化疗组。结论黄芪党参蘑菇煎配合化疗治疗食管癌胃癌可以改善生活质量,提高免疫功能,提高疗效及生存率。

Gardner综合征是一种家族性的结肠息肉,伴发皮肤肿瘤或骨瘤的一种常染色体显性遗传的单基因病,患者子女50%发病,在不进行治疗的情况下患者100%发生结肠癌,严重威胁人类的健康.我国近10年文献报道有约40例患者,我们对3家系Gardner综合征17例患者,观察约10余年的时间,现将这三家系患者临床表现及家系之间的差异,报告如下。

目的:探讨益沐片[1、2]在晚期食管癌胃癌患者化疗时增效减毒,延长生存期,提高患者的免疫功能;材料与方法:50例病人(男性36例,女性14例),胃癌25例,食管癌25例.治疗方法:益沐片组和化疗组,均使用羟喜树碱、氟脲嘧啶,顺铂,连用5日,间隔4周,再连用5日.益沐片组(加用益沐片每次2片,3次/日,口服,连服2个月为1个疗程).观察病人免疫功能(Ag-NORs、CD3、CD4、CD8、NK)、血常规及一般状况.结果:1、近期疗效、远期疗效、益沐片组好于化疗组;2、生活质量、神疲乏力、食欲差恶心、睡眠状况缓解;体重益沐片组有所提高;3、血常规;血细胞计数,益沐片组优于化疗组,比较有差异性(P＜0.05)益沐片能够延缓减轻化疗后的WBC下降程度.对红细胞和血小板无变化.4、免疫功能 T淋巴细胞活性(Ag-NORs)、NK细胞活性、提高免疫细胞亚群数量,益沐片组优于化疗组,比较有差异性.结论:益沐片配合化疗治疗晚期食管癌胃癌可以提高疗效和生存率,改善生活质量,降低毒副反应,提高免疫功能.

母乳是婴儿最佳的食品,是钙元素的主要来源.通过乳钙测定可了解食物内钙含量,检测尿钙可了解婴儿体内钙含量.现将我院近三年母乳钙和新生儿尿钙检测结果报道如下.

1必要性 实习生病案讨论是以扩展临床思维过程、提高疾病诊疗水平、适应新的医学模式满足社会医疗需求为目标.在临床医师引导下,借鉴"病案",学生参与,复习所学有关章节或资料、质疑讨论、归纳总结等达到诊断思维过程,对疾病制定治疗方案的能力,培养学生自学能力.