针对胆囊结石现今多采用损伤小、恢复快的腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术式,由于需要采用全麻及CO2气腹,腹腔镜手术对呼吸功能有明显的影响,术中及术后可发生呼吸系统多种并发症[1,2].尤其是有慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)病史的老年患者,肺功能受到不同程度的损坏,更容易出现呼吸系统并发症.因此,术前对老年COPD进行手术耐受力的评估及呼吸系统并发症的预测尤显重要.能否耐受腹腔镜手术,要根据体检及手术前心肺功能等进行综合评估.本研究对560例老年COPD并胆石症手术治疗者术前进行肺功能测定,术后呼吸功能的病理生理改变及影响因素进行了综合性分析,报告如下.

Objective To compare the effect of new quadruple chemotherapy and traditional triple therapy for helicobacter pylori. Methods Totally 120 ulcer patients which being detected positive on 14C-Urea Breath Test (14C-UBT) are divided into 2 groups. The patients of treatment group were treated by omeprazole + bismuth +acheomycin + tinidazole and the control groups were treated with omeprazole + clarithromycin + amoxicillin. The patients of two groups were all made electronic gastroscope, histology and 14C-Urea Breath Test within 1 week after the course of treatment has ended. Results The positive-nategive rate on 14C-UBT of first time treated patients is 95.1%, the repeated treated patients was 89.5% and the total positive-nategive rate was 93. 3% on 14C-UBT in the treatment group, while the positive-nategive rate on 14C-UBT was 77.5%, 55.0% and 70.0% in the control group. The ulcer recovery rate in the patients of treatment group was 86.7% while control group was 71.7%. The ulcer recovery rate and the positive-nategive rate on 14C-UBT of first time treated, repeated treated and the total in the patients of treatment group were higher than the control group all (P ＜ 0.05). Conclusions The positive-nategive rate on 14C-UBT and the ulcer recovery rate of new quadruple chemotherapy are higher than that of traditional triple therapy.

肺癌系全球范围内最常见的恶性肿瘤之一,占我国和西方国家肿瘤死因的首位.非小细胞肺癌(NSCLC)占所有肺癌患者的80％～85％,小细胞肺癌(SCLC)占15％ ～20％.肺癌半数以上的患者年龄＞65岁.所以,高龄就在肺癌治疗中成了一个重要因素.本文就老年NSCLC治疗方面的问题做以述评.

炎症性肠病(inflammatory bowel disease,IBD)专指病因未明的炎症性肠病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病.IBD的发病率持续增高,已知肠道粘膜免疫系统异常反应所导致的炎症反应在IBD发病中起重要作用,目前认为发病主要与环境、遗传、感染和免疫因素有关.近年来随着结肠镜在临床上广泛应用,溃疡性结肠炎的检出率较以前明显提高.

胆石症是临床多发病之一,特别是新疆地区由于水质及其它因素导致本病的发病率较高,如同时并有上胃肠道疾病时,易将上胃肠道疾病的临床表现归于胆石症所致,从而忽略了上胃肠道疾病的诊断.本研究就我科胆石症患者胃镜检查结果进行回顾性分析,现报道如下.

胃十二指肠内容物反流是造成胃食管粘膜损伤的重要原因.行胃镜检查操作时,我们发现许多患者存在胆汁反流现象并胃粘膜损伤.现将胆囊切除术者与未行胆囊切除术者行胃镜检查,并做分析.