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find Author "李平" 44 results
  • Evidence-based treatment for local advanced nasopharyngeal carcinoma

    Objective We searched and reviewed medical evidence to find the guide of treatment for local advanced nasopharyngeal carcinoma. Methods Firstly, we put forward clinical questions. Secondly, we searched medical evidence from Medline (1985-2002), Embase (1984-2000), Cochrane library (2002.1) and ACP. And then we reviewed the results. The key words we used were "nasopharyngeal carcinoma, chemotherapy and radiotherapy randomized" and "meta analysis or randomized control trial". Results Through searching, we got 17 papers including 1 systematic review and 16 randomized control trials, in which there were 8 prospective randomized phase Ⅲ trials. Most of these trials concluded that combination chemo-radiotherapy were better than radiotherapy alone. We think these results were suitable for our patient’treatment decision. Conclusion To treat our patients,we choosed the method of the mutimodality of squeitial neoadjuvant chemotherapy, concurrent chemo-radiotherapy and adjuvant chemotherapy with the drug doses down-adjusted.

    Release date:2016-08-25 03:33 Export PDF Favorites Scan
  • Therapeutic Effect on Radial Nerve Injuries in Plateau Area

    【摘要】 目的 探讨高原地区桡神经损伤的治疗效果,并总结影响疗效的因素。 方法 回顾性分析2005年6月-2010年6月收治的桡神经损伤并有完整随访资料的54例患者,其中男40例,女14例;年龄8~69岁,平均32.6岁。开放性损伤5例,闭合性损伤49例;左侧26例,右侧28例。受伤原因:刀伤5例,医源性损伤(手术牵拉伤、被钢板挤压伤)10例,肱骨干骨折合并桡神经损伤39例。神经损伤类型:桡神经完全断裂12例;大部分断裂15例;挫伤27例,挫伤长度1.5~4.5 cm。所有患者均有典型的感觉及运动功能障。采用神经吻合修复27 例,神经松解减压27例。骨折均用钢板内固定。 结果 所有患者手术均顺利,术后切口均I期愈合,无手术相关并发症发生。54例均获随访16~24个月,平均18个月。骨折于术后8~14个月达临床愈合。末次随访时根据中华医学会手外科上肢周围神经功能评定标准,神经吻合的27例中,获优14例,良8例,差5例;神经松解减压术治疗的27例均获优。总优良率为91%。 结论 上臂桡神经损伤宜早期手术修复,神经吻合的疗效较神经松解减压术差。【Abstract】 Objective To explore the therapeutic effect on radial nerve injuries in plateau area, and to analyze the influencing factors. Methods The clinical data of 54 patients with radial nerve injuries who were treated between June 2005 and June 2010 were retrospectively analyzed. The patients included 40 males and 14 females and aged 8-69 years (averaged 32.6 years old). Of these 54 patients, 5 were open injuries, 49 were closed injuries; 26 were on the left side, and 28 were on the right sides. Causes of injuries included: 5 direct cut injuries, 10 iatrogenic injuries (including traction injuries and crush injuries by steel plates), and 39 humeral shaft fracture and radial nerve injuries. Types of nerve injuries included: 12 complete radial neurotmesis, 15 partial radial neurotmesis, and 27 radial contusions (with contusion length ranged 1.5-4.5 cm). All patients had radial nerve injuries experienced significant motor dysfunctions. Among these patients, 27 underwent nerve anastomosis, the remaining 27 were treated by nerve decompression; all fractures were treated with internal fixation with steel plates. Results During the average follow-up of 18 months (16-24 months), all 54 patients completely recovered from radial nerve injuries without any complications. The time for fracture healing ranged 8-14 months. According to the evaluation standards for radial nerve functional recovery, developed by the Chinese Medical Association, among the 27 cases treated by nerve anastomosis, 14 were “optimal”, 8 were “fair”, and 5 were “bad”; and all 27 cases treated by nerve decompression were “optimal”. Conclusion It is suggested to have early surgical treatment for the upper arm radical nerve injuries. The nerve decompression had better curative effects than the nerve anastomosis does.

    Release date:2016-08-26 02:18 Export PDF Favorites Scan
  • SURGICAL INTERVENTION FOR CANCEROUS POLYP OF LOW RECTAL

    目的探讨低位直肠息肉恶变的合理的外科手术方式。方法对我院1997年1月至2001年12月收治的32例低位直肠息肉恶变患者的资料进行回顾性分析。 结果32例中经肛门局部切除20例,经腹前切除低位吻合(Dixon术)8例,经腹会阴联合切除(Miles’术)4例,其中27例术后给予放、化疗。28例获随访1~5年,2例死亡,余均无局部复发。 结论低位直肠息肉恶变手术方式的正确选择是达到“根除癌肿”、“改善患者生活质量”目的的关键,术中冰冻病理检查是手术方式选择的重要依据。

    Release date:2016-08-28 05:12 Export PDF Favorites Scan
  • Usher 综合征一例

    Release date:2016-09-02 06:35 Export PDF Favorites Scan
  • 恶性肿瘤放射增敏机制及药物研究进展

    放射治疗是恶性肿瘤治疗的有效方式之一,几乎超过50%的恶性肿瘤患者在抗癌过程中接受过放射治疗。但是高能量的放射线在杀死肿瘤细胞的同时,不可避免会损伤肿瘤周围正常组织。所以控制肿瘤放射剂量,使肿瘤放射“局部化”,是肿瘤科医生共同的追求。放射增敏剂的使用助于获得相对低量高效的放射剂量,有效增加肿瘤局部控制率,降低放射对肿瘤周围正常组织的伤害。但是目前临床上使用的放射增敏剂,大多数存在药物自身细胞毒性大、选择性低、价格昂贵等特点,限制了临床广泛使用。所以寻找安全经济且可区分肿瘤组织和正常组织的“智能型”放射增敏物质十分迫切且必要。这篇综述主要对肿瘤放射增敏机制及相关药物研究进展进行了总结分析,并介绍一些新兴的放射增敏措施,为临床上放射增敏剂的使用和进一步研发提供方向。

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  • 儿童头颈部胚胎型横纹肌肉瘤复发一例报道及文献回顾

    目的胚胎型横纹肌肉瘤(ERMS)是一种幼儿、青少年较多见的的软组织肿瘤。通过介绍典型病例及文献复习,以总结ERMS的治疗经验。 方法报道1例腮腺咬肌区来源的头颈部ERMS患儿,二次切除术后再次复发,肿瘤增长速度快,局部侵及面广,累及区域淋巴结。复发后行3个周期TI(紫杉醇脂质体+异环磷酰胺)一线化学疗法(化疗)后给予适形调强放射治疗(放疗),观察患儿治疗后的疗效。完善相关检查,排除肿瘤远处转移后,行3个周期TI化疗,化疗结束2周后行适型调强放疗,化疗期间每周期及放疗前后复查肿瘤原发灶CT,根据实体肿瘤RESEST version 1.1疗效评价标准,测量肿瘤最大径,比较其在治疗前后及过程中的变化,进行疗效评价。 结果患儿3个周期化疗后疗效评价部分缓解,放疗结束后疗效评价为完全缓解,治疗后迄今无复发转移征象。 结论ERMS复发后暂无标准治疗方案,对于巨大头颈部横纹肌肉瘤,如果无法手术切除,可进行化疗+放疗综合治疗。新辅助化疗采用TI方案局部肿瘤消退效果好。

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  • 多原发恶性肿瘤的病因和发病机制的探讨

    多原发恶性肿瘤是肿瘤发生学上一种少见的现象。但近年来,随着诊疗技术的进步,肿瘤患者的5年 生存率普遍提高。基于人群的研究结果提示伴随着生存期的延长,患者发生第二肿瘤的概率也逐渐提高。因此, 关于多原发恶性肿瘤的报道越来越多。现通过复习国内外的历年有关报道,主要探讨多原发癌的病因和发病机 制,以加深医务人员对多原发恶性肿瘤的认识。

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  • From Microdosimetry to Nanodosimetry--the Link between Radiobiology and Radiation Physics

    The link between micro- and macro-parameters for radiation interactions that take place in living biological systems is described in this paper. Meanwhile recent progress and development in microdosimetry and nanodosimetry are introduced, including the methods to measure and calculate these micro- or nano-parameters. The relationship between radiobiology and physical quantities in microdosimetry and nanodosimetry was presented. Both the current problems on their applications in radiation protection and radiotherapy and the future development direction are proposed.

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  • 保乳术后放射治疗的研究进展

    Release date:2018-02-05 01:53 Export PDF Favorites Scan
  • The Cochrane systematic review of iodised salt for preventing iodine deficiency disorders

    Backgroud Iodine deficiency is the main cause for potentially preventable mental retardation in childhood and is still prevalent in large parts of the world. Objectives To assess the effects of iodised salt in comparison with other forms of iodine supplementation or placebo in the prevention of iodine deficiency disorders.Search strategy We searched the Cochrane Library, Medline, the Register of Chinese trials developed by the Chinese Cochrane Centre, and the Chinese Med Database. We performed handsearching of a number of journals (Chinese Journal of Control of Endemic Diseases, Chinese Journal of Epidemiology, Chinese Journal of Preventive Medicine, and Studies of Trace Elements and Health up to February 2001), and searched reference lists, databases of ongoing trials and the Internet. Date of latest search: November 2001. Selection Criteria We included prospective controlled studies of iodised salt versus other forms of iodine supplementation or placebo in people living in areas of iodine deficiency. Studies reported mainly goitre rates and urinary iodine excretion as outcome measures. Data collection amp; analysis As the studies identified were not sufficiently similar and not of sufficient quality, we did not do a meta-analysis but summarised the data in a narrative format. Main results We found six prospective controlled trials relating to our question. Four of these were described as randomised controlled trials, one was a prospective trial that did not specify allocation to comparison groups, and one was a large population-based study comparing different interventions. Comparison interventions included non-iodised salt, iodised water, iodised oil, iodation with potassium iodide versus potassium iodate. Numbers of participants in the trials ranged from 35 to 334; over 20 000 people were included in the population-based study. There was a tendency towards goitre reduction with iodised salt, although this was not significant in all studies. There was aim an improved iodine status in most studies (except in small children in one of the studies), although urinary iodine excretion did not always reach the levels recommended by the WHO. Reviewers’ conclusions The results suggest that iodised salt is an effective and safe means of improving iodine status. However, high quality controlled studies are needed to address questions of dosage and best means of iodine supplementation in different population groups.

    Release date:2016-08-25 03:17 Export PDF Favorites Scan
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