目的:总结分析子宫内膜癌临床特点、治疗方法的疗效及与各预后高危因素之间的关系，以提高临床诊疗水平。方法:回顾性分析我院1998年1月～2005年12月收治住院的子宫内膜癌患者499例的临床病理资料，总结患者的一般情况、临床特点并进行随访，分析内膜癌高危因素对预后的影响。采用寿命表法计算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例风险模型分析预后因素。结果:(1) 手术－病理分期I、Ⅱ、Ⅲ期患者5年生存率分别为94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 单因素分析显示：病理类型、手术－病理分期、组织学分级、肌层浸润深度、淋巴结转移和是否行淋巴结切除术是影响预后的高危因素。（3）多因素分析显示：病理类型、手术－病理分期、组织学分级和肌层浸润深度是影响患者预后的独立危险因素。结论:(1) 对具有高危因素的患者，如特殊病理类型、手术－病理分期期别晚、组织学分级为G3和深肌层浸润，应辅以术后治疗以提高生存率。(2)分期越晚，生存率越低（Plt;0.05）。
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To discuss feasibility and effectivity of intraoperative ultrasound (US) during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. Methods A radiographic contrast nephropathy patient of abdominal aortic aneurysm and left internal iliac artery aneurysm was treated by EVAR without iodine contrast media assisted by US. Then summarized the data of this patient. Results The precise placement of the stent-graft was performed for abdominal aortic aneurysm. The left internal iliac artery aneurysm was successfully treatment with the stent-graft and coils. Intraoperative Ⅱ type endoleak from inferior mesenteric artery and Ⅰ b type endoleak from right iliac stent were identified by using US. The operative duration was 120 min and the blood loss was only 20 mL. Ⅱ type endoleak was still detected and the Ⅰ b type of endoleak was loss on postoperative a week. Conclusion Intraoperative US-assisted EVAR in patients with infrarenal abdominal aortic aneurysm represents a new option for intraoperative visualization of aortoiliac segments required as proximal or distal fixation zones and identification of endoleaks, especially in those patients with contraindications for usage of iodine-containing contrast agents.