摘要:目的:探討滋養葉細胞腫瘤的臨床特征、治療、預后。方法:回顧性分析我院1997年1月至2008年12月診治的28例良、惡性滋養葉細胞腫瘤患者的臨床資料。結果:28例中,侵蝕性葡萄胎1例,經化療后已隨訪3年無復發征象;2例因“肺部轉移”和“持續性葡萄胎”回內地治療;5例尚在隨訪中,其余經隨訪已達臨床治愈。結論:妊娠滋養葉細胞腫瘤患病率高;良性葡萄胎預后好,但應警惕其潛在惡變性,應早期發現,早期治療,以減少其惡變帶來的危害;惡性滋養葉細胞腫瘤經積極化學治療后可達到根治。Abstract: Objective: To explore the clinical feature，treatment and prognosis of gestational trophoblastic tumor. Methods: Retrospectively analyzed the clinical pathological materials of 11 patients with carcinoid and malingnant gestational trophoblastic tumor treated from January.1997 from December 2008 in our hospital. Results: In the 28 cases,1 case of erosive hydatidiform mole did not relapse after the chemical treatment of 3 years’ survey; 2 cases went back to the inland due to “lung transference and continuous hydatidiform mole”; 5 cases was still in the followup survey; the last had been cured after followup survey. Conclusion: Gestational trophoblastic tumor have a higher rate or happening; The carcinoid tumor has a better prognosis, yet people should guard its initial bad change; malignant gestational trophoblastic tumor can be cured after the positive chemical treatment.
Objectives Retrospective analysis of the Tibetan convulsive status epilepticus (CSE) for the aetiology, prognosis and its influencing factors in Tibet area. Methods Through electronic patient record, making “epilepsy”, “status epilepticus ”, “epileptic seizure” as keywords, convulsive status epilepticus patients in the People’s Hospital of Tibet Autonomous Region hospitalized from January 2015 to December 2020 were retrospectively observed, gathering their clinical data and aided examinations furthermore, and the prognoses were returned by telephone, meanwhile the functional status of those patients was assessed by the modified rankin scale. and the causes differ in gender, age, out-of-hospital antiepileptic treatment, family history of epilepsy and history of epilepsy were analyzed. The prognostic factors were analyzed by logistic regression. Results A total of 2 254 hospitalized patients with epilepsy were retrieved, including 331 CSE patients aged 14~84 years, 219 males and 112 females. There were 36 lost calls, 62 CSE deaths (21.01%), and 4 adverse outcomes (non-death)(1.7%).There were statistically significant differences in etiology of CSE in different ages and history of epilepsy (P<0.05), but there were no statistically significant differences in gender, out-of-hospital antiepileptic treatment, progression of refractory status epilepticus and family history of epilepsy. Cerebrovascular disease was the main cause of CSE in people aged 45 and over (54 cases), while the main cause of CSE in people aged under 45 was unknown (104 cases).Among the patients with previous history of epilepsy, the highest proportion was unknown cause [117 cases (48.8%)]; Among patients without a history of epilepsy, cerebrovascular disease [34 cases (37.4)] was the most common cause of CSE. Multivariate logistic regression analysis of prognostic factors of CSE showed that gender, age, GCS and electrolyte disorder had statistically significant effects on the death of CSE patients (P<0.05), while altitude and their duration and other factors had no statistically significant effects on the death of CSE patients (P>0.05). ConclusionsCerebrovascular disease is the leading cause of CSE in people aged 45 and over. Male, advanced age, low GCS score at discharge, and electrolyte disorder were risk factors.
ObjectiveTo investigate the situation of tuberculosis (TB) infection in primary and middle school students and to provide scientific basis for TB prevention and control in Nyingchi. MethodsPrimary and middle school students in Nyingchi were investigated from 2006 to 2008 using a questionnaire, and purified protein derivative (PPD) tests were carried out among the sampling students. Data analysis was conducted by SPSS 13.0. ResultsIn 3 987 included primary and middle students, the positive, strongly positive and overall positive rates of PPD were 11.4%, 5.1%, 16.5%, respectively. Five patients with TB were found in the investigation, and the prevalence was 125.4 per 100 000. The positive and strongly positive rates were 11.3% and 4.4% in male, 11.5% and 5.7% in female, respectively. The positive and strongly positive rates were 6.9% and 3.9% in primary school students, 18.8%, 7.1% in middle school students, respectively. Both the positive rate and strongly positive rate in middle school students were higher than those in primary school students (P < 0.05). The positive rates in town, village and floating population were 16.5%, 9.5%, 8.9%, respectively, and their strongly positive rates were 6.1%, 4.8%, 1.4%, respectively. Both the positive rate and strongly positive rate in town were higher than those in village and floating population (P < 0.05). The strongly positive rates in Tibetan, the Han nationality and other ethnic minorities were 5.2%, 4.0%, 6.0%, respectively. The strongly positive rates in Tibetan and other ethnic minorities were higher than those in the Han nationality (P < 0.05). ConclusionThe infection and prevalence rate of TB of primary and middle school students in Nyingchi are fairly high. TB prevention and control for the high-risk populations should be strengthened in primary and middle schools in Nyingchi.
Objective To observe and evaluate the safety and efficacy of anti-vascular endothelial growth factor (VEGF) in the treatment of eyes with macular edema (ME) secondary to branch retinal vein occlusion (BRVO) in Lhasa, Tibet. MethodsA retrospective case series. From September 2018 to January 2022, a total of 41 patients (41 eyes) with BRVO-ME, who were diagnosed in Department of Ophthalmology of Tibet Autonomous Region People’s Hospital, were included in this study. There were 21 eyes in 21 males and 20 eyes in 20 females. The median age was 53 (31,75) years. There were 24 patients with hypertension (58.8%, 24/41). Best corrected visual acuity (BCVA), ocular pressure, fundus color photography and optical coherence tomography (OCT) were performed in all eyes. The BCVA was performed using the international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for record. The foveal macular thickness (CMT) was measured by OCT. All eyes were treated with intravitreous injection of anti-VEGF drugs, once a month, among which 23 eyes (56.1%, 23/41) received intravitreous injection of ranibizumab (IVR), and 18 eyes (43.9%, 18/41) received intravitreous injection of conbercept (IVC), and were grouped accordingly. There was no significant difference in age (Z=－0.447), gender composition (Z=－0.485), logMAR BCVA (t=－1.591), intraocular pressure (t=－0.167) and CMT (t=－1.290) between two groups (P＞0.05). During the follow-up, the same devices and methods were used at baseline to perform relevant examinations, and the changes of BCVA, intraocular pressure, CMT and new cardiovascular and cerebrovascular events were compared between baseline and the last follow-up. logMAR BCVA, intraocular pressure and CMT were compared between baseline and last follow-up using Student t test. The comparison of injection times and follow-up time between IVR group and IVC group was conducted by Mann-Whitney U test. ResultsAt baseline, logMAR BCVA, intraocular pressure, and CMT were 0.852±0.431, (12.5±2.5) mm Hg (1 mm Hg= 0.133 kPa), and (578.1±191.1) μm, respectively. At the last follow-up, the number of anti-VEGF drug treatments was (2.7±1.2) times; logMAR BCVA and CMT were 0.488±0.366 and (207.4±108.7) μm, respectively, with CMT > 250 μm in 14 eyes (34.1%, 14/41). Compared with baseline, BCVA (t=4.129) and CMT (t=－0.713) were significantly improved, with statistical significance (P＜0.001). The injection times of IVR group and IVC group were (2.6±0.9) and (3.0±1.5) times, respectively. There were no significant differences in the number of injection times (t=－1.275), logMAR BCVA (t=－0.492), intraocular pressure (t=0.351) and CMT (t=－1.783) between the two groups (P＞0.05). No new hypertension, cardiovascular and cerebrovascular events occurred in all patients during follow-up. At the last follow-up, there were no eye complications related to treatment modalities and drugs. ConclusionShort-term anti-VEGF treatment can improve the visual acuity of BRVO secondary ME patients and alleviate ME in Lhasa, Tibet. The safety and efficacy of ranibizumab and conbercept were similar.
West China Hospital of Sichuan University as a national-level regional medical center in the western part of the country, focused on the actual situation in Tibet and actively carried out precision health poverty alleviation work. Guided by " precision”, the hospital has built a close-knit medical association – Hospital of Tibet People’s Government in Chengdu Office, and through the comprehensive improvement of medical care, teaching, scientific research, and management, creates a medical and health service system with Tibet characteristics. Combining " blood transfusion” and " hematopoietic” to build a " West China Model” for precision health poverty alleviation, West China Hospital of Sichuan University fully demonstrates the public welfare and responsibility of a national-level regional medical center, and constantly exerts regional radiation and leading role, promotes the medical and health service system continuous improvement in Tibet.
Objective To analyze the death constitution of inpatients in The Tibet Autonomous Region People's Hospital from 2014 to 2015 and to provide baseline data for further rational drug use. Methods The medical records of death inpatients between 2014 and 2015 were collected. We classified all diseases according to the international classification of diseases coding (ICD-10) and analyzed the general situation, main death discharge diagnosis and single death diseases. Distribution of inpatients frequency, constituent ratio, cumulative frequency of death diseases were calculated by EXCEL 2007 software. Results (1) A total of 40 147 patients were discharged and 339 (8.44‰) inpatients died between 2014 and 2015. The sex ratio of male to female was 2.08 to 1 for death inpatients. (2) Death constitution of four diseases' categories were over 10%, including circulatory system diseases, exogenous injury or poisoning system diseases, respiratory system diseases, and digestive system diseases. (3) Death constitution of 3 diseases' categories were between 5% to 10%, including tumor, abnormal signs and symptoms, urogenital system diseases. (4) The main death cause single diseases were cerebral hemorrhage diseases, myocardial infarction, respiratory failure, damage, pneumonia, cancer, neonatal hypoxic-ischemic encephalopathy. Conclusion The main death inpatients of the Tibet Autonomous Region People's Hospital are of the age 25 to 59, and the main death cause diseases are circulatory system diseases.
ObjectiveTo analyze the types and characteristics of common paroxysmal diseases in order to improve the diagnosis of onset types and to analyze the related factors of epileptic seizures in Tibetan population.Methods510 patients with paroxysmal diseases were enrolled in the Department of Neurology, People's Hospital of Tibet Autonomous Region from June 2013 to December 2018 and the video electroencephalogram (VEEG) data were analyzed.ResultsAmong the 510 patients, there were 35 types of paroxysmal diseases, 335 cases (65.69%) of seizures and 86 cases (16.86%) of psychogenic non-epileptic seizures (PNES). There were significant differences in the incidence of seizures between male and female patients (P<0.05), the incidence of seizures were different at different altitude and the concentration of hemoglobin (P<0.05), the course of seizures was always more than 2 years (P<0.05), and the frequency and age of seizures were higher, but there were no significant difference, and epileptic patients in Tibet were more likely to be young adults (34.51%).ConclusionsThere are many kinds of paroxysmal diseases in Tibetan population, and epileptic seizures are the main type. There was a qualitative relationship between the incidence of epilepsy and altitude. The incidence of epilepsy didn’t increase along with the increase of hemoglobin, and the course of seizures was mostly more than 2 years.
It has always been an important policy of the Chinese government to provide aid and assistance for the development of Tibet. With nearly one-eighth of China’s total land areas and about 0.002% of China’s total population, the Tibet Autonomous Region lags behind the domestic average level in medical education and is in bad need for medical professionals. The West China Center of Medical Sciences (WCCMS) of Sichuan University has managed to introduce US projects to set up the West China–Tibet Telemedical Education System to transmit medical courses in a real-time and interactive way. Based on this system, WCCMS has established a model for assisting the Tibet University Medical College through transmitting medical courses, training their medical faculty, sending WCCMS faculty to work in Tibet and admitting medical teachers and students from Tibet to study and be trained at West China Medical School and Hospital.