為中醫墊背說謊，吳孟超你如何教導後人？

為中醫墊背說謊，吳孟超你如何教導後人？　　作者：王澄　　在共產黨的領導下，科學家都變成了偽科學家。前有大科學家錢學森證明能“畝產萬斤糧”，鼓吹氣功和中醫，武漢的裘法祖支持肖傳國拿中國人作偽科學實驗，又有中華醫學會會長鍾南山為中醫背書，說“看到北京兩個治療H1N1中藥的研究(數據)，我很服氣”。今天又跳出個外科老家夥吳孟超說“西醫治療注重局部，而中醫重視整體，兩者結合優勢互補，相得益彰。如今在腫瘤治療當中，中醫已經不再是輔助治療，而是腫瘤的常規治療手段。所以，中西醫結合可以提高肝癌的療效。”　　請問吳孟超老先生，你說的“中西醫結合可以提高肝癌的療效”的科學實驗報告在哪裏？這種實驗研究在國際上什麽地方被重複過？你是88歲的人了，快死了還給中醫墊背。你和錢學森裘法祖一樣，多年來摸出了一個道理，想要在科學領域裏保持永久性霸主地位，就要在政治上保持一貫正確。60年來，你們混淆了科學和政治的基本概念，88歲時已經糊塗到不知道自己什麽時候是為政治說話，什麽時候是為科學說話。　　你的這種屁話“中西醫結合可以提高肝癌的療效”是對中國醫學科學的最大的侮辱和背叛。　　我在這裏帶你讀一下英文eMedicine裏對原發性肝癌Primary Hepatic Carcinoma的處理原則。我這樣作是想讓你回答大家一個問題，你說的“中西醫結合可以提高肝癌的療效”和國際上對原發性肝癌的處理原則的區別在哪裏？如何證明這個區別能夠“提高療效”？　　中醫現在是兩頭說謊，一頭是不用治就好的病，比如流感；另一頭是治了也不好的病，比如肝癌。中醫的辦法是作東郭先生，“參與了，結果說不清”。除了這兩頭的病，那些治了就有救，不治就要壞事的病，中醫早就被踢出去了。　　88歲的吳孟超臨死前還要無視科學根據，為中醫墊背說謊，把你祖先的臉都丟盡了。吳孟超你如何教導後人？　　原發性肝癌死亡率和並發症Mortality/Morbidity　　Cure, usually through surgery, is possible in fewer than 5% of all patients.通過手術治愈的不到5％。Median survival from time of diagnosis is generally 6 months. 存活一般是6個月。Length of survival depends largely on the extent of cirrhosis in the liver; cirrhotic patients have shorter survival times and more limited therapeutic options; portal vein occlusion, which occurs commonly, portends an even shorter survival.影響存活的主要因素是肝硬化和門靜脈堵塞。Complications from hepatocellular carcinoma are those of hepatic failure; death occurs from cachexia, variceal bleeding, or (rarely) tumor rupture and bleeding into the peritoneum.並發症由肝衰產生，死亡原因有惡病質，靜脈曲張出血，或腫瘤破裂出血。　　Medical Care藥物治療包括係統化療Systemic chemotherapy　　Surgical Care手術治療包括部分肝切除Partial hepatectomy，肝移植Transplantation，局部腫瘤剝離Local tumor ablation。　　Available treatment options depend on the size, number, and location of tumors; presence or absence of cirrhosis; operative risk based on extent of cirrhosis and comorbid diseases; overall performance status; patency of portal vein; and presence of metastatic disease.　　Before instituting definitive therapy, it is best to treat the complications of cirrhosis with diuretics, paracentesis for ascites, lactulose for encephalopathy, ursodiol for pruritus, sclerosis or banding for variceal bleeding, and antibiotics for spontaneous bacterial peritonitis.在定義性治療前，最好先用利尿劑處理肝硬化並發症，穿刺抽腹水，治療腦病，治療搔癢，用硬化和綁紮治療靜脈曲張出血，用抗菌素治療細菌性腹膜炎。　　Follow-up　　Further Outpatient Care隨訪和門診處理　　Monitor the progression of disease or adequacy of treatment with imaging studies every 2-3 months and LFTs and AFP monthly or as appropriate for the stage of disease and patient's performance status. These interventions, however, have little or no impact on prognosis for survival and therefore should be performed in accordance with the patient's functional status.　　Deterrence/Prevention避免/預防　　Patients should avoid alcohol and other hepatic toxins because prognosis is related to worsening cirrhosis and tumor stage.病人不要喝酒和吃對肝髒有毒性的東西。　　Complications並發症　　Symptoms of hepatic failure may signify tumor recurrence and/or progression.肝衰的症狀　　Prognosis預後　　Overall prognosis for survival depends on the extent of cirrhosis and tumor stage, 預後主要依賴肝硬化程度和腫瘤的早/晚分期which then determine the appropriate treatment. Patients able to undergo a curative resection have a median survival of as long as 4 years; patients who present when they are too ill to be treated have a median survival of 3 months.　　Patient Education病人教育　　Medicolegal Pitfalls有關事項　　Consider hepatocellular carcinoma in any person with possible risk factors who develops symptoms of liver disease, such as unexplained jaundice, increased abdominal girth, or pruritus.有肝病症狀的比如黃疸，腹圍增加，搔癢的病人要排除肝癌。　　Family members of patients with hepatitis B infections should undergo screening for the virus.乙肝病人的家人要查乙肝。　　Consider screening of patients with cirrhosis, especially those with hepatitis C infection.肝硬化者要排除肝癌。　　Special Concerns特別注意　　Screening for hepatocellular carcinoma排查肝癌　　Despite the widespread use of screening and surveillance programs for hepatocellular carcinoma, the efficacy and cost-effectiveness of screening programs for at-risk patients is unclear.目前認為，肝癌排查工作的效/價比並不明確。　　In general, the annual incidence of developing hepatocellular carcinoma in the setting of cirrhosis is approximately 1-4%. Screening studies have shown that, although lesions may be discovered at an earlier stage, the lack of curative treatment options in patients with cirrhosis may not lead to improvements in survival.每年有1-4％ 的肝硬化病人發展成肝癌。經管能早期發現，但有肝硬化的病人的存活期並不改善。Patients with chronic hepatitis B without cirrhosis have a much lower annual incidence of developing hepatocellular carcinoma of 0.46%. 乙肝病人如果沒有合並肝硬化發展成肝癌的每年是0.46%，比有肝硬化病人少很多。The incidence of hepatocellular carcinoma in patients with chronic hepatitis C without cirrhosis is even lower. 丙肝病人如果沒有合並肝硬化發展成為肝癌的機會更低。Screening programs using AFP and an imaging modality in patients with hepatitis B or C without cirrhosis is not cost-effective given the low incidence of hepatocellular carcinoma in these patients and the high cost of imaging techniques.　　Survival advantage with screening in these at-risk populations has not been demonstrated. The retrospective screening studies that have shown modest survival advantages are confounded by lead-time and length-time bias.　　If screening is to be undertaken, AFP should not be used alone as a screening test. Instead, AFP should be combined with an imaging modality (ultrasonography, CT scan) to improve sensitivity and specificity.　　附錄：健康報20091