Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach

Summary. Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P<0.001); deep myometrial invasion (P<0.001); poorly differentiated histological grade ( P =0.11); lack of resection of the upper vagina ( P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.     

中医治疗糖尿病肾病近5年来的研究进展

综述近5年中医治疗糖尿病肾病在病因病机、辨证论治及实验研究方面取得的进展，提出了其存在的问题并分析了对策。     

米非司酮治疗后VEGF-165在异位和在位子宫内膜中的表达

目的探讨米非司酮对VEGF-165在子宫腺肌症中表达的影响。方法43例子宫腺肌症患者分为对照组(n=21)和米非司酮治疗组(n=22),采用放射免疫法测定对照组(月经第3天)和米非司酮组(术前)血清中FSH、LH、E2、PRL、P及T的水平。采用免疫组化法测定两组患者在在位和异位子宫内膜中的VEGF-165蛋白水平。结果米非司酮组较对照组血清FSH、LH、E2、P明显降低(P<0.05),而血清PRL和T的水平两组间无统计学差异(P>0.05)。VEGF-165在子宫内膜腺上皮细胞内的表达,异位内膜均明显高于在位内膜(P<0.05);而其在间质细胞内的表达,异位内膜与在位内膜无统计学差异(P>0.05)。米非司酮组异位和在位内膜腺上皮细胞、间质细胞中VEGF-165的表达水平均较对照组明显降低(P<0.05)。VEGF-165在对照组异位内膜腺上皮细胞中的表达,增殖期高于分泌期(P<0.05)。结论米非司酮治疗后,VEGF-165在异位和在位内膜中的表达明显下降,可能是通过抑制VEGF蛋白合成,降低血管通透性,抑制新生血管生成,从而有效地控制子宫内膜异位症的发生发展。     

Preliminary report on the validation of a grammar-based computer system for assessing skeletal maturity with the Tanner-Whitehouse 2 method

A series of hand and wrist radiographs was assessed manually by two individuals and by a fully automated computer system for determining bone age. Assessments were repeated after 1 month to determine variability between and within the methods of bone age assessment. There was slight intra-observer variation, but complete reproducibility when assessments were made by computer. The variation between the human assessors was less than that between human and computer assessments. The difference between overall maturity scores made by the human observer and the computer system was, however, acceptably small, and the majority of assessments were the same. It is concluded this computer system for assessing bone age in normal children is reliable and accurate, but that it needs to be validated against a much larger set of radiographs.