46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

可溶性fms-样酪氨酸激酶受体-1不同基因片段对视网膜新生血管的抑制作用

Objective To investigate the inhibitory effects of fms-like typrosine kinase receptor sFh-1 on retinal neovascularization (RNV). Methods Recombinant lentivirus sFh-1 ( 2-3 ) and sFh-1 ( 2-4 )expressing the sFh-1 (2-3) and (2-4) immunoglobulin-like regions of sFh-1 were constructed. 96 seven-dayold C57/6J mice were randomly divided into 4 groups with 24 mice in each group. Group 1 : normal control;group 2: experimental control; group 3: sFlt-1(2-3); group 4: sFlt-1(2-4). The mice in group 2-4 were exposed to hyperoxia with (75±2)% O2 for 5 days and then returned to normoxia with 21% O2 ; the mice     

电针周围性面瘫患者地仓穴的fMRI研究

目的：采用功能性磁共振成像（fMRI）技术,研究电针周围性面瘫患者地仓穴对脑功能的影响。方法：筛选6例左侧周围性面瘫患者为研究对象,电针刺激,同时行全脑fMR I扫描,SPM软件进行图像后处理,t检验（P〈0.01）分析得出电针不同穴位的脑功能图像。结果：双侧中央前回、双侧中央后回等多个脑区信号发生变化。结论：电针刺激引起了多个脑区信号的变化,穴位治疗作用的发生可能是多个脑区互相联络,对信息进行分析、整合,共同作用的结果。     

米格列奈片人体药动学研究

 目的 考察米格列奈在中国健康人体内的药动学特征， 估算主要药动学参数，为本品的临床应用提供参考。 方法 12 名健康受试者，按平行三周期设计方法进行 3 个剂量组（分别为 5 ， 10 ， 20 mg ）的单次 po 给药。给药后按预定时间点抽取静脉血 3.5 mL ，用液相色谱 - 质谱联用法测定血浆中米格列奈的浓度，估算药动学参数。 结果 12 名受试者单次口服米格列奈片 5 ， 10 和 20 mg 后， <> ρ _max 分别为（ 742.86 ± 272.60 ），（ 1 447.42 ± 590.64 ）和（ 2 614.43 ± 721.09 ） μg·L^-1 ； t _max 分别为 （ 0.32 ± 0.12 ），（ 0.34 ± 0.11 ）和（ 0.35 ± 0.11 ） h ； t _1/2 分别为（ 1.61 ± 0.39 ），（ 1.91 ± 0.66 ）和（ 1.70 ± 0.38 ） h ； AUC_0-12 分别为（ 1 006.27 ± 218.09 ），（ 1 928.35 ± 596.17 ）和 (3 677.82 ± 901.27) μg·h·L^-1 。 结论 米格列奈 在人体内的吸收、分布、代谢和排泄均为一级动力学过程，吸收、消除速率呈现剂量非依赖性。     

人工股骨头置换治疗高龄不稳定型股骨转子间骨折

2003年2月～2005年2月，我院对23例高龄不稳定型股骨转子间骨折患者采用人工股骨头置换术治疗，取得满意疗效。     

警惕下肢内固定术中主干动脉损伤

下肢骨折内固定术中动脉损伤很容易漏诊和延误治疗,并造成严重残废[1].2002年3月～2005年3月,笔者共收治4例下肢内固定术中并发主干动脉损伤病例.现报道并分析原因,旨在提高对这种损伤的警惕,最大限度地避免该并发症的发生.     

腹腔镜辅助胃底贲门癌根治术：附22例报告

目的探讨腹腔镜辅助下行D2式胃底贲门癌根治术的临床效果。方法回顾性分析3年间行腹腔镜辅助下胃底贲门癌根治术22例患者的临床资料。全组均行腹腔镜辅助下近端胃大部切除术。结果无中转开腹,平均手术时间188(162~270)min。术中平均出血182(100~260)mL。淋巴结清扫18.6(10~32)枚。术后患者平均胃肠道功能恢复时间78(48~140)h。1例肿瘤侵犯食管下段的患者术后发生吻合口瘘,经留置空肠营养管、抗炎、充分引流等处理后4周痊愈。无手术死亡。全组术后随访1~37个月,平均9.2个月,无复发转移病例。结论腹腔镜辅助下行D2式胃底贲门癌根治术方法可行,效果好,具有视野清晰、创伤小、出血少、恢复快等优点。     

脊髓型颈椎病与肌萎缩性侧束硬化的电生理对比研究

目的：探讨电生理检查对脊髓型颈椎病（CSM）与肌萎缩性侧束硬化（ALS）的签别诊断价值。方法：对124例其中52例脊髓型颈椎病和72例肌萎缩性侧束硬化症进行上、下肢肌、胸锁乳突肌肌电图检查，及C5～C8皮节体感诱发电位（DSEP）检查。结果：肌电图（EMG）检查脊髓型颈椎病上、下肢肌、胸锁乳突肌肌电图异常率分别为54％、8％、8％；肌萎缩性侧束硬化异常率分别为97％、89％、69％。DSEP检查脊髓型颈椎病异常率为92％；肌萎缩性侧束硬化异常率为l％，差异具有非常显著性意义（P〈0、001）。结论：选择上、下肢肌、胸锁乳突肌肌电图检查及C5-C8皮节体感诱发电位检查应作为两种病的常规电生理检查项目，可提高两种病的鉴别诊断率。     

Novel IgE peptide-based vaccine prevents the increase of IgE and down-regulates elevated IgE in rodents

BACKGROUND: Immunotherapy with anti-IgE antibodies for treatment of allergy is promising but a short half-life and extremely high cost limit its application. OBJECTIVE: We sought to develop IgE vaccines that induce longer-lasting auto-antibodies to neutralize self-IgE as an alternative therapy. METHODS: The vaccine was made by conjugating three synthetic peptides corresponding to human IgE receptor-binding sites to a carrier, hepatitis B surface antigen. To test the immunogenicity of the vaccine, rats were immunized with the vaccine or hepatitis B surface antigen as control. Serum IgG titres to human IgE and the IgE of other species were measured. The inhibition by rat antisera of the binding of human IgE to its receptor was assessed by ELISA, flow cytometry analysis, and passive cutaneous anaphylaxis (PCA), and its ability to recognize receptor-bound IgE was examined. The in vivo effect of the vaccine was evaluated in trichosanthin-sensitized mice and rats. In the preventative study, vaccination started before sensitization commenced, while in the treatment study, vaccination started after sensitization. Sensitized mice and rats receiving injections of the carrier served as controls. Trichosanthin-specific IgE was measured using PCA. RESULTS: Sera from vaccine-immunized rats contained high titre antibodies that reacted with soluble and plate-bound but not with receptor-bound human IgE; they also reacted with mouse, rat, and dog IgE. Furthermore, the sera inhibited the binding of human IgE to its receptor in a dose-dependent manner. In preventative and treatment studies, serum trichosanthin-specific IgE levels were significantly reduced in vaccinated groups compared with controls. CONCLUSION: Antibodies against self-IgE can be induced by IgE peptide-based vaccines, which are effective in preventing the increase of IgE and in down-regulating IgE in sensitized animals.     

Selective parity RARE imaging.

This work describes a novel method for rapid acquisition with relaxation enhancement (RARE)/fast spin-echo (FSE) imaging that removes the constraint of compliance with the Carr-Purcell-Meiboom-Gill (CPMG) condition. In a multiecho sequence, echoes with either odd or even parities are acquired. The refocusing angles are chosen using a recursive algorithm, so that the signal amplitude satisfies a predetermined modulation function. In the examples given in this article an exponential decay to a plateau is used. At each echo the echo parity that gives the desired signal amplitude for the minimum refocusing angle is selected. It is further shown that in the presence of an initial magnetization having an arbitrary phase distribution, the complex conjugate of the signal of one echo parity has to be taken and its k-space coordinates reversed. T(2) (*)-weighted images are presented and initial applications to diffusion-weighted imaging (DWI) and functional imaging shown.