Role of surgical treatments in high-grade or advanced gastroenteropancreatic neuroendocrine neoplasms

Over the last 40 years, the incidence and prevalence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have continued to increase. Compared to other epithelial neoplasms in the same organ, GEP-NENs exhibit indolent biological behavior, resulting in more chances to undergo surgery. However, the role of surgery in high-grade or advanced GEP-NENs is still controversial. Surgery is associated with survival improvement of well-differentiated high-grade GEP-NENs, whereas poorly differentiated GEP-NENs that may benefit from resection require careful selection based on Ki67 and other tissue biomarkers. Additionally, surgery also plays an important role in locally advanced and metastatic disease. For locally advanced GEP-NENs, isolated major vascular involvement is no longer an absolute contraindication. In the setting of metastatic GEP-NENs, radical intended surgery is recommended for patients with low-grade and resectable metastases. For unresectable metastatic disease, a variety of surgical approaches, including cytoreduction of liver metastasis, liver transplantation, and surgery after neoadjuvant treatment, show survival benefits. Primary tumor resection in GEP-NENs with unresectable metastatic disease is associated with symptom control, prolonged survival, and improved sensitivity toward systemic therapies. Although there is no established neoadjuvant or adjuvant strategy, increasing attention has been given to this emerging research area. Some studies have reported that neoadjuvant therapy effectively reduces tumor burden, improves the effectiveness of subsequent surgery, and decreases surgical complications.     

心肺复苏中的相关问题探讨(附249例报告)

心肺复苏（CPR）指对心脏骤停者所采取的及时而有效的抢救措施，目的是使已经停止的心脏排血和呼吸功能得到恢复。由于病种的复杂和病情危重，在施救的过程中，医护人员在采取有效措施挽救病人生命的同时，还会涉及到诸如是否需要进行CPR、CPR的持续时间以及目标等医学伦理和道德问题。本文通过对我院急诊科2002年1月-2005年12月间接诊的院前死亡及急诊抢救室进行的心肺复苏的249例情况作一回顾性分析，探讨CPR中存在的相关问题。     

中国优秀马拉松运动员ACE基因I/D多态性频率分布特征

通过分析中国马拉松运动员ACE基因I/D多态频率分布特征,探讨其作为杰出耐力基因标记的可行性。选择我国马拉松健将、国际健将级运动员26名作为马拉松运动员组,汉族学生216名作为对照组。对两组受试者进行ACE基因I/D多态性测定。结果显示:我国马拉松运动员组的等位基因频率和基因型频率与对照组比较无显著差异,其中15名国际健将中无一DD型纯合子,提示我国优秀马拉松运动员的纯合子DD型频率低下是其ACE基因多态频率分布的主要特征。     

Lugol液染色对食管早期癌和癌前病变的诊断价值

目的 探讨Lugol液染色对食管早期癌和癌前病变的诊断价值。方法 对45例食管黏膜可疑病变经内镜以2％Lugol液喷洒染色，观察黏膜染色情况，并取活检送病理组织学检查。结果 45例食管病变染色后，39例呈浅染色或不染色，其中食管癌8例（食管早期癌5例，进展期癌3例），Barrett食管5例，轻至中度不典型增生1l例。本组Lugol液染色对食管早期癌和癌前病变的检出率达46．7％。结论 内镜下应用Lugol液染色结合活检有助于食管早期癌和癌前病变的诊断，且操作简便，具有重要的临床价值。     

和儿子过招

我现在能控制自己的生活，但是对于我的准翻版，我投入了许多心愿和期望的儿子，他的成长方向却完全让我不可理解和头痛。[编者按]     

蒙医陶拉布日疗法简介

被称之为蒙医传统五种疗法之首的陶拉布日（下泻）疗法在临床应用有越来越少的趋势。这主要是因为陶拉布日疗法的服药方法略繁琐所致。陶拉布日疗法服药方法有三个步骤：即下泻施治前的准备，泻药的使用和善后调理。服药前的准备又有远近之分。泻药的使用包括配方、服法、洗肠、下泻程度和辅助疗法等五个部分。陶拉布日疗法又分为峻泻剂与缓泻剂两种。缓泻剂可无需实施施治前的准备和善后调理，直接用药，不会影响患者的工作学习，所以被广泛应用于临床。     

Prior immunologic experience potentiates the subsequent antibody response when Salmonella strains are used as vaccine carriers.

Prior immunologic experience with homologous and heterologous serotype Salmonella strains potentiated the subsequent antibody response when the same strains were used as vaccine carriers of foreign antigens. This potentiation was positively correlated with the appearance of antibody directed against the lipopolysaccharide of the carrier strain. Both serum and mucosal antibody responses against the foreign antigen increased over time. Antibody responses in sera of animals primed with either the homologous or heterologous serotype strain were not statistically significantly different, while animals primed with the homologous serotype strain developed significantly better mucosal antibody responses against the foreign antigen.     

先天性胆总管囊肿23例的术式及疗效分析

目的：探讨先天性胆总管囊肿的术式及疗效。方法：回顾分析手术治疗先天性胆总管囊肿23例，其中Roux-Y囊肿-空肠吻合8例；囊肿切除，Roux-Y肝总管-空肠吻合15例。结果：20例获得随访，Roux-Y囊肿-空肠吻合随访6例，仅2例无症状，另4例反复发作腹痛，发热或黄疸，其中1例再手术，囊肿切除，Roux-Y肝总管-空肠吻合随访14例。仅1例有腹痛，余13例无症状，结论：Roux-Y肝总管-空肠吻合是治疗先天性胆总管囊肿的首选术式。