新辅助化疗治疗头颈部骨肉瘤单中心临床效果回顾

目的 评价新辅助化疗在头颈部骨肉瘤治疗中的效果。方法 回顾2007—2015年于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科接受治疗的头颈部骨肉瘤患者的基本信息、围术期治疗信息、影像学信息、病理学信息以及随访记录,采用SPSS 17.0软件包对数据进行统计学分析。结果 最终纳入患者157例,男68例,女89例,5年总生存率（OS）为50.96%。≤30岁51例,31~60岁85例,≥61岁21例。91例肿瘤位于下颌骨,66例位于上颌骨及颅底。高级别骨肉瘤141例,低级别骨肉瘤8例,分化程度未知8例。54例肿瘤最大直径>4 cm,103例肿瘤直径≤4 cm。术区切缘阳性7例。单纯手术治疗65例,手术联合化疗15例,手术联合放、化疗23例,手术及放疗54例。单因素分析显示,肿瘤远处转移的相关因素为上颌骨及颅底肿瘤（P=0.022）、高级别骨肉瘤（P=0.011）以及阳性切缘（P=0.031）;下颌骨骨肉瘤（P=0.032）、阴性切缘（P=0.006）与患者OS相关;阴性切缘（P=0.007）与患者无瘤生存率（DFS）相关。多因素分析显示,肿瘤部位（P=0.034）、切缘（P=0.006）、化疗（P=0.025）、病理学亚型（P=0.012）与患者总体生存率相关;阳性切缘（P=0.002）、未接受放疗（P=0.005）与肿瘤局部复发相关。结论 术区安全切缘是头颈部骨肉瘤良好预后的关键,放疗在一定程度上可以抑制肿瘤复发,化疗（新辅助化疗、辅助化疗）可提高患者术后总体生存状况。     

Improvement method for cervical cancer detection: A comparative analysis

Cervical cancer is a prevalent and deadly cancer that affects women all over the world. It affects about 0.5 million women anually and results in over 0.3 million fatalities. Diagnosis of this cancer was previously done manually, which could result in false positives or negatives. The researchers are still contemplating how to detect cervical cancer automatically and how to evaluate Pap smear images. Hence, this paper has reviewed several detection methods from the previous researches that has been done before. This paper reviews pre-processing, detection method framework for nucleus detection, and analysis performance of the method selected. There are four methods based on a reviewed technique from previous studies that have been running through the experimental procedure using Matlab, and the dataset used is established Herlev Dataset. The results show that the highest performance assessment metric values obtain from Method 1: Thresholding and Trace region boundaries in a binary image with the values of precision 1.0, sensitivity 98.77%, specificity 98.76%, accuracy 98.77% and PSNR 25.74% for a single type of cell. Meanwhile, the average values of precision were 0.99, sensitivity 90.71%, specificity 96.55%, accuracy 92.91% and PSNR 16.22%. The experimental results are then compared to the existing methods from previous studies. They show that the improvement method is able to detect the nucleus of the cell with higher performance assessment values. On the other hand, the majority of current approaches can be used with either a single or a large number of cervical cancer smear images. This study might persuade other researchers to recognize the value of some of the existing detection techniques and offer a strong approach for developing and implementing new solutions.     

THE ARABIC SCALE OF DEATH ANXIETY (ASDA): ITS DEVELOPMENT,VALIDATION, AND RESULTS IN THREE ARAB COUNTRIES

The Arabic Scale of Death Anxiety (ASDA) was constructed and validated in a sample of undergraduates (17–33 yrs) in 3 Arab countries, Egypt (n = 418), Kuwait (n = 509), and Syria (n = 709). In its final form, the ASDA consists of 20 statements. Each item is answered on a 5-point intensity scale anchored by 1: No, and 5: Very much. Alpha reliabilities ranged from .88 to .93, and item-remainder correlations ranged between .27 and .74; the 1-week test-retest reliability was .90 (Egyptians only), denoting high internal consistency and stability. The correlations between the ASDA and Templer's DAS ranged from .60 to .74 denoting high convergent validity of the ASDA against the DAS in the 3 Arab countries. Four factors were extracted in the Egyptian sample and labeled “Fear of dead people and tombs”, “Fear of postmortem events”, “Fear of lethal disease”, and “death preoccupation”. The first two factors were almost completely identical in the three countries. The item, “I fear the torture of the grave”, had a very high mean score. There were significant correlations between the ASDA and death depression, death obsession, reasons for death fear, and general anxiety, depression, obsession-compulsion, neuroticism, and being a female. All female groups attained significantly higher mean ASDA scores than their male counterparts. Kuwaitis had higher mean ASDA total scores, in comparison with their Egyptian and Syrian counterparts, whereas female Syrians attained the lowest mean ASDA total score in proportion to their female peers.     

THE COLLETT-LESTER FEAR OF DEATH SCALE: A CORRECTION

A revision of the Collett-Lester Fear of Death Scale is presented, eliminating a deviant item that reduced the reliability of the scale. Using a sample of 191 undergraduates, four 7-item subscales were derived with adequate reliabilities and factorial congruence for 2 ofthe subscales (Fear of Death of Self and Fear of Dying of Self).     

Complete Atrioventricular Block during Ablation of Atrial Flutter

We report the case of a 51‐year‐old patient who developed a complete atrioventricular (AV) block during the isthmic radiofrequency catheter ablation of a typical atrial flutter. The cause was an acute occlusion of the segment three of the right coronary artery. His recanalization was associated with the immediate restoration of a normal AV conduction. The complication is exceptional (one of 740 consecutive atrial flutter ablations). (PACE 2010; 516–519)     

A double-blind study of misoprostol (SC-29333) in the healing of duodenal ulcer

In a double-blind randomized placebo controlled trial, 50 patients with endoscopically confirmed duodenal ulcer were treated with either misoprostol 200 micrograms or placebo in q.i.d. doses for 4-8 weeks. Of 25 patients in the placebo group, four defaulted and two were withdrawn due to worsening of symptoms. Of 25 misoprostol-treated cases, 17 cases (68%) and 21 cases (84%) healed at 4 and 8 weeks respectively, compared with three (14%) and five (24%) of the 21 placebo-treated cases (P less than 0.001). Except for diarrhoea in 2 patients in each group and itching in one with misoprostol, no serious side effects were noted.     

Hepatitis C viral load, genotype and histological severity in patients with bleeding disorders

We report the relationship between hepatitis C virus (HCV) titre, liver histology and HCV genotype in patients with bleeding disorders. One hundred and thirty-two RIBA-2-positive patients, including 56 who were also HIV positive, were identified at our centre. Fifty of these patients, including nine who were HIV infected, underwent percutaneous liver biopsy. Liver histology was assessed using a modified histological activity index (HAI). Qualitative serum HCV PCR was positive in 87 (87%) of the 101 patients tested including 43 of 50 biopsied patients. HCV RNA titres, measured by quantitative PCR, were significantly higher in HIV-positive patients compared with HIV-negative patients (P < 0.05) but were not related to HAI, mean factor concentrate usage, duration of HCV infection or HCV genotype. There was no relationship between HCV genotype and HAI. Qualitative HCV PCR was positive in 30 of 43 liver biopsies tested. Biopsy PCR-positive and -negative cohorts were not distinguished by HAI or serum HCV titre. We conclude that although serum HCV PCR is useful in confirming the presence of HCV infection in patients with bleeding disorders, little meaningful information concerning the severity of the disease can be obtained from serum HCV quantification.     

TINEA VERSICOLOR AND VISCERAL LEISHMANIASIS

Background. Visceral leishmaniasis (VL) is endemic in several areas in the Sudan. The disease is associated with depressed cellular immunity. Tinea versicolor is a normal commensal of the skin which can become pathogenic particularly in patients with depressed cell-mediated immunity. Patients with VL have a high prevalence of tinea versicolor. Methods. One hundred and thirty patients with parasitologic confirmation of VL were screened for tinea versicolor infection. In the suspected cases the diagnosis was made by demonstrating the fungal hyphae and spores in skin scrapings. All patients were treated with sodium stibogluconate. Results. Of the 130 patients with VL, 10.8% were found to have severe tinea versicolor. The fungal infection developed or became worse with the start of VL. After successful treatment of VL, the tinea lesions disappeared completely or decreased in severity. Conclusions. Depressed cell-mediated immunity that is a feature of VL is the probable underlying cause for fungal infection. Tinea infection during the course of VL is to be distinguished from lesions of post-kala-azar dermal leishmaniasis.