不能手术切除的直肠癌不同治疗方法研究

目的；对不能手术切除的直肠癌采用不同治疗方法的预后进行研究。方法；对52例不能手术切除的直肠癌分别采用单纯放疗，放疗＋化疗、手术＋放疗＋化疗三种方法治疗，并进行1、2、3年生存率的分析。结果：单纯放疗组18例，1、2、3年生存率分别为83．33％（15／18）、22．24％（4／18）、5．56％（1．18）；放疗＋化疗组18例，1、2、3年生存率分别为88．96％（16／18）；33．36％（6／18）；22．24％（4／18）；手术＋放疗＋化疗组16例，1、2、3年生存率分别为93．75％（15／16）；50％（8／16）；37．53％（6／16）。三组1年生存率无明显差异（P＞0．05），2、3年生存率有显著差异（P＜0．05）。结论：对不能手术切除的直肠癌，采用综合治疗是今后发展的方向，提倡先行姑息性乙状结肠造瘘术，再行综合治疗，可以提高生存率和生存质量，延长生存期。     

晚期食管癌外科治疗116例临床分析

目的：探讨晚期食管癌手术切除与预后的关系,方法：收集116例质差、病变范围广的晚期食管癌手术病例进行临床分析,结果：（1）116例晚期食管癌中,肿瘤切除加纵隔淋巴结清扫112例,切除率达96．5％,其中根治性切除占70％,非根治性切除28．5％,姑息性手术4．4％。（2）术后并发症13例,占11．2％,主要并发症为吻合口瘘、脓胸、肺部及切口感染,大出血、脑血栓等。4年生存率64．1％（25／39）,5年生礅率47．6％（10／21）。结论晚期食管癌治疗的首选方法仍是手术切除。     

56例局部晚期鼻咽癌同期放化疗的临床疗效观察

[目的]观察单纯放疗和同期放化疗两种治疗方法对局部晚期鼻咽癌的临床疗效、毒副反应。[方法]将56例T3-4N3M0鼻咽癌病人随机分为单纯放疗组（对照组）和同期放化组（放化组）各28例。放疗：两组病人均使用常规分割外照射，使鼻咽部剂量达到70～78Gy，颈部剂量达到66～80Gv。化疗：放化组采用顺铂、氟尿嘧啶（5-Fu），1次／周，共用3～6个周期。[结果]对照组28例病人均按计划完成治疗，放化组中有6例病人因严重放化疗反应未能按计划完成。对照组和放化组3年生存率分别为71．42％、75．00％（P〉0．05）；3年远处转移率分别为28．57％、25．00％（P〈0．05）；3年累计复发率分别为14．28％、17．85％（P〉0．05）；3年无瘤生存率分别为67.85％、64．28％（P〈0．05）。[结论]局部晚期鼻咽癌顺利完成同期放化疗的患者，远处转移率及无瘤生存率体现一定的优势。     

237例肺癌外科治疗影响预后因素的分析

目的：分析TNM分期，病理类型，年龄和手术方式与预后的关系，探讨在各影响预后因素中外科治疗手段的正确选择。方法：应用SPSS8．0统计，对237例肺癌患者资料建立数据库并进行统计分析，用寿命表法进行生存率分析。两组间生存率差异显著性检测用Logrank方法。结果：Ⅱb期以上肺癌总的5年生存率为49．8％，Ⅲa期仅为13．1％（P＜0．001），Ⅲb和Ⅳ期肺癌均为0％，但伴颅内单发转移病灶手术后平均生存期19个月。鳞癌5年生存率48．3％，腺癌和腺鳞癌分别为30．5％和13．3％（P＜0．05和＜0．01）；小细胞肺癌为0；大细胞肺癌为60．2％，70岁以下肺癌患者肺楔形切除术5年生存率为0，肺叶切除术31．4％（P＜0．01）；全肺切除术18．2％（P＜0．01）；肺叶加支气管袖状切除术37．6％（P＜0．01），70岁以上肺癌患者肺楔形切除5年生存率33．4％,肺叶切除27．0％（P＜0．05）；全肺切除和肺叶加支气管袖状切除术3年经分别为20．2％和50．5％（P＜0．01）。结论：Ⅱb期以上肺癌外科治疗应为首选；Ⅲa期应采用术前新辅助治疗的综合治疗；手术可作为Ⅲb和Ⅳ期肺癌姑息性治疗的手段；脑部单个转移病灶的肺癌不应为手术禁忌证。腺癌和腺鳞癌应以手术为主的综合性治疗；小细胞肺癌应以化疗为主的综合性治疗；透明细胞类型的大细胞肺癌以手术为主的综合性治疗。70岁以下肺癌患者肺叶切除加淋巴结清扫应为外科治疗肺癌的标准术式。70岁以下高龄肺癌患者应尽量选择对机体创伤小的术式。     

吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌

目的：观察和评价吉西他滨（GEM）联合长春瑞滨（NVB）治疗晚期非小细胞肺癌（NSCLC）的疗效和毒性。方法：GEM1000mg／m^2加生理盐水（Ns）100ml，30分钟内滴注，第1、8天；NVB25mg／m^2加NS 70ml快速静脉推注，第1、8天。21天为1个周期，至少治疗2个周期。结果：21例NSCLC患者，10例完成2个周期，6例3个周期，5例4个周期，共治疗58个周期。CR1例，PR9例，SD9例，PD2例，总有效率（CR＋PR）为47．6％；初治8例，复治13例，有效率分别为62．5％（5／8例）和38．5％（5／13例）（P〈0．05）；鳞癌8例，腺癌13例，有效率分别为62．5％（5／8例）和38．5％（5／13例）（P〈0．05）。中位生存期（MST）11．5个月，1年生存率为42．0％。毒性反应主要有白细胞减少、血小板下降、血红蛋白降低；白细胞减少Ⅲ-Ⅳ度者占28．6％（6／21），血小板下降和血红蛋白下降Ⅲ-Ⅳ度分别为14．3％（3／21）和4．8％（1／21）。结论：吉西他滨联合长春瑞滨治疗晚期非小细胞肺癌具有较好的疗效，毒性反应可以耐受，特别是老年患者化疗更适宜。     

黏着斑激酶的表达与结直肠癌侵袭和转移的相关性

目的 探讨黏着斑激酶(FAK)表达与结直肠癌发生及其生物学行为的关系。方法 应用免疫组织化学S—P方法，检测67例结直肠癌和配对的正常黏膜以及37例结直肠区域淋巴结转移癌组织中FAK的表达。结果 正常结直肠黏膜、结直肠癌及淋巴结转移癌组织中FAK阳性率分别为71．6％(48／67)、89．6％(60／67)和97．3％(36／37)(P=0．001)；FAK强阳性率分别为6．0％(4／67)、77．6％(52／67)和83．8％(31／37)(P=0．000)。结直肠癌中区域淋巴结有转移及区域淋巴结无转移者FAK阳性率分别为100．0％(37／37)和76．7％(23／30)(P=0．007)；FAK强阳性率分别为89．2％(33／37)和63．3％(19／30)(P=0．012)。FAK表达水平与结直肠癌浸润深度呈正相关(P=0．009)；而与结直肠癌的分化程度无关(P=0．438)。结论 FAK表达水平增高可加速结直肠恶性细胞的增殖、浸润和转移。故检测结直肠活检黏膜及癌组织中FAK表达水平，有助于进一步了解结直肠黏膜癌变倾向及结直肠癌生物学行为，有利于预后判断。     

长段食管癌的外科治疗

目的 探讨长段食管癌手术治疗的可行性及影响生存率的主要因素。方法 对本科1990年1月至2003年6月手术治疗病变长段超过10cm的128例食管癌进行回顾性分析。结果 手术切除率97．6％(125／128)，术后并发症发生率10.2％(13／128)，死亡率0．8％(1／128)。1、3、5a生存率分别为79．8％(95／119)、34．3％(37／108)、25．6％(23／86)。结论 只要适应证掌握得好，长段食管癌手术治疗仍有一定的意义。     

分段加速超分割放疗联合化疗治疗晚期宫颈癌的临床研究

目的：探讨分段加速超分割放疗联合化疗治疗晚期子宫颈癌的临床价值。方法：1998年6月～2001年2月分别采用全盆常规放疗（A组）、全盆分段超分割放疗（B组）以及全盆分段超分割放疗同时联合化疗（C组）治疗ⅡB期以上宫颈鳞癌，对放疗不良反应和治疗效果进行临床比较研究。结果：1）A组全疗程平均58d完成，B组39．1d完成，C组40．1d完成，分段超分割放疗组疗程显著短于常规放疗组，P〈O．05；2）5年生存率3组分别为39．28％（11／28）、52．17％（12／23）和62．96％（17／27），局部控制率3组分别为57．14％（16／28）、69．57％（16／23）和77．78％（21／27），均有上升趋势，但差异无统计学意义，P〉0．05；3）A、B和C组转移率分别为32．14％（9／28）、30．43％（7／23）和3．70％（1／27），单纯放疗组明显高于放化疗组，P〈0．05；4）各种近期放疗反应3组差异无统计学意义；远期放疗反应分别为照射野皮下纤维化[发生率3组分别为75．OO％（21／28）、65．22％（15／23）和70．37％（19／27）]、阴道闭锁和狭窄、直肠反应及膀胱反应，差异均无统计学意义，P〉0．05。结论：全盆加速超分割放疗联合化疗治疗晚期宫颈癌有提高晚期宫颈鳞癌生存率及局部控制率的趋势，并能降低远处转移发生率，明显缩短总疗程，不增加放疗不良反应。     

大蒜对煤焦沥青烟气的致癌性的阻断作用的实验研究

在染毒柜内加热沥青产生烟气，选2组动物吸入烟气，其中1组在吸入的同时饮用大蒜水．2组动物同时出现肺癌和皮肤癌．不同时期肺癌发生率为：1组：6个月时4／6；9个月6／8；11-12个月28／28；合计38／48．染毒同时饮用大蒜水组：6个月1／6：9个月5／10，11-12个月17／26；合计23／48．饮用大蒜水组动物不同对期肺癌发生率均比单纯吸入烟气组明显减少．     

CPT-11联合顺铂治疗22例晚期恶性肿瘤

[目的]研究CPT-11（伊立替康）联合顺铂二线治疗晚期恶性肿瘤的疗效及毒副反应。及Ki67阳性对化疗的疗效是否有预测作用。[方法]22例晚期恶性肿瘤患者接受CPT-11 120mg／m^2。静脉滴注，第1、8天；顺铂70mg／m^2，静脉滴注，分为第2～4天用；每3周重复1次．2个周期后评价疗效.[结果]21例可评价疗效。共行治疗61个周期，平均2．9个周期，CR4．76％（1／21），PR23．80％（5／21），SD28．57％（6／21），PD42．85％（9／21），客观缓解率28．57％（6／21）．临床受益率57．14％（13／21）；1年生存率为33．33％（7／21），中位TTP为6．1个月，治疗前后卡氏评分提高者7例，稳定者7例，下降者7例。Ki67阳性组在近期疗效上略占优势，阴性组在1年生存及中位TTP上略占优势。Ⅲ-Ⅳ度毒性反应以骨髓毒性及恶性呕吐为主。[结论]CPT-11联合顺铂二线治疗晚期恶性肿瘤有一定近期疗效，且毒性可以耐受。Ki67阳性组及阴性组治疗结果相仿。     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.     

Temozolomide treatment in glioma--experiences in two university hospitals in Finland

Thirty-two patients with relapsing glioma were treated with temozolomide in two university hospitals in Finland. One patient (3%) had complete response and 9 (28%) partial response, with 8 patients (25%) showing stable disease. Median progression-free survival for these 18 patients (56%) was 7 months (range 2-11+). The remaining either had progressive disease (25%) or only clinical evaluation (19%). Karnofsky score improved in 34% of patients and decreased in 3%. Symptoms were alleviated in 44% and deteriorated in 9%. Grade 3-4 toxicity was detected in 9% of the patients. Only 4% of the days in treatment were spent in hospital. An average 1.8 neuroradiological investigations, 6.9 laboratory visits, and 5.3 visits to the oncologist were made. This study confirms that temozolomide has positive effects on the outcome of often heavily pretreated glioma patients. High drug costs are compensated by prolonged home care and even the possibility to maintain working capacity.