SURGICAL TREATMENT OF MALIGNANTESOPHAGEAL TUMORS IN PUMC HOSPITAL

To study how to prolong the postoperative survival time of the patients with malignant esophageal tumors. The clinical data of 1098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed.The deletion of fragile histnmine triplet (FHIT) gene (a tumor suppressor gene) in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT-PCR method. The resectability was raised gradually and the operatire morbidity and mortality decreased year by year, but there was no significant improvement on the postoperative 5-year survival rate. Delayed diagnosis and irradical resection influenced the long-term survival. The deletion of cDNA of FHIT gene was 64. 2% in esophageal cancer and 20% in the resected margin of the cancer. We believe that high-grade atypical hyperphsia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively,and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical.resection, and postoperative nutritional support are very important for the improvement of the postoperative survival time of the patients.     

ANALYSIS OF EFFECT AND COMPLICATION ON SURGICAL TREATMENT OF CAROTID BODY TUMORS IN 46 CASES

Carotidbodytumor(CBT),namelytheparagan-glioma,isakindofrarechemodectomas.Becauseofitsspeciallesionlocationwithcomplexanatomicstructure,whereabundantwithbloodvessels,andtherequirementofsimultaneousresectionandreconstruc-tionofcarotidartery,thesurgicaldifficultyandcom-plicativeriskhavebeengreatlyincreased.Thehighpostoperativeincidencerateofcomplicationsuchashemiplegiaandcranialnerveimpairmentusuallymakesthemanagementmoredifficult.Inthisarticle,effectsandcomplicationsof46carotidbodytumorpatients…     

CLINICOPATHOLOGIC FEATURES AND SURGICAL TREATMENT OF NONFUNCTIONING ISLET CELL TUMORS

INTRODUCTIONMostpancreaticendocrineneoplasmcouldinduceanoverproductionofhormones,leadingtorelatedclinicalsymptomsandsigns.However,about15%～25%patientswithpancreaticendocrineneoplasmlackspecificclinicalsymptomswithnormalserumhormonelevels,andsomeotherpatientsshowonlyminorele-vationsinserumhormonelevels,therefore,suchneoplasmarecategorizedasnonfunctionalisletcelltumor(NIT).Withinrecentyears,throughimmuno-histologicalexaminationsandresearch,suchneoplasmarefoundtosecretevarioustypesofpancre…     

PROPRANOLOL IN THE SURGICAL TREATMENT OF HYPERTHYROIDISM

ＰＲＯＰＲＡＮＯＬＯＬＩＮＴＨＥＳＵＲＧＩＣＡＬＴＲＥＡＴＭＥＮＴＯＦＨＹＰＥＲＴＨＹＲＯＩＤＩＳＭＫｕａｎｇＹａｏｌｉｎ；（邝耀麟），ＳｈｅｎＹｏｕｑｉｎ；（沈又琴），ＹｉｎＺｈｉｑｉａｎｇ；（殷志强）Ａｂｓｔｒａｃｔ：ＦｒｏｍＪｕｌｙ１９７６ｔｏ...     

DIAGNOSIS AND SURGICAL TREATMENT OF BRONCHOGENIC CYSTS

Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years, The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9 (40.9%). There were symptoms (chest pain and recurrent bronehiolits) in 20 patients (91%). The preoperative complications included infection in the lung and in the cyst and dysphagia due to esophageal eornpression. Chest pain was the main symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary cyst. Plain chest radiograms showed that a rousd shadow, occasional air-fluid levels, and peripheral calcification may be found in cysts. An operation is the best treatment for cysts. All cysts were completely excised. No postoperative complieations, late complica-tions, or recurrence developed in our patients.     

SURGICAL TREATMENT OF GYNECOLOGIC MALIGNANCES IN PATIENTS 70 YEARS OF AGE AND OLDER

Accordingtothedatafromepidemiology,thein-cidenceofcancerrisessteadilywithadvancingage.Age?specificincidenceratesfromtheThirdNationalCancerSurveyoftheUnitedStatesrevealedthattheriskofcancerdevelopmentinthe6thdecadeoflifeisapproximately1%,whichincreasesto2%inthe81styearoflife(1).Theincidencesofmostgyneco-logiccancersincludingcervicalcancer,endometrialcancer,ovariancancerandvulvarcancerpeakaftertheageof60years(2-4).Surgeryisoneofthemaintreatmentoptionsforgynecologiccancerandmaybringaboutsomeeff…     

SURGICAL TREATMENT OF TETRALOGY OF FALLOT IN CHILDREN: A REPORT OF NO SURGICAL DEATH IN 115 CONSECUTIVE CASES

ffeSUIn Objeetif Un groupe de chrurghns a fait la correction totale pour la tdtratogh de Fallot sur115 meW cootutimnt sens un cos de mot ortratOire. As then t article est une invotoption sur les fac-teurs d' andlioration du theltat Oviratoire. -- Parmi 115 enfants dont I' dge etait de 9 mOs d 13ans(4, 6 f 2, 7 ans), 47, 8% des enfantS etalent mOns de 3 ans. Les nzaffrvtions orha mpient I'atrdrie du tronc et de la branChe uniIathele de l' art8re PUhaonaire chez 4 mahaes; les mmunicotions…     

STATUS OF SURGICAL TREATMENT OF RECTAL CANCER IN CHINA

The multimodality treatment methods of rectal cancer in China are presented. Extended radical excisions are used for Dukes' B and C cases to reduce local recurrence. These include: high ligation with clearance of proximal lymph nodes at origin of inferior mesenteric artery, lateral pelvic lymphadenectomy, posterior or total pelvic exenterations in selected cases; but controversy exists. Radical sphincter-saving resections are advocated to improve the quality of life. Prerequisites of sphincter-saving resection are adequate resection of bowel and mesentery distal to the lesion, depending on the macroscopic type of lesion and degree of differentiation. The decisive factor in the choice of type of operation is the length of rectal stump above levator ani after resection. Bacon's pull through resection was modified by preservation of levator ani and dentate margin, much better functional results were obtained postoperatively. Transanal full thickness local excision is advocated for small, protuberant, mobile, well differentiated lesions below the peritoneal reflection. Pre- or postoperative adjuvant radiation therapy is sometimes used for Dukes' B and C cases. Adjuvant 5-Fu chemotherapy is usually used intraoperatively (intraluminal) or postoperatively (intravenous). The superiority of preoperative intrarectal 5-Fu emulsionover the conventional intravenous route has been demonstrated by experimental and clinical studies, which showed much higher and lasting concentration of 5-Fu in the rectal wall tissues and mesenteric lymph nodes, and a much lower concentration of 5-Fu in bone marrow after intrarectal administration. Several surgical groups employed varying techniques of sphincteric reconstruction of perineal colostomy after abdominoperineal excision, utilizing the gracilis or gluteus maximus sling, or intussusception of the colonic stump; with favorable late results in reported cases. However, controversy exists, so strict appropriate case selection is emphasized to avoid unnecessary sacrifice of the normal anus.     

THE TREATMENT OF PAIN IN BONE METASTASIS OF CANCER WITH THE ANALGESIC DECOCTION OF CANCER AND THE ACUPOINT THERAPEUTIC APPARATUS

The pain in 286 cases of bone metastasis of cancer was treated with an analgesic decoction of herbal drugs in combination with the Acupoint Therapeutic Apparatus that generated low frequency electric impulses into the acupoints. This series of patients comprised 104 cases of medium pain and 182 cases of severe pain, which was practically or completely relieved in 17 or 29 minutes respectively after the treatment; the total effective rate was 74.2% for 212 cases, and the duration of analgesic effect lasted 2.7 hours to 5.2 hours, averaging 3.6 hours. The cases that needed considerable dosages of analgesic tablets or sedatives markedly re-duced their requests of such drugs. Determination of bone marrow stem cells indicated that the herbal treatment produced effects of promoting and protecting the stem cells. The rate of lymphocyte transformation was 45-76% before the treatment and rose to 57-96% after the treatment, demonstrating an increase of 15.2%, which was statistically significant (P< 0.001). The analgesic effect of the decoction was not correlated to the age and sex of the patients or the variety of cancer, except that it was not effective for uterine carcinoma. The main side effects included nausea, vomiting, somnolence, and numbness of the tongue.     

SURGICAL TREATMENT AND PROGNOSIS OF BRONCHIAL CARCINOID TUMOR

In order to understand the effect of surgery in the treatment of the bronchial carcinoid tumor and thefactors affecting prognosis, 18 cases of bronchial carcinoid tumor are presented, including 5 cases withCushing‘s syndiome. There were Iobectoray in 10, lung wedge resection in 3, excision of intraluminal tumor of bronchus in 3, exploratory thoracotomy in 2 cases.No operation death.Pathological examinstion revealed 14 cases were typical carcinoid tumor and 4 cases were atypical carcinoid tumor.By 2-13 years fol-low-up,3,5 and 10 years survival rate were 82%,78% and 70% respectively.Bronchial carcinoid tumor is often confused microscopic and immunohistochemistry studies.Those patients accompanied with ectopicACTH secretion always have Cushing‘‘s syndrome,resection of tumor can produce good result.Proper operation method depnds on the location of the tumor and patient‘‘s extent of cardiac and pulmonary peserve.Atypical carcinoid tumor had high malignancy and poor prognosis.The size of tumor,lymph node involve ment and adjuvant therapy seem no definite effect on the patients‘‘ survival rate.     

ACUPUNCTURE TREATMENT OF SCIATICA AND A PRELIMINARY STUDY OF THE ANALGESIC MECHANISM

This article reports 145 cases of moderate andsevere sciatica treated with acupuncture.The totaleffective rate was 95.7%,the basically cured rate42.7%.The average number of acupuncture sessionsfor the basically cured was 15.The chief acupointsused were Shenshu (UB 23),Huatuojiaji L_4,L_5 (Extra21),Dachangshu (UB 25),Guanyuanshu (UB 26),and Weizhong (UB 40).Additional auxiliary pointsused for the Shaoyang type were Huantiao (GB 30),Yanglingquan (GB 34) and Huanzhong (GB 39).Forthe Taiyang type they were Zhibian (UB 54),Cheng-shu (UB 57) and Kunlun (UB 60).The points takenfor acute and severe pains were Sizhukong (SJ 23),Renzhong (Du 26) and Yanglao (SI 6).The casesof wind and cold type and kidney deficiency typewere given moxibustion and cupping in addition.The results of acupuncture treatment show theprocedure to be effective in relieving the pain of alltypes of sciatica,including cases of long duration.Follow-up of the cured patients indicates that thesecondary type is apt to relapse.Fifteen patients suffering from acute sciatica hadserum 5-HT increased after acupuncure.In ten ofthe 15 cases,plasma cAMP,cGMP and PGE_2 in-creased and PGF_(2α) decreased after acupuncture.These findings suggest that the physiological basis ofthe regulatory effect of acupuncture may be bioactivesubstances,a possibility meriting further research.     

A COMPARATIVE CLINICAL STUDY ON PREVENTION AND TREATMENT WITH SELECTED CHRONOMEDICATION OF LEUKOPENIA INDUCED BY CHEMOTHERAPY

During the period of therapy,leukopenia induced by chemotherapy was less severe and wascured more rapidly in the selected chronomedieation group (CMG) than in the routinemedication group (RMG).The incidence of leukopenia was markedly lower in CMG(12.9%) than in RMG (48.4%),and the rate of uneventful completion of chemotherapy wasalso higher in CMG (96.8%) than in RMG.These results suggest that selectedchronomedication may he beneficial to the successful completion of chemotherapy in pa-tients with malignant tumor.     

SURGICAL TREATMENT OF BLUNT CARDIAC TRAUMA IN CHILDREN： REPORT OF 2 CASES AND REVIEW OF LITERATURES

Objective Summarizing the clinical experience of surgical treatment in 2 cases of blunt cardiac trauma and reviewing the relevant literaturesMethods A 6-year-old girl was diagnosed muscular ventricular septal defect and left ventricular aneurysm 2d after automobile accident and underwent ventricular septal defect repair 2 weeks after injury. Another 9-year-old boy was diagnosed severe mitral regurgitation resulted from rupture of posterior papillary muscle 9d after automobile accident and underwent mitral valvuloplasty 2 weeks after injury. Results Heart function of the first patient was in New York Heart Association (NYHA) class Ⅰ, echocardiography showed no residual septal defect and the size of left ventricular aneurysm reduced. Heart function of the second patient is in NYHA class Ⅱ, echocardiography showed mild mitral regurgitation. Conclusion Blunt traumatic heart disease occurs either because of heart compression between sternum and the spine and/or because of myocardial contusion; A more aggressive strategy with surgical treatment earlier before deterioration of heart function is advocated; Earlier surgical correction of anatomic deformity will achieve a good result and a long time follow-up is necessary.     

HIGH DOSE COMBINATION CHEMOTHERAPY WITH AUTOLOGOUS BONE MARROW TRANSPLANTATION IN 10 CASES OF ADVANCED SOLID TUMORS

High dose combination chemotherapy with autologous bone marrowtransplantation in 10 cases of advanced solid tumors were performed.As regardstherapeutic results,4 CR(2 lymphomas,1 Wilms′tumor,1 synoviosarcoma),1GR(lymphomas),4FR(osteosarcoma),1 NR(glioma)were obtained.Ne-vertheIess most of them were relapsed or deteriorated within 1 year.In conclusion:1.Marrow for ABMT could be stroed in 4℃ for 5 days.2.In order to demin-ish the residual cells,reradio-therapy or sensitive drugs to kill cells in G~0 phaseshould be used.3.Less nucleated cells infused in ABMT also favour the recovery ofhemopoiesis without worrying graft rejection.4.ABMT was worth increasingapplication for advanced tumor patients in otherwise no way.     

THE PRESENT STATUS OF SURGICAL TREATMENT OF GASTRIC CANCER IN CHINA

Gastric cancer remains one of the leading malignancies in China. The history of modern surgical treatment of gastric cancer could be dated back to the early fifties with an overall 5-year survival rate of around 10%. Remarkable progress has been achieved ever since in terms of operability, resectability and 5-year survival rate which ranges now from 30% to over 50% after radical resection. In regard to problems and future perspective, apart from the effort which should be redoubled in increasing the detection rate of EGC, the need to popularize the new international TNM staging system, to carry out in-depth studies on the biological behavior of gastric cancers and the role of the spleen in the evolution of gastric cancer, and to include new potential adjuvant measures in the therapeutic regimen of AGC are emphasized.     

OBSERVATION OF THERAPEUTIC EFFECT IN 50 CASES OF CHRONIC RENAL FAILURE TREATED WITH RHUBARB AND ADJUVANT DRUGS

Renal disease is a commonly seen con-dition with numerous patient sufferers.Pro-gressive deterioration of renal function is thefinal outcome of almost all those afflictedwith persistent chronic renal disease.It is es-timated that there are around 600,000 peo-ple in the world who receive dialysis treat-ment and nearly 200,000 who have been op-erated on for kidney transplantation.Al-     

EXPERIMENTAL STUDY ON THE EFFECTS OF HYPERTHERMIA COMBINED WITH CHEMOTHE－RAPY AND IRRADIATION ON ESOPHAGEAL CARCINOMA IN VITR

ＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＮＴＨＥＥＦＦＥＣＴＳＯＦＨＹＰＥＲＴＨＥＲＭＩＡＣＯＭＢＩＮＥＤ　ＷＩＴＨＣＨＥＭＯＴＨＥ－ＲＡＰＹＡＮＤＩＲＲＡＤＩＡＴＩＯＮＯＮＥＳＯＰＨＡＧＥＡＬＣＡＲＣＩＮＯＭＡ　ＩＮ　ＶＩＴＲＯＺｈｏｎｇＨｏｎｇ（钟竑...     

ACHIEVEMENTS IN THE TREATMENT OF HYPERLIPIDEMIA WITH TCM-WM

In recent ten years, TCM--WM re-searches on the etiology, pathogenesis,treatment and prevention of hyperlipidemiahave been extensively carried out in China,and considerable progress has been made.     

TREATMENT OF URINARY RETENTION WITH ACUPUNCTURE AND MOXIBUSTION

The author treated 20 cases of urinaryretention with acupuncture andmoxibustion effectively,as reported in thefollowing:GENERAL DATAThe 20 patients comprised 7 males and13 females,while 11 cases aged 20-40 years,and 9 cases 41-60 years.The patients pres-ented themselves for acupuncture treatmentwhen other Chinese or western drugs failedto produce effects.