CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines.

BACKGROUND AND PURPOSE: The appropriate application of 3-D CRT and IMRT for HNSCC requires a standardization of the procedures for the delineation of the target volumes. Over the past few years, two proposals--the so-called Brussels guidelines from Grégoire et al., and the so-called Rotterdam guidelines from Nowak et al.--emerged from the literature for the delineation of the neck node levels. Detailed examination of these proposals however revealed some important discrepancies. MATERIALS AND METHODS: Within this framework, the Brussels and Rotterdam groups decided to review their guidelines and derive a common set of recommendations for delineation of neck node levels. This proposal was then discussed with representatives of major cooperative groups in Europe (DAHANCA, EORTC, GORTEC) and in North America (NCIC, RTOG), which, after some additional refinements, have endorsed them. The objective of the present article is to present the consensus guidelines for the delineation of the node levels in the node-negative neck. RESULTS AND CONCLUSIONS: First a short discussion of the discrepancies between the previous Brussels and the Rotterdam guidelines is presented. The general philosophy of the consensus guidelines and the methodology used to resolve the various discrepancies are then described. The consensus proposal is then presented and representative CTVs that are consistent with these guidelines are illustrated on CT sections. Last, the limitations of the consensus guidelines are discussed and some concerns about the direct applications of these guidelines to the node-positive neck and the post-operative neck are described.     

肾上腺素诱导兔血小板聚集的实践与理论探讨

目的创建以Ａｄｒ诱导兔血小板聚集的方法，并对受体分子特性作初步探讨。方法以高Ｋ＋缓冲液等取代兔ＰＲＰ中血浆，以Ａｄｒ诱导聚集，以Ａｐｙｒ证实结果。结果兔血小板悬浮于高Ｋ＋缓冲液时Ａｄｒ能单独诱导真正的聚集。结论由此推测血小板膜上α２肾上腺素受体分子可能为由两种亚单位组成：促聚亚单位和辅助亚单位。人辅助亚单位当Ａｄｒ浓度高达聚集阈值以上时可被激活，与促聚亚单位结合为活性的二聚体，与Ａｄｒ进一步结合发生聚集作用。兔辅助亚单位则还需要高Ｋ＋方能被激活     

氯硝安定与安定溶液直肠给药用于惊厥急救的对照研究

目的以安定为对照，探讨氯硝安定溶液直肠给药对惊厥急救的实用价值。方法在２８例儿童中对比观察直肠注入氯硝安定与安定溶液的吸收速度和对脑电活动的影响，并比较两药对大鼠实验性惊厥的疗效。结果氯硝安定与安定溶液均能从直肠迅速吸收，皆于用药５分钟后达有效血浓度，分别于３～８分钟及２～８分钟对脑电活动产生显著影响，明显抑制癫痫样波发放，使美解眠诱发的惊厥致死率从对照组的７０％降为０。结论氯硝安定与安定溶液直肠给药，均能作为小儿惊厥抢救的有效措施。     

喉腔及喉咽部平滑肌肉瘤3例报告

为了解发生于喉腔及喉咽部的平滑肌肉瘤的临床特点，报告１例喉咽部平滑肌肉瘤和２例喉腔平滑肌肉瘤患者早期症状都不明显，且无特异性，临床表现与该部常见鳞癌极为相似，术前明确诊断有一定困难。     

咽旁间隙肿瘤及手术入路

为探讨咽旁间隙肿瘤的手术方法及入路的选择。报告６６例经各种手术入路治疗的良、恶性肿瘤。结果表明，经颈或经颈合并下颌及正中裂开外旋入路较之其他几种手术入路具有手术适应证广、安全、术后并发症少等优点。认为经颈或经颈合并下颌正中裂开外旋入路是一种安全、彻底切除咽旁间隙原发肿瘤效果最好的入路。     

组织蛋白酶D在ⅡB型骨肉瘤中的表达及其临床意义

目的探讨组织蛋白酶Ｄ（ＣＤ）与骨肉瘤患者预后的关系。方法应用免疫组化技术检测３４例骨肉瘤组织标本中的ＣＤ表达水平，并结合患者临床病案记录和随访资料进行分析。结果ＣＤ高表达与低表达之间的肿瘤转移人数和２年生存人数差异显著，且ＣＤ低表达患者的平均生存时间较高表达者为长。经Ｋａｐｌａｎ┐Ｍｅｉｅｒ分析，两组间生存率有显著差异。结论ＣＤ高表达的骨肉瘤易发生转移，预后不良，应加强治疗。     

刺五加注射液治疗脑出血的临床评价

30例高血压脑出血患者在常规疗法基础上加用紫外线辐射血液疗法作为对照组,另30例在上述疗法基础上加用刺五加注射液静脉滴注为治疗组。结果治疗组显效率96.7％,总有效率100％,对照组显效率60.0％,总有效率83.3％,治疗组明显优于对照组(P<0.01)。表明刺五加注射液不仅用于缺血性脑梗塞的治疗,而且也可用于脑出血,对出血量在30ml以下的病例,疗效较好。     

Hydrocephalus in the H-Tx rat: a monogenic disease?

The H-Tx rat is a genetic model of hydrocephalus for which thereis a poor understanding of the mode of inheritance.Previous studies suggested a polygenicmode of inheritance but the breeding data to supportthis hypothesis have not been reported. In an attempt to clarify the hereditary mode we have analyzed the data from eight generations of H-Tx rats and four generations of cross-matings between H-Tx rats and Sprague-Dawley (SD) rats. In the H-Tx rat colony 113 of 129 random brother-sister matings (87.60%) produced hydrocephalic offspring, with males and females being equally affected. The overall incidence varied greatly with an average of 30. 35%. In matings with more than three litters, all mating pairs yielded hydrocephalic pups. In cross-matings both hydrocephalic and normal H-Tx rats were mated with normal SD rats. No hydrocephalus was observed in the first generation of 124 pups (F1). Subsequent brother-sister matings of F1 animals generated hydrocephalic pups in the F2 generation with a lower incidence (4.67% in hydrocephalic HTx/SD matings and 5.11% in normal HTx/SD matings, respectively) than in the H-Tx rat colony (30.35%). Back-cross-matings between F2 rats and normal H-Tx rats yielded an incidence of hydrocephalus higher than that of the cross-matings but lower than that of the H-Tx colony. These data strongly suggest that the H-Tx rat is a homozygous carrier of an autosomal recessive hydrocephalus gene with incomplete penetrance. Furthermore, the data clearly rule out sex-linked and polygenic modes of inheritance and provide further insight with respect to genetic inheritance of hydrocephalus.