Critical reassessment of second-look exploratory laparotomy for epithelial ovarian carcinoma. Minimal diagnostic and therapeutic value in patients with persistent cancer.

From 1979 to 1984, 88 women with epithelial ovarian cancer were treated with surgery and chemotherapy, achieved a clinical complete response, and then had "second-look" exploratory laparotomy to assess the pathologic status of their disease. Persistent cancer was found in 50 (57%) patients: 34 of 50 (68%) had gross tumor, which was larger than 2 cm in 12 (24%) and smaller than 2 cm in 22 (44%), and 16 (32%) had microscopic disease. Salvage therapy was as follows for these patients: whole abdominal irradiation, 29 (58%); chemotherapy, 17 (34%); intraperitoneal chromic phosphate, 1 (2%); and no further therapy, 3 (6%). With a follow-up time of 4 to 8 years, 7 (14%) patients are alive without evidence of cancer, 7 (14%) are alive with disease, 35 (70%) are dead of disease, and 1 (2%) has died of treatment complications. At 5 years, the relapse-free rate was 18% and the survival rate was 25%. Seventy-two parameters of suspected prognostic significance and 64 potential sites of tumor involvement were correlated with survival in a univariate analysis. The factors favorably affecting survival included the following: lower grade; microscopic tumor versus gross disease at second-look laparotomy; removal of the uterus; removal of the omentum; pelvic and paraaortic lymph node biopsy; negative results of a right diaphragm biopsy; and radiation therapy at Stanford University Medical Center, Stanford, California. There was no survival advantage for whole abdomen irradiation compared with chemotherapy or for the patients who had their disease successfully debulked at second-look laparotomy. The above factors and others were evaluated by multivariate regression. The best model (P = 0.000004) for predicting survival included largest tumor mass (P = 0.0002), operative blood loss (P = 0.002), perioperative blood transfusion (P = 0.003), and grade (P = 0.004). The detection of persistent ovarian cancer by second-look exploratory laparotomy should identify a subgroup of patients whose conditions can be salvaged by a second-line therapy. Unfortunately, that subgroup is small (8%) and an effective salvage therapy remains to be identified.     

Treatment of glomerulonephritis in the elderly

With the increasing use of renal biopsy in the elderly, glomerulonephritis is now known to be a common finding. Whereas membranous glomerulonephritis and minimal change disease are common in younger and older adults, primary amyloidosis and crescentic glomerulonephritis are more common in the elderly. Other glomerulonephritides such as focal segmental glomerulosclerosis or IgA nephropathy are very uncommon in the elderly. Because of the serious consequences of the nephrotic syndrome and acute and chronic renal failure in the elderly, aggressive treatment with immunosuppression should not be withheld. Caution should always be taken because of the presumed greater morbidity and mortality from such treatment in the elderly.     

高强度体外聚焦超声热疗治疗局部晚期胰腺癌的多中心临床研究

目的：探讨临床单用HIFU治疗局部晚期胰腺癌(local advanced pancreatic carcinoma，APC)的可能性。方法：4个中心共41例患者入选进行非随机病例对照研究，其中HIFU组24例，单用HIFU治疗；对照组17例，接受HIFU及吉西他滨综合治疗。比较两组的疗效、治疗费用及安全性，采用Cox回归分析进一步确定吉西他滨化疗对生存期的影响。结果：HIFU组临床受益率、平均生存期与对照组相似，分别为66．7％比76．5％(P=10．740)和141．5天比176．5天(P=0．3510)；而治疗费用较低，为20500元比51805元(P=0．000)；安全性更高。Cox回归分析显示仅体力状态、HIFU次数及临床受益进入方程(P=0．000)，化疗对生存期无影响。结论：单用HIFU治疗APC，其疗效等同于HIFU和吉西他滨的综合治疗，但较综合治疗经济、安全。推测可以单独应用HIFU治疗局部晚期胰腺癌．值得临床进一步验证。     

青岛地区消化性溃疡1963例胃镜分析

目的　了解青岛地区消化性溃疡的发病学特点。方法　分析 1996年～ 2 0 0 3年间我院经胃镜检查诊断为消化性溃疡的病例。结果　在 13478例行胃镜检查患者中检出消化性溃疡 196 3例 (14 5 6 % ) ,其中十二指肠溃疡 135 2例(6 8 87% ) ,胃溃疡 5 5 7例 (2 8 38% ) ,复合性溃疡 5 4例 (2 75 % ) ;溃疡患者男性 15 34例 ,女性 4 2 9例 ,男女之比为 3 5 8∶1。十二指肠溃疡好发年龄段为 2 0～ 4 0岁 ,平均年龄 39 7岁 ,胃溃疡好发年龄段为 4 0～ 6 0岁 ,平均年龄 4 7 2岁。消化性溃疡检出率较高的月份为 12月和 3月。结论　十二指肠溃疡发病率高于胃溃疡。溃疡发病男性明显高于女性 ,且好发于天气寒冷和气温易变的季节     

榼藤子水溶性提取物的体外抗肿瘤作用

目的观察榼藤子水溶性提取物对3种不同肿瘤细胞株的抑制作用。方法采用噻唑蓝染色法(MTT法),肿瘤细胞株选用人类慢性髓性白血病细胞株(K562)、人类淋巴瘤细胞株(U937)和人早幼粒白血病细胞株(HL60),检测A值,计算抑瘤率。结果榼藤子水溶性提取物对K562、U937、HL60有较强的抑制作用,且呈一定的浓度依赖性,半数生长抑制剂量(IC50)均<20μg·ml-1。结论榼藤子水溶性提取物体外实验具有显著的抗肿瘤活性。     

栀子及其制剂中栀子苷含量测定方法研究进展

栀子为茜草科植物(Gardenia jasminoides Fills)的果实[1],具有泻火除烦、清热利尿、凉血解毒作用,用于热病心烦、黄疸尿赤、血淋涩痛、血热出衄、目赤肿痛、火毒疮伤、外治扭挫伤痛[2]。栀子中主含栀子苷(Geniposide)[3],具有利胆、降压作用。栀子在许多中成药配伍中应用,例如     

重视子癎前期子癎的治疗

子疒间前期、子疒间是导致孕产妇和围生儿病率和死亡率的主要原因。由于病因不明,至今仍然停留在对症治疗水平。因此,该病的治疗问题一直是产科领域中的难点和热点。近来该病病因、发病机制研究的进展为进一步搞好该病的治疗开辟了一些新的思路。目前,对子疒间前期、子疒间的基本治疗原则是解痉、降压、改善脏器灌流量和脏器功能。在临床上诊治病人要从多脏器可能受累角度,作好临床症状监护,及时发现和掌握疾病发展的进程,并及时予以妥善处理,以免发生严重的、危及生命的并发症。在治疗中,以下几个方面提请临床医生高度重视:(1)治疗目的:预…     

人肝癌细胞株VEGF/VEGFR的检测及意义探讨

目的：筛选血管内皮生长因子（vascular endothelial growth factor，VEGF）高表达肝癌细胞株，为进一步研究VEGF在肝癌治疗中的作用提供理论依据。并探讨VEGF受体在肝癌细胞株的表达及意义。方法：ELISA法及Western blot法分别检测人肝癌细胞株培养上清及细胞内VEGF蛋白的表达。免疫细胞化学方法检测VEGFR在人肝癌细胞中的表达。结果：5株肝癌细胞株均见VEGF蛋白表达，其中SMMC-7721的VEGF表达量最高，VEGF特异性受体Fit-1在HepG2、HHCC、SMMC-7721、Bcl-7402见阳性表达，KDR在HepG2、HHCC、Bel-7402、QGY-7701见阳性表达。结论：肝癌细胞株中VEGF表达量不尽一致，VEGF在肝癌发生发展中可能存在自分泌作用方式。     

超导型磁共振冷头的工作原理及维护保养

冷却系统是超导型磁共振正常运行的重要保障,而冷头是磁共振冷却系统的重要组件.本文着重介绍冷头的工作原理、运行方式及其在使用中的日常维护和定期保养.     

生命探测仪电池容量检测电路的设计

介绍了基于bq2050电池容量检测电路的设计，实测结果表明此电池容量检测电路设计合理，实用有效，且精度高、体积小、功耗低，适合生命探测仪使用。