Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

白内障超声乳化人工晶体术后视网膜脱离临床分析

目的 探讨超声乳化白内障人工晶体术后视网膜脱离的特点及手术疗效。方法 对16例视网膜脱离患者做常规巩膜扣带术或玻璃体切割联合眼内填充进行回顾性分析。结果 视网膜脱离手术后完全复位14例，一次复位率为87．5％，另2例患者经二次手术后完全复位，视力均有不同程度提高。结论 对该类患者术前应仔细检查，选择合适的手术方式尽早施行手术，以提高疗效。     

Molecular determinants of cetuximab efficacy.

PURPOSE: To investigate whether mRNA expression levels of cyclin D1 (CCND1), cyclooxygenase 2 (Cox-2), epidermal growth factor receptor (EGFR), interleukin 8 (IL-8), and vascular endothelial growth factor (VEGF), all members of the EGFR signaling pathway, are associated with clinical outcome in patients with EGFR-expressing metastatic colorectal cancer (CRC) treated with cetuximab. PATIENTS AND METHODS: Thirty-nine patients with metastatic CRC, refractory to both irinotecan and oxaliplatin, were enrolled on IMCL-0144 and treated with single-agent cetuximab. The intratumoral mRNA levels of CCND1, Cox-2, EGFR, IL-8, and VEGF were assessed from paraffin-embedded tissue samples using laser-capture microdissection and quantitative real-time polymerase chain reaction. RESULTS: There were 21 women and 18 men with a median age of 64 years (range, 35 to 83 years). Higher gene expression levels of VEGF were associated with resistance to cetuximab (P = .038; Kruskal-Wallis test). The combination of low gene expression levels of Cox-2, EGFR, and IL-8 was significantly associated with overall survival (13.5 v 2.3 months; P = .028; log-rank test). Both findings were independent of skin toxicity that was itself significantly correlated to survival. Patients with a lower mRNA amount of EGFR had a longer overall survival compared with patients that had a higher mRNA amount (7.3 v 2.2 months; P = .09; log-rank test). Patients with lower expression of Cox-2 had a significantly higher rate of grade 2 to 3 skin reactions under cetuximab treatment. CONCLUSION: This pilot study suggests that gene expression levels of Cox-2, EGFR, IL-8, and VEGF in patients with metastatic CRC may be useful markers of clinical outcome in single-agent cetuximab treatment.     

磁共振血管成像技术与高压注射器匹配的应用探讨

目的 探讨磁共振血管成像技术与高压注射器应用的匹配问题.方法 本组68例,年龄36岁-85岁,平均60岁,其中男53例,女15例.使用德国西门子1.0T超导磁共振成像仪及德国Ulich高压注射器和北陆的造影剂GD-DTPA静脉团注.结果 动脉显影良好64例(94%),3例患者血管显影欠佳(4.4%),1例患者出现药液渗漏失败(1.4%),所有检查病人均无出现不适.结论 正确熟练掌握高压注射器,使3D-CE-MRA成像扫描时间和团注速度相匹配,是获得高质量图像的重要环节,也是3D MRA检查成功的关键之一.     

急性脑梗死88例临床分析

[背景 ]比较分析 88例不同年龄组急性脑梗死患者的病因、症状、体征及头部CT所见 .[病例报告 ]将 88例急性脑梗死患者分为老年组和非老年组 ,对发病因素、症状、体征和头部CT特点进行对比分析 ,发病因素中有高血压者占 6 4 % ,心脏病者占 2 3% ,糖尿病者占 2 5 % ,有短暂性脑缺血发作病史者占 30 % ,高脂血症者占 4 5 % ,吸烟者占 5 2 % ,有家族史者占 33% .非老年组中初发者多见 ,有头痛、头晕及偏身感觉障碍等症状者比老年组多见 ,而偏瘫、四肢瘫、构音障碍及意识障碍者则老年组多见 .头部CT示单梗塞灶者在非老年组多见 ,多梗塞灶、脑白质脱髓鞘及脑萎缩者在老年组多见 .[讨论 ]脑梗死病人因年龄不同 ,其发病因素、临床表现及头部CT所见有所不同     

外刊速览

中国研制出抗禽流感药物——路透社目前,中国已研制出一种与“达菲”相应的抗禽流感病毒药物,但并没有说明该药物何时会投入使用,以及它与“达菲”的可比性。鉴于缺乏禽流感疫苗,世界卫生组织已经建议各国政府储备“达菲”。该药虽然不能治愈禽流感,但可以抑制病毒发展,减缓病毒扩散。全球唯一能够生产“达菲”的瑞士罗氏公司上星期宣布,他们已经停止在中国市场     

接触镜与泪液形态关系的临床评价

目的 :观察配戴不同种类接触镜后眼表面泪膜的形态、稳定性及泪液量的变化。方法 :对日戴SCL、RGPCL和Ortho KCL的 2 14名近视患者 4 2 8只眼 ,利用表面泪膜观察装置 (DR 1)观察戴镜前后眼表泪液膜和戴镜状态下镜上泪液膜的形态分级 ,同时测定泪膜破裂时间 (BUT)。利用酚红染色棉丝测定SCL戴镜前后的泪液量 ,并用折射仪 (AtagoCL 1)测量SCL含水量的变化。结果 :SCL配戴者随戴镜时间延长 ,BUT明显缩短 (P <0 .0 1) ,RGPCL和Ortho KCL配戴者戴镜 5年以内 ,BUT无明显变化 (P >0 .0 5 )。戴镜后RGPCL ,Ortho KCL和非戴镜正常眼三组间眼表泪膜分级比例差异无显著性 ,SCL组Ⅰ级比例为 6 .5 % ,显著低于其他组(16 .1%～ 2 3.0 % )。镜上泪膜 ,SCL、RGPCL和Ortho KCL三组均以Ⅳ级为主 (分别占 5 4 .4 %、5 3.4 %和 5 1.5 % ) ,SCLⅠ级比例仅 1.9% ,显著低于另二组 (分别占 6 .2 %和 12 .4 % )。SCL配戴者随戴镜时间延长 ,泪液量轻度减少 ,SCL含水量在戴镜 1w后即显著降低。结论 :科学配戴接触镜对泪液膜质量无明显影响 ,但SCL长期使用可能对泪膜有一定干扰作用。     

纸本与数字的交互：手机阅读的最佳效果

随着全球3G商用的推进和拥有大容量存储能力的智能终端的日益普及,手机正逐步演变成为一个新型的数字阅读终端。利用手机进行电子阅读的全新模式,正以前所未有的普及速度冲击着人们的阅读习惯。而这趋势也逐渐为"阅读"进行重新的定义。对于每一个读者而言,在这样一个信息化的时代里,手机阅读和纸本阅读的交互使用、取长补短,才是获得最佳阅读效果的最有效方式。     

奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗晚期大肠癌的临床观察

目的 探讨奥沙利铂为主的化疗联合腹腔温热灌注治疗晚期肠癌的临床效果.方法 对42例晚期大肠癌患者,予腹腔温热灌洗化疗及体外高频透热治疗,联合以奥沙利铂为主的静脉化疗,至少2个周期,观察疗效及不良反应.结果 全组患者完成169个周期治疗,CR 5例,PR 22例,SD 8例,PD 7例,总有效率66.3%.完全缓解率11.9%.不良反应以白细胞下降及消化道反应多见,少数患者出现周围性神经毒性,以I-Ⅱ 度为主.结论 以奥沙利铂为主的静脉化疗联合腹腔温热灌注和体外高频透热治疗,对晚期大肠癌具有一定的疗效,毒副作用小;腹腔局部化疗是一种值得关注的治疗途径.     

实习护生护理程序应用能力的培养

我科开展整体护理以来，将护理程序应用能力作为基础护理技能纳入临床护理教学计划中，提高了实习质量。现将具体做法介绍如下。