The role of MRI in the illustration of metastatic lymphatic pathways and clinical N-staging of nasopharyngeal carcinoma

Subject: To study the role of MRI in the illustration of metastatic lymphatic pathways and clinical N-staging of nasopharyngeal carcinoma (NPC). Methods: Eighty NPC patients were examined with MRI before radiotherapy from Mar. 1994 to Jun. 1996. MRI were performed using T₁ weighted image (T,WI) and T₂ weighted image (T₂WI) in transverse, and using T₁WI in sagittal and coronal sections. Results: 1. NPC chief metastatic lymphatic pathways are: primary foci → Rouviere’s node (RN), or retrostyloid space nodes (RSN) secondarily → deep cervical nodes; 2. The superior border of neck fields should be moved upward to the level of external acoustic meatus; 3. The authors suggested that in N-staging for NPC, N_o and N₁ be divided into Noa and N₁b, and N₁a and N₁b. Conclusion: MRI is very useful in clinical N-staging of NPC, especially for the reflection of the influance of RN and/or RSN tumefaction on N-staging.     

Clinical study on the pattern of lymphnode metastasis in carcinoma of esophagus (an analysis of 200 cases)

Objective: To study the pattern of lymphnode metastasis in carcinoma of esophagus. Methods: 200 cases of resected esophageal cancer specimens were carefully examined pathologically. Lymphnode metastasis, its pathway and extent in relation to pathological changes were analyzed. Results: Lymphnode metastasis was mainly regional and extended vertically in both directions. Leaping-over metastasis was another feature. The deeper invasion by the tumor, the higher frequencies of metastasis development, and vice versa. However, leaping-over metastasis was more likely to occur where tumor invasion was less severe. Conclusion: Owing to the high frequency of lymphnode metastasis in the superior mediastinum and the widely spanned leaping-over metastasis, an operative approach by three incisions through right thoracotomy with excision of the whole segment of esophagus and anastomosis at cervical region was recommended, in order to dissect lymphnodes in the cervical, thoracic and abdominal regions and to leave less or no metastatic lymphnodes behind.     

医院各区域内空气消毒效果及监测方法的探讨

目的探讨医院各区域内空气消毒效果及监测、培养所需时间.方法对3496份消毒后空气采用"平板暴露法”进行监测.第一组848份采样时平板暴露15min、置35C温箱培养48h,第二组2648份采样平板暴露5min、培养24h.结果第一组检测无菌生长率为2.6%、阳性检出率为97.4%、合格率为83.3%;第二组无菌生长率为l7.5%.阳性检出率为82.5%,合格率为88.4%.结论根据尘粒(1～10μ粒径)自然下降规律和所带细菌受损后修复需要时间,我们认为采用"平板暴露法”监测消毒后空气时以暴露15min培养48h为好.     

P73—肿瘤抑制基因P53家族成员的候选成员

人体正常细胞内肿瘤抑制基因的存在对控制人类肿瘤细胞的发生及增殖有重要作用.p53蛋白是最早发现的人类细胞的肿瘤抑制基因.经过近20年的努力,人们终于发现了人类的另一个肿瘤抑制基因—P73.这个基因的蛋白产物与P53蛋白在结构及功能上有不少相似之处,因此P53基因是P53基因家族成员的一个有力后选成员.深入研究不同的肿瘤抑制基因产物及抑制肿瘤细胞生长的特点,将有利于人们搞清肿瘤抑制基因的一般及特殊作用机制,为人们今后预防及控制肿瘤的发生奠定基础.     

食管腺癌单纯手术与合并术前化疗比较

[目的]比较食管腺癌单纯手术与合并术前化疗的预后。[方法]单纯手术组91例，术前DDP，5FU联合化疗组16例，术前VP16、ADM、DDP联合化疗组22例，比较3组的生存率。[结果]单纯手术组91例手术死亡率2％，2年生存率24％，4年生存率8％。术前DDP、5FU联合化疗组16例，化疗后完全缓解1例（16％），部分缓解5例（31％），无效10例（63％），12例手术切除，1例由于化疗有关死亡，1例手术死亡，2、4年生存率均为42％。术前DDP、ADM、VP16联合化疗组22例，化疗后1例完全缓解（5％），11例部分缓解（50％），10倒无效（45％），18例手术切除，无手术死亡，2年生存率58％。[结论]术前化疗能明显提高食管腺癌病人的生存率，同时治疗应个体化。     

Timed intercourse after intrauterine insemination for treatment of infertility

Objective: To compare the pregnancy rates, between intrauterine insemination (IUI) followed by timed intercourse and IUI only for treatment of the infertile couples. Study design: A prospective study of two different protocols of intrauterine insemination in two hundred and one infertile couples with a normal spermiogram was carried out. Of these, 101 couples were treated with IUI alone and 100 couples had both IUI and timed intercourse within a 12-18 h period. The pregnancy rates were compared between groups. Results: The characteristics of the two groups were similar in terms of the mean age, as well as the duration and causes of infertility. The cycle characteristics following follicular stimulation were also similar between two groups. The pregnancy rate per cycle increased with increasing numbers of total motile sperm per insemination in the IUI alone group (P=0.045). Timed intercourse increased pregnancy rate in patients with lower motile sperm number (<40×10⁶) (27.7% versus 10.5%, P=0.023), but not in patients with higher sperm number (≥40×10⁶) (25.7% versus 22.7%, P=0.671). Conclusions: In IUI with low number of motile sperm inseminated, timed intercourse significantly increases the pregnancy rates over IUI alone in infertile couples with a normal sperminogram. This alternative treatment appears to be a practical, simple, and inexpensive addition that improves the pregnancy rate in patients receiving ovulation induction and intrauterine insemination program.     

Focal cerebral ischemia alters the spatio-temporal properties, but not the amount of locomotor activity in mice

Cerebral ischemia induces hyperlocomotion in gerbils, and sensorimotor and cognition dysfunctions in rodents ; however little is known about the spatio-temporal organization of locomotor activity after ischemia. In this study, we continuously （22 h） assessed the spatio-temporal organization of locomotor activity in focal cerebral ischemic mice in an open field with feeding and drinking supplies. To observe the spatio-temporal changes,     

6例口腔粘膜疣状黄瘤的诊断及治疗

目的:探讨疣状黄瘤的临床生物学特征、病理诊断及治疗.方法:对6例口腔粘膜疣状黄瘤的临床病理资料进行回顾性分析,并进行随访.结果:6例患者5例术前误诊,术中快速病理及术后病理确诊为疣状黄瘤,局部切除即可治愈,随访无复发、恶变病例.结论:疣状黄瘤临床上易误诊,怀疑恶性肿瘤者术中需作快速病理确诊,以避免过度治疗,局部切除后预后良好.     

肺癌肺叶袖状切除术的安全性和有效性

目的:评价肺癌肺叶袖状切除术后患者的手术安全性和远期生存状况.方法:回顾分析了1999年10月至2003年12月行肺癌根治术的94名病例,其中肺叶袖状切除术11例(Ⅰ组),全肺切除术17例(Ⅱ组),肺叶切除术66例(Ⅲ组).通过比较三组术后气管插管时间、ICU停留时间、吻合口并发症率及围手术期死亡率,评价肺叶袖状切除术的手术安全性,比较Ⅰ、Ⅱ组间的生存期和转移复发率探讨其远期有效性.组间率比较用x2检验或Fisher精确检验,均数比较用t检验,生存分析用Kaplan-Meier法,生存曲线比较用Log rank检验.显著性差异标准α=0.05.结果:Ⅰ、Ⅱ、Ⅲ组的手术死亡率为0,11.8%,3.0%,组间无显著性差异;平均气管插管时间为0.5±2.3天,2.0±7.2天,0.6±4.1天(Ⅰ、ⅢVSⅡ组,P＜0.05);吻合口并发症率为3.0%,0,5.8%,组间无显著性差异.Ⅰ组1年、3年生存率为45.5%、32.5%,Ⅱ组为58.8%、45.8%.两组生存率、远期局部复发率和转移率无显著性差异.结论:肺癌肺叶袖状切除术具有和肺叶切除术相近的手术安全性,优于全肺切除术,而其复发转移率、远期疗效与后者相近,是安全有效的手术方式.