An audit of surgical outcomes of esophageal squamous cell carcinoma.

OBJECTIVE: Esophageal squamous cell carcinoma and adenocarcinoma were increasingly recognized as two entities with different biologic behaviors and prognosis. Surgical risks and oncologic benefits of transthoracic and transhiatal esophagectomy for esophageal squamous cell carcinoma patients are not confessed. METHODS: Between 1994 and 2005, 216 esophageal squamous cell carcinoma patients underwent esophagectomy were enrolled and analyzed retrospectively. RESULTS: One hundred sixty-six patients underwent transthoracic esophagectomy and 50 patients underwent transhiatal esophagectomy. The overall hospital mortality and postoperative complication rates were 9.7 and 49%, respectively. The amount of intra-operative blood loss or transfusion, postoperative complication rate, lengths of hospital stay and hospital mortality rate were not significantly different between both groups. However, shorter operative time was noticed in transhiatal group (p<0.001). The overall 5-year survival rate was 16.8%. ESCC patients underwent either transthoracic or transhiatal esophagectomy had comparable long-term survival. The pTNM stage was independent prognostic factor for patients underwent transthoracic esophagectomy. However, location of tumor (p=0.009) and pathologic tumor length (p=0.012) were predictors of prognosis for patients underwent transhiatal esophagectomy. CONCLUSIONS: For esophageal squamous cell carcinoma patients, no significant differences in postoperative mortality or morbidity rates were observed between transthoracic and transhiatal esophagectomy. However, traditional pTNM staging system might underestimate the severity of esophageal squamous cell carcinoma patients who underwent transhiatal esophagectomy. The information of dissimilar prognostic factors for transhiatal or transthoracic esophagectomies will be helpful in tailoring more individualized adjuvant therapy to optimize esophageal squamous cell carcinoma patient's outcome.     

NONMEM法分析临床病人静脉输注阿米卡星的群体药代动力学

收集52例呼吸科感染病人静脉输注阿米卡星(amikacin,AMK)的临床数据,用荧光偏振免疫法(FPIA)测定临床病人AMK的血清浓度275点,按二房室开放模型,用NONMEM程序一步估算出AMK的群体药代动力学参数,并定量地分析病人的体重、肌酐清除率、长期用药和病理状况(慢性阻塞性肺病,COPD)等固定效应对药代动力学参数的影响。经统计分析病人的肌酐清除率和COPD对AMK的药代动力学参数的影响有显著意义,而体重对表观分布容积Vc的影响无显著意义。由最终回归模型估算出AMK的群体药代动力学参数。     

表鬼臼毒素羧酸酯的合成及体外抗肿瘤活性

在三氟化硼·乙醚的催化作用下,鬼臼毒素(I)与有机酸直接脱水生成了具有4β-构型的表鬼臼毒素羧酸酯(IIa～g),所有合成产物经IR,¹HNMR,MS和元素分析等确证其结构,初步药理试验表明,该类化合物对小鼠白血病P388、人胃癌SGC-7901有一定的抑制活性。     

热敏脂质体

目的:综述热敏脂质体的原理和它作为靶向药物载体的应用。方法:论述了脂质体相变的原理和热敏脂质体的研究概况,以及携带化疗药物的热敏脂质体和肿瘤热疗结合后治疗效果的增强作用,指出了热敏脂质体的发展前景。结果:热敏脂质体有良好的热靶向性,在肿瘤治疗方面效果明显。结论:热敏脂质体是新一代热靶向药物载体,有重要的开发价值。     

Squamous cell carcinoma in an ileal neobladder: a case report and review of the literature

Itis rare for a primary tumor to occur in an ileal conduit, although it has been used for urinary diversion for more than four decades. Most malignant tumors that have been reported in ileal conduits have been adenocarcinomas. 1,2 To our knowledge, squamous cell carcinoma in an orthotopic and continent ileal neobladder has not been reported. We report here a case of squamous cell carcinoma and calculi in an ileal neobladder 6 years after a cystectomy and an ileal neobladder diversion for transitional cell carcinoma of the bladder and also review the literature.     

Large pedunculated lipoma of the esophagus.

Pedunculated lipoma of the esophagus is rare and easily misdiagnosed in clinical practice. The presenting symptoms of esophageal lipoma are dysphagia, regurgitated mass and persistent sensation of a lump in the throat. The most frequent location of the tumor pedicle is the upper esophageal sphincter. Although the lipoma is pathologically benign, if it is large enough, it may cause airway obstruction secondary to the mechanical pressure to the larynx when the tumor is regurgitated. We present the case of a 67-year-old man who had the symptoms of dysphagia, nausea and vomiting. Esophagography and chest computed tomography revealed that he might have an esophageal submucosal or intraluminal tumor mass. Panendoscopy showed a pedunculated tumor mass within the esophageal lumen with its peduncle arising from the cervical esophagus. The tumor mass measured 9.0 x 4.7 x 2.5 cm in size. Thoracic approach via the right chest wall was performed for confirmation. After removal of the intraluminal mass, the patients symptoms dramatically improved. Pathology showed a lipoma arising from the submucosa of the esophagus.     

充血性心力衰竭患者甲状腺激素辅助治疗40例

1对象和方法 1.1对象我院2002-05/2004-05住院CHF患者40(男28,女12)例,年龄43～72(63.7±9.6)岁.其中缺血性心肌病25例、扩张型心肌病7例,风湿性心脏病6例,其他2例.心功能为Ⅱ～Ⅳ级(按NYHA分级标准).