Operable squamous esophageal cancer: Current results from the East

From 1958 through 1992 a total of 3603 patients underwent surgery for esophageal squamous cell carcinoma in our department. Among these patients 3099 resections were performed, for an overall resectability of 86.0%. Of the resections, 2341 (75.5%) were classified as curative and 758 (24.5%) palliative. The overall morbidity and 30-day mortality rates were 23.4% and 3.8%, respectively. For resected cases the mortality was 4.0%. The more than 5-year follow-up rate of patients with resection was 97%. The actual 5-, 10-, and 15-year survival rates were 30.4%, 23.6%, and 17.9%, respectively. Recurrence or metastasis remained the cause of death in 60.9% and 25.5% of patients who lived longer than 5 years and 15 years, respectively, after operation. The TNM staging, lymph node metastasis, extraesophageal invasion, tumor differentiation, tumor length, and category of operation were major determinants influencing long-term prognosis. The left thoracotomy approach was used exclusively in 2613 cases (84.3% of all resected cases) in which intrathoracic resections and anastomoses were performed. The stomach was used as a substitute for the esophagus in 98.8% of the resected cases compared with 1.2% colon transplants. The former procedure was far safer than the latter. Above-average results presented in this paper support the surgical policy we have pursued thus far: to resect the primary tumor by partial or subtotal esophagectomy and to remove all lymph nodes wherever they were found in all patients with disease earlier than stage III. Early detection and early treatment no doubt are the only ways to materially improve the long-term surgical results.

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Resumen Entre 1958 y 1992, 3.603 pacientes fueron sometidos a cirugía por carcinoma escamocelular del esófago en nuestro departamento; se efectuaron 3.099 resecciones, para una tasa global de resectabilidad de 86%. De las resecciones, 2.341 (75.5%) fueron clasificadas como curativas y 758 (24.5%) como paliatives. Las tasas globales de morbilidad y de mortalidad a 30 días fueron 23.4% y 3.8%, respectivamente.La mortalidad para los casos resecados fue 4.0%. La rata de seguimiento para los pacientes operados más de 5 años atrás fue 97%. Las tasas actuariales de sobrevida a 5, 10 y 15 años fueron 30.4%, 23.6% y 17.9% respectivamente.La recidiva y las metástasis se mantuvieron como causas de muerte en 60.9% y 25.5% respectivamente de los pacientes que sobrevivieron más de 5 años y 15 años luego de la operación.La estadificación TNM, las metástasis ganglionares, la invasión extraesofagiana, el grado de diferenciacíon tumoral, la longitud del tumor y la categoría de la operación fueron los principales factores determinantes de pronóstico a largo plazo.Se utilizó el abordaje por toracotomía izquierda exclusiva en 2.613 casos (84.3% de la totalidad de casos resecados) en los cuales se efectuó resección intratorácica con anastomosis. El estómago fue utilizado como sustituto del esófago en 98.8% de los casos resecados, en contraste con el trasplante de colon que se hizo en 1.2% de los casos. El uso del estómago como sustituto es, por mucho, un procedimiento bastante más seguro.

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Résumé Entre 1958 et 1992, 3603 patients ont été opérés d'un cancer épidermoïde de l'oesophage. Parmi eux, 3099 résections ont pu être effectuées avec un taux de résecabilité de 86%. Parmi ces résections, 2341 (75.5%) ont été considérées comme curatives, et 758 (24.5%) ont été considérées comme palliatives. La morbidité et la mortalité à 30 jours ont été respectivement de 23.4% et de 3.8%. En cas de résection, la mortalité a été de 4%. Quatre-vingt dix-sept pourcent des patients ont été suivis pendant plus de 5 ans. Les taux de survie actuarielle à 5, 10 et 15 ans ont été respectivement de 30.4%, 23.6%, et 17.9%. La récidive ou les métastases ont été la cause principale de décès chez 60.9% et 25.5% des patients ayant vécu plus de 5 et 15 ans après l'opération. Le stade TMN, l'existence de métastases ganglionnaires, l'extension extraoesophagienne, la différentiation tumorale, la longueur de la tumeur et le type de l'intervention ont été des déterminants majeurs du pronostic. Une thoracotomie gauche a été utilisée exclusivement chez 2613 patients (84.3% de toutes les résections en cas de résection et anastomoses intrathoraciques). Une gastroplastie a été utilisée chez 98.8% des cas de résection et un transplant colique seulement dans 1.2% des cas. II n'y avait aucune différence entre les deux en ce qui concerne les complications. Les résultats nettement au-dessus de la moyenne dans cette série sont en faveur de la chirurgie: réséquant la tumeur primitive par une oesophagectomie totale ou subtotale, accompagnée d'un curage lymphatique aussi complet que possible chez les patients stade III ou moins. La détection et le traitement précoces sont sans doute les seules façons d'améliorer les résultats à long terme.

     

卧位电子线全身照射的剂量分布

对Ｔ细胞淋巴瘤等广泛的皮肤病变患者采用仰卧和俯卧的电子线全身疗法。加速器光阑开到最大，不加限光筒。治疗时沿患者纵轴，３～４个野覆盖全长，机架对两种体位顺时针、逆时针４５°各照１次。用胶片法检测相邻野间的剂量均匀性，未见明显的剂量热点和冷点。用热释光剂量计等间隔地分布在人体模型６个不同体层上，６０个测试点结果表明全身剂量均匀性在±１０％以内。     

Viral etiology of chronic cervicitis and its therapeutic response to a recombinant interferon.

Chronic cervicitis was shown to be related to papillomavirus type 16(HPV-16), herpes simplex virus type 2 and cytomegalovirus (CMV) infections as demonstrated by DNA hybridization technique and virus isolation method from samples taken from erosive and normal cervices. After one course of treatment with recombinant interferon alpha 1 (rIFN-alpha 1), 93.8% of cases showed clinical improvement and 60% marked improvement. The HPV-16 and HSV detection rates dropped down significantly after rIFN-alpha 1 treatment as compared with those before treatment. Astragalus membranaceus, a Chinese herbal drug, was shown to be synergic to interferon therapy.

     

血浆内皮素—1,醛固酮在肾病综合征患儿钠潴留中的作用

为探讨血浆内皮素－１（ＥＴ－１）和醛固酮（Ａｌｄ）在肾病综合征患者儿钠潴留中的作用，对１４例肾病综合征患者儿在水肿期和消肿期的血浆ＥＴ－１、Ａｌｄ及血清渗透压、白蛋白（Ａｌｂ）、Ｎａ＾＋的变化了观测。结果显示患儿水肿期血浆ＥＴ－１比消肿期显著性升高（Ｐ〈０．０１），水肿期血浆Ａｌｄ与消肿期无明显差异（Ｐ〉０．０５）；血浆ＥＴ－１与血清Ｎａ＾＋呈直线正相关（ｒ＝０．４８６，Ｐ〈０．０１），与血清Ａｌ     

烹调烟雾冷凝物对人外周血淋巴细胞的毒性

目的：通过检测居民厨房内烹调烟雾冷凝物对人外周血淋巴细胞的毒性作用，为全面评价烹调烟雾对健康的危害提供依据。方法：应用ＭＴＴ法检测以菜油为食用油的烹调烟雾冷凝物对人外周血淋巴细胞的毒性作用。结果：不同浓度烹调烟雾冷凝物受试组间的ＯＤ值存在显著性差异（Ｐ＜０．０００１）；各受试浓度组与ＤＭＳＯ对照组进行比较，受试浓度在１２５μｇ·ｍｌ１以上时，各受试组与ＤＭＳＯ对照组的ＯＤ值都存在显著性差异，而且各浓度组与对照组的ＯＤ值之差随测试浓度的升高而递增。结论：烹调烟雾冷凝物对人外周血淋巴细胞具有一定的毒性作用，并且存在剂量－反应关系。     

激光打孔心肌血运重建术新进展

激光心肌血运重建术(TMIR)是利用激光在缺血的左心室壁制造多个心肌隧道,以促使心腔内的氧合血经隧道注入心肌内,并通过心肌大量的窦状隙及冠状动脉交通网营养该区域心肌。在60年代用针穿刺左心室壁造成孔道改善心肌缺血的基础上Mirhoseini等在70年代末开始了TMLR的实验研究。80年代围绕TMLR的组织学、生理学、生物物理学等方面的研究报道较多,低功率二氧化碳激光TMLR作为冠脉搭桥(CABG)的辅助方法也开始用于临床。90年代在高功率二氧化碳激光成功地用于人心脏跳动下心肌打孔手术后,TMLR成为单独治疗晚期重症冠心病的另一种新方法。1994年尸检发现了激光孔道长期通畅并内皮化及与周围心肌血窦相沟通的组织学证据。近年来,有关TMLR在(1)促进血管内皮生长方面的实验研究,(2)用磁共振成像(MRI)、单光子发射计算机断层(SPECT)和正电子断层扫描(PET)、心肌造影超声(MCE)等手段进行临床随访,(3)临床开展的心脏搏动条件下CABG结合TMLR,(4)TMLR术式及其适应证的选择等实验与临床应用方面均有很大进展。     

百日咳菌液致大鼠脑水肿模型脑组织氧化还原酶变化的研究

应用组织化学方法对百日咳菌液所致大鼠急性感染性脑水肿脑组织内乳酸脱氢酶、琥珀酸脱氢酶、单胺氧化酶的活性进行研究，结果显示：注菌组与正常对照组比较，三种氧化还原酶在脑组织内均出现多个局灶性酶活性减弱区，内毒素预处理组比注菌组酶活性强，提示急性感染性脑水肿时，脑组织内三种氧化还原酶活性均减弱，内毒素预处理对脑水肿有保护作用。     

A longitudinal study of the nutritional and immunological composition of human milk

Eleven healthy women, who were 25–35 years of age, primipara, fullterm and had had normal delivery, were included in this study. Breast milk was estimated for protein, non-protein nitrogen, lipids, lactose, sIgA, IgM, IgG and total and differential cell counts. In the first 3–5 days post-partum, protein concentration (chiefly immunoglobulins sIgA, IgM, IgG) was very high but decreased rapidly by day 5 and remained rather stable afterwards. The contents of fat and lactose were low in the first few days and increased gradually later. Neutrophils, lymphocytes, colostral cells and macrophages were all found in the breast milk.     

A semi-automated method for measuring the potential for protein covalent binding in drug discovery

INTRODUCTION: Covalent protein binding of metabolically reactive intermediates of drugs has been implicated in drug toxicity including the occurrence of idiosyncratic drug toxicity. Investigators therefore would prefer to avoid developing compounds that produce significant amounts of reactive metabolites. By incubating the radiolabeled drug of interest with liver microsomes it is possible to evaluate the propensity of a drug candidate to covalently bind to proteins. METHODS: Here we present a semi-automated method in which a Brandel cell harvester is used to collect and wash proteins that have been incubated with radiolabeled drug. This method utilizes glass fiber filter paper to capture precipitated protein, rather than the more traditional exhaustive extraction/centrifugation approach. Using model compounds (including [14C]diclofenac, [3H]imipramine, [14C]naphthalene, and [14C]L-746530) we compare the covalent binding results obtained using this method to results generated using the traditional method and we performed cross-laboratory testing of assay reproducibility. RESULTS: It was found that results from new method correlated highly with the traditional method (R2=0.89). The cross-laboratory testing of the method showed an average interlaboratory coefficient of variation of only 18.4%. DISCUSSION: This method provides comparable results to the more traditional centrifugation-based method with considerable time and labor savings.