Periodontitis, a risk factor for cardiovascular diseases?

Exist a statistically significant association between a diagnosis of coronary heart disease and certain oral health parameters. These parameters are independent and more strongly associated with coronary heart disease than were recognized risk factors, such as serum cholesterol levels, body mass index, diabetes and smoking status. The correlation between serum and salivary cholesterol concentration and the role of salivary lipids in oral health have been poorly characterized. Lipids in saliva are mostly glandular in origin, through some may diffuse diffuse directly from the serum. The surface of the enamel (in case of dietary fat which have an cariostatic effect) is protected against demineralization by a mixture of salivary lipids and proteins. Salivary lipids may have anucleating role in the early mineralization of the dental plaque. The prevalence of periodontal disease may be increased in patients with atherosclerosis, and dental and periodontal infections have been shown to be associated with occurrence of acute and chronic coronary heart disease. Among the known risk factors of atherosclerosis, high serum lipid levels, especially cholesterol may be important with regard to periodontal health.     

犬失血性休克早期血浆3种酶活性值的变化

用１０只犬复制失血性休克模型,观察休克前、休克３０ｍｉｎ及回输血后３０ｍｉｎ时,血浆中心肌相关酶—肌酸激酶（ＣＫ）、谷草转氨酶（ＧＯＴ）、α－羟丁酸脱氢酶（ＨＢＤ）活性值的变化。结果发现：失血性休克３０ｍｉｎ时,ＣＫ、ＧＯＴ较休克前显著下降（Ｐ＜０．０５,Ｐ＜０．０１）;ＨＢＤ值也下降,但无统计学意义（Ｐ＞０．０５）。输血后３０ｍｉｎ时,ＣＫ、ＧＯＴ、ＨＢＤ值回升,与休克３０ｍｉｎ时比显著升高（Ｐ＜０．０５）,与休克前比无显著性差别（Ｐ＞０．０５）。提示：失血性休克早期心肌细胞可能存在有一种保护性反应,心肌细胞没有发生明显损伤。     

我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。     

The ocular changes in patients on chronic dialysis

The paper propose the study of lacrimal secretion alterations, the lacrimal level of the urea and the fundus optic alterations at the patients with chronic renal failure, during the hemodialysis. For the study we used the general ophthalmologic examination, the fundus optic examination before and after the hemodialysis, the lacrimal secretion examination by Schirmer l-test and the measure of lacrimal urea by the Berthelot modified method. The study was done on a member of 30 patients, with chronic renal failure, having a age of the dialysis between one and 80 months. The results of the study showed lacrimal hyposecretion, the urea lacrimal level being lower than the urea blood level and a concordance between the lacrymal and sanguine clearance of the urea. The fundus optic examination during the hemodialysis showed a pale aspect of the fundus the pallidity being more pronounced before the dialysis with filiforme arterioles, apparently without content, significant for decreasing of the circulatory debit.     

小分割分次立体定向放射治疗脑转移瘤近期疗效观察

目的观察小分割分次立体定向放射治疗(fractionated stereotatic radiation therapy,FSRT)脑转移瘤的近期疗效.方法15例病人单纯全脑外照射(WBRT组),中间平面剂量20～40Gy/10～20次/2～4周.17例病人接受FSRT(FSRT组),每次分次剂量为2.5～3.0Gy.其中11病人行单纯FSRT,中心总剂量为30～60Gy/1 0～20次/2～4周;6例病人先行WBRT,然后行FSRT,中心总剂量为46～60Gy/5～6周.结果KSP评分增加10分以上者,WBRT组为5 3.3%,FSRT组为82.4%.(P＜0.05).WBRT组有效率(CR PR)为50.0%;FSRT组有效率(CR PR)为80.0%.中位生存率:WBRT组为3.5月,FSRT组为10.0月.结论FSRT能有效地控制脑转移瘤,减轻神经系统症状,提高生存质量,延长病人生存期,而没有增加副作用,值得临床推广应用.     

妊娠合并肺动脉高压23例分析

目的 探讨合并肺动脉高压(PH)妇女能否妊娠及妊娠的适宜时间。方法 回顾性分析1997～2002年在我院诊治的23例合并有PH的孕妇，分析PH的分类，妊娠结局。结果 3例合并原发性肺动脉高压(PPH)孕妇，2例在剖宫产术中死亡，1例在孕早期终止妊娠后存活。14例因合并风湿性心脏病(风心病)致PH的孕妇，妊娠至足月行剖宫产者10例，1例早产，3例引产，无一例孕妇死亡。6例因合并先天性心脏病(先心痛)致PH的孕妇，轻度PH孕妇3例，均妊娠至足月；重度PH孕妇3例，2例死亡，1例存活。结论 PPH患者应避免妊娠。风心病致PH的孕妇，依心功能、PH高低及血氧饱和度决定是否终止妊娠。对先心病致PH者，最好在手术或药物治疗后妊娠；患Eisenrnenger’s综合征妇女禁止妊娠。     

原发性卵巢平滑肌肉瘤临床分析(附3例报告及国内20例综合分析)

目的 探讨原发性卵巢平滑肌肉瘤的临床特点、诊断、治疗方法，以及可能预后相关因素。方法 对3例原发性卵巢平滑肌肉瘤综合国内近10年报道20例进行分析。结果 原发性卵巢平滑肌肉瘤可发生于任何年龄，主要为绝经后妇女。临床表现不典型，诊断主要依靠病理，同时结合免疫组化Desmin( )，Vimentin( )诊断。结论 原发性卵巢平滑肌肉瘤恶性度高，预后差，并且可能与分化程度及其微血管相关。治疗以手术为主，辅以合适的放疗和化疗综合治疗。     

Lymphangioma of the spermatic cord

We report a new case of spermatic cord lymphangioma in a infant 2 years old. The initial diagnosis was funicular hydrocele. The treatment was the local excision of tumor and the diagnostic was histological. Postoperative course was excellent. Must be explored the transillumination of the mass which would have led us to think other the diagnosis different from that of the cord hydrocele before the operation since it would have given negative. During the operation, must the assured that the cystic anomaly is limited to spermatic cord, to evite recurrences in the postoperative course.     

Randomized parallel study of doxorubicin plus paclitaxel and doxorubicin plus cyclophosphamide as neoadjuvant treatment of patients with breast cancer.

PURPOSE: This randomized, noncomparative, parallel-group study was designed to evaluate the pathologic complete response (pCR) rate of combined doxorubicin plus paclitaxel (AP) and doxorubicin plus cyclophosphamide (AC) as neoadjuvant chemotherapy in patients with previously untreated breast cancer who were unsuitable for conservative surgery. PATIENTS AND METHODS: A total of 200 patients with T2-3, N0-1, M0 disease were randomly assigned in a 2:1 ratio to receive preoperative chemotherapy with either doxorubicin 60 mg/m(2) plus paclitaxel 200 mg/m(2) as a 3-hour infusion (AP) or doxorubicin 60 mg/m(2) plus cyclophosphamide 600 mg/m(2) (AC) every 3 weeks for 4 courses followed by surgery. RESULTS: A pCR (eradication of invasive carcinoma in tumor and in axillary lymph nodes) was found in 16% and 10% of patients in the AP and AC arms, respectively, by study center pathologists, and in 8% and 6% of patients, respectively, by independent pathologists. Patients with pCRs tended to have unifocal disease, tumors with negative hormonal receptor status, and less differentiation (Scarff, Bloom, and Richardson scale grade 3). Breast-conserving surgery was performed in 58% and 45% of patients in the AP and AC arms, respectively. An objective clinical response was achieved in 89% of patients in the AP arm and 70% in the AC arm. At a median follow-up of 31 months, disease-free survival (DFS) was higher in patients who reached pCR versus those without pCR (91% v 70%). CONCLUSION: The encouraging pathologic and clinical responses of patients with breast cancer after neoadjuvant chemotherapy with doxorubicin plus paclitaxel warrant additional investigation of paclitaxel in the neoadjuvant setting of breast cancer management.     

Phase II study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma: therapeutic monitoring with plasma Epstein-Barr virus DNA.

PURPOSE: To assess the efficacy of neoadjuvant paclitaxel and carboplatin (TC) followed by concurrent cisplatin and radiotherapy (RT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and to monitor treatment response with plasma Epstein-Barr virus (EBV) DNA. PATIENTS AND METHODS: Thirty-one patients with International Union Against Cancer stages III and IV undifferentiated NPC had two cycles of paclitaxel (70 mg/m2 on days 1, 8, and 15) and carboplatin (area under the curve 6 mg/mL/min on day 1) on a 3-weekly cycle, followed by 6 to 8 weeks of cisplatin (40 mg/m2 weekly) and RT at 66 Gy in 2-Gy fractions. Plasma EBV DNA was measured serially using the real-time quantitative polymerase chain reaction method. Results All patients completed planned treatment. Response to neoadjuvant TC was as follows: 12 patients (39%) achieved partial response (PR) and 18 achieved (58%) complete response (CR) in regional nodes; five patients (16%) achieved PR and no patients achieved CR in nasopharynx. At 6 weeks after RT, one patient (3%) achieved PR and 30 patients (97%) achieved CR in regional nodes, and 31 patients (100%) achieved CR in nasopharynx; 29 patients (93%) had EBV DNA level of less than 500 copies/mL. Neoadjuvant TC was well tolerated, and the most common acute toxicity of cisplatin plus RT was grade 3 mucositis (55%). At median follow-up of 33.7 months (range, 7 to 39.3 months), six distant and three locoregional failures occurred. Plasma EBV DNA level increased significantly in eight of nine patients who experienced treatment failure but did not increase in those who did not. The 2-year overall and progression-free survival rates were 91.8% and 78.5%, respectively. CONCLUSION This strategy was feasible and resulted in excellent local tumor control. Serial plasma EBV DNA provides a noninvasive method of monitoring response in NPC.