复发性鼻腔及鼻窦恶性肿瘤的挽救性治疗

目的 探讨鼻腔及鼻窦恶性肿瘤复发后的临床表现、与复发有关的因素、再手术的意义及缺损组织的修复。方法 排除原发性鼻腔鼻窦恶性肿瘤，仅收集治疗后复发并且有再手术意义的病例。应用乘积极限法估计生存率，Stata7．0统计软件进行统计运算。结果 1993～2002年共有25例患者符合要求。男19例，女6例，年龄13～66岁，平均46．1岁。所有患者均有至少1次手术或放射治疗史。末次治疗至复发的时间2周～46个月，中位时间18个月，80％的患者肿瘤复发出现于末次治疗后2年内。术后随访1～65个月。再手术中无死亡病例。5例健在无肿瘤复发；局部复发2例，颈部淋巴结转移1例，经过1刀或手术治疗后2例健在、1例带瘤生存；死于局部复发13例，死于肺转移1例，死于无关疾病1例，失访2例。1年生存率62．5%，2年生存率43．7％，3年生存率29．1％，中位生存时间18个月。术后发生脑脊液漏3例次，中枢性尿崩症1例次，皮瓣部分坏死1例次。手术修补脑脊液漏l例。结论 鼻腔及鼻窦恶性肿瘤局部复发多发生于末次治疗后2年之内，主要症状是头痛及局部隆起。肿瘤的类型和分化程度与复发密切相关。合理、及时的综合治疗有助于减少复发。运用有效修复手段的再手术可改善晚期患者的生活质量，延长生命。并发症主要是脑脊液漏，多数可通过保守方法治愈。     

Longitudinal,population-based study of racial/ethnic differences in colorectal cancer survival: impact of neighborhood socioeconomic status,treatment and comorbidity

Background  

Colorectal cancer, if detected early, has greater than 90% 5-year survival. However, survival has been shown to vary across racial/ethnic groups in the United States, despite the availability of early detection methods.     

Two-stage treatment of skeletal Class III malocclusion during the early permanent dentition.

A patient with skeletal Class III malocclusion was treated in 2 phases during the early permanent dentition. In phase 1, maxillary protraction was combined with rapid palatal expansion; in phase 2, fixed appliances were placed. The results were good posttreatment, and, 1 year later, a favorable growth tendency could be observed. This report shows that treatment for a patient with skeletal Class III malocclusion can be started in the early permanent dentition, with very good final results.     

针灸现代化刍议

什么是针灸现代化?1997年11月在北京举办的世界针联成立10周年学术大会上，王雪苔教授以《针灸的现状与未来》为题作特别演讲时认为，20世纪针灸发展的时代特征是针灸国际化和现代化。针灸现代化的主要标志是既保持中医学理论体系，又赋予现代科学内涵的现代针灸学的形成。笔者认为：在针灸现代化过程中，     

Production and characterization of monoclonal antibody against colon cancer associated antigen in Chinese]

Although many monoclonal antibodies have been made in human colon cancer, none of them are from the Chinese species. Recently, a colon cancer cell line CC-M2 established from a Chinese patient has been completely characterized and used as immunogen to produce monoclonal antibodies. Monoclonal antibodies were produced by standard hybridoma technique. The fusion rate was 95.8%. An isotype IgG1 of high proliferation named as Sam-2 was used in this study. The titers were measured around 10(4). Further studies on MoAb Sam-2 through indirect immunofluorescent and immunoperoxidase tests revealed its good specificity and sensitivity in colorectal cancer tissue. In CEA study, the result indicated that Sam-2 may react on a non-CEA related antigen. For further clinical application, the antigen was identified as a glycoprotein by chemical resistant test. In preliminary studies using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting techniques, Sam-2 could recognize two closed antigens or a dimer antigen with molecular weight 25.2 and 27 Kd respectively.     

HPLC法测定盐酸美沙酮含量

本文采用高效液相色谱法，以盐酸布比卡因为内标，检测波长220nm，在Symmetry-C18柱上，以己腈-磷酸二氢钾（pH2．5）（3862，V／V）为流动相，测定盐酸美沙酮及其口服液的含量。方法平均回收率为100．17％，日内及日间的RSD均＜1％。方法简便、快速、准确。     

Serial peritoneal macrophage function studies in new and established continuous ambulatory peritoneal dialysis patients

Peritoneal macrophages (PM) perform first-line defense activity against peritonitis, the most important complication in continuous ambulatory peritoneal dialysis (CAPD) therapy. Our longitudinal study has compared the PM function in 20 uremic patients during periods free of peritonitis since they started CAPD therapy in January 1987. The results showed that at the initiation of CAPD, there was a higher bactericidal activity, phagocytosis index, H2O2 production and interleukin-1 (IL-1), gamma-interferon (IFN-gamma) and tumor necrosis factor (TNF) production ability and MHC expression. As time went on, these progressively decreased, and by 9 months after CAPD therapy had started they were significantly lower than at the beginning. During the 1.5-year follow-up period, there was a significantly increased peritonitis rate in the period 6 months after the beginning of CAPD than in the period before the 6th month (88.3 vs. 11.7% respectively; p less than 0.001). These results indicate that PM of new CAPD patients have a more active function than those of established patients. The established patients had a greater risk of peritonitis. A comparison of the immunological profiles of PM from patients who had a peritonitis history shows that phagocytosis index, bactericidal activity and IL-1 and TNF production of PM were significantly decreased during the period free of peritonitis. This result suggests that these parameters may serve as an indicator in developing peritonitis.     

Clinicopathological features of bladder cancer associated with chronic exposure to arsenic.

A high incidence of bladder cancer has been documented in an area of chronic arsenic (As) exposure. This study investigates the characteristics of As-associated (n = 49) and other (n = 64) bladder cancers. A higher histological grading was observed for the As-exposed tumours (P = 0.04), but no other difference in pathobiological features or prognosis was found between the two groups.     

单波长荧光分光光度计测定细胞内Ca^2＋浓度的方法探索

在使用单波长荧光分光光度计测定细胞内游离钙浓度时，通过快速（４～６ｓ）手动转换激发波长（ＥＸ），分别测定ＥＸ３４０和３８０ｎｍ时的荧光强度变化，并计算出３４０ｎｍ与３８０ｎｍ时的荧光强度比率（Ｒ），然后也采用双波长荧光分光光度计测定细胞内Ｃａ２＋浓度的计算公式计算细胞内游离钙浓度。结果显示单波长荧光分光光度计按比例法测得的细胞内游离Ｃａ２＋浓度与使用双波长荧光分光光度计测得的结果相似。