Refractive astigmatism acts predominantly as a source of high spatial frequency image distortion: The associated lineal distortions can be overcome by using a low pass spatial filter!

Purpose: Surprisingly, an important characteristic of astigmatism has been overlooked by ophthalmic and clinical scientists. Apparently, refractive astigmatism is due largely to a form of high spatial frequency image distortion. Methods: Characteristic astigmatic image distortion can be minimized or eliminated by using a low-pass spatial filter (here, a ground glass plate was employed for this purpose). The ground glass is placed a short distance in front of a visual acuity chart, or it may be used with other tests, such as vernier acuity. Results: This test has been performed by us on large numbers of patients and test subjects. A clinician can try this test for himself/herself. Place a +2.00 D.C. (any axis) lens in front of the eye; the usual distortions will be observed. Locate the ground glass plate as described. The usual distortions associated with the conoid of Stürm will not be visible or will be virtually eliminated, although some image blur will remain. Conclusions: This technique has significance, e.g., in visual screening programs in developing nations, or in assessing patients with media disorders prior to ophthalmic surgery. This revised version was published online in July 2006 with corrections to the Cover Date.     

中国科学院大学附属肿瘤医院（浙江省肿瘤医院）鼻咽癌诊治研究进展

中国科学院大学附属肿瘤医院近年来就鼻咽癌诊治开展了数十项研究,这些研究大部分是针对Ⅱ期、局部晚期、转移鼻咽癌的治疗干预性研究,其余的是针对预后因素、分期以及放疗毒副反应的研究。全文就这数十项研究作一综述,一方面是对浙江省鼻咽癌学科发展的宣传与肯定,另一方面为临床医师合理制定临床治疗策略提供一些参考,也为扩大国内外鼻咽癌学科的交流和发展提供契机。     

The clinicopathological significance of p21 and p53 expression in esophageal squamous cell carcinoma: an analysis of 153 patients

OBJECTIVE: The p21 gene is thought to play a central role in tumor suppression. The aim of this study was to examine the clinicopathological role of p21 and p53 in esophageal squamous cell carcinomas. METHODS: The expression of p21 and p53 proteins in 153 Chinese patients (131 men, 22 women) with resected esophageal squamous cell carcinomas was investigated by the immunohistochemical method. Correlation between p21 and p53 expression and clinicopathological features was examined. RESULTS: The expression of p21 and p53 was detected in 70% and 64% of the tumors, respectively. The staining of p21 and p53 was also found in squamous carcinoma in situ, dysplasia, and nontumor epithelium. p21 expression was often weak in the suprabasal cells and found in better differentiated tumors. There was no significant correlation between the expression of p21 and the abnormal accumulation of p53. The prognosis of the patients depended on the size, stage, and p21 expression of the lesion. In stage III lesions with tumor diameter < or = 7.5 cm (n = 93), patients with loss of p21 expression had better survival. The survival rates of patients were worse if they had expression of both p21 and p53. CONCLUSIONS: Thus, p21 and p53 had prognostic value for esophageal squamous cell carcinomas. Loss of p21 expression was shown without p53 alternations, indicating that other mechanisms are also involved in turning off the gene. The pattern of p21 and p53 expression predicts an aggressive clinical course of esophageal squamous cell carcinomas.     

老年高血压患者脉压与左心室肥厚的关系

目的　研究老年高血压患者 2 4h动态脉压 (2 4hpp)与左心室肥厚 (LVH)的相关关系。方法　测定 5 4例老年高血压病患者进行动态血压 (ABp)和超声心动图的各种参数。将 2 4hpp≥ 60mmHg者 2 8例为A组 ,2 4hpp <60mmHg为B组。结果　A、B两组LVH的发生率有非常显著的差异 (P <0 .0 1) ,左心室重量指数 (LVMI)与 2 4hpp、2 4h平均收缩压 (2 4hSBP)呈密切正相关。结论　 2 4hpp可作为评价抗高血压药物能否更好地减少高血压患者靶器官损害的重要指标之一。     

Topography of Prostate Cancer Recurrence After Radiation Therapy: A Detailed Mapping Study of Salvage Radical Prostatectomy Specimens

In men who do not respond to initial radiation therapy, accurate knowledge of the site of cancer recurrence or persistence is necessary to understand treatment failure. We evaluated the pathologic characteristics of recurrent/persistent prostate cancer with tumor maps from the whole-mount slides of salvage radical prostatectomies performed between 2000 and 2014. Of 216 consecutive patients, detailed tumor maps were available for 77. Sixty-nine patients (90%) were found to have tumor in the apex, of which 46% occurred in the most apical 3 mm. Fifty-three patients (69%) had tumors at a distance of ≤5 mm from the urethra. Five patients had tumor directly involving the urethra, all of whom had urethral invasion at the apex. Seminal vesicle involvement was seen in 32 patients (42%), two of whom had tumor only in the seminal vesicles. Sixty-two patients (81%) had tumors in the distal apex, periurethral area, or seminal vesicles, that is, areas that are not routinely biopsied. Targeting these areas could improve the accuracy of biopsy when cancer recurrence is suspected.

A decade of trials of interferon-alpha for chronic hepatitis C. A meta-regression analysis

The most relevant randomized controlled trials of interferon-alpha (IFN) for naive patients with chronic hepatitis C (CHC) published in a decade, just before appearance of pegylated IFN trials in 2000, were included in this paper. Its purpose is to review the relationship between sustained biochemical response in active versus control group versus usual clinical variables as IFN regimens, cirrhosis, genotype and versus less frequently addressed variables as funding, methodological quality or location of principal author. Meta-analysis estimates of global treatment effect varied according to trial design: group 1=IFN versus placebo/no treatment, 32 RCTs, 2499 pts, OR 9.5 (6.3-14.2); group 2a=comparison of IFN schedules, 43 RCTs, 7454 pts, OR 1.6 (1.4-1.9); group 2b=IFN+other drugs versus standard IFN, 30 RCTs, 4737 pts, OR 2.0 (1.6-2.6). Fixed effects (arm-level) meta-regression on the complete data set (171 arms, 10,580 pts) revealed that sustained response was most likely in experimental arms of IFN+ribavirin or other drugs (OR 2.4), arms using yearly schedule (OR 2.0), trial principal author from Asia (OR 1.7), trial sample size >200 (OR 1.4) and arms enrolling less than 50% of cirrhotics (OR 1.3). Moreover, focus was on some significant interactions too, as the effect of trial's quality interacting to the recorded funding (more benefit if no-profit, less if for-profit) and the effect of trial funding interacting to the location of first author (more benefit if from Asia). Three main effects (experimental arm, cirrhosis, funding) and one interaction (funding*location of principal author) explained 31% of between study variability in a random-effect meta-regression. In a subgroup analysis on a data set including available information on HCV genotype (93 arms, around 7000 pts), meta-regression revealed that genotype 1 or 4 less than 50% per arm and specialistic journal were significant predictors of either biochemical (transaminases) or virological (HCV-RNA) sustained response, in a model including the same main effects identified in the complete data set analysis. Finally, although mostly captured by different IFN regimens along time, heterogeneity of effect in a large set of (not-pegylated) IFN trials was also explained by HCV genotype and variables of quality and reporting, such as trial's principal author from Asia.     

The experience of Chinese bereaved persons: a preliminary study of meaning making and continuing bonds

This study explores the bereavement process of Chinese persons in Hong Kong, with the focus on how they make meaning of the death as well as how they maintain a bond with the deceased. A review of video- and audiotapes of 52 bereaved persons in bereavement counseling pointed to how these concepts are reflected in key themes that appeared throughout these interviews. The way this bereaved population found meaning in the death was reflected in how they understood the cause of death, their observations at the death moment, their understanding of the life of the deceased after the death, the life of the bereaved after the death, and the burial and mourning rituals that were followed. The continuing bond the bereaved felt with the deceased was experienced by the bereaved as either initiated by the deceased, for example by the deceased appearing in dreams or initiated by the bereaved themselves in their talking with the deceased. These 2 aspects of the bereavement process seem to be similar to those found in other societies, but the ways in which they were manifested were unique to the Chinese culture. Based on these findings, the authors conclude with implications for intervention with this bereaved population.