CNS angiitis in graft vs host disease

Graft-vs-host disease (GVHD) is a potentially treatable cause of progressive neurologic decline after bone marrow transplantation (BMT). The authors present histologic confirmation of CNS granulomatous angiitis in a child with chronic GVHD after BMT. Since cranial MRI showed only nonspecific findings, CNS vasculitis associated with GVHD after BMT may be underdiagnosed.     

Overcoming drug resistance in multiple myeloma: the emergence of therapeutic approaches to induce apoptosis.

Drug resistance remains a major clinical challenge for cancer treatment. Early studies suggested that overexpression of P-glycoprotein was a major contributor to the chemotherapy resistance of myeloma cells and other tumor cells. Attempts in several clinical studies to reverse multidrug resistance protein (MDR) by using MDR modulators have not yet generated promising results. Recently, the emerging knowledge about the importance of overcoming antiapoptosis and drug resistance in treating a variety of malignancies, including multiple myeloma (MM), raises new hope of improving the treatment outcome for patients with cancer. The therapeutic value of targeting therapies that aim to reverse the antiapoptotic process in MM cells has been explored in a number of experimental systems, and the results have been promising. The proteasome inhibitor PS-341 is a new specifically targeted proapoptotic therapy that has been tested in clinical studies. The results indicate that PS-341 alone is an effective therapy for patients with MM who experience disease relapse. Recent in vitro data also demonstrate that PS-341 can markedly sensitize chemotherapy-resistant MM cells to various chemotherapeutic agents. On the basis of these encouraging results, clinical studies are underway to test the efficacy of PS-341 and chemotherapeutic agents as combination therapy in treating patients with refractory and relapsed MM.     

Systemic consultation--about possibilities and limitations

The paper presents the role of systemic consultation in the diagnostic and therapeutic process of the people hospitalised for the first time because of a psychotic episode. The following questions are going to be put: What is the role of systemic family consultation in the diagnostic and therapeutic process on the inpatient ward? What are the differences between systemic consultation and others forms of family interventions f.e. family interviews, psycho--education, systemic therapy? What are possibilities and limitations of consultation? What does it invite to? These are only some of those questions, which are typical for daily clinical practice, in which the family consultation takes an important part. In this paper according to our clinical experience, we would like to share some of our thoughts on the questions put. In spite of difficulties the family consultation confronts us with, we are deeply convinced that it has an important part in therapeutic and diagnostic process.     

Features of angioplasty and stenting in atherosclerotic stenting of coronary artery occlusions

The authors analyze results of coronary angioplasty in 257 patients with ischemic heart disease who had occlusions of the coronary arteries. Clinical, angiographic and other findings showing the duration of having the occlusions of the coronary artery are described in detail. The details of the steps of the technique of the endovascular intervention are considered including the most difficult step--passing through the occluded portion of the artery. Great attention is given by the authors to the criteria of using the correct instruments (conducting catheter, conductors, balloon-catheters) during the operation. Good results were obtained in 80.2% of the patients after coronary angioplasty. Stenting of the coronary arteries was performed in 65 patients (25.3%).     

先天性高肩胛症的手术治疗

介绍和评价Ｗｏｏｄｗａｒｄ手术治疗先天性高肩胛症的情况，讨论２例发生臂丛神经损伤的教训。全组手术３０例，男１２例，女１８例，术时年龄３～９岁１９例，１１～１４岁１１例。单纯先天性高肩肿症８例，伴有先天性脊柱侧凸者２２例。２例术后出现臂丛神经损伤，经松解而恢复。１４例同时做了锁骨粉碎术。所有病例均做了肩胛下移，达到外形改善。肩的外展功能大部分病例有所提高。Ｗｏｏｄｗａｒｄ手术治疗先天性高肩肿症与其他手术比较创伤小，出血少，操作简便，效果好。锁骨粉碎术有预防臂丛神经损伤的作用。     

Dose-Tumor Response for Carcinoma of Cervix: An Analysis of 594 Patients Treated by Radiotherapy

This is a retrospective study of 594 histologically proven carcinomas of the uterine cervix treated with radiotherapy alone between January 1970 and December 1986. The age of this group of patients ranged from 22 to 86 years, and the median age was 57 years. There were 544 (91.6%) patients with squamous carcinoma and 36 (6.1%) with adenocarcinoma. There were 24 (4.0%) patients who were treated by two sessions of intracavitary brachytherapy only using intrauterine tandem and vaginal ovoids; 513 (86.4%) patients received whole pelvis irradiation followed by two sessions of brachytherapy at 1-week intervals, with or without additional boost to the parametrium. The dose to point A ranged from 40 to 100.9 Gy for the patients with stage IB to IIIB disease. The 5- and 10-year survival for stages IB, IIA, IIB, IIIA, and IIIB were 90.0, 82.1, 72.0, 50.0, 51.5, and 86.9, 71.0, 67.5, 41.7, and 46.9%, respectively. There was no long-term survivor for stage IV disease; the median survivals for patients with stages IVA and IVB were 15.2 and 9.3 months, respectively. Dose response was demonstrated for stages IIB and III tumors; dose to point A greater than 85 Gy was associated with better central control (P = 0.0036 and 0.0234, respectively). However, further increase in dose to point A beyond 85 Gy was not associated with improvement in central control (P = 0.3128 and 0.3394, respectively, for stages IIB and III). It was also found that the occurrences of rectosigmoid and bladder complications were correlated with the rectal and point A dose. Thus, for these patients, there is no need to increase the dose to point A beyond 85 Gy so that the risk of radiation sequelae can be cut down.     

Ganglionic blockers in abdominal surgery: facts and hypotheses. 2.Clinical,pathophysiological and pharmacological aspects of ganglionic blocker use

The authors discuss facts and hypotheses on the effects of benzohexonium upon the motor activity of the intestine and the significance of N-cholinolytics for prophylactics and treatment of postoperative pareses of the gastrointestinal tract. The ganglioblockers possess antistress effect, reduce the degree of pathological vegetative reactions and facilitate realization of the mechanisms of selfregulation of functions of the small and large intestine. Using benzohexonium during operation and in the first days after it makes the intestinal pareses less frequent. N-cholinolytics however do not have a considerable stimulating influence on the contracting activity of the gastrointestinal tract that accounts for their not high effectiveness in treatment of early functional motor evacuatory disorders. The points of action of gangliolytics, those at the level of the intestinal wall included, can not be considered to be completely established, as well as the mechanisms of their indirect effect. The ganglionic blockade should be considered as the basic method of prophylactics of the postoperative paresis of the intestine.     

着床前后兔子宫内膜表面岩藻糖化抗原的变化

为了解子宫内膜表面复合糖在胚泡着床中的作用，本文以八种抗原结构相关对岩藻糖化寡糖特异的单克隆抗体为探针，研究着床前后家兔子宫内膜岩藻糖化抗原的分布状态与胚泡植入的关系。免疫组化分析的结果表明：（１）未孕内膜表面岩藻糖化抗原ＬｅＹ、ＬｅＫ、Ｈ－１为阳性。植入前ｄ４～７内膜表面岩藻糖化抗原则以ＬｅＹ为主，ＬｅＸ、Ｈ－１逐渐转为阴性。但植入时ｄ７．５内膜上皮ＬｅＹ转为阴性，而腺体仍为阳性。（２）未孕和植入期ｄ４～７．５内膜表面岩藻糖化糖抗原（ＬｅＹ、ＬｅＸ等）之母链Ｇａｌβ１－４ＧｌｃＮＡｃβ１－３Ｇａｌ－表达较强，植入后（ｄ９）消失。（３）抗原ＧｌｃＮＡｃβ１－３Ｇａｌ－在未孕期和植入后（ｄ９）为阳性，植入期ｄ４～７．５则为阴性。（４）植入时ｄ７．５胚泡外膜无岩藻糖化抗原表达，但有抗原Ｇ１ｃＮＡｃβ１－３Ｇａｌ－（抗体为ＦＥ－Ｊｌ）和Ｇａｌβ１－４ＧｌｃＮＡｃβ１－３Ｇａｌ－表达。上述结果提示胚泡植入前后，兔子宫内膜表面岩藻糖化抗原ＬｅＹ的表达有阶段特异性变化，这种变化可能与胚泡和内膜之间的粘连和植入有关。     

甘遂野生变家种的研究

1992～1994年，通过对甘遂生活习性，生物学特性，种子处理，病虫害防治等调研和试验研究，肯定有性繁殖优于无性繁殖，有性秋播优于春播。发现了种籽后熟，植株夏眠等生物学特性。1994年底收获表明，有性3、4年生甘达，个大、色白、粉性足，产量达254．99～344，989／m2。栽培后植物鉴定无变异。有性栽培和野生甘遂成分的初步对比分析研究表明：成分相同，符合药典规定，能同等入药。总结出一套完整、切实可行的栽培技术，为保护中药资源及药农种药致富提供了科学依据．     

肺癌和食管癌淋巴结转移的比较研究

通过肺癌１５２例，食管癌８２例，手术廓清淋巴结１４１２个的区域分布和病理结果的比较分析，显示其共性规律是上位癌向上转移大于向下。上叶肺癌转移路近似于“√”号，下叶肺癌转移路似倒“√”号，上段食管癌其梭形转移圈上长下短，下段食管癌则上短下长。