两种微创治疗方法在盘源性腰痛治疗中的应用

目的比较水冷式双极射频纤维环成形术和椎间盘内电热疗法治疗盘源性腰痛的临床效果及其并发症。方法 80例盘源性腰痛患者,随机分为A、B两组,每组40例,分别采用水冷式双极射频纤维环成形术和椎间盘内电热疗法进行治疗,观察两组患者手术前后VAS疼痛评分、Oswestry功能障碍指数评定的功能状态以及手术并发症等情况变化。结果经两种微创方法治疗后,两组患者疼痛评分均明显降低,功能状态显著改善,无严重并发症发生。结论水冷式双极射频纤维环成形术和椎间盘内电热疗法均能快速缓解患者疼痛,显著改善患者功能状态,并发症少,两者都是治疗盘源性腰痛的安全、有效的方法。     

2004-2009年广西靖西县淋病、梅毒、AIDS/HIV流行状况分析

目的了解位于中越边境的靖西县2004-2009年梅毒、淋病、艾滋病感染及发病情况,分析其流行特征和规律,为制订性病艾滋病防治策略和措施提供科学依据。方法收集该县2004-2009年的梅毒、淋病、AIDS/HIV病例疫情资料,采用Excel软件进行统计分析。结果全县人口数为61.7万,近6年报告梅毒、淋病、AIDS/HIV阳性病例共767例,人群发病率为21.68/10万,男性高于女性,其中淋病118例、梅毒595例、艾滋病11例(死亡6例)、HIV阳性43例(死亡10例)。以上3种疾病高发年龄在15～44岁年龄组,占总发病率的68.06%。农民发病人数占59.06%。梅毒病例数2007年后增多明显。自1997年发现HIV感染者后,2004-2009年AIDS/HIV患者每年有所增加,病死率呈逐年上升,平均病死率为29.63%。结论该县2004-2009年梅毒患者增加较快,AIDS/HIV阳性病例有所增多,防治工作应进一步加强。     

开通闭塞冠状动脉策略的全球性研究 GUSTO—Ⅱb（亚组研究）

病人资料 3 289例因急性冠脉综合征而接受溶栓治疗的患者,2274例接受t－PA治疗,1015例接受链激酶治疗。     

Interleukin 1 induces human marrow stromal cells in long-term culture to produce granulocyte colony-stimulating factor and macrophage colony- stimulating factor

Pure interleukin 1 (IL 1) was found to stimulate established human bone marrow stromal layers in long-term culture to produce colony- stimulating activity (CSA). Maximal concentrations in the culture medium were reached 24 hours after a single IL 1 pulse. The effect could be neutralized by a specific rabbit anti-IL 1 antiserum. Stromal layers, once stimulated by IL 1, continued to release CSA into the culture medium in the absence of exogenous IL 1. A second IL 1 pulse induced CSA release in an identical manner, as did the primary stimulation, indicating that the CSA released was actively produced. Using specific immunologic assays, both granulocyte colony-stimulating factor (G-CSF) and macrophage CSF (M-CSF) could be identified in the culture supernatants, and production of both factors was inducible by IL 1. Shortly after initiation of the long-term marrow cultures "spontaneous" G-CSF and M-CSF release occurred. The release of G-CSF diminished following addition of the anti-IL 1 antiserum, indicating that endogenous production of IL 1 by stromal cells had contributed to this effect. These results further support the role of IL 1 as an important modulator of CSF production by cells of the hematopoietic microenvironment.     

Immediatevs. Salvage resection after local treatment for early rectal cancer

PURPOSE: There is an increasing awareness of local procedures to treat early stage rectal cancer. Abdominoperineal resection (APR) or low anterior resection (LAR) has been recommended if adverse pathologic findings are encountered in the local excision specimen. No data compare the impact on survival of immediate resection for adverse featuresvs. salvage resection for clinical recurrence. METHODS: We reviewed retrospectively 155 patients who underwent initial curative treatment of invasive rectal cancer by excision (91), snare-cautery (44), and fulguration (20). RESULTS: Twenty-one patients underwent APR/LAR immediately after initial local treatment, whereas another 21 patients underwent salvage APR/LAR for local recurrence. The disease-free survival after APR/LAR was 94.1 percent for the immediate group and 55.5 percent for the delayed group (P<0.05). CONCLUSION: This decreased survival observed after delayed resection supports the recommendation for immediate APR/LAR when adverse pathologic features are present in the excision specimen. Presented at the Annual Cancer Symposium of the Society of Surgical Oncology, New York, New York, March 15 to 18, 1992.     

Interleukin-6 is not involved in the interleukin-1-induced production of colony-stimulating factors by human bone marrow stromal cells and fibroblasts

Interleukin-6 (IL-6) is a multifunctional cytokine that plays a role in regulation of hematopoiesis. Because IL-6 is coinduced with colony- stimulating factors (CSFs) by various cell types in response to stimulation with IL-1, we investigated whether IL-6 is involved in the IL-1-induced production of CSF by human bone marrow (BM) cells in long- term culture or human fibroblasts. We showed that IL-6 does not induce CSF production by these cells. Neither addition of exogenous IL-6 nor neutralization of endogenous production of IL-6 by an anti-IL-6 monoclonal antibody (MoAb) diminished the IL-1-induced colony- stimulating activity (CSA), indicating that IL-6 did not act synergistically with IL-1. Finally, IL-6 did not influence the kinetics of IL-1-induced CSA production by human fibroblasts. We conclude that IL-6, either alone or in combination with IL-1, does not induce CSF production by human BM stromal cells or fibroblasts.     

Flow cytometry of colorectal carcinoma with three-year follow-up

Flow cytometry DNA measurements were carried out on colorectal carcinomas from a series of 33 patients who have since been followed for three to four years. The tumors could be subclassified by this technique into 15 that had near-diploid DNA and 18 that were aneuploid. Prior reports had suggested that the near-diploid tumors carry a better prognosis than aneuploid tumors, but in this study the distribution by Dukes' stage and survival were the same in both groups. supported by NCI Grants No. CA-34134 and CA-31545.     

米非司酮抗人子宫内膜癌裸鼠移植瘤作用的实验研究

目的：观察米非司酮抗人子官内膜癌裸鼠移植瘤的作用，为临床应用提供依据。方法：将裸鼠分为米非司酮、三苯氧胺、米非司酮＋三苯氧胺、对照４组，用药并观察移植瘤生长情况，电镜观察移植瘤，测定裸鼠血清雌二醇。结果：米非司酮抗癌作用与三苯氧胺相似，二者联合作用增强。米非司酮使癌细胞坏死，内质网及线粒体肿胀，使裸鼠血清雌二醇升高。结论：米非司酮有抗子宫内膜癌作用，与三苯氧胺联合作用增强。     

En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer.

From 1968-1976, 412 patients were operated on for rectal cancers. One hundred fifty-six underwent abdominoperineal resection (APR) and 256 underwent low anterior resection (LAR). One hundred ninety-two underwent en bloc pelvic lymphadenectomy in conjunction with their resection, while 220 patients underwent more conservative or conventional resection. Thirty-day hospital mortality was 1.7%. The cancer-related 5-year survival was 58.8% for all patients. The proportion of patients surviving 5 years after LAR (62.8%) was significantly better than those surviving after APR (52.4%), p = 0.008. Statistically significantly superior survival was observed after extended dissection when compared to conventional resections in Dukes' A, B, and C patients as a whole (63.8 and 54.3%) and in Dukes' C patients in particular. Superiority of en bloc pelvic lymphadenectomy versus conventional resection was observed in all cases of Dukes' Stage C, Astler-Coller Stage C1, Level II (adjacent) lymph nodes, and Level I (proximal) lymph nodes and was most effective in combination with sphincter-preserving operations. Patient groups were compared for bias and/or case selection, using both contingency tables and Cox-based multiple covariant linear regression analysis, and none was found. In the face of current adjuvant therapy, which is of questionable benefit and which carries its own treatment morbidity, en bloc pelvic lymphadenectomy is advocated as an adjunct to the curative operations for rectal cancer. To improve the overall benefit, patients can be selected for pelvic lymphadenectomy as an adjuvant to resection when preoperative examination suggests that the rectal cancer penetrates the bowel wall. Accurate preoperative staging may help to define a more restricted group of patients warranting (pelvic lymphadenectomy) (PLND). A control randomized trial of the effectiveness of PLND is appropriate to further test its value.