外科治疗纵隔原发神经源性肿瘤的手术径路评价

目的　探讨外科治疗原发纵隔神经源性肿瘤的手术径路。方法　 1963年 3月至2 0 0 3年 9月外科治疗原发纵隔神经源性肿瘤 91例。所有病例均于术前行X线胸片检查 ,其中 65例行CT或磁共振检查。根据肿瘤的大小、部位及其是否向椎管内延伸选择不同的手术入路 ,其中胸后外侧切口 84例 ,半哈壳状切口 2例 ,高位胸后侧切口 4例 ,胸后外侧加脊柱旁切口 1例。所有病例均经病理证实并行 6个月～ 15年的术后随访。结果　本组手术切除率 97.8% ( 89/91) ,术后并发症发生率 4.4% ( 4 /91) ,无手术死亡病例。术后病理诊断良性肿瘤 79例 ( 86.8% ) ,恶性肿瘤12例 ( 13 .4% )。 1例神经纤维瘤 2年后复发经再次手术切除治愈 ;恶性肿瘤平均生存 3 8.1个月。结论　适当的手术径路是提高纵隔原发神经源性肿瘤切除率的关键。     

Pycnogenol® as an Adjunct in the Management of Childhood Asthma

A randomized, placebo-controlled, double-blind study involving 60 subjects, aged 6-18 years old, was conducted over a period of 3 months to determine the effect of Pycnogenol® (a proprietary mixture of water-soluble bioflavonoids extracted from French maritime pine) on mild-to-moderate asthma. After baseline evaluation, subjects were randomized into two groups to receive either Pycnogenol® or placebo. Subjects were instructed to record their peak expiratory flow with an Assess® Peak Flow Meter each evening. At the same time, symptoms, daily use of rescue inhalers (albuterol), and any changes in oral medications were also recorded. Urine samples were obtained from the subjects at the end of the run-in period, and at 1-, 2-, and 3-month visits. Urinary leukotriene C₄/D₄/E₄ was measured by an enzyme immunoassay. Compared with subjects taking placebo, the group who took Pycnogenol® had significantly more improvement in pulmonary functions and asthma symptoms. The Pycnogenol® group was able to reduce or discontinue their use of rescue inhalers more often than the placebo group. There was also a significant reduction of urinary leukotrienes in the Pycnogenol® group. The results of this study demonstrate the efficacy of Pycnogenol® as an adjunct in the management of mild-to-moderate childhood asthma.     

外伤性肝破裂的救治

目的 分析创伤性肝破裂外科多种干预治疗的效果。方法 总结分析1982-2002年我院收治创伤性肝破裂76例的救治方法和病死率。其中Ⅲ级以上的严重肝破裂46例(60．53％)。手术治疗56例，手术方式包括单纯修补、清创性肝切除、规则性肝切除、肝周填塞止血；非手术治疗20例。结果 手术组：治愈44例，术后并发症17例均经保守治疗治愈，死亡12例，其中术中死亡2例；非手术组：治愈12例，好转6例，2例失访。全组治愈64例，死亡12例，病死率15．8％。结论 Ⅰ-Ⅱ级单纯性外伤性肝破裂可保守治疗；手术是治疗创伤性肝破裂的主要措施，正确的手术方式，积极处理合并伤，重视综合治疗可提高救治成功率。     

Glycine transporter I inhibitor, N-methylglycine (sarcosine), added to antipsychotics for the treatment of schizophrenia.

BACKGROUND: Hypofunction of N-methyl-D-aspartate glutamate receptor had been implicated in the pathophysiology of schizophrenia. Treatment with D-serine or glycine, endogenous full agonists of the glycine site of N-methyl-D-aspartate receptor, or D-cycloserine, a partial agonist, improve the symptoms of schizophrenia. N-methylglycine (sarcosine) is an endogenous antagonist of glycine transporter-1, which potentiates glycine's action on N-methyl-D-aspartate glycine site and can have beneficial effects on schizophrenia. METHODS: Thirty-eight schizophrenic patients were enrolled in a 6-week double-blind, placebo-controlled trial of sarcosine (2 g/d), which was added to their stable antipsychotic regimens. Twenty of them received risperidone. Measures of clinical efficacy and side effects were determined every other week. RESULTS: Patient who received sarcosine treatment revealed significant improvements in their positive, negative, cognitive, and general psychiatric symptoms. Similar therapeutic effects were observed when only risperidone-treated patients were analyzed. Sarcosine was well-tolerated, and no significant side effect was noted. CONCLUSIONS: Sarcosine treatment can benefit schizophrenic patients treated by antipsychotics including risperidone. The significant improvement with the sarcosine further supports the hypothesis of N-methyl-D-aspartate receptor hypofunction in schizophrenia. Glycine transporter-1 is a novel target for the pharmacotherapy to enhance N-methyl-D-aspartate function.     

纳米技术在肿瘤诊断与治疗中的现状与展望

目的介绍21世纪前沿科技--纳米技术在肿瘤诊断与治疗中的现状与展望.方法通过检索国内外文献,从肿瘤的诊断与治疗两方面分别论述.结果纳米技术在肿瘤诊断与治疗中有其巨大优势.结论尚处初级阶段,广泛应用于临床还需多方努力.     

Growth, bone maturation and pubertal development in children with the EMG-syndrome

In 7 patients (5 girls, 2 boys) with the EMG or Wiedemann-Beckwith syndrome, statural growth, bone age (BA), weight and pubertal development were studied longitudinally. Height was above the 90th percentile (%) for chronological age (CA) after age 2 years, reaching an average of 2.5 SD above the mean at or after puberty. Adult or attained height also exceeded significantly (P<0.015) parental (genetic) target height by 13.2 cm on the average. In one girl, adult height prognosis (190 cm) could be reduced to an adult height of 183 cm by high-dose estrogen treatment. In most children, growth velocity remained above the 90th % up to 4–6 years of age and normalized thereafter. In all patients studied, bone age was markedly advanced and particularly so during the first 4 years after birth. Weight was above the 90th–97th % during infancy and early childhood and remained there, appropriate or slightly subnormal for height, until adulthood, except for 3 girls who reached and maintained the 50th % during or after puberty. Spontaneous pubertal development occurred within normal limits for CA and around the 50th % for BA. Except for the marked bone age acceleration, the reason for the increased statural growth and adult height in patients with the EMG syndrome is still unknown.     

复方金荞麦颗粒治疗肺癌1000例临床疗效观察

目的 总结复方金荞麦颗粒治疗肺癌的疗效。方法 对1000例各种类型的肺癌患者采用复方金荞麦颗粒5g，3次·d^-1 口服，同时辅以中药汤剂治疗，3mo为1疗程，病情稳定后逐渐减量维持。结果本组1000例患者经3mo～15a以上治疗，基本治愈181例（18．1％），显效518例（51．8％），有效204例（20．4％），无效97例（9．7％），总有效率为90．3％。结论 复方金荞麦颗粒为抗肿瘤的纯中药制剂，具有明显抑制肿瘤细胞生长、增强免疫功能、提高患者生存质量等功效，尤其是对失去手术治疗机会、不能接受化疗和放疗的肺癌患者具有较好疗效。     

Social and psychological factors associated with adolescents'' self-acceptance of occlusal condition

Studies using plaster models of teeth and photographs simulating the full range of occlusal conditions have found high agreement between measures of adolescent social acceptability of these conditions and perceived need for orthodontic treatment. This study examined the association between adolescents' acceptability of their own occlusal condition, severity of malocclusion, and likelihood of undergoing orthodontic treatment. The factors predicting the acceptability of occlusal condition of 13-yr-olds, as assessed by the SASOC scale, were measurements of acceptability of general physical appearance, and the severity of occlusal condition. Variability in SASOC scores appeared to be independent of gender, socioeconomic status, and ethnicity. Gender, and severity of occlusal condition were important differences between subjects who had received, planned, or were undergoing orthodontic treatment, and those who had not. Neither SASOC scores nor perceived need for treatment accounted for a significant proportion of the variance between these groups. Although adolescents seeking orthodontic treatment had a greater severity of malocclusion than those not, little difference was observed between these groups in acceptance of occlusal condition.