Endocrine therapy with or without radical prostatectomy for T1b-T3N0M0 prostate cancer

BACKGROUND: We retrospectively compared the 5-year survival rates of T1b-T3N0M0 prostate cancer patients treated either by endocrine therapy plus radical prostatectomy or endocrine therapy alone. METHODS: Clinical T1b-T3N0M0 prostate cancer patients were enrolled at 104 institutions in Japan. They were assigned to study 1 (n = 176), if they were indicated to prostatectomy, if not indicated, they were assigned to study 2 (n = 151). The indication of prostatectomy was based on the clinical judgement of physicians and/or patients. Those assigned to study 1 underwent prostatectomy and adjuvant endocrine therapy with or without preoperative androgen deprivation. Those assigned to study 2 were treated with leuprorelin acetate with or without chlormadinone acetate. They were followed-up every 3 months until death or for 5 years and over. RESULTS: Those assigned to study 1 were younger (mean age 67.2 vs 75.7 years), less advanced in clinical stage, and had lower prostate specific antigen levels (mean 43.8 vs 103.6 ng/mL). Death for any reason was observed less frequently in study 1 (n = 29, 16%) than study 2 (n = 50, 33%), and the 5-year overall survival rate was higher in study 1 (87 vs. 68%). However, prostate cancer deaths were comparatively seldom (9% in study 1 and 7% in study 2), resulting in the identical 5-year cause specific survival rate in both study groups (91%). In both study groups the overall survival was almost equal to the natural survival of age-matched men. CONCLUSIONS: Endocrine therapy offers a reasonable survival rate in T1b-T3 prostate cancer patients within a 5-year follow-up. Observation will be extended to determine 10-year outcomes.     

头面颈部毛细血管畸形的手术治疗

目的 探讨手术治疗头面部不同类型毛细血管畸形的适应证,手术方法及疗效.方法 对适合手术的23例头面颈部患者,根据病灶的面积和手术前的条件分别采用了植皮,扩张器局部皮瓣转移修复和游离皮瓣修复等方法,并进行术后评价和随访.结果 除一例特别原因造成皮片下积血,皮片部分成活不良二期再植,一例同位素治疗后扩张器病例远端发生血运障碍后改植皮以外,其余皮片,皮瓣均成活良好,但随访皮片有较明显的色差,而皮瓣色泽,质地良好.结论 皮瓣修复效果较好,其中扩张的局部皮瓣转移修复效果最佳.游离皮瓣较适合有皮下组织萎缩的大面积的病例,而其他大面积病灶可采用分期分区植皮.     

Minilaparotomy for type II and III radical hysterectomy: technique, feasibility, and complications

The objective was to assess the feasibility, the operative and postoperative outcome, and complications in the use of minilaparotomy for type II and III radical hysterectomy (RH) and pelvic lymphadenectomy (PLN) in early-stage cervical/endometrial cancer. A pilot study on 91 consecutive patients submitted to type II and III RH and PLN for early-stage cervical/endometrial cancer was performed between March 2002 and May 2003 in the Division of Gynecologic Oncology (UCSC, Rome). Thirty-two of 91 cases (35.2%) were eligible for minilaparotomy. The mean operative time was 156.7 min, whereas the mean intraoperative estimate of blood loss was 303.7 ml. A mean number of 32.7 pelvic lymph nodes and 6.2 common iliac nodes were removed. Ileus and removal of bladder catheter were on mean postoperative day 2.4 and 3.4, respectively. The mean number of postoperative days spent in the hospital was 3.7. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy and Pfannenstiel incision, showing substantially comparable results. Minilaparotomy is acceptable for selected patients undergoing radical abdominal hysterectomy (RAH) and PLN and does not compromise the adequacy of the procedure. It can be considered as an alternative to the classic midline vertical incision or even to the Pfannenstiel incisions and laparoscopy.     

猪喉软骨硫酸软骨素的制备和自由基清除活性

直接用木瓜蛋白酶水解软骨,三氯醋酸除蛋白质,乙醇沉淀干燥得硫酸软骨素粗多糖,经DEAE-Sepharose fast flow离子交换层析分离纯化,高效凝胶渗透色谱和琼脂糖凝胶电泳测定其相对分子质量和纯度,比较硫酸软骨素粗品和纯品的体外自由基清除活性。结果显示硫酸软骨素粗品和纯品提取率分别为31.56±0.46%和19.79±0.78%,后者相对相对分子质量为75 174,粗品的DPPH.和.OH清除活性最强,随着产品纯度的提高,活性降低,而对于O2-.清除活性结果则相反。     

NO-1886对高糖高脂饲料喂养新西兰兔糖代谢的影响

合成药NO-1886是脂蛋白脂肪酶(LPL)的激动剂，能降低血浆甘油三酯(TG)并升高高密度脂蛋白胆固醇(HDL-c)水平。我们曾发现NO-1886还具有降低血糖的作用。本研究主要观察NO-1886对糖尿病兔胰岛素抵抗及β-细胞功能方面的影响。用高糖高脂饲料诱导，使新西兰兔血浆葡萄糖升高，发生胰岛素抵抗。在高糖高脂饲料中添加1％NO-1886进行治疗。结果：发现NO-1886可抑制血清葡萄糖升高，经糖耐量和胰岛素敏感性试验检测，NO-1886可保护胰岛素的急性相分泌，增强胰岛素对葡萄糖的清除能力。研究结果提示NO-1886具有改善胰岛素抵抗、降低血糖的作用。     

二乙基二硫代氨基甲酸钠对沙土鼠脑缺血再灌注损伤的影响

沙土鼠脑缺血60min后,脑组织氧自由基和MDA含量无明显升高,而Mn-SOD的活性下降。缺血60min再灌注5min时,氧自由基显著升高。再灌注30min时,MDA的生成显著增多,Mn-SOD和Cu,Zn-SOD活性显著降低。缺血前15 min,iv DTC对缺血再灌注脑组织中氧自由基和MDA升高有显著抑制作用,对Mn-SOD活性有显著保护作用,且呈剂量依赖关系。     

固相板酶免法测定人血清游离三碘甲状腺原氨酸

目的 :探讨游离三碘甲状腺原氨酸 (FT3)的酶免疫测定法对于诊断甲状腺功能亢进和监测甲状腺激素补充治疗效果及预后情况的重要意义。方法 :采用聚苯乙烯96孔板作为固相载体 ,利用亲和纯化的兔抗T3 抗体和T3 - β-半乳糖苷酶标记物 ,建立了固相板竞争法。结果 :可测范围为0.48～45.0ng/L ,灵敏度0.13ng/L ,平均批内变异系数为 (n=20)6.4 % ,平均批间变异系数为 (n=8)12.4% ,正常参考范围4.14±0.97ng/L。正常人与甲亢病人能明显分开。结论 :酶免法测定血清FT3,其灵敏度、精密度均达到放免水平 ,且可避免同位素污染     

Recurrent venous thrombosis following free flap surgery: The role of heparin-induced thrombocytopenia

Complications following free tissue transfer have been well established in the literature. Common and rare causes of free flap failure must be addressed by the treating surgeon when microvascular patency is threatened. With the evolution and prevalence of microsurgery, ‘rare’ causes of free flap failure will become increasingly frequent. A high index of suspicion must be established in patients with multiple failed operative interventions. A case of recurrent free flap failure secondary to heparin-induced thrombocytopenia is presented in a patient with a history of squamous cell carcinoma of the floor of the mouth, and a long-standing history of alcohol and tobacco consumption.     

大气颗粒物健康效应生物学机制研究进展

大量流行病学研究发现，大气颗粒物的污染水平与心肺系统疾病的超额发病、死亡存在密切关联，但其毒理学机制尚未阐明。本文对近年来大气颗粒物毒理学研究进行综述，包括大气颗粒物对呼吸系统、心血管系统及神经系统的毒性作用，并对氧化应激损伤、细胞钙稳态失衡及激活关键转录因子等分子毒理学机制进行了初步的阐述。     

卡托普利对.OH所致异常血流动力学的保护作用

．ＯＨ生成液０．０５ｍｌ．１００ｇ＾－１经胶静脉注入心脏，可使麻醉大鼠的左心室收缩压力、左心室压力与心率乘积、左心室压力上升最大速率和左心室压力下降最大速率明显下降。