Clinical Analysis of 57 Patients with Ovarian Dysgerminoma

Objective  Ovarian dysgerminoma is an uncommon ovarian malignancy, Its clinicai features are special and there are many factors affecting its prognosis. If treated properly, the patient can be cured. Otherwise it may endanger the patient’s life. The aim of this study is to investigate the clinical features and factors related to prognosis of ovarian dysgerminoma. Methods  Data from 57 patients with pure ovarian dysgerminoma were analyzed retrospectively. The patients were admitted to the Cancer Center, Sun Yat-sen University from January 1.1964 to December 31, 2000. Results  The main clinical features were abdominal mass (56.1% ), abdominal pain (21.1% ), abdominal swelling (17.5%.), vaginal bleeding (5.3% )and genital tract abnormalities (5.3%). Twenty-six patients had stage I diseases, 8 stage II.9 stage III.1 stage IV and 13 recurrent and persistent diseases. The uterus was involved in 41.2% of patients with stage II -III diseases. Combined modality was given to 52 cases and a single-method treatment to 5 cases. The total overall 5 and 10-year survival rates for stages I-IV was 80.1 % and 70.0% respectively. The 5-year survival rate for stage I was 100%, stage II 55.2%. stage III 55.6% and stage IV 0%; for recurrent and persistent diseases, 72.7%. The stage I group of 12 patients. received adnexectomy and 14 patients underwent hysterectomy and adnexa removal. There was no significant difference between the 5 and 10-year survival rates (all 100%). Of the 23 patients in the stage I group to whom oniy chemotherapy was given after operation, 19 cases received 3 or more courses and were well without recurrence; 4 patients received only one course and one of them recurred 21 months after the operation. In the group of stages II and III cases, the 5-year survival rate was 86.7% for those whose chemotherapy courses were 3≥ 4 and 25.0% for patients who received less than 4 courses of chemotherapy (P<0.05). Conclusions  The prognosis of ovarian dysgerminoma is closely related to the disease stage and treatment modality. A fertility-preserving operation can be considered in early -staged patients, but caution needs to be exercised in the middle to late staged cases. Good results can be achieved with an operation-based combined modality in recurrent patients.     

灯盏花素对豚鼠单一心室肌细胞ICa的抑制作用

目的：观察灯盏花素对豚鼠单一心室肌细胞钙离子电流（ＩＣａ）的影响。方法：应用全细胞膜片钳制技术。结果：灯盏花素能明显抑制心室肌细胞的Ｃａ＾２＋通道,使ＩＣａ减小。此作用有明显的电压依赖性。在峰电流电压下作用最明显,而对其反转电位无明显影响。在指令电位０ｍＶ时,０．５ｍｇ％灯盏花素使ＩＣａ减小５．４％,１ｍｇ％灯盏花素使ＩＣａ减小２２．９％（Ｐ〈０．０１）,２ｍｇ％灯盏花素使ＩＣａ减小４５．０％（Ｐ     

腺苷三磷酸结合盒转运蛋白A1在动脉粥样硬化中的作用及其受控特点

目的:分析腺苷三磷酸结合盒转运蛋白A1(ATP binding cassette transport proteion A1,ABCA1)在动脉粥样硬化中的作用及其受控机制。资料来源:以“腺苷三磷酸结合盒转运蛋白A1”为检索词,应用计算机在Pubmed、中文全文数据库CNKI中检索2000-01/2006-11腺苷三磷酸结合盒转运蛋白A1与人有关的期刊文献,前者限定语言种类为英文,后者限定语言种类为中文。资料选择:对英文文献390篇、中文文献58篇初审。纳入标准:①与ABCA1结构及功能有关的文献。②与核受体有关的文献。③与载脂蛋白AⅠ有关的文献。④与ABCA1基因的突变、单核苷酸多态性有关的文献。⑤ABCA1蛋白、核受体、ABCA1基因的突变、单核苷酸多态性与动脉粥样硬化有关的文献。排出标准:①与哮喘、癌症、代谢性疾病有关的文献。②相关文献中内容相似的文献。③综述文献。资料提炼:选取3篇涉及ABCA1结构、功能的基础内容;18篇涉及与核受体的内容;2篇涉及载脂蛋白AⅠ的内容;7篇涉及ABCA1基因的突变、单核苷酸多态性的内容;9篇涉及ABCA1蛋白、核受体、ABCA1基因的突变、单核苷酸与动脉粥样硬化的内容。其中30篇列为参考文献。资料综合:分析了腺苷三磷酸结合盒转运体A1的结构和功能的基本情况;文献显示腺苷三磷酸结合盒转运体A1在动脉粥样硬化发病过程中起重要作用;核受体对腺苷三磷酸结合盒转运体A1的表达有调节,且腺苷三磷酸结合盒转运体A1受基因调控。结论:腺苷三磷酸结合盒转运体A1可能是与动脉粥样硬化密切相关的重要候选基因;深入探讨其机制,有利于开发新药防治动脉粥样硬化。     

Impact of Myocardial Acceleration during Isovolumic Contraction in Evaluating Subclinical Right Ventricular Systolic Dysfunction in Type 2 Diabetes Mellitus Patients

Aim: In diabetes mellitus (DM) patients, left ventricular dysfunction is widely evaluated and established by conventional diagnostic methods, whereas right ventricular (RV) function is not as sufficiently evaluated. The aim of this study is to assess the preclinical effects of DM on RV function by using novel Tissue Doppler Imaging (TDI)‐derived indices. Methods: The study included 96 patients with type II DM [60 with DM only and 36 patients with coexisting DM and hypertension (DMHT)] and 40 healthy controls. Conventional parameters and TDI‐derived systolic velocities of tricuspid annulus [isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), RV Tei index] were measured. Results: TDI‐derived RV IVA was significantly lower in both DM and DMHT patients compared to controls indicating subclinical impairment in RV systolic function in the study patients (P = 0,0001). However RV IVA was similar in DM and DMHT subgroup supporting RV systolic impairment in DM was independent from HT. In correlation analysis, RV IVA was significantly correlated with the existence of diabetic nephropathy (r =?0,38; P = 0,003), retinopathy (r =?0,35; P = 0,006), insulin resistance (r =?0,52; P = 0,0001). Conclusions: Diabetes is associated with subclinical RV systolic dysfunction, regardless of coexisting hypertension. Tissue Doppler‐derived IVA; is a novel, non‐invasive parameter which may be used in early detection of RV systolic dysfunction in patients with DM. (Echocardiography 2010;27:1211‐1218)     

Urothelial cancer of bladder in young versus older adults: Clinical and pathological characteristics and outcomes

Bladder urothelial carcinoma is rare in young adults and occurs more commonly in older individuals. The aim of this study was to compare the clinical behavior, pathologic characteristics, and prognosis of urothelial carcinoma of urinary bladder in young versus older adults. A retrospective review of our records between 2007 and 2013 identified 56 patients (42 males and 14 females) with transitional cell carcinoma of the bladder who were less than 40 years old. Clinical and pathological parameters of patients who were less than 40 years of age were compared with those of a series of patients older than 40 years of age (the control group) during the same period. A survival analysis was performed using the Kaplan–Meier method and log-rank test, and Cox regression was performed to identify clinical parameters that affected the clinical outcomes. The mean age was 29.21 years (range, 5–40 years) for patients less than 40 years old and 61.66 years (range, 41–75) for those older than 40 years. The mean follow-up was 40.26 months (range, 12–65 months) for young patients and 42.57 months (range, 12–72 months) for the older patients. Young bladder cancer patients had smaller-sized tumors (less than 3 cm), less high-grade cancers, higher papillary urothelial neoplasms of low malignant potential, and low-grade tumors than patients older than 40 years. Multivariate logistic regression analysis predicted tumor recurrence in young patients with high-grade tumors [odds ratio (OR), 1.959; 95% confidence interval (CI), 1.235–2.965; p = 0.046] and tumors larger than 3 cm (OR, 1.772; 95% CI, 1.416–1.942; p = 0.032). The 5-year overall survival rate was 100% for young patients and 88.1% for older patients. No difference was observed in the recurrence-free (p = 0.321) and progression-free (p = 0.422) survival rates between the two groups. We concluded that although the clinical stage distribution, natural history, and outcomes of bladder urothelial cancer in young adults are similar to those in their older counterparts, clinicians must be aware that patients under 40 years of age presented with higher-grade and larger (>3 cm) tumors and are more likely to experience tumor recurrence.     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.