Role of surgical treatments in high-grade or advanced gastroenteropancreatic neuroendocrine neoplasms

Over the last 40 years, the incidence and prevalence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have continued to increase. Compared to other epithelial neoplasms in the same organ, GEP-NENs exhibit indolent biological behavior, resulting in more chances to undergo surgery. However, the role of surgery in high-grade or advanced GEP-NENs is still controversial. Surgery is associated with survival improvement of well-differentiated high-grade GEP-NENs, whereas poorly differentiated GEP-NENs that may benefit from resection require careful selection based on Ki67 and other tissue biomarkers. Additionally, surgery also plays an important role in locally advanced and metastatic disease. For locally advanced GEP-NENs, isolated major vascular involvement is no longer an absolute contraindication. In the setting of metastatic GEP-NENs, radical intended surgery is recommended for patients with low-grade and resectable metastases. For unresectable metastatic disease, a variety of surgical approaches, including cytoreduction of liver metastasis, liver transplantation, and surgery after neoadjuvant treatment, show survival benefits. Primary tumor resection in GEP-NENs with unresectable metastatic disease is associated with symptom control, prolonged survival, and improved sensitivity toward systemic therapies. Although there is no established neoadjuvant or adjuvant strategy, increasing attention has been given to this emerging research area. Some studies have reported that neoadjuvant therapy effectively reduces tumor burden, improves the effectiveness of subsequent surgery, and decreases surgical complications.     

Cardiac Denervation for Arrhythmia Treatment with Transesophageal Ultrasonic Strategy in Canine Models

Stellate ganglion (SG) modification has been investigated for arrhythmia treatment. In this study, transesophageal SG imaging and intervention were explored using a homemade 30F integrated focused ultrasonic catheter in healthy mongrel canines in vivo. Anatomic details of SGs were ultrasonically imaged and evaluated. SG had a heterogeneous echoic structure and characteristic profiles sketched by hyper-echoic outlines in an ultrasonogram. Left SGs in the experimental group were successfully ablated through the esophagus under ultrasonic guidance provided by the catheter itself. Two weeks after the ablation, the QT and QTc of the experimental group decreased compared with those of the sham group and at baseline (both p values < 0.001). Histologic examination revealed that left SGs were destroyed. No major complications were observed. This approach may be further explored as a method for ganglia remodeling evaluation and as a strategy of ganglia modification for arrhythmia and for other diseases.     

高频电磁场对工人行为功能的影响

采用世界卫生组织推荐的神经行为核心测试组合（ＷＨＯ－ＮＣＴＢ），对高频作业工人４１名（平均工龄１３．９ａ（年）及年龄、性别、文化程度与接触组相匹配的对照组工人３９名（平均工龄１３．３ａ）分别进行了行为功能测试。结果表明高频作业工人部分情感状态得分和某些行为功能得分与对照组相比差异有显著性。长期接触高频电磁场可能引起工人情感状态改变，记忆力减退、注意力分散及心理运动稳定度下降。     

腹腔镜下输卵管妊娠保守性手术38例分析

目的探讨腹腔镜下输卵管妊娠保守性手术不同术式的近期效果。方法对输卵管妊娠腹腔镜下行保守性手术38例患者的临床资料进行回顾性分析。结果所有手术均在腔镜下顺利完成,发生持续性妊娠率2%(1/38)。结论输卵管妊娠是腹腔镜手术的最佳适应证,镜下开窗术是标准的保守性手术,对年轻有生育要求者更具临床价值,而伞端挤压术发生持续妊娠的倾向性大,应尽量避免。     

赤灵芝的致突变性试验

使用赤灵芝的水提取液、乙醇（３０％）提取液进行鼠伤寒沙门氏菌回复、小鼠骨髓多染红细胞微核和雄小鼠精子畸变等三种致突变试验。剂量为１０００μｇ．皿＾－１和５０００μｇ／皿＾－１的鼠伤寒沙门氏菌回复试验的结果为阴性。小鼠在服用７５００ｍｇ．ｋｇ＾－１的水提取液或２５００ｍｇ．ｋｇ＾－１的醇提取液时，微核试验和精子畸变试验结果均为阴性。     

托吡酯和丙戊酸钠治疗特发性全面性强直阵挛发作的临床疗效比较

目的:探讨中等剂量托吡酯(商品名:妥泰)200mg对特发性全面性强直阵挛(GTCS)发作的疗效。方法:64例GTCS患者分成三组,妥泰单药治疗21例,妥泰联合丙戊酸钠治疗22例,另外21例采用丙戊酸钠治疗作对照。结果:妥泰单药组及联用药组治疗GTCS有效例数明显高于单用丙戊酸钠组,差异显著(P<0.05);同时单用妥泰组与联用丙戊酸钠组疗效相近(P>0.05)。结论:妥泰治疗GTCS疗效优于丙戊酸钠,且妥泰单一用药与联用丙戊酸钠治疗疗效相近。     

金黄色葡萄球菌D型肠毒素抗血清的制备和致敏血球效果的初步观察

我们制定了制备抗-SED血清的免疫方案,抗原用量6.9mg/兔,注射8针,免疫时间共14周。实验表明,抗-SED血清效价可达1∶128,所制备的抗血清与纯度高(98%)及纯度较低(50%～60%)的SED肠毒素都只产生1条沉淀线,并且融合,同SEA、SEB、SEC_I、SEC_Z均没有交叉反应。硫铵盐析沉淀法提取的抗-SED IgG,用于致敏醛化血球,该抗体诊断致敏血球检出SED灵敏度较高,约1ng/ml。同时用该抗体诊断血球对6种罐头食品人工污染SED肠毒素进行了检验,检出灵敏度为0.78～3.12ng/ml,略低于含纯SED标本,食物成分对反向间接血凝没影响,不出现假阳性和假阴性。效价高或效价低的抗-SED血清都可用于致敏醛化血球。     

Availability of elements in leaded/unleaded automobile exhausts,a leaded paint,a soil,and some mixtures

The availabilities of elements in some dust proximal sources of urban pollution were investigated. The sources were: leaded and unleaded automobile exhaust; leaded dry paint; one soil; and mixtures that included the leaded exhaust as a common component. A miniaturized modified Tessier et al. leaching scheme was developed that showed little redistribution of the most available elements. Mn, Pb, S, and Sb were the most readily available in both the leaded and unleaded exhaust; C and Pb in the paint; and Mn and S in the soil. The available elements for the leaded exhaust predominated in its mixtures with evidence of redistributions for the three-component mixture. The environmental pollution (EP) toxicity procedure with five leachings was shown to be approximately equivalent to adding the water-soluble, exchangeable, carbonate, iron/manganese oxide, and part of the organic fractions. Simulated acid rainwater leached elements up to the iron/manganese oxide fraction. The results have application to storm runoff and acid rain leaching of dusts, aerosols, wastes, and soils.