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.     

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。     

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.     

Strength and fracture toughness of MgO-modified glass infiltrated alumina for CAD/CAM.

OBJECTIVE: This study was conducted to investigate the effect of MgO additive to Al2O3 on the flexural strength, fracture toughness of glass infiltrated alumina for CAD/CAM application. METHODS: Alumina blanks with additive of 0.5 wt% MgO were prepared via isostatic pressing and sintering at 1400 degrees C for 2h, and then alumina-glass composites were fabricated by infiltrating the molten glass into the partially sintered alumina compact. Flexural strength and fracture toughness were determined using three point bending methods and a single edge notched beam method. The mechanism of crack propagation was observed under a field emission scanning electron microscope. RESULTS: The three-point flexural strength and fracture toughness of partially sintered alumina and alumina-glass composite were 210 MPa, 1.86 MPam(1/2), and 432.2 MPa, 5.12 MPam(1/2), respectively, and they were free of shrinkage during the processing of glass infiltration. The field emission SEM micrograph indicated that indentation caused a non-planar crack propagation including crack deflection and crack bowing. SIGNIFICANCE: MgO was used as an additive to alumina to improve the strength and fracture toughness of partially sintered alumina and alumina-glass composite. The high strength and toughness are related to toughening by the distribution of alumina with uniform particle sizes, crack bowing, crack deflection and the beneficial wetting properties of the particle surface.     

腹股沟疝不同手术方式修补的比较

目的探讨腹股沟疝不同修补手术方法的优缺点.方法75例腹股沟疝行腹腔镜疝修补术,96例腹股沟疝行Bassini疝修补术,记录手术时间、术后下床活动时间、住院时间及各种并发症并进行比较.结果腹腔镜组手术全部成功完成,8例病人同时行阑尾切除术、4例病人同时行胆囊切除术.腹腔镜组手术时间、术后下床活动时间、住院时间较Bassini组少(P＜0.05).Bassini组术后并发症较腹腔镜组多,(χ 2=14.3339,P＜0.01).腹腔镜组1例(1.33%)复发,Bassini组4例(4.25%)复发,差异无显著性(P＞0.05).结论腹腔镜疝修补术是一种安全而有效的无张力疝修补手术,较Bassini组手术后恢复时间短,术后并发症少.     

益气化瘀法治疗糖尿病皮肤溃疡38例临床观察

糖尿病皮肤溃疡是外科常见病、多发病，因其反复发作，长期不愈，形成顽固性难愈性溃疡，愈后又极易复发，少数尚有癌变可能，所以严重影响了患者的身心健康及生命质量。西医多集中在控制血糖、抗感染、外用生长因子、外科清创术及植皮术等治疗措施上，虽然有一定的疗效，但是却缺乏安全有效加速创面愈合的积极措施。我们采用益气化瘀法为主治疗糖尿病溃疡，可以明显促进与加速创面愈合，减少疤痕形成，提高愈合质量。1993年10月～2002年12月共收治38例糖尿病皮肤溃疡患者，取得了较好的疗效。现报道如下。     

全肝MR灌注成像早期监测肝VX2肿瘤经皮酒精注射疗效的实验研究

目的研究全肝MR灌注成像（MRPI）早期监视兔肝VX2瘤经皮酒精注射（PEI）疗效的价值。方法新西兰大白兔10只，经开腹手术于肝内注射VX2肿瘤细胞悬液0．1ml，分别在种瘤后第2、3周进行MRT。WI、T2WI检查监视肿瘤生长情况。在种瘤后第3周时，于CT引导下，于肿瘤一侧的早期强化最明显处注射无水乙醇1.0ml，治疗1周后应用MRPI观察治疗效果。灌注参数包括：对比剂到达时间（T0）和最大上升斜率（ss），应用t检验比较治疗区与肿瘤未治疗区的灌注参数。结果10只兔肿瘤均种植成功，第3周时肿瘤直径（2．6±0．6）cm。治疗过程中3只兔死亡，PEI治疗1周后的治疗区呈无或低度强化。肿瘤未治区与治疗区的11D分别为（16．0±1．2）、（50，8±5．9）S，ss分别为38．9±2．2、6．0±1．2，差异均有统计学意义（t值分别为15．8、-39．6，P值均〈0．05）。常规T1 WI、T2 WI无法清晰显示治疗区与未治疗区的差异。结论全肝MRPI可以较敏感的早期监测PEI疗效，早期强化的消失可作为PEI治疗有效的标志。     

p21-ras、p53和VEGF在甲状腺乳头状癌中的表达及意义

目的　研究原癌基因Ras、抑癌基因p5 3及血管内皮生长因子 (VEGF)在甲状腺乳头状癌中的表达及相关性。方法　应用免疫组织化学S P法对 4 0例甲状腺乳头状癌中p2 1 ras、p5 3及VEGF的表达进行研究。结果　甲状腺乳头状癌中存在p2 1 ras、p5 3及VEGF的过度表达 ;VEGF的表达与p2 1 ras、p5 3的表达显著相关 (P <0 .0 5 ) ;VEGF的表达与甲状腺乳头状癌淋巴结转移显著相关 (P <0 .0 5 )。结论　p2 1 ras、p5 3、VEGF在甲状腺乳头状癌的发生发展过程中起重要作用 ;VEGF的表达与p2 1 ras、p5 3表达显著相关 ,可能受其调控。