Prospective randomized trial of surgery combined with preoperative and postoperative radiotherapy for rectal carcinoma

Objective To assess the effect of surgery combined with preoperative and postoperative radiotherapy ("sandwich" treatment) in rectal carcinoma. Methods From October 1990 to January 2002, 260 patients with stage Ⅱ (117 patients) and stage Ⅲ (143 patients) rectal carcinoma were randomly divided into three groups: "sandwich" group (92 patients, group A), postoperative radiotherapy group (98 patients, Group B) and operation group (70 patients, Group C). The preoperative accelerated hyperfractionation (15 Gy/6f/3d) was given for "sandwich" group which was followed by conventional postoperative fractionation (DT 35 - 40 Gy/3.5 - 4 weeks). Patients in Group B were given postoperative radiotherapy (Dr 50 Gy/5 weeks). Patients treated with surgery alone served as control. Results The local recurrence rates of Group A, B and C were 5.4% (5/92), 16.3% (16/98) and 64.3% (45/70), respectively (X2 =5.726, P=0.017); and the distant metastasis rates were 6.5% (6/92), 28. 6%(28/98) and 31.4%(22/70), respectively (X2 =15. 703, P= 0. 001). The 3-ycar survival rate was 86. 9%(80/92), 62.2%(61/98) and 51.4%(36/70), respectively (X2 =15. 141, P=0. 001). The 5-year survival rate was 68. 5%(63/92), 54.1%(54/98)and 41.4%(29/70), respectively (X2 =4. 218, P=0.04). The Ⅰ and Ⅱ grades of radiation entero-colitis in Group A and Group B were 7.6% (7/92) and 6.1% (6/98), respectively (X2 = 0. 164, P= 0. 685). Conclusion Surgery combined with preoperative and postoperative radiotherapy can improve the survival rate and reduce the local recurrence rate in rectal carcinoma patients with stage Duke's B (Ⅱ) and C (Ⅲ).     

THE EFFECT OF INTERNAL AND EXTERNAL CAROTID ARTERIAL INFUSION CHEMOTHERAPY ON 41 ADVANCED HEAD AND N

ＴＨＥＥＦＦＥＣＴＯＦＩＮＴＥＲＮＡＬＡＮＤＥＸＴＥＲＮＡＬＣＡＲＯＴＩＤＡＲＴＥＲＩＡＬＩＮＦＵＳＩＯＮＣＨＥＭＯＴＨＥＲＡＰＹＯＮ４１ＡＤＶＡＮＣＥＤＨＥＡＤＡＮＤＮＥＣＫＣＡＮＣＥＲ　ＰＡＴＩＥＮＴＳＬｉＳｈｕｙｅ；ＸｕＲｏｎｇ；ＸｉｅＷｅｎｋ...     

THE CHANGES OF PERIPHERAL BLOOD T LYMPHOCYTE SUBSETS IN PATIENTS WITH PRIMARY HEPATIC CARCINOMA BOTH PRE-TACE AND POST-TACE

Ｔｈｅｂｏｄｙ’ｓａｎｔｉ ｔｕｍｏｒｉｍｍｕｎｏｒｅａｃｔｉｏｎｉｓｍａ ｉｎｌｙｔｈｅｃｅｌｌｕｌａｒｉｍｍｕｎｉｔｙ .Ｔｌｙｍｐｈｏｃｙｔｅｓｕｂｓｅｔｉｓｔｉｇｈｔｌｙｒｅｌａｔｅｄｔｏｉｔ .Ｒｅｃｅｎｔｓｔｕｄｉｅｓｈａｖｅｄｅｍｏｎｓｔｒａｔ ｅｄｔｈａｔｍａｎｙｋｉｎｄｓｏｆｍａｌｉｇｎａｎｔｔｕｍｏｒｐａｔｉｅｎｔｓｈａｖｅｔｈｅａｂｎｏｒｍａｌｃｏｎｄｉｔｉｏｎｏｆＴｌｙｍｐｈｏｃｙｔｅｓｕｂｓｅｔａｎｄｌｏｐｓｉｄｅｄｄｅｖｅｌｏｐｍｅｎｔ.Ｗｅｈａｖｅｏｂｓｅｒｖｅｄ 4 5 ｐａ …     

人心房间隔的动脉及其吻合

使用90例人心脏标本,研究人心房间隔的动脉来源及分布特点。房间隔的动脉有窦房结动脉的分支(100%)、房室结动脉(100%)、kugel动脉(93.33%)、左房后支(76.67%)等。房间隔的动脉沿房间隔边缘成环状吻合,然后各分支向卵圆窝中心会聚。房间隔的动脉吻合丰富,30.67%的标本出现吻合。因此成为冠状动脉之间建立侧支循环的重要途径之一,具有重要的临床意义。     

倍他乐克联合安体舒通治疗肥厚型心肌病心力衰竭的疗效观察

目的 观察倍他乐克联合安体舒通治疗肥厚型心肌病并心力衰竭的临床疗效。方法 将60例肥厚型心肌病并心力衰竭患者随机分为倍他乐克组(A组,n=30),给予倍他乐克6.25mg,2次/d,无不良反应,每周用量加倍,直至50mg,2次/d。倍他乐克联合安体舒通组(B组,n=30),倍他乐克量用及方法同A组,加用安体舒通10mg,3次/d,一周后无不良反应,加量为20mg,3次/d,两组疗程均为6个月。治疗前后观察临床疗效、心率、血压、左室射血分数(LVEF)的变化。结果 A组临床 显效23..3%、有效66..7%、无效10..0%;B组临床 显效33..3%、有效63..4%、无效3..3%。心功能指标EF、心率两组治疗后与治疗前相比,均明显改善(P＜0..05),治疗后B组优于A组(P＜0..05)。结论 倍他乐克联合安体舒通治疗肥厚型心肌病心力衰竭疗效优于单用倍他乐克。     

The expressions and significance of MMP-2 and TIMP-2 in human pancreatic carcinoma

Objective To study the expressions of MMP-2 and TIMP-2 in pancreatic carcinoma and their relationship with tumor invasion, local metastasis and prognosis of the carcinoma. Methods The expressions of MMP-2 and TIMP-2 were examined in 32 patients with pancreatic carcinomas by S-P immunohistochemical technique and the correlation with pathological tumor parameters were analyzed. Survival analysis was made by using the Kaplan-Meier method. Results The positive rates of MMP-2, TIMP-2 in 32 patients with pancreatic carcinoma were 56.25% and 75.00%, which were significantly higher than those of the controls（P〈0.05）. Expressions of MMP-2 and TIMP-2 were independent of sex, age, histological grading and type, but well correlated with the lymph node metastasis and TNM clinical staging （Ⅰ and Ⅲ, Ⅱ and Ⅲ ）. There was a significant association between MMP-2, TIMP-2 and prognosis in pancreatic carcinoma. Conclusion MMP-2 and TIMP-2 might be useful markers for biological aggressiveness of this malignancy and might contribute to the invasive properties of pancreatic carcinoma, which can be used to evaluate the prognosis of patients.     

TREATMENT OF CANINE ACUTE LIVER FAILURE WITH MODIFIED EXTRACORPOREAL PIGLIVER PERFUSION

Acuteliverfailure(ALF)isaseveresymptomcausedbykindsofreasons ,suchaschemicalandvirologicalones.Becauseofthelife threatingcom plicationsofacuteliverfailure ,75 %of patientswilldiewithinafewdaysofonset.TherewasnosatisfactorytreatmentforALFexceptlivertrans plantation .Althoughlivertransplantationissuccess ful,withasurvivalraterangingfrom 6 0 %to80 % [1] .Thereisashortageofavailabledonoror gans.Onlyalittleamountofpatientsreceivedlivertransplantation[2 ] .Sothereisagreatneedforanef fectiveliver…     

保尔佳治疗晚期恶性肿瘤的临床观察

将76例晚期恶性肿瘤患者随机等分为2组：单纯化疗组及化疗加用保尔佳治疗组，以观察保尔佳的临床作用。结果：保尔佳治疗组有效率42．1％，体力状况改善老39．5％，外周血白细胞数正常者73．7％，均显著高于化疗组（分别为21．1％、15.7％和44．7％；P＜0．05、P＜0．025和P＜0．025）；毒副反应两组无显著性差异。提示保尔佳与化疗药物联合应用治疗晚期恶性肿瘤优于单纯化疗，并能改善患者的体力状况，减轻化疗所致的外周血白细胞数下降。     

EXPRESSION OF HEAT SHOCK PROTEIN 90α IN HEPATOCELLULAR CARCINOMA AND ITS SIGNIFICANCE

Ｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ(ＨＣＣ)ｉｓｏｎｅｏｆｔｈｅｍｏｓｔｃｏｍｍｏｎｍａｌｉｇｎａｎｔｔｕｍｏｒｓｉｎＣｈｉｎａ ,ａｎｄｇｒｅａｔａｔｔｅｎｔｉｏｎｈａｓｂｅｅｎｐａｉｄｔｏｉｔｓｃａｒｃｉｎｏｇｅｎｅｓｉｓｒｅｓｅａｒｃｈ .Ｉｎｒｅｃｅｎｔｙｅａｒｓ ,ｉｔｈａｓｂｅｅｎｆｏｕｎｄｔｈａｔｈｅａｔｓｈｏｃｋｐｒｏｔｅｉｎ(ＨＳＰ) ｐｌａｙｓａｇｒｅａｔｒｏｌｅｉｎｔｈｅｏｃｃｕｒｒｅｎｃｅａｎｄｄｅｖｅｌｏｐｍｅｎｔｏｆｃａｒｃｉｎｏｍａ .Ｔｈｅｐｕｒｐｏｓｅｏｆｔｈｉ…     

五种血清肿瘤标志物单个或联合检测在肺癌诊断中作用的初步评价

目的初步评价细胞角蛋白19的片段(Cyfra21-1)等5种肿瘤标志物单个或联合检测在肺癌诊断,尤其是早期诊断中的作用。方法采用电化学发光免疫法检测了124例肺癌和41例非肿瘤肺病患者血清中Cyfra21-1、癌胚抗原(CEA)、神经元烯醇化酶(NSE)、糖链抗原19-9(CA19-9)及鳞状细胞抗原(SCCAg)等五种标志物的水平。结果CEA特异性最高,达97.56%,Cyfra21-1最低,为73.17%;CEA、Cyfra21-1及NSE的敏感性分别在腺癌、鳞癌、小细胞肺癌中最高(分别为68.29%、62.30%、66.47%);Cyfra21-1、NSE在早期和晚期肺癌中的敏感性无显著性差异(P>0.05)。联合检测Cyfra21-1+CEA诊断肺癌的特异性和敏感性分别为70.73%和66.13%;同时检测3或4个标志物可提高诊断的敏感性,但特异性却明显降低;Cyfra21-1+CEA、Cyfra21-1+CA19-9诊断早期和晚期肺癌的敏感性无显著性差异(P>0.05)。结论作为肺癌筛查指标,上述标志物均不理想;CEA>10μg/L对肺癌,尤其是腺癌的定性诊断有较大价值;Cyfra21-1和NSE分别是鳞癌和小细胞肺癌较好的标志物,两者在肺癌早期诊断中均可能有一定价值。Cyfra21-1+CEA可能是诊断肺癌(包括早期)的一个较佳组合。     

CLINICAL COMPARISION OF THE TREATMENT OF CERVICAL PROLAPSE OF INTERVERTEBRAL DISC BY USING CAGE OR TITANIUM PLATE

In the past,cervical prolapse of intervertebraldisc,a more common cervical vertebral disease,wasoftentreated withremoval of nucleus pulposus com-bined with autogenous iliac crest graft(AICG)andtitaniumplate.In recent years,cage becomes moreand more popular and is accepted gradually.Goodclinical effects have been achieved in the treat mentof cervical prolapse of intervertebral disc by usingSolis cage.However,at present few reports havebeen available to describe the clinical effects of trea-ti…     

Vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer

Objective Systemic chemotherapy for metastatic pancreatic cancer is still a difficult problem in clinical practice. The standard chemotherapy of pancreatic cancer has been gemcitabine, but the response rate is low. Therefore, it is in urgent need to explore an effective clinical therapy for this cancer. This paper, a case report, is aimed at discussing the effectiveness of vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer. Methods A 52-year-old female patient was diagnosed with pancreas cancer with liver metastasis at the time of the first visit to our hospital. Systemic chemotherapy with vinorelbine and cisplatin combined with endostatin was conducted. Results Liver metastases almost disappeared after the first cycle of chemotherapy. The primary tumor decreased by one third in size after four cycles and disappeared after the sixth cycle according to the CT scan evaluation. Conclusion Vinorelbine and cisplatin combined with endostatin can be a promising regimen for metastatic pancreatic cancer.     

THE ROLE OF MUSCLE SPINDLE IN MUSCLE ATROPHY INDUCED BY SIMULATED MICROGRAVITY

Musclesizeisdeterminedbythebalancebe tweentheratesofproteinsynthesisanddegradation .Acceleratedproteindegradationisanimportantfac torcontributingtothelossofmuscleweightinvari ousphysiologicalandpathologicalconditions .Antigravityslow twitchmusclessuchastheso leusarepreferentiallyatrophiedduringmicrogravityexperiments.Studiesbothinvivoandinvitrohaveprovidedstrongevidencethatincreased proteinbreakdownismainlyresponsibleforthesoleusmus clewastingofnon weighting bearinganimals[1] ,al thoughthereis…     

EXPLORE ON DIAGNOSTIC AND PROGNOSTIC VALUES OF EXTRAHEPATIC CHOLANGIOCARCINOMA： UTILITY OF SERUM CA19-9 AND SERUM CEA

Extrahepaticcholangiocarcinoma (EHCC)isamalignanttumorarisingfrombileductepithelium .Unlikemosthumancancers ,atissuediagnosisofcholangiocarcinomaisoftenextremelydifficultbe causeoftumorlocation ,size ,anddesmoplasticcharacteristics .Percutaneousfineneedleaspirationisfrequentlynotpossiblebecausemanyofthesetu morsarelocatedintheliverhilumamidlargevascu larstructure .Furthermore ,tumormassesareoftennotevenidentifiablebyCT ,ultrasound ,ormag neticresonanceimaging .Endoscopicapproachesarealsoofl…     

EXPERIMENTAL STUDY ON SPINAL CORD INJURY TREATED WITH THE COMBINATION OF FETAL SPINAL CORD TRANSPLANTATION AND METHYLPREDNISOLONE

ＴｈｅｔｈｅｒａｐｙｏｆＬａｒｇｅＤｏｓａｇｅｏｆＭｅｔｈｙｌｐｒｅｄｉｎ ｓｏｌｏｎｅ(ＭＰ)ｆｏｒＳＣＩｈａｓｄｅｖｅｌｏｐｅｄｃｌｉｎｉｃａｌｌｙｂｅｃａｕｓｅｉｔｃａｎｇｒｅａｔｌｙｉｍｐｏｖｅｔｈｅｎｅｒｖｅｆｕｎｃｔｉｏｎ .Ｉｎｔｈｅｍｅａｎ ｔｉｍｅ,ａｎｉｍａｌｔｅｓｔｓｈａｖｅａｌｒｅａｄｙｆｏｕｎｄｔｈａｔｉｆｆｅｔａｌｓｐｉｎａｌｃｏｒｄｉｓｔｒａｎｓｐｌａｎｔｅｄｔｏｔｈｅｉｎｊｕｒｅｄｓｐｉｎａｌｃｏｒｄａｒｅａ ,ｉｔｃａｎｓｔｉｍｕｌａｔｅｔｈｅａｘｏｎｓｏｆｔｈｅｈｏｓ…     

EFFECTS OF DESENSITIZATION AND REBOUND TO ADENOSINE ON ACTION POTENTIAL AND CONTRACTILITY IN ATRIAL CELLS IN GUINEA-PIGS

Ａｄｅｎｏｓｉｎｅ (Ａｄｏ)ｉｓａｎｅｎｄｏｇｅｎｏｕｓｐｕｒｉｎｅｎｕ ｃｌｅｏｓｉｄｅｔｈａｔｒｅｇｕｌａｔｅｓｍａｎｙｐｈｙｓｉｏｌｏｇｉｃａｌａｎｄｐａｔｈｏ ｐｈｙｓｉｏｌｏｇｉｃａｌｐｒｏｃｅｓｓｅｓｉｎｂｏｄｙ .Ｔｈｅｅｆｆｅｃｔｓｏｎｃａｒｄ ｉｏｖａｓｃｕｌａｒｓｙｓｔｅｍａｒｅｅｓｐｅｃｉａｌｌｙｏｂｖｉｏｕｓ .Ｐｅｏｐｌｅｆｏｕｎｄｔｈａｔａｃｅｔｙｌｃｈｏｌｉｎｅ (ＡＣｈ)ａｎｄａｄｅｎｏｓｉｎｅｈａｄｔｈｅｎｅｇａｔｉｖｅｉｎｏｔｒｏｐｉｃ ,ｎｅｇａｔｉｖｅｃｈｒｏｎｏｔｒ…     

β-IRRADIATION WITH A LIQUID~(188)Re-FILLED BALLOON PREVENTS NEOINTIMAL PROLIFERATION IN THE CAROTID OF RABBIT

Ｐｅｒｃｕｔａｎｅｏｕｓｔｒａｎｓｌｕｍｉｎａｌｃｏｒｏｎａｒｙａｎｇｉｏｐｌａｓｔｙ(ＰＴＣＡ )ｉｓｏｎｅｏｆｔｈｅｍｏｓｔｃｕｒｒｅｎｔｔｈｅｒａｐｉｅｓｆｏｒｃｏｒｏｎａｒｙａｒｔｅｒｙｄｉｓｅａｓｅ ,ｂｕｔｉｔｒｅｍａｉｎｓｌｉｍｉｔｅｄｂｙａ30 %ｔｏ 6 0 %ｒｅｓｔｅｎｏｓｉｓｒａｔｅ .Ｉｎｔｒａｖａｓｃｕｌａｒｂｒａｃｈｙｔｈｅｒａｐｙ (ＩＶＢ)ｉｓａｎｅｆｆｅｃｔｉｖｅｍｅｔｈｏｄｔｏｉｎｈｉｂｉｔｃｏｒｏｎａｒｙｒｅｓｔｅｎｏｓｉｓａｆｔｅｒＰＴＣＡ .Ａｎｅｗｃｏｎｃｅｐｔｏｆｐｒｅ…     

Solute clearance effect of citrate anticoagulation hemodialysate for hemodialysis in patients with high risk of bleeding

Objective To study the solute clearance effect of the new concentrated anticoagulation hemodiaiysate of citrate for hemodialysis in patients with high risk of bleeding. Methods Forty-two kidney failure patients with high risk of bleeding were divided into two groups (Group A and Group B) according to their hemodialysis manners. Patients in Group A were hemodialyzed with bicarbonate hemodialysate with low-molecular-weight heparin (dalteparin) anticoognlation and those in Group B with the new citrate antieoagnlation hemodialysate prepared in our hospital without any other anticoagulant. Blood urea nitrogen (BUN) and creatinine (Cr) concentrations were measured before and after dialysis, and Kt/V and urea reduction rate (URR) were calculated. In addition, activated clotting time (ACT) and ionized calcium (iCa2 ) concentration were also measured at the arterial and venous ends. Results ACT was extended and iCa2 concentration decreased significantly at the venous end compared with those at the arterial end in Group B (P<0.01). BUN and Cr concentrations were markedly decreased after dialysis compared with those before dialysis in both groups (P<0.01), and no significant difference in solute clearance effect, as indicated by Kt/V and URR, was observed between Group A and Group B (P>0.05). Conclusion The solute clearance effect of the new concentrated anticoagnlation hemodialysate of citrate is excellent during hemodiaiysis in kidney failure patients with high risk of bleeding.     

bcl-2蛋白和PCNA在乳癌中表达的定量测定及其预后

应用图像分析仪对６０例乳癌ｂｃｌ－２、ＰＣＮＡ和雌孕激素受体进行免疫组织化学及酶联亲和法定量研究。结果表明：ｂｃｌ－２蛋白定量高值组，乳癌组织学分级低，患者生存期长、生存率高（Ｐ＜０．０５）；ＰＣＮＡ表达定量高值组，组织学分级高，患者生存期短、生存率低（Ｐ＜０．０５）。显示了定量检测ｂｃｌ－２蛋白和ＰＣＮＡ对评估乳癌分化程度及判断预后具有一定价值。ｂｃｌ－２与雌孕激素受体间有显著的正相关性（Ｐ＜０．００１），提示ｂｃｌ－２蛋白检测对乳癌患者内分泌治疗有重要参考价值。     

Bcl-2蛋白与P-糖蛋白在胃癌中的表达及其相关性研究

目的　探讨Bcl 2蛋白与P 糖蛋白在胃癌发生、发展和耐药性产生中的作用以及二者间的相互关系。方法　应用免疫组化SP法检测胃癌组织中的Bcl 2蛋白与P 糖蛋白表达情况。结果　胃癌中Bcl 2蛋白阳性表达率为 37.5%,高分化腺癌和组织学Ⅰ级阳性表达率显著高于未分化癌和组织学Ⅲ级 (P <0 .0 5) ;P 糖蛋白阳性表达率为 30 .0 %,淋巴结转移和癌细胞浸润浆膜及浆膜外者表达率显著高于无淋巴结转移和浆膜内浸润者 (P <0 .0 5)。胃癌中Bcl 2蛋白与P 糖蛋白共同表达率为 2 1 .4%(P <0 .0 5)。结论　Bcl 2参与了胃癌的发生 ;P 糖蛋白阳性表达提示胃癌细胞对化疗药存在原发性耐药 ,同时与癌细胞浸润深度、淋巴结转移有关。胃癌中Bcl 2蛋白、P 糖蛋白的表达可能有一定的联系