益母败酱汤灌肠联合腹部理疗治疗慢性盆腔炎疗效分析

目的:分析益母败酱汤灌肠联合腹部理疗治疗慢性盆腔炎的临床疗效。方法:选取236例慢性盆腔炎患者,随机分为对照组116例,治疗组120例;治疗组给予腹部理疗联合中药灌肠治疗,对照组给予康妇消炎栓治疗;治疗1疗程后对比两组临床疗效、对腹痛与盆腔积液症状的治疗效果。结果:两组治疗1个疗程后治疗组临床治疗有效率为85.00%,对照组临床治疗有效率为65.51%,治疗组腹痛有效率与盆腔积液有效率均高于对照组(P<0.05);两组治疗2个疗程后治疗组临床治疗有效率为92.50%,对照组临床治疗有效率为74.13%,治疗组腹痛有效率与盆腔积液有效率均高于对照组(P<0.05)。结论:腹部理疗联合中药灌肠治疗慢性盆腔炎疗效确切。

外敷方与理疗配合西药治疗膝骨关节炎35例

目的:祛风湿类中药外敷配合理疗及利美达松关节腔注射治疗膝关节骨关节炎的疗效。方法:采用外敷方(川芎、生川乌、生草乌等)外敷配合理疗及西药(美达松)治疗本病35例,并设对照组对比。结果:治疗组总有效率100%,明显优于对照组。提示:本方法对本病有消肿镇痛,改善关节功能的功效。

天津市重点人群家庭医生服务利用度与满意度现况调查分析

目的调查分析天津市重点人群家庭医生服务利用度与满意度情况,从而为提升天津市家庭医生团队服务能力,促进家庭医生签约服务的开展提供参考。方法采用随机抽样方法,选取天津市16个行政区的社区居民作为研究对象,从机构的家庭医生团队签约底册中随机抽取被试样本,采用电话收集数据的方式完成对签约居民的问卷调查,根据问卷调查结果对居民服务利用情况、家庭医生服务效果等进行分析。结果居民对家庭医生签约服务的利用度、依从性和配合度较高,对家庭医生服务较认可。影响居民家庭医生服务利用度的主要因素为年龄、性别、文化程度、区域、供需不匹配以及签约服务内容等方面,签约居民对目前家庭医生签约服务总体满意度较高。结论需进一步提高家庭医生服务能力、水平及服务质量,细分居民群体,以更好地满足居民个性化需求,增加居民对签约的知晓度,优化基层医疗资源配置,提升居民满意度。

Vascular Calcification:Where is the Cure?

With the progress of aging,the incidence of vascular calcification(VC)gradually increases,which is correlated with cardiovascular events and all-cause death,aggravating global clinical burden.Over the past several decades,accumulating approaches targeting the underlying pathogenesis of VC have provided some possibilities for the treatment of VC.Unfortunately,none of the current interventions have achieved clinical effectiveness on reversing or curing VC.The purpose of this review is to make a summary of novel perspectives on the interventions of VC and provide reference for clinical decision-making.

中药联合物理疗法治疗儿童弱视32例

目的:观察中药联合物理疗法治疗儿童弱视的疗效。方法:将中药(熟地黄、黄精、党参、当归、山药、川芎等)联合传统的物理疗法治疗弱视儿童32例(53只眼)。结果:总有效率达到96%。结论:中药联合物理疗法治疗弱视的确是一种安全有效的治疗方法。

补肾益精汤配合理疗治疗男性更年期综合征36例

目的:观察补肾壮阳类中药配合睾丸理疗治疗男性更年期综合征的疗效。方法:补肾益精汤(仙灵脾、仙茅、当归、益智仁、生地、熟地、枸杞子、黄精、赤丹参等)配合睾丸理疗治疗本病36例。结果:治疗前后PADAM评分、IIEF-5评分、血清睾酮值有显著改善(P<0.01)。结论:本方法对本病有补肾壮阳、益精通络的功效。

Expression and Significance of Survivin mRNA in Lung Cancer of Different Progression Stages by FISH and Tissue Microarray Technology*

Objective： To investigate the expression of Survivin mRNA in lung cancer progression tissue microarray by FISH （fluorescence in situ hybridization） method and determine its role and significance in lung cancer genesis and progress. Methods： The expression of Survivin mRNA was detected by FISH method and tissue microarray technology. 89 cases of primary lung cancer, 12 cases of lymph node metastasis of lung cancer, 12 cases of precancerous lesion and 10 cases of normal lung tissue were examined. Results： 69.7% of primary lung cancer express Survivin mRNA; the positive ratio of primary lung cancer and precancerous lesion were both significantly higher than that of normal lung tissue （P〈0.05）; the expression of Survivin mRNA was related to the differentiation degree, lymph node metastasis and clinical stages （P〈0.05）. Conclusion： FISH has good sensitivity and stability. Tissue microarray technology has many advantages, such as high efficiency, high throughput, etc; it may have good prospect in pathology. Survivin mRNA was highly expressed in lung cancer and precancerous lesion; it was related to the progress and malignant behavior; it may play a promotion role in lung cancer genesis and progress and offer basis to early diagnosis, prognosis estimate and treatment.

In vitro Study of Interstitial Combination Chemotherapy in the Treatment of Glioma

Objective： To investigate the inhibitory effects of combination chemotherapy of Carboplatin （CBP）, Teniposide （Vm-26）, Methasquin （MTX）, and Nimodipine （NIM） on glioma, and to explore the sensitivity of glioma cells to different treatment regimens so as to provide some clues for clinical usage of interstitial combination chemotherapy. Methods： MTT assay and 3H-TdR incorporation assay were performed to evaluate the inhibitory effects upon the proliferation of glioma cells, and to compare the sen- sitivity of glioma cells to administration of CBP, Vm-26, MTX, and NIM with that of the administration of CBP＋NIM, Vm-26＋NIM, MTX＋NIM, CBP＋Vm-26＋MTX, or CBP＋Vm-26＋MTX＋NIM, respectively. Results： The inhibition rate of CBP＋Vm-26＋MTX＋NIM combination administration against glioma cells was 96.64%, higher than that of CBP＋NIM （69.03%）, Vm-26＋NIM （71.53%）, MTX＋NIM （52.75%）, CBP＋Vm-26＋MTX （78.59%） （P〈0.01）, and the dosage of CBP, Vm-26, and MTX was declined to 1/10- 1/100 that of respective use of CBP, Vm-26, and MTX. Conclusion： The curative effect of combination administration of CBP, Vm-26, MTX, and NIM was much better than that of respective administration, suggesting a higher inhibition rate and a lower dosage use.

The Characteristics of Immunophenotype in Acute Lymphoblastic Leukemia and Its Clinical Significance

Objective： To study the characteristics of immunophenotype in acute lymphoblastic leukemia （ALL） and its clinical significance. Methods： Immunophenotyping was performed on 81 ALL patients by three-color flow cytometry analysis using CD45/SSC gating, meanwhile the cytogenetic analysis was performed on 45 cases out of 81 ALL patients. Results： （1） CD19 was the most commonly expressed of all B-lineage antigens detected with the positive rate being 100%. In T-ALL, the positive expression rate of CD5 and CD7 was the highest, being 90%. Both B-ALL and T-ALL overlapped in expression of lineage antigens. There was no significant difference in the complete remission rate （CR rate） between T-ALL and B-ALL. （2） The incidence of ALL with rayeloid antigens expression （My＋ALL） was 39.5%. CD13 was most often seen among the myeloid markers. My＋ALL always involved in B-lineage antigens and the CR rate in children and adults was 72.2% and 78.6% respectively. （3） The incidence of HAL was 19.8%. Coexpression of B-lineage and myeloid-assoeiated antigens was the commonest subtype in HAL. The expression of CD34 was commonly seen in HAL patients （81.3%）. The CR rate was low in HAL, 50% for children and 40% for adults. （4） Compared to T-ALL, B-ALL, My＋ALL, and HAL had a higher positive rate of CD34 expression with the difference being significant （P〈0.025）. Conclusion： Immunophenotyping had remarkable predominance in diagnosing special category of ALL （such as HAL and My＋ALL）; CD19 and CD5 were highly sensitive in diagnosing B-ALL and T-ALL, but less special, and overlapping was found in expression. No significant association was found between the expression of CD34 or myeloid antigens and CR rate, while low CR rate was found in HAL patients, especially for those coexpressing CD34 antigen.

Clinical Study of Photodynamic Therapy for Upper Gastrointestinal Tract Cancers

Objective： To evaluate the clinical effectiveness and adverse effects of photodynamic therapy （PDT） for the upper gastrointestinal tract cancers. Methods： 56 patients with upper gastrointestinal cancers in different clinical stages were treated with PDT. Diode laser （630 nm） was used as the light source and the parameters were as follows： power density 200 to 400 mW/cm, energy density 100 to 300 J/cm. PHOTOFRIN was used as photosensitizer, which was given in a dose of 2 mg/kg intravenously 12-24 h before irradiation. Results： Evaluation of the 56 patients＇ therapeutic effectiveness showed that 6 patients （10.7%） had a complete response （CR）, 33 patients （58.9%） partial response （PR）, 12 patients （21.4%） mild response （MR）, and 5 patients （8.9%） no response （NR）. The total response rate （CR＋PR） was 69.6%. No patients had severe adverse effects in this group. Conclusion： PDT is an effective and safe palliative modality for upper gastrointestinal tract cancers.

Replication-selective Oncolytic Adenovirus CNHK300 in the Treatment of Breast Cancer Cell Lines in vitro

Objective： To evaluate the tumor selectivity and therapeutic efficiency of replication-competent adenovirus CNHK300 on human breast cancer cells. Methods： RT-PCR was used to detect the hTERT mRNA activity in various breast cancer and normal fibroblast cell lines. Virus proliferation assay, cell viability assay and Western blot were applied to evaluate the proliferation and cytolysis selectivity of CNHK300. Results： The telomerase activity of MCF-7, BT-549 and SK-BR-3 was positive, while telomerase in MRC-5 and BJ was negative. The progeny virus titers in MCF-7, BT-549 and SK-BR-3 after 48 h of CNHK300 exposure was 40 625, 1 265 and 20 000 fold higher than those of 0 h, even slightly higher than those of wtAd5 （except in SK-BR-3）. ONYX-015 virus proliferation ability was weaker than that of CNHK300 in cancer cells. However, CNHK300 exhibited attenuated replicative ability as compared with wtAd5 in MRC-5 and BJ. The CNHK300 replicatative multiple was 63 and 192 fold at 48 h respectively, while the wtAd5 still multiplied 3 160-4 846 fold. CNHK300 could cause about half of breast cancer cells to die within 7 days at MOI 10 pfu/cell and below, whereas the IC50 in BJ and MRC-5 was as high as MOI 100 pfu/cell. CNHK300 E1A protein could be detected in breast cancer cells and 293 cells but not in normal fibroblast cells. Conclusion： hTERT promoter can successfully modulate the CNHK300 to be selectively replicated in breast cancer cells positive for telomerase, which may be a potential treatment strategy in breast cancer.

Histopathological study of hepatocellular carcinoma after transcatheter hepatic arterial embolization

AIMS To study the histopathological changes in hepatocellular carcinoma (HCC) after transcatheter arterial embolization (TAE). METHODS Histopathological analysis was made in 39 cases of liver neoplasms after TAE and 11 cases of liver neoplasms after digital selective angiography (DSA), including pathological type, histological grade, necrotic degree, capsule, times of treatment, injured vessel and lymphocyte infiltration. RESULTS Six cases with 100% necrosis, 14 cases with 30% 95% necrosis, 19 cases with 0% 5% necrosis after TAE and 11 cases without necrosis after DSA were found histologically. The necrosis was related to the pathological type, capsule, injured vessels, but not to the histological grade, time of treatment and lymphocyte infiltration of the liver neoplasms. CONCLUSIONS TAE is an effective therapy for the late stage HCC. The encapsulated HCC is a preferable indicator for TAE.

Treatment of Primary Liver Cancer with Postoperative After-Loading Radiotherapy and Gemcitabine

Objective： To evaluate the curative effectiveness of postoperative after-loading radiotherapy with the use of gemcitabine in 22 patients with primary liver cancer. Methods： From Oct. 1999 to Dec. 2001, 22 patients with primary liver cancer underwent postoperative after-loading radiotherapy 3-10 days after hepatectomy and chemotherapy using gemcitabine （1400 mg every week for 3 weeks, repeated after one week interval, total cycles were 6） and compared with 22 cases of sole hepatectomy. Three-six catheters were placed for irradiation after hepatectomy. The single-dose of after-loading radiotherapy was 10 Gy, 24 sessions per person. Results＇. The rate of AFP negative-reversion was 100% （17/17） in the treated group, higher than in control group （62.5%, 10/16, P〈0.05）. In the treated group, the 1-year relapse rate, metastasis rate and survival rate were 18.2% （4/22）, 0 and 100% （22/22） respectively, while in the control group they were 45.5% （10/22）, 13.6% （3/22） and 77.3% （17/22） respectively. There were significant differences between the two groups in relapse rate, metastasis rate and survival rate within a year （P〈0.05）. Conclusion： Postoperative after-loading radiotherapy with gemcitabine is an effective way for the treatment of primary liver cancer.

Initial Study on Immune Escape Mechanism of Mouse Acute Myelomonocytic Leukemic Cell Line WEHI-3

Objective： To investigate the expression of Fas, Fas ligand （FasL） and CD80 on the cell surface of mouse acute myelomonocytic leukemia cell line WEHI-3 and the function of FasL. Methods： The expression of Fas, FasL and CD80 was detected on WEHI-3 cell surface by flow cytometry. Simultaneously the function of FasL was determined by Thymidine （^3H-TdR） Incorporation. Results： The expression of CD80 and Fas on WEHI-3 cell surface was 5.06%±0.41% and 6.75%±2.31% （n=5） respectively, and the expression of FasL was up to 63.73%±5.23% （n=5）. The apoptotic rate of YAC-1 cells was 26%±4.5%, 35%±3.2% and 43%±2.7% （n=5） respectively when WEHI-3 （effector cell, E） and Fas^＋ YAC-1 cells （target cell, T） were cultured in the ratio of 3：1, 10：1 and 30：1. Conclusion： WEHI-3 cells express high FasL, low Fas and CD80, and can induce apoptosis of Fas^＋ YAC-1 cells.

Prognostic Impact of Histopathologic Response after Neoadjuvant Chemotherapy in Stage Ⅲ_A Non-small Cell Lung Cancer

Objective： To investigate prognostic impact of histopathologic response induced by neoadjuvant chemotherapy in patients with stage ⅢA non-small cell lung cancer （NSCLC）. Methods： Forty patients with stage ⅢA NSCLC underwent two cycles of neoadjuvant chemotherapy with mitomycin, vindosine, and cisplatin followed by surgery. Histopathologic response in resection of the tumor was examined after surgery. Tumor regression was classified as grade Ⅳ, grade Ⅲ, grade Ⅱ, and grade Ⅰ according to the extent of tumor necrosis and the extent of the vital tumor tissues. The tumor regression grading was correlated with the survival time of the patients. Results： After two cycles of chemotherapy, 19 （47.5%） of 40 patients had objective response （2 complete and 17 partial response）. In 40 resected tumor specimens, 2 （5%） were classified as regression grade Ⅳ, 16 （40%） as regression grade Ⅲ, 18 （45%） as regression gradeⅡ, and 4 （10%） as regression grade Ⅰ. The rate of complete surgical resection was significantly higher in patients with tumor regression grade Ⅲ-Ⅳ （〈10% vital tumor tissue）（P〈0.05）. The median survival time in patients classified as having tumor regression grade Ⅲ-Ⅳ was significantly longer than that in patients who had regression grade Ⅰ-Ⅱ （P〈0.05）. The 3-year survival rate in patients with regression grade Ⅲ-Ⅳ was markedly higher than that in patients who had regression grade Ⅰ-Ⅱ （P〈0.05）. Conclusion： The extent of tumor regression induced by neoadjuvant chemotherapy is a critical issue for successful therapeutic approach in patients with stage ⅢA NSCLC. In resected specimens of tumors after chemotherapy, the presence of marked tumor regression （regression grade Ⅲ-Ⅳ） is predictive for superior survival time.

Clinical Analysis of 81 Cases of Benign Retroperitoneal Schwannoma

Objective： To analyze the clinical manifestations of retroperitoneal schwannoma in order to improve the diagnosis and treatment of this rare disease. Methods： Between January 1951 and September 2004, 81 patients with retroperitoneal schwannoma were retrospectively analyzed. Results： All cases received operative therapy. Sixty cases （74.1%） received a total resection; 12 cases （14.9%） subtotal resection, and 9 cases （11.1%） exploration. During the surgical operation, a single tumor was found in 77 cases （95.1%）, and multiple tumors in 4 cases （4.9%）. Most of the retroperitoneal schwannomas located beside the spine. The tumor was a fusiform, round or oval mass that was sharply circumscribed and encapsulated. Pathologic results showed all 81 cases were benign schwannoma. In the 4 cases of multiple tumors, 2 （2.5%） were diagnosed as double-primary tumors associated with ascending colon adenocarcinoma and lung squamous-cell cancer. One case recurred postoperatively. Conclusion： Retroperitoneal schwannoma was rare and preoperative diagnosis was difficult. Most of retroperitoneal schwannoma were benign and the surgical treatment was the first choice.

ADVANCES OF EXPERIMENTAL RESEARCH ON ACUPUNCTURE AND MOXIBUSTION FOR TREATMENT OF WOMEN'S CLIMACTERIC SYNDROME

To introduce the advances of experimental research on acupuncture and moxibustion for treatment of Women＇s Climacteric Syndrome.The recent years experimental research literature of acupuncture and moxibustion for treatment of Women＇s Climacteric Syndrome were reviewed.The research literatures on acupuncture treatment were major,focusing on the field of acupuncture and moxibustion regulating hypothalamic-pituitary-gonad axis and nerval-endocritic-immune net.Acupuncture and moxibustion could regulate the endocrine environment of menopausal women.Taking advantage of combination biomedicine with multi-sciences,to improve the acupuncture and moxibustion curative effct and probe the mechanism of menopausal pathology and acupuncture and moxibustion function to Women＇s Climacteric Syndrome,is the research direction afterward.

浅议胎儿利益的法律保护

目前我国在胎儿利益保护方面的立法尚有缺陷,笔者试图结合我国司法实践和国外立法例,提出在现实社会中对胎儿利益的保护。

Patterns of Relapse and Management Options in Unknown Primary Cervical Metastatic Carcinoma

Objective: To analyze the patterns of relapse and management options in unknown primary cervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and long-term survival were compared among different groups. Results: Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC should primarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necks radiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation is recommended for potential primary treatment.

Application of Support Vector Machine to Predict 5-year Survival Status of Patients with Nasopharyngeal Carcinoma after Treatment

Objective： Support Vector Machine （SVM） is a machine-learning method, based on the principle of structural risk minimization, which performs well when applied to data outside the training set. In this paper, SVM was applied to predict 5-year survival status of patients with nasopharyngeal carcinoma （NPC） after treatment, we expect to find a new way for prognosis studies in cancer so as to assist right clinical decision for individual patient. Methods： Two modelling methods were used in the study; SVM network and a standard parametric logistic regression were used to model 5-year survival status. And the two methods were compared on a prospective set of patients not used in model construction via receiver operating characteristic （ROC） curve analysis. Results： The SVM1, trained with the 25 original input variables without screening, yielded a ROC area of 0.868, at sensitivity to mortality of 79.2% and the specificity of 94.5%. Similarly, the SVM2, trained with 9 input variables which were obtained by optimal input variable selection from the 25 original variables by logistic regression screening, yielded a ROC area of 0.874, at a sensitivity to mortality of 79.2% and the specificity of 95.6%, while the logistic regression yielded a ROC area of 0.751 at a sensitivity to mortality of 66.7% and gave a specificity of 83.5%. Conclusion： SVM found a strong pattern in the database predictive of 5-year survival status. The logistic regression produces somewhat similar, but better, results. These results show that the SVM models have the potential to predict individual patient＇s 5-year survival status after treatment, and to assist the clinicians for making a good clinical decision.