陕北神府矿区浅部煤层的赋存特征

从含煤地层沉积特征入手，对浅部1-2、2－2煤层赋存范围，可采特征、结合地质发育史及构造，第四纪地质、地貌等特征，论述了煤层赋存特征及原生、后生因素对煤层赋存的影响，进行了剥蚀期次的划分。

Prognostic factors for 5-year survival after local excision of rectal cancer

AIM:To evaluate the prognostic factors for 5-year survival after local excision of rectal cancer,and to examine the therapeutic efficacy and surgical indications for this procedure. METHODS:Clinical data,obtained from 106 local rectal cancer excisions performed between January 1980 and December 2005,were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier method,statistical comparisons were performed using the log-rank test,and multivariate analysis was performed using the Cox proportional hazards model. RESULTS:Transanal,transsacral,and transvaginal excisions were performed in 92,12,and 2 cases, respectively.The rate of complication,local recurrence, and 5-year survival was 6.6%,17.0%,and 86.7%, respectively.Univariate analysis showed that T stage, vascular invasion,and local recurrence were related to the prognosis of the cases(P<0.05).Multivariate analysis showed that T stage[P=0.011,95% confidence interval(CI)=1.194-3.878]and local recurrence(P=0.022,95%CI=1.194-10.160)were the major prognostic factors for 5-year survival of cases after local excision of rectal cancer. CONCLUSION:Local rectal cancer excision is associated with few complications,and suitable for stages Tis and T1 rectal cancer.Prevention of local recurrence,active postoperative follow-up,and administration of salvage therapy are the effective methods to increase the efficacy of local excision of rectal cancer.

The oncofetal protein IMP3 is an indicator of early recurrence and poor outcome in mucoepidermoid carcinoma of salivary glands

Objective: Mucoepidermoid carcinoma(MEC) is the most common primary malignancy of the salivary glands. Insulin-like growth factor-II m RNA-binding protein-3(IMP3) is an important prognostic factor in some cancers and a tool that differentiates between benign and malignant pancreatic lesions. This study aimed to identify a relationship between the expression of IMP3 and the outcome of salivary gland MEC, as well as to differentiate MEC from pleomorphic adenoma(PA).Methods: Tissue specimens from 70 cases of salivary gland MEC, 40 cases of PA, and 10 cases with normal salivary gland were examined immunohistochemically for IMP3. The association among the expression of IMP3, clinicopathological characteristics and patient's survival was assessed.Results: IMP3 was present in 51.4% of MEC but absent in PA and normal salivary gland tissues. IMP3 expression was associated with age > 60 years, submandibular gland tumors, tumor size > 4 cm, high-grade tumors, lymph node metastasis, involvement of surgical margins, perineural invasion, distant metastasis, advanced TNM stage, tumor relapse, and death(P<0.05). Increased expression of IMP3, tumors of the submandibular gland, and lymph node metastasis were independent prognostic factors of disease-free survival(DFS). In addition, IMP3 was a strong predictor of overall survival(OS) together with distant metastasis and intermediate and high-grade tumors.Conclusions: IMP3 expression is highly important in evaluating the outcome of MEC. IMP3 can be used to differentiate MEC from PA of salivary glands.

Prognostic factors for the survival of 66 cases with extensive stage-small cell lung cancer

Objective The objective of this retrospective study was to investigate the prognostic factors associated with survival among patients with extensive stage-smal cel lung cancer （ES-SCLC）. Methods Clinical data from 66 patients with ES-SCLC diagnosed via histopathology or cytology between July 2005 and July 2009 at Anyang Tumor Hospital （China） were analyzed. Univariate and multivariate Kaplan-Meier, log-rank, and Cox proportional hazard regression analyses were conducted. Results The 12-, 24-, and 36-month survival rates among patients with ES-SCLC were 40.9%, 13.6%, and 6.1%, respectively. The median survival time （MST） was 10 months. Univariate analyses indicated that weight loss, eficacy of first-line chemotherapy, total number of chemotherapy cycles, treatment meth-od, and serum sodium levels significantly influenced survival among patients with ES-SCLC. Multivariate analyses suggested that the eficacy of first-line chemotherapy, total number of chemotherapy cycles, and serum sodium levels were independent prognostic factors associated with survival. Conclusion The eficacy of first-line chemotherapy, total number of chemotherapy cycles, and serum sodium levels are important prognostic factors for patients with ES-SCLC.

Analysis of Prognosis and Prognostic Factors of Cervical Adenocarcinoma and Adenosqumous Carcinoma of the Cervix

OBJECTIVE To analyze clinical characteristics and treatment methods of the patients with adenocarcinoma of the uterine cervix （AUC） and adenosquamous carcinoma of the cervix （ASCC）. To compare the survival time of the patients in 2 groups and analyze the prognostic factors. METHODS Clinical data of both 123 patients with AUC and 32 patients with ASCC treated at the Cancer Hospital, Chinese Academy of Medical Science （CAMS） ＆ Peking Union Medical College （PUMC）, were retrospectively analyzed. RESULTS The median age of the AUC patients was 50 years, and that of the ASCC patients was 44, P = 0.019. Poorly-differentiated （grade 3） cases accounted for 59.5% of the total ASCC patients, while only 32.5% of the AUC patients were in grade 3, P = 0.002. In 123 AUC patients, relapse or failure of the treatment occurred in 63 of the patients （51.2%）, and the median relapse time was 6 months （0-59 months）. In 32 ASCC patients, relapse or failure of the treatment occurred in 8 of these patients （51.2%）, with a median relapse time of 4.5 months （0-52 months）. The overall 5-year survival rate of the AUC patients was 49.8%, which was significantly lower than that of the ASCC patients （74.1%）, P = 0.015. The 5-year survival rates of the ASCC patients in Stage Ⅰ-Ⅲ were higher than that of the AUC patients with the same stages. However, statistical significant difference could only be found among the patients in Stage II, P = 0.006. The 5-year survival rates of the ASCC patients with various differential grade were higher than those of the AUC patients with the same differential grade, but statistical significant difference could only be found among the patients in the two groups with moderately differentiation, P = 0.039. It was found by Cox regression analysis that only clinical stage （P 〈 0.001） and histological type （P = 0.046） were the independent prognostic factors. CONCLUSION Clinical stage and histological type were the independent prognostic factors of the AUC and ASCC patients. The prOgnosis of ASCC patients is better than that of the AUC patients.

Causes and consequences of the Cambrian explosion

The Cambrian explosion has long been a basic research frontier that concerns many scientific fields. Here we discuss the cause-effect links of the Cambrian explosion on the basis of first appearances of animal phyla in the fossil record, divergence time, environmental changes, Gene Regulatory Networks, and ecological feedbacks. The first appearances of phyla in the fos- sil record are obviously diachronous but relatively abrupt, concentrated in the first three stages of the Cambrian period （541- 514 Ma）. The actual divergence time may be deep or shallow. Since the gene regulatory networks （GRNs） that control the de- velopment of metazoans were in place before the divergence, the establishment of GRNs is necessary but insufficient for the Cambrian explosion. Thus the Cambrian explosion required environmental triggers. Nutrient availability, oxygenation, and change of seawater composition were potential environmental triggers. The nutrient input, e.g., the phosphorus enrichment in the environment, would cause excess primary production, but it is not directly linked with diversity or disparity. Further in- crease of oxygen level and change of seawater composition during the Ediacaran-Cambrian transition were probably crucial environmental factors that caused the Cambrian explosion, but more detailed geochemical data are required. Many researchers prefer that the Cambrian explosion is an ecological phenomenon, that is, the unprecedented ecological success of ruetazoans during the Early Cambrian, but ecological effects need diverse and abundant animals. Therefore, the establishment of the eco- logical complexity among animals, and between animals and environments, is a consequence rather than a cause of the Cam- brian explosion. It is no doubt that positive ecological feedbacks could facilitate the increase of biodiversity. In a word, the Cambrian explosion happened when environmental changes crossed critical thresholds, led to the initial formation of the meta- zoan-doruinated ecosystem through a series of knock-on ecological processes, i.e., ＂ecological snowball＂ effects.

Serum albumin predicts survival in patients with hilar cholangiocarcinoma

Background and aims:Hilar cholangiocarcinoma is a devastating malignancy with incidence varying by geography and other risk factors.Rapid progression of disease and delays in diagnosis restrict the number of patients eligible for curative therapy.The objective of this study was to determine prognostic factors of overall survival in all patients presenting with hilar cholangiocarcinoma.Methods:All adult patients with histologically confirmed hilar cholangiocarcinoma from 2003 to 2013 were evaluated for predictors of survival using demographic factors,laboratory data,symptoms and radiological characteristics at presentation.Results:A total of 116 patients were identified to have pathological diagnosis of hilar cholangiocarcinoma and were included in the analysis.Patients with a serum albumin level>3.0 g/dL(P<0.01),cancer antigen 19-9≤200U/mL(P=0.03),carcinoembryonic antigen≤10g/L(P<0.01)or patients without a history of cirrhosis(P<0.01)or diabetes(P=0.02)were associated with a greater length of overall survival.A serum albumin level>3.0 g/dL was identified as an independent predictor of overall survival(hazard ratio 0.31;95%confidence interval 0.14–0.70)with a survival benefit of 44 weeks.Conclusion:This study was the largest analysis to date of prognostic factors in patients with hilar cholangiocarcinoma.A serum albumin level>3.0 g/dL conferred an independent survival advantage with a significantly greater length of survival.

Missed posterior shoulder dislocation and McLaughlin lesion after an electrocution accident

Posterior shoulder dislocation is a rare event that may occur after a direct trauma, an epileptic seizure, electric shock or electroconvulsive therapy. In more than 50% of the cases, posterior dislocations are missed on initial evaluation and often misdiagnosed as frozen shoul- ders with unfortunate consequences. We present the case of a missed posterior suhluxation and reverse Hill Sachs lesion （McLaughlin lesion） in a 40-year-old woman caused by anelectric shock of 240 V. The patient underwent sur- gery in our institute two weeks after the injury. The humeralhead was reduced and the reverse Hill Sachs lesion was filled by demineralized bone matrix allograft with osteoinductive factors. Tendons were repaired and a temporaneous artrodesis was performed. At the final follow up of 12 months, we obtained a Costant Score of 93 and the patient returned to her previous daily activities.