TREATMENT OF LOCAL RECURRENCE OF NASOPHARYN-GEAL CARCINOMA WITH REIRRADIATION

From 1975 to 1987, 112 patients with loco-regional recurrence of nasopharyngeal carcinoma (N P C) were treated again with radiation at our hospital. All cases were proven histologically by biopsy. Of these patients, 92 had their recurrence in the nasopharynx only, 13 had additional involvement of the base of the skull, and 7 had tumor recurrences simultaneously in the nasopharynx as well as the cervical lymph nodes. Radiotherapy adopted in this series was 60Co external irradiation (X R Te) and/ or betatron in 96 patients, X R Te plus intracavitary 60Co irradiation (X R Ti) in 12 patients and X R Ti alone in the other 4 patients. The 1-, 3-, and 5-year survival rates were 86.3%, 45.8% and 30.2% respectively after the start of recurrence retreatment. The 63 patients who survived for 5 years or more were analyzed. The prognosis of the patient was related to the histological type, clinical stage, modality of treatment, and disease interval to recurrence and site of recurrence. No serious complications occurred. It is suggested that re-irradiation is appropriate in the treatment of loco-regional recurrent N P C.

THE FACTORS AND TREATMENT OF LOCAL RECURRENCE AFTER RADICAL RESECTION RESERVING THE ANUS IN THE PATIENTS WITH RECTAL CANCER

Of seventy-one patients with rectal cancer after radical resection retaining the anus, 15 developed local recurrence with a recurrence rate of 21.1%. Local recurrence was correlated with improper safety margin from the lower edge of cancer to the anal end. There was statistical significant difference between 3 cm or more and 2 cm or less. The local recurrence was also related to the pathologic stage, histologic differentiation and implant of free cancer cells. It is suggested that the surgical indication of saving the anus be strict and without stretching, the safety margin from the lower edge of cancer to the anal end should not be less than 2 cm in early rectal cancer and not less than 4 cm in advanced lesions. During the operation, no touching tumor technique, thorough rinsing of the peritoneal cavity and pre- or post-operative radiotherapy are important for prevention of local recurrence. Early local recurrent rectal cancer can be detected by periodic examinations.

Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8% , focal absorption effective rate 91. 3% , cavity closing rate 58. 7% and 10-day symptom improving rate 54. 4% , while in the control group, the corresponding rates were 65.2% , 73. 9 % , 37.0% and 26.1 % , respectively. Comparison between the groups showed significant difference in all the parameters (P<0.05, P<0.05, P<0.05 and P<0.01). The incidence of adverse reaction and 2-year bacteriological recurrence rate in the treated group were 23. 9% and 2.6% respectively, while those in the control group 50. 0% and 16. 7% , which were higher than the former group with significant difference ( P<0. 01 and P<0. 05, respectively). Conclusion: The therapeutic effect of combined treatment with anti-TB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

Effects of Second Order Scattered Wave in Stratified Ocean

By using the theories on Stokes multicolored water waves and taking the two- layer ocean as a basic model of stratified ocean, the paper analyzes the problems related to the effects of the nonlinear water wave on offshore structures. A mathematical expression is presented to describe second order wave radiation conditions. Using integral principle, the analytical integral solutions are given to evaluate second order scattered wave loads on general vertical circular cylinders in the two-layer ocean, and the special recurrence formulas for infinite integrals over free and stratified surfaces are derived.

How Does the Cortactin Gene Expression Affect Breast Cancer among Iranian Females?

Introduction: Breast cancer is the most common cancer in the Iranian female population, and the incidence of the disease is rising. Early detection in association with staging or grading the tumor is the most effective method to increase survival rates. Studies have revealed that cortactin overexpression may play a role in the final stages of tumor progression and affects invasion and cellular motility. The aim of this study is to evaluate cortactin gene expression among Iranian female patients with breast cancer. Materials and Methods: Samples belonging to 70 breast cancer patients were randomly selected from the Imam Khomeini tumor bank. Normal and tumor tissues were prepared and stored at -80°C. Cortactin gene expression was evaluated by real-time PCR. Finally the data, along with demographic and clinical parameters, were analyzed using Prism 5.0 software, followed by t-test and ANOVA analysis. Results: Cortactin gene expression among tumor tissues increased 95.71% in comparison with normal tissues. A significant correlation between cortactin gene expression and lymph nodes’ involvement (P = 0.0077) and tumor stage (P = 0.0030) was observed. However, tumor grade (P = 0.8598), tumor size (P = 0.3058), and patient’s age (P = 0.4135) had no significant correlation with the gene’s expression level. Discussion: This study demonstrated that the cortactin gene’s overexpression in breast cancer may enhance lymph nodes’ involvement. This study also found that the gene’s expression was raised significantly in progressed stages of the cancer. Therefore, cortactin gene overexpression is an important factor indicating breast cells’ invasion. Conclusion: The cortactin gene’s expression level can be considered an accurate indicator for female breast cancer and also an appropriate biomarker for this cancer in clinical evaluations.

STAGE IB, HA AND PROXIMAL IIB, CARCINOMA OF THE UTERINE CERVIX, TREATED BY IRRADIATION ALONE OR IN COMBINATION WITH SURGERY

This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor complication in the patients treated with RT was rectosigmoiditis.

RELATION BETWEEN MORPHOMETRIC GRADES OF BLADDER TUMOR AND PROGNOSIS

The relation between morphometric grades (M grading) of 84 cases of bladder tumor and prognoses was evaluated. The results shown that the higher the M grading, the lower the survival rate and the higher the recurrence rate. As the M grade increases, the tumor has partial of total absence of ABO(H) antigens of tumor cell surface and could be accompanied with muscular invasion. When recurring, the tumor has a poor prognosis if M grading increases from lower to higher grades. The morphometric grading system is able to make a quantitative pathologic diagnosis and can predict the biological behavior of bladder tumors.

POSTOPERATIVE IRRADIATION OF KELOIDS: ANALYSIS OF 125 PATIENTS

Between October 1985 and June 1992 Postoperative kelolds of 125 Patients were treated with superficial X-ray (100-140 Kv) and electron beam (6 and 9 MeV ), in an attempt to prevent their recurrence, 100 patients with 129 sites received a dose of 1200-4000 cGy at 200-300 cGy per fraction within one to four weeks and at intervals of one to three weeks between excision and irradiation. Rate of success In the prevention of kelold was only 28. 6% (37/ 129). However, 25 patients with 25 sites received a total dose of 1500 cGy at 500 cGy per fraction starting within one week after excision and at Intervals of 96 hours. The success rate was 84% (21/25).

GENE ENGINEERING EB VIRUS MEMBRANE ANTIGEN IN DETECTION OF MA-IgA ANTIBODY(COMPARISON WITH VCA-IgA AND EA-IgA ANTIBODIES)

With gene engineering EB virus membrane antigen as the diagnostic antigen, indirect immunofluo-rescence (IF) assay was used to detect IgA antibody against EB virus membrane antigen (MA-IgA) in sera from 202 nasopharyngeal carcinoma (NPC) patients and 315 controls (normal and patients with other tumors). MA-IgA antibody was positive in 96.8% of the pretreatment NPC patients with a GMT of 1:36.3. MA-IgA detection by this method was more sensitive than EA-IgA detection by IE. In contrast, patients with tumors other than NPC were negative for MA-IgA antibody. 9.1% of VCA-IgA positive persons were MA-IgA positive with a GMT of less than 1:5. No MA-IgA positive was found in VCA-IgA negatives. The results indicated that this method was relatively specific. In the treatment group, the positive rate and GMT of MA-IgA antibody declined with increase in survival time and the decline was faster than VCA-IgA. When recurrence or distant metastasis developed, similar to VCA-IgA and EA-IgA antibodies, the positive rate and GMT of MA-IgA antibody increased to its pretreatment level. Therefore, MA-IgA detection might be valuable in the early diagnosis and monitor of NPC.

OUTCOMES OF INVASIVE STRATEGY TO PATIENTS WITH NON-ST-ELEVATION ACUTE CORONARY SYNDROMES

To compare the outcomes of an invasive with a conservative strategy in the management of patients with non-ST-elevation acute coronary syndromes. Methods From January 2000 to June 2001,505 patients presenting with unstable angina or non-Q wave myocardial infarction were divided into two groups (conservative vs. invasive) according to management strategy. Patients assigned to an early invasive strategy underwent coronary angiography within 7d of enrollment after intensive antiplatelet, antithrombotic and antiangina therapy and revascularization as appropriate. All patients were followed up at least 6 months. The primary endpoints were cardiac death and acute myocardial infarction. Recurrence angina and readmission were the secondary endpoint. Results There were 194 patients in conservative group and 311 patients in invasive group. Overall, coronary angiography was performed in 100% and 56%, and revascularization in 93% and 52% in the invasive and conservative groups, respectively. During a mean of 11 + 5. 7 months ( range 6 ~ 24 months) of follow-up, the occurrence of primary endpoint was significantly lower in the invasive group than that in the conservative group (3.9% vs8. 2% , P =0. 036). The rate of recurrent angina (48% vs 17% , P =0. 001 ) , readmission (41% vs 13% , P =0. 001 )and revascularization ( 12% vs 35%, P =0. 001 ) was also significantly lower in patients assigned to invasive strategy. Conclusion The study indicates that the early invasive approach may be the preferred strategy in patients with unstable angina or non-Q wave myocardial infarction.

The Clinical and Angiograghic Outcome of 190 Cases after Stent Placement in Small Coronary Vessels

Objectives To invest the success procedure, immediate outcome after procedure, the rate of main adverse cardiac events after procedure and restenosis after stent placement in small coronary vessels. Methods 290 patients with selected or emergency stent implantation in small vessels from April, 1997 to March,2002. Total 299 vessels,304 lesions and 316 stents were statisted. The successs rate of procedure, immediate outcome after procedure, the rate of main adverse cardiac events after procedure and restenosis after stent placement in small coronary vessels were assessed. The patients were followed up 1 month to 4 years. Re-catheter angiography were done in 122/290 patients. Results The narrow rate of lesion dropped from 89% ± 12% before procedure to 5% ±5% after procedure (diameter). 202 patients were followed up 1 month (69.7%). 197/202 cases were survival. 5/202 cases died in 3hrs to 7days. 2/5 cases died of persistent hypotension after procedure. 1/5 case died of acute left heart failure. 2/5 cases died of sudden death. 180 cases were followed up 5 months to 4 years. The non-event survival (NES) rate was 73.3% (132/180). The re-angiography were done in 122 cases. Restenosis happened in 39 cases (30.3%). 37 patients repeated PCI. 2 patients went to CABG. 2 cases got angina recurrence and were proved second time restenosis by re-angiography. The third time PCI was done in 1 patient. The other patients went to CABG. 1 case died of chronic heart failure after 2 years, 1 case suffered acute myocardial infarction on artery stent implanted. Conclusions There are high success rate of procedure and perfect immediate outcome in stent placement in small vessels. Main adverse cardiac events did not increased. Non-event survial was satisfied in long term follow -up. Restenosis rate was showed slightly higher than the one of main vessels.

Multiomics analysis reveals metabolic subtypes and identifies diacylglycerol kinase α (DGKA) as a potential therapeutic target for intrahepatic cholangiocarcinoma

Background:Intrahepatic cholangiocarcinoma(iCCA)is a highly heteroge-neous and lethal hepatobiliary tumor with few therapeutic strategies.The metabolic reprogramming of tumor cells plays an essential role in the develop-ment of tumors,while the metabolic molecular classification of iCCA is largely unknown.Here,we performed an integrated multiomics analysis and metabolic classification to depict differences in metabolic characteristics of iCCA patients,hoping to provide a novel perspective to understand and treat iCCA.Methods:We performed integrated multiomics analysis in 116 iCCA samples,including whole-exome sequencing,bulk RNA-sequencing and proteome anal-ysis.Based on the non-negative matrix factorization method and the protein abundance of metabolic genes in human genome-scale metabolic models,the metabolic subtype of iCCA was determined.Survival and prognostic gene analy-ses were used to compare overall survival(OS)differences between metabolic subtypes.Cell proliferation analysis,5-ethynyl-2’-deoxyuridine(EdU)assay,colony formation assay,RNA-sequencing and Western blotting were performed to investigate the molecular mechanisms of diacylglycerol kinaseα(DGKA)in iCCA cells.Results:Three metabolic subtypes(S1-S3)with subtype-specific biomarkers of iCCA were identified.These metabolic subtypes presented with distinct prog-noses,metabolic features,immune microenvironments,and genetic alterations.The S2 subtype with the worst survival showed the activation of some special metabolic processes,immune-suppressed microenvironment and Kirsten ratsar-coma viral oncogene homolog(KRAS)/AT-rich interactive domain 1A(ARID1A)mutations.Among the S2 subtype-specific upregulated proteins,DGKA was further identified as a potential drug target for iCCA,which promoted cell proliferation by enhancing phosphatidic acid(PA)metabolism and activating mitogen-activated protein kinase(MAPK)signaling.Conclusion:Viamultiomics analyses,we identified three metabolic subtypes of iCCA,revealing that the S2 subtype exhibited the poorest survival outcomes.We further identified DGKA as a potential target for the S2 subtype.

CLINICAL SIGNIFICANCE OF ELEVATED SERUM SOLUBLE INTERLEUKIN-2 RECEPTOR IN GASTRIC CANCER

This is China’s pilot stndy in the assessment of the diagnostic value of serum soluble IL-2 receptor (sIL-2R) in gastric cancer.We measured its level by ELISA method in 45 patients with gastric cancer (without metastasis:32;with metastasis:5;recurrence:8)27 gastric ulcer,

ORIGINAL ARTICLES CALCIUM CHANNEL BLOCKERS IN CIRRHOTIC PATIENTS WITH PORTAL HYPERTENSION

Four calcium channel blockers, i.e. nifedipine, verapamil, cinnarizine and tetrandrine are currently available and used widely in treating cardiovascular diseases. To confirm the effects, if any, of calcium channel blockers on cirrhotic patients with portal hypertension, a study was performed on esophageal variceal pressure and rebleeding rate of esophageal varices after 2 years by using calcium channel blocker in 321 patients from some 23 hospitals. The results demonstrated that the calcium channel blockers could significantly reduce the esophageal variceal pressure and the portal blood flow in cirrhotic patients with portal hypertension. The proportion of patients with no recurrent gastrointestinal bleeding after 2 years medication of tetrandrine was 87.9% in tetrandrine group, significantly higher than those in the other 4 groups (P<0.05). It is suggested that tetrandrine should be more effective for cirrhotic patients with portal hypertension in preventing recurrent variceal bleeding.

CONJECTURE OF CHOWLA-COWLES ON APARY NUMBERS

Ⅰ. INTRODUCTION At the 1978 ICM conference held in Helsinki, Ap?ry gave a proof of ζ(3)=Σ1/N^3 being irrational. For this purpose he introduced the numbers α_n (n≥0) defined by recurrence

Q-BAND POLYMORPHISM IN CHROMOSOMES OF CHINESE POPULATIONS (HAN NATIONALITY)

In human and other mammalian populations there are many inheritable traits that do not appear to have gross phenotypic effects. These normal variations occur more frequently than that as expected from recurrent mutation rates alone. With the

RHETORIC OF THE LAWYER AND PHILOSOPHICAL CONVERSATION

文章集中于战略辩术和哲学的谈话之间的差别。它首先试着在诡辩操作和有效战略推论之间区分。以便做那，把一个新意思给在标识语之间的旧亚里士多德的分成三部分的作者尝试，文化精神，和悲怆。然后，他使用推论的 Chaim Perelmans 理论证明在实际推理的合理性的标准是特定的。在澄清了战略推论的概念以后，作者把它与哲学的谈话的观点区分开来。他试着证明如果后者被前者完全代替，危险存在那牺牲和道德套餐将产生批评思维的失败。