Objective To assess the efficacy of surgical treatment and the prognostic factors predicting survival for patients with local recurrence of rectal cancer. Methods The clinical data of 43 rectal cancer patients who received reoperation at Beijing Cancer Hospital from November 1998 to April 2005 were retrospectively analyzed. The postoperative 5-year survival, incidence of complications, perioperative mortality were calculated. Postoperative survival was analyzed by Kaplan-Meier method and prognostic factors by univariate analysis and Cox proportional hazard regression model. Results Of all patients, 35 underwent radical resection, 8 underwent palliative resection or colostomy. The incidence of complications, perioperative mortality and postoperative 5-year survival were 26% (11/43), 2% (1/43) and 9% (4/43), respectively. Patients who received radical resec-tion, with primary tumor of TNM Ⅱ stage, with normal level of carcinoembryonic antigen, and with the time of recurrence within postoperative 24 months had better prognosis (χ~2 = 21.30, 14.17, 5.93, 5.53, P < 0.05). Modality of reoperation and TNM staging of primary tumor were the independent factors influcing the prognosis (χ~2 = 8.89, 6.96, P < 0.05). Conclusion Radical resection for patients with postoperative local recurrence of rectal cancer results in a favorable prognosis.

Objective To summarize the neuropsychic manifestations of thallium poisoning to attract attention of neuropsychiatrists. Methods Eight cases of thallium poisoning were reported. The manifestations of thallium poisoning and the relative literatures were reviewed. We discussed the relationship between mechanism of thallium poisoning and nervous system,neuropsychic manifestation and pathology of thallium poisoning. Results Three of 8 cases were acute and severe,presenting bellyache,nausea,vomit, fantod,delirium,coma,convulsion,respiratory failure,low blood pressure and tachycardia. They all died in a short period. The other 5 cases were subacute or chronic. Most of them manifested the impairment of central nervous system,peripheral nerve and optic nerve. Some of them had alopecia.Six of 8 cases were misdiagnosed as other neurological diseases. Two were suspicious of thallium poisoning,but failed to be diagnosed for the time being. The 5 survivors of 8 cases obviously restored after heteropathy. Few cases had neurologic sequelae. Conclusions For lacking of contact history, it is difficult to diagnose thallium poisoning caused by malicious contamination or accidental poisoning. Attention should be paid to those patients with indefinite damage of peripheral and central nervous system. When alopecia appears,thallium poisoning must be suspicious of. For the suspected cases,it is necessary to measure the thallium level in blood and urine in order to verify the diagnosis.

Fifty-two cases of acute leukemia were treated with chemotherapy, and forty-one cases in combination vrith Spirulina platensis. After the therapy, the patient's bone marrow was inhibited. The inhibition period of bone marrow was shortened and the recovery period was advanced in the combined Spirylina platensis therapy, the level of peripheral blood cells was raised. The results suggest that the combined spirulina platensis therapy in chemotherapy could accelerate the recovery of the normal hematopoiesis and increase the amounts of blood cells.

Objective To investigate any effects of carbamylated erythropoietin (CEPO) on the expression of LINGO-1,growth-associated protein-43 (GAP-43) and the infarcted volume after cerebral ischemia,so as to explore the effect of CEPO on neural regeneration after cerebral ischemia.Methods Forty-eight Sprague-Dawley rats were randomly divided into a sham operation group,an ischemia control group and a CEPO treatment group,each of 16.Middle cerebral artery occlusion (MCAO) was used to simulate focal cerebral ischemia in all except the rats in the sham operation group.Then the CEPO group was injected with 0.5 ml of CEPO,while the other two groups were given a 0.5 ml injection of normal saline daily for 7 days before they were sacrificed to prepare slices of brain tissue.Western blotting was used to detect the expression of LINGO-1 and activated caspase-3.Immunohistochemical staining was applied to observe the expression of GAP-43.The slices of brain tissue were stained with cresyl violet and the volume of infarction and edema were quantified with the Image J software.Results The average expression of LINGO1 in the sham operation group,the ischemia control group and the CEPO treatment group were (0.25±0.02),(1.22±0.06) and (0.66±0.05) respectively,with significant differences among the 3 groups.There was no expression of activated caspase-3 in the sham operation group.However,the expression of activated caspase-3 increased significantly (to 86.6±10.2)％ in the ischemia control group and increased significantly less (to 40.3±8.7)％ in the CEPO treatment group.The average positive expression of GAP-43 in the sham operation group,the ischemia control group and the CEPO treatment group were 0,(55.02± 1.62) and (72.11±3.23)/HP,respectively,with significant differences among them.Moreover,the average volumes of cerebral infarction and brain edema in the CEPO treatment group were significantly lower than those in the ischemia control group.Conclusions CEPO can inhibit the expression of LINGO-1 and activated caspase-3,promote the expression of GAP-43,reduce infarct volume and limit cerebral edema so as to promote neural regeneration after cerebral ischemia,at least in rats.

Using chemotherapy (DA or HA and ATRA) to treat 22 cases of acute promyelocytic leukemia following to give PSS (100mg/d X 7d) ,the patients complicated with DIC were treated then were given the chemotherapy,combined with PSS to end. The results showed that the complete remission rate of the therapy of APL with PSS was increased to

Objective To investigate blood pressure control the glucose metabolism,cardiovascular risk factors of patients who were regularly followed up at professional hypertension clinics in China.Methods A cross-sectional survey was conducted in 32 004 patients from 127 professional hypertension clinics across China.The questionnaires included case history and related treatment physical examination and laboratory biochemical tests were also taken at the same time.Results The mean blood pressure of overall population was (151 ± 13)/(92 ± 10) mm Hg(1 mm Hg =0.133 kPa).Totally 3424 patients (10.7％) had never taken any anti-hypertension medicine.Among patients treated with anti-hypertension drugs,19 818 were of mono-therapy (69.3％) and 8762 were of combination therapy.The most frequently used drug was reninangiotensin system inhibitor,followed by calcium-channel blocker.Fixed compound preparations accounted for 15.6％.The overall blood pressure control rate (＜ 140/90 mm Hg) was 26.8％,among them,27.7％,30.0％,25.4％ and 21.3％ patients were complicated with coronary heart disease,diabetes mellitus,kidney diseases and cerebral stroke respectively.About 70.3％ hypertensive patients had abnormal glucose metabolism whose mean glycosylated hemoglobin (GHbA1 c) was 7.84％,which was significantly higher than 7.0％,the target value defined by ADA.Even among them,20.2％ patients have never received any anti-diabetic drugs.Low-risk and medium-risk patients accounted for 16.0％.Totally 48.0％ patients were classified in high-risk group and 36.0％ in very high risk group.About half of all patients had different target organ dysfunction.About 49.0％ patients had associated comorbidities.Conclusions Co-existence of hypertension and abnormal glucose metabolism is common in Chinese population.Among these patients,target organ dysfunction and comorbidities are prevalent,but blood pressure is only effectively controlled in less than 30％ patients.Low proportion of combination therapy is one of the reasons for unsatisfied control of blood pressure.It indicates that effective management of hypertension is urgent.

Objective To explore the feasibility and advantage of the small figure-L unilateral transternal incision for the treatment of anteri or mediastinal tumor. Methods Twenty-four patients with anteri or mediastinal tumor were enrolled in the study. Under general anesthesia, after a 6 to 10 cm midline skin incision was made, a unilateral figure-L partial ste rnotomy on the side occupied by the tumor was made in the second or third interc ostals space, taking into account the tumor size and location. Tumors were resec ted with excellent exposure. Results All tumors were completely resected during the operation. In 8 cases, tumors encroached on the adjacent lu ng tissue, and lung tissue was partially resected. In 6 cases, tumors invaded th e pericardium, and the pericardium was partially removed. Mean operating time wa s 106 minutes (80~125 minutes). The mean time of hospital stay was 5 days after the operation, and there was no complication. All patients were alive with a mea n follow-up period of 14 months (3~24 months). Conclusion The figure-L unilateral mini-sternotomy is considered as an effective and useful mi nimally invasive approach for anterior mediastinal tumors.

Objective To explore the clinical character,diagnosis and treatment principals of pyeloureteritis glandularis and cystitis glandularis.Methods The clinical manifestation,character of imageology and endoscopy images of the case for one year follow-up were analyzed and the relevant literatures were reviewed.Results During one year follow-up,there was no clinical symptoms and any progress on imageology.The patient is still in close following-up.Conclusions According to literatures,cystitis glandularis is not common in clinical,and it should be paid more attention by clinicians.There were a few reports about the ureteritis glandularis.Pelvis,ureter and bladder have the same epithelial tissue,pyelitis glandularis is very rare,up to now there is no efficient treatment ways.

BACKGROUND:It has been proved that bone marrow mononuclear cel transplantation can obviously improve neurological function of rats with cerebral hemorrhage. OBJECTIVE:To investigate the effects of transplanted bone marrow mononuclear cel s on the neurological function and apoptosis in perihematomal brain tissues fol owing cerebral hemorrhage in a rat model. METHODS:Twenty-four Sprague-Dawley rats were given stereotaxical injection of col agenase IV into the caudate nucleus to establish cerebral hemorrhage models in transplantation group (n=12) and model group (n=12), and then at 6 hours after cerebral hemorrhage, rats in these two groups were administrated 3x1010/L al ograft bone marrow mononuclear cel s and the same amount of PBS, respectively. Another 12 rats were given no interventions as control group. Neurological functions of rats were assessed at 1, 4, 8, 16 days after cerebral hemorrhage;pathological changes of the injury sites were observed at 16 days after transplantation;neuronal apoptosis rates in the perihematomal brain tissue were detected by flow cytometry at 2 and 4 days after transplantation. RESULTS AND CONCLUSION:The modified neurologic severity scores in the transplantation group were significantly lower than those in the model group at 8 and 16 days after cerebral hemorrhage (P<0.05). In the control group, cel s in each layer arranged closely with complete structure, and neurons and glial cel s were in good shape;in the model group, perihematomal brain tissues were loose with intercel ular gap, in which most neurons and glial cel s became necrotic;in the transplantation group, cel s in each layer arranged closely and regularly, and glial cel proliferation occurred. Besides, compared with the model group, the neuronal apoptosis rate in the transplantation group was significantly lower (P<0.05). To conclude, bone marrow mononuclear cel s can significantly enhance the neurological function recovery and reduce neuronal apoptosis in the brain of cerebral hemorrhage rats.

Objective To investigate the curative effect of the Idarubicin(IDA) in combination with Am-Cand VP16 (IAE) regimen for treatment on refractory acute myelecytic leukemia. Methods Idarubiein 7 mg/m2 iv gtt for 3 days, Ara-C 100 mg/m2 and VP16 100 mg/d iv gtt for 5 days continuously were used as one course.Results Among 17 refractory leukemia patients complete remission was achieved in 9 patients and partial remission in 4 patients, but no remission in 3 patients and one patient died of cerebral hemorrhage after one-two courses of the treatment. Conclusion The IAE regimen for treatment of refractory acute myelocytic leukemia is an effective therapy. The major toxic side effects encountered were marrow suppression,neutropenia and thrombocytopenia. The toxic side effects in heart, liver and kidney were not found.