Purpose:To study the clinical and pathologica l features of rectal carcinoid and factors influencing the prognosis.Metho ds:Data of 43 rectal carcinoid patients were analyzed retrospectively.4 2 patients were followed up postoperatively. Primary tumors were classified by s ize and muscularis invasion respectively.Results:The 5-year su rvival rate was 100% for the patients with tumor 2cm. the 5-year survival rate was 100% for the patients without muscularis invasion, and 50% for those with muscularis invasion.Conclusions:Tumor size and muscularis invasion are important pr ognostic factors for rectal carcinold.

Objective To seek an effective and feasible treatment for esophageal carcinoma with unequal fractionation radiotherapy.Methods 160 patients with esophageal squamous carcinoma were randomized into an unequal frationation radiotherpy (UEFRT) group and a conventional fractionation radiotherapy (CFRT) group with 80 cases on each side. All the patients were simulated and irradiated by three port technique. Patients in the UEFRT group received D T70 Gy, at 4 Gy once daily, 5 days in the first week, then at 2 Gy daily, 5 days per week during the following five weeks. In the CFRT group,70 Gy was delivered with the routine regimen. Results The 5 year local control rates in UEFRT and CFRT groups were 46.3% and 27.5%(P

Background and purpose:Blood vessel metastasis often occurs after the operation of rectal cancer of stage Ⅱ and Ⅲ,angiogenesis is an important step of the procedure.Cycloxygenase-2(COX-2) and vascular endothelial growth factor(VEGF-C) are correlated to angiogenesis. The purpose of this study is to investigate the expressions of Cycloxygenase 2(COX-2) and vascular endothelial growth factor(VEGF-C) in rectal cancer of stage Ⅱ and Ⅲ,to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis.Methods:The expressions of COX-2,VEGF-C and the microvessel density(MVD) were detected by immunohistochemical staining.Results:①The positive rates of COX-2 and VEGF-C expression in rectal cancer were 72.5%,higher than those in peritumoral normal tissue(P

Objective To investigate the clinical characteristics of isolated renal mucormycosis in children. Methods The clinical manifestations,CT,IVU and surgical findings of 3 children with isolated renal mucormycosis were analyzed. Results A three-month newborn presented asymptomatically except for renal mass.The other two children had fever,lumbar pain,hematuria,renal enlargement and tenderness.CT scan showed multiple low density foci in the kidneys.All of the three children underwent nephrectomy and systemic amphotericin B treatment,and the diagnoses were confirmed by pathological examination. Conclusions Isolated renal mucormycosis is a rare fungal infection without predisposing factors,and its clinical characteristics are different from the usual systemic mucormycosis.Early diagnosis,nephrectomy and systemic amphotericin B treatment are necessary for improving the prognosis.

Objective To study and analyze the cause, prevention and treatment for complications in patients with serious hypospadias repaired by one-stage urethroplasty. Methods From 1987 to 2002,275 patients with serious hypospadias were repaired by one-stage urethroplasty, there were 35 cases had complications. The classifications were penoscrotal 148 cases, scrotal 95 cases and perineal 32 cases. The lengths of new urethras were from 3.0 to 8.4 cm, the mean was (4.1?0.7) cm. Thirty-two cases were received endocrinotherapy before urethroplasty. Results The rate of complications was 12.7% for 1～3 years following survey. There were urethral fistulas 24 cases (8.7%),urethral strictures 6 (2.2%), diverticulums 3 (1.1%), chordees 2 (0.7%).The rate of urethral fistulas was the first and urethral stricture was the second, they were higher than those of other complications (P

Objective To study the correlation between clinicopathological characteristics and lymph node metastasis and prognosis of rectal neuroendocrine tumors (NET),and try to explore the choice of surgical approach.Methods The clinicopathological data of 48 postoperative rectal NET patients were collected.The univariate and multivariate analysis of the correlation between clinicopathologic characteristics and lymph node metastasis were performed by chi-square test and Logistic regression.The prognosis single factor survival analysis was analyzed by Kaplan-Meier method.The survival rates were compared by Log-rank test.The prognosis multivariate survival analysis was performed by the use of Cox model.Results The results of univariate analysis indicated that clinicopathological characteristics related with lymph node metastasis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,distant metastasis and histological grade 3.The results of multivariate analysis showed that histological grade 3 was an independent risk factor of lymph node metastasis (OR=9.333,95 ％CI:1.054 to 82.635,P=0.045).The results of univariate survival analysis suggested that factors correlated with poor prognosis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,lymph node metastasis,distant metastasis and histological grade 3.The results of multivariate survival analysis indicated that tumor distance from anal verge less than six cm (HR=0.215,95 ％CI:0.047 to 0.980,P=0.047),distant metastasis (HR=8.788,95％CI:2.612 to 29.571,P＜0.01) and histological grade3 (HR=5.510,95％CI:1.692-17.944,P=0.005) were independent factors associated with poor prognosis.Conclusions For histological grade 1 and 2 rectal NET patients without distant metastasis,radical surgery is recommended when tumor diameter over two cm or muscularis invasion exists.For histological grade 3 rectal NET patients without distant metastasis,radical surgery is recommended.

Objective: To study the mechanism of chitosan i n inhibiting the proliferation of rabbit aortic smooth muscle cells(SMCs). Methods: By means of c-myc probe labelled with random primers and Northern blot hybridization, we examined the effect of chitosan on vascu lar SMC c- myc mRNA expression, which was stimulated by newborn bull serum (NB S,20%). Results: The oncogene c-myc mRNA expression incerased in cultured vascular SMC 24 h after NBS exposure. These effects were inhibite d by chitosan (20 μg/ml). Conclusion: Chitosan might inhibit the expression of vascular SMC c-myc mRNA stimulated by NBS, through which the proliferation of vascular SMC are inhibited.

Objective To investigate the hemostatic effect of Bletillastriata hemostatic sponge .Methods Tail hemor‐rhage model in rats was preparation .Another model was established in liver and spleen hemorrhagic model of rabbits ,Beagle dog's abdominal aorta and liver were made .Hemostasis was performed with medical gauze ,gelatin sponge and Bletillastriata hemostatic sponge .The hemostatic effects were evaluated by total blood loss ,hemostatic time and histological observation . Observation of Bletillastriata hemostatic sponge change was completed to determine their degradation in the bodies .Results Rats tail hemorrhage was clamped ,after 1 min , Bletillastriata hemostatic sponge could effectively stop the bleeding .The Bletillastriata hemostatic sponge has good hemostatic effect of rats tail hemorrhage model compared to blank group(P<0 .01) . Compare with the gelatin sponge group ,the Bletillastriata hemostatic sponge could significantly shorten the liver and spleen bleeding time(P<0 .05) ,decrease the volume of the spleen bleeding(P<0 .05) and the liver bleeding(P<0 .01) ,in hemor‐rhagic model of rabbits .Compared with the gelatin sponge group ,Bletillastriata hemostatic sponge could more effectively stop the bleeding in the abdominal aorta and liver model of Beagle dogs (P<0 .05) .The Bletillastriata hemostatic sponge could be degraded in vivo .Histologic study revealed the Bletillastriata hemostatic sponge was no significant pathological change around the liver and spleen .Conclusion The Bletillastriata hemostatic sponge has good hemostatic effect .The hemostatic effect of Bletillastriata hemostatic sponge is better than gelatin sponge ,which could be a good topical hemostatic material .

ObjectiveTo observe the treatment effects in 48 cases of advanced lung cancer patients,with the immune therapy of the dendritic cells loading of tumor autologous antigen (DCTAA) combining with the cells induced factor of the killer cells(CIK)from the matched umbilical cord blood cells.MethodsThe peripheral blood mononuclear cell(PBMC)from the matched umbilical cord blood cells was seperated,and induced to CIK and DC with some cytokines in vitro, such as CD3McAb, IL-2, IFN-γ IL-1α, etc. After 12 to 15 days, the amplified CIK cells obtained were obtained, with the strict quality control, infused the CIK cells to the patients body back in six times,about(5-8)×109 CIK cells in each time.In the fifth day of the cultivation,DETAA cells were loaded and DCTAA cells were collected in the eighth day,and then hypodermic injection was done. The patient' s general situation after the immune treatment was observed, such as the size of the tumors, clinical symptom score, the quality of life and immune indexes. Karnofsky score, weight, toxic side effects and the patient's survival were also studied.ResultsIn the 48 cases with the DCTAA-CIK treatment, complete remission (CR), partial remission (PR)was 37 cases, the overall remission rate was 77.1％. The improvement rate of clinical symptom scores was from 78.9 ％ to 84.7 ％, the increasing rate of Karnofsky score was 89.6 ％ (43/48). 1-year survival reached to 80.6 ％. There were significant difference in little toxic side effects(P ＜ 0.01). The proportion of CD3, CD4 and NK cells in peripheral blood cells increased significantly (P ＜ 0.01) after DCTAA-CIK cells treatment[(42.21±6.12)％, (24.42±3.01)％, 0.99±0.34, (24.98±3.02) ％; (71.58±7.64) ％, (37.25±2.13) ％, 1.62±0.45, (35.23±4.11) ％](t = 6.34, 5.67, 0.25, 4.43, P ＜0.01).ConclusionThe DCTAA-CIK immune therapy is benefit for advanced lung cancer,not only improve the immune function but also ameliorate the clinical symptoms.

The clinical evidences of the guideline came from clinical trials based evidence-based medicine. Applied principle of the evidence was: systematic reviews, RCTs, the results from multiple factors ana-lysis, consensus, especially combined with Chinese experience and some lung cancer guidelines used in USA or Europe. All doctors who use the guideline in making therapeutic strategy must combine patients' conditions with the knowledge of biological behavior, dynamic change and response to treatment of lung cancer.