Humans ; Mining ; Noise, Occupational ; statistics & numerical data ; Occupational Exposure ; statistics & numerical data ; Work Schedule Tolerance

Objective:To investigate the clinical characteristics and therapy of laryngeal neuroendocrine carcinoma(LNEC).Method:Ten cases of LNEC treated in our department were retrospectively analyzed.Result:Eight out of 10 cases were were atypical carcinoid:1 case treated as supraglottic horizontal partial laryngectomy died 22 months after operation; 1 case was lost;the other 6 cases were followed up for more than 2 years. Two cases were small cell type,one received supra-cricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) ,neck dissection,and radiotherapy,but died after 14 months;the other was receiving radiotherapy.Conclusion:LNEC is a rare malignant tumor and the diagnosis relies on clinical characteristics, histopathological and immunohistochemistry examination. The different types of LNEC should give different treatment protocols.

Objective To summarize the nursing experience of treatment of percutaneous and transhepatic portal venous autologous bone marrow stem cell transplantation for chronic hepatic failure.Methods 19 patients who were definitely diagnosed as chronic liver failure received pertinent nursing in different perioperative period of transhepatic portal venous autologous bone marrow stem cell transplantation.Results All of the 19 patients went through perioperative period safely without any adverse reactions or complications.Conclusions In the process of treatment of autologous bone marrow stem cell transplantation for chronic hepatic failure,sufficient preoperative preparation,good communication and close cooperation among doctors,nurses and patients during operation,careful nursing and rehabilitation instruction after operation,are important assurances for autologous bone marrow stem cell transplantation to run smoothly.

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.

Objective:To analyze the radionuclide bone imaging features of spine tumors and its clinical value.Methods and results:Data of radionuclide planar whole-body bone imaging with 99m Tc-MDP were analyzed in90patients with various spinal tumors confirmed by histopathology.In49patients with metastases,bone imaging was positive in43;37vertebra showed strong uptake;30patients involved the whole vertebra with symmetrical enlargement in18;other extravertebral bone foci were seen in29.In17patients with primary malignant bone tumors,bone imaging was positive in12;11vertebra showed strong uptake;and8involved the whole vertebra;3focal lesions had local irregular bulging;other extravertebral bone foci were seen in4.In24patients with benign bone tumors,bone imaging was positive in13;6vertebra showed strong uptake; other extravertebral bone foci were seen in1.Conclusion:Spinal metastases in bone imaging are mainly multiple,strong up-take of whole vertebra and accompanied by symmetrical enlargement with other extravertebral bone foci.Primary malignant bone tumor is mainly single or multiple,strong uptake of whole vertebra without symmetrical enlargement,some with local irregular bulging lesions. [

Objective To observe the apoptosis of retina and the expression of caspase-3 in mice with premature myopia and to explore the pathogenesis of premature myopia.Methods Together 60 newborn C57BL/6J mice were selected and divided randomly into three groups (n =20):P6 group (opening the eyelid on day 6 after birth),P10 group (opening the eyelid on day 10 after birth) and normal group (opening the eyelid naturally).The right eyes of mice in the P6 and P10 group were subjected to lighting exposure,and the left eyes were left untreated serving controls with its right eyes;while the eyes in the normal group open naturally without any treatment.Then the refraction was checked on day 15 through retinophotoscopy,and ocular axial length was measured by micrometer with electronic digital display.TUNEL assay was used to determine retinal apoptosis.Immunohistochemistry and Western blot were used to detect the expression of caspase-3 in mice retina.Results The right eyes developed significant myopia in the P6 group [(-7.55 ±0.15)D] and P10 group [(-5.25 ±0.10)D],while the eyes in the normal group did not suffer from myopia,and there was significant difference in the three groups (P ＜0.05).The average axial length of right eyes in the P6 group [(2.49 ± 0.08) mm] and the P10 group [(2.51 ±0.03)mm] was shorter than that in the normal group [(2.58 ± 0.04) mm],with significant difference (P ＜ 0.05).Immunohistochemistry showed that the expression of caspase-3 had a dramatically increase in ganglion cell layer and inner nuclear layer of retina of mice in P6 group and P10 group.TUNEL results showed that brown-stained positive apoptotic cells appeared in ganglion cell layer in the P6 and P10 group,while Western blot showed that the expression of caspase-3 protein in mouse retina in P6 group (gray value 52.70％) and P10 group (gray value 35.76％) was upregulated.Conclusion Early lighting exposure can induce premature myopia of mice,and the earlier the mice receive light,the higher the relative degree of myopia is;meanwhile during the process of premature myopia,ganglion cells and nuclear layer cells suffer apoptosis,as well as caspase-3 protein involves in the occurrence of apoptosis.

Objective To investigate the influencing factors and prognosis of early and late recurrence after radical resection of primary hepatocellular carcinoma(HCC).Methods The clinical data of 117 patients who received radical resection of HCC at the Tongji Hospital of Huazhong University of Science and Technology from January 2003 to December 2006 were retrospectively analyzed.Tumor recurrence occurred within 2 years after operation was defined as early recurrence,and tumor recurrence occurred latter than 2 years after operation was defined as late recurrence.Relationship between postoperative tumor recurrence and level of alpha-fetoprotein (AFP),AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation,hepatic cirrhosis,hepatic function,hepatitis B surface antigen,procedure of hepatic resection and blood transfusion was analyzed.The overall survival and disease-free survival rates were determined by Kaplan-Meier method,and the survival rate was analyzed by Log-rank test.Results Eighty-five(72.6％)patients were found with tumor recurrence,including 59(50.4％)with early tumor recurrence and 26(22.2％)with late tumor recurrence.Levels of AFP,AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation and blood transfusion were the influencing factors of early recurrence(x2 = 12.78,13.40,5.79,9.98,10.26,9.48,8.32,P ＜ 0.05).Level of AFP and hepatic cirrhosis were the influencing factors of late recurrence(x2 =4.46,7.75,P ＜ 0.05).AFP/V,tumor number and blood vessel invasion were the independent risk factors of early recurrence(RR = 0.170,0.172,0.064,P ＜ 0.05).Hepatic cirrhosis was the independent risk factor of late recurrence(RR = 2.809, P ＜ 0.05).The 1-,3-,5-year overall survival rates and tumor-free survival rates were 82.6％,60.8％,54.9％ and 65.0％,38.5％,23.1％.There were significant differences in overall survival and disease-free survival rates among patients with AFP ＜20 μg/L,AFP/V ＜ 14 μg/(L · cm3)or AFP/V ≥ 14 μg/(L · cm3)(P ＜ 0.05).The 1-,3-,5-year overall survival rates of patients with early tumor recurrence were 64.9％,23.0％ and 20.5％,respectively,and the 1-,3-,5-year overall survival rates of patients with late tumor recurrence were 100.0％,88.5％ and 72.5％,respectively.A significant difference in the 1-,3-,5-year overall survival rates between patients with early or late tumor recurrence was observed(x2 = 26.918,P ＜0.05).Conclusions AFP/V,tumor number,blood vessel invasion were independent risk factors of early tumor recurrence,and hepatic cirrhosis was the independent risk factor of late tumor recurrence.There is a significant difference in the survival rate between patients with early or late tumor recurrence.

BACKGROUND: There are disputes concerning limb salvage and reconstruction in treating pelvis malignant tumor.OBJECTIVE: To study the surgical treatment following resection of tumor at acetabular region in order to restore pelvic stability with less damage or recurrence.METHODS: Thirty-three patients diagnosed with pelvic tumor at Department of Orthopaedics, First Affiliated Hospital of Second Military Medical University from April 2002 to June 2008 were selected. All patients were received tumor resection and computer-aided prosthetic replacement, 18 patients (8 cases with chondrosarcoma, 2 cases with Ewing sarcoma, 2 cases with osteosarcoma, and 6 cases with malignant fibrous histiocytoma) were combined with antitumor drug treatment. Functional assessment of therapeutic efficacy was divided into 4 levels: excellent, good, moderate, and inferior.RESULTS AND CONCLUSION: Two patients died at months 4 and 6 after prosthetic replacement; 31 cases were followed-up for 8-32 months, mean 12.5 months. Seven cases were recurred chondrosarcoma, the recovery of other patients were as follow: 18 cases were excellent, 4 cases were good, 2 cases were moderate and no case was inferior. Most of limb function and pelvic stability was preserved. The results suggested that malignant fibrous histiocytoma and Ewing sarcoma can receive a high rate of limb preservation if treated by effective chemotherapy with low recurrence; the recurrence of chondrosarcoma was high. Tumor resection combined with computer-aided prosthetic replacement can maximatily reserve limb function and raise life quality.

Objective To explore the molecular mechanism through detecting methylation status in esophageal carcinoma and Barrett's esophagus.Methods The methylation-specific PCR was employed to detect the expressions of RASSF2 in esophageal carcinoma tissues,adjacent tissues from 27 patients after surgery and Barrett's esophagus tissues from 18 patients after gastroscopic biopsy.Results The rate of RASSF2 methylation was much higher in esophageal carcinoma (66.7 ％,18/27) than that in adjacent tissues (22.2 ％,6/27) (P ＜ 0.05),and was more frequently than that in Barrett's esophagus (33.3 ％,6/18) (P ＜ 0.05).However,no significant difference of methylation status was observed between Barrett's esophagus and adjacent tissue (P ＞ 0.05).Conclusion The hypermethylation of RASSF2 may be the molecular mechanism in the development of esophageal carcinoma,and more samples should be used for further experiment in Barrett' s esophagus.

OBJECTIVE:To study the feasibility of overflow dissolution method for evaluating the drug in vitro sustained re-lease performance. METHODS:Overflow dissolution method was established by simulating the drugs elimination in vivo. Using Nifedipine sustained-elease tablets(Ⅰ)from 2 different manufacturers as model drug A,B,concentration-time curve,cumulative release rate- time curve,release velocity-time curve of model drugs in release pool at 3 different overflow speed (0,1.50,3.00 mL/min)were investigated. RESULTS:When overflow speed was 0,the cumulative dissolution was consistent with that of the con-ventional dissolution method. As the overflow speed increased,cmax of drug A,B was decreased [A:(8.89±0.20),(5.21±0.04), (3.51±0.03)μg/mL;B:(7.62±0.05),(4.80±0.09),(2.89±0.04)μg/mL];cumulative release rate was increased [A:(85.47± 2.45)%,(94.29 ± 2.44)%,(96.04 ± 2.56)%;B:(73.28 ± 1.13)%,(78.46 ± 1.94)%,(82.50 ± 1.69)%] ;tmax was ahead (A:1.5,1.0,0.5 h;B:2.0,1.0,0.5 h). CONCLUSIONS:Overflow dissolution method has avoided the inhibition of too large drug concentration on drug release,making complete drug release and more accurate evaluation of in vivo sustained release performance of the preparation.