Objective To assess the value and complications of restaging laparotomy in women with presumed early ovarian cancer who have undergone inadequate initial staging procedures. Methods Between 1986 and 1996, 42 patients underwent restaging laparotomy in Cancer Hospital, Peking Union Medical College after receiving inadequate initial surgical procedure for presumed early ovarian cancer. Presumed stages from initial surgery include stage Ⅰa in 28 cases; Ⅰb in 1 case; Ⅰc in 12 cases; Ⅱa in 1 case. Histological distributions were as follows: epithelial cancer in 26 cases; malignant germ cell tumor in 9 cases; granulose cell tumor in 7 cases. Results Twelve patients (28.6%) had disease upstaged and eight (19.0%) had stage Ⅲ disease confirmed by restaging laparotomy. Positive findings at restaging laparotomy were mainly in omentum (16.7%) and pericolic gutters (33.3%). Peritoneal cytology was positive in 25.0 percent of patients. Three and five year survival rates for 30 patients with negative findings were 96.7% and 86.7%, respectively. Complications of restaging laparotomy included hemorrhage blood loss (50～ 1 100 ml, average 280 ml) and lymphocyst (7.1%). Conclusions Patients with presumed early ovarian cancer who had undergone inadequate staging procedures should undergo restaging laparotomy. Patients with negative findings have an excellent prognosis. Complications of restaging laparotomy were minor.

Objective To evaluate the safety and efficaey of oxaliplatin plus capecitabine combined with concurrent radiotherapy in treatment of locally advaneed oesophageal squamous cell cancer (OSCC).Methods Between July 2003 and December 2008, 46 patients with locally advanced OSCC were irradiated with a dose of 60-64 Gy in 30-32 fractions. The target area included the primary tumor, the lymph nodes with short axis ≥ 10 ram, and the lymphatic drainage region. Two cycles of concurrent chemotherapy was given during radiotherapy, with the oxaliplatin of 85 mg/m~2 on d_1, d_(21), d_(41) and capecitabine of 850 mg/m~2 on d_(1-14) and d_(21-35), which was followed by two cycles of adjuvant chemotherapy. Results The complete re-sponse rate was 33% (14/46), and partial response rate was 56% (24/46), thus the response rate was 88%. Three patients (7%) had no response and 2 patients (5%) had progression. Obstruction relief rate was 90% ,and pain in the chest and back disappeared in 100% of patients. The 1-,2- and 3-year local con-trol rates and overall survival rates were 72% ,40%, 34% and 80%, 45%, 40%, respectively. Acute ra-diation-induced esophagitis rate was 100%, of which 19% was ≥ grade 3. Leuoopenia occurred in 65% of paients and 23% was ≥ grade 3. 23% of the patients had reduced hemoglobin, and 10% with ≥ grade 3.Hand and foot syndrome rate was 16%, and 4% was ≥grade 3. Conclusions Oxaliplatin plus capecit-abine combined with concurrent radiotherapy may be an effective and well-tolerated regimen in patients with locally advanced oesophageal cancer.

Objective　To summarize the experience in diagnosis and treatment of rare type of hepatic benign tumor and tumor-like lesions.Methods　The clinical data of 58 cases of uncommon benign hepatic tumor and tumor-like lesions admitted to Changhai Hospital from January 1980 to June 2000 were retrospectively reviewed. Results　Of the 58 cases, 26 were inflammatory pseudotumors, 8 focal hyperplastic lesions, 7 hepatocellular adenomas, 7 lipomatous tumors, 5 cystadenomas, 3 tuberculosis, 1 harmatoma and 1 neurofibroma. 82.8% of the cases had symptoms, 17.2% without obvious symptoms. Single lesion was found in 93.1%, multiple lesions in 6.9%. Operative procedures as follows: 30 local resections of the lesion, 14 hepatic segmentectomies, 9 hepatic lobectomies, 2 hepatic artery ligations, 1 hepatic artery ligation plus drainage of cyst, 2 liver biopsies. No operative mortality and no serious morbidity were noted. Conclusions　With popularization of advanced imaging techniques, the incidences of the benign tumor and tumor-like lesions of the liver have been increased in recent years. However, current imaging studies lack specificity, and differential dignosis of these lesions remains difficult. So we should be familiar with the clinical behavior, presentation of imagings and management of the diseases mentioned above.

OBJECTIVE: To observe anatomic structure of jugular foramen region by endoscope, to provide anatomic data for avoiding damnification in the surgery. METHOD: We performed the retrolabyrinthine and retrosigmoid endoscopic surgery on 8 fomalin-fixed adult cadaver specimens and observed the structures of jugular foramen by endoscope and compared the different surgeries at the same time. We excised the calvarium and cereburm and exposured and observed the nerves and vessels. Moreover we measured the the distance from internal accoustic pore to glossopharyngeal and analyse the data by SPSS. RESULT: All retrolabyrinthine endoscopic surgeries were performed successfully. Only 4 postsigmoid endoscopic surgeries were performed without damage of cerebellum which is the major obstacles. The distance from internal accoustic pore to glossopharyngeal was(8.26 ± 1.05) mm. About half of posterior inferior cerebellar arteries located to inboard of nerves. CONCLUSION The jugular foramen region endoscopic surgery can be performed successfully by retrolabyrinthine. The "lockhole" technology by retrosigmoid is more difficult for blocking of cerebella. The internal acoustic porus is a fixed structure of the cerebellopontine angleand a perfect landmark to the surgery.
Adult ; Cadaver ; Endoscopy ; Foramen Magnum ; anatomy & histology ; Humans ; Jugular Veins ; anatomy & histology ; Temporal Bone ; anatomy & histology

[ABSTRACT]OBJECTIVETo investigate the clinic significance of nasal septal swell body by observing and measuring it in the normal and deviated nasal septum on CT images.METHODSThe locations of the nasal septal swell bodies on horizontal CT images in 50 normal subjects and 30 patients with deviated nasal septum were studied, and their length, width and the thicknesses of the mucosa of the both sides were measured. The data were analyzed with SPSS.RESULTSSeptal swell bodies were observed in most of CT images. The swell body was fusiform and located anterior to the middle turbinate, with mean(SD) width of (10.30±1.27) mm and length of (31.35±5.18) mm. There no marked difference in thickness of the nasal septal swell body between two sides of the nasal septum in normal nasal septum, but the thickness of the nasal septal swell body in camber side was thicker than that in the other side of the deviate nasal septum.CONCLUSIONThe shape and location of spetal swell body suggests its potential capacity may be to alter the nasal airflow. Additional study is required for its clinical significance.

Objective To investigate the patterns of intrathoracic lymph node metastasis in nonsmall cell lung cancer (NSCLC) and to provide a theoretical basis for the delineation of radiotherapy target volume.Methods A retrospective analysis was performed on the clinical data of 314 NSCLC patients after operation.Our focus was to investigate the distribution characteristics and metastatic extent of intrathoracic lymph nodes and their relationship with tumor size,pathological type,and primary site.Comparisons between groups were made by one-way analysis of variance.Results The frequencies of metastases to lymph nodes at stations 4,5,7,10,and 11 were all above 12％,while those at stations 1,2,3,6,8,and 9 were all below 12％.The lymph node metastasis rate was similar on the primary tumor site (P =0.102).The patients with T3 and T4 NSCLC had a significantly higher frequency of N2 lymph node metastasis than those with T1 and T2 NSCLC (17.0％ vs.11.6％,P =0.002) ;the patients with adenocarcinoma had a significantly higher frequency of N2 lymph node metastasis than those with squamous cell carcinoma (34.5 ％ vs.23.2％,P =0.008).Conclusions For patients with T3 and T4 NSCLC of adenocarcinoma subtype,we should highlight the lymph nodes at stations 4,5,7,10,and 11 when delineating the radiotherapy target volume after operation.

In the Jinsong district of Beijing,345 patients with dyslipidemia were selected for study.Health management was implemented for one year,during which time,monitoring,analysis,and evaluation of the health of individuals and groups was conducted; health advice and guidance were given with regard to health risk factors.After the one-year intervention,the average daily dietary intake of salt,oil,and meat was reduced by 2,4,and 18 g,respectively,and the average daily intake of vegetables increased by 45 g.The average levels of body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol,triglycerides,and low-density lipoprotein cholesterol were reduced by 0.47 kg/m2,3.0 mm Hg ( 1 mm Hg =0.133 kPa),1.6 mm Hg,0.76 mmol/L,0.83 mmol/L,and 0.42 mmol/L,respectively,while the average level of high-density lipoprotein cholesterol increased by 0.05 mmol/L.All the differences were significant.

Obstetrics and Gynecology Hospital, Capital University of Medical Science, Beijing 100026, ChinaAbstract Objective To observe the change of lipid metabolic parameters, sex hormone and bone mineral density(BMD) in patients with endometriosis before and after oral administration of gestrinone. Methods Fifty-six patients with endometriosis, aged from 20 to 45, were treated with gestrinone 2.5 mg two times a week for 6 months one week after operation. Serum total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C),ApoA_1,ApoB,follicle stimulating hormone (FSH), luteinizing hormone(LH),E_2 and BMD were determined before taking gestrinone, after taking for 6 months and withdrawal for 6 months. Results After administration of gestrinone for 6 months, serum HDL-C and ApoA_1 decreased significantly (P

Objective To evaluate the formation of coronary collateral circulation with intracoronary Doppler ultrasound in pigs after acute occlusion and the influence of nitroglycerin and phentolamine on it.Methods The blood flow spectrun was detected in 14 pigs using intracoronary Doppler ultrasound before and after acute occlusion of the left circumflex artery (LCX) and its response to nitroglycerin and phentolamine.The average peak velocity (APV) and the diastolic systolic velocity ratio (DSVR) were recorded. Results The APV of the LCX decreased significantly at 10 min after acute occlusion (0.97?1.05 vs 25.78?4.36 cm/s,P0.05). Conclusion Intracoronary Doppler ultrasound can be used to evaluate coronary collateral circulation. The formation collateral circulation was insufficient after acute occlusion of coronary artery in pigs and nitroglycerin or phentolamine can improve the blood flow.

OBJECTIVE To compare the BacT/Alert FN with Botai SN anaerobic blood culture bottles for detection of commonly encountered anaerobes.METHODS Using these two types of anaerobic bottles to culture 5 commonly encountered anaerobes in automatic blood culturing system and BacT/Alert system,and then to analyze the results.RESULTS There were all 32 anaerobic bottles reported positive results by BacT/Alert FN bottles,and only 8 positive bottles were reported by Botai SN bottles.CONCLUSIONS The performance of the BacT/Alert FN is much better than Botai SN anaerobic blood culturing bottle when it is used to detect commonly encountered anaerobes.