Purpose:To analyze retrospectively the clinical manifestation, treatment and prognosis. Methods:From 1978 to 1996,16 patients with olfactory neuroblastoma were treated.4 cases were stage A,6 cases were stage B and 6 cases were stage C. Six patients were treated with radiotherapy alone or combined with chemotherapy, 9, with surgery and postoperative radiotherapy and 1,with operative alone. The radiation dosage ranged from 40～70Gy with 2 Gy per day. Results:The 1 , 3 and 5 year survival rates were 75%, 75% and 69%.Conclusions:Olfactory neuroblastoma is sensitivity for radiotherapy, for the patients with stage A, radiotherapy alone is effective for stage B and C olfactory neuroblastoma , combined modality of surgery and postoperative radiotherapy should be the treatment of choice.

AlM:To evaluate the efficacy of retrobulbar injection of triamcinolone acetonide ( TA ) combined with 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema.
METHODS: Fifty-eight cases ( 66 eyes ) with cystoid macular edema caused by different diseases were recruited in this study. The included patients were treated with both retrobulbar injection of triamcinolone acetonide and 577nm laser macular grid photocoagulation. The best corrected visual acuity, macular thickness, fundus and intraocular pressure were observed in the 1wk, 1 and 3mo after the treatment in all of the included cases.
RESULTS: After treatment, all of the 66 eyes showed cystoid macular edema partially or completely subsided according to optical coherence tomography and fluorescence fundus angiography; 54 eyes ( 82%) visual acuity improved, 12 vision remained the same.
CONCLUSlON: Retrobulbar injection of triamcinolone acetonide combined with 577nm laser macular grid photocoagulation has good curative effect, simple operation procedure and rare complications in the management of cystoid macular edema.

Objectives To clarify the basic data such as prevalent range,regiohal characteristics and the population at risk of drinking brick-tea type fluorosis in China.Methods Comprehensive survey for basic information was conducted in the provinces and autonomous regions where drinking brick-tea type fluorosis Wag prevalent,ineluding Inner Mongolia Autonomous Region,Tibet Autonomous Region, Sichuan Province,Xinjiang Autonomous Region, Qinghai Province,Gansu Province,Ningxia Autonomous Region and Yunan Province.The survey included the number ot counties(cifies)and townships(towns)where the people were accustomed to drinking brick-tea,pepulation,ethnic minority composition,the production and living style,sales and the kinds of brick-tea aIn so on.Results Two hundred and forty-one counties and 3246 townships were found to haye the habit 0f drinking brick-tea,among which 87.46%(2839/3246)had the habit for more than 30 years.There were 31 684 administrative vilages(residents' committees),15 047 elementary schools and 2873 temples surveyed,coveting a total population of 31 052 398 and 122 739 monks.Fifty-three ethnic minorities were involved.Han accounted for 44.86%(12 902 710/31 052 398), Uighur ethnic for 20.98%(7 416 474/31 052 398),Tibetan ethnic for 13.34%(4 323 272/31 052 398),Muslim ethnicfor 8.15%(2 767 603/31 052 398),Mongolian ethnic for 4.61%(1 400 206/31 052 398),Kazak ethnicfor 3.45% (1 218 272/31 052 398),of the population of drinking brick-tea,farmer population accounted for 64.13%(19 912 833/ 31 052 398),herdsman population for 8.79%(2 728 418/31 052 398),farmer-herdsman population for 12.53%(3 889 678/ 31 052 398)and town population for 14.56%(4 521 169/31 052 398).There Was 3926.74 tons of brick-tea sold per year in the investigated regions,mainly of Fu brick-tea,Green brick-tea and Black brick-tea.Areas with high brick- tea consumption distributed mainly in farmer region and farmer-herdsman region.Annual per capita consumption of brick-tea for farmers was 3.77 kg,and for farmer-herdsman population was 2.05 kg.Conclusions Begions with the habit of drinking brick-tea distributes extensively in western China and cover a huge population,and the herdsmen and farmer-herdsman are the main risk population.Drinking brick-tea type fluorosis is a seriolls public health issue in western China.

OBJECTIVETo explore the clinical characteristics and prognosis of children and adolescents over 10 years of age with acute lymphoblastic leukemia (ALL).

METHODSA total of 86 newly diagnosed ALL children and adolescents over 10 years of age (62 cases of B-ALL and 24 cases of T-ALL) were enrolled. Clinical characteristics, therapeutic effect and prognostic factors were retrospectively analyzed. Event-free survival (EFS) and overall survival (OS) rates were estimated by the Kaplan-Meier method. Prognostic factors were evaluated by COX regression analysis.

RESULTSOf 86 patients, 62 were in medium risk, and 24 in high risk. At diagnosis, 53 patients (62%) had hepatomegaly, 50 patients (58%) had splenomegaly, and 46 patients (54%) had lymphoadenopathy. Twenty-nine patients (34%) showed high leukocyte counts (≥50×10/L) at diagnosis. The karyotype analysis was performed on 78 patients. The percentage of hyperdiploidy was 19% (15 cases), and that of hypodiploidy was 5% (4 cases). Eleven patients (14%) had abnormalities of chromosome structure. Of them, one patient was Philadelphia chromosome-positive, and another patient had the t (1; 19) chromosomal translocation. Three patients (4%) were positive for TEL/AML1, 3 (4%) were positive for E2A/PBX1, 6 were positive for BCR/ABL (7%), and 4 (5%) were positive for SIL/TAL1. During 4 weeks of induction therapy, 85 patients (99%) achieved complete remission (CR). In 86 patients, the 5-year anticipated EFS and OS were (64±6)% and (75±5)% respectively. The 5-year EFS and OS in the medium risk group were significantly higher than those in the high risk group (P<0.05). The 5-year EFS in B-ALL patients was significantly higher than that in T-ALL patients (P<0.05). COX multivariate analysis showed that white blood counts at diagnosis and minimal residual disease (MRD) after induction therapy were independent prognostic factors.

CONCLUSIONSChildren and adolescents with ALL over 10 years of age often have clinical characteristics of unfavorable prognosis. White blood counts at diagnosis and MRD after induction therapy may be important factors for the long-term prognosis.

Adolescent ; Child ; Female ; Humans ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; mortality ; Prognosis ; Proportional Hazards Models

OBJECTIVETo evaluate the possibility of applying oligonucleotide microarrays for detection of the fusion genes in childhood acute lymphoblastic leukemia (ALL).

METHODSTo detect five types of fusion genes emerging frequently in childhood ALL including TEL/AML1, E2A/PBX1, BCR/ABLp190, BCR/ABLp210, MLL/AF4, probes were designed, synthesized and spotted on the chemical-material-coated-glass plates in array. The total RNAs were extracted from patients' bone marrow or peripheral blood cells at the beginning of diagnosis, analyzed by multiplex nested reverse-transcription-polymerase chain reaction (RT-PCR), and labeled by fluorescein. The products of RT-PCR were hybridized with microarray in order to detect specific types of fusion genes in leukemia cells.

RESULTSDistinctive hybridization signals were obtained for internal positive control and specific types of fusion genes. TEL/AML1 gene was found positive in 2 of the 36 cases, E2A/PBX1 gene in 3, BCR/ABLp190 gene in 2, BCR/ ABLp210 gene in one, and MLL/ AF4 gene in one. The results of the microarray and RT-PCR were consistent.

CONCLUSIONThe microarray-based assay could screen 5 types of chromosome structural aberrations and the splice variants at the same time. It can provide reliable and helpful information for patient stratification, evaluation of therapeutic effects and prediction of prognosis in childhood ALL, although there are both advantages and disadvantages in applying this new method.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Oligonucleotide Array Sequence Analysis ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.

METHODSThis study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes.

RESULTSThe success rate of bilateral vasoepididymostomy, unilateral vasoepididymostomy, and unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis) were 62.26% (33/53), 35.71% (5/14), and 77.78% (7/9), respectively. The average sperm concentrations in the three groups of patients were (27.9 +/- 5.74), (11.8 +/- 8.33), and (19.9 +/- 7.53) x 10(6)/ml, the average total sperm counts were (65.6 +/- 13.71), (28.0 +/- 15.86), and (69.2 +/- 28.59) x 10(6), and the mean rates of progressively motile sperm were (22.3 +/- 3.18), (11.0 +/- 9.77), and (15.8 +/- 5.05)%, respectively. The success rates of bilateral vasoepididymostomy that involved the epididymal head, body, tail, and all the three parts were 62.5, 72.22, 60, and 54.55%, respectively. Natural pregnancy was achieved in 8 (10.53%) of the total number of cases.

CONCLUSIONMicrosurgery is effective for the treatment obstructive azoospermia. Unilateral vasoepididymostomy + unilateral vasovasostomy is superior to the other procedures, followed by bilateral vasoepididymostomy. Bilateral vasoepididymostomy involving the epididymal body may achieve a slightly better effect than that involving the other epididymal parts.

Adult ; Anastomosis, Surgical ; methods ; Azoospermia ; etiology ; surgery ; Epididymis ; surgery ; Female ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; Pregnancy ; Pregnancy Rate ; Sperm Count ; Treatment Outcome ; Vas Deferens ; surgery ; Vasovasostomy ; methods

Objective To evaluate the applied value of percutaneous oxygen-ozone injection in the treatment of lumbar disc herniation under open 0.23 T MRI guidance.Methods Mounted with ipath 200 optical tracking system,MR-guided injection of oxygen-ozone were performed via a medial border of the articular processes approach in 73 patients with clinically diagnosed LDH.MR compatible 19.5G or 21.0 G biopsy needle was used. Discography was performed in order to select indication before injection oxygen- ozone into nucleus pulposus in 26 patients.Sixty-four patients were injected to three sites:(1)Six to 10 ml oxygen-ozone was injected into discs centers,injected and suctioned alternately in order to make nucleus pulposus oxidation thoroughly.(2)The needle was withdrawn according to the scale of biopsy needle and optical tracking.Then,10 ml oxygen-ozone was injected into disc herniation. (3)After that,needle was withdrawn further about 1.0—1.5 cm to outside of annulus fibrosus.Fifteen to 20 ml oxygen-ozone was injected into intervertebral foramina around nerve roots.The oxygen-ozone concentration was 35—45?g/ml. Nine patients were only performed injection of oxygen-ozone into around nerve root,while not injection oxygen-ozone to nucleus pulposus for considering bad curative effect after discography.Results All of 73 patients were successfully local targeted and treated under MRI guidance without serious complications, such as nerve root injury.After 3—6 months follow-up,total overall efficacy was 91.3% with the excellent in 28,good in 39,and poor in 6,respectively.Conclusion Open MR-guided injection of oxygen-ozone, mounted with optical tracking system,is a safe and effective minimally invasive therapy for treating LDH.

Child ; Epstein-Barr Virus Infections ; complications ; Female ; Giardia lamblia ; isolation & purification ; Giardiasis ; complications ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Lymphohistiocytosis, Hemophagocytic ; drug therapy ; etiology

Child, Preschool ; Humans ; Male ; Neurofibromatoses ; etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications

Objective To explore the effect of glutamine on the nutritional status and inflammatory response by strengthening parenteral nutrition in patients after general surgery .Methods Forty patients with systemic inflammatory response syndrome ( SIRS ) in our hospital were selected , and all patients were randomly divided into treatment group and control group, with 20 cases in each group.Patients in treatment group were given glutamine to strengthen parenteral nutrition , while those in the control group received amino acid solution for parenteral nutrition .The treatment continued for one week .The data of level of hemoglobin , albu-min, transferrin and immunoglobulin (IgG, IgA, and IgM), as well as nutrition risk screening score and acute physiology , age and chronic health evaluation score in two groups before and after parenteral nutrition were recorded and compared .Results After parenteral nutrition , the data of hemoglobin ,albumin and transferrin in the treatment group were (116.5 ±9.2), (35.7 ±2.4) and (66.3 ±2.4) g? L-1, respective-ly, and (102.5 ±8.6), (30.8 ±2.2) and (59.6 ±2.1) g? L-1 in control group (P<0.05);after parenteral nutrition, the data of IgG, IgA, and IgM levels in the treatment group were significantly higher than those in the control group , and nutrition risk screening score and acute physiology and chronic health score were significantly lower than those in the control group (P <0.05).Conclusion The effect of glutamine parenteral nutrition on SIRS patients is significant , and it can im-prove patients′nutritional status and the immune function recovery .