PURPOSE 10 cases of testicle embryonal rhabdomyosarcoma (RMS) were treated in the Cancer Hospital of Shanghai Medical University from 1971 to 1988. All cases were treated by orchiectomy followed by retroperitoneal node dissection and three of them did not have lymph node metastases. Methods 2 cases were given postoperative irradiation, 7 cases received adjuvant chemotherapy. Results The 2-. 5-year overall survival were 50% and 30% respectively. Conclusion This report analyzes the prognosis of adult testicle embryonal rhabdomyosarcoma. The treatment is a combination of surgery、 chemotherapy and radiotherapy. Intensive chemotherapy should be administered. The prognosis of RMS in adult seems to be worse than in childhood. Patients with negative lymph nodes has better outcome than those with node metastases. Retroperitoneal lymph node dissection after radical inguinal orchiectomy is unnecessary in patients without CT evidence of nodal involvement.

Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.

The paper carries out statistical analysis on medical source journals of CJCR ( Chinese S&T Journal Citation Reports), in order to evaluate the changing trends of academic influence of medical journals form the view of impact factor. The results show that the overall influence of medical core journals assume trend of escalation during the Tenth Five-year, but the growth rate is relatively slowed down. There arc extremely differences in influence levels of medical journals between in China and international, but the overall superiority of medical journals as well as the increasing impact could be continued.

Objective To evaluate the therapeutic effect of transanal local excision in the treatment of low rectal cancer.Methods The data of 49 cases of low rectal cancer patients treated by transanal local excision (group A,37 cases of T1 patients and 12 cases of T2 patients) were reviewed retrospectively,and compared with the group of 45 cases treated by radical resection( group B,11 cases of T1 patients and 34 cases of T2 patients).The 5-year survival rates,recurrence rates and postoperative complications between the two groups were compared.Results The incidence of postoperative complications in group A was significantly lower than that in group B(4.1％ vs 15.6％,x2 =4.69,P ＜0.05 ).The 5-year survival rate of group A was 97.9％ and the 5-year survival rate of group B was 95.6％.There was no significantly statistical difference on the 5-year survival rate between the two groups( x2 =0.439,P ＞ 0.05 ).But for the T2 patients,the recurrence rates in group A was 33.3％,which was significantly higher than the T2 patients in group B(5.9％ ) ( x2 =5.89,P ＜0.05 ).All patients with low histopathological grade tumor in group A showed postoperative recurrence and metastasis.Conclusion Transanal local excision with a rigid criteria can get good curative effect in the T1 patients,but not suitable for the T2 patients or patients with low histopathological grade tumor.

Objective To research etomidate or propofol in the whole intubation during the induction of elderly coronary heart disease autonomic nervous system function. Methods Ninety patients undergoing abdominal surgery patients with coronary heart disease were randomly divided into etomidate group (E group, 45 cases) and propofol group (P group, 45 cases). In pre-anesthesia, after the induction of anesthesia and after intubatiou with power spectral analysis of heart rate variability (HRPSA) observed in patients with heart rate variability (HRV) changes. Results After the induction of anesthesia, the low frequency(LF)[(316±301) ms2/Hz] end total power(TP)[(756±535) ms2/Hz] decreased significantly in E group(P<0.05) and LF, high frequency (HF), LF/HF ratio(LF/HF)and TP decreased significantly in P group [ (187±168) ms2/Hz, (89±48)ms2/Hz, 2.3±1.6 and (616±462) ms2/Hz] (P<0.05). The duction degree of LF, HF, TP and LF/HF in E group was more significant than that in P group (P<0.05). After intubation, LF, HF, LF/HF and TP increased significantly in both groups and no significant difference of HRV was observed between the two groups (P>0.05). Conclusions Propofol decreases the activity of autonomic nervous system, wherea etomidate produces minimal changes under anesthesia induction in elderly coronary heart disease patients.There is no remarkable difference in cardiovasological changes induced by etomidate and propofol during tracheal intubation.

Objective To observe the effect of Glutsmine on intestinal barrier function after traumatic brain injury in rats. Methods A total of 54 adult male Wistar rats were divided randomly into 3 groups, ie, normal group (Group N, 6 rats), TBI group (Group T, 24 rats) and Giutamine intervention group (Group G, 24 rats). Group T and Group G were subdivided into 4 groups according to detection time at days 1,3, 5 and 7 respectively. Meanwhile, 6 rats were enlisted in each group. The intestinal mucosa structure was detected by histopathological examination and electron microscopy. Apoptosis was detected by in situ immunohistochemical staining (TUNEL). Results Glutamine could relieve the pathological lesion of gut mucosa and decrease intestinal mucosa cell apoptosis after traumatic brain injury. Conclusion Glutamine can protect intestinal mucosa barrier function following traumatic brain injury.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

BACKGROUND:Acute myeloid leukemia after liver transplantation is a rare complication with high mortality. OBJECTIVE:To study the clinical features of acute myeloid leukemia after liver transplantation. METHODS:One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed. RESULTS AND CONCLUSION:Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARαpositive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.

Objective To detect the levels of insulin-like growth factors in children with acute leukemia (AL). Methods A total of 50 previously untreated AL patients were selected, meanwhile 30 healthy children were selected as normal controls. AL children were given regular chemotherapy. All cases were not given the brain radiotherapy. The levels of insulin-like growth factor-1 (IGF-1), free insulin-like growth factor-1 (fIGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) in AL patients before treatment and 6 months after complete remission were measured by enzyme-linked immunosorbent assay (ELISA), and were compared with those in normal controls. Results Before treatment, compared with normal controls, the serum levels of IGF-1, IGFBP-3 in AL patients were lower while the level of fIGF-1 was higher, and the differences were signiifcant (P<0.01). At six months after complete remission, the levels of IGF-1 and fIGF-1 in AL patients were similar to those before treatment, but were signiifcantly different from those in control group (P<0.05);the level of IGFBP-3 was signiifcantly higher than that before treatment (P<0.01), but was similar to that in control group. Before treatment, the level of IGFBP-3 in AL patients was positively correlated with the level of IGF-1 (r=0.777, P<0.01), and negatively correlated with the level of fIGF-1 (r=-0.714, P<0.01). Conclusion Insuline-like growth factors were involved in the pathophysiological process in children with AL.

Objective To observe the clinical effect of moxibustion on body sub-health fatigue state.Methods 120 cases of body sub-health patients were randomly divided into A,B,C three groups,with 40 cases in each group.Group A was treated with moxibustion,group B was treated with acupuncture therapy,and group C (control group) did not receive any measure of treatments.Fatigue scale (FS) was adopted to the three groups respectively for measuring physical fatigue score,mental fatigue score and total fatigue score before and after the treatment.Treatment efficacy was evaluated and analyzed after three weeks of continuous treatment.Results The total score of fatigue scale was 6.10 ± 2.47、6.82± 2.36、and 10.10±2.66 respectively in group A,group B and group C.Compared with group C,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was not statistically significant (P＞0.05) ; The Physical fatigue points of group A,B,C was 2.46± 2.06、3.60 ± 2.24 and 5.03 ± 2.66 respectively.Compared with C group,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was statistically significant (P＜0.05).Conclusions Moxibustion and acupuncture can effectively improve patients total body sub-health state of fatigue.Moxibustion treatment showed better effects in alleviating physical fatigue,