Objective:To evaluate the effects of modified neck dissection (MND)preserving jugular vein on patients with supraglottic laryngeal carcinoma,the clinical data of 88 cases were analyzed retrospectively.Methods:There were 48 males and 40 females,ranging in age from 37 to 72 years old who were diagnosed supraglottic laryngeal squamous cell carcinoma.The clinical stages were T18,T2 30,T3 28,T4 22,cN1 38,cN2 48,cN3 2;pN0 11,pN1 21,pN2 54 and pN3 2,respectively.Among 146 lateral neck dissections in 88 cases (bilateral 58 cases,one lateral 30 cases),106 were MND,40 being radical neck dissections (RND).Of 106 MND,64 were simultaneously performed bilateral neck dissections (18 cases preserved bilateral jugular veins,14 cases preserved on side jugular veins),52 subsequently bilateral neck dissections(first time was RND ,and the second time was all MND).One side MND was performed in 30 cases,which preserved jugular veins.Results:The 3-year survival rate was 81.5%(22/27)in the simultaneous bilateral neck dissection,60.9%(14/23)in the subsequent neck dissection,75.0%(15/20)in the one lateral neck dissection.The 5-year survival rate was 61.5%(16/26),40.9%(9/22),70.6%(12/17)respectively.The recurrent rate of lymph node postoperative was 12.9%(11/85)in the lymph node less than 3cm in diameter,47.6%(10/21)more than 3cm in diameter.The recurrent rate of lymph node was 22.5%(9/40)in the group of RND,19.8%(12/106)in the group of MND.Conclusions:Because the neck lymph node metastasis often occurred in supraglottic carcinoma,the bilateral neck dissection is necessary during which one side jugular vein must be preserved.Results suggested that if the metastasis lymph node was less than 3cm in diameter and had not adhered to jugular vein,the jugular vein should be preserved,which could lesson complications and get better life quality.

Objective To explore the prevalence of hypertension in children with obstructive sleep apnea syndrome(OSAS).Methods Ninety snoring children were enrolled and stayed in sleeping monitor unit for a night.24 h ambulatory blood pressure(ABP)monitoring and polysomnography were simultaneously carried out. The children were classified depending of [Apnea Hypopnea Index(AHI≥5)] as OSAS group and(AHI

Objective To assess the diagnostic value of spiral CT colonography(SCTC)with orally administered Mannitol as negative contrast in colorectal tumor.Methods 27 volunteers and 68 patients suspected of various kinds of colorectal diseases were examined.About 1500 ml isosmotic Mannitol as oral negative contrast agent was administered and then 20mg of Raceanisodamine hydrochloride was injected intramuscularly,three phase enhanced spiral CT scanning was performed 5 to 10 minutes later.imaging data were post-processed with multiplanar reformation(MPR),maximum intensity projection(MIP).All normal colorectal were correctly subarea and were measured intestinal wall thickness and maximum outer diameters,the CT values of bowel wall in different phases were measured either,the bowel with tumor as control,and the results were statistically calculated.SCTC was classifield into three Grades according to the effect of intestinal preparation.CT data of 61 cases colorectal tumors identified by pathology were retrospective analysed.Results SCTC was successfully done in all objects,the SCTC grading included Grade 1 in 52 cases,Grade 2 in 39 cases and Grade 3 in 4 cases.The total rate of satisfaction towards examinantion was 95.8%.The lesions in 60/61 cases were demonstrated clearly by SCTC,among them,there were carcinoma in 30,lyphoma in 8,abscess in 8,polyps in 8,metastases in 4 and carcinoid in 3.One case with polyp(less than 5 mm)was missed.The sensitivity and specificity of SCTC in diagnosing colorectal lesions were 98.36% and 78.9% respectively.27 cases with colorectal carcinoma were correctly staged in Duke and the accuracy was 90%.Conclusion SCTC is a simple,rapid,noninvasive and effective method for evaluating colorectal tumor.

0.05). Of 98 cagE positive isolates, 14(14.3%) were cagA negative. Conclusion Most of the H. pylori isolates in Shanghai region may have intact cag PAI. cagE, could be taken as the marker for the presence of cag PAI. There is no correlation between the integrality of cag PAI and the clinical outcome of H. pylori of infection.

Objective To investigate the status of Helicobacter pylori(H.pylori) infection and the accuracy of the two commonly used diagnostic methods, the 14 C urease breath test( 14 C UBT) and the rapid urease test(RUT) in patients with partial gastrectomy due to peptic ulcer or gastric cancer. Methods Culture, histology, RUT, combined with 14 C UBT, were carried out to diagnose the H. pylori infection in patients with partial gastrectomy. The Giemsa staining and H.pylori culture served as the ‘golden reference’ in evaluating the diagnostic accuracy of the RUT and 14 C UBT. The prevalence of H.pylori infection of patients with partial gastrectomy was determined with the dyspeptic controls without surgery. Results 37 patients (17 Billroth Ⅰ resection, 20 Billroth Ⅱ resection) were included in the study. The overall prevalence in the Giemsa staining and culture proved as H.pylori infection was 29.7%, and no statistical difference was seen between patients will Billroth Ⅰ(29.4%) and Billroth Ⅱ(30.0%) resections. The sensitivity of the RUT was 72.7%, the specificity was 57.7%, and the overall accuracy was 62.2%. The sensitivity of the 14 C UBT was 63.6%, the specificity was 100.0%. The negative predictive value was 86.7%, and the overall accuracy was 89.2%. The total prevalence of H.pylori infection in the controls was 71.4%. Conclusion Prevalence of H.pylori infection in patients with partial gastric resection is low. The two diagnostic methods, 14 C UBT and RUT, cannot be recommended as accurate diagnostic tools for H.pylori infection in patients after partial gastrectomy due to low specificity and low sensitivity, respectively.

Objective To investigate the effect of nimesulide,a selective cyclooxygenase (COX)-2 inhibitor,on the chemoprevention of N-ethyl-N-nitro-N-nitrosoguanidine (ENNG)-induced gastric cancer in rat model. Methods Ninety-six male Wistar rats were randomized to drink the solution of ENNG (group M), ENNG/low dose nimesulide (group MN_L), ENNG/ high dose nimesulide (group MN_H), low dose nimesulide (group N_L), high dose nimesulide (group N_H) or water (group P). Eighty-nine(92.7%) rats completed the study and were sacrificed at (28?2) weeks. The animals were assessed for the presence of gastric cancer, COX-2 expression and precancerous changes in gastric mucosa. Results The incidence of gastric carcinoma in group M was 56.3% (9 /16), significantly higher than 7.4%(1/14)in MN_L group and 6.3%(1/16)in MN_H group( P

Objective To investigate the inhibitory effects of combined treatment of nimesulide, a selective cyclooxygenase-2 inhibitor, with 5-fluorouracil (5-FU) on gastric cancer cell lines and its pos-sible mechanisms. Methods The human gastric cancer cell lines MKN45 and MKN28 were used in the study. After 48 hours treatment with nimesulide or 5-FU alone or in combination, the cells growth was determined by MTT assay. Flow cytometry and FITC-Annexin-V/PI kit were used to determine the effect of drugs on the cell cycle and the apoptosis of gastric cancer cells. The expression of COX-2 mRNA was detected by RT-PCR. The expressions of apoptosis-associated protein Bax and Bcl-2 were detected by Western blotting. Results Different level of COX-2 mRNA expression was observed in MKN45 and MKN28 cell lines. Treatment of the two cell lines with nimesulide in combination with 5-FU can significantly reduce the expression of COX-2 mRNA. Nimesulide could inhibit the growth and induce apoptosis of gastric cells. Combined treatment of nimesulide with 5-FU resulted in a synergistic effect of inhibiting growth and inducing apoptosis. The synergistic inhibiting effect on cell growth was irrespective of treatment sequence, but the highest cytotoxity was obtained when the cell lines were treated with two drugs simultaneously. Treatment with 5-FU enhanced expression of the pro-apoptotic gene Bax, while nimesulide reduced expression of the anti-apoptotic gene Bcl-2, resulting in a significantly higher ratio of Bax-to-Bcl-2. Conclusions The combined treatment of nimesulide with 5-FU results in synergistic inhibiting effect on growth of gastric cancer cell lines, and inducing apoptosis by enhanced Bax-to-Bcl-2 ratio and suppression of COX-2 mRNA expression may be the mechanisms.

Seventy days after inoculation of 1. 0 ? 104 M. leprae to the foot--pads,the mice were treated with home-made ofloxacin 150mg/kg daily by gavage 5 times weekly for 63 days. The results showed that M. leprae multiplied well in the foot--pads of untreated mice,but no growth of M. lepare were found in the foot-pads of the mice treated with home-made ofloxacin, imported ofloxacin or rifampin until 12 months after infection of M. leprae. Eleven newly diagnosed and untreated BL/LL patients and 2 recently relapsed patients after dapsone monotherapy were treated with home--made ofloxacin 400mg daily 6 times weekly for 12 weeks. The results showed that the skin lesions of all patients markedly improved at the end of therapy. The mean morphological index(MI) in skin smear decreased from 11. 89% before therapy to 2. 59% at the end of 2 week treatment,and to 0% at the end of 4 week treatment. The mean bacteriological index(MI) decreased from 4. 28 before therapy to 3. 90 at the end of therapy. During the therapy, 4 patients developed type Ⅱ lepra reaction, but all patients tolerated the drug well. The study showed that the therapeutic effect of home-made ofloxacin is similar to that of imported one as reported in the literature. The home-made ofloxacin can be used in multidrug therapy for leprosy.

Objective To explore the changes of indicators for total parenteral nutrition (TPN) and parenteral nutrition (PN) combining enteral nutrition (EN) support in patients with severe acute pancreatitis (SAP), and to analyze the treatment effects of two groups. Methods 29 patients with SAP were randomly divided into two groups: TPN group (n=14) and PN+EN group (n=15). Nonoperative treatment were applied to the two groups. The changes of indicators and therapeutic outcome of two groups were recorded after nutrition support 14 days. Results After 14 days nutritional support, serum albumin (ALB), total serum protein (TSP), blood calcium, glutamic-pyruvic transaminase (ALT), glutamic-oxaloacetic transaminase (AST) in each group increased significantly (P<0.05). While blood glucose, serum amylase, leucocyte count decreased significantly (P<0.05). However, there were no significant difference between two groups except leucocyte count in all laboratory tests. The leucocyte count in the PN+EN group was significantly lower than that in the TPN group (P<0.05). In both group there was no difference found in serum total bilirubin (TB) before and after nutrition support (P>0.05). The APACHE II scores, average hospital days, average hospital charges, incidence of infection and mortality rate in the PN+EN group were significantly lower than that in the TPN group (P<0.05). ConclusionsPN combining EN support was superior to TPN in the treatment of patients with SAP.

Objective To have insight into the epidemiological situation and to predict the possibilities for achieving the national goal of basic eradication or the WHO target of elimination of leprosy as a public health in the leprosy high－ endemic areas in China. Methods Based upon the data during 1983－ 1996 from the National Leprosy Recording and Reporting Surveillance System and using the appropriate mathematical models, the expected calendar year of reaching the national goal in terms of detection and prevalence rates and the WHO target of elimination under different conditions was predicted. Results Of 337 counties where the national goal of basic eradication of leprosy had not reached and 40 counties where the WHO goal of leprosy elimination had not achieved in 1996, the detection rates in calendar years followed the negatively exponential models with a significant goodness－ of－ fit in 67 and 11 counties, respectively. In the former, the national goal can be met in 6％ of counties before the year 2000 or 34.4％ before 2010 in terms of detection rate, or 31.3％ before the year 2010 in terms of prevalence rate. In the latter, the WHO target can be met in 8－ 10 counties within this century when the duration of disease was determined with the WHO definition. While the MB proportion among new cases increased by 10％ , the target would be met one year later. However, at the same MB proportion, the change of the duration of completing the fixed treatment from PB 0.5 year and MB 2 years to PB 0.75 year and MB 3 years will result in the achievement of the goal 2－ 10 years later. Conclusion The results imply that WHO goal of leprosy elimination can be reached in more than 95％ of counties by the end of this century, but the national goal of achieving basic eradication of leprosy in more than 95％ of counties by this century will not be met, indicating that leprosy control will go beyond the century in China.