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.

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 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.

Objective To evaluate the effectiveness of Leprosy Elimination Compaigns (LEC) integrated with routine case- finding of leprosy in the high leprosy- epidemic areas in Yunnan, Guizhou and Sichuan Provinces. Methods Extensive health education of leprosy in the community, training of paramedical workers on leprosy, clue survey and contact survey were carried out to make diagnosis and provide treatment. Results A total of 122 new leprosy cases were detected in 6 high leprosy- epidemic counties through LEC in 1999 with a detection rate of 3.7/100 000, but in contrast, the annual number of newly detected leprosy cases was 67 cases with an average detection rate of 2/100 000 during the period of 3 years before LEC. Among the newly detected leprosy cases, about 47％ were leprosy household contacts. Conclusion LEC combined with routine activities of case finding can improve the detection of the back- log cases in the communities. In the high epidemic areas, especially in the remote and difficult- to- access areas, majority of leprosy cases can be detected through combining active and passive case- finding methods, providing extensive health education, improving leprosy services in skin clinic, leprosy contact and clue surveys.

Objective To approach the status of leprosy disabilities in newly detected cases in recent 10 years in China and provide the scientific basis for formulating the preventive strategies. Methods Based upon the individual records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 22 437 leprosy cases detected during 1989－ 1998 in China were analyzed in terms of leprosy disability. Results The proportion of disabilities in newly detected leprosy cases in 1989 in whole country was 46.49％ and decreased to 32.31％ in 1998, and the proportions of cases with grade II disabilities were 25.55％ (1989) and 20.23％ (1998). There were 18 provinces where disability rate was more than 40％ . Out of patients with disabilities, those with grades I and II disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.86％ , 60.64％ and 1.5％ , respectively. There were 25 provinces where grade II disabilities accounted for more than 50％ of all patients with disabilities. The disability rates in patients aged under 15 years, 15－ 65 years and over 65 years were 24％ , 39.85％ and 53.33％ . The patients with a delay in detection of 2 years had a disability rate of 29.85％ , and those with a delay of more than 2 years and 5 years had the rates of 48.82％ and 61.17％ , respectively. The disability rate was 52.9％ in patients with leprosy reactions and 46.1％ in patients with a damage of more than 3 nerves. The grade II disability rate in paucibacillary patients(28.99％ ) was significantly higher than that in multibacillary ones (22.04％ ). Conclusion Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 10 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.

Objective To analyze the detection modes of leprosy and their influencing factors and outcomes. Methods Based upon the nationwide registration of leprosy patients detected during 1981～ 1998, the profiles of these patients at detection were studied. Results The proportions of cases significantly correlated with calendar years in the detection by dermatologic clinic, contact check, clue survey and mass survey, showing a significant increases in percentage of cases detected through dermatologic clinic and contact check and decreases through clue survey and mass survey. Detection of leprosy cases through dermatologic clinic and voluntary reporting became the main modes of case－ finding during 1997－ 1998, accounting for 37.3％ and 28.6％ respectively, whereas contact check only accounted for 9.1％ . More MB patients were detected by voluntary reporting than PB, whereas detection by dermatologic clinic resulted in a significantly higher proportion (38.0％ ) in PB patients than in MB (33.5％ ). The voluntary reporting and clue survey resulted in higher proportions of detection in prefecture and county rural areas. In areas with good facilities of dermatologic services, significantly higher extent (75.9％ ) of cases were detected through dermatologic clinic, whereas the voluntary reporting and clue survey were main modes of case detection in endemic areas. A great majority of cases were confirmed by leprosy units even though they were detected by various modes. Only 6.5％ of leprosy cases were detected and consequently confirmed by doctors in dermatologic clinics. Conclusion This study emphasizes the importance of providing training on leprosy to the doctors in dermatologic clinics while continuously encouraging their involvement in leprosy control.

Objective To study clinical characteristics and the trends of leprosy relapse cases after dapsone(DDS) monotherapy or multidrug therapy(MDT) from 1949 to 1998. Methods The data of leprosy relapse cases in China from 1949 to 1998 were analyzed. Results There were a total of 12 403 leprosy relapse cases during 1949～ 1998 in China with a cumulative relapse rate of 3.28％ . Among them, 11 803 were relapsed after DDS monotherapy with a relapse rate of 3.83％ and 236 were after MDT with a relapse rate of 0.57％ . The relapse rate (0.84％ ) in PB cases which were previously treated with DDS monotherapy a half year was significantly higher than that (0.36％ ) in PB cases treated with MDT a half year. The relapse rate (0.37％ ) in MB cases which were previously treated with DDS monotherapy plus MDT also significantly higher than that (0.23％ ) in MB cases which were just treated with MDT two years. The proportions of cases with gradeⅡ disabilities and positive skin smears in relapse cases were 49.9％ and 69.3％ , respectively. Conclusion The peak of leprosy relapses after DDS monotherapy occurred during 1959～ 1988. The relapses after MDT started at the end of 1980s and may reach its peak in the next decades.