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Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.
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Humanos , Carcinoma Adenoide Quístico/patología , Neoplasias de los Senos Paranasales/terapia , Pronóstico , Modelos de Riesgos Proporcionales , Estudios RetrospectivosRESUMEN
BACKGROUND@#Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT). However, neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT. It remains unclear how radiation affects patient brain function. This pilot study aimed at finding cerebral functional alterations in NPC patients who have received RT.@*METHODS@#From September 2014 to December 2016, 42 individuals, including 22 NPC patients and 20 normal volunteer controls in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, were recruited in this study. All patients received resting-state functional magnetic resonance imaging scans and neurocognitive tests 1 day before the initiation of RT (baseline) and 1 day after the completion of RT; the 20 normal controls were also subjected to the same scans and tests. The amplitude of the low-frequency fluctuations (ALFF) in blood oxygen level-dependent signals and functional connectivity (FC) were used to characterize cerebral functional changes. Independent t test, paired t test, and analysis of variances were used to obtain statistical significance across groups.@*RESULTS@#After RT, NPC patients showed significantly decreased ALFF values in the calcarine sulcus, lingual gyrus, cuneus, and superior occipital gyrus and showed significantly reduced FC mainly in the default mode network (P < 0.05, corrected by AlphaSim). Relative to the controls, ALFF was decreased in the lingual gyrus, calcarine sulcus, cingulate cortex, medial prefrontal gyrus (P < 0.05, corrected by AlphaSim), and FC reduction was found in multiple cerebellar-cerebral regions, including the cerebellum, parahippocampus, hippocampus, fusiform gyrus, inferior frontal gyrus, inferior occipital gyrus, precuneus, and cingulate cortex (P < 0.001, corrected by AlphaSim).@*CONCLUSIONS@#Cerebral functional alterations occur immediately after RT. This study may provide an explanation for the cognitive deficits in the morphologically normal-appearing brains of NPC patients after RT and may contribute to the understanding of the complex mechanism of RT.
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Background@#Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy (RT). However, neurocognitive complications such as memory loss and learning and attention deficits emerge in the survivors of NPC who received RT. It remains unclear how radiation affects patient brain function. This pilot study aimed at finding cerebral functional alterations in NPC patients who have received RT.@*Methods@#From September 2014 to December 2016, 42 individuals, including 22 NPC patients and 20 normal volunteer controls in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, were recruited in this study. All patients received resting-state functional magnetic resonance imaging scans and neurocognitive tests 1 day before the initiation of RT (baseline) and 1 day after the completion of RT; the 20 normal controls were also subjected to the same scans and tests. The amplitude of the low-frequency fluctuations (ALFF) in blood oxygen level-dependent signals and functional connectivity (FC) were used to characterize cerebral functional changes. Independent t test, paired t test, and analysis of variances were used to obtain statistical significance across groups.@*Results@#After RT, NPC patients showed significantly decreased ALFF values in the calcarine sulcus, lingual gyrus, cuneus, and superior occipital gyrus and showed significantly reduced FC mainly in the default mode network (P < 0.05, corrected by AlphaSim). Relative to the controls, ALFF was decreased in the lingual gyrus, calcarine sulcus, cingulate cortex, medial prefrontal gyrus (P < 0.05, corrected by AlphaSim), and FC reduction was found in multiple cerebellar–cerebral regions, including the cerebellum, parahippocampus, hippocampus, fusiform gyrus, inferior frontal gyrus, inferior occipital gyrus, precuneus, and cingulate cortex (P < 0.001, corrected by AlphaSim).@*Conclusions@#Cerebral functional alterations occur immediately after RT. This study may provide an explanation for the cognitive deficits in the morphologically normal-appearing brains of NPC patients after RT and may contribute to the understanding of the complex mechanism of RT.
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This study is designed to explore the possible effects of Hemerocallis citrina baroni flavonids (HCBF) on liver fibrosis induced by CCl4 in rats. The liver fibrosis model was induced by CCl4, and HCBF were administered by gastric perfusion at 25 and 50 mg x kg(-1) qd for 50 days, while the contents of alanine transaminase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), superoxide dismutase (SOD), maleic dialdehyde (MDA) and transforming growth factor-β1 (TGF-β1) were measured and the contents of PINP were measured in liver tissue, and the expression of TGF-β1 were observed by immunohistochemisty and Western blot. The pathological changes of liver tissue were examined by HE. The results showed that HCBF (25, 50 mg x kg(-1)) improved the liver function significantly through reducing the level of ALT, AST, GGT and ALP (P < 0.05 or P < 0.01), and increasing the content of SOD (P < 0.01), while reducing the content of MDA (P < 0.05 or P < 0.01), the expression of TGF-β1 (P < 0.05) and the content of PINP (P < 0.05). The results suggest that HCBF (25, 50 mg x kg(-1)) may inhibit the liver injury induced by CCl4 by decreasing the oxidative stress.
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Animales , Ratas , Alanina Transaminasa , Metabolismo , Fosfatasa Alcalina , Metabolismo , Aspartato Aminotransferasas , Metabolismo , Tetracloruro de Carbono , Medicamentos Herbarios Chinos , Farmacología , Flavonoides , Farmacología , Hemerocallis , Química , Cirrosis Hepática , Quimioterapia , Malondialdehído , Metabolismo , Estrés Oxidativo , Extractos Vegetales , Farmacología , Superóxido Dismutasa , Metabolismo , Factor de Crecimiento Transformador beta1 , Metabolismo , gamma-Glutamiltransferasa , MetabolismoRESUMEN
Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture.
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Humanos , Masculino , Enfermedades de los Genitales Masculinos , Diagnóstico , Terapéutica , Liquen Escleroso y Atrófico , Diagnóstico , Terapéutica , Estrechez UretralRESUMEN
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of transrectal 125 I seeds implantation brachytherapy (BT) combined with intermittent hormonal therapy (IHT) in the treatment of locally advanced prostate cancer.</p><p><b>METHODS</b>We treated 27 patients with locally advanced prostate cancer by transrectal 125I seeds implantation BT combined with IHT, and dynamically observed the changes in the PSA level, prostate volume, maximum urinary flow rate (Qmax) and International Prostate Symptoms Score (IPSS).</p><p><b>RESULTS</b>All the implantation procedures were completed smoothly, lasting 20 to 35 minutes, with 40 to 58 seeds implanted. At 6 months after implantation, the PSA level was < 0.2 microg/L in all the patients (< 0.1 microg/L in 19 cases), the prostate volume was significantly reduced (P < 0.05), and Qmax and IPSS remarkably improved (P < 0.05). At 3 years after implantation, 19 cases were in the first cycle and the other 8 in the third cycle of IHT, of which 2 progressed to androgen-independent prostate cancer, and another 2 developed early bone metastasis. The rates of 3-year biochemically and clinically progression-free survival were 70.3% and 85.2%, respectively, and the rate of therapeutic effectiveness was 92.6%. No severe complications occurred in any of the cases.</p><p><b>CONCLUSION</b>Transrectal 125I seeds implantation BT combined with IHT is a safe and minimally invasive procedure for locally advanced prostate cancer, which can effectively retard its clinical progression with no such complications as severe urethral, rectal or erectile dysfunction.</p>
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Anciano , Humanos , Masculino , Braquiterapia , Terapia Combinada , Hormonas , Usos Terapéuticos , Radioisótopos de Yodo , Usos Terapéuticos , Neoplasias de la Próstata , Radioterapia , Terapéutica , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To investigate whether FTY720 inhibits rat mesangial proliferation and extracellular matrix expansion through suppression of transforming growth factor β1-connective tissue growth factor (TGFβ1-CTGF) pathway, and to explore experimental evidence for its effect on mesangial proliferative glomerulonephritis.</p><p><b>METHODS</b>A rat model of anti-Thy-1 mesangial proliferative glomerulonephritis was established and FTY720 intervention was performed. Periphery blood lymphocyte count, urine protein excretion, glomerular mesangial proliferation, protein and gene expression of TGFβ1 and CTGF and extracellular matrix protein including fibronectin, laminin and collagen IV in isolated glomeruli were documented at 1, 3 and 7 days after injection of anti-Thy-1 antibody.</p><p><b>RESULTS</b>The model group developed proteinuria at 1, 3 and 7 days after injection of anti-Thy-1 antibody, which were significantly higher [(27.9 ± 7.3), (63.5 ± 18.8) and (52.4 ± 15.4)mg/d, respectively] than those in the control group [(8.4 ± 2.4), (8.4 ± 2.1) and (10.4 ± 3.2) mg/d; respectively, P < 0.01]. FTY720 intervention group showed significantly decreased proteinuria at 3 and 7 days after injection [(31.4 ± 7.0), (25.5 ± 7.7) mg/d, respectively] than model group (P < 0.01), although higher than the control group (P < 0.01). After intervention for 3 and 7 days, FTY720 significantly down-regulated both TGFβ1 and CTGF gene and protein expression in cultured glomeruli, and suppressed the production of glomerular extracellular matrix protein secretion, leading to attenuated mesangial cell proliferation and extracellular matrix expansion in rat anti-Thy-1 mesangial proliferative glomerulonephritis.</p><p><b>CONCLUSION</b>FTY720 significantly attenuates mesangial proliferation and extracellular matrix expansion through inhibition of TGFβ1-CTGF pathway in rat, and thus ameliorates the development of anti-Thy-1 mesangial proliferative glomerulonephritis.</p>
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Animales , Masculino , Ratas , Proliferación Celular , Factor de Crecimiento del Tejido Conjuntivo , Genética , Metabolismo , Regulación hacia Abajo , Proteínas de la Matriz Extracelular , Metabolismo , Clorhidrato de Fingolimod , Expresión Génica , Mesangio Glomerular , Metabolismo , Patología , Glomerulonefritis Membranoproliferativa , Alergia e Inmunología , Metabolismo , Patología , Inmunosupresores , Farmacología , Isoanticuerpos , Alergia e Inmunología , Glomérulos Renales , Metabolismo , Patología , Glicoles de Propileno , Farmacología , Proteinuria , Orina , Ratas Wistar , Transducción de Señal , Esfingosina , Farmacología , Antígenos Thy-1 , Alergia e Inmunología , Factor de Crecimiento Transformador beta1 , Genética , MetabolismoRESUMEN
<p><b>BACKGROUND</b>Local failure of nasopharyngeal carcinoma (NPC) after radiotherapy (RT) remains one of the major treatment failures. This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy (FSRT) with vagina carotica protection technique for local residual of NPC patients after the primary RT.</p><p><b>METHODS</b>From August 2006 to August 2010, FSRT with vagina carotica protection technique was applied to 36 patients in our department, the patients aged between 13 and 76 years with a median of 41.3 years, 25 of them were male and 11 were female. According to 2002 Union for International Cancer Control (UICC) Staging System, the stages before primary radiotherapy were: IIa 2, IIb 5, III 18, IVa 7, IVb 4. In the first course of radiotherapy, 9 patients received conventional RT, 27 patients received intensity modulated radiotherapy (IMRT) and 20 out of the 36 patients received concurrent chemoradiotherapy. The total dose in the first course of RT was 69.96 - 76.90 Gy (median, 72.58 Gy). The intervals between the primary RT and FSRT ranged from 12 to 147 days (median, 39.8 days). Target volumes ranged from 1.46 to 32.98 cm(3) (median, 14.94 cm(3)). The total FSRT doses were 10.0 - 24.0 Gy (median, 16.5 Gy) with 2.0 - 5.0 Gy per fraction. The most common regimen was 15 Gy in 5 fractions of 3 Gy, the irradiation dose to vagina carotica was less than 2 Gy per fraction.</p><p><b>RESULTS</b>The median follow-up time was 34 months (range, 12 - 59 months). The 3-year local control rate was 100%; the 3-year overall survival rate was 94.4%; the 3-year disease-free survival rate was 77.8%. In this study, we had one case of cranial nerve injury, two cases of temporal lobe necrosis, and no nasopharyngeal massive hemorrhage was observed.</p><p><b>CONCLUSION</b>FSRT with vagina carotica protection technique is an effective and safe RT regimen for local residual of NPC with reduction of radiation-related neurovascular lesions.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Carcinoma , Fraccionamiento de la Dosis de Radiación , Neoplasias Nasofaríngeas , Radioterapia , Recurrencia Local de Neoplasia , Dosificación RadioterapéuticaRESUMEN
Application of HPLC-ESI-ITMS in the quality control of carboxyterminal sequence confirmation for insulin and insulin chain B was studied. The solution of intact insulin or insulin chain B was added to the solution of carboxypeptidase P (CPP) and carboxypeptidase Y (CPY). Fractions of appropriate volume were removed at some appointed time points, acidified with the same amount of 1% formic acid to stop the digestion, and then briefly vortexed for HPLC-ESI-ITMS analysis. Mobile phase A consisted of 0.02% TFA in 98% ultra-pure water and 2% acetonitrile. Mobile phase B consisted of 0.02% TFA in 98% acetonitrile and 2% ultra-pure water. The solution used for post-column fix consisted of propionic acid and isopropyl alcohol (20 : 80, v/v). Chromatographic separation was carried out on a reversed-phase column (Zorbax Prosphere C18, 300A, 5 microm, 2.1 mm ID x 150 mm length). The molecular weights of the multiply charged ions representing consecutive truncated losses of carboxyterminal amino acids were determined by the use of HPLC-ESI-ITMS. The differences between the consecutive truncated peptides are the experimental weights of the carboxyterminal amino acid residues. The carboxyterminal amino acid residue Ala, which released from chain B of intact insulin, was confirmed in the nanomolar concentration range by analyzing the molecular weight of the truncated peptides. Another one carboxyterminal amino acid Ala was confirmed in the nanomolar concentration range of insulin chain B. In the quality control for recombinant DNA product or natural protein, the confirmation of 1 - 3 carboxyterminal amino acid residues is regarded to be up to standard. One amino acid residue of insulin or insulin chain B could be confirmed accurately in the nanomolar concentration range. The results showed that intact insulin could be directly sequenced in the quality control without separating chain B from chain A. There would be no need to separate chain A from chain B to identify carboxyterminal of intact insulin. Furthermore, the method saved us a lot of trouble from the preparation and purification of insulin chain A and chain B.
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Secuencia de Aminoácidos , Carboxipeptidasas , Química , Catepsina A , Química , Cromatografía Líquida de Alta Presión , Métodos , Insulina , Química , Estándares de Referencia , Datos de Secuencia Molecular , Peso Molecular , Fragmentos de Péptidos , Química , Control de Calidad , Espectrometría de Masa por Ionización de Electrospray , MétodosRESUMEN
<p><b>OBJECTIVE</b>To investigate the indication, location and dose of postoperative radiotherapy for primary intraosseous carcinoma (PIOC) of the jaws.</p><p><b>METHODS</b>From October 1969 to November 2005, 13 patients with PIOC were treated at the Cancer Hospital of Chinese Academy of Medical Sciences. Forty six cases with complete clinical data were collected from 27 published reports. Twenty-seven of the 59 patients were treated with surgery plus postoperative radiotherapy, and 22 with surgery alone.</p><p><b>RESULTS</b>All of the 13 cases in our series had advanced disease, and overall 1-, 2- and 3-year survival rats were 59.2%, 33.8% and 12.7% , respectively. For the reported 59 cases in literature, the overall 1-, 2- and 3-year survival rats were 78.4%, 53.9% and 34.0%, respectively. They were 84.3%, 57.2% and 43.6% for the patients treated by surgery plus postoperative radiotherapy, whereas they were 81.8%, 71.2% and 35.1% for the patients by surgery alone (P = 0.908). It seemed that surgery plus postoperative radiotherapy could not improve the survival of PIOC patients with involvement of adjacent soft-tissues or positive neck nodes or partial excision of primary tumor when compared with surgery alone, if the bias of selection in the patients for postoperative radiotherapy was neglected.</p><p><b>CONCLUSION</b>Postopreative radiotherapy may improve the survival for the patient with primary intraosseous carcinoma of the jaws. Our suggestion is that postoperative radiotherapy should be applied to the patient with any of the following items: positive operative margin; tumor involvement of adjacent soft-tissues; positive neck nodes; partial excision of primary tumor. However, the location and dose of postoperative radiotherapy may be varying at different situation.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Carcinoma de Células Escamosas , Patología , Radioterapia , Cirugía General , Estudios de Seguimiento , Neoplasias Hepáticas , Escisión del Ganglio Linfático , Metástasis Linfática , Mandíbula , Cirugía General , Neoplasias Mandibulares , Patología , Radioterapia , Cirugía General , Maxilar , Cirugía General , Neoplasias Maxilares , Patología , Radioterapia , Cirugía General , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Radioterapia Adyuvante , Radioterapia de Alta Energía , Tasa de SupervivenciaRESUMEN
<p><b>OBJECTIVE</b>To evaluate the efficacy and safty of the humanized anti-epidermal factor receptor monoclonal antibody h-R3 in combination with radiotherapy for locoregionally advanced nasopharyngeal carcinoma.</p><p><b>METHODS</b>Totally, 137 patients from 7 medical center around China were randomly divided into combined therapy group or control group. There was no difference in Karnofsky performance score between two groups. All patients in both groups received radical conventionally fractionated radiotherapy to the total dose of D(T) 70-76 Gy. For the combined therapy group, h-R3 was added at a dose of 100 mg i.v. weekly for 8 weeks started at the beginning of radiotherapy.</p><p><b>RESULTS</b>Of the 137 eligilbe patients, 70 were in the combined therapy group treated by h-R3 plus radiotherapy and 67 in the control group by radiotherapy alone. The intent-to-treat (ITT) population consisted of 130 patients, while the per-protocol (PP) population was composed of 126 patients. The efficacy was assessed respectively at three point of time: the end of treatment, the 5th- and 17th-week after treatment. The complete response (CR) of the combined therapy group was significantly higher than that of the control group in both ITT and PP (ITT: 65.63%, 87.50%, 90.63% versus 27.27%, 42.42%, 51.52%; PP: 67.21%, 90.16%, 93.44% versus 27.69%, 43.08%, 52.31%; P < 0.05, respectively). The most common h-R3-related adverse reactions were fever (4.3%), hypotension (2.9%), nausea (1.4%), dizziness (2.9%) and rash (1.4%), which could be reversible if treated properly. Radiotherapy combined with 100 mg h-R3 i. v. weekly was tolerable and did not aggravate the side effects of radiation. The quality of life in the combined therapy group was comparable to that in the control group.</p><p><b>CONCLUSION</b>This phase 1 multicenter clinical trial shows that h-R3 in combination with radiotherapy is effective and well-tolerated for the treatment of locoregionally advanced nasopharyngeal carcinoma.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Anticuerpos Monoclonales , Usos Terapéuticos , Carcinoma de Células Escamosas , Patología , Terapéutica , Terapia Combinada , Fiebre , Hipotensión , Neoplasias Nasofaríngeas , Patología , Terapéutica , Estadificación de Neoplasias , Calidad de Vida , Radioterapia , Métodos , Receptores ErbB , Alergia e Inmunología , Inducción de RemisiónRESUMEN
The occurrence of eating disorders in Chinese adolescents is increasing. However the cause, diagnosis, treatment and prognosis of this disorder are rarely reported by pediatricians. This paper investigated the cause and treatment of six cases of eating disorders in adolescent patients. The medical data of six cases of eating disorders in the Shanghai Children's Medical Center from January 2003 to September 2005 were retrospectively reviewed. The patients were 5 girls and 1 boy, whose onset ages ranged from 12.4 to 15.8 years. They were initially referred to the clinic between 12.9 to 16.7 years, with a course of disease varying from three to twelve months. The patients' body mass index (BMI) varied from 9.07 to 17.0. Four out of the six patients were hospitalized because of low temperature, low blood pressure, bradycardia, dehydration and multiple systems damages. The other two were treated in the out-patient clinic. Based on the medical history and physical examination as well as laboratory findings, five of them were diagnosed with anorexia nervosa and the other one were bulimia nervosa. All of the patients were under the care of a team consisting of pediatricians, dietitians, psychiatrists and nurses. When the patients whose vital signs were unstable, medical treatment focused on life sustention and they were kept on beds compulsively and given nutrition transfusion. Meanwhile cognition and behavior therapy was administered to help the patients find out the internal and environmental factors related to the development of this disorder, establish a new conception of healthy weight, and correct their abnormal eating behaviors. The patients who had a severe distortion of body image and a big resistance to the treatment were additionally administered with psychiatry drugs. After treatment, three patients set up a healthy eating behavior, their body weights gradually recovered and they had no relapse during a 1-year follow-up. The other three patients retained some abnormal eating behaviors and their body weights were always below normal. It was found that eating disorders in adolescents may be triggered by some environmental factors, such as comments on body shape from their peers, fashion influence, academic pressures, and problems in communication. Since the patients' abnormal eating behaviors were masked or neglected by parents at the early stage of the disease and the clinical presentations were related to multiple systems, it is difficult to make an early diagnosis and treatment. It is important to improve the pediatricians' knowledge of eating disorders of adolescents and perform cooperation between a multidisciplinary team for the early diagnosis and treatment of this disorder.
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Adolescente , Niño , Femenino , Humanos , Masculino , Trastornos de Alimentación y de la Ingestión de Alimentos , Psicología , TerapéuticaRESUMEN
<p><b>OBJECTIVE</b>To study the relationship between the symptoms and prognosis of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>The clinical data of 905 M0 NPC patients who received radical radiotherapy from January 1990 to May 1999 were retrospectively studied. Nodal distribution, cranial nerve paralysis, as well as the relationship between symptom duration and prognosis were analyzed.</p><p><b>RESULTS</b>The most common symptom in patients with NPC is neck node metastasis, with an incidence of 40.0% at the time of diagnosis, followed by blood-staining sputum (18.7%) and aural symptoms (17.0%). Node metastasis in the lower neck and supraclavicular region alone was seen in 10 patients (1.1%). Cranial nerve paralysis was found in 179 patients (19.8%). The 5-year overall survival and disease-free survival were significant lower in symptom duration more than 6 months group than in less than 6 months group (71.2% vs 79.8%, P = 0.008 and 51.9% vs 63.6%, P = 0.0008); however, the local control rate between these two group was not significantly different (79.4% vs 83.5%, P = 0.138).</p><p><b>CONCLUSION</b>The symptom duration is associated with the prognosis of NPC. Early diagnosis and treatment are the most important factors in improving the prognosis of NPC.</p>
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis Linfática , Neoplasias Nasofaríngeas , Diagnóstico , Patología , Radioterapia , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosRESUMEN
<p><b>OBJECTIVE</b>To study the variation Laws of content of danshensu accelerated in control and in danshen injection in order to provide reference for stability investigation of danshensu.</p><p><b>METHOD</b>The tests was carried out by classic isothermal method and the content of danshensu was determined by HPLC.</p><p><b>RESULT</b>The contents of danshensu in accelerated tests increase in control and decrease in danshen injection respectively.</p><p><b>CONCLUSION</b>The component of phenic acidity would be hydrolyzed to become danshensu in the accelerated tests. Much attention should be paid to the unusual increase when studies of danshen preparations are carried out.</p>
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Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Hidrólisis , Hidroxibenzoatos , Química , Inyecciones , Lactatos , Química , TemperaturaRESUMEN
Objective To explore the efficacy and safety of metformin therapy on obese nondiabetic children with hyperinsulinemia.Methods Twenty-two obese nondiabetic children with hyperinsulinemia were divided into two groups:control group(dietary counseling and exercise) and treatment group(dietary counseling and exercise combined with metformin).The changes of body mass index(BMI),fasting glucose(FPG),fasting insulin(FINS),insulin resistance(HOMA-IR),2 h PG,2 h INS,total cholesterol(TC) and triglyceride(TG),before and after treatment were determined,and the findings were compared and analyzed.Results After treatment,there were significant differences in BMI,TC,FINS,HOMA-IR levels(P0.05),except the BMI(P