Seven hundred and eighty three cases of rectal carcinoma were treated in this hospital Jan. 1986 to Dec. 1994. There were 552 cases(70.5%)in which the tumor located in the middle and lower portion of the rectum. Of this group, 201 cases were treated with the operations of preservation of sphincter ani. The operations included transabdomino-sacral resection(5 cases), transpubic resection(5 cases), Dixon’s operation(67 cases), perineal pull through anastomosis(44 cases), Welch’s operation(68 cases), and local resection(12 cases). The 3-year survival rate was 90.9%. We consider that anal sphincter preservation is rational in the treatment of rectal cancer of middle and lower segment, As often os the radical resection and maintenauce of normal defecation is concerned, it is suitable for rectal carcinomas in Duke’s A and B1 stages. Combined treatment is necessary to prevent the recurrence and increase the survival rate.
甲状腺外科疾病常见，有许多进展和进步，这是热点； 但许多治疗意见不一，分歧极大，长久难以统一，故又有许多难点
目的 探讨结节性甲状腺肿与甲状腺癌并存时的诊治方法。 方法 回顾性分析我院1961～2000年手术治疗的4 622例结节性甲状腺肿病例中169例并存甲状腺癌患者的临床资料。 结果 患者平均年龄（42.71±12.96）岁，病程平均19.15年； 43例出现短期内颈部肿块快速长大，32例有气管受压症状，27例出现声音嘶哑； 行超声检查105例，提示甲状腺癌者52例； 行放射性核素扫描检查38例，24例显示甲状腺内凉结节或冷结节； 行术前细针穿刺细胞学检查18例，找到癌细胞11例。术前确诊率为12.43%。术中行快速病理检查57例，55例诊断为甲状腺癌。 结论 在结节性甲状腺肿临床表现的基础上出现颈部肿块增长迅速、气管受压、声音嘶哑等症状时应高度怀疑结节性甲状腺肿与甲状腺癌并存； 甲状腺彩色超声多普勒、甲状腺核素扫描、细针穿刺细胞学等检查对诊断本病有重要意义； 术前检查怀疑甲状腺癌者术中应行快速冰冻切片病理检查，可有效避免再次手术。
【摘要】目的 探讨亚急性甲状腺炎的诊断和治疗。 方法 回顾性分析吉林大学中日联谊医院1962年1月至2000年1月期间收治的372例亚急性甲状腺炎患者的临床资料。结果 372例亚急性甲状腺炎中129例误诊为其他甲状腺疾病，6例合并甲状腺乳头状癌。183例在发病前有上呼吸道感染病史，235例颈前区疼痛，348例发现颈前区包块，45例合并乙型肝炎病毒感染。 行彩色多普勒检查、甲状腺核素扫描检查、甲状腺吸131Ⅰ率测定及细针穿刺细胞学检查，其阳性率分别为95.62%、89.66%、69.70%及89.41%，T3、T4及TSH指标也有不同程度改变。107例患者行激素加甲状腺素治疗，133例行口服肠溶阿斯匹林连续2个月以上治疗，部分患者加服优甲乐100 μg/d。135例行手术治疗。 结论 无上呼吸道感染病史和无颈前区疼痛的亚急性甲状腺炎病例易误诊为其他甲状腺疾病。彩色多普勒、细针穿刺细胞学检查诊断率高，特异性强，是首选的检查手段； 甲状腺核素扫描可以准确地反映甲状腺功能状态； 检测血清中T3、T4及TSH水平可以协助诊断本病，判断疾病所处阶段。口服肠溶阿斯匹林加用优甲乐治疗本病效果良好。
【Abstract】Objective To investigate a more rational modality which is in the treatment of severe acute pancreatitis (SAP) and effective in preventing liver from damages due to SAP. Methods SAP model was established by retrograde injection of 5% sodium taurocholate (1.0 ml) in the subserosa of pancreas in rats (n=80) weighting 200-250 g.The rats were catheterized using PE-50 angiocatheter from femoral artery to celiac trunk. Then they were randomly divided into four groups. Twenty animals served as controls (A group) and received only fluid infusion. The 40 animals, B and C group (20 animals in each one group) received continuous regional arterial infusion (CRAI) of somatostatin （4 μɡ/kg） and the medicines improving microcirculatory (dextran-40 1.5 ml, dopamine hydrochloride 5 μg/kg, anisodaminum 1.5 ml/kg) respectively. The other 20 animals (D group) were treated by somatostatin combined with the medicine improving microcirculatory through CRAI simultaneously with the induction of pancreatitis. The AST, ALT, ALP and serum amylase were recorded, the liver and pancreas tissue were observed pathologicaly after 6 hours. Results There were a ignificant decrease in the serum amylase in B group (Plt;0.05) and D group (Plt;0.05). The AST, ALT, ALP was decreased in B and D group (Plt;0.05). The damage to liver and pancreas were reduced in D group. Conclusion CRAI is effective in preventing liver damages due to SAP and is an effective way in the treatment of SAP.
ObjectiveTo establish an animal model of anaplastic thyroid cancer with high metastatic activity as in human body. MethodsHuman anaplastic thyroid cancer cell line TAK was injected into one of the lateral lobes of the thyroid gland, as well as in the subcuitis in a series of nude mice. Mice were sacrificed when found moribund, and autopsy and histology were performed subsequently.ResultsThe implantation of human anaplastic thyroid cancer cells in an ectopic enviroment did not permit expression of metastasis potential. In contrast, intrathyroid implantation did. Lymph node (5/10), lung (3/10) and one metastasis (1/10) were noted upon histological examination. ConclusionAn animal model with high metastatic activity is established when human anaplastic thyroid cancer cell line TAK is implanted orthotopically into nude mice.
ObjectiveTo investigate the clinicopathological features, diagnosis and treatment of invasive micropapillary carcinoma (IMPC) of the breast.MethodThe relevant literatures at home and abroad in recent years about the clinical features, pathological features and diagnosis and treatment of IMPC were reviewed.ResultsIMPC is in low incidence and mostly in mixture. Because the clinical manifestations of IMPC and invasive ductal carcinoma of breast are basically similar, only the typical pathological features in pathological examination can confirm the diagnosis as " inside-out growth pattern” and " morula-like clusters of cancer cells surrounded by clear stromal spaces”.ConclusionsIMPC is a special subtype of breast invasive carcinoma, which should be pay enough attention to it in clinic due to its unique microscopic morphology, high vessel invasiveness and high lymph node metastasis rate, high malignancy, poor prognosis and so on.
Objective To determine whether regional arterial infusion (RAI) of 5-Fu and imipenem could decrease infection and mortality of acute necrotic pancreatitis (ANP) or not. Methods Fifty three patients with ANP were devided into three groups, group A, 16 patients who received intravenous 5-Fu and imipenem, group B, 22 patients who received 5-Fu by RAI and imipenem intravenously, and group C, 15 patients who received both 5-Fu and imipenem by RAI. Results The incidence of infection of ANP in group C (0%) was significantly lower than that in group A (50.0%) and B (27.2%), and the mortality rates in group B (18.1%) and C (13.3%) were significantly reduced as compared with group C (43.8%). Conclusion RAI of 5-Fu and imipenem was effective in reducing ANP infection and mortality rates.