磷酸二酯酶5型抑制剂治疗时代勃起功能障碍的评估和诊断性检测

The diagnosis and treatment of erectile dysfunction has changed dramatically since the availability of safe and effective oral therapies. Unfortunately, not all men can be adequately treated in this way, and might require more invasive testing to diagnose and treat the specific cause of their dysfunction. This review looks at the tests and strategies available for men who cannot be treated by oral therapy alone.

The predictive factors of prognosis and treatment strategies for small?cell carcinoma(SCC) of the urinary tract are controversial. This study was aimed to investigate the clinical experience and management of patients with SCC of the urinary tract. We collected data of patients who were diagnosed with genitourinary SCC(GSCC) between 2002 and 2013 and were treated in the Fudan University Shanghai Cancer Center. Atotal of 18patients were diagnosed with GSCC of which 10 originated from the prostate, seven from the bladder and one from the adrenal gland. The mean follow?up time was 15.5months and progression?free survival(PFS) was 9.3months. Primary tumor resection was attempted in 13 of 18patients(72.2%) in whom radical surgery was performed in six of 14(42.9%) limited disease patients. Most of the patients(13, 72.2%) received cisplatin?based chemotherapy. Patients who had normal lactic dehydrogenase(LDH) levels showed a signiifcantly higher median PFS and overall survival(OS) compared with patients with high LDH levels(P=0.030,P=0.010). Patients with limited disease treated with a radical operation experienced a non?signiifcant(P=0.211) longer PFS compared with patients who were not treated, but this reached statistical signiifcance after analyzing OS(P=0.211,P=0.039). Our patients showed a poor prognosis as reported previously. Serum LDH levels beyond the normal range indicate a poor prognosis. For GSCC patients who are diagnosed with limited disease, radical surgery is strongly recommended along with cisplatin?based chemotherapy.

支气管针吸活检技术的临床应用

Transbronchial needle aspiration(TBNA) is able to provide definitive answers for a wide variety of pulmonary benign and malignant diseases including infectious diseases,cystic lesions, granulomatous diseases, pulmonary and mediastinal mass, etc. It's proved particularly revolutionary to stage bronchogenic carcinoma during routine flexible bronchoscopy. What's more, TBNA is an extremely safe procedure with no reported major complications. This review introduces the techniques about identifying the target, obtaining the specimen and preparing and interpreting the specimen when conducting TBNA. The complications, a through unusual, and major limitations are also touched in this review.

Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.

Objective: To study the clinical significance for measuring serum immunosuppressive acidic protein(IAP) levels to diagnose and follow up survey patients with the gynecological tumor.Methods: Serum IAP levels were determined by IAP-single radial immunodiffusion test in 235 patients with the gynecological tumor,including 38 cases of benign tumor of ovary,41 cases of malignant tumor of ovary,66 cases of hysteromyoma,34 carcinomas of uterine cervix, 16 endometrial carcinomas,27 cases of chemotherapy,13 cases of recurrence, and the control group was 50 cases health women.Results: Serum IAP level was 889.4±207.8mg/L in malignant ovary tumors,which was significantly higher than that of health women and benign tumors of ovary (P＜0.01).In patients with carcinoma of uterine cervix and endometrial carcinoma, their IAP levels were 741.4±212.6mg/L and 763.3±209.4mg/L,which were higher than those of the health women and benign tumor of ovary(P＜0.01).After chemotherapy, serum IAP levels of malignant tumor of ovary were decreased;in patients with recurrence of tumor of ovary,IAP levels increased compared with the health women(P＜0.01).Incidence of the abnormal value was 100%.Conclusion:Measuring IAP level of the gynecological tumor may be an auxiliary index for monitoring gynecological tumor and identifying benign and malignant tumor.

Objective:The aim of this study was to explore the diagnostic value of multi-slice computer tomography (MSCT) in solitary pulmonary nodule (SPN). Methods:Contrastive analysis of the dif erences of CT signs between benign and malig-nant SPN. Results:The typical sign of pleural indentation was a reliable sign for lung cancers. Vacuole sign suggested lung cancer highly. Blood vessels cluster involving the vein alone had big opportunity to lung cancer. Type I tumor-bronchial relation was the most common relation in lung cancers. Type V tumor-bronchial relation was the most common relation in benign SPN. Conclusion:MSCT had a very high diagnostic value in SPN.

The functional state of local immunity in the female genital tract during the HPV-infection

Congenital Thrombocytopenia

Platelets are essential for normal hemostasis.Platelets adhere to damaged blood vessels, and then aggregate and promote activation of coagulation factors, resulting to ceasing bleeding.Both quantitative and qualitative abnormalities of platelets can cause bleeding problems.Among them, immune thrombocytopenias are the most common conditions.However, congenital thrombocytopenias are often neglected because of their relative rarity and complex laboratory tests.That causes misdiagnosis and unnecessary and potentially harmful treatments for many patients.

The Diagnosis and Prevention, Treatment of Venous Thromboembolism

1 High-risk of venous thromboembolism(VTE)1.1 The high incidence of VTE detected in the autopsy rate was as high as 35% ～ 52%, 70% of life have not been diagnosed before. Western population epidemiological survey of its annual incidence rate was 0.1%, in particular, the highest incidence rates in Caucasians, the incidence in Asia than Europe and the United States, according to the present investigation is about the 1/5. Increased incidence of age increased, the highest incidence in the elderly up to 1%.

Venous Thromboembolism Diagnosis and Management

February 2, 2007 - The American College of Physicians and American Academy of Family Physicians announced clinical practice guidelines for the diagnosis and management of venous thromboembolism (VTE), which claims more than 200,000 lives each year in the United States.

Idiopathic thrombocytopenic purpura (ITP) is a common hematologic disorder manifested by immunemediated thrombocytopenia. The estimated incidence ranges from 50 ～ 100 per million each year in western countries, roughly divided between adults and children.

Acquired von Willebrand syndrome (AvWS) is kind of bleeding disorder with laboratory findings similar to those in congenital yon Willebrand disease (vWD).AvWS doesn's have any personal or family history of bleeding, but is associated with certain diseases or abnormal conditions or drugs. Although AvWS is being stated as a rare disease, it has gained more and more attention during the past years. Not because of the severity of the disease, but it is more common than we thought and most patients don' t have a proper diagnosis.

The current World Health Organization classification system of primary brain tumors is solely based on morphologic criteria. However, there is accumulating evidence that tumors with similar histology have distinct molecular signatures that significantly impact treatment response and survival. Recent practice-changing clinical trials have defined a role for routine assessment of O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in glioblastoma patients, especially in the elderly, and 1p and 19q codeletions in patients with anaplastic glial tumors. Recently discovered molecular alterations including mutations in IDH-1/2, epidermal growth factor receptor (EGFR), and BRAF also have the potential to become targets for future drug development. This article aims to summarize current knowledge on the molecular biology of high-grade gliomas relevant to daily practice.

氯离子通道蝎毒素在肿瘤影像诊断及靶向治疗中的应用研究进展

Precisely locating tumors always proves to be difficult. To find a molecule that can specifically bind to tumor cells is the key. Recently, chlorotoxin (CTX) has been proved to be able to bind to many kinds of tumor cells. The CTX receptor on the cell surface has been demonstrated to be matrix metalloproteinase-2 (MMP-2). Many researchers have combined CTX with other molecules, including 131I, Cy5.5, iron oxide nanoparticles coated by polyethylene glycol (NP-PEG), and so on, and thus synthesized various types of probes that can be detected by y-camera, single photon emission computed tomography (SPECT) or magnetic resonance imaging (MRI). With these methods, the binding degree of CTX could be assessed. These studies demonstrated that CTX has a highly specific binding ability, high stability, and security. CTX could also inhibit or kill the tumor cells. A nonviral nanovector has been developed for gene therapy. As a result, it gradually develops into a new method of diagnosis and targeted therapy of tumors. This article reviews the current progress on CTX including the origin, chemical construction, the mechanism of binding with tumor cells, and the application to tumor imaging diagnosis and therapy.

肺重复癌发生机制和诊断预测的研究进展

Due to the advanced diagnostic technique and better understanding for multiple primary lung cancers (MPLC), the increasing incidence of MPLC has been reported. Very often, MPLC are misdiagnosed as metastasis because of lacking efficient molecular biomarkers for prediction and diagnosis. Studies on the molecular mechanism for tumorgenesis and progression of MPLC may therefore facilitate the discovery of biomarkers for disease diagnosis and prognosis, so that an individual and rational treatment can be achieved. We tried to further our understanding and improve the diagnostic skill for MPLC by reviewing the current status and the latest advancement of molecular markers related to MPLC.

PRDX3在前列腺癌组织中表达的临床意义

目的研究硫氧还蛋白依赖的过氧化物还原酶（PRDX3）在前列腺癌组织中的表达情况及其临床意义。方法应用过氧化氢标记的链霉素抗生物素蛋白-过氧化氢酶法（SP 法）检测147例前列腺癌组织和28例良性前列腺增生组织中 PRDX3的表达情况，并对 PRDX3与前列腺癌临床关系进行统计分析。结果PRDX3在前列腺癌中呈高表达，在良性前列腺增生症和前列腺癌中的表达有差异（P ＜0.001）。结论PRDX3在前列腺癌组织中的表达比良性前列腺增生组织中高，有可能成为一种鉴别前列腺癌与良性前列腺增生的新的肿瘤标记物。

New Spectacle on Dementia——Concern together brain healthy of humanity

Dementia is a syndrome due to brain disease and is characterized by a progressive, global deterioration in intellectual abilities, including memory, learning, orientation, language, comprehension, and judgment. Alzheimer's disease, in particular, is progressive and fatal. It mainly affects older people, especially those over aged 65. From this age, dementia prevalence doubles every five years. Dementia is one of the major causes of disability in late-life. Alzheimer's disease is the most common cause of dementia, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are the next most common.

The fibrous epulis, a common tumor-like lesion of the gingiva, appears in the interdental papilla as a result of local irritation. Lesions are asymptomatic and have a variable growth rate. A 75-year-old woman was referred for the evaluation of a large painless gingival mass. It had started 10 years back and has been increasing in size the last year. No bone involvement was noted. The tumor was totally removed by excision with surgical scalpel under local anesthesia without teeth extraction. The microscopic findings were suggestive of a fibrous epulis. Differential diagnosis, clinical considerations and factors to prevent recurrence are discussed.

Objective: To recognize diagnostic factors of acute abdomen and investigate the control methods. Methods: A total of 8 patients caused by mesenteric vascular lesions were treated, followed up and analyzed on. Results: Six patients were operated on and confirmed pathologically; of two cases being superior mesenteric arterial embolism with abdominal aorta straddle and arterial embolism in both lower extremities (1 case died of whole bowel gangrene in 5 hours postoperatively, another one was recovered smoothly by resection of 60cm necrotic jejunum, removal of emboli in both iliofemoral artery, thrombolysis, and anticoagulatant therapy postoperatively); one patient with mesenteric artery thrombosis; of two cases with mesenteric venous thrombosis (1 case was removal of emboli and thrombolysis, anticoagulatant therapy postoperatively, another one was resection of 95% small intestine), one case with false aneurysm in superior mesenteric artery, resection of aneurysm and permutation of artificial blood vessel was performed successfully. The remained 2 cases with mesenteric vascular insufficiency were recovered by anticoagulatant and antispasmodic therapy. Seven cases cured. Conclusions: Mesenteric vascular diseases were relatively uncommon, symptoms and signs showed to be rather nonspecific, therefore, one should not merely rely on them for accurate diagnosis. Uhrasonography, CT are the sensitive examinations and benefit to diagnosis. Early interventions such as resecting bowel gangrene involved their mesentery and anticoagulant therapy may be essential to reduce the fatality and recurrence.

Objective: To provide the experience in imaging diagnosis of cervical spine and spinal cord injuries in children.Methods: Imaging data of cervical spine and spinal cord injuries in 62 children were retrospectively reviewed.The routine radiography including the lateral,anteroposterior and open-mouth odontoid views were performed in all the patients. Tomography was available for 25 patients, and flexion-extension lateral views for 28patients, CT scanning for 21 patients, MRI for 26 patients.Results: Of these patients, 46 patients were identified with injuries of upper cervical spine (9 with atlantal arch fracture, seven with axial fracture, 21 with odontoid fracture, 1 with atlantal arch fracture combining with odontoid fracture, and 1 with atlantal transverse ligament disruption); 7 patients sustained injuries of lower cervical spine (3 fractures of vertebral body, 2 dislocations and 6fracture-dislocations ); 2 patients had multiple noncontiguous cervical injuries; and 3 had cervical spinal cord injury without radiographic abnormalities (SCIWORA).Conclusions: Imaging assessment is of great importance in the diagnosis of cervical spine and spinal cord injuries in children. Whenever cervical spine and spinal cord injuries are suspected for children patients, and the three-views should be routinely indicated. MRI should be routinely performed in all children with cervical SCIWORA.