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世界核心医学期刊文摘（胃肠病学分册） 2006年第9期2卷 60-60页

作者： Felderbauer P. Klein W. Bulut K. 张欣 department of Internal Medicine I St.Josef-HospitalRuhr-University of BochumGudrun Str.54D-44791 BochumGermany Dr.

*** 2003 we identified a family with familial hypocalciuric hypercalcemia(FHH)(heterozygous CASR gene mutation L173P)and a mutation in the pancreatic secretory trypsin inhibitor gene(SPINK1)(N34S).While family members with an isolated calcium-sensing receptor gene(CASR)mutation remained healthy,a combination of the CASR and SPINK1 gene mutation caused chronic pancreatitis(CP).We thus speculate that the combination of two genetic defects affecting calcium homeostasis and pancreatic enzyme activation might represent a novel approach in chronic inherited pancreatic *** therefore sought to explore whether CASR gene mutations were prevalent in a cohort of patients with CP and confirmed SPINK1 *** and methods.A cohort of 19 families(n = 170)with a history of idiopathic CP(ICP)was screened for mutations within the CASR gene;104 members of that cohort had a mutation(N34S)within the SPINK1 gene and 66 of those were suffering from *** entire CASR gene was screened for single strand conformation polymorphism under varying polyacrylamide gel conditions and subjected to direct dideoxy nucleotide sequencing of amplified ***-strand conformation polymorphisms were observed in 59 samples,clustering of exons 3,4 and *** sequence analysis revealed a yet unreported missense mutation in exon 7(R896H)and two conservative mutations in exon 4(F391F)and exon 7(E790E).Furthermore,an intronic polymorphism in nucleotide position 493-19 G > A was detected in 19 out of 170 members of that *** identified three novel calcium-sensing receptor gene mutations(1 missense mutation,2 silent mutations and 1 intronic polymorphism)in a cohort of 19 families with *** particular,the kindred with the R896H mutation presenting with a similar pedigree to the family described above may indicate a role for CASR gene mutations in SPINK1-related ***,only the patient with the combination of both CASR and N34S SPINK1 gene mutation developed

关键词：慢性胰腺炎基因突变钙敏感受体遗传危险因素聚丙烯酰胺凝胶电泳分析单链构象多态性胰蛋白酶抑制剂 DNA序列分析

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孕酮治疗后子宫内膜增生进展为子宫内膜腺癌

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世界核心医学期刊文摘（妇产科学分册） 2006年第3期2卷 43-43页

作者： Rubatt J.M. Slomovitz B.M. Burke T.W. Broaddus R.R. 张旸 department of Pathology Box 85 University of Texas M.D. Anderson Cancer Center 1515 Holcombe Blvd. Houston TX 77030 United States

Background. conservative treatment with progestins is a reasonable treatment option for endometrial complex atypical hyperplasia and, in the experimental setting, for some women with grade 1 endometrial endometrioid adenocarcinoma. The risk of progression to a high-stage endometrial cancer is quite low, with only two previously reported cases in the English literature. Case. A 40-year-old woman with endometrial complex atypical hyperplasia diagnosed by dilatation and curettage was managed conservatively with progestin therapy (initially, megesterol acetate; then, a combination oral contraceptive). More than 2 years after her original diagnosis, she developed endometrial endometrioid adenocarcinoma,FIGO grade 2, with lymph node metastasis. The tumor was microsatellite instability-high due to methylation of MLH1 and loss of MLH1 protein. Conclusion. Currently, there are no good criteria for predicting which patients with complex atypical hyperplasia/grade 1 endometrioid adenocarcinoma will optimally respond to progestin therapy. There is some evidence that endometrial complex hyperplasia demonstrating loss of MLH1 protein by immunohistochemistry is strongly related to subsequent or concurrent endometrial cancer, especially tumors of higher grade and stage. In a woman with a biopsy diagnosis of endometrial hyperplasia, evaluation of MLH1 protein status by immunohistochemistry may provide useful information when medical management is being considered.

关键词：子宫内膜腺癌子宫内膜增生分段诊刮非典型增生复杂型活检诊断口服避孕药淋巴结转移晚期肿瘤

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阴性表浅腹股沟淋巴结切除术后Ⅰ/Ⅱ期外阴癌患者的结局

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世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 45-45页

作者： Kirby T.O. Rocconi R.P. Numnum T.M. 刘亦恒 Division of Gynecologic Oncology Department of Obstetrics and Gynecology University of Alabama at Birmingham 619 19th Street South Birmingham AL 35249-7333 United States

Objectives. To investigate the patterns of recurrence associated with superficial inguinal lymphadenectomy (SupIL) and vulvectomy for patients with Stage Ⅰ/Ⅱ vulvar cancer. Methods. A retrospective chart review identified patients from 1990-2001 with Stage Ⅰ/Ⅱ vulvar cancer that underwent SupIL and vulvectomy. Survival was analyzed using the Kaplan-Meier method with Fisher Exact and Chi-square tests for comparisons between groups. Results. 65 patients with Stage Ⅰ/Ⅱ vulvar cancer with a pathologically negative SupIL were identified (30 Stage Ⅰ, 35 Stage Ⅱ ). Three patients recurred in the inguinal region, (4.6% ) and 11 patients (16.9% ) recurred on the vulva. Two of the 11 patients died of disease, six patients are alive without evidence of disease after additional therapy. Five-year disease-free survival and overall survival were 66% and 97% , respectively. Risk of recurrence was not associated with smoking status, stage, or margin status. Conclusions. SupIL and vulvectomy for Stage Ⅰ /Ⅱ vulvar cancer have a low recurrence rate in the inguinal region when nodes are negative. The local recurrence rate (17% ) is acceptable, and overall survival is good using this conservative approach.

关键词：局部复发率腹股沟区存活者精确检验复发风险接受范围肿瘤分级

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视网膜母细胞瘤眼球摘除术后多孔性聚乙烯移植物暴露的处理

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世界核心医学期刊文摘（眼科学分册） 2005年第4期1卷 54-54页

作者： Kim J.- H. Khwarg S.- I. Choung H.K. 肖颖 department of Ophthalmology Seoul Natl. Univ. Coll. of Medicine 28 Yongon- dong Chongno- gu Seoul 110- 744 South Korea Dr

BACKGROUND AND OBJECTIVE: To report the features and the management of porous polyethylene implant exposure in patients with retinoblastoma following enucleation. PA- TIENTS AND METHODS: The medical records of 33 patients (33 sockets) following enucleation and porous polyethylene implantation for retinoblastoma were reviewed. RESULTS: The mean age at enucleation was 24 months (range, 2 to 85 months). The exposure rate was 33% (11 cases), and the mean time from enucleation to exposure was 15 months (range, 7 to 29 months). One case was resolved only by supportive management, and the remaining 10 were successfully treated with a scleral patch graft and maintained well during a mean follow- up of 15 months after surgical repair. There was no statistical evidence that age, gender, implant size, or chemotherapy had an effect on implant exposure. CONCLUSIONS: Porous polyethylene implant exposure does not seem to be resolved by conservative management. We recommend early surgical management, such as scleral patch graft, as opposed to supportive management.

关键词：移植物视网膜母细胞瘤眼球摘除术支持治疗医疗记录

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Large potential of strengthening the land carbon sink in China through anthropogenic interventions

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Science Bulletin 2024年第16期69卷 2622-2631页

作者： Xu Yue Hao Zhou Yang Cao Hong Liao Xiaofei Lu Zhen Yu Wenping Yuan Zhu Liu Yadong Lei Stephen Sitch Jürgen Knauer Huijun Wang Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment TechnologySchool of Environmental Science and EngineeringNanjing University of Information Science&Technology(NUIST)Nanjing 210044China College of Meteorology and Oceanography National University of Defense TechnologyChangsha 410073China Jiangsu Nanjing Environmental Monitoring Center Nanjing 210013China Key Laboratory of Agrometeorology of Jiangsu Province Institute of EcologySchool of Applied MeteorologyNUISTNanjing 210044China Institute of Carbon Neutrality Sino-French Institute for Earth System ScienceCollege of Urban and Environmental SciencesPeking UniversityBeijing 100871China department of Earth System Science Tsinghua UniversityBeijing 100084China State Key Laboratory of Severe Weather and Key Laboratory of Atmospheric Chemistry of CMA Chinese Academy of Meteorological SciencesBeijing 100081China College of Life and Environmental Sciences University of ExeterExeter EX44RJUK Hawkesbury Institute for the Environment Western Sydney UniversityPenrith 2751Australia Key Laboratory of Meteorological Disaster Ministry of EducationJoint International Research Laboratory of Climate and Environment ChangeCollaborative Innovation Center on Forecast and Evaluation of Meteorological DisastersNUISTNanjing 210044China

The terrestrial ecosystem in China mitigates 21%-45%of the national contemporary fossil fuel CO_(2) emissions every *** and strengthening the land carbon sink is essential for reaching China’s target of carbon ***,this sink is subject to large uncertainties due to the joint impacts of climate change,air pollution,and human ***,we explore the potential of strengthening land carbon sink in China through anthropogenic interventions,including forestation,ozone reduction,and litter removal,taking advantage of a well-validated dynamic vegetation model and meteorological forcings from 16 climate *** anthropogenic interventions,considering Shared Socioeconomic Pathways(SSP)scenarios,the land sink is projected to be 0.26-0.56 Pg C a^(-1) at 2060,to which climate change contributes 0.06-0.13 Pg C a^(-1) and CO_(2) fertilization contributes 0.08-0.44 Pg C a^(-1) with the stronger effects for higher emission *** anthropogenic interventions,under a close-to-neutral emission scenario(SSP1-2.6),the land sink becomes 0.47-0.57 Pg C a^(-1) at 2060,including the contributions of 0.12 Pg C a^(-1) by conservative forestation,0.07 Pg C a^(-1) by ozone pollution control,and 0.06-0.16 Pg C a^(-1) by 20%litter removal over planted *** sink can mitigate 90%-110% of the residue anthropogenic carbon emissions in 2060,providing a solid foundation for the carbon neutrality in China.

关键词： Carbon sink Forestation Ozone Litter removal

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卵巢低度恶性潜在肿瘤的保留生殖力的手术治疗

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世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 40-40页

作者： Skinner E.N. Gehrig P.A. J.O. Schorge 刘亦恒 Division of Gynecologic Oncology Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard J7.124 Dallas TX 75390-9032 United States

Objective. Ovarian low malignant potential (LMP) tumors have an excellent prognosis when treated by surgical resection. conservative management usually involves leaving behind the uterus and contralateral adnexa to allow future childbearing. The purpose of this study was to determine the outcome of women treated with fertility-sparing surgery. Methods. All patients diagnosed with ovarian LMP tumors between 1984 and 2003 were identified at three institutions. Data were retrospectively extracted from clinical records. Results. Thirty eight (15% ) of 249 women with LMP tumors underwent fertility-sparing surgery. Twenty-three were nulliparous and four primiparous. Thirty-three (87% ) underwent unilateral salpingo-ophorectomy and five (13% ) cystectomy. Fourteen patients also had contralateral cystectomy or biopsy. Thirty four (89% ) were stage Ⅰ , one (3% ) stage Ⅱ and three (8% ) stage Ⅲ . Most tumors had serous (55% ) or mucinous (42% ) histology. No patients received adjuvant therapy. Six (16% ) of 38 recurred after a median follow-up of 26 months: five in the remaining ovary were salvaged with surgical resection alone, and none died from recurrent LMP tumor. Five women delivered six term infants during post-treatment surveillance. Conclusion. Fertility-sparing surgery for ovarian LMP tumors is an option for motivated patients. Preservation of the contralateral adnexa increases the risk of recurrence, but surgical resection is usually curative.

关键词：生殖力黏液性囊肿切除术恶性潜能单侧输卵管临床记录组织活检未产妇医疗机构

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采用内镜和金属支架植入术成功治疗1例环形壁内食管分割患者

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世界核心医学期刊文摘（胃肠病学分册） 2006年第5期2卷 49-49页

作者： Kim S.H. Lee S.-O. 程妍 Division of Gastroenterology and Hepatology Department of Internal Medicine Chonbuk National University Medical School 634-18 Geum-am dong Deokjin-gu Jeonju Chonbuk 561-712 South Korea

Spontaneous intramural esophageal dissection is a rare disorder characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, without perforation. The majority of previously reported cases of spontaneous intramural esophageal dissection were partial, and the circumferential type of intramural esophageal dissection has not been reported previously. Most spontaneous intramural esophageal dissection responds to conservative management, and usually it dose not lapse into a long protracted course of dealing with sequelae. We report an unusual case of circumferential intramural esophageal dissection, in which initial conservative management failed to alleviate the patient’ s dysphagia, necessitating the use of several endoscopic treatments, including incision of the septum between the false and true lumens, transection of the true esophageal wall, balloon dilatation, and metal stent insertion.

关键词：金属支架植入术内镜下治疗保守治疗食管壁分割环形患者黏膜下层球囊扩张术自发性

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原位腺癌锥切活检显示边缘阴性与宫颈浸润性腺癌

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世界核心医学期刊文摘（妇产科学分册） 2005年第10期1卷 48-48页

作者： Cohn D.E Morrison C.D Zanagnolo V 侯巍 department of Obstet rics and Gynecology Division of Gynecologic Oncology Ohio State University College of Medicine and Public Health 320 West 10th Avenue Columbus OH 43210 United States

Background. Cervical adenocarcinoma in situ is often diagnosed in younger women who may wish to preserve the potential for fertility. Given that the rate of recurrent adenocarcinoma in situ is relatively low and the risk of invasive adenocarcinoma is extremely rare, conservative management in this population after a cone biopsy demonstrates negative margins has been accepted as an appropriate management strategy. This case challenges the concept of conservative management of cervical adenocarcinoma in situ. Case. A 42- year- old G2P2002 with previously normal annual cervical cytology had a Pap smear demonstrating atypical glandular cells of uncertain significance. A 1.5- cm lesion was noted at the endocervix, and a punch biopsy revealed adenocarcinoma in situ. A large cold knife cone biopsy confirmed cervical adenocarcinoma in situ with negative margins. Definitive therapy for in situ disease with an extrafascial hysterectomy was performed 12 days after conization, and demonstrated stage IB1 cervical adenocarcinoma. A radical parametrectomy, radical upper vaginectomy, and pelvic lymphadenectomy were without persistent disease. Conclusion. conservative management of cervical adenocarcinoma in situ after a cone biopsy with negative margins does not exclude the possibility of concurrent invasive cervical adenocarcinoma. This case challenges the current balance between risk and benefit associated with the conservative management of cervical adenocarcinoma in situ.

关键词：原位腺癌锥切浸润性腺癌手术病理分期宫旁组织巴氏涂片淋巴结切除术阴道切除术复发率穿刺活检

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I期阴道鳞状细胞癌合并妊娠的成功保守治疗

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 49-49页

作者： Fujita K. Aoki Y. Tanaka K. 杨晓梅(译) 马超(校) Y. Aoki Division of Molecular Genetics Department of Obstetrics and Gynecology Niigata University Graduate School of Medical and Dental Sciences 1-757 Asahimachi-dori Niigata 951-8510 Japan 不详

Background. Vaginal squamous cell carcinoma in pregnancy is very rare situation. Case. The patient was a 33- year- old woman, presenting with a complaint of vaginal brownish discharge at a 23 weeks of gestation. On pelvic examination at that time, a 2 by 2 cm mass on posterior vaginal fornix was seen. Biopsy of the lesion demonstrated a nonkeratinizing type invasive squamous cell carcinoma. She desired to continue the pregnancy and postpone the treatment until after delivery. On 23 weeks of gestation, we performed wide local excision, confirming T1 stage. On 33 weeks of gestation, a pelvic lymphadenectomy was carried out at the time of cesarean section to secure lymph node status pathologically. Further, she began intracavitary brachytherapy via vaginal cylinder in an adjuvant setting. She is 36 months from her initial surgery and remains disease free. Conclusion. Treatment could be individualized for primary stage I vaginal squamous cell carcinoma complicating pregnancy.

关键词：阴道后穹隆鳞状细胞癌合并妊娠保守治疗 Ⅰ期盆腔淋巴结清扫术浸润性鳞癌女性患者腔内近程放疗淋巴结转移

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卵巢交界性肿瘤复发和预后的影响因素

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 46-46页

作者： Ayhan A. Guvendag Guven E. S. Guven S. Kucukali T. 张丽娟(译) S. Guven Department of Obstetrics and Gynecology. Division of Gynecologic Oncology Hacettepe UniverSity Faculty of Medicine M Esat B. Caddesi No: 69/20NCEBECI Ankara Turkey 不详

. The purpose of this study was to evaluate the survival estimates and clinico-pathological variables in patients treated for borderline ovarian tumors. Methods. The patients treated for borderline ovarian tumors were evaluated retrospectively. Data were obtained from hospital records and special gynecologic oncology forms. Results. Overall, 100 patients were evaluated. The mean age at the time of diagnosis was 41.7 (range, 19- 84). Seventy one (71% ) patients underwent surgical staging including 49 (49% ) of them with comprehensive surgical staging, 22 (22% ) with fertility-sparing surgery. Only 30 (30% ) patients were unstaged. The histopathological diagnosis was serous, mucinous, and the other types of borderline ovarian tumor in 54 (54% ), 39 (39% ), and 7 (7% ) of the patients, respectively. Seventy patients had stage IA (70% ), 10 had st age IB (10% ), 9 had stage IC (9% ), 3 had stage IIIA (3% ), and 8 had stage IIIC (8% ) disease. The stage of only four patients in which disease confined to ovary was upgraded as stage IIIC following surgical staging procedure. The recurrence rate was found 3% (3). The overall disease-free survival rates of BOT in surgically staged (comprehensive, fertility-sparing surgery) and unstaged patients were 97.92% , 95.00% , and 96.30% , respectively. But, the overall tumor-free survival was significantly found to be decreased in cases of young age ( conservative surgery.

关键词：卵巢交界性肿瘤肿瘤复发率组织病理学诊断手术分期年轻患者无瘤生存率预后保守手术低度恶性潜能平均年龄

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