Objective: To investigate the effects of epileptic discharges in sleep of epileptic patients on sleep-breath events. Methods: Polysomnograph (PSG) and long-term video electroencephalogram (LTVEEG) were used to monitor 82 adult epileptic patients. The condition of paroxysmal events in nocturnal sleep was analyzed, and the epileptiform discharge and effects of antiepileptic drugs were explored. Results: In epileptic group, latency to persistent sleep (LPS) and REM sleep latency increased, the proportion of light sleep increased while that of deep sleep decreased, sleep efficiency reduced, nocturnal arousal times increased and apnea hyponea indexes (AHI) improved, which demonstrated significant differences by comparison to control group. Periodic leg movements (PLM) had no conspicuous differences compared with control group. There were no speciifc effects of epileptiform discharge and antiepileptic drugs on AHI and PLM indexes. Conclusion: Epileptic patients have sleep structure disorders and sleep-disordered breathing, and arousal, respiratory and leg movement events inlfuence mutually. Synchronous detection of PSG combined with LTVEEG is in favor of comprehensively analyzing the relationship between sleep structures and epilepsy-breath events.

作者： 刊期： 2013年第02期

作者： 刊期： 2013年第02期

A case of a 53-year-old man with adult T-lymphoblastic lymphoma (T-LBL) in mediastinum who survived more than 33 months in our hospital was reported. LBL was more common in school-age and teenage boys than adults. The reported patient manifested progressive dyspnea. Chest CT scanning showed a huge irregular soft tissue shadow in anterior mediastinum which extended into posterior mediastinum and left chest wall. The tumor was 20 cm×15 cm×15 cm in size in left upper mediastinum and its boundaries with pericardium and left lower lung were unclear. The diagnosis of T-lymphoblastic lymphoma was confirmed by immunohistochemical staining. After surgery, he received five chemotherapy courses including Gem, CTX and VCR and biological therapies with IL-2 and IFN-α2b. About 16 months later, he complained of diplopia in the left eye without any evidence of recurrence. Blood examination which showed leukemoid reaction twice returned to normal after dehydration, hormone and thalidomide treatments. Finally, his condition became worse and died of pulmonary infection 33 months after ifrst medical service. In summary, T-LBL is a rare disease which may result in poor prognosis even if the patient has received immediate chemotherapy. Hormone and thalidomide can be applied to treat adult T-LBL.

作者： 刊期： 2013年第02期

Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods:The clinical features of2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results:The ratio of male/female was 4.8:1 and the peak onset age was 60~69 years old. The major pathological type was squamous cell carcinoma (44.5%), then adenocarcinoma (25.9%) and small cell lung cancer (18.3%). The incidence of squamous cell carcinoma was the highest in males (50.6%), while that of adenocarcinoma in females (56.2%). The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can signiifcantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

作者： 刊期： 2013年第02期

作者： 刊期： 2013年第02期

Chemotherapy, endocrine therapy and molecular targeted therapy are vital means in the treatment of metastatic breast cancer (MBC), whose reasonable and standard applications are of great importance to prolong patients’ survival and improve the quality of life. The expressions of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) present signiifcant differences between primary and metastatic breast cancer. However, these differences may affect the selection of MBC patients for therapeutic strategies and judgment on the prognosis. Hence, the relevant researches on variations of hormone receptors and HER-2 in primary and metastatic breast cancer, discordant causes of ER, PR and HER-2 expression in primary and metastatic lesions and clinical value of biopsy to the metastases are reviewed in the study.

作者： 刊期： 2013年第02期

Objective: To investigate the effects of blood-cooling and stasis-removing formula on hemorheology in rats with acute blood stasis induced by mutifactor stimuli. Methods: The selected SD rats orally took blood-cooling and stasis-removing granule for six days, then the model of acute blood stasis was prepared on the iffth day by injection of epinephrine combined with ice-water bath. The variations of blood-cooling and stasis-removing granule on hemorheology were detected. Results: The high-dose group of blood-cooling and stasis-removing formula can decrease plasma viscosity in rats with acute blood stasis, and obviously reduce the blood viscosity under the condition of shear rates (200s-1, 30s-1, 5s-1, 1s-1) (P<0.01,P<0.05). The middle-dose group can decrease the blood viscosity under the condition of shear rate (30s-1) (P<0.05). Conclusion: Blood-cooling and stasis-removing formula can improve abnormal hemorheology in rats with acute blood stasis.

作者： 刊期： 2013年第02期

Most of cancer patients are suffering from psychological distress which is under-diagnosed and under-treated in China. The purpose of this study is to evaluate the psychometric properties of a new screening instrument for psychological distress in cancer patients based on Chinese culture and personality traits. The scale was created after face-to-face interviews and focus group discussion of 50 medical staffand 30 cancer patients; the analysis of reliability and validity came from 1122 scales completed by cancer patients and non-cancer patients. Data was analyzed for internal consistency reliability, construct validity and discrimination validity in clinical practice. The internal consistency reliability of the scale was 0.906. Principal components factor analysis and structural equation modeling showed that the scale was comprised of four dimensions: depression, anxiety, interpersonal barrier and suspiciousness. The ift indices were χ2(149)=257.594, χ2/d?=1.729, GFI=0.927, NFI=0.846, NNFI=0.906, RMSEA=0.061. These results indicated there were signiifcant differences between cancer patients and non-cancer patients, with respect to the total scores, anxiety scores, interpersonal barrier scores and suspiciousness scores. The psychological distress scale is a new screening instrument for Chinese cancer patients, which is in line with the emphasis of Chinese culture.

作者： 刊期： 2013年第02期