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Biomedical subjects

D Zhang

Publications and source records attributed to D Zhang.

At least 505 records · Page 28Linked to original sources
PubMed1996

Prognostic significance of lymph node metastasis in surgical resection of esophageal cancer.

OBJECTIVE: Although surgery is relatively successful in eradicating local tumor, post-resection five-year survival rate for esophageal cancer is still lower than 30%. Multiple factors are found to influence the long-term results after surgical treatment. However, recent investigations have focused on the significance of lymph node matastasis (LNM), which seems to be one of the most important factors leading to poor survival. Hence, the prognostic significance of LNM in surgical resection of esophageal cancer was studied. METHODS: The rate and degree of LNM were evaluated and their prognostic significance was investigated through a retrospective study of 474 patients with esophageal cancer treated by surgery alone. RESULTS: LNM was positive in 211 patients, with an incidence of 44.5% (211/474). A total of 5382 lymph nodes were resected and studied pathologically, among which metastasis was found in 690 nodes with an overall LNM degree of 12.8% (690/5382). The 5-year survival rate was 30.6% (145/474) in the entire series, 12.8% (27/211) in patients with LNM, and 44.9% (118/263) in those without LNM. CONCLUSIONS: Surgery remains the first choice of treatment for carcinoma of the esophagus, and that meticulous lymph node dissection is an important practice of surgical oncology. However, in more advanced cases of this disease, surgery alone is of limited value in eradicating all cancer compromized tissue, and therefore the routine practice of extensive lymph node dissection in such cases may not be rewarding.

Adult↗
PubMed1996

[Thoracoscopy in malignant pleural effusions].

To assess the value of thoracoscopy in malignant pleural effusions, the procedure and results of thoracoscopy by using a fiberoptic bronchoscope and a rigid cold-light thoracoscope in 130 cases with malignant pleural effusion are reported. The overall diagnostic rate was 91.5% (119/130). The malignant pleural mesothelioma in 24 cases and metastatic cancers in 95 cases were histopathologically confirmed. Talcum powder, tetracycline and Corynebacterium parvum were separately sprayed through thoracoscope into pleural cavity in 69, 10 and 10 patients, and the success rates of complete and lasting pleurodesis were 87.0%, 5/10 and 8/10 respectively. Postoperative complications included transient fever and chest pain, local subcutaneous emphysema in 6 cases and tumor seeding at thoracoscopy site in 4 cases. It is concluded that thoracoscopy is simple, safe, reliable and of high practical value in the diagnosis of malignant pleural effusions and in assessment before exploratory thoracotomy, and that transendoscopical administration of drugs for pleurodesis is a very effective method for controlling malignant pleural effusions. The efficacy of the talc poudrage is better than tetracycline and Corynebacterium parvum.

Adenocarcinoma↗
PubMed1996

[The most important prognostic factors for 736 patients with adenocarcinoma of the gastric cardia: a multivariate analysis using COX proportion hazard model].

A prognostic study was done in 736 patients with primary resectable adenocarcinoma of the gastric cardia whose postoperative survival time was longer than three months. The 3-, 5-, and 10-year cumulative survival rate was 32.2%, 20.2% and 12.2%, respectively. Thirty individual variables were evaluated statistically using the cumulative survival rate by the computer's COX multivariate analysis model. The results showed that the most important prognostic variables for predicting overall survival included maximal tumor diameter, type of resection, depth of invasion and paracardial lymph node metastasis. Sex and preoperative radiotherapy did not influence prognosis.

Adenocarcinoma↗
PubMed1996

[Metabolism of angiotensin I in placenta tissue].

OBJECTIVE: To explore whether placenta tissue could produce angiotensin I and the metabolism pathway of angiotensin I in placenta. METHODS: Placenta tissues from 6 term pregnant women without any complication were cultured in vitro for 1 to 6 days, the angiotensin I concentrations in the medium were measured by radioimmunoassay in the first, second, fourth and sixth day. 5 to 500 mumol/l, captopril were added to the culture medium and the concentrations of angiotensin I were measured at the same times to observe the effect of angiotensin converting enzyme on the production of angiotensin I. RESULTS: The concentration of angiotensin I in the placenta culture medium increased with the culture time. There were no significant differences in the concentrations, when captopril was added. CONCLUSIONS: The placenta tissue can produce angiotensin I and its production does not depend on the angiotensin converting enzyme.

Adult↗
PubMed1996

Abnormal coronary flow reserve in patients with angina pectoris and hypertensive left ventricular hypertrophy.

OBJECTIVE: To assess coronary flow reserve using a computer-assisted method with intracoronary papaverine in patients with angina pectoris. PATIENTS AND METHODS: Coronary arterial diameter, cross-sectional area and blood flow velocity were measured during coronary arteriography before and after intracoronary papaverine in 26 control subjects, 45 patients with significant coronary artery disease (> 50% luminal narrowing), 16 patients with syndrome X and 14 patients with hypertension and left ventricular hypertrophy (LVH). RESULTS: After intracoronary administration of papaverine, proximal diameter, cross-sectional area, blood velocity, flow volume and reserve capacity of both left anterior descending and right coronary arteries were lower in patients with significant coronary stenosis than in the controls. Despite similar changes in diameter and cross-sectional area, the blood velocity, flow volume and reserve capacity of the two vessels were also lower in patients with syndrome X than in the controls. In 14 patients with hypertension and LVH, although the blood velocity and flow volume were augmented for the two arteries and did not differ from those in the controls, the flow reserve was reduced because of higher baseline blood velocity and flow volume. CONCLUSIONS: Coronary flow reserve is reduced in patients with coronary artery disease, syndrome X or hypertensive LVH, which may be related to abnormal changes at different levels of the coronary vasculature or resting flow states.

Angina Pectoris↗
PubMed1996

[Nitric oxide delivery through ventilator and its toxic oxidative product nitrogen dioxide].

OBJECTIVE: To observe nitric oxide(NO) delivery through mechanically ventilator. NO is rapidly converted to nitrogen dioxide(NO2)in oxygen(O2) environments. METHODS: NO(800 ppm)was blended with compressed air, delivered to the high-pressure air inlet of a Siemens Servo 900C or VIP BIRD ventilator, and used to ventilator as a test lung. The ventilator settings were varied, minute ventilation (VE)from 2 to 6 L/min, inspired O2 fraction(FiO2)from 0.25 to 0.65, and NO concentration from 10 to 80 ppm. The inspiratory gas mixture was sampled just at the outlet port of ventilator. NO and NO2 were measured both by hemiluminescence and electro-chemical fuel cell technique. RESULTS: No NO was detected during any trial with VE 5 or 6 L/min., with FiO2 0.35 or 0.25, with NO 20 or 10 ppm. Low VE and low NO, NO2 values were greater with Servo 900C ventilator than with VIP BIRD ventilator at similar settings High VE and low NO or low VE and high NO, NO2 values were similar with both ventilators. High VE and high NO, NO2 values were greater with VIP BIRD ventilator than with Servo 900C ventilator. At same VE, NO2 values increased with increased FiO2 and NO. (NO2) = 0.0607 (NO)- 0.6604 VE + 7.004 FiO2, R2 = 0.7649 with Servo 900C ventilator,(NO2) = 0.0929(NO)- 0.1296 VE + 7.9360 FiO2, R2 = 0.8687 with VIP BIRD ventilator. CONCLUSIONS: NO(800 ppm) was blended with compressed air, delivered to the high-pressure air inlet of a Siemens Servo 900C or VIP BIRD ventilator is a portable, accurate, and adaptable system to deliver NO. During NO inhalation, VIP BIRD ventilator is more adaptable while low VE. Servo 900C ventilator is more adaptable while high VE.

Humans↗
PubMed1996

[Prevention of endotoxic shock in rats with hepatic stimulating substance].

In order to understand the mechanism of prevention of endotoxic shock and evaluate the pathological changes taking place, an animal model of endotoxic shock was established by intravenous injection of endotoxin into rats, which were then treated with a hepatic stimulating substance, hepatopoietin (HPN). The results were as follows; (1) There was coincidence of low blood pressure and high serum level of tumor necrosis factor (TNF) in the experimental rats. (2) Simultaneous intravenous injection of endotoxin and introperitoneal injection of HPN showed that HPN can prevent the drop of blood pressure, lower the TNF level and ameliorate the tissure injury in lungs and kidneys induced by endotoxin. If HPN was given 15 minutes ofter injection of endotoxin, the drop of blood pressure could not be prevented and the TNF level remained high. It is suggested that TNF is an important mediator for endotoxic shock and treatment of endotoxic shock might be effective, if it is intituted early.

Animals↗
PubMed1996

[Results of initial surgery and adjuvant chemotherapy in treating small-cell lung cancer].

Results of initial surgery and postoperative chemotherapy in the treatment of 104 small-cell lung cancer (SCLC) were reported. The overall resectability rate was 84.6%. Operative modes include pneumonectomy in 16 cases, regular lobectomy (bilobectomy) in 62, and sleeve lobectomy in 10. There was no resection mortality. The clinical TNM staging was: stage I in 77 cases, stage II in 19, stage III a in 8. The pathological TNM staging was: stage II in 45 cases, stage I in 32, stage III a in 25, stage III b in 1, and stage IV in 1. A total of 54 cases was incorrectly staged, of which 46 cases were clinically understaged while 8 cases were overstaged. The follow-up rate reached 94.9%. The overall 5-yr survival rate was 27.5%. The modes of resection, surgica pathological staging and postoperative chemotherapy are three factors possibly related to long-term survival. The 5-yr survival rate for lobectomy and pneumonectomy was 30.9% and 12.5%, that for stage I, II, III was 33.3%, 14.3%, and 33.3%. The 5-yr survival rate with and without postoperative chemotherapy was 32.4% and 16.7%. The results suggest that for SCLC surgery is indicated in T3N0 and T3N1 among stoge I, II and III a patients. Correct preoperative staging and postoperative chemotherapy are indispensable for better prognosis.

Adult↗
PubMed1996

[A clinicopathological study of small-cell esophageal carcinoma].

Small-cell esophageal carcinoma (SCEC) is not uncommon. From 1979 through 1994, 42 cases of SCEC were diagnosed among 711 patients with cancer of the esophagus, with a relative frequency of 5.9%. Differential diagnosis is difficult according to clinical symptoms and signs. However, SCEC differs greatly from squamous-cell carcinoma of the esophagus in histopathology and biologic behavior but is similar to small-cell lung cancer (SCLC). Surgical treatment alone of SCEC patients has a mean survival period of 11.2 months while patients treated with radiotherapy alone has a longer survival (22.8 months). No case was treated only with chemotherapy in this group of patients. Those received no treatment could survive 6.2 months only. Therefore, SCEC is a very aggressive tumor with poor prognosis. Histochemical and immunohistochemical study revealed both epithelial and neuro-endocrine differentiation potentials suggesting that SCEC probably originates from mulfipotential primitive stem cells in the esophageal mucosa.

Adult↗
PubMed1996

[Displaying of infrared thermogram of temperature character on meridians].

In this work we have observed the skin temperature of central line of the back and chest-abdomen on the human body truck by the infrared thermography. Here care the results: (a) Of all the volunteers, 57.1% central lines of the back and 7.7% central lines of the chest-abdomen of the volunteers are the longitudinal high thermal lines in normal state. (b) After moxibustion at Mingmen (GV 4) point, the temperature of 70.4% central lines of the back is going up. After moxibustion at Zhongwan (CV 12) point, the temperature of 56.0% central lines of the chest-abdomen is going up. The high thermal lines are longer and their continuity is hotter after moxibustion. (C) The lines on the back which are about 20 approximately 50 centimetres are longer than those on the chest-abdomen which are about 10-30 centimetres. The results suggest that the high thermal lines are the objective display of the temperature character on the Governor and Conception vessel. The formation of high thermal line may have some relationship with the compact connective tissue or microcirculation.

Acupuncture Points↗
PubMed1996

[The role of thoracoscopy in the diagnosis and management of pleural effusion].

To assess the value of thoracoscopy in the diagnosis and management of pleural effusion, 146 patients with pleural effusion of unknown causes had this examination by using fiberoptic bronchoscope the rigid cold light thoracoscope. 127 of these cases were histopathologically diagnosed. 109 had malignant diseases and 18 benign specific diseases. The histologic diagnoses following thoracoscopic biopsy in all the patients were compared with the clinical findings at follow-up, the results showed that the sensitivity was 92.7%, specificity 100.0% and diagnostic accuracy 93.2%. 72 patients with more than moderate volume of pleural effusion were treated with intrapleural talcum powder suspensions (3% 100 ml) under thoracoscopic control, 63 of them obtained complete pleurodesis. The success rates of talc poudrage pleurodesis were 88.1% in 67 cases with malignant effusion (59/67) and 80.0% in 5 cases with benign pleural effusion (4/5). There were only minor postoperative complications: transient fever in 54 cases, local subcutaneous emphysema in 6 and thoracoscopy site tumor seeding in 2. It was shown that thoracoscopy is simple, safe, reliable and practical in the diagnosis of pleural effusion and that talc pleurodesis is a very effective method for controlling refractory pleural effusion transendoscopically.

Adult↗
PubMed1996

[Reconstruction of right ventricular outflow tract using transannular patch in 52 children with tetralogy of Fallot].

52 children with tetralogy of Fallot received reconstruction of right ventricular outflow tract (RVOT) by using transannular patch. The indications for using transannular patch to reconstruct RVOT, patch materials, and the standard of enlargement pulmonary annulus were studied. The indications were held correctly for reconstruction of RVOT with transannular patch. The autologous pericardium was the most acceptable material for patch. All patients showed no obstruction of RVOT during early and late postoperative follow-up, althought most of them had certain degree of pulmonary regurgitation (PR) in first postoperative year, whicli was gradually attenuated as their life time long-drawn, with better exertion tolerance.

Adolescent↗
PubMed1996

[Histopathological and immunohistochemical studies in hepatoid adenocarcinomas of the stomach].

To clarify the pathomorphology and the characteristics of clinical biological behaviors in hepatoid adenocarcinoma of the stomach (HAS), the clinical data of 24 HAS cases were reviewed and the specimens studied with light, electron microscopy and immunohistochemistry methods. The results show that HAS was more often found in middle aged and elderly people, and their serum alphafetoprotein (AFP) levels were significantly high. Among the 16 deceased cases, 12 died within one year and the mean survival period after operation was 10 months, only one of the 24 cases was early stage carcinoma, all others were of the advanced stage. Vessels were invaded in 18 cases (75%), metastasis to the regional or distant lymph nodes in 22 cases (91.7%) and liver metastasis in 14 cases (58.3%). HAS is a highly malignant tumor with poor prognosis. The tumors were composed of two different but closely related hepatoid and adenocarcinomatous areas. The tumor cells in the hepatoid region possess many features of hepatic cell carcinoma, such as abundant eosinophilic or clear cytoplasm, PAS positive hyaline globules in both intra- and extracellular spaces. AFP positive staining, intracytoplasmic bile, glycogen granules and intercarcinocyte bile canaliculus. Microvilli with intestinal epithelial type were found not only in adenocarcinoma areas but also in hepatoid areas. An indication that the HAS was differentiating into hepatic cell and intestinal epithelial types. We conclude that HAS possesses similar pathomorphologic pattern and clinicobiological behaviors of hepatic cell carcinoma and HAS should be classified as a special subtype of gastric carcinoma.

Adenocarcinoma↗
PubMed1996

[Surgical treatment of aortoesophageal fistula induced by foreign body in esophagus].

It is well known that there is no effective therapy to cure aortoesophageal fistula induced by a foreign body in the esophagus all over the world. In 220 cases of foreign body in esophagus, 4 developed the life-threatening complication of aortoesophageal fistula as the foreign body eroded through the esophageal wall and perforated the aorta. Although 3 of 4 patients were operated upon, only one survived by means of profound hypothermia and circulatory arrest. According to the successful experience and a review of the literature, the authors considered that some patients with aortoesophageal fistula may be saved if an emergency operation is undertaken immediately after the diagnosis made. Meanwhile, they divided this disease into 3 pathological types, and suggested the optimal operation procedure individualized to the different pathological types.

Adult↗
PubMed1996

[Clinical observation of TMJDS treated with pivot splint].

The pivot splint was applied to 50 patients with temporomandibular joint dysfunction syndrome that included 30 patients of anterior disc displacement without reduction, 12 patients of anteriordisc displacement with partial reduction and 8 patients of upward condyle displacement. The mouth opening and joint space of the TMJ tomographies before and after treatment were measured for each case. The results indicated that treatment with pivot splint was very effective for the patients with downward diplacemenr of the condyle. As a result, among 50 patients, 36 patients were cured (72%) and 14 patients were improved (28%). The results of 3 years follow-up indicated that original symptoms of the patients had no recurrence.

Adolescent↗