Cancong

 

美加州大学教授撰文反对抵制奥运呼吁宽容博爱
新华网 - 北京,China
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奥运快点开，房价快点掉！
焦点网地产网 - China
奥运快点开，房价快点掉！ - <0bytes> 过客评论08/04/10 08:23 (2次点击) 验证码：看不清？点图片更换输入验证码 1.反对宪法基本原则,危害国家安全、政权稳定统一的；煽动民族仇恨、民族歧视的； 2.宣扬邪教和封建迷信的；散布谣言，破坏社会稳定的；侮辱诽谤他人，侵害他人合法权益的；
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共守精神家园祈福北京奥运
新华网河南频道 - Zhengzhou,Henan,China
4月8日，省政协主席、中华炎黄文化研究会副会长王全书在戊子年黄帝故里拜祖大典仪式上恭读拜祖文。 4月8日，在戊子年黄帝故里拜祖大典仪式上几位礼仪小姐手捧故乡圣土将由有关领导馈赠游子。 4月8日，第29届奥运会组委会北京奥运新闻中心美国专家杰夫・纳弗罗先生参加拜祖大典活动后在黄帝塑像前留影（左一）。他说，相信北京奥运会一定能够 ...
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核子猎潜艇;中国奥运来了,多少反华人想搭顺风车
中华网 - Beijing,China
上次大家都关注台湾选举会不会让中国奥运没发办,但没想到人家在西藏这边开始动手.使本来安静的地方出现了问题.前些年由于工作关系去了西藏,对于很多问题做了一些深入实际的了解.下面是我但是写的一些实地看到的东西大家看下: 西藏独特的地理环境吸引了世界众多的人们好奇和神秘的向往.藏民族在恶劣的地理气候环境中坚强的繁衍生息了几千年. ...
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希拉里抵制北京奥运失策
央视国际 - Beijing,China
新快报讯美国民主党总统候选人希拉里本周一呼吁现任总统布什抵制北京奥运开幕式。可是有趣的是，希拉里的这一言论似乎连她的丈夫也不支持。美国媒体日前报道称，前美国总统克林顿曾明确表示，反对抵制北京奥运会。报道称,去年，克林顿曾劝美国艺术家斯皮尔伯格不要抵制奥运会，因为只有这样，斯皮尔伯格才能更好地与中国政府沟通，表达 ...
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"Overview"



Pleural mesothelioma have a better prognosis of benign fibrous mesothelioma, and diffuse malignant pleural mesothelioma, which is considered the worst prognosis chest tumor, yet no effective treatment measures.



"Diagnosis"



Have exudative pleural effusion, in particular with exposure to asbestos patients should take into account the history of malignant pleural mesenchymal skin tumor diagnosis. Ct chest can confirm the diagnosis, chest ct examination of pleural calcifications can be judged whether or bone structure damage. When the diaphragm and chest wall invasion, the magnetic resonance imaging is better than ct (Figure 1). While pleural effusion cells smears, breast wear pleural biopsy and pleural effusion cells can be made vicious block biopsy in the diagnosis, but it can not identify metastatic carcinoma and malignant pleural mesothelial Liu.



Figure 1 magnetic resonance: the right lower chest wall malignant pleural mesothelioma



Under Yebei left lung layer of dirt have malignant pleural mesothelioma (surgery confirmed)



If in the past 10 years developed three kinds of technology, certainly compared to a diagnosis of malignant mesothelioma. These three technologies are periodate - Schiff staining liquid done to keratinocytes and carcinoembryonic antigen for immune peroxidase testing and electron microscope examination. To carry out these checks biopsy specimens must be immediately used in the sexual wellbeing of fixed Le Marin, another small tumor biopsy specimens destined for the glutaraldehyde solution for the use of electron microscopy.



Periodate - Schiff staining (pas) is the only reliable technique, it can identify cancer and malignant pleural mesothelioma, although all the characteristics of metastatic adenocarcinoma not the same, but after enzymatic digestion of starch strong positive cavitation can be diagnosed as malignant pleural mesothelioma and not adenocarcinoma.



Immune peroxidase antibody technology is used in the role of keratinocytes protein and carcinoembryonic antigen (cea), the Act also effectively distinguish malignant pleural mesothelioma in metastatic adenocarcinoma. Carcinoembryonic antigen to the immune peroxidase stain, the stain of malignant pleural mesothelioma may generally very light colored. On the contrary, the middle and adenocarcinoma were very strong. In addition, the immune peroxidase keratinocytes for research, it also shows adenocarcinoma and mesothelioma have significant differences. Has been found eight signs can be used for identification: Tumor merger glycoprotein 72 (b72.3), the leu-mi, vimentin, thrombosis in Treating Nien protein composition, the cancer antigen positive adenocarcinoma 100% specificity and sensitivity sexual. Carcinoembryonic antigen testing as often false negative, the best selection of two tumor markers, and the general use of cea b72.3. If there was a 100% adenocarcinoma of the special nature of the sensitivity of 88% and if the two were negative, mesothelioma a 100% specificity and 97% sensitivity.



Electron microscope examination of the identification of malignant pleural mesothelioma and pleural metastatic adenocarcinoma also uses. Malignant pleural mesothelioma different from the lung, breast and upper gastrointestinal adenocarcinoma is the source of its surface microvilli thin and long, and there are branch tension wire is rich, and no microvilli, and the small-loaded; source in ovarian and endometrial metastatic adenocarcinoma of the inherent tissue deformation, including rich mucin small drops, a large number cilia, intensive nuclear particles, these changes in the stromal tumors do not exist, adenocarcinoma of the villi and short rough .



Malignant pleural mesothelioma pathological diagnosis still controversial. Although malignant mesothelioma and soft tissue sarcoma with classification, but only 20 percent of organizations is purely sarcoma. Malignant pleural mesothelioma 33% to 50% of their organization is or tubular epithelial and papillary type, and 30% for other epithelial sarcoma and mixed type, the majority of pathologists are convinced that only or mixed organizations sarcoma patients, the diagnosis can malignant pleural mesothelioma. Comprehensive special staining and electron microscopy examination of information, experienced pathologist also willing to epithelial type of patients to make the diagnosis of malignant pleural mesothelioma.



"Treatment"



Even today, the malignant pleural mesothelioma Changfu effective method of treatment, but after some treatment, both at home and abroad a few patients live five years, 22 of the longest, most people think that may be related to tumor survival and natural stage. By butchart staging of malignant pleural mesothelioma is divided into four (Table 1).



According to clinical manifestations, � epithelial type of malignant pleural mesothelioma may have long-term survival, it was recommended for these patients underwent radical resection of lung pleura. The �, � and � epithelial type and other pathological types of cases, regardless of governance and died, a curative or palliative surgery and the use of chemotherapy and radiation effect or not, the survival curve after treatment basically the same, the average survival time was 18, about 10% of patients live past three years.



Table 1 malignant pleural mesothelioma clinical stage � pleural tumors confined to the layer, only involved ipsilateral pleura, the lung, mediastinal and pericardial tumors � violations involving the chest wall or mediastinal structures, esophagus, heart and the contralateral pleura. Lymph node involvement only in the chest (n2) � tumors through the diaphragm involved peritoneum, pleura and bilateral violations contralateral breast, lymph node involvement, chest � of distant blood-borne metastatic bone



1. Palliative treatment of malignant pleural mesothelioma patient's pleural effusion, puncture aspiration might emerge soon after by chemical injection pleural cavity, causing pleurodesis, and the majority of patients have control of the pleural effusion, pleural this fixation or in the event of a failure to trip diagnostic thoracotomy patients, consideration should be given to stripping of pleura.



Malignant pleural mesothelioma can be along the puncture hole, home access and chest tube thoracotomy incision disseminated, but the skin caused by sediment rarely cause symptoms, there is no need treatment, if treatment for patients, subcutaneous nodules also can be used as observation Clinical indicators.



Malignant pleural mesothelioma patient's chest pain is the most difficult to deal with the symptoms, in late particularly serious, sustained non-stop all day, without response to radiotherapy, should be given sufficient sedation analgesics, including preparations to alleviate opiate pain, peacefully the final moment of life .



2. Surgical treatment there are all kinds of surgical treatment of malignant pleural mesothelioma measures, first of all, is to expand and pleural pneumonectomy, which involved radical resection was part of the chest wall, lung, diaphragm, mediastinal and pericardial. This method is only applicable to � function of epithelial type of malignant pleural mesothelioma cases. Serious heart and lung damage in the taboo subject of this permit. In the fourth intercostal do a standard posterolateral thoracotomy incision, will be tenacious and pleural thickening layer and the nodules together from the chest wall blunt dissection, this action will cause extensive bleeding, oppression, and electrocautery suture careful and thorough bleeding. Then, mediastinal pleura from the top of hilar separate tracheal resection of adjacent lymph nodes. In front of the pulmonary apex level, internal mammary artery ligation and vein, the former chest wall resection and pleural these blood vessels and lymph nodes that all together. Behind, and resection of esophageal and tracheal carina area adjacent lymph nodes. Left behind from the corresponding part of pericardial incision. This time when it decided to cut lung resection or first diaphragm, the violations of the order depends on tumor location and extension of the scope. Transection and vascular and bronchial lung, as in any approach pericardium (widening), like lung resection. Unlike the diaphragm, as pleural lower low in the pleural free, in the pleura, with fold lower diaphragm. For the full exposure of the general ipsilateral to 8 ~ 10 for the first two intercostal incision. Patients in the home because of the lateral position, with the diaphragm, liver tend to mediastinal shift from, oppression inferior vena cava, resulting in heart rate and blood flow obstacles. After resection of the diaphragm, the defect can be maxlex siliceous material polyester fibre network or repair, it was also used dural repair. Whether the use of any materials and technology, we must do well not to miss, in order to prevent blood from the pleural effusion or chest farmers will flow peritoneal; should be continuous suture, the diaphragm will substitute the residual solid suture diaphragm edge of the abdominal viscera not all into the chest cavity or hernia. Commissioner chest tube in the chest to connect with suction attract. Expansion of the pleural pneumonectomy operative mortality of 10% to 25%, but the effect is no less than pleural resection, and it is not recommended wider use.



The second surgical treatment for pleural resection, of this non-radical, often tired because of tumors of the lung and Below. This operation will not improve malignant pleural mesothelioma patient survival time, but it seems to control pleural effusion, improving the patient's quality of life. In addition, the malignant pleural mesothelioma caused by chest pain, sometimes with ease after the pleura, the membrane static suspected malignant mesothelioma cases, intended for diagnostic biopsy thoracotomy, consideration should be given at the same time do pleural resection. A large number of pleural effusion, and pleural chemical fixation failure cases might also consider doing pleural resection. From the above, the resection of the pleural palliative surgery, the aim is resection layer of visceral pleura and the pleura, pleural effusion to prevent recurrence and reduce chest pain symptoms. General rule for the first six intercostal posterolateral thoracotomy incision, sharp or blunt free layer of the tumor and part of the visceral pleural involvement, from the separation of the chest wall and lungs removed, this action will cause thermal conductivity caused by spinal cord or arm plexus damage in the thoracic spine peri top tumor resection, it is best to use high-frequency argon knife. In particular, we should keep careful mediastinal pleural top and the nerves and blood vessels, tumor resection, as far as possible, to reduce its volume is conducive to postoperative radiotherapy and chemotherapy. Purchase of Albert closed thoracic drainage suction.



3. Chemical treatment of anthracycline-Pharmacy was considered effective for malignant pleural mesothelioma, followed by cisplatin, mitomycin, cyclophosphamide, 5-fluorouracil, methotrexate, Vindesine, the current use of, anthracycline-based chemotherapy integrated. In recent years, both at home and abroad to statistics adriamycin-based chemotherapy, and the total efficiency of about 20%, which is better A new base (cao); non-anthracycline treatment of the various programmes of the total efficiency for 21%, which is better mitomycin plus cisplatin (mp). Cisplatin increased dose methotrexate. Chemotherapy continued until disease so far do not aggravate.



4. Radiotherapy external radiotherapy of malignant pleural mesothelioma very disappointed, but in vitro expansion of radiotherapy was considered effective, some cases can alleviate chest pain and control of pleural effusion, but the disease itself has no effect of the disease. In vitro exposure above 40 gy a palliative effect, 50 to 55 gy irradiation remission rate was 67%, a small number of patients survive to five years, but almost all patients still die of recurrence or metastasis.



Intraluminal brachytherapy on a small number of malignant pleural mesothelioma have some reaction, and a small number of patients long-term results, it seems that there are a glimmer of hope. Radioactive isotope is the main gold, and its coverage serous cavity affinity of the cell, particularly suited to the treatment of diffuse tumors, such as mesothelioma. Its main therapeutic effect is due to the radioactive β plasmid, and its penetrating power of 2 to 3 mm, the most effective in the early tumor, but it is very difficult early detection of malignant pleural mesothelioma cases. Early application of the gel into the pleural cavity 198, live five years of a few cases, since protection difficulties, has been seldom applied.



Comprehensive treatment and surgery or radiation isotope 132 i, 192ir, 32p after in vitro and implanted intracavitary radiotherapy plus chemotherapy, and other measures, are no long-term cure.



5. Comprehensive treatment in recent years, a comprehensive treatment measures in the pleura and the lung resection letter cap chemotherapy (cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2, 75600 mg/m2 of cisplatin, with five consecutive treatment Each treatment time interval of 3 weeks). After the site of the original tumor or residual tumor location for 55 gy in vitro irradiation. Analysis of 53 cases of patients receiving comprehensive treatment, perioperative complication rate was 17%, the operative mortality 5.8%. Average survival time of 16 months (1 to 8). 31 cases of patients with epithelial type 1, 2, 3-year survival rates were 7%, 50% and 2% mixed and sarcoma patients with type 2 years survival rate after 45% and 7.5%, none of living had 25 months. Local mediastinal lymph node metastasis, survival time than those without lymph node metastasis short, E-mediastinal lymph node negative, the 5-year survival rate is 45 percent, so the importance of early treatment.



"Etiology"



All types of asbestos fibers, and almost all of the pathogenesis of mesothelioma, but the risk of fiber self-sufficiency is not the same, the most dangerous is asbestos exposure Qingshi, is the smallest risk of asbestos exposure Huang. First contact with the asbestos-induced disease incubation period is generally 20 to 40 years, the incidence of mesothelioma and exposure to asbestos and the time is proportional to the magnitude.



Mao in the atmosphere such as zeolite content increased, people's exposure to such silicate zeolite powder, but also can cause mesothelioma. There are reports of radiation exposure induced pleural mesothelioma cases from radiation exposure to the suffering from pleural mesothelioma found time for 7 to 36 years, with an average 16. Nitrosamines, glass fiber, hydrocyanic acid, thorium oxide, beryllium and other pulmonary diseases (such as tuberculosis and chemical substances and lipid aspiration pneumonia), may also lead to pleural mesothelioma.



"Pathological changes"



Early in malignant mesothelioma, or visible to the naked eye in the normal opaque visceral pleura or layer on a large number of white or grey particles and thin plate or nodules, with the development of cancer, pleural thickening increasing surface, covered nodules, nodules extend to the Quartet, for a film, the cyst shrink lungs to pit the smaller lateral chest wall collapse and involvement. In advanced stages, the tumor can be involved diaphragm, intercostal muscle, mediastinal structures, and the contralateral pericardial pleura. 50% of patients autopsy found hematogenous metastasis, but clinical rarely mentioned.



There are two malignant mesothelioma pathological anatomy type: ① single fiber of pleural mesothelioma. Growth from the visceral pleura, or flat-Rujing, tumor caused clinical symptoms due to their expansion and development, squeezing chest structure to shift, if early diagnosis and treatment can be used for. ② extensive proliferation of mesothelioma. This type of lung, diaphragm infiltration, intercostal muscle, which is involved mediastinal pleural and pericardial and great vessels.



Malignant mesothelioma microscope seen its characteristics, that is, in a single tumor nodules or the naked eye appearance of the same tumor nodules, are all distinctly different organizations ingredients. Cheung malignant skin tumors with pathological typing epithelial type, fiber (interstitial) and mixed three. E-epithelial tumor cells with a variety of structures, such as papillary, tubular, the papillary, shingles Gong Flake. Polygonal epithelial cells have many long and slim, a branch of the surface microvilli, desmosomes, and the elastic filaments into bundles and cell cavity (Figure 2). Fiber similar spindle-shaped cells, equality configuration, or a slender-shaped egg form the nucleus of a good nucleolus (Figure 3). E-hybrid combination of both fiber and organizational structure. From a block tumor biopsy, from various samples from the site more, as more mixed.



Figure 2-epithelial malignant pleural mesothelioma (left), and skin cancer malignant pleural (right)



Figure 3-malignant fibrous mesothelioma



81-year-old male, beam and all kinds of atypical collagen membrane



"Clinical manifestations"



Malignant pleural mesothelioma patients more men than women (2:1). In the majority of patients between the ages of 40 to 70 foreign patients average age 60 years old, my only 45.2 years old. First symptom was chest pain, cough and shortness of breath most common, about 10.2% of patients with fever and sweating, 3.2% of patients with joint pain mainly v. symptoms. The involvement and the diaphragm, chest pain can be affected conduction supremacy abdomen and shoulder. About 50% to 60% of patients with pleural effusion a large number of serious shortness of breath, bloody pleural effusion, 3 / 4. Pleural effusion with a large number of patients in severe chest pain. Weight loss common. Some patients periodic low blood sugar and hypertrophic osteoarthropathy lung disease, but these indications in the more benign mesothelioma see.



Epithelium and mixed pleural mesothelioma accompanied a large number of pleural effusion, and fiber type are usually only a small amount of pleural effusion or no. E-patients seem more involved subclavian or axillary lymph nodes and extended to the pericardium, the contralateral pleural and peritoneal; fiber many distant metastases and bone metastases.



Radiology indications: common x-ray found pleural effusion, pleural often accounted for 50 per cent of the side. Ipsilateral lung tumor tissue was wrapped, mediastinal shift to the side of a tumor, the smaller side pleural disease advanced thoracic Tablets of mediastinal widening, pericardial fluid to expand the heart shadow, and that shadow rib soft tissue damage.



X-conventional chest radiography in the pleural diseases can be covered up pleural effusion, and the evaluation of suspected malignant pleural stromal tumor patients, the most useful ct inspection, ct can show that the pleural thickening with irregular nodular edge, as from pleural thickening of the other lesions identify malignant pleural mesothelioma. As fibrous tissue and tumor tissue and pleural effusion, the main pulmonary interstitial thickening split obvious, such as tumor invasion, lung performance can be split between the nodular. Ct usually can be found in the lung tumor nodules and pulmonary cysts, and the shrinking of the extent of the collapse of the chest wall (Figure 4).



Figure 4 right diffuse malignant pleural mesothelioma



Since layer pleural tumors long crack extending Rufei



Pleural effusion: the merger of mesothelioma is pleural effusion exudates, 50% of blood serum. If the tumor volume huge, pleural effusion of blood sugar levels and may reduce the ph value, containing large transparent acid (gt; 0.8mg/ml), pleural effusion more viscous. Pleural effusion in general contain normal mesothelial cells, differentiation good or differentiation of malignant skin cells and lymphocytes and different amounts of interleukin multicore. Cytological examination of pleural fluid to help make the diagnosis.



Routine laboratory tests: in the course of platelet number can be found in individual reports of up to 1000 × 109 platelet / l, serum carcinoembryonic antigen increased in some patients, the immune serum electrophoresis phenomenon igg, igm iga or higher, why not, the normal serum-fetoprotein.



"Prognosis"



Asbestos workers suffering from malignant pleural mesothelioma, the average survival time from symptom onset to death only 11.4, in the majority of patients died within 1 year. The next step should be more scientific and comprehensive treatment of various measures, and the development of new technologies in order to find out more effective pharmaceutical and diagnostic methods for early treatment.

Malignant pleural mesothelioma is a particularly lethal cancer, the incidence rate is on the rise around the world. Although malignant pleural mesothelioma and common tumors such as breast cancer or prostate was small in comparison to draw attention, but so that patients and their families have paid a heavy price. Although the disease is generally considered traditional non-save, but the current trend is changing.

What is malignant pleural mesothelioma?

Malignant pleural mesothelioma is pleural lung cancer or capsule. Because of its location in the body's anatomy, the tumor growth can be squeezed lung and the chest in the middle of the anatomical structure of displacement, including heart and Atmospheric Road. It is worth noting that tumor growth can be expanded oppression diaphragm so that breathing dynamics is limited.

What led to malignant pleural mesothelioma?

Malignant pleural mesothelioma is a major causal factor in contact with asbestos, when many years ago has not yet recognized the danger of asbestos, many engaged in the transport, mining and insulation industry through exposure to asbestos fibers work, but not only directly with asbestos contact with men and women, reports indicate that touch relatives through indirect contact with the overalls of asbestos have also taken place in the family of malignant pleural mesothelioma.

Disease demonstrated need more time?

Typical takes 20 to 40 years before performance, the latency of malignant pleural mesothelioma is very long.

How common disease?

The United States each year there are about 3,000 new cases, in general, the global incidence rate of about 10,000 a year to 15,000 patients. The disease incidence rates in the United States may have reached its peak, mainly because of the United States in the early 1970s issued a ban on asbestos, but in Europe, to reduce asbestos exposure to the efforts made by the backward 10 to begin the destruction of all clean and Asbestos materials were late a lot of the work, therefore, the incidence rate in Europe in 2010 will be the peak.

In patients with malignant pleural mesothelioma is a typical example of what?

Almost all patients in the initial diagnosis of pleural mesothelioma, the cancer has some symptoms - usually severe pain, shortage of breath, weight loss and fatigue. Most patients symptoms generally more suddenly and gradually worsen until the patient bedridden development and the loss of activities of daily living.
Mesothelioma needs to be emphasized is the most serious symptoms of pain, many nerve endings in the pleura, as a result of tumor growth, and the pain reached incredible level, and the pain can be so severe that patients often wake up from sleep. In addition, as in lung cancer - lung tumor squeezing or pressure, the diaphragm movement restrictions - so that patients can not breathe right.

How diagnosis disease?

Patients usually is mainly due to respiratory symptoms, lung attending doctors will be carried out x-ray inspection, and to CT scanning to provide x-ray than a more precise diagnosis, a typical performance for lung biofilm thickness can be up to normal 20 times, the general diagnosis of mesothelioma can be.
Then, the patient will be accepted histological examination, generally thoracoscopic or fine-needle aspiration, through careful observation under a microscope tissue diagnosis is not easy, from the perspective of organizations have 10-20% of the diagnosis of mesothelioma was misdiagnosed. Combined with CT scan, histological diagnosis of cancer doctors to help clear diagnosis of mesothelioma.
Another key is the diagnosis of disease stage, tumor that is what is in a degree of progress, unfortunately, 75% of patients with mesothelioma diagnosis is already very late for three or four.

What is the traditional treatment plan?

Over the past few decades, cancer doctors use a variety of chemotherapy in the treatment of patients with mesothelioma, but in fact have failed to show that the cancer effectively, using combined chemotherapy or new drugs targeting the disease for more than 50 clinical study showed no long-term survival. He does not have any control through well-designed studies have shown that the drug can change the course of the disease.

Can choose whether surgery or radiotherapy?

Radiation can be used to alleviate the pain, but can not be used as an effective treatment options, because the nature of this disease and other widespread in the chest, and could not be concentrated in a specific radiation on the target. If the large body radiotherapy, it will be very serious adverse reaction. On the other hand, patients with early surgery is one of the few (I, II), the only treatment option.

Can prevent the disease?

The only way to the measures taken is to avoid exposure to asbestos, removed the asbestos, we believe that the incidence of mesothelioma will be reduced. Of course, some people have this disease susceptibility, but we believe that the environment of asbestos exposure initiated a series of carcinogenic incidents.