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ObjectiveTo investigate the diagnosis and treatment of familial hypokalemic periodic paralysis with acidosis. MethodsThe proband's medical history， clinical manifestations， laboratory examinations and imaging characteristics were retrospectively analyzed， and prevalence situation of family members was investigated in detail. Next generation sequencing technology was used to detect the pathogenic gene loci related to periodic paralysis， and the relevant literatures were summarized. ResultsThe proband was definitely diagnosed as familial hypokalemic periodic paralysis. There was a heterozygous mutation in the SCN4A gene of the proband， which was c.2006G>A， resulting in amino acid changes R669H.The proband's grandfather， father and uncle shared the same variation. ConclusionsFamilial hypokalemic periodic paralysis with paroxysmal acidosis is rare， which is easily misdiagnosed as renal tubular acidosis. c 2006G>A mutation in SCN4A gene is the molecular basis of the disease in this family. The clinical phenotypes of different gene mutations are different， and gene screening is helpful for diagnosis and treatment.
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The report presents a case with Enterobius vermicularis infections in Guiyang City, Guizhou Province, aiming to strengthen the attention to parasitic infections.
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BACKGROUND@#Cardiovascular (CV) disease is the leading cause of morbidity and mortality in adults with type 2 diabetes (T2D). The aim of this study was to determine the CV risk in Chinese patients with T2D based on the 2019 European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and CV diseases.@*METHODS@#A total of 25,411 patients with T2D, who participated in the study of China Cardiometabolic Registries 3B study, were included in our analysis. We assessed the proportions of patients in each CV risk category according to 2019 ESC/EASD guidelines.@*RESULTS@#Based on the 2019 ESC/EASD guidelines, 16,663 (65.6%), 1895 (7.5%), and 152 (0.6%) of patients were included in "very high risk," "high risk," and "moderate risk" categories, respectively. The proportions of patients in each category varied based on age, sex, body mass index, and duration. While 58.7% (9786/16,663) of elderly patients were classified to "very high risk" group, 89.6% (3732/4165) of patients with obesity were divided into "very high risk" group. Almost all patients with a duration of diabetes >10 years had "very high risk" or "high risk." However, 6701 (26.4%) of Chinese T2D patients, who had shorter duration, and one or two risk factors, could not be included in any category (the "unclear risk" category).@*CONCLUSIONS@#In China, most patients with T2D have "very high" or "high" CV risk based on 2019 ESC/EASD guidelines. However, the risk of patients in "unclear risk" group needs to be further classified.
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Adult , Aged , Humans , Cardiovascular Diseases/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Heart Disease Risk Factors , Risk FactorsABSTRACT
In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.
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In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.
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ARIDI A encodes a non-catalytic subunit of SWI/SNF chromosome remodeling complex BAF. Cancer genome sequencing data based on next-generation sequencing techniques have shown that ARIDIA is frequently mutated in a variety of cancers, up to 20% in some cancer types. A growing body of evidence shows that ARIDIA, as a tumor suppressor gene, affects the occurrence and development of cancers. ARIDIA plays an important role in cell cycle, DNA replication, DNA repair and transcriptional regulation, which might contribute to tumor formation, proliferation and migration. This review article mainly describes the research progress on ARIDIA in pan-cancer, as well as potential therapeutics, hoping to provide new ideas for the diagnosis and treatment of tumors.
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Rectal neuroendocrine neoplasms (NENs) are low-grade malignancies, which are slow-growing and usually become symptomatic late in the course of the disease (Basuroy et al., 2016). In recent years, rectal NENs are increasingly frequently detected, with the widespread availability and accessibility of endoscopy and cross-sectional imaging modalities (Kos-Kudla et al., 2017). Multiple studies have shown that endoscopic ultrasound (EUS) is an advanced endoscopic technique and is currently used in the diagnosis and preoperative assessment of NENs (Kim, 2012; Liu et al., 2013; Zhang et al., 2017). However, EUS imaging of rectal NEN and differential diagnosis with other submucosal tumors (SMTs) has not been adequately reported. In this study, we reviewed and summarized the EUS imaging and pathological features of rectal NENs of 38 cases to improve preoperative diagnosis rate and reduce unreasonable treatment.
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Adult , Aged , Female , Humans , Male , Middle Aged , Endosonography/methods , Neuroendocrine Tumors/therapy , Rectal Neoplasms/therapyABSTRACT
@#【Objective】Serum gamma-glutamyltransferase（GGT）has recently been implicated in the pathogenesis of atherosclerosis and coronary heart disease（CHD）. We aimed to evaluate the association between the serum GGT level and the 10-year risk score for CHD（Framingham Risk Score，FRS）in a Chinese population.【Methods】We conducted a population-based cross-sectional study in 9，544 Guangzhou residents aged 40 years and older. Participants were divided into four quartiles according to their GGT levels：Quartile 1 <15 U/L（n=2 407），Quartile 2 15~19.9 U/L（n=2 302）， Quartile 3 20~28.9 U/L（n=2 442），and Quartile 4 ≥29 U/L（n=2 393）. The multivariate logistic regression analysis was used to assess the incidence of intermediate and high risk of developing CHD at 10 years（FRS≥10%）in relation to each quartile increase of serum GGT level.【Results】The incidence of FRS≥10% increased with elevating serum GGT levels（P for trend<0.001）. Compared with the lowest quartile of serum GGT level ，the adjusted odds ratio in the highest quartile was 1.72（95% confidence interval 1.28 to 2.29）.【Conclusion】Serum GGT level is associated with the FRS for CHD ，and might be used as an adjuvant marker for identifying patients at increased risk of cardiovascular events and early intervention.
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BACKGROUND:Readmission to intensive care unit (ICU) after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay (LOS). The objective of this study was to investigate whether ICU readmission are preventable in critical y il cancer patients. METHODS:Data of patients who readmitted to intensive care unit (ICU) at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between January 2013 and November 2016 were retrospectively collected and reviewed. RESULTS:A total of 39 patients were included in the final analysis, and the overall readmission rate between 2013 and 2016 was 1.32％ (39/2,961). Of 39 patients, 32 (82.1％) patients were judged as unpreventable and 7 (17.9％) patients were preventable. There were no significant differences in duration of mechanical ventilation, ICU LOS, hospital LOS, ICU mortality and in-hospital mortality between patients who were unpreventable and preventable. For 24 early readmission patients, 7 (29.2％) patients were preventable and 17 (70.8％) patients were unpreventable. Patients who were late readmission were all unpreventable. There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable (100％ vs. 66.8％, log rank=1.668, P=0.196). CONCLUSION:Most readmission patients were unpreventable, and all preventable readmissions occurred in early period after discharge to ward. There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.
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Abstract: The torsion of vessels after liver transplantation rarely occurs. Likewise, calcification of a liver graft has seldom been reported. This report details a case which had torsion of the left hepatic vein on the seventh day after living-related donor liver transplantation. The torsion was reduced soon after re-exploration; however, congestion with partial necrosis of the graft occurred. On the follow-up imaging studies, some resolution of necrosis and graft regeneration were found, yet geographic calcification of the liver graft appeared. The patient died of pneumonia after 13 weeks, post-operation. The avoidance such torsion of vessels is necessary and important.(AU)
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Humans , Male , Middle Aged , Torsion Abnormality/etiology , Vascular Diseases/etiology , Calcinosis/etiology , Calcinosis/diagnostic imaging , Liver Transplantation/adverse effects , Living Donors , Allografts , Hepatic Veins/surgery , Reoperation , Time Factors , Torsion Abnormality/surgery , Torsion Abnormality/diagnostic imaging , Vascular Diseases/surgery , Vascular Diseases/diagnostic imaging , Phlebography/methods , Fatal Outcome , Computed Tomography Angiography , Hepatic Veins/diagnostic imaging , NecrosisABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of thrombocytopenia on the migration patterns of adoptive dendritic cell(DC) in vivo.</p><p><b>METHODS</b>The mouse model of thrombocytopenia was established by intraperitoneal administration of anti-CD41 mAb MWReg30. Mouse bone marrow(BM)-derived DC were injected into thrombocytopenia mouse by footpad infusion and intravenous infusion. The DC migration and distribution pattern were detected by bioluminescence imaging.</p><p><b>RESULTS</b>More than 80% platelets were cleared in the experimental group which was infused with anti-CD41 antibody. At 72 h after injection, the percentage of injected DC that migrated from footpad to popliteal lymph nodes(PLNs) and inguinal lymph nodes(ILNs) were (0.32±0.02)% and (0.02±0.01)% in experimental group, and (0.27±0.15)% and (0.02±0.02)% in control group, respectively. Statistic data showed that there was no statistical difference between these 2 groups (P>0.05). The issue distribution pattern of intravenously injected DC between experimental group and control group were not distinctly different, and large amounts of injected DC accumulated in the spleen, liver draining lymph-nodes lungs and liver.</p><p><b>CONCLUSION</b>Thrombocytopenia has not a distinct effect on the migratory capacity and tissue distribution of DC by either footpad or intravenous injection.</p>
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BACKGROUND:Esophagectomy is a very important method for the treatment of resectable esophageal cancer, which carries a high rate of morbidity and mortality. This study was undertaken to assess the predictive score proposed by Ferguson et al for pulmonary complications after esophagectomy for patients with cancer. METHODS:The data of patients who admitted to the intensive care unit after transthoracic esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2008 and October 2010 were retrospectively reviewed. RESULTS:Two hundred and seventeen patients were analyzed and 129 (59.4％) of them had postoperative pulmonary complications. Risk scores varied from 0 to 12 in all patients. The risk scores of patients with postoperative pulmonary complications were higher than those of patients without postoperative pulmonary complications (7.27±2.50 vs. 6.82±2.67;P=0.203). There was no significant difference in the incidence of postoperative pulmonary complications as well as in the increase of risk scores (χ2=5.477,P=0.242). The area under the curve of predictive score was 0.539±0.040 (95％CI 0.461 to 0.618;P=0.324) in predicting the risk of pulmonary complications in patients after esophagectomy. CONCLUSION:In this study, the predictive power of the risk score proposed by Ferguson et al was poor in discriminating whether there were postoperative pulmonary complications after esophagectomy for cancer patients.
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The Formosan sika deer (Cervus nippon taiouanus) is an endemic subspecies in Taiwan. The original wild deer has been extinct since the late 1960s. The largest captive population is located at the Taipei Zoo. Except for infectious disease outbreaks, no systemic medical research has been reported for this subspecies. This study was conducted to analyze the medical status of the captive Formosan sika deer population, including the hematological and serum chemistry characteristics. To accomplish this, medical records for 34 Formosan sika deer from January 2003 to January 2014 were acquired and analyzed. The most common illness and cause of death was trauma, followed by gastrointestinal and respiratory disease, respectively. The hematologic and serum chemical values of healthy adults were quite different from those of sika deer (Cervus nippon yesoensis). This study provides a closer medical understanding of this subspecies and the results will facilitate its management.
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Adult , Humans , Cause of Death , Chemistry , Deer , Disease Outbreaks , Gastrointestinal Diseases , Medical Records , Retrospective Studies , TaiwanABSTRACT
@#BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insufficiency who had received sedation or no sedation. METHODS: The data of 91 patients who had received mechanical ventilation in the first 24 hours between November 2008 and October 2009 were retrospectively analyzed. These patients were divided into two groups: a sedation group (n=28) and a non-sedation group (n=63). The patients were also grouped in two groups: deep sedation group and daily interruption and /or light sedation group. RESULTS: Overall, the 91 patients who had received ventilation ≥48 hours were analyzed. Multivariate analysis demonstrated two independent risk factors for in-hospital death: sequential organ failure assessment score (P=0.019, RR 1.355, 95％CI 1.051–1.747, B=0.304, SE=0.130, Wald=50483) and sedation (P=0.041, RR 5.015, 95％CI 1.072–23.459, B=1.612, SE=0.787, Wald=4.195). Compared with the patients who had received no sedation, those who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and hospital, and an increased in-hospital mortality rate. The Kaplan-Meier method showed that patients who had received sedation had a lower 60-month survival rate than those who had received no sedation (76.7％ vs. 88.9％, Log-rank test=3.630, P=0.057). Compared with the patients who had received deep sedation, those who had received daily interruption or light sedation showed a decreased in-hospital mortality rate (57.1％ vs. 9.5％, P=0.008). The 60-month survival of the patients who had received deep sedation was significantly lower than that of those who had daily interruption or light sedation (38.1％vs. 90.5％, Log-rank test=6.783, P=0.009). CONCLUSIONS: Sedation was associated with in-hospital death. The patients who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and in hospital, and an increased in-hospital mortality rate compared with the patients who did not receive sedation. Compared with daily interruption or light sedation, deep sedation increased the in-hospital mortality and decreased the 60-month survival for patients who had received sedation.
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<p><b>OBJECTIVE</b>To observe the effect of Tongguan Capsule (TC) on the number of endothelial progenitor cells (EPCs) in the peripheral blood of patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Recruited were 60 CAD patients undergoing PCI who were admitted and treated at ICU and the Heart Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from March to October 2010. They were assigned to the treatment group (treated by TC) and the control group (treated by placebos) according to the random digit table, 30 cases in each group. They took TC or placebos from the day of PCI, three pills each time, three times a day, for three consecutive months. The numbers of peripheral blood CD34 and vascular endothelial growth factor receptor-2 (VEGFR2) positive cells were detected before PCI and 3 months after PCI respectively. The echocardiography was performed before PCI and 3 months after PCI respectively to determinate the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), stroke volume (SV), cardiac output (CO), and left ventricular ejection fraction (LVEF). The wall motion score index (WMSI) was assessed in the two groups.</p><p><b>RESULTS</b>There was no statistical difference in the number of EPCs, LVEF,WMSI, or SV in the two groups before PCI (P > 0.05). The number of EPCs increased in both the two groups after 1 month of PCI (P < 0.05). It was obviously higher in the treatment group than in the control group (P < 0.05). The LVEF both increased in the two groups 3 months after PCI (P < 0.05, P < 0.01). The WMSI decreased and SV increased in the treatment group (P < 0.05). The improvement of LVEF and WMSI was better in the treatment group than in the control group (P < 0.05).</p><p><b>CONCLUSION</b>TC could up-regulate the number of EPCs in the peripheral blood of CAD patients after PCI, and improve their cardiac functions.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Blood Cell Count , Coronary Artery Disease , Drug Therapy , Therapeutics , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Endothelial Progenitor Cells , Cell Biology , Percutaneous Coronary Intervention , PhytotherapyABSTRACT
BACKGROUND: Consensus guidelines suggested that both dopamine and norepinephrine may be used, but specific doses are not recommended. The aim of this study is to determine the predictive role of vasopressors in patients with shock in intensive care unit.METHODS: One hundred and twenty-two patients, who had received vasopressors for 1 hour or more in intensive care unit (ICU) between October 2008 and October 2011, were included.There were 85 men and 37 women, with a median age of 65 years (55-73 years). Their clinical data were retrospectively collected and analyzed.RESULTS: The median simplified acute physiological score 3 (SAPS 3) was 50 (42-55). Multivariate analysis showed that septic shock (P=0.018, relative risk: 4.094; 95% confi dential interval: 1.274-13.156), SAPS 3 score at ICU admission (P=0.028, relative risk: 1.079; 95% confidential interval: 1.008-1.155), and norepinephrine administration (P<0.001, relative risk: 9.353; 95% confidential interval: 2.667-32.807) were independent predictors of ICU death. Receiver operating characteristic curve analysis demonstrated that administration of norepinephrine ≥0.7 μg/kg per minute resulted in a sensitivity of 75.9% and a specifi city of 90.3% for the likelihood of ICU death. In patients who received norepinephrine ≥0.7 μg/kg per minute there was more ICU death (71.4% vs. 44.8%) and in-hospital death (76.2% vs. 48.3%) than in those who received norepinephrine <0.7 μg/kg per minute. These patients had also a decreased 510-day survival rate compared with those who received norepinephrine <0.7 μg/kg per minute (19.2% vs. 64.2%).CONCLUSION: Septic shock, SAPS 3 score at ICU admission, and norepinephrine administration were independent predictors of ICU death for patients with shock. Patients who received norepinephrine ≥0.7 μg/kg per minute had an increased ICU mortality, an increased in-hospital mortality, and a decreased 510-day survival rate.
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BACKGROUND: This study aimed to investigate the risk factors and outcome of critically ill cancer patients with postoperative acute respiratory insuffi ciency.METHODS: The data of 190 critically ill cancer patients with postoperative acute respiratory insuffi ciency were retrospectively reviewed. The data of 321 patients with no acute respiratory insuffi ciency as controls were also colected. Clinical variables of the fi rst 24 hours after admission to intensive care unit were colected, including age, sex, comorbid disease, type of surgery, admission type, presence of shock, presence of acute kidney injury, presence of acute lung injury/acute respiratory distress syndrome, acute physiologic and chronic health evaluation (APACHE II) score, sepsis-related organ failure assessment (SOFA), and PaO2/FiO2 ratio. Duration of mechanical ventilation, length of intensive care unit stay, intensive care unit death, length of hospitalization, hospital death and one-year survival were calculated.RESULTS: The incidence of acute respiratory insufficiency was 37.2% (190/321). Multivariate logistic analysis showed a history of chronic obstructive pulmonary diseases (P=0.001), surgery-related infection (P=0.004), hypo-volemic shock (P<0.001), and emergency surgery (P=0.018), were independent risk factors of postoperative acute respiratory insufficiency. Compared with the patients without acute respiratory insuffi ciency, the patients with acute respiratory insuffi ciency had a prolonged length of intensive care unit stay (P<0.001), a prolonged length of hospitalization (P=0.006), increased intensive care unit mortality (P=0.001), and hospital mortality (P<0.001). Septic shock was shown to be the only independent prognostic factor of intensive care unit death for the patients with acute respiratory insufficiency (P=0.029, RR: 8.522, 95%CI: 1.243-58.437, B=2.143, SE=0.982, Wald=4.758). Compared with the patients without acute respiratory insufficiency, those with acute respiratory insuffi ciency had a shortened one-year survival rate (78.7% vs. 97.1%,P<0.001).CONCLUSION: A history of chronic obstructive pulmonary diseases, surgery-related infection, hypovolemic shock and emergency surgery were risk factors of critically ill cancer patients with postoperative acute respiratory insuffi ciency. Septic shock was the only independent prognostic factor of intensive care unit death in patients with acute respiratory insufficiency. Compared with patients without acute respiratory insufficiency, those with acute respiratory insufficiency had adverse short-term outcome and a decreased one-year survival rate.
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BACKGROUND: Several risk scoures have been used in predicting acute kidney injury (AKI) of patients undergoing general or specific operations such as cardiac surgery. This study aimed to evaluate the use of two AKI risk scores in patients who underwent non-cardiac surgery but required intensive care. METHODS: The clinical data of patients who had been admitted to ICU during the first 24 hours of ICU stay between September 2009 and August 2010 at the Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively collected and analyzed. AKI was diagnosed based on the acute kidney injury network (AKIN) criteria. Two AKI risk scores were calculated: Kheterpal and Abelha factors. RESULTS: The incidence of AKI was 10.3％. Patients who developed AKI had a increased ICU mortality of 10.9％ vs. 1.0％ and an in-hospital mortality of 13.0 vs. 1.5％, compared with those without AKI. There was a significant difference between the classification of Kheterpal's AKI risk scores and the occurrence of AKI (P<0.001). There was no significant difference between the number of Abelha's AKI risk scores and the occurrence of AKI (P=0.499). Receiver operating characteristic curves demonstrated an area under the curve of 0.655±0.043 (P=0.001, 95％ confidence interval: 0.571–0.739) for Kheterpal's AKI risk score and 0.507±0.044 (P=0.879, 95％ confidence interval: 0.422–0.592) for Abelha's AKI risk score. CONCLUSION: Kheterpal's AKI risk scores are more accurate than Abelha's AKI risk scores in predicting the occurrence of AKI in patients undergoing non-cardiac surgery with moderate predictive capability.
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AIM:To determine whether acellular porcine cornea stroma (APCS) could support the growth of the rabbit corneal cells in vitro.METHODS: APCS was prepared. The rabbit's corneal epithelium and stromal cells were cultured and seeded on, APCS in vitro.The observation of phase contrast photograph and histological examination were performed.RESULTS: Histological examination showed the epithe- lium grew on the scaffold of APCS in 2-3 layers at 10th day. The stromal cells adhered to the surface of the scaffold after 24 hours and invaded into the interlaminar of the material at 5th day.CONCLUSION: These results indicate that APCS can support the growth and proliferation of the corneal epithelium and stromal cells in vitro.
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<p><b>OBJECTIVE</b>To discuss the treatment of cN(0) tongue carcinoma patients.</p><p><b>METHODS</b>185 cases of the mobile tongue carcinoma patients (male 102, female 83, aged 28 to 88) treated with surgery from 1988.5 to 1995.6 had been followed up and retrospectively analyzed. Extensive resection of the primary tumors and neck dissections were performed, and all the samples were pathological positive.</p><p><b>RESULTS</b>The cervical lymphatic node metastasis rates for stage I-II, III-IV disease, grade I, II disease were 16.66%, 38.05%, 17.42% and 37.50% respectively. And the rates were 9.00%, 31.37% and 55.55% for submucous infiltration, muscle infiltration and perineural infiltration, respectively. The overall 5 year survival was 72.43%, and the 5 year specific survival rate was 44.44% and 83.96% for those having or not having cervical node metastasis. The levels of 29 patients with positive node metastasis for 148 cN(0) patients were submandibular and submental lymphatic nodes (22.64%), superior deep cervical lymphatic nodes (35.84%), middle deep cervical lymphatic nodes (26.41%), inferior deep cervical lymphatic nodes (15.09%), posterior neck lymphatic nodes (0.00%). The over all 5 year survival rates for selective neck dissection were 85.13% and 21.62% in therapeutic dissection (chi(2) = 29.73, P < 0.01). Patients performed selective neck dissection the rates were 68.96% and 89.07% respectively with or without lymphatic node metastasis. Comparably the 5-year rate was only 20.00% for the patients performed the therapeutic dissection with lymphatic node metastasis.</p><p><b>CONCLUSIONS</b>(1) cN(0) patients should be observed carefully in stage I, and the selective dissection must be performed in stage II-IV. (2) Supraomohyoid ND is essential for T(2) patients, and functional ND is essential for T(3 - 4) patients. (3) There is correlation between cervical metastasis and the stage, grade or infiltration of tongue cancer (P < 0.05). The prognosis could be expected from these factors.</p>