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@#This article summarizes and analyzes the reported synthetic routes of brivudine in patent and literature.2′-Deoxyuridine was employed as starting material, affording brivudine through iodization, heck coupling, hydrolysis, decarboxylation, bromination and recrystallization.After optimization of reaction conditions of each step, a synthetic route suitable for industrial production was achieved with simple synthetic process, high yield and excellent purity.
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Objective To assess the clinical value of vascular enhancement technology (VET) in diagnosis of fetal pulmonary sequestration (PS).Methods Color Doppler velocity (CDV),color Doppler energy (CDE) and VET were performed in 11 fetus with PS to display the vessels in region of interest.Results The abnormal vessels in region of interest were displayed in distinct degree with CDV,CDE and VET.The courser and disposition of the great vessels were displayed with CDV and CDE,while lumen of blood vessel was clearly discriminated with VET,while CDV depicted the direction of blood flow.Satisfaction assessment of the VET image was superior than those of CDV and CDE image (P0.05).Conclusion VET can improve the contrast resolution,having superiority in displaying vessels and fine branches,therefore has clinical value in the diagnosis of fetal PS.
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Objective To explore the clinical diagnostic and therapeutic characteristics，prognostic factors of pailents with primary clear cell carcinoma of the cervix.Methods The clinical,pathologic and follow-up data of patients with primary clear cell carcinoma of the cervix treated in our hospital from Jan 2003 to Dec 2006 were collected and analyzed retrospectively.The relative literature was reviewed.ResultsFive patients with primary clear cell carcinoma of the cervix were treated(1 case stage Ⅰ b1，2 of stage Ⅰ b2，1of stage Ⅱ a，1 of stage Ⅳa).The mean age was 40.2 years(32 to 50 years).The primary symptom was mostly irregularly vaginal bleeding(3/5)and clinical type was predominantly(4/5)endophytie growth.The positive rate of cervical cytologic examination was 2/4,the negative rate of cervical human papillomavirus(HPV)DNA examination was 4/4.Serum CA125 level was abnormal(62.5 to 592.1 kU/L)before operation and when relapse occurred,and returned to normal after operation.All of five patients underwent operation,pathologic examination showed that three patients with infihration in deep 1/2 myomctrium of cervix,and two patients with infiltration in cervix-corpus juncture.Four patients underwent radical abdominal hysterectomy with systematic pelvic lymphadenectomy.All of four patients underwent four courses of chemotherapy with fluorouracil(5-FU)and carboplatin，one patient(stage Ⅱ a)was added with intracavitary brachytherapy.None of the four patients had relapse or metastasis after a follow-up of 10 to 44 months.The patient with stage Ⅳ a underwent firstly hysterectomy and prerectum mass removal.Pelvic relapse occurred three months after operation and the patient then underwent the second operation，external beam radiotherapy and intracavitary brachytherapy and 8 courses of chemotherapy with paclitaxel(taxol) and carboplatin.There was no relapse or metastasis after a follow-up of 26 months.Conclusions Primary clear cell carcinoma of the cervix may be unrelated to HPV infection.It shows predominantly endophytic growth and tends toward deep infiltration in cervix and extending to uterine corpus.Operation combined with chemotherapy with carboplatin and 5-FU or taxol may lead to relatively perfect short-term therapeutical effect.Serum CA125 can help to monitor prognosis.Objective To study the clinical characteristics，treatment modalities.and prognosis of cervical adenosquamous carcinoma.Methods The data of 21 patients with adenosquamous cervical cancer who were admitted into Zhongnan Hospital，Wuhan University from Jan 2001 to Dec 2005 were analyzed retrospectively.Six patients received Surgical therapy only and 15 patients received combined therapy.ResultsSeven cases were with positive pelvic lymph node metastases and 3 cases were with ovarian metastases.The median survival time of the combined therapy group and surgical therapy group was 54 and 20 months，respectively.In stage Ⅰ and stage Ⅱ patients，the median survival time of the combined therapy group and surgical therapy group was 66 and 20 months,respectively.The difference was significant between the two groups(P＜0.05).ConclusionsCombined therapy should be given to patients with adenosquamous carcinoma of the cervix.Surgical therapy and chemotherapy play an important role in the management and prognosis of adenoquamous carcinoma of cervix.Preserve of ovary for patients with adenosquamous carcinoma of the cervix should only be done when the ovary is confirmed free from any malignant involvement by pathology.
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Objective To study the management and prognosis of nongenital metastatic ovarian carcinoma. Methods Thirty-four patients with nongenital metastatic ovarian carcinoma who were admitted in to Zhongnan Hospital of Wuhan University between 1998 and 2004 were analyzed retrospectively. Results The median survival time of group A (optimal cytoreductive surgery), group B (optimal cytoreductive surgery+chemotherapy), group C (sub-optimal cytoreductive surgery) and group D (sub-optimal cytoreductive surgery+chemotherapy ) was 5.0,10.0,4.0 and 6.5 months, respectively. The difference was significant between groups A and B, B and C, as well as between group C and D(P
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Objective To investigate the diagnosis,treatment and prognosis of recurrent epithelial ovarian carcinoma. Methods Fifty-two patients with recurrent epithelial ovarian carcinoma who were admitted in Zhongnan Hospital of Wuhan University between 1997 and 2002 were analyzed retrospectively,and their diagnostic methods and the survival rates were compared. Results The positive diagnostic rate of pelvic examination,CA 125 and ultrasound examination was 73.1%,84.6% and 53.8%,respectively to the recurrent epithelial ovarian carcinoma. The median survival time of group A(surgery+chemotherapy) and group B ( chemotherapy) was 11 and 12 months,respectively. Conclusions The diagnostic methods should include pelvic examination,CA 125 and ultrasound examination. We could not know the exact role of surgery to the management and prognosis of recurrent epithelial ovarian carcinoma. Chemotherapy may have an important role to the management and prognosis of recurrent epithelial ovarian carcinoma.
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Objective To determine the resistance reversion of mitomycin (MMC) by 3′-Keto-bmt 1-val 2-cyclosporin (SDZ PSC 833) in human cervical cancer in vitro and in vivo. Metheds A xenografted mitomycin resistant mice model of cervical cancer was devolped. The reversion of mitomycin resistance by SDZ PSC 833 (1 or 3 mg/L) was detected from human cervical cancer cell (Hela) and its resistant subline Hela/MMC in vitro and in vivo. Studies in vitro include drug resistance reversion experiment and the changes of morphology. Studies in vivo including tumor volume and tumor related histopathological changes in the autopsied specimen were evaluated by comparing random sections of each group. Results Nontoxic doses of SDZ PSC 833 could result in almost partial reversion of MMC-resistance of Hela/MMC.In vivo studies also showed SDZ PSC 833 augmented the growth inhibitory effect of mitomycin on Hela/MMC xenografted in nude mice. Conclusion SDZ PSC 833 can overcome mitomycin resistance of Hela/MMC in vitro and in vivo ,so SDZ PSC 833 will be a better candidate clinically for reversing multidrug resistance.