Objective To evaluate the efficacy of the coated metallic stent insertion in patients with complexity esophageal stricture and(or) fistula caused by carcinoma. Metheds 51 cases with complexity esophageal stricture and (or) fistula caused by carcinoma had undergone the treatment in our hospital. Different methods were used with different patients.Patients were evaluated for symptomatic dysphagia improvement 1-month and 12-month after treament. Results It were succeeded in placement of stents in all cases. All of them nearly complete symptomatic dysphagia relief or significant improvement .The diameter of the stricture increased from(4.05?1.34) mm to (13.03?3.99) mm (P

Objective To prospectively determine the dosimetric and clinical factors for predicting the risk of acute radiation oral mucositis ( ROM ) in patients receiving intensity?modulated radiotherapy ( IMRT) with concurrent chemotherapy for local advanced nasopharyngeal carcinoma. Methods Ninety?two patients who were treated with IMRT with concurrent chemotherapy from 2015 to 2016 for local advanced nasopharyngeal carcinoma were included in this study, and their acute ROM was scored according to the RTOG criteria. Grade≥3 ROM was used as a surrogate marker for severe mucositis, which was defined as a toxicity endpoint. The clinical data were reviewed, and the dose?volume histograms ( DVHs) of the patients were exported from the IMRT planning system. Optimal thresholds for predicting the incidence of severe ROM were evaluated by the area under the receiver operating characteristic ( ROC) curve ( AUC) . Results The incidence of severe ROM was 21%(19/92). Weight loss and V30 of the oral mucosa were determined as the independent predictors for severe ROM ( P=0017 and 0003, respectively) . The optimal cut?off point and AUC of V30 of the oral mucosa as a predictor for severe ROM were 7316%( 0842 sensitivity and 0671 specificity) and 0753( P=0001) , respectively. Conclusion Weight loss and V30 of the oral mucosa are predictors for severe ROM.

ObjectiveTo summarize the experience of nursing patients with heat illness combined with respiratory failure. Method The nursing records of 13 patients with heat illness combined with respiratory failure were reviewed for summarizing the nursing measures.Result After treatment and nursing care,12 of them were discharged and 1 died from multiple organ dysfunction. Conclusions Rapid cooling is key to the success of rescue.The nursing measures include keeping respiratory tracts unobstructed and preventing complications from artificial airway and mild hypothermia therapy.

Objective To investigate the relationship between D-dimer levels and the clinical stage and pathological grade of patients with ovarian cancer.Methods The clinical data of 66 patients with ovarian cancer whose D-dimer had been monitored before surgery were retrospectively analyzed.The relationship between D-dimer levels and the clinical stage,pathological grade was evaluated.Results D-dimer levels before surgery were uncorrelated with the patient's age (r =0.1324,P ＞ 0.05 ).There was significant difference in D-dimer levels between FIGO Ⅰ + Ⅱ patients and FIGO Ⅲ + Ⅳ patients [(377.89 ± 183.85) mg/L vs.(858.03 ± 138.29) mg/L] (t =11.602,P＜0.01).There was significant difference in D-dimer levels between high-moderately differentiated patients and poorly differentiated patients [(463.39 ±246.85) mg/L vs.(784.64 ±265.69) mg/L](t =4.983,P＜0.01).Conclusions D-dimer levels are related with the clinical stage and pathological grade of patients with ovarian cancer.It can predict the harmful biological behaviour of ovarian cancer.

Purpose To explore the CT features of solid components between benign and malignant mixed ground-glass nodules(mGGO),and between minimally invasive adenocarcinoma(MIA)and invasive adenocarcinoma(IAC),and to improve the accuracy of preoperative diagnosis of mGGO.Materials and Methods The clinical and imaging data of 313 patients with mGGO admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to July 2022 were retrospectively analyzed,and all patients were divided into benign group(95 cases)and malignant group(218 cases)according to follow-up or pathological results.All patients in malignant group were further divided into MIA(118 cases)and IAC(100 cases)groups.Logistic regression analysis models were established using the statistically significant CT features above,and the area under the curve(AUC)was calculated to evaluate the effectiveness of the model.Results ① Comparison of clinical characteristics between benign and malignant groups:malignant mGGO were more common in older people,females and nonsmokers,without smoking history,and the differences between two groups were significantly different(Z=-3.776,χ2=13.587,19.257;all P<0.001).②Comparison of CT features between benign and malignant groups:benign group existed a higher proportion of single solid component(84.21%vs.55.50%),while malignant group existed a higher proportion of multiple solid components(44.50%vs.15.79%),and the difference between two groups was significantly different(χ2=23.728,P<0.001).As for patients with single solid component,the solid components in malignant group were more likely to be irregular,mostly with eccentric distribution,and the proportion of solid components connected with blood vessels and pleura were higher than the benign group,the differences between two groups were significant(χ2=23.785,5.025,7.264;all P<0.05).Meanwhile,the benign group also had higher CT value[-153.00(-254.00,-80.50)Hu vs.-265.00(-363.25,-122.00)Hu],while lower relative CT value(0.30±0.16 vs.0.41±0.22),the differences between two groups were significant(all P<0.001).Logistic regression analysis:irregular morphology of the solid component(OR=0.236,P<0.001)and higher CT value(OR=1.009,P<0.05)were independent predictors of malignant mGGO.Receiver operator characteristic(ROC)curve analysis showed that the AUC was 0.772,and its accuracy,sensitivity and specificity was 70.65%,74.40%and 65.00%,respectively.③Comparison of CT features between MIA and IAC groups:MIA group existed a higher proportion of single solid component(74.58%vs.33.00%),while IAC group existed a higher proportion of multiple solid components(67.00%vs.25.42%),and the difference between two groups was significantly different(χ2=37.885,P<0.001).As for patients with single solid component,the solid components in IAC group were more likely to be irregular,it also had higher area,area proportion,and CT value,while lower relative CT value than the MIA group,the differences between two groups were significant(χ2=7.563,Z=-4.388,-3.923,-3.996;all P<0.05).Logistic regression analysis:eccentric distribution of the solid component(OR=0.083,P<0.05)and large area(OR=1.063,P<0.05)were independent predictors of IAC.ROC curve analysis showed that the AUC was 0.865,and its accuracy,sensitivity and specificity was 83.47%,87.90%and 68.20%,respectively.Conclusion The solid components between benign and malignant nodules as well as between MIA and IAC show different CT features.Based on these different features,it's helpful to improve the preoperative diagnostic accuracy of mGGO and guide the clinical treatment plans.