1.Diagnosis and treatment of pulmonary synovial sarcoma
Chinese Journal of Postgraduates of Medicine 2014;37(20):29-31
Objective To investigate the way of improving the diagnosis and cure rate of pulmonary synovial sarcoma.Methods One case of pulmonary synovial sarcoma was selected,at the same time accompanied with 80 cases of pulmonary synovial sarcoma with complete data referenced from China Journal Full-text Database on October 2012 were retrospectively studied.The main clinical manifestations,imaging characteristics were analyszed.According to the pathology,immunohisochemistry and molecular biology for diagnosis and discrimination,in order to reduce the misdiagnosis.Results All of 81 patients,40 male cases and 41 female cases,the main clinical manifestations were chest pain,difficult breathing,hemoptysis and cough.In individual cases without any discomfort.All cases had not been accurately diagnosed before surgery.Ultimately diagnosis of patients depend on histopathology and immunohistochemistry.Conclusions Pulmonary synovial sarcoma shows different clinical symptoms but specific imaging characteristic and maybe confused with other pulmonary tumors or inflammation.Histopathological,immunophenotypic and fusion gene detection is the mainly technics for diagnosis.Surgery is the primary therapy,patients undergoing uncompletely resection have a poor prognosis.
2.Treatment and follow-up observation of fifty-four patients with glandular cystitis
Zhu SHI ; Hongfei CAO ; Shilu QIU
Chinese Journal of Postgraduates of Medicine 2019;42(2):148-150
Objective To evaluate the treatment effect of bladder instillation chemotherapy on glandular cystitis. Methods The clinical data of glandular cystitis of 54 cases were retrospectively analyzed, all cases were treated individually and the applications of chemotherapeutic drugs bladder instillation were not adopted. Results Follow-up period ranged from 2.5 to 9.0 years, and the average was 4.6 years. Lower urinary tract symptoms score before treatment, 3 month , 6 month, 2 years , 4 years after treatment was (8.5 ± 3.7), (5.7 ± 2.3), (3.9 ± 1.3), (4.0 ± 1.9), (4.2 ± 1.9) scores, and the scores after treatment were improved significantly compared with that before treatment (P < 0.05). Recurrence rate 3 months , 6 months, 2 years and 4 years after treatment was 3.7%(2/54), 13.0%(7/54), 5.6%(3/54) and 1.9%(1/54). Conclusions Eliminating the inducements and improvement of symptoms provides a significantly curative effect in glandular cystitis. Postoperative bladder instillation chemotherapy is not recommended.
3. Diagnosis and treatment of 66 cases with vesicoenteric fistula
Shilu QIU ; Jiwei YU ; Xiaohui LIU ; Hongye WANG
Chinese Journal of Postgraduates of Medicine 2019;42(11):1017-1019
Objective:
To investigate the clinical characters and diagnosis and treatment in patients with vesicoenteric fistula.
Methods:
Two patients with vesicoenteric fistula were admitted to the Affiliated Hospital of Shanxi Datong University in 2012 and 2019, at the same time 64 cases with complete data referenced from China Journal Full-text Database from September 2001 to December 2018 were retrospectively studied. The pathogeny, main clinical manifestations, relevant examination, treatment methods and prognosis were analyzed, to explore the best diagnosis and treatment of vesicoenteric fistula.
Results:
Among all of 66 patients, there were 49 males and 17 females. The pathogeny included intestinal cancer in 31 cases (46.97%), Crohn disease in 11 cases (16.67%), intestinal diverticulitis in 10 cases (15.15%), bladder cancer in 8 cases (12.12%), appendicitis and other inflammatory diseases in 5 cases (7.58%) and intraoperative injury in 1 case (1.52%). The main clinical feature included recurrent urinary tract infection in 45 cases (68.18%), fecaluria in 43 cases (65.15%), abdominal pain in 16 cases (24.24%) and pneumaturia in 16 cases (24.24%). Forty-one cases underwent CT examination, and the diagnostic rate was 58.54% (24/41); 47 cases underwent cystoscopy, and the diagnostic rate was 55.32% (26/47); 34 cases underwent cystography, and the diagnostic rate was 44.12% (15/34). Six cases (90.91%) were treated with surgery, and no perioperative death occurred. Twenty-eight cases were followed up, and the mean follow-up time was 4.1 years. Seven cases died of tumor recurrence and metastasis; 2 cases died of other basic diseases such as cardiovascular and cerebrovascular diseases. No other patients with benign vesicoenteric fistula died during follow-up.
Conclusions
The major cause of vesicoenteric fistula is intestinal malignancy, which shows emblematic clinical symptoms, and specific imaging characteristic. CT, cystoscopy and cystography are the main diagnostic technique. Surgical intervention is the major therapeutic choice, and the prognosis depends on the primary disease.