BACKGROUNDTo introduce the experience of anaesthesia management of lobectomy combined with resection and reconstruction of superior vena cava (SVC) with graft in the treatment of lung cancer patients with superior vena cava syndrome.

METHODSUnder intubation and general anaesthesia, lobectomy combined with resection and reconstruction of superior vena cava with graft was carried out in 18 lung cancer patients with superior vena cava syndrom.

RESULTSThe anaesthesia was very stable and operation was smooth in all patients. All of the patients safely returned to intensive care unit. No symptom and sign of nervous system damage was found after anaesthesia consciousness in all patients.

CONCLUSIONSThe key of anaesthesia management is to maintain a stable hemodynamics and to decrease the pressure of superior vena cava, which is the key point of brain protection.

Adult ; Fatty Liver ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Complications ; diagnosis ; diagnostic imaging ; Ultrasonography ; Young Adult

OBJECTIVETo investigate the growth of craniopharyngioma involving the third ventricular floor with regard to the hypothalamus by detecting expressions of leukocyte common antigen (CD45) and intercellular adhesion molecule (ICAM-1) in the tumor tissue.

METHODSThe expressions of CD45 and ICAM-1 proteins in 30 craniopharyngioma samples with third ventricular floor involvement were detected by SP immunohistochemistry.

RESULTSThe inflammations labeled by CD45 were identified commonly in the craniopharyngioma tissues involving the third ventricular floor. The expression of ICAM-1 was mainly in the inner tumor cells and interstitial cells, but not detected in the basilar tumor cells growing toward the third ventricular floor. Adamantinomatous craniopharyngiomas showed markedly higher CD45 and ICAM-1 expressions than squamous papillary tumors (P<0.05).

CONCLUSIONInflammatory adhesion largely characterizes the growth of the craniopharyngioma tissues involving the third ventricular floor toward the hypothalamus without the tendency of invasion. The difference in the inflammation between the two types of craniopharyngioma may affect the prognosis of the patients.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; metabolism ; secondary ; Child ; Craniopharyngioma ; metabolism ; pathology ; surgery ; Female ; Humans ; Hypothalamus ; metabolism ; pathology ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; biosynthesis ; Leukocyte Common Antigens ; biosynthesis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pituitary Neoplasms ; metabolism ; pathology ; surgery ; Third Ventricle

OBJECTIVETo analyze the factors contributing to the occurrence of diabetes insipidus after operations for craniopharyngiomas.

METHODSA total of 121 cases of diabetes insipidus following surgeries for craniopharyngiomas were retrospectively analyzed and the factors associated with postoperative diabetes insipidus were analyzed.

RESULTSThe incidence of diabetes insipidus was 27.3% (33/121 cases) before the operation, 89.9% (107/1119) early after the operation and 39.8%(37/93) in later stages after the operation. The occurrence of early postoperative diabetes insipidus showed a significant relation to the classification and calcification of the craniopharyngioma. Patients with supradiaphragmatic and extraventricular tumors had the lowest incidence of postoperative diabetes insipidus. Late postoperative diabetes insipidus was closely correlated to such factors as age, classification of craniopharyngioma, and intraoperative treatment of the pituitary stalk, but not to the scope of tumor resection or tumor calcification. Late diabetes insipidus was more frequent in children and patients with severed pituitary stalk. The incidence of late postoperative diabetes insipidus was significantly higher in patients with supradiaphragmatic and extra-intraventricular tumors than in those with tumors beneath the diaphragma sellae and extraventricular tumors.

CONCLUSIONSPostoperative diabetes insipidus following surgeries for craniopharyngiomas is closely related to the tumor classification, calcification and pituitary stalk protection.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Craniopharyngioma ; pathology ; surgery ; Diabetes Insipidus ; epidemiology ; etiology ; Female ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Neurosurgical Procedures ; adverse effects ; methods ; Pituitary Neoplasms ; pathology ; surgery ; Postoperative Complications ; blood ; etiology ; Regression Analysis ; Retrospective Studies ; Sella Turcica ; Young Adult

Objective To explore serum long stranded noncoding RNA (lncRNA) transcript 1 (PCAT-1) expression level of patients with multiple myeloma (MM) and clinical value.Methods 72 cases of patients with MM treated in the Second People's Hospital of Zhaoqing City were selected as the study objects,and 60 cases of normal subjects undergoing physical examination in the same period were as the control group.Serum lncRNA PCAT-1 expression was detected by RT-PCR method.The relationship between lncRNA PCAT 1 expression and clinical pathological parameters,treatment effect was analyzed,and 5 years survival was analyzed by using Kaplan-Meier,and survival difference was detected by using Log-Rank method.Results Serum PCAT-1mRNA expression in MM group (2.65 ± 0.64) was significantly higher than that in the control group (1.06 ± 0.23,t=18.276,P=0.000).There were no significant differences in sex,clinical stage and pathological types of hemoglobin,plasma cells,platelets,albumin,β2-MG and CRP between PCAT 1 mRNA high expression group and low expression group (x2 =0.001 ～ 3.345,all P ＞ 0.05).Ca2+ ≥ 10 mg/dl in the PCAT-1 high expression group (57.14％) was significantly higher than that in the low expression group (27.27％,x2 =5.229,P=0.022).There was no significant difference in treatment effect between PCAT-1 mRNA high expression group and low expression group (88.64 ％ vs 75.00％,x2 =2.291,P=0.130).PFS and OS expression in PCAT-1 high expression group were lower than that in the low expression group (x2 =7.269,P =0.007;x2 =9.190,P =0.002).COX risk regression multiple factor analysis showed that age and PCAT-1mRNA expression were independent prognostic factors influencing patients (OR =3.275,P =0.025,95％CI:2.691～3.761;OR=2.136,P=0.046,95％CI:2.034～2.685).Conclusion LncRNA PCAT-1 is highly expressed in serum of patients with multiple myeloma,and correlated with the prognosis of patients.

Objective To evaluate the clinical effect in the treatment of the young patients(≤45 years old) with acute myocardial infarction(AMI)underwent emergent percutaneous transluminal coronary angioplasty(PTCA) combined with Lipo-PGE_1.Methods 39 patients with AMI(paroxysm within 12 hours),were underwent emergent PTCA(coronary stem performed in some patients),including 18 cases which were treated combined with Lipo-PGE_1 in the mean time.And the clinical efficacy and the results of short-period follow-up were recorded.Results The in- farctive vasculars were re-open in 37 patients(23 cares were routinely placed translunrinal srents),and the successful rate was 94.9 %.Those who also used Lipo-PGE_1 were re-open in 17 patients.The successful rate was 94.4 %,their ST segments on EKG 30 minutes after operations reduced significantly than that of patients who did not use Lipo- PGE_1,their cardial functions were also improved significantly 24 hours after operations and no side effects on blood pressure and heart rate were observed.Conclusion The emergent PTCA combined with Lipo-PGE_1 for acute my- ocardial infarction can protect the cardial function and show a better early therapy effect.

Saliva and blood were collected from two patients who had not received post exposure prophylaxis in the cities of Wenzhou and Xinning respectively. Both patients were confirmed as positive for rabies by detection of rabies virus specific nucleoprotein antibodies in the sera by Western Blot. However, rabies virus specific RNA was only identified in the saliva collected from the patient in Wenzhou. Furthermore, the isolate Zhejiang Wz0 (H) was obtained by inoculating one-day-old suckling mice. Both nucleoprotein (N) and glycoprotein (G) genes from the isolate were amplified by RT-PCR and sequenced. Phylogenetic analysis indicated that the isolate belonged to classic rabies virus, and shared a higher homology with the street viruses from dogs in the main endemic areas in China and the street virus from dogs in Indonesia than with other known strains. Further comparison of the deduced amino acid sequences between the isolate and the vaccine strains used in China showed that the virus had a higher level of homology with the vaccine strain CTN than with the other vaccine strains (3aG, PV, PM and ERA). In particular, amino acid residues substitutions located in antigenic site Ⅲ in the G protein, which could react with the neutralizing antibodies, were observed. These results suggested that the virus belonged to the classic rabies virus, and both N and G genes diverged from the current vaccine strains used in China at either the nucleotide or the amino acid level.

Objective To study the expression of cyclooxygenase-2(COX-2) and survivin in children with acute leukemia(AL) and its significance.Method The expression of COX-2 and survivin were determined by immunohistochemical SABC assay.Results The expression rate of COX-2 and survivin were 52.4%(22/42 cases)and 45.2%(19/42 cases)in AL,and the expression rate of COX-2 and survivin were 46.9%(15/32 cases)and 40.6%(13/32 cases)and in acute lymphonate leukemia(ALL),both of them were higher than those in control group(Pa0.05).The positive rate of COX-2 was 84%(16/19 cases)in 19 cases with survivin positive expression,and the negative rate of COX-2 was 85%(17/20 cases)in 20 cases with survivin negative expression,and there was positive correlation between COX-2 expression and survivin expression(r=0.579 P

Objective: To conduct a systematic review and meta-analysis of studies evaluating the oncological and fertility outcomes of early-stage endometrial cancer (EC) treated with the levonorgestrel-releasing intrauterine system (LIUS)-based regimens. Methods: The Meta-analyses Of Observational Studies in Epidemiology statement for meta-analyses was followed. Searches were conducted on MEDLINE, Embase, PubMed, Preprints, and the Cochrane Central Register of Controlled Trials from January 1990 to August 4, 2022. The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment. The primary endpoint was the complete response (CR) rate and the secondary endpoints were relapse, pregnancy, and live birth rate. Results: A total of 25 studies (821 women) were included. The CR rate of LIUS-based regimens was 63.4% (95% confidence interval [CI]=52.3%–73.2%), with 29.6% (95% CI=23.3%–36.8%) of cases experiencing recurrence during follow-up. In sensitivity analyses, patients younger than 45 years of age with a body mass index <30 kg/m2 who were treated with LIUS-based regimens achieved a high CR rate of 84.6% (95% CI=80.3%–88.1%) over a median follow-up of more than 24 months. Overall pregnancy and live birth rates were 37.9% (95% CI=24.1%–53.9%) and 39.3% (95% CI=24.0%–57.0%), respectively. No statistical differences were apparent in CR or relapse rates among the LIUS+GnRH agonist, LIUS+oral progesterone, or hysteroscopic resection followed by LIUS subgroups. Conclusion LIUS-based therapies are viable for the conservative management of early-stage endometrioid EC on CR and fertility outcome.

PURPOSETraumatic optic neuropathy (TON) is a serious complication of head trauma with the incidence rate of 0.5%-5%. The aim of this study was to investigate the therapeutic efficacy of endoscopic decompression of the optic canal for optic nerve injuries.

METHODSIn this study, 11 patients treated in our hospital from January 2009 to January 2015 with the visual loss resulting from TON were retrospectively reviewed for preoperative vision, visual evoked potential (VEP) scan, surgical approach, postoperative visual acuity, complications, and follow-up results.

RESULTSAll these patients received endoscopic decompression of the optic canal. At the 3-month follow- up, the visual acuity improvement rate of the 11 patients was 45.5%. The vision acuity of 2 cases improved from hand movement to 0.08 and 0.3 after operation. Another patient's vision acuity returned to 0.05 compared to light sensation preoperatively. Two cases had finger counting before surgery but they had a vision acuity of 0.4 and light sensation respectively after surgery. However, the other 6 cases' vision did not improve after surgery.

CONCLUSIONEndoscopic decompression of the optic canal is an effective way to cure TON. VEP could be used as an important reference for preoperative and prognosis evaluation. Operative time after trauma is only a relative condition that may affect the therapeutic effect of optic canal decompression. Poor results of this procedure may be related to the severity of the optic nerve injury.

Adolescent ; Adult ; Aged ; Decompression, Surgical ; methods ; Endoscopy ; Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Optic Nerve Injuries ; physiopathology ; surgery ; Visual Acuity