Objective To explore the operative cooperation of the intra-extra cranial bypass operation of the intracranial giant aneurysms. Methods A retrospective analysis of 7 patients who had intracranial giant aneurysm and received the intra-extra cranial bypass operation from October 2014 to June 2016. All preoperative and intraoperative nursing points of operative cooperation were analyzed. Results The post-operative digital subtraction angiographies of 7 patients without any perioperative nursing complications showed enough flow in the bypass arteries. Conclusions Operative multi-incision managing, positive temperature intervening, special instruments using and thrombosis preventing play very important roles in the nursing points of the successful operative cooperation.

A pot experiment was conducted to study effect of drought stress on leaf physiological characteristics and growth of one year old Stellaria dichotoma seedlings. The result showed that plant height and shoot dry weight significantly decreased with decrease in soil water content; however, root length and root dry weight increased at light drought stress and decreased at severe drought stress. The result also showed that with the decrease of soil water content, proline content in S. dichotoma leaves decreased then increase, while solube protein content decreased. Activities of SOD and POD in S. dichotoma leaves significantly decreased as soil water content decreased, while activity of CAT significantly decreased at severe drought stress. Membrane permeability in S. dichotoma leaves increased, while MDA content decreased then increased as soil water decreased. These results suggest that S. dichotoma had osmotic stress resistance ability and reactive oxygen scavenging capacity at light drought stress, which caused S. dichotoma growth was no inhibited at a certain extent drought stress.
Droughts ; Plant Leaves ; enzymology ; growth & development ; metabolism ; Plant Proteins ; metabolism ; Plant Roots ; enzymology ; growth & development ; metabolism ; Proline ; metabolism ; Seedlings ; enzymology ; growth & development ; metabolism ; Stellaria ; enzymology ; growth & development ; metabolism ; Water ; metabolism

Objective To evaluate the therapeutic effects and safety of amitrine bismesylate in patients with mild vascular dementia.Methods An open multicenter self-controlled trial was carried out with 128 mild vascular dementia patients clinically diagnosed.Patients were treated with amitrine bismesylate in a dose of 2 tablets per day for 12 weeks.The neuro-psychologieal scale of MMSE,ADAS-cog,CDR, ADL were used to evaluate patients′cognitive condition before therapy and 6,12 weeks after treatment.The adverse effects,such as nausea and vertigo and so on,were monitored at the same time to evaluate the safety of this drug.Results After 3 months of treatment,the MMSE score(16.98 before therapy and 17.97 after treatment,P

Objective To evaluate the relationship between diaphragmatic ultrasound and postoperative residual neuromuscular blockade(PRNB). Methods The patients undergoing non-thoracic and abdominal surgery under general anesthesia from August to October in 2019 were randomly enrolled from Peking Union Medical College Hospital.Diaphragmatic ultrasound was acquired pre-operation and post extubation.A 4-15 MHz probe was used to measure diaphragmatic thickness at the intersection point of 8-9 intercostal space with right anterior axillary line at the end of inspiration and expiration during quiet breathing and deep breathing(DB),and the diaphragmatic thickness fraction(DTF)was calculated.A 1-5 MHz probe was used to measure diaphragmatic excursion(DE)at the intersection point of right costal margin with midaxillary line during quiet breathing and DB.Train of four ratio(TOFr)was recorded for neuromuscular monitoring.TOFr,observer assessment of alertness and sedation score at extubation,Aldrete score at postanesthesia care unit,and postoperative pulmonary complication were recorded. Results The PRNB rate was 54.7%.The DTF-DB [31.3(21.1,45.0)vs.38.5(26.6,53.9),P=0.045] and DE-DB(2.9±1.4 vs.4.1±1.0,P<0.001)in PRNB group was lower than those in the group without PRNB.DTF-DB(r=0.351,P=0.002)and DE-DB(r=0.580,P<0.001)were correlated with TOFr. Conclusion Perioperative diaphragmatic ultrasound may be helpful for the diagnosis of PRNB.
Delayed Emergence from Anesthesia ; Diaphragm/diagnostic imaging* ; Feasibility Studies ; Humans ; Prospective Studies ; Ultrasonography

OBJECTIVETo summarize the clinicopathological features and prognosis of malignant ovarian neoplasms complicating pregnancy and explore the rational treatment.

METHODSThe clinical data of 38 patients with malignant ovarian neoplasms complicating pregnancy were retrospectively analyzed,and the intra-surgical pathological sections were reviewed. International Federation of Gynecology and Obstetrics (FIGO) staging system (1988) was applied.

RESULTSOf these 38 patients,the malignancies included epithelial ovarian cancer (n=9, 23.7%), epithelial borderline ovarian tumor (n=13, 34.2%),ovarian malignant germ cell tumors (n=11, 28.9%), sex cord stromal tumors (n=3, 7.9%), and metastatic tumor from gastrointestinal tracts (n=2, 5.3%). Twenty-seven patients (71.1%) were at stage I. The pregnancy outcomes included termination in the first trimester (n=8), full-term vaginal delivery (n=6), full-term Cesarean section (n=15), and therapeutical Cesarean section for premature birth (n=9). One newborn died,and the remaining 29 survived in a healthy status. All patients underwent surgical treatment,among whom two patients received surgeries during pregnancy. Patients were followed up for (40.5±38.5) months,during which one patient was lost to follow-up, 7 died, 1 survived with tumor, and 29 (76.3%) survived free of tumors.

CONCLUSIONSThe management of ovarian malignancies complicating pregnancy should be individualized. Both surgical treatment and chemotherapy are relatively safe in the second and third trimesters. Satisfactory prognosis can be expected after appropriate treatment.

Adult ; Female ; Humans ; Ovarian Neoplasms ; pathology ; therapy ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the prognostic factors and fertility outcomes of borderline ovarian tumors (BOT) after conservative surgery.

METHODSThe clinical data of 109 patients with BOT who were treated in Peking Union Medical College Hospital from January 1990 to December 2007 were retrospectively analyzed. According to the FIGO staging system,there were 34(31.2%) patients at Stage Ia and Ib, 66 (60.6%) at Stage Ic, 2 (1.8%) at Stage II and 7(6.4%) at stage III. No patient was at Stage 4.

RESULTSSurgical treatment included comprehensive staging surgery (n=40, 36.7%), ovarian cystectomy (n=27,24.8%), and unilateral salpingo-ovariectomy (n=42, 38.5%). The average follow-up period was (60.3±42.5) months. Relapse occurred in 25 patients (22.9%), and the mean duration from therapy to recurrence was (36.1±31.9) months. Only one patient died of BOT. Multivariate analysis showed that surgery procedure and tumor stage were the independent prognostic factors affecting recurrence. Of 66 patients with the desire of fertility, 24 (36.4%) finally got pregnant.

CONCLUSIONSConservative surgery has comparatively good prognosis and should be the first choice for younger patients with the desire of fertility. The high-risk factors should be evaluated before the initiation of treatment.

Adolescent ; Adult ; Female ; Fertility ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial ; surgery ; Ovarian Neoplasms ; surgery ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the impact of lymphadenectomy on the relapse and survival of malignant ovarian germ cell tumor (OGCT).

METHODSThe clinical data of 102 OGCT cases treated in Peking Union Medical College Hospital from June 1980 to June 2003 were analyzed retrospectively. All the data about lymphadenectomy during primary and secondary surgery were collected, and other factors related to prognosis were also collected at the same time. Chi-squared test was applied in the univariate analysis related to relapse of disease. Cox model was applied in multivariate analysis related to relapse and survival of disease.

RESULTSPelvic and paraaortic lymph node metastasis was not significantly related to prognosis in primary and secondary treated patients. Lymphadenectomy showed no significant impact on disease relapse and survival. In the primary treatment, International Federation of Gynecology and Obstetrics (FIGO) staging, chemotherapy regimen, residual tumor and lymphadenectomy were the significant factors related to the relapse. After being stratified for the chemotherapy regimen, lymphadenectomy was not significantly related to the relapse in bleomycin +etoposide +cisplatin or cisplatin +vincristine +bleomycin regimen group, and lymphadenectomy could prevent relapse in no chemotherapy or other chemotherapy regimen group. In relapsed patients, only residual tumor was significantly related to survival time after relapse.

CONCLUSIONSPelvic lymph node metastasis is not the significant risk factor related to prognosis. Lymphadenectomy may have a beneficial effect on survival, although such effect is not significant. Although lymphadenectomy provides important information for prognosis, they provide little benefit to those patients already requiring chemotherapy based on the original operative findings. Lymphadenectomy should be performed to primary or relapsed patients by an expert surgical team.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Combined Modality Therapy ; Female ; Germinoma ; mortality ; pathology ; surgery ; therapy ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; mortality ; pathology ; surgery ; therapy ; Neoplasm Staging ; Ovarian Neoplasms ; mortality ; pathology ; surgery ; therapy ; Prognosis ; Retroperitoneal Space ; Retrospective Studies

BACKGROUNDThe primary ovarian sarcoma is a very rare malignancy. The objective of this study was to further investigate the clinicopathologic features and outcome in patients with primary sarcoma of the ovary.

METHODSBetween 1988 and 2007, 24 patients with primary ovarian sarcoma who underwent treatment at Peking Union Medical Hospital were reviewed retrospectively. Response to treatment, progression and overall survival were analyzed.

RESULTSPatients with ovarian sarcoma had a mean age of (54.3 ± 10.3) years, and 16 of them were postmenopausal. The most common symptom was abdominal pain, present in 14 patients. Of the 24 patients, 16 patients were pathologically diagnosed as carcinosarcoma (known as malignant mixed mesodermal tumor (MMMT)), 2 as ovarian leiomyosarcoma (LS) and 6 patients as ovarian endometrial stromal sarcoma (ESS). The patients in optimal debulking group had a median survival period of 28 months and 1-year survival rate of 71%. The patients in suboptimal debulking group had a significantly lower median survival of 6 months (P = 0.02) and 1-year survival rate of 29%. Among the patients, 23 patients received chemotherapy and most of regimens were based on platinum, 3 patients received chemoradiation. The mean number of courses of combined chemotherapy was 6.6 ± 5.0, and the response was unsatisfactory. The median survival for the entire group was 18.7 months. The one-year survival rate was 58%, and two-year survival rate only 29%.

CONCLUSIONSOvarian primary sarcoma has a poor overall prognosis. Optimal debulking surgery appears to be of prognostic significance. There is a clear need for further study to explore the role and the regimen of platinum-based chemotherapy in primary ovarian sarcoma.

Adult ; Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Retrospective Studies ; Sarcoma ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Survival Rate

OBJECTIVETo evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.

METHODSPhase II study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50.5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractory. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.

RESULTSA total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10.0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy. There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0.061). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8% of patients. Grade II/III anemia (54.5%) and grade III/IV neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia, and 8 (36.4%) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treat-ment-associated death.

CONCLUSIONGemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Deoxycytidine ; administration & dosage ; adverse effects ; analogs & derivatives ; Female ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial ; drug therapy ; Ovarian Neoplasms ; drug therapy ; Platinum Compounds ; administration & dosage ; adverse effects

OBJECTIVETo compare the clinical characteristics of three subcategories of laparoscopic hysterectomy: total laparoscopic hysterectomy (TLH) and two subcategories of laparoscopic-assisted vaginal hysterectomy (LAVH): LAVHs and LAVHb.

METHODSWe retrospectively analyzed the clinical data of 393 patients underwent laparoscopic hysterectomy, including TLH (n=178), LAVHa (n=177), and LAVHb (n=38), in our hospital from September 2002 to September 2005.

RESULTSMyoma and adenomyosis of uterus were the most common diseases in this study, accounting for 66.9%, 38.4%, and 52.6% in TLH group, LAVHa group, and LAVHb group, respectively. The mean surgery duration and blood loss were not significantly different between TLH group and LAVHa group (P > 0.05), but were significantly less in TLH group than in LAVHb group (P < 0.05). The bulk of uterus in TLH group was significantly bigger than in other two groups (P < 0.05). The incidence of major complications in the TLH group (9. 0%) was lower than in LAVHa group (14.1%) and in LAVHb group (18.4%), but without statistical significance. Conclusion Compared with LAVH, TLH is feasible to deal with bigger uterus with less blood loss and shorter surgery duration and without more frequent complications.

Endometriosis ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Hysterectomy, Vaginal ; adverse effects ; methods ; Laparoscopy ; adverse effects ; methods ; Myoma ; surgery ; Retrospective Studies ; Uterine Neoplasms ; surgery