OBJECTIVETo investigate the ability of contrast enhanced multiple-row detector computed tomography(ceMDCT) in the determination of extramural venous invasion (EMVI) in patients with gastric cancer and to analyze associated factors of EMVI.

METHODSFrom January 2009 to December 2013, 253 patients with gastric cancer undergoing ceMDCT in Peking University People's Hospital were included in this study. The imaging characteristics and clinical data were retrospectively reviewed. Positive or negative EMVI on ceMDCT(ctEMVI) was determined according to the EMVI scores criteria defined by MR high resolution image of rectal cancer. Chi-square test was used to analyze the associations of ctEMVI with other images and clinicopathological data.

RESULTSThe positive rate of ctEMVI was 32.8%(83/253) according to the EMVI scores criteria. Positive ctEMVI was associated with following CT findings, such as ctT (χ(2)=46.848, P=0.000), ctN (χ(2)=41.095, P=0.000), ctM (χ(2)=23.864, P=0.000), tumor growth pattern (χ(2)=8.580, P=0.003), tumor sizes (χ(2)=21.177, P=0.000), and with pathological T staging (χ(2)=28.994, P=0.000) and N staging (χ(2)=28.671, P=0.000), while no association with age, gender, histological type and tumor differentiation were seen(all P>0.05).

CONCLUSIONSceMDCT can be used to detect ctEMVI in patients with gastric cancer. ctEMVI is associated with invasion depth, lymph node metastasis, distant metastasis, tumor size, tumor location and growth pattern.

Chi-Square Distribution ; Humans ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; Tomography, X-Ray Computed

BACKGROUND:With the further development of minimally invasive concepts,unicompartmental knee arthroplasty has become an important treatment for osteoarthritis of the knee;however,early postoperative pain adversely affects the recovery process,so effective analgesic measures are necessary.Femoral nerve block and cocktail therapy are common analgesic methods for unicompartmental knee arthroplasty,but there is a lack of studies confirming the analgesic effect and safety of their combined application. OBJECTIVE:To investigate the analgesic effect of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty. METHODS:One hundred patients who received unicompartmental knee arthroplasty from October 2021 to January 2023 were selected as the study subjects.They were divided into a control group(n=50)and a study group(n=50)using a random number table method.The femoral nerve block was used in the control group,while cocktail therapy combined with femoral nerve block was used in the study group during unicompartmental knee arthroplasty.Postoperative analgesia effect,analgesic frequency of dezocine injection within 2 days after surgery,motion range of affected knee joint,KSS function scores,and the occurrence of postoperative adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:(1)Visual analog scale scores in the study group were lower than those in the control group at 12,24,and 48 hours after surgery(P<0.05).(2)The analgesic frequency of dezocine in the study group was less than that in the control group within 2 days after surgery(P<0.05).(3)The motion range in the study group was higher than that in the control group 1 and 3 days after surgery(P<0.05).On day 14 after surgery,there was no significant difference in motion range between the two groups(P>0.05).(4)The knee KSS score in the study group was higher than that in the control group at 2 weeks after surgery(P<0.05).There was no statistically significant difference in knee KSS scores between the two groups from 6 weeks to 6 months after surgery(P>0.05).(5)The difference in the occurrence of adverse reactions within 14 days after surgery was not significant between the two groups(P>0.05).(6)These results show that the use of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty can effectively reduce postoperative pain,improve the analgesic effect,reduce the frequency of analgesic drugs,and improve motion range of the early affected knee joint of patients.