Objective Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery Method We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non surgical treatmen from 1997 to 2002 Results During the study period,67 operations were performed on 67 patients Among them,surgical procedure was completed in 58 cases Successful palliation was achieved in 64 2% of cases in which surgical correction was possible The median survival of the entire cohort was 7 8 months,and 12 6 months for the surgically successfully relieved patients and 3 7 months for those non surgical patients The rate of major surgical morbidities was 22 4 % The perioperative mortality rate was 6 0% Successful palliation was associated with the absence of two prognostic factors:multiple obstructive sites and palpable abdominal and pelvic masses Conclusion Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile,and properly selected patients are the key to its success

1cm)(P=0.0000)and the type of adjuvant chemotherapy implemented (non-standard chemotherapy versus standard chemotherapy)( P=0.0028). Among them tumor size was exclusively an independent factor.Conclusions:Histology、FIGO stage、residual tumor after surgery and the type of adjuvant chemotherapy were independent factors associated with recurrence in MOGCT .For those patients with high risks of recurrence, full dose and cycles of standard BEP/PVB regimen should be used.

an those received RH (29% vs. 9%, P=0.042). Conclusion NSRH is safe and feasible surgical management for cervical cancer patients, which would improved the physiology of pelvic autonomic nerve postoperatively.

chronic cervicitis(0%),(P=0.000).The positive rates of EPMMPRIN overexpression in metastatic lymph nodes was 54.5%(12/22),no difference was found from corresponding primary tumor(72.7%,P=0.210).But EMMPRIN overexpression in primary tumor was related to lymph node metastasis(P=0.026),no relationship was found between EMMPRIN expression and other clinical-pathological parameters.Univariate analyses revealed that EMMPRIN expression did not correlate to tumor-specific survival.In contrast,lymph vascular space invasion,deep stromal invasion and lymph node metastasis were significantlyassociated with poor prognosis.In multivariate analysis,lymph-node metastasis was the independent prognostic factor for tumor-specific survival(P=0.006;HR=0.038;95% confidence interval,0.0190.763).Conclusion:EMMPRIN overexpression may play an important role in progression of human cervical cancer,and in the development of cervical cancer from CIN.

Background and purpose:Primary malignant melanomas of the uterine cervix and vagina are rare neoplasms with very poor prognosis. This article aimed at investigating the clinicopathologic characteristics, treatment and prognosis of primary malignant melanomas of the cervix and vagina. Methods:The clinical data of 51 patients with primary malignant melanomas of the cervix and vagina treated at Fudan University Shanghai Cancer Center from Dec.1998 to Jul. 2011 were reviewed. Results:The 2-and 4-year progression-free survival (PFS) rates were 32.8%and 13.1%, respectively. The 2-and 4-year overall survival (OS) rates were 67.2%and 39.8%, respectively. Three patients survived more than 5 years. Twenty-nine (56.9%) patients had a recurrence. The common sites were vaginal stump/pelvis (10 patients, 34.5%), liver (4 patients, 13.9%), lung (3 patients, 10.3%), bone (3 patients, 10.3%) and vulva (3 patients, 10.3%). Larger tumor size and lymphovascular space invasion were the independent predictors of poor OS (P<0.05). Pelvic lymph nodes metastases were associated with shorter PFS (P=0.05). Among them, those who received combined immunotherapy and chemoradiotherapy achieved longer median time to progression (TTP) (17 months) compared with patients who had chemotherapy alone (9 months) or immunotherapy alone (11 months). Conclusion:Primary melanomas of cervix and vagina have a very poor prognosis. The multidisciplinary treatment of combining surgery, chemoradiotherapy, and immunotherapy can improve the patients’ prognosis.

10.3969/j.issn.1007-3969.2013.05.009

Objective To explore the rehabilitation effect of pelvic floor muscle training combined with traditional Chinese medicine in the treatment of mild-moderate pelvic organ prolapse.Methods A prospective ease-control study,choosing 103 patients of mild-moderate pelvic organ prolapse from October 2012 to May 2014 in Maternal and Child Health Hospital Outpatient of Hunan Province,which were randomly divided into study group (52 cases) and control group (51 cases).All of the patients underwent two courses of pelvic floor muscle training,including Kegel exercise,biofeedback,electrical stimulation therapy,the study group combined with traditional Chinese medicine (Buzhongyiqitang) at the same time.The efficacy was analyzed before and after treatment of pelvic floor muscle strength,myoelectric potential and indexing of pelvic organ prolapse quantification (POP-Q) changes.Results There werent statistically significant differences in type Ⅰ and Ⅲ muscle fiber muscle strength and myoelectric potential of two groups before treatment,while the shrinkage index improved significantly after treatment,and the study group was significantly higher with statistically significant difference (P ＜ 0.05).The effective rates of POP-Q indexing changes in two groups were 71.2％ and 56.9％,respectively.The effective rate of the study group was significantly higher than the control group(P ＜ 0.05).Conclusions The clinical efficacy of pelvic floor muscle training combined with Buzhongyiqitang in the treatment of mild-moderate pelvic organ prolapse was significant,and it had a good clinical value.

OBJECTIVE: Distal pancreatectomy with splenectomy may be required for optimal cytoreductive surgery in patients with epithelial ovarian cancer (EOC) metastasized to splenic hilum. This study evaluates the morbidity and treatment outcomes of the uncommon procedure in the management of advanced or recurrent EOC. METHODS: This study recruited 18 patients who underwent distal pancreatectomy with splenectomy during cytoreductive surgery of EOC. Their clinicopathological characteristics and follow-up data were retrospectively analyzed. RESULTS: All tumors were confirmed as high-grade serous carcinomas. The median diameter of metastatic tumors located in splenic hilum was 3.5 cm (range, 1 to 10 cm). Optimal cytoreduction was achieved in all patients. Eight patients (44.4%) suffered from postoperative complications. The morbidity associated with distal pancreatectomy and splenectomy included pancreatic leakage (22.2%), encapsulated effusion in the left upper quadrant (11.1%), intra-abdominal infection (11.1%), pleural effusion with or without pulmonary atelectasis (11.1%), intestinal obstruction (5.6%), pneumonia (5.6%), postoperative hemorrhage (5.6%), and pancreatic pseudocyst (5.6%). There was no perioperative mortality. The majority of complications were treated successfully with conservative management. During the median follow-up duration of 25 months, nine patients experienced recurrence, and three patients died of the disease. The 2-year progression-free survival and overall survival were 40.2% and 84.8%, respectively. CONCLUSION: The inclusion of distal pancreatectomy with splenectomy as part of cytoreduction for the management of ovarian cancer was associated with high morbidity; however, the majority of complications could be managed with conservative therapy.
Adult ; Aged ; *Cytoreduction Surgical Procedures ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial/mortality/pathology/*surgery ; Ovarian Neoplasms/mortality/pathology/*surgery ; *Pancreatectomy/adverse effects ; Postoperative Complications/epidemiology/therapy ; *Splenectomy/adverse effects ; Splenic Neoplasms/pathology/*secondary/*surgery

Objective:To investigate the correlation between cardiac polyps and gastroesophageal flap valve (GEFV).Methods:The clinical, endoscopic and pathological data of 349 patients with cardiac polyps (the cardiac polyp group) visiting Affiliated Hospital of Yangzhou University from January 1, 2016 to December 31, 2021 were retrospectively collected, and the same number of non-cardiac polyp patients (the non-cardiac polyp group) were matched in the same period as control according to the propensity score. The clinical, endoscopic and pathological data of the two groups were compared.Results:After matching with propensity score, there were 296 patients in each group, with no significant differences in smoking, acid reflux, heartburn, Helicobacter pylori infection, bile reflux, reflux esophagitis or pancreatitis between the two groups ( P>0.05). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in GEFV Ⅱ patients ( OR=3.046, 95%CI: 2.100-4.419, P<0.001) and GEFV Ⅲ patients ( OR=4.202, 95%CI: 2.299-7.681, P<0.001). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in patients with GEFV abnormalities ( OR=2.822, 95%CI: 1.615-4.931, P<0.001). GEFV abnormalities was associated with the cardiac polyp site ( χ2=22.169, P=0.003) and was not significantly associated with cardiac polyp size, number, morphology, intestinal metaplasia of the surrounding mucosa or intraepithelial neoplasia ( P>0.05). Conclusion:The occurrence of cardiac polyps is related to GEFV, and the patients with GEFV abnormalities are more likely to develop cardiac polyps.

ObjectiveTo investigate the mechanism of acupuncture in the treatment of chemotherapy-related cognitive impairment （CRCI） of breast cancer based on resting-state functional magnetic resonance imaging （rs-fMRI）. MethodTwenty-five patients with CRCI of breast cancer were included and treated with the acupuncture based on the method of regulating qi and blood， nourishing mind and benefiting intelligence； the selected acupoints included Zusanli （ST 36， bilateral）， Xuehai （SP 10， bilateral）， Tanzhong （CV 17）， Zhongwan （CV 12）， Qihai （CV 6）， Baihui （GV 20）， Fengfu （GV 16， bilateral）， Xinshu （BL 15， bilateral）， Tongli （HT 5， bilateral）， Zhaohai （KI 6， bilateral）， Yixi （BL 45， bilateral） twice a week， each time interval of 2-3 days， for 8 weeks. The scores of Montreal Cognitive Assessment （MoCA）， Mini-mental State Examination （MMSE）， European Cancer Research and Treatment Organization Quality of Life Questionnaire （EORTC QLQ-C30） were compared before and after acupuncture， and the effectiveness were evaluated by MoCA scale. The patients received rs-fMRI before and after treatment， and used low-frequency oscillation amplitude and functional connectivity （FC） analysis to extract the mean zALFF values of regions of interest such as bilateral anterior cingulate gyrus， bilateral hippocampus， bilateral amygdala， bilateral temporal pole middle temporal gyrus， and bilateral temporal pole supramarginal gyrus for comparison， and used the brain regions with statistically significant differences in the pre- and post-treatment zALFF values as the seed points for the seed-point-based FC Analysis. Correlation analyses were performed between the imaging metrics and the clinical scales. ResultsTwenty-four patients with CRCI of breast cancer completed treatment and follow-up. The zALFF values of the left hippocampus， left amygdala， and left temporal pole temporal gyrus in patients' rs-fMRI decreased after treatment （P＜0.05 or P＜0.01）， and left temporal pole temporal gyrus and right posterior cerebellar lobe FC were elevated （t = -5.169）， and MoCA scale total scores and visuospatial and executive， naming， and delayed recall cognitive scores， MMSE scale total scores， and EORTC QLQ-C30 scale mood scores were significantly higher （P＜0.05 or P＜0.01）. The total effective rate of MoCA was 58.33%. The difference in zALFF values of the left temporal pole middle temporal gyrus before and after treatment was negatively correlated with the MoCA total score （r= -0.499， P = 0.015）， as well as the difference in abstract function （r = -0.498， P = 0.016）. ConclusionThe acupuncture method of regulating qi and blood， nourishing mind and benefiting intelligence can improve the cognitive function of breast cancer patients with CRCI， and its mechanism may be related to improving the functional activities of hippocampus， amygdala and temporal lobe， as well as the functional connections of left temporal pole-temporal middle gyrus and right posterior cerebellar lobe.