1.Clinical features,diagnosis,and treatment of gastric duplication in childhood
Wei WANG ; Jinbao HAN ; Shuanling LI ; Li WANG ; Yiyuan LIANG ; Qiulong SHEN ; Xianling LI ; Tingting LIU ; Dayong WANG ; Liuming HUANG
Journal of Clinical Surgery 2025;33(5):461-465
Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8%.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.
2.Clinical features,diagnosis,and treatment of gastric duplication in childhood
Wei WANG ; Jinbao HAN ; Shuanling LI ; Li WANG ; Yiyuan LIANG ; Qiulong SHEN ; Xianling LI ; Tingting LIU ; Dayong WANG ; Liuming HUANG
Journal of Clinical Surgery 2025;33(5):461-465
Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8%.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.
3.Efficacy and safety of radiotherapy combined with pyrotinib in treatment of human epidermal growth factor receptor 2-positive breast cancer patients with brain metastasis
Cancer Research and Clinic 2024;36(8):622-625
Objective:To investigate the clinical efficacy and safety of radiotherapy combined with pyrotinib for human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients with brain metastasis.Methods:A retrospective cohort study was conducted. The clinical data of 36 HER2-positive breast cancer patients with brain metastasis admitted to Shanxi Province Cancer Hospital from January 2021 to January 2023 were retrospectively analyzed. According to the different treatment methods, the patients were divided into the observation group and the control group, 18 cases in each group. The control group was treated with radiotherapy alone, and the observation group was treated with radiotherapy combined with pyrotinib. The objective remission rate, the disease control rate and the incidence of adverse reactions of both groups were compared; Kaplan-Meier method was used for survival analysis.Results:All patients were female and received trastuzumab or trastuzumab combined with pertuzumab chemotherapy or neoadjuvant therapy. The objective response rate of and disease control rate of in the observation group were higher than those in the control group [83.33% (15/18) vs. 50.00% (9/18), 94.44% (17/18) vs. 66.67% (12/18)], and the differences were statistically significant (χ 2 = 4.71, P = 0.034; χ 2 = 4.43, P = 0.034). The incidence of diarrhea in the observation group was higher than that in the control group [55.56% (10/18) vs. 16.67% (3/18), P = 0.035]. However, there were no statistically significant differences in the incidence of nausea, fatigue, and stomatitis between the 2 groups ( P = 1.000). The median progression-free survival (PFS) time in the observation group and the control group was 14.38 months and 12.08 months, respectively, and the difference in PFS was statistically significant ( P = 0.040). The median overall survival (OS) time in the observation group and the control group was 15.78 months and 11.19 months, respectively, and the difference in OS was statistically significant ( P = 0.034). Conclusions:Radiotherapy combined with pyrotinib is effective in the treatment of HER2-positive breast cancer patients with brain metastasis. It has no serious side effects, and can prolong the survival time of patients.
4.Erythropoietic protoporphyria with liver cirrhosis as the main manifestation: A case report
Zhendong WU ; Guoqiang ZHOU ; Yan XIANG ; Xianling WANG ; Jiandong SU ; Sichun LIU
Journal of Clinical Hepatology 2024;40(3):581-584
Erythropoietic protoporphyria (EPP) is a rare inherited metabolic disease that often involves skin, blood, and nervous systems, and EPP with the main manifestations of severe liver damage and acute abdominal pain is extremely rare. By reviewing the clinical data and genetic testing results of a patient with EPP, this article discusses the clinical features and pathogenic genes of this disease, in order to improve the understanding of the disease among hepatologists and achieve early diagnosis and treatment.
5.Hypercalcaemia crisis: A retrospective series of 143 cases
Yang LIU ; Xianling WANG ; Qinghua GUO ; Jin DU ; Yu PEI ; Jianming BA ; Weijun GU ; Jingtao DOU ; Zhaohui LYU ; Yiming MU
Chinese Journal of Endocrinology and Metabolism 2024;40(2):115-120
Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.
6.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
7.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
8.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
9.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
10.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.

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