Deep infiltrating endometriosis(DIE)is defined as endometriotic lesions infiltrating≥5 mm beneath the peritoneum,commonly affecting the uterosacral ligaments,rectovaginal septum,vaginal vault,and rectal wall.Due to nonspecific clinical manifestations and atypical imaging features,DIE is often misdiagnosed.This study reports a case of rectal DIE diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)and summarizes the multidisciplinary treatment experience in conjunction with a literature review.A 35-year-old woman was admitted for defecation difficulty.MRI and EUS-FNA confirmed rectal DIE.After multidisciplinary team(MDT)evaluation involving colorectal,gynecologic,and urologic specialists,laparoscopic resection of the rectal lesion,sigmoid-rectal anastomosis,and protective ileostomy were performed.Pathology confirmed rectal DIE with negative margins.The stoma was successfully reversed 4 months later,and no recurrence was observed during 21 months of follow-up.These findings highlight the pivotal role of EUS-FNA in early diagnosis and demonstrate that an MDT approach led by colorectal surgeons can significantly enhance surgical safety and completeness,providing valuable guidance for the individualized management of complex pelvic endometriosis.

Deep infiltrating endometriosis(DIE)is defined as endometriotic lesions infiltrating≥5 mm beneath the peritoneum,commonly affecting the uterosacral ligaments,rectovaginal septum,vaginal vault,and rectal wall.Due to nonspecific clinical manifestations and atypical imaging features,DIE is often misdiagnosed.This study reports a case of rectal DIE diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)and summarizes the multidisciplinary treatment experience in conjunction with a literature review.A 35-year-old woman was admitted for defecation difficulty.MRI and EUS-FNA confirmed rectal DIE.After multidisciplinary team(MDT)evaluation involving colorectal,gynecologic,and urologic specialists,laparoscopic resection of the rectal lesion,sigmoid-rectal anastomosis,and protective ileostomy were performed.Pathology confirmed rectal DIE with negative margins.The stoma was successfully reversed 4 months later,and no recurrence was observed during 21 months of follow-up.These findings highlight the pivotal role of EUS-FNA in early diagnosis and demonstrate that an MDT approach led by colorectal surgeons can significantly enhance surgical safety and completeness,providing valuable guidance for the individualized management of complex pelvic endometriosis.

OBJECTIVE: To compare the effectiveness of unilateral biportal endoscopy (UBE) technique assisted spinal canal decompression combined with percutaneous pedicle screw internal fixation versus traditional open decompression and internal fixation for treatment of lumbar burst fractures. METHODS: A retrospective study was conducted on the clinical data of 61 patients with single-segment lumbar burst fractures who met the selection criteria and were admitted between October 2022 and December 2023. Of them, 25 patients received UBE technique assisted decompression combined with percutaneous pedicle screw fixation (UBE group), while 36 patients were treated with traditional posterior unilateral hemilaminectomy decompression and internal fixation (open group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, body mass index, fracture segment, cause of injury, AO classification of lumbar fractures, and preoperative height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion, the classification of American Spinal Injury Association (ASIA) grading, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. VAS score, ODI, and ASIA grading were used to evaluate the effectiveness before operation, at 1 week after operation, and at last follow-up. Lumbar anteroposterior and lateral X-ray films and CT were performed to measure the segmental kyphosis angle, height ratio of the anterior margin of injured vertebra, and the rate of spinal canal invasion. RESULTS: Surgery was successfully completed in both groups. No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. There was no significant difference in operation time between the two groups ( P>0.05), the UBE group revealed significant less intraoperative blood loss when compared with open group ( P<0.05). Patients in both groups were followed up 6-20 months, with an average of 13 months. There was no loosening, breakage, or failure of internal fixation in all patients. The ASIA grading, VAS score, ODI of the two groups significantly improved at 1 week after operation and further improved at last follow-up ( P<0.05). There was no significant difference in ASIA grading at 1 week after operation and last follow-up between the two groups ( P>0.05), but the VAS score and ODI in the UBE group were significantly superior to the open group ( P<0.05). At 1 week after operation, the height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion significantly improved when compared to preoperative ones ( P<0.05), the height ratio of the anterior margin of injured vertebra and segmental kyphosis angle significantly decreased at last follow-up when compared to the values at 1 week after operation ( P<0.05), but the rate of spinal canal invasion was further significantly improved, and there was no significant difference between the two groups at different time point postoperatively. CONCLUSION UBE technique assisted spinal canal decompression combined with percutaneous pedicle screw fixation is a safe and effective treatment for lumbar burst fractures, which with little trauma and faster recovery when compared with traditional open decompression and internal fixation.
Humans ; Lumbar Vertebrae/injuries* ; Spinal Fractures/surgery* ; Fracture Fixation, Internal/instrumentation* ; Endoscopy/methods* ; Decompression, Surgical/methods* ; Pedicle Screws ; Treatment Outcome ; Retrospective Studies ; Male ; Female ; Middle Aged ; Adult

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

Pathology rotation is an important part in resident standardization training. Impor-tance should be attached to the residents' learning during the standardization training in Pathology De-partment, such as standardizing training and strict departmental rotation examination, developing the residents' thinking ability of the relationship between clinical and pathology with the main line of spe-cialty pathology learning , and improving clinical research capacity through pathology technical methods and principles, and training pathology literacy from pathology requisition filled to interpreta-tion of the pathology report, which will also help to improve the medical service quality of the hospital.

Objective To investigate the expression of CD44v3 and VEGF-C in human gastric cancers and the clinical significance. Methods The expression of CD44v3 and VEGF-C was detected by immunohistochemistry SP method in 92 gastric cancer tissues. Results Positive immunohistochemical stain for CD44v3 was identified in 27.2% of gastric cancer tissues. There was no correlation found among the expression of CD44v3 with sex, location,depth of invasion, WHO type, Lauren type as well as distant metastasis (all P ＞ 0. 05 ). The expression of CD44v3 was positively correlated with lymph node metastasis and tumor differentiation( all P ＜ 0. 05 ). Positive immunohistochemical stain for VEGF-C was identified in 48.9% of gastric cancer tissues. There was no correlation found among the expression of VEGF-C with sex,location, tumor differentiation, depth of invasion, WHO type, as well as distant metastasis ( all P ＞ 0. 05 ). The expression of VEGF-C was positively correlated with lymph node metastasis and Lauren type ( all P ＜0. 05). Cox-Regression reflected that only the lymphatic metastasis situation correlated with the life ratio( P =0. 015). Conclusion The expression of CD44v3 and VEGF-C could suggest the progression and metastatic potential value of gastric cancer,but didnt correlate with the life ratio. There was no cooperation between CD44v3 and VEGF-C in promoting gastric cancer metastasis.

OBJECTIVETo study the predictive factors that are associated with intraoperative identification of the sentinel lymph node (SLN).

METHODSLymphatic mapping using blue dye was performed in 108 patients with stage I and II operable primary breast cancer. Subsequently the patients received operations of breast cancer including axillary dissection. Clinical and histological factors were assessed to determine those that were associated with intraoperative identification of the SLN.

RESULTSThe sentinel node was identified at the time of surgery in 84 patients (77.78%). Of the clinical factors assessed, age(y) < 50 (chi(2) = 7.447, P < 0.01), tumour in the upper quadrant (chi(2) = 6.330, P < 0.05), diagnosis by preoperative biopsy (chi(2) = 5.509, P < 0.05), successful mapping of the lymphatic duct (chi(2) = 13.125, P < 0.01) were significant in identifying the sentinel node at operation. No histological factor was associated with intraoperative identification of the sentinel node.

CONCLUSIONThere are the possibility of failure of SLN identification at sentinel lymph node biopsy. Our results suggest that the best predictor of intraoperative sentinel node identification is the visualization of the lymphatic duct on mapping by blue dye. Other factors such as age, tumour site as well as diagnostic method are also important in determining the success of the procedure.

Breast Neoplasms ; pathology ; Female ; Humans ; Intraoperative Care ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Sentinel Lymph Node Biopsy

OBJECTIVE:To evaluate the safety of Chitosan DCX-16elementarily.METHODS:DCX-16was injected i.p.to observe the acute toxicity in mice.The local irritating effects were observed on tolerance test,cerato-conjunctiva and muscles stimulus test in rabbits.The cell shape and proliferative rate of3T3cells were determinated by MTT in cell culture with DCX-16.RESULTS:It showed that DCX-16had no irritation on the eyes and muscles in rabbits.Tolerance dose of DCX-16in mice was as high as3.0g/kg per day.Cell culture with DCX-16demonstrated that3T3cell's shape and growth were normal.The relative growth rate of3T3cells had no statistical difference between control and DCX-16groups on the2nd,3rd,4th day.CONCLUSION:DCX-16is safe.