The lungs are the most common sites of metastases from non-pulmonarymalignancies. Endobronchial metastases are rare and have no specificity in clinical manifestations,thus being prone to misdiagnosis and delayed treatment.The common tumors associated with endobronchial metastasis are renal,breast,and colorectal cancers.This article reported one case of postoperative rectal cancer with endobronchial and lung metastases,which was relieved by high-frequency electrocautery ablation via bronchoscope,chemotherapy,and targeted drugs,aiming to provide a reference for clinical diagnosis and treatment.
Humans ; Rectal Neoplasms/pathology* ; Electrocoagulation/methods* ; Bronchial Neoplasms/drug therapy* ; Bronchoscopy ; Lung Neoplasms/secondary* ; Bronchoscopes

Hepatocellular carcinoma (HCC) is one of the most common malignancies and a leading cause of cancer-related death worldwide. Surgery remains the primary and most successful therapy option for the treatment of early- and mid-stage HCCs, but the high heterogeneity of HCC renders prognostic prediction challenging. The construction of relevant prognostic models helps to stratify the prognosis of surgically treated patients and guide personalized clinical decision-making, thereby improving patient survival rates. Currently, the prognostic assessment of HCC is based on several commonly used staging systems, such as Tumor-Node-Metastasis (TNM), Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC). Given the insufficiency of these staging systems and the aim to improve the accuracy of prognostic prediction, researchers have incorporated further prognostic factors, such as microvascular infiltration, and proposed some new prognostic models for HCC. To provide insights into the prospects of clinical oncology research, this review describes the commonly used HCC staging systems and new models proposed in recent years.
Humans ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Prognosis ; Neoplasm Staging ; Survival Rate ; Retrospective Studies

Purpose To explore the effects of ploidy analysis on thoracic neoplasms based on DNA image cytometry (DNA-ICM), and to look for a meaningful novel diagnostic assay for tumor patients. Methods 4 402 patients who were diagnosed with thoracic disease were recruited in 2 years. By the DNA-ICM analysis, all the specimens were diagnosed as three types——positive, equivocal and negative ones. The results of701 specimens were compared with biopsy and clinical followup. Results DNA aneuploidy detected by DNA-ICM were65％ in confirmed malignant samples, 64％ in equivocal malignancy, and 8％ in non-malignant diseases. The comprehensive performance of DNA-ICM in malignancy was 73％, 93％, 71％, 94％ respectively for sensitivity, specificity, positive predictive value and negative predictive value. OR analysis found that the risk ratio of aneuploidy in malignancy was 23.236 compared to non-malignancy. Conclusion DNA-ICM can be applied in thoracic malignancy and have more potential values to be explored in oncology.

With the promoting of medicine and health system reform,it provided new requirement for the price management of medical consumbles.Based on the current statns of medical consumbles price management in China,it studied the mechanism of pricing and reimbursement of Japan and Australia.To implement the price management mode of Chinese medical consumables through optimizing China medical service item package charging,playing the function of evidence-based evaluation and economic evaluation and establishing the supervision system of medical consumable prices.

Objective:To investigate the technique and efficacy of PTES for treatment of L5/S1 disc herniation.Methods:PTES was performed on 52 cases of L5/S1 herniations without spinal instability and central spinal canal stenosis,including 24 cases of high iliac crest,from November 2012 to April 2013.The operation duration,frequency of intraoperative fluoroscopy,blood loss and hospitalization days were recorded.Leg pain was evaluated by using the visual analog scale(VAS)Preoperatively and immediately,1 week,1 month,2 months,3 months,6 months,1 year and 2 years after surgery.The results were determined to be excellent,good,fair,or poor according to the Macnab classification,and complications were observed at 2-year follow-up.Objective:The mean operation duration was(56.3 ±11.5)min per segment.The median frequency of intraoperatively fluoroscopy was 5(3-14)times.The median blood loss was 5(2-20)mL.The median hospital stay was 3(2-4)days.The average postoperative follow-up was(26.2±2.0)months.The median preoperative VAS score of leg pain was 9(6-10),1(0-3)immediately after the operation and 0(0-3)2 years after operation,and the differences were statistically significant(P<0.001).There were 3 cases of lower limb rebound pain 1 week after operation,which were relieved within 2 months after operation.The rate of excellent and good curative effect was 98.1％(51/52)2 years after operation.No complications such as nerve injury,infection,abdominal organ damage and rupture of large vessels occurred.No recurrence occurred.Conclusions:PTES for L5/S1 disc herniation including the cases with high iliac crest is an easy,effective and safe technique.The method has the advantages of simple positioning,easy puncture,simple steps and less fluoroscopy,and the learning curve is not steep for surgeons.

Objective To analyze and discuss the status of fighter pilots' centrifuge training,to investigate the pilots' G tolerance and to provide reference for training program improvement.Methods One thousand and one hundred ninety-nine fighter pilots' human centrifuge training data were collected and analyzed by cross-sectional study.Pilots were classified by the training purposes that were for aeromedical qualification and competitive assessment.The up-to-standard rates were compared upon the analysis of pilots' training performance.Results In 877 pilots for aeromedical qualification,594 completed the runs of 8 G for 10 s,106 completed 9 G for 10 s.The qualification rate was 79.1％.In 180 high performance fighter pilots selected for competitive assessment,141 completed the runs of 9 G for 10 s.The qualification rate was 78.3％.In 142 second generation fighter pilots selected for competitive assessment,140 completed the runs of 7 G for 10 s.The qualification rate was 98.6％ which was significantly greater than that of the pilots for aeromedical qualification (x 2 =31.141,P ＜ 0.01) and high performance fighter pilots selected for competitive assessment (x 2 =29.318,P＜0.01).There was no difference on qualification rate between the latter two groups (x2 =0.058,P ＞0.05).The incidence of G-LOC and A-LOC was 5.0％ and 2.7％ respectively.The incidences of G-LOC (x2 =4.983,P＜0.05) and A-LOC (x2 =7.528,P＜0.05) of the pilots selected for competitive assessment were significantly greater than those of the pilots for aeromedical qualification.In 1 199 pilots,only 2 pilots (0.17％) had severe acute lumbar sprain.Conclusions Advanced anti-G methods have been adopted in our centrifuge training.The incidences of G-LOC and spinal injury induced by centrifuge training are low.The training program still needs further development and the training effectiveness should be improved.

Objective To analyze and discuss the status of fighter pilots' centrifuge training,to investigate the pilots' G tolerance and to provide reference for training program improvement.Methods One thousand and one hundred ninety-nine fighter pilots' human centrifuge training data were collected and analyzed by cross-sectional study.Pilots were classified by the training purposes that were for aeromedical qualification and competitive assessment.The up-to-standard rates were compared upon the analysis of pilots' training performance.Results In 877 pilots for aeromedical qualification,594 completed the runs of 8 G for 10 s,106 completed 9 G for 10 s.The qualification rate was 79.1％.In 180 high performance fighter pilots selected for competitive assessment,141 completed the runs of 9 G for 10 s.The qualification rate was 78.3％.In 142 second generation fighter pilots selected for competitive assessment,140 completed the runs of 7 G for 10 s.The qualification rate was 98.6％ which was significantly greater than that of the pilots for aeromedical qualification (x 2 =31.141,P ＜ 0.01) and high performance fighter pilots selected for competitive assessment (x 2 =29.318,P＜0.01).There was no difference on qualification rate between the latter two groups (x2 =0.058,P ＞0.05).The incidence of G-LOC and A-LOC was 5.0％ and 2.7％ respectively.The incidences of G-LOC (x2 =4.983,P＜0.05) and A-LOC (x2 =7.528,P＜0.05) of the pilots selected for competitive assessment were significantly greater than those of the pilots for aeromedical qualification.In 1 199 pilots,only 2 pilots (0.17％) had severe acute lumbar sprain.Conclusions Advanced anti-G methods have been adopted in our centrifuge training.The incidences of G-LOC and spinal injury induced by centrifuge training are low.The training program still needs further development and the training effectiveness should be improved.

Objective The aim of this study was to investigate the heating and facial nerve preservation in the middle fossa approach surgery for the removal of small acoustic tumor (vestibular schwannomas,VS).Methods A prospective database was established,and data were retrospectively reviewed.Between January 2004 and February 2013,13 patients with acoustic tumor underwent surgery via middle fossa approach for heating preservation.The patients consisted of six men and seven women with a mean age of 48 years.Tumor size ranged from 0.8 cm to 1.5 cm.Heating loss was categorized as American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) class A,class B,class C and class D.Facial nerve function was evaluated according to House-Brackmann (HB) Grade Ⅰ-Ⅵ.Results Grosstotal resection was accomplished in 12 of 13 patients.Preoperative heating as class A in ten,class B in two,and class C in one patient respectively.Postoperatively,heating was graded as class A in eight patients,class B in 3,and class C in 2 patients.Facial nerve function was House-Brackmann(HB) grade Ⅰ in twelve patients,grade Ⅱ in one patient preoperatively.Postoperatively,facial nerve function was HB Grade Ⅰ in twelve patients and Grade Ⅲ in one patient.The overall heating preservation rate was at least 80％ (8/10)and HB Grade Ⅰ facial nerve outcome of 100％ (12/12).All cases were followed up for 0.5 to 5 years,no complications were abserved.Conclusions The middle fossa approach for the resection of small VS with heating preservation is a viable and relatively option.It should be considered among the various options available for the management of small and growing VS.

Objective To explore the correlations of biochemical factors as gamma-aminobutyric acid (GABA) level with amino acid metabolism level in the blood, levels of intestinal immunoglobulin A (IgA)+complement factor 3 (C3), feeding intolerance and fatiguability in children with hypotonia cerebral palsy. Methods Ninety-six children with hypotonia cerebral palsy,admitted to our hospital from January 2009 to January 2012,were chosen in our study; questionnaire was used to understand the clinical symptoms of the children; the blood ammonia level,hepatic function and IgA+C3 level were obtained from routine blood chemistry testing, and amino acid metabolism was detected by blood tandem mass spectrometry; the correlations of GABA level with amino acid metabolism level in the blood, levels of IgA+C3, feeding intolerance and fatiguability were statistically analyzed. Results In all the 96 children with hypotonia cerebral palsy,63 (65.63％) had low arginine; 52 had both decreased arginine and elevated blood ammonia levels, enjoying negative correlation (r=-0.776,P=0.000); 42 had decreased arginine and reduced levels of IgA+C3 enjoying positive correlation (r=0.351,P=0.000); both decreased arginine level and feeding intolerance were noted in 47 with positive correlation (r=0.372,P=0.000).In these 96 children,30 (31.25％) had carnitine metabolism abnormality,including decreased propionyl carnitine/free carnitine or propionyl carnitine/acetylcarnitine levels in 21 (21.88％),increased hydroxyl palmitoyl carnitine/hydroxyl Palm enoyl carnitine level in 9 (9.37％),and decreased cysteine content in 3 (3.12％). Conclusion Metabolic abnormalities of arginine,carnitine and cysteine are noted in children with hypotonia cerebral palsy; a lot of exercise will consume arginine,carnitine and cysteine,which causes fatigue; children with low blood arginine content might also have increased blood ammonia level,reduced IgA+C3 level,trends of vomiting,susceptibility to infection and feeding difficulties,and therefore,children's mental state,immune function and exercise tolerance ability are affected.

Background Roux-en-Y gastric bypass (GBP) is the main surgical procedure used in type 2 diabetes.The objective of this study was to evaluate the different types of GBP in treatment of type 2 diabetes.Methods Patients with type 2 diabetes were randomly divided into two groups:those who underwent gastrojejunal loop anastomosis bypass and those who underwent gastrojejunal Roux-en-Y bypass.Blood glucose alterations,operation time,and operation complicatiors were observed.Results Gastrojejunal loop anastomosis bypass and gastrojejunal Roux-en-Y bypass were both effective in the treatment of selected patients with type 2 diabetes.Compared with gastrojejunal Roux-en-Y bypass,gastrojejunal loop anastomosis bypass had the advantages of easier implementation,shorter operation time,and fewer operation complications.Conclusions Gastrojejunal loop anastomosis is effective in treatment of type 2 diabetes.It is safe,easy to implement,and worthy of clinical popularization.