BACKGROUND: The relationship between quality of life at three months after lung cancer surgery and different surgical approaches is remains unclear. This study aimed to compare the quality of life of patients three months after uniportal and multiportal thoracoscopic lobectomy. METHODS: Data from patients who underwent lung surgery at the Department of Thoracic Surgery, Sichuan Cancer Hospital between April 2021 and October 2021 were collected. The European Organization for Research and Treatment of Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Lung Cancer 29 (EORTC QLQ-LC29) were used to collect quality of life data of the patients. Potential confounding factors in the baseline data were included in a multivariate regression model for adjustment, and the quality of life of the two groups three months postoperatively was compared with traditional clinical outcomes. RESULTS: A total of 130 lung cancer patients were included, with 57 males (43.8%) and 73 females (56.2%), and an average age of (57.1±9.5) yr. In the baseline data of the two groups, there was a statistical difference in the number of chest drainage tubes placed (P<0.001). After adjustment with the regression model, at three months postoperatively, there were no significant differences in all symptoms and functional status scores between the two groups (all P>0.05). The multiportal group had longer surgery time (120.0 min vs 85.0 min, P=0.001), postoperative hospital stay (6.0 d vs 4.0 d, P=0.020), and a higher incidence of early ≥ grade 2 complications (39.0% vs 10.1%, P=0.011) compared to the uniportal group. CONCLUSIONS Patients undergoing uniportal and multiportal thoracoscopic lobectomy have similar quality of life at three months postoperatively. The uniportal group may have certain advantages in terms of traditional clinical outcome indicators such as operation time, postoperative hospital stay, and early postoperative complications.
Male ; Female ; Humans ; Lung Neoplasms/surgery* ; Quality of Life ; Thoracic Surgery, Video-Assisted/adverse effects* ; Pneumonectomy/adverse effects* ; Postoperative Complications/surgery* ; Retrospective Studies

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Purpose Central nervous system (CNS) hemangiopericytoma (HPC) is rare in clinic and prone to misdiagnosis. This paper aims to improve the diagnostic accuracy of CNS HPC by analyzing the MRI and CT features. Materials and Methods CT and MRI appearances and pathologic features of 14 cases with surgery and pathology proved CNS HPC were analyzed retrospectively. Results There were intracranial and intraspinal lesions in 12 and 2 cases respectively. 5 cases were lobular, 4 cases irregular, and 5 cases were round or oval in shapes. On CT scan, 2 intracranial lesions showed slight hyperdensity and were avidly enhanced following contrast injection. On T1WI, 11 cases showed isointensity compared with brain white matter;on T2WI, 10 cases showed isointensity compared with brain gray matter. Marked heterogeneous enhancement was shown in 7 cases. Necrosis and cystic changes were seen in 6 cases. Flow-void sign was seen in 9 cases;9 cases were attached to meninges through narrow base. Dural tail sign was observed in 4 cases. Bone erosion was seen in 4 cases. In 5 cases with DWI scan, isointensity was shown in 4 cases and slight hyperintensity in 1 case. The density and signals in 2 cervical spine lesions were uniform with homogenous enhancement;expansive bone swelling in 1 case. Conclusion CNS HPC shows hyperdensity on CT. They present equal signal compared with white matter on T1WI and equal signal compared with grey matter on T2WI, with some void signal of vessel, and isointense on diffusion weighted images. Tumor invades adjacent skull with rare dural tail sign.

Objective To investigate CT appearances of abdominal primary malignant fibrous histiocytoma(MFH).Methods The CT characteristics,clinical features and pathological data of 1 7 patients with MFH proved pathologically were analyzed retrospectively. Results The lesions located in retroperitoneum were 6,in liver were 5,in kidney were 2,in superior mesentery was 1,in greater omentum was 1,in stomach was 1,in ileum was 1.The lesions are oval shape,lobulated,nodule shape,and the size of these lesions were large. 2 cases of MFH located in gastrointestinal tract were slightly low density,and the remaining were uneven high density due to necro-sis.In CT contrast enhanced scan,the solid portion and internal divisions showed progressive or continuous enhancement,and the nec-rosis were not enhanced in MFH located in the retroperitoneum,the greater omentum,the superior mesentery and the liver.MFH in kidney was poorly circumscribed and showed mild progressive enhancement lower than normal renal parenchyma.The stomach and ileum lesions showed uniform and continuous enhancement with normal gastrointestinal mucosa in corresponding parts.Conclusion Imaging features of retroperitoneal MFH were the same as those of interstitial tumors,and most tumors showed features of progres-sive and persistent enhancement,but have different imaging appearances with the malignant lesions in corresponding parts.

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

OBJECTIVE:To investigate the characteristics and factors of ADR caused by Chinese patent medicine(CPM)and to provide reference for rational drug use and safety evaluation in the clinic. METHODS:158 cases of ADR caused by CPM collect-ed from our hospital during Jan.2009-Dec.2014 were analyzed. RESULTS:The occurrence of ADR caused by CPM was related to patient’s age,route of administration,category of drugs,irrational drug-use and so on. The incidence of ADR in patients over the age of 60 was the highest (31.01%),the largest number of ADR were caused by intravenous injection (79.11%),ADRs were most likely caused by blood-regulating preparation and dissipate blood stasis preparation (79.75%);ADR manifested as lesion of skin and its appendents(43.01%),followed by gastro-intestinal injury(16.06%)and whole-general injury(10.36%). The severe ADR was anaphylactoid reaction;after symptomatic treatment,the prognosis is good. CONCLUSIONS:According to syndrome differentiation and individual difference,CPM should be used rationally,and great importance should be attached to drug use moni-toring to reduce the incidence of ADR.

Objective To study the characteristic findings of computer tomography (CT) and magnetic resonance imaging (MRI) in hepatobiliary cystadenocarcinoma.Methods CT,MRI and clinical data were analysed retrospectively.Plain,dynamic CT and MRI were performed in all patients.Results There were 8 patients,7 female,1 male,aged 48-74 years,with a median age of 58.Five lesions were in the left liver,and 3 lesions were in the right liver.One lesion was multilocular cysts with septations.Seven lesions were solitary.The lesions showed low or mixed density on plain CT.Two cysts showed evidence of hemorrhage,while 3 cysts showed fluid levels.There were different signal intensities in the cystic wall nodules which could appear as slightly low intensity on T1WI or slightly high intensities on T2WI.The cyst wall and septations appeared as slightly low intensity on T1WI and T2WI.The cystic fluid signal intensity changed with liquid ingredients.The nodularities showed obviously high signal intensity on DWI,and the fluid showed slightly high signal,while the cystic wall and separations showed slightly low signal intensity.On CT and MRI dynamic enhancement scanning,the nodularities showed obvious enhancement on the arterial phase,while the cystic wall and separations showed no enhancement.The nodularities showed persistent enhancement on the portal venous and delayed phases while the cystic wall and separation showed slight enhancement.Conclusions Hepatobiliary cystadenocarcinoma showed characteristic features on MSCT and MRI.MSCT combined with MR is an important method in the diagnosis and differential diagnosis of hepatobiliary cystadenocarcinoma.

OBJECTIVE: To evaluate the clinical significance of microvessel density (MVD) and investigate the relationship of Endoglin (CD105), VEGF and p53 protein and their significance of clinical pathology. METHOD: Pathologic paraffin-embedded tissues and clinic data of 40 patients with primary squamous cell carcinoma of larynx were studied. Serial sections were respectively stained with Endoglin (CD105), VEGF and p53 by immunohistochemistry and its expressions were investigated. Microvessel density (MVD) highlighted by Endoglin (CD105) were counted according to a standard protocol. RESULT: Endoglin (CD105) expression in tumour tissue was significantly higher than in normal mucosa (P < 0.05). The mean MVD value for Endoglin (CD105) was 14. 90 +/- 7.40. The mean CD105-MVD value of T3 and T4 tumours showed a significantly higher staining than that of T1 and T2 tumours; The mean CD105-MVD value of tumours with metastasis was also higher than that of tumours with no metastasis (P < 0.05); The expression of VEGF was observed in cytoplasm of tumour cell and its positive rate was 77.5% in laryngeal carcinoma, which was significantly correlated with TNM stage and pathological differentiation of laryngeal carcinoma (P < 0.05). The expression of p53 protein was mainly observed in nucleolus of tumour cell and its positive rate was 67.5%, which was significantly correlated with metastasis of lymph node. Positive relevance was found between CD105-MVD and VEGF (r = 0.641, P < 0.01); Positive relevance was also found between CD105-MVD and p53 (r = 0.534, P < 0.01). CONCLUSION Endoglin (CD105) is a marker of tumour angiogenesis for its significant associated with active angiogenesis in laryngeal carcinoma. The study shows that CD105-MVD in laryngeal carcinoma is an independent indicator of predicting invasion, metastasis and recurrence, and evaluating prognosis of malignant tumours. CD105-MVD, VEGF and p53 could be important indicators to evaluate invasion, metastasis and recurrence of laryngeal carcinoma.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Biomarkers, Tumor ; metabolism ; Endoglin ; Female ; Humans ; Laryngeal Neoplasms ; blood supply ; metabolism ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; Receptors, Cell Surface ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVE To study and evaluate the surgical management of cervical anastomotic stricture of the esophagus and its efficiency. METHODS Cervical anastomotic stricture resulted from colon by-pass for patients with esophagus stricture due to corosive in 5 cases,and gastric pull-up in 3 with esophagus carcinoma,one patient suffered serious esophagus stricture at its upper end because of previous radiation,and failed to the anastomoticplasty RESULTS All of them failed to respond to prior dilation. Anastomoticplasty was used in 6 of them,local flap,colon by-pass and jejunal free flap interposition was chosen based on the patient's situation. The operation got succeeded at its first time in seven patients,and at its second time in two cases. Normal oral feeding was restored in seven of them,and semiliguid feeding in the other two. CONCLUSION Surgical treatment is reliable in dealing with patients with problem of anastomotic stricture of the cervical esophagus.

OBJECTIVE To evaluate the clinical features of tumors primarily in the pterygopalatine fossa, and the efficiency of surgical management for these lesions. METHODS The clinical data of 7 cases with tumors primarily in the pterygopalatine fossa were retrospectively studied. Three of them were primary diseases, i.e. fibrous histiocytoma, neurofibroma and cholesteatoma. The other 4 cases were secondary tumors mainly located in pterygopalatine fossa. There were 1 case with epithelial-myoepithelial carcinoma, 1 case with adenoid cystic carcinoma , 1 case with recurrent inverted nasal papilloma, 1 case with recurrent malignant fibrous histiocytoma. Approaches to tumors in pterygopalatine fossa lesions included lateral rhinotomy, and transnasal or transantrum approaches under the nasal endoscope. RESULTS The patient suffered from adenoid cystic carcinoma developed local recurrence 4 months after operation, and extended resection of the recurrent tumor with laser was performed again. No further recurrence was found after following-up for 3 years. Neither local recurrence nor regional metastasis was found in the remaining 6 cases with a follow-up period of 2 to 4 years. The main complication was oronasal fistula. CONCLUSION CT scan or MRI is the main method to the early diagnosis of pterygopalatine fossa tumors. Lateral rhinotomy, endoscopic trasnnasal or transantrum approaches are feasible procedures to resect the tumors.