ObjectiveTo analyze the reasons for misdiagnosis of gastrointestinal metastatic ovarian cancer, in order to increase the rate of correct diagnosis and treatment, and to investigate the prognostic factors. MethodsWe retrospectively analyzed the clinical features, pathological features and prognostic factors of 43 cases of metastatic ovarian carcinoma from gastrointestinal tract treated between 2004 and 2014. ResultsGastrointestinal metastatic ovarian cancer was characterized by the diversity of clinical manifestations and lack of specific symptoms. The common initial symptom was pelvic mass, frequently accompanied with gastrointestinal symptoms of ascites, anemia or weight loss, abdominal pain, bloating, gastrointestinal obstruction and bleeding. Signs and symptoms of primary and secondary tumor sites often coexisted with each other, leading to misdiagnosis. Univariate analysis showed that primary site, histological type, surgical treatment, the residual tumor debulking size, lymph node metastasis, tumor invasion and standard chemotherapy had significant impacts on the prognosis (P < 0.05). ConclusionsGastrointestinal metastatic ovarian cancer occurs in premenopausal women, often with ascites, abdominal pelvic masses as the first symptom. Primary tumor site is often ignored, and the initial correct diagnosis rate is low. Metastasis from stomach cancer is the most common, followed by colorectal cancer and esophageal cancer. Prognosis is correlated with the primary site, histological type, degree of differentiation, depth of invasion, lymph node metastasis and other factors. Radical surgery and chemotherapy can improve survival.
【摘要】 目的 探讨抗氧化应激是否参与参附注射液预处理诱导的肾脏保护作用。 方法 健康成年雄性SD大鼠21只随机分为假手术对照组（Sham组）、肾脏缺血再灌注组（I/R组）和参附注射液组（SF组）；SF组给予参附注射液10 mL/kg腹腔注射，每日1次，连续给药7d。麻醉下行右肾切除后，用无损伤动脉夹钳夹左侧肾蒂60min，再灌注24 h，制备肾缺血再灌注损伤动物模型。比较各组SD大鼠再灌注24 h肾脏组织中超氧化物歧化酶（superonidedismutase，SOD）水平、过氧化氢酶（catalese，CAT）和丙二醛（malonicalaldehyed，MDA）含量。 结果 与Sham组相比，I/R和SF组肾脏组织SOD和CAT显著降低，而MDA明显升高（Plt;0.05）；与I/R组比，参附注射液能明显增加SOD和CAT水平（Plt;0.05），降低MDA含量（Plt;0.05）。 结论 参附注射液预处理可增强缺血再灌注损伤肾脏组织抗氧化应激，其表现为增强SOD和CAT的活力，减少MDA的生成。【Abstract】 Objective To explore the protective effect of Shenfu injection combined with antioxidant system on rats’ kidney after ischemia-reperfusion injury. Methods Twenty-one male Sprague Dawley (SD) rats were randomly divided into 3 groups: sham operation group (Sham group), ischemia-reperfusion group (IR group), and shenfu injection treated group (SF group). The rats were anesthetized with valebarbitone. Bilateral kidneys were exposed through midline incision. The right kidney underwent the nephrectomy and left renal pedicels were occluded for 60 minutes with a traumatic mini-clamp and then unclamped for 24 hours. Animals in SF group received Shenfu injection (10 mL/kg) through intraperitoneal injection every day for 7 days. About 24 hours after reperfusion, superoxide dismutase (SOD), CAT and malonical aldehyde (MDA) were measured. Results The levels of MDA were lower in SF group than those in IR group (Plt;0.05). The level of SOD and CAT in SF group increased more significantly than which did in IR group (Plt;0.05). Conclusion Our finding suggests that antioxidant system in SF group works more efficiently than IR group to overcome oxidative stress in renal ischemia-reperfusion injury.
Objective To investigate the effectiveness of pretreatment with mixture of lidocaine and flurbiprofen axetil in reducing injection pain of propofol. Methods One hundred and sixty ASI I–II patients undergoing general anaesthesia were randomly allocated into four groups (40 cases in each group): the control group, the lidocaine (Lc) group, the flurbiprofen axetil (FA) group and the mixture of lidocaine and flurbiprofen axetil (hereafter termed as “mixture”) group. After the occlusion of venous drainage, patients were pretreated with 7 mL of 0.9% saline in the control group, 5 mL (50 mg) of flurbiprofen axetil and 2 mL of 0.9% saline in the FA group, 2 mL (40 mg) of 2% lidocaine and 5 mL of 0.9% saline in the Lc group, and 5 mL (50 mg) of flurbiprofen axetil and 2 mL (40 mg) of 2% lidocaine in the mixture group, respectively. The occlusion was released 2 min later and then 0.5 mg/kg propofol was injected into the vein within 5 s. During injecting propofol, the patients were asked by another anesthetist to assess and record their pain through using VSR. Results No significant differences in the demographic characteristics were found among the four groups. In comparison with the control group, the incidence rates of propofol injection pain were obviously lower in the mixture group, the FA group and the Lc group (Plt;0.05); there was a significant reduction in the incidence rate of pain in the mixture group compared with the other three groups. The median pain score was significantly lower in the mixture group and the Lc group than that in the control group. During the 24 hour follow-up after operation, neither the adverse events such as red-swelling in injection site, phlebitis or drug eruption, nor the gastrointestinal stimulating signs were found. Conclusion The mixture of flurbiprofen axetil and lidocaine is found to be more effective in reducing injection pain of propofol.
Objective To explore the effectiveness of triple osteotomy in correcting severe hallux valgus with the first metatarsal pronation deformity. Methods A retrospective analysis was conducted on the clinical data of 29 patients (40 feet) with severe hallux valgus accompanied by the first metatarsal pronation deformity, who were admitted between January 2022 and December 2023 and met the selection criteria. There were 8 males (10 feet) and 21 females (30 feet), with an average age of 50.0 years (range, 44-62 years). The disease duration ranged from 5 to 9 years (mean, 6.5 years). All patients underwent triple osteotomy to correct the deformity. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were used to evaluate joint function and pain before and after operation. Based on pre- and post-operative X-ray films, hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured to evaluate the correction of hallux valgus; the shape classification of the lateral edge of the first metatarsal and the pronation of first metatarsal angle (PFMA) were observed to assess the correction of the first metatarsal pronation deformity. Results A superficial infection occurred in 1 foot and the incison healed after dressing change; the remaining incisions healed by first intention. All patients were followed up 12-18 months (mean, 12.6 months). Three cases (4 feet) experienced limited movement of the metatarsophalangeal joint after operation, and the joint function recovered after strengthening functional exercises. During follow-up, no recurrence of deformity or secondary metatarsal pain occurred. Compared with preoperative scores, the AOFAS score increased and the VAS score decreased at last follow-up, and the differences were significant (P<0.05). Radiographic examination showed that the osteotomy achieved bony healing, with the healing time of 2.5-6.2 months (mean, 4.1 months). The hallux valgus deformity was corrected, and the IMA, HVA, and DMAA were significantly smaller at last follow-up when compared with those before operation (P<0.05). The first metatarsal pronation deformity was also corrected; there was no R-type (R-type for pronation deformity) on the lateral edge of the first metatarsal at last follow-up, and the PFMA decreased compared with preoperative levels (P<0.05) and was corrected to the normal range. Conclusion Triple osteotomy can achieve good effectiveness for correcting severe hallux valgus with the first metatarsal pronation deformity. The functional training of the first metatarsophalangeal joint needs to be strengthened.
【Abstract】Objective To investigate the role of VEGF and its soluble VEGF receptor ( sVEGFR-1) in pathogenesis of acute lung injury ( ALI) induced by immersion in seawater after open chest trauma. Methods Sixteen hybridized adult dogs were randomly divided into control group and seawater group. The control group only suffered from open chest trauma, whereas the seawater group were exposed to seawater after open chest trauma. Blood samples were collected at the 0, 2, 4, 6, 8 h after trauma for measurement of white blood cell count, arterial blood gas, plasma osmotic pressure ( POP) , electrolyte concentration, IL-8, vWF, VEGF and sVEGFR-1 levels. The lungs tissue and BALF was collected at 8 h after trauma. Pathological changes of the lung was observed under light microscope by HE staining. Meanwhile VEGF and sVEGFR-1 levels were measured in BALF and lung tissue homogenate. Total protein concentrations in plasma and BALF were measured to calculate the pulmonary penetration index ( PPI) . Results The lung of the seawater group showed interstitial mononuclear cell and neutrophil infiltration, interstitial edema, and vascular congestion. VEGF and sVEGFR-1 were significantly increased in the plasma, while VEGF was significantly reduced in the lung tissues and BALF. The levels of IL-1β, IL-8 and vWF, just as the level of VEGF, were significantly increased in the plasma. Meanwhile, the POP and electrolyte concentration were significantly increased. In the plasma, the responses of VEGFs during the early onset of ALI induced by immersion in seawater after open chest trauma were consistent with the POP and PPI. Conclusions High plasma levels and low BALF/ lung tissue levels of VEGFs is a distinguishing characteristic during the early onset of ALI induced by immersion in seawater after open chest trauma. VEGF may be a novel biomarker which has an important role in the development of ALI.