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PurposeTo evaluate the diagnostic value of multi-slice spiral CT (MSCT) in preoperative TNM staging in non-small cell lung cancer (NSCLC) by comparing with corresponding postoperative pathology.Materials and Methods Ninety-two cases of surgically resected lung cancer were included. Clinical and pathological staging were made and compared, and to evaluate the sensitivity, specificity and accuracy of the MSCT in diagnosing lymph node metastasis.Results MSCT made correct T staging in 83.7% of the cases with excellent agreement (Kappa=0.727,P<0.05). Accurate N staging was in 79.3% of the patients with acceptable agreement (Kappa=0.635,P<0.05). The TNM staging was 75.0% accurate with moderate agreement (Kappa=0.680,P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in diagnosis of lymph node metastasis were 71.1%, 85.2%, 77.1%, 80.7% and 79.3%, respectively. CT accuracy in the diagnosis of groups 4, 5, 6, 10 lymph nodes metastasis was relatively low, in which group 4 had highest false positive, and group 10 had the highest false negative.Conclusion The TNM staging of NSCLC based on MSCT scan is valuable. It can be used as the main basis to evaluate the patient's ability to choose the best treatment plan and predict the prognosis.
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Objective:To investigate the relationship between helicobacter pylori ( Hp) infection and proliferation as well as invasion of Uygur esophagus squamous cell carcinoma.Methods: Immunohistochemistry were used to detect Hp , Ki67 and MMP2 protein in 164 cases of Xinjiang Uygur esophageal squamous cell carcinoma tissue specimens.Results: The positive rates of Hp,Ki67 and MMP2 were 81.7%(134/164),67.1%(110/54) and 86.6%(142/164) respectively in 164 cases of esophageal squamous cell carcinoma.The expression of Ki67 in the Hp positive group of patients with esophageal squamous cell carcinoma were significantly higher than that in the Hp negative group and had positive correlation between them (rs=0.340,P<0.01),the expression of MMP2 in the Hp positive group were significantly higher than that in the Hp negative group and had positive correlation between them ( rs=0.739,P<0.01).Conclusion:The relationship between Xinjiang Uygur esophageal squamous cell carcinoma patients with Hp infection and cancer cell malignant degree of proliferation and invasion is close.
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BACKGROUND:Undergoing femoral head replacement in senile osteoporosis patients with intertrochanteric fracture is a chal enging problem. OBJECTIVE:To explore the clinical effect of the use of joint instal ation and fracture reduction on the treatment of unstable intertrochanteric fractures in elderly patients. METHODS:A total of 21 elderly patients with unstable intertrochanteric fractures underwent femoral head replacement. Simultaneously, we col ected clinical data of 20 elderly patients with unstable intertrochanteric fractures undergoing internal fixation of dynamic hip screw. Operation time, blood loss amount, time of walking practice after replacement, complications, and Harris score were compared between the two groups. Clinical effects in patients with femoral head replacement were observed. RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 20 months (ranged from 6 months to 36 months). After replacement, the incision was first healing. The operation time of femoral head replacement was short;blood loss amount was less;the time of walking practice was early. However, no significant difference in Harris score was detected between the two groups (P>0.05). After femoral head replacement, no infection, inversion and shift, or hip joint loose occurred. Results suggested that correct anteversion angle, eccentricity and femoral calcar size should be identified before the implementation of artificial joint replacement for the elderly femoral intertrochanteric fracture. After implantation of the prosthesis, reduction and fixation of trochanter and femoral calcar bony landmarks are simple easily operated surgery. It can reduce blood loss amount, shorten operation time and elevate clinical effects.
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Objective To evaluate the risk factors of myasthenic crisis(MC) after thymectomy for myasthenia gravis (MG) Methods A retrospective study was conducted in 84 patients with MG from July 1995 to December 2009. The following factors were evaluated: sex, age, history of preoperative myasthenic crisis, Osssrmen classification, use steroid hormones and anticholinesterase drugs before operation, operation methods, operation time, thymoma, pathology, transfusion, course of disease, postopertive lung infection,etc. Multivariate logistic regrossion analysis was used to find the predictors of postoperative myasthenic crisis. Results Twenty-four patients(28.6%) developed myasthenic crisis after thymectomy. Statistics showed that history of preoperative myasthenic crisis, Ossermen classification, operation methods, operation time were related to postoperative myasthenic crisis. Conclusion Preoperative myastheric crisis, Ossermen classification≥I b, traditional operation methods, long opertion time are the independent risk factors for myasthenic crisis after thymectomy.