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Objective To explore clinical characteristics,diagnosis and treatment method after Peutz-Jeghers Syndrome (PJS) secondary malignant.Methods The clinical date of five cases with malignant tumors associated with Peutz-Jeghers syndrome from June 2014 to January 2017 were analyzed retrospectively in Beijing Friendship Hospital,Capital Medical University.The patients were followed up by phone,outpatient service,and hospitalization.The starting point of the follow-up was the visit date.The patient's death was the end point.The clinical and pathological features,therapy,and postoperative survival were observed.The follow-up deadline was May 2018.Results PJS secondary malignant patients lack clinical specificity.Two cases of five patients accepted endoscopic resection,three cases accepted surgery,and were treated with chemotherapy postoperatively,including 1 case died from tumor progression of 6 months after operation.Tumor recurrence was not found in the rest 4 cases till May 2018.Conclusions Part of the malignant polyp,endoscopic resection is feasible.When endoscopic resection is not feasible,operation treatment is needed;and postoperative adjuvant chemotherapy is needed to improve the long-term prognosis.
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Objective To introduce details of a new procedure of sleeve gastrectomy in mice by using titanium clip,and to observe whether this model has the same post-surgical metabolic effects as traditional procedure of sleeve gastrectomy in mice by using running stitch.Methods Thirt-one male FVB-Tg (NPY-hrGFP) mice,6 weeks (29-31 g) were randomly divided into SG (running stitch) group (n =8),SG (titanium clip) group (n =15) and Sham Operation (SO) group (n =8) by using random number table.Titanium clip was applied to close the side incision of stomachin SG (titanium clip) group,while running stitch was used in SG (running stitch) group which was detailed described in current references.Ligaments around stomach were detached without any stomach incision in SO group.Operation duration,mortality,and changes of post-surgical body weight and food intake were observed.Measured data were expressed as mean ± standard deviation ((x) ± s).Independent sample t test was used for comparison between the two groups.The variance of the data between the three groups was equal and analysis of variance (least significant LSD method) was used to compare each group.Preoperative and postoperative data were compared using a paired t test.Results Operation duration of SG (running stitch) group and SG (titanium clip) group were (44.60 ± 3.13) min and (28.25 ± 2.77) min,respectively.Compared with SG (running stitch) group,operation duration was significantly reduced in SG (titanium clip) group (P ≤ 0.01).Mortality of SG (running stitch) group and SG (titanium clip) group were 37.5％ and 20％,respectively,which has no significant difference (P =0.621).Compared with SO group,postoperative food intake was significantly reduced in both two SG groups (P ≤ 0.01),but there's no difference between two SG groups (P =0.149).At the end of the 6-week-postoperative,body weights of SG (running stitch) group and SG (titanium clip) group were reduced (17.67 ± 5.06) ％ and (18.76 ± 7.87) ％,respectively,while body weight of SO group increased (7.17 ± 2.31)％.Compared with SO group,postoperative change of body weight was significantly reduced in both two SG groups (P≤ 0.0 1),but there's no difference between two SG groups (P =0.746).Conclusions SG by using titanium clip in mice can reduce food intake and body weight as traditional SG by using running stitch does.But with shorter operation duration,this new model of SG in mice can provide a better and stable surgical model in research of mechanism of SG.
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Objective To investigate the clinical efficacy and safety of ziprasidone and risperidone in the treatment of schizophrenia.Methods According to the digital table,64 patients with schizophrenia were randomly divided into the two groups,32 cases in each group.The control group was given risperidone for treatment,while the observation group was given ziprasidone for treatment.The clinical efficacy was assessed by using the positive and negative symptom scale(PANSS),and adverse events were observed.Results The total effective rates of the control group and the observation group were 84.38％ and 87.50％,there was no significant difference between the two groups(x2 =2.66,P ＞ 0.05);The PANSS score and each factor score of the two groups after treatment decreased significantly than before treatment (t =8.11,7.86,7.72,7.90,6.77,6.58,7.52,7.40,all P ＜ 0.05),but there was no significant difference between the two groups (t =2.18,P ＞ 0.05) ;The incidence rate of adverse reaction of the observation group was 18.75％,which was significantly lower than 40.63％ of the control group (x2 =8.66,P ＜0.05).Conclusion Ziprasidone has therapeutic equivalence with risperidone in the treatment of schizophrenia,with less adverse reaction,high security,it has good clinical application value.
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ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.
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About 5％- 15％ patients suffered from gallbladder stones may have secondary bile duct stones.How to diagnose secondary bile duct stones in time preoperatively or intraoperatively has been a focus of research.In this paper,the advantages and disadvantages of a variety of diagnostic methods of secondary bile duct stones including B ultrasonography,computed tomography,percutaneous transhepatic cholangiography,endoscopic retrograde cholangiopancreatography,endoscopic ultrasonography,magnetic resonanced cholangiopancreatography,intraoperative cholangiography,intraoperative ultrasonography,choledochoscope,are reviewed.
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Objective To investigate the diagnosis and treatment of pancreatic cystic tumors. Methods The clinical data of 35 patients with pancreatic cystic tumors were retrospectively analyzed. Results The preoperative diagnosis rate was as follows: ultrasound was 28.6% ( 10/35 ), CT 44.4% ( 12/27 ), MRI 70% (7/10). Twenty-eight cases underwent operation and were diagnosed finally by postoperative pathology. Serous cystic neoplasm (SCN) was found in 2 cases, mucinous cystic neoplasm (MCN) in 9 cases,cystic adenocarcinoma in 7 cases, intraductal papillary mucinous neoplasm ( IPMN ) in 3 cases, solid pseudopapillary tumor (SPT) in 7 cases. Twenty-three cases were followed up successfully. The post-operative 5 years survival rate was 62.5% (5/8) in pancreatic cystic adenoma without recurrence. The longest survival time in cystic adenocarcinoma after complete resection was 5 years and 8 months, while in which after incomplete resection was 6 months. The 4 cases of SPT are all alive, and one of them has survived for 4 years as the longest one. Conclusions It is difficult to diagnose the pancreatic cystic neoplasm accurately before operation. CT and MRI may be helpful to make the diagnosis. Surgical resection is the most effective treatment. The enhancement of the communication and cooperation between the related departments, the early diagnosis, and the appropriate operation are needed to improve the diagnostic and therapeutic efficacy.