ABSTRACT
Objective@#To compare the clinicopathological characteristics of second primary lung cancer following breast cancer and lung metastases from breast cancer, and then to analyze the risk factors in breast cancer patients with second primary lung tumor.@*Methods@#Clinical data of 55 breast cancer patients with second primary lung tumor and 205 breast cancer patients with solitary pulmonary metastasis in Shandong Cancer Hospital from January 2006 to January 2017 were retrospectively analyzed. The risk factors of primary lung cancer following breast cancer were analyzed using logistic regression model.@*Results@#Second primary lung cancer in patients with first breast cancer accounted for approximately 21.2%(55/260) of pulmonary malignant solitary nodules, and 0.84%(55/6 580) of all breast cancer patients. The median intervals between the diagnosis of second primary lung cancer or lung metastasis and first breast cancer were 52 months and 42 months, respectively. These two groups showed significant difference between age, time interval between diagnoses, breast tumor size, axillary lymph node metastasis, estrogen receptor, molecular subtype (luminal B and triple-negative) and history of radiotherapy (P<0.05 for all). A multivariate logistic regression model confirmed that age (OR=1.088, P<0.001), breast tumor size(OR=0.480, P<0.001), and radiotherapy history (OR=3.460, P=0.004) were all independent factors for second primary lung cancer.@*Conclusions@#For isolated pulmonary nodules in patients with breast cancer, especially for those with elder age, larger tumor size and radiotherapy history, we should distinguish the second primary lung cancer from pulmonary metastasis. The treatment regimen for lung metastasis and primary lung cancer in patients with breast cancer are entirely distinct. The timely histopathology examinations for pulmonary nodes in patients with breast cancer are recommended.
ABSTRACT
Objective To investigate prevention and treatment of cerebrospinal fluid leakage (CSFL)in anterior cervical spine surgery for severe ossification of posterior longitudinal ligament (OPLL).Methods A retrospective analysis of 47 patients with severe cervical OPLL (thickness of the ossified mass ＞ 5 mm,spinal stenosis ＞50％),who had undergone anterior cervical surgery between January 2008 and May 2011,was conducted.Fifteen cases of dural defect were found intraoperatively,including 11 males and 4 females,aged from 40 to 68 years (average,55.6 years).Preoperative CT scans were earefully analyzed.During the operation,the ossified mass was excised or floated and the arachnoid was reserved in order to reduce dural damage.Dural defects were repaired by suturing or covering with muscle.After surgery,patients were confined to bed rest to allow for drainage or puncture.Results All 15 patients were followed up for 12 to 18months (average,14.8 months).After operation,10 patients recovered fully without CSFL.Five patients developed CSFL,including 4 cases of spinal dural mater injury that healed within 4-6 days with bed rest and pressure dressing,and 1 case of cerebrospinal fluid pseudocyst that disappeared within 3 weeks with repeat puncture and aspiration treatment.No cases required secondary operations or shunt placement.All cases exhibited good neurological improvement.Conclusion During anterior surgical treatment for severe cervical OPLL,CSFL can be effectively prevented through eareful analysis of preoperative CT images,meticulous operative technique,reasonable handling of the ossified mass and positive repair of dural damage.Moreover,postoperative bed rest and drainage are effective to treat CSFL.
ABSTRACT
ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.
ABSTRACT
Objective To compare the Occurrence rate of unplanned extubation(UEX)and anastomotic leakage by two different gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma.Methods Three hundred and eighty patients were randomly divided into two groups,the experimental group(n=90),ballonet gastric tubes were used;the control group(n=90),general gastric tubes were used.The occurTence rate of unplanned extubation(UEX)and anastomotic leakage were investigated.Results There was a remarkable difference(P＜0.01)in the rate of UEX between the experimental group and the control group.Though no statistical difference was seen in the rate of anastomotic leakage(P＞0.05),lower incidence of anastomofic leakage was seen in the experimental group.Conclusions BalIonet gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma can reduce the rate of UEX,improve the nursing qualiy and also successfully reduce the rate of anastomotic leakage.
ABSTRACT
OBJECTIVE To investigate the incidence of hospital infection in surgery intensive care unit(SICU) and to provide evidence for controlling hospital infection.METHODS Managers of hospital infection entered SICU from Jan to Jun in 2007 and monitored items of inpatients who stayed more than two days,such as incidence of hospital infection,infective sites,underlying diseases,invasive operation and time in hospital.Patients had been followed up for 2 days after moving out of SICU.RESULTS In 341 cases,the total incidence of hospital infection was 19.64%(67/341).Constituent ratio:respiratory tract infection was 68.65%(46/67),and urinary tract infection was 19.4%(13/67).Incidence of hospital infection in patients older than 60 years was 48.24%(41/85)and in patients younger than 60 years was 10.16%(26/256).There was significant difference between these two groups(?2= 58.60,P
ABSTRACT
The blood supply of metatarsuses and pha-langeals in 30 cases of fetuses and infants was ob-served by microangiographic methods. The resultsdemonstrated that diaphyses and cartilages of bothends of metatarsuses and phalangeals gradually in-creased in the fetal period and appeared nourishingartery and cartilage canal. Both ends of metatar-suses and phalangeals gradually decrea.ed in the. infant period and cartilage canals gradually disap-peared also. These implied that the appearance ofcartilage canals was related to the size of cartilageblocks. Cartilage Canals were temporary bloodsystem of fetal cartilage. Characteristics of bloodsupply of metatarsuses and phalangeals: 1. Asym-metrical distribution of blood supply on metatar-suses and phalangeal, that is the blood supply ofepiphyseal end is richer than one of non--epiphy-seal end, is adapted with the difference of growthability at both ends. 2. There is distribution ofcartilage canals at the epiphyseal end of the distalphalanx, and it is adapted with having growth a-bility at the proximal end. These show that bloodsupply of metatarsuses and phalangeals is closelyrelated to their growth and development.