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Traditional endocrine drugs, such as bicalutamide, are the first choice for neoadjuvant therapy of prostate cancer. There are few reports on the use of new endocrine drugs in neoadjuvant therapy in China. The patient, male, 63 years old. He was admitted to the hospital for the finding of prostate space occupying. Blood PSA 53.50 ng / ml. Prostate MRI suggested that the prostate lesion broke through the left capsule, the left seminal vesicle gland was invaded, and the bladder wall was invaded. Bone scan suggested that: the left 8th posterior costal branch radioactivity was limited and increased. Prostate adenocarcinoma was diagnosed by puncture, Gleason score 4 + 4 = 8 points, and stage T 4bN 1M 1. The patient was treated with goserelin combined with enzalutamide for 3 months, and PSMA-PET CT: prostate size was normal, no significant 68Ga PSMA uptake was increased, no abnormally high Ga PSMA uptake in bones. The patient was treated with enzalutamide combined with ADT as neoadjuvant endocrine therapy, winning surgical conditions for the patient to undergo surgical resection.
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Objective:To investigate the effect of AngioJet thrombectomy on proximal iliofemoral vein thrombosis after trauma.Methods:The clinical data of patients with proximal iliofemoral vein thrombosis treated with AngioJet thrombectomy were retrospectively analyzed at Vascular Surgery Department of our hospital in 2019.Results:A total of 76 patients were enrolled. After PMT 20 patients had grade Ⅲ thrombolysis clearance(26.3%), 41 patients (53.9%) had grade Ⅱ clearance, and 15 cases (19.7%) had grade Ⅰ clearance. Thirty four cases (44.7%) of grade Ⅲ were cleared after catheter aspiration or catheter thrombolysis, 35 cases (46.1%) of grade Ⅱ, 7 cases (9.2%) of grade Ⅰ were cleared, thrombus clearance rate increased significantly ( P<0.05). Cerebral hemorrhage occurred in 1 case (1.3%), and thrombosis recurred in 2 cases (2.6%). The patency rate was 91.8% at 3 months follow-up. Conclusions:AngioJet thrombectomy is a safe and effective method for treating post-traumatic proximal iliac femoral vein thrombosis. Intraoperative application of urokinase thrombolysis, catheter aspiration and catheter-directed thrombolysis can increase thrombus clearance effect.
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Objective To investigate the effect of the endoscopic surveillance system in irrigating fluid absorption and bleeding during transurethral resection of the prostate.Methods In vitro trials,we simulated the fluid absorption and bleeding in the operation by using self-developed endoscopic surveillance system from January 2013 to June 2013.Continuous irrigation of 5 ％ mannitol solution,we extracted 5 times irrigating fluid (each time 100 ml and a total of 500 ml) in the process of irrigation and recorded absorption measurements of every time extraction rinses.At the same time,we dripped human whole blood 5 times(each time 5 ml and a total of 25 ml) in the process of irrigation and recorded the bleeding measurements.The above process was repeated three times to detect the accuracy and consistency of the endoscopic surveillance system.In clinical trials,50 cases of BPH were monitored in surgery and the biochemical index,hemodynamics,irrigating fluid absorption and bleeding were compared from October 2016 to April 2017.The included criteria contained as follow:the age of patients should be more than 50 years.The transabdominal ultrasound showed that the volume of prostate should be more than 60 ml.The maximal uroflowmetry should be less than 15ml/s.The IPSS scores should be more than 8.Based on the operative time,two groups (＜60 min and ≥ 60 min) were classified.Results We developed the endoscopic surveillance system which is original in the world.In vitro trials,the average irrigating fluid were (100.60 ± 2.07) ml,(201.00±3.39) ml,(302.00±4.67) ml,(403.60±4.39) ml and (502.40 ±7.57) ml;and the average bleeding were (5.06 ± 0.11) ml,(10.10 ± 0.16) ml,(15.04 ± 0.15) ml,(20.06 ± 0.11) ml and (25.10 ± 0.16) ml.No significant difference was observed in all groups (P ＞ 0.05).In clinical trials,we compared some preoperative and postoperative indexes.The average blood oxygen saturation were (94.46 ± 2.49) ％ and (92.39 ± 2.77) ％ (P ＜ 0.01),the average Serum sodium ion concentration were (141.05 ± 2.52) mmol/L and (138.06 ± 4.27) mmol/L(P ＜ 0.01),the average HGB were (143.50 ± 13.43) g/L and (137.04 ± 14.25) g/L(P ＜ 0.01).The average HCT were (42.05 ± 4.09) ％ and (137.04 ± 14.25) ％ (P ＜ 0.01).The average HR were (77.9 ± 7.6) beats per minute and (77.93 ± 6.93) beats per minute (P＞0.05).The MAP were (90.32 ± 9.75) mmHg and (91.07±8.96)mmHg(P＞0.05).The average serum potassium ion concentration were (4.13 ± 0.53) mmol/L and (4.09 ± 0.37) mmol/L (P ＞ 0.05).The average irrigating fluid absorption of the group less than 60 minutes and the group equal or more than 60 minutes were (401.83 ± 279.23) ml and (885.25 ± 367.68) ml (P ＜ 0.01).The average blood loss were (64.10 ±47.47) ml and (158.40 ± 65.22) ml(P ＜0.01).The preoperative and postoperative hemodynamic,blood biochemical and hematology showed difference in our trials.Irrigating fluid absorption and blood loss were positively associated with operation time.Conclusions The endoscopic surveillance system was safety and accuracy.It can offer real-time monitoring data and alarm mechanism for the surgeons that possibly improve operation safety.
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Venous thromboembolism ( VTE ) is a common vascular disease.It has become an important public health problem because of its high incidence, recurrence and mortality rate.Because the clinical symptom of VTE is relatively hidden, it is difficult to diagnose and treat it.This article focuses on the clinical diagnosis,treatment and laboratory examination of VTE.
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Objective To investigate the pathological characteristics of lymph nodes,liver and bone morrow in adult-onset still' s disease (AOSD).Methods The clinical data of three AOSD patients were collected and their biopsy of enlarged lymph nodes,liver and bone marrow were analyzed by histology and immunohistochemistry.Results In AOSD lymphadenopathy,there were high lymph node hyperplasia,partial architecture damage and an intense paracortical hyperplasia along with diffused infiltration of large immunoblasts,activated lymphocytes,Langerhans cells,histocytes,neutrophils and chronic inflammatory cells.Bone marrow biopsy showed a significant increase in the proportion of granulocytes and erythrocytes,with apparently increased segmented neutrophils.Hepatic biopsy showed hepatocellular spotty necrosis.Meanwhile,there was some infiltration of lymphocytes and neutrophils in the periportal fibrosis area.Immunohistochemical staining showed CD21 expression in lymphoid follicle remnants and B cell markers with few T markers in most of immunoblasts.Conclusion The pathological characterizations of lymph nodes,liver and bone marrow provide important clues to the diagnosis of AOSD as well as its differential diagnosis.
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Objective To summarize the experience and efficiency of coils in endovascular aortic repair.Methods From September 2008 to December 2013,48 patients received endovascular aortic repair in combination of coil embolization including abdominal aortic aneurysm in 32 patients, and aortic dissection in 16.Results Coils were successfully implanted in all cases.One patient with ruptured abdominal aortic aneurism (AAA) underwent emergency endovascular aortic repair and died of multiple organ failure the day after surgery.One patient died of pulmonary artery embolization 3 hours after TEVAR.44 patients were followed up ranging from 7 to 60 months.In AAA group, 25 patients received endovascular exclusion in combination with internal iliac artery embolization, four of them had claudication due to gluteal ischemia but without other severe complications.Post-operative CTA found endovascular thrombosis in aneurysm.In the aortic dissection group, one patient died of pulmonary infection.During the follow up, there was no AAA dissection, and AAA rupture.Post-operative CT confirmed thrombus in cavity.There were no scaffold and coil translocation and surrounding tissue injury.Conclusions Endovascular aortic repair in combination with coil embolization is a complementary treatment to aortic diseases.
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Objective To explore the relationship between abnormal copy number of mitochondrial DNA (mtDNA) and prognosis of the patients in colorectal cancer (CRC).Methods A total of 60 cases of CRC and corresponding adjacent noncancerous tissue specimens were selected.Genomic DNA was extracted.The mitochondrial ND1 gene was detected by quantitative real-time polymerase chain reaction and β-actin was set as internal control.And then the copy number of mtDNA was caculated and analyzed by t-test.The prognosis of patients was determined by Kaplan-Meier survival analysis.Results The mean mtDNA copy number of CRC tissue was 108.60±20.11,while that of the corresponding adjacent noncancerous tissues was 153.68±25.72,the former was significantly lower than that of the latter (t=10.69,P＜0.01).The rate of low mtDNA copy number in case with positive lymph nodes metastasis was higher than that in cases with negative lymph nodes metastasis (x2 =4.022,P＜0.05),however there were no obvious correlation with gender,age,pathological type,TNM stage.The survival rate of high mtDNA copy number group was higher than that of low mtDNA copy number group,however there was no statistical significance (P＞ 0.05).Conclusions mtDNA copy number of CRC was significantly lower than that of the adjacent noncancerous tissues.However the change of copy number was not correlated to the prognosis.
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Objective To study the relationship between the abnormality of mitochondrinl DNA (mtDNA) copy number and the clinical parameters and microsatellite instability (MSI) in colorectal cancer. Methods Total DNA was extracted from cancer and pericancer tissue from 50 colorectal cancer (CRC) biopsy samples. Non-ceding region sequencing was done and the copy number of mtDNA was quantitated with real-time PCR in mitochondrial NDI gene. The relationship between clinical indicators, mtMSI and mitochondrial copy number was detected. Results The mean copy number of mtDNA 312±185 in the tumor tissue was significantly lower than that 525±125 of the corresponding non-tumor tissue of these patients (P<0.001). No significant correlation was found between mtDNA copy number and other variables including age, gender, pathological type and clinical stage (P > 0. 05). However, there was a significant correlation between copy number and mtMSI (P<0.001). Conclusion There is a significant reduction of mtDNA in CRC patients, which may be caused by mtMSL