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Background: Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer, however, the understanding on this special entity of gastric cancer is still lacking. Aims: To investigate the clinical, endoscopic and pathological characteristics of crawling-type early gastric adenocarcinoma. Methods: Patients diagnosed as crawling-type early gastric adenocarcinoma in Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2021 were recruited consecutively in a retrospective study. The clinical data were reviewed, the pathological specimens were collected for immunohistochemical staining, and a telephone follow-up was conducted for prognosis analysis. Results: Fourteen patients with crawling-type early gastric adenocarcinoma and fulfilling the inclusion criteria were enrolled in the study, of them, 9 were male, 5 were female, and the mean age was 65.9 years old. No family history of gastric cancer was reported. The clinical manifestations were not specific. All patients were positive for Helicobacter pylori (Hp) infection. Tumors were more likely to occur in the middle and lower thirds of the stomach, with marked atrophic background mucosa. Macroscopically, 11 lesions were superficial-depressed (0-IIc) and 3 were superficial-flat type (0-IIb+ IIc). The color of the lesions was red. Lesions with indistinct border were observed endoscopically in 10 cases. Complete resection was achieved in all 14 patients after endoscopic submucosal dissection n=10 or surgical treatment n=4. Three submucosal and 11 intramucosal infiltration were observed pathologically. Immunohistochemical results of gastric (MUC5AC and MUC6) and intestinal (MUC2, CD10 and CDX-2) markers showed that most of the patients were mixed immunophenotype; the Ki-67 index ranged mostly between 30% and 70%. In a mean follow-up time of 38 months, all 14 patients were survived. Two patients with heterochronous early gastric cancer were found by follow-up endoscopy. Conclusions: When a superficial-depressed or superficial-flat type tumor with reddish color change and atrophic background mucosa is observed endoscopically in an Hp-positive patient, the possibility of crawling-type early gastric adenocarcinoma should be considered. Adequate preoperative evaluation should be carried out to judge the extent and depth of tumor invasion, which may guide the decision of treatment strategy. Postoperative endoscopic surveillance is recommended.
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Objective:To investigate the specific effect of minimally invasive hard channel intracranial hematoma crush suction flow on patients with cerebral hemorrhage, and to analyze the prognostic factors.Methods:A total of 80 patients with primary intracerebral hemorrhage who were treated in Bengbu First Peopl′s hospital from Aug. 2014 to Aug. 2018 were selected, with 52 males and 28 females, aged from 48 to 81 years and averaged (66.07±13.34) years. The prognosis of patients was assessed using the Bathel Index (BI), and the patients were divided into a control group (BI≥ 60 point considered a good prognosis, n=54) and an experimental group (BI<60 point considered a poor prognosis, n=26). Suspicious prognostic factors were formulated, including gender, age, average drainage time, average puncture needle indwelling time, average hospital stay, Glasgow score, time from injury to operation, bleeding volume, cause of disease, bleeding site, postoperative rebleeding to carry out univariate analysis between groups, and incorporate the difference items in univariate analysis into multivariate logistics regression analysis to explore related prognostic factors were compared by single factor analysis, and the difference items in the single factor analysis were included into the multivariate logistics regression analysis for the related prognostic factors exploring. Results:The hemorrhages was successfully cleared in all patients, and the average drainage time was (5.07±1.25) days. Mean needle retention time was (4.84 ± 1.37) d. Mean length of stay time was (15.26±1.44) days. Allpatients completed follow-up after operation. During 1 year of follow-up, 12 patients showed obvious brain atrophy, subdural broadening and effusion. All patients were followed up for 3 years, and their symptoms completely disappeared and their daily living ability recovered. No death was occured during the follow-up. According to the BI assessment results, the scores of 54 patients were ≥60, with an average score of (74.57±4.36). The scores of 26 patients were <60, with an average score of (48.24±5.12). The age, time from injury to operation and amount of blood loss of control group were significantly lower than those of experiment group, and Glasgow scores were significantly higher than those of experiment group, with statistically significant differences ( P<0.05). The percentage of patients in control group with infratentorial hemorrhage (14.81%) was significantly lower than that in experiment group (34.62%), and the rate of postoperative re-bleeding (1.85%) was significantly lower than that in experiment group (23.08%), with statistically significant differences ( P<0.05). Glasgow score was positively correlated with the prognosis of patients ( OR=3.449, P=0.005). The time from injury to operation was negatively correlated with the prognosis ( OR=0.580, P=0.023). Supratente hemorrhage was a protective factor for patient prognosis ( OR=3.813, P=0.024). Postoperative re-bleeding was correlated with the patients ( OR=19.963, P=0.008). A ROC curve was drawn with Glasgow score and the time from injury to operation. Glasgow score was selected as cut-off point at 7.5 point, with sensitivity of 96.30% and specificity of 88.46%. The time from injury to operation was selected as the cut-off point at 8.35 h, with sensitivity of 84.62% and specificity of 92.59%. Conclusion:Minimally invasive hard channel crush suction flow is effective and safe in the treatment of intracranial hematoma. The severity of cerebral hemorrhage, infratentorial hemorrhage and postoperative re-bleeding are prognostic factors.
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Objective@#To compare the surgical accuracy of the 3D printing surgical guide and traditional occlusal splint in the treatment of skeletal facial asymmetry cases.@*Methods@#12 facial asymmetric patients underwent joint orthognathic and orthodontics treatments were included in this research. In the 3D printing group (n=6) the pre-surgical CT scan for the skeleton and laser scan for the dentures were performed and 3D orthognathic procedures including Le FortⅠ and BSSRO combined with genioplasty were planned. The 3D printing surgical guides were manufactured and applied during surgeries. Another 6 cases were received same procedures by traditional occlusal splint techniques as the control group. Post-surgical CT reconstruction and 3D superimposition with pre-surgical planning was carried out for outcome comparison.@*Results@#The maximal error of maxillar was 0.65 mm and average error was less than 1 mm in 3D printing group, while the maxillary maximal error was 2.11 mm and average error was greater than 1 mm in traditional group which showed the statistical significance (P<0.05).@*Conclusions@#The usage of 3D printing surgical guide could improve the orthognathic surgical precision by controlling the jaw bone in a three-dimensional way.
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<p><b>OBJECTIVE</b>To develop a new method of presurgical nasoalveolar molding based on computer-aided design technique.</p><p><b>METHODS</b>Twenty patients(16 boys, 4 girls) with complete unilateral cleft lip and palate(UCLP) who received presurgical nasoalveolar molding were recruited as the treatment group. Twenty patients(15 boys, 5 girls) with complete UCLP who did not receive presurgical orthopedic treatment were selected as the control group. All parameters of the digital maxillary model were measured using the Rapidform XOR3 software. The statistical analysis was performed with SPSS 15.0.</p><p><b>RESULTS</b>A'-X and B-Il were reduced significantly after presurgical nasoalveolar molding. However, the mean alveolar height [F- hight (3.7 ± 1.1) mm, F'-height (4.6 ± 0.9) mm] decreased significantly after treatment(P <0.05). There were significant differences between the treatment group and the control group(P<0.05).</p><p><b>CONCLUSIONS</b>Maxillary alveolar morphology could be improved in UCLP infants treated with computer-aided presurgical nasoalveolar molding. The width of the cleft could be reduced and the maxillary midline corrected effectively. However, the alveolar height decreased significantly after the treatment.</p>
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Female , Humans , Infant , Male , Alveolar Process , Pathology , Case-Control Studies , Cleft Lip , Therapeutics , Cleft Palate , Therapeutics , Computer-Aided Design , Maxilla , Models, Anatomic , Nose , Pathology , SoftwareABSTRACT
Objective To investigate the effect of posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autogenous bone grafting using bone particles harvested from resected vertebral body in treatment of lumbar spondylolisthesis.Methods Fifty-six cases of lumbar spondylolisthesis treated from June 2005 and June 2006 were reviewed retrospectively.According to Meyerding classification,35 cases were classified as grade Ⅰslippage and 21 cases as grade Ⅱ slippage.There were 19 spondylolisthesis at L4/5 and 37 at L5-S1.After posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autologous bone grafting using particles of resected vertebral body,surgical outcome was analyzed.Results All cases achieved bone fusion without evidence of nail breakage or nerve injury.According to Macrab criteria,the results were excellent in 53 cases and good in three.Moreover,both the full reduction rate and interbody fusion rate were 100％.Conclusion Posterior pedicle screw reduction and fixation,decompressive laminectomy plus massive autogenous bone grafting is one of the ideal treatments for lumbar spondylolisthesis,for it achieves satisfactory fixation,decompression,reduction and fusion.
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Objective To investigate effects of dynamic hip screw (DHS) fixation assisted with blocking screws in treatment of intertrochanteric fracture.Methods A total of 150 patients with intertrochanteric fracture were selected as the combined treatment group,of which the patients managed by DHS intemal fixation were followed by the parallel placement of a blocking screw closely beneath the main screw for stability with its end rested on the plate.Another 87 patients managed by DHS fixation alone were determined as the control group.The surgical outcomes of the two groups were analyzed and compared.Results Good fixation without external displacement of femoral neck and cut-out of the main screw in femoral head was achieved in the combined treatment group.Also,fracture nonunion or death did not exist in the combined group.The patients in combined treatment group could take care of themselves after operation in the absence of severe pain and functional disturbance,with higher excellence rate (98.7％)than that in control group (P ＜ 0.01).Whereas,the operation failure rate was significantly lower in combined treatment group than in control group (P ＜ 0.05).Conclusion DHS fixation assisted with blocking screws is an ideal treatment of incomplete intertrochanteric fracture in medial wall of calcar femorale for it can achieve reliable fixation and definite curative effect,favor fracture healing,early functional exercise and low incidence of postoperative complications.
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Background and purpose:It was reported that erythropoietin may directly or indirectly induce the tumor cells to proliferate and result in diseases progression when recombinant human erythropoictin is used clinically in cancer-related anemia.Recently,the expression of erythropoietin-receptor(Epo-R)was detected in breast cancer.This study was done to detect the expression of Epo-R,estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(Her-2)in breast cancer,and to investigate the relationships between these indexes and the clinical significance.Methods:Sixty breast cancer patients were analyzed,the expression of Epo-R and microvascular density(MVD)were detected by immunohistochernistry,in order to clarify the relationships between the expression level of Epo-R,MVD and ER,PR,Her-2.Results:The rate of Epo-R expression was 78.3%,the mean number of positive tumor cells was 39±24,while the tissue MVD was 25±9.The expression level of Epo-R was positively correlated with the MVD.Also,the level of MVD was higher in the group of Epo-R positive than the negative,which has significant difference(t=3.4252,P＜0.001).The expression level of ER,PR has no definite relationships with Epo-R,MVD.The expression level of Her-2 was both closely associated with Epo-R,MVD.The expression level of Epo-R has an obvious relationship with clinical stage,lymph node status and the size(P＜0.001).The value of MVD was positively correlated with lymph node status,while not with clinical stage and the size.Conclusion:The expression level of Epo-R was markedly higher in breast cancer,and has a positive correlation with the tissue MVD.The expression level of Epo-R and MVD were significantly associated with Her-2,but not with ER and PR.It may contribute to clarifying the clinicopathological characteristics and prognosis of breast cancer by detecting both the expression level of Epo-R and MVD.
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Twelve cases of pelvis sarcoma around acetabulum were selected from Department of Orthopaedics, Wuxi Second Hospital, Nanjing Medical University between January 2001 and December 2007 including 5 males and 7 females, aged 51-72 years. According to pathological diagnosis, there were 3 cases of sarcoenchondroma, 2 cases of osteosarcoma, 3 cases of giant cell tumor of bone, 2 cases of adenocarcinoma, and 2 cases of osteoblastoma. According to tumor position by Enneking dividatur sectors, there were 5 cases of Ⅰsector, 4 cases of Ⅱsector, and 3 cases of Ⅲ sector. The Harris score of pre-replacement was 88.5?8.8. All cases were treated by saddle prosthetic replacement successfully, and no accidents happened. The operation time was 2.5-3.5 hours; blood volume was (1 250?407) mL. Twelve cases were followed up for 18 months (range 5-36 months). One case died of tumor metastasis and body exhaustion 5 months postoperation. Infection of incision took place in 1 case, and cured by operation with antibiotic combined with bone cement chain pearls. The Harris scores 4 months post-replacement: 6 cases were between 40-49, 3 cases between 50-59, and 3 cases between 60-69. Twelve cases could walk with double orthosis 3 months postoperation, and 3 cases could walk with single orthosis 6 months postoperation; 1 case walked with near normal walking, but major walking was bad. No artificial joint loosening or dislocation occurred. Although the joint function of major cases treated by saddle prosthetic replacement was not fairly satisfactory, it is a better treating method for malignant tumor whose limbs can be reserved and live their daily life by orthosis.
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BACKGROUND: Bioglass is a kind of bioactive material to repair the bone defect and promote the bone growth. Many studies have focused on the underlying mechanism of promoting the proliferation of osteoblasts, but no reports concerns about the human osteoblast growth cycle. OBJECTIVE: To observe the effect of bioglass on human osteoblasts growth cycle in vitro. DESIGN, TIME AND SETTING: An observation study osteoblasts growth cycle in vitro was performed in the Haematology Research Institute of Jiangsu Province and Department of Thrombus, Haematology Research Institute of Soochow University First Affiliated Hospital between October 2005 and March 2006. MATERIALS: Nine specimens of trabecular bone were harvested from femoral head following total hip replacement and other three specimens of trabecular bone were harvested from condyles of femur following total hip replacement. Bioglass conditioned medium was produced by Gibco Company (USA) and Dulbecco’s modified eagle medium (DMEM) was produced by Hangzhou Sijiqing Biological Engineering Materials Co., Ltd (China). METHODS: The ionic products of bioglass had been introduced to a cell culture medium by dissolving bioglass particles into DMEM fluid at 37 ℃ for 24 hours. The modified DMEM with ionic products of bioglass dissolution was used as the experimental medium, while the DMEM without bioglass modification was used as the control medium. The human osteoblasts isolated from trabecular bone were treated by the mediums and the time of osteoblast growth cycle was examined. Osteoblasts were treated for 7 days with two kinds of culture media. MAIN OUTCOME MEASURES: Cell growth index as determined using MTT colourimetry. The percentages of human osteoblasts at presynthetic phase, synthesis phase, post-synthesis phase were recorded by flow cytometry every day, resulting in the cell proliferation activity index, synthesis phase fraction and proliferous index. RESULTS: The concentration of Si in the bioglass conditional medium was 26.12% of the control medium (P