ABSTRACT
Objective:To investigate the clinical efficacy of superior hypogastric nerve block (SHNB) in relieving pelvic pain after uterine artery embolization (UAE).Methods:Totally 50 patients of UAE before the curettage of uterine incision pregnancy were selected in Affiliated Zhenjiang Fourth People′s Hospital,Jiangsu University from February 2019 to December 2020 and were randomly divided into SHNB group( n=22) and control group( n=28) using random number table. The SHNB group underwent fluoroscopy-guided SHNB before UAE, and the control group received dizocine 10 mg intramuscularly before embolization. Both groups were treated with curettage 24 h after UAE. The pain scores were evaluated by using a numerical rating scale (NRS) to compare the pain scores between the two groups atthe time period A1 (from the beginning of UAE to immediate postoperative period) and at the time period A2 (from leaving the interventional operating room to the time before curettage). Data was recorded and compared between the two groups at the time period from the beginning of UAE surgery to the time before curettage for the doses of opioids used.The differences inage and weight between the two groups were compared by independent sample t test, and the NRS score and morphine dose were compared by Mann-whitney U test. Results:All patients completed SHNB and UAE without serious complications.There was no significant difference in age and weight between the two groups ( P>0.05).The maximum pain scores in the SHNB group were lower than those in the control group at both the A1 and A2 time periods[0(0, 0.25) vs. 3.00 (2.00, 4.00), and 2.50 (0.75, 5.50) vs. 4.00 (3.25, 7.00); Z=-4.932, -2.351, P<0.05]. The equivalent dose of morphine required in the SHNB group was lower than that of the control group [0(0, 10.00) vs. 10.00 (5.00, 15.00)mg, Z=-2.247, P=0.025]. Conclusion:Fluoroscopic-guided SHNB is a safe, effective, and minimally invasive way to reduce pain and the opiate dose after UAE.
ABSTRACT
Objective To investigate the feasibility and clinical efficacy of intra-arterial infusion chemotherapy within concurrent chemoradiation therapy (CCRT)for local advanced cervical cancer (LACC:Stage Ⅰb2 - Ⅳa).Methods 42 LACC patients were treated with CCRT combining with intra-arterial infusion chemotherapy (CCRT group),and another 60 LACC patients were under-went radiotherapy alone (control group).The clinical efficacy,adverse reactions and overall survivals (OAS)were evaluated,be-tween the two groups,respectively.Results Overall response rate was 92.8% in CCRT group.Of 42 patients,24 had achieved complete response (CR)in CCRT group (57.1%).The 5-year overall survival rate in CCRT group was 76.2%,which was signifi-cantly higher than that of control group (49.3%),respectively (P =0.01).Multivariate COX proportional hazards model revealed that the clinical stage(P =0.01 6),pelvic positive lymph nodes (P =0.007)were independent factors of monitoring prognosis of LACC patients treated with CCRT combining with intra-arterial infusion chemotherapy.Conclusion CCRT with intra-arterial infu-sion chemotherapy is a safe and effective method for LCCA,and clinical stage and pelvic positive lymph node were independent fac-tors of the prognosis of patients.
ABSTRACT
Objective To explore the imaging diagnosis of chorea associated with nonketotic hyperglycemia by describing its CT and MR findings and correlating those findings with the clinical manifestations. Methods The imaging findings and clinical data from 6 patients with chorea associated with nonketotic hyperglycemia were retrospectively analyzed. All 6 patients had unenhanced CT scans, 1 also had MR imaging examination. Three of 6 patients had follow-up CT scans and 1 of 3 patients had follow-up MRimaging studies. Results CT studies of all 6 patients showed unilateral or bilateral hyperdense striatum.The putamen was involved in all 6 patients, the caudate nucleus or lateral portion of the globus pallidus were involved in 5 of all 6 patients. All 3 follow-up CT studies depicted a decreased or resolved hyperdensity of the abnormal striatum. T1-weighted MR images in 1 patient showed the hyperintense lesions of bilateral lentiform nuclei, T2-weighted MR images of the patient showed the hypointense lesions of the corresponding lentiform nuclei, and its follow-up MR images depicted invariable signal intensity of T1-weighted and T2-weighted images. In all patients, the chorea resolved within 2 to 6 days after treatment of the hyperglycemia. Conclusion The characteristic imaging findings of chorea associated with nonketotic hyperglycemia can suggest an accurate diagnosis.