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<p><b>OBJECTIVE</b>To investigated the characteristics and regularity of lymph node metastasis around gastric cancer in order to provide reference for standardized and optimal surgical treatment.</p><p><b>METHODS</b>A retrospective case series study was carried out on 1456 patients with gastric cancer undergoing surgical treatment at the Affiliated Tumor Hospital of Tianjin Medical University from March 2003 to August 2011. The number of harvested lymph node and metastasis status of various lymph node station were determined by routine pathological examination of specimens, including resected gastric tissue and dissected lymph node tissue, according to the 13th version of the Japanese Gastric Cancer Treatment Guidelines. Tumor T, N and M staging was performed to evaluate lymphatic metastasis status of different locations of gastric cancer according to the TNM staging criteria of the 8th edition of the American Joint Committee on Cancer (AJCC). The influence of gender, age, tumor diameter, Borrmann type, T staging and M staging, tumor differentiation degree, invasion of vessels, lymphatic vessels and nerves, radical surgical degree and other clinical factors on lymph node metastasis was analyzed.</p><p><b>RESULTS</b>A total of 1062 cases(72.9%) had lymph node metastasis in the 1456 patients with gastric cancer. A total of 9766 lymph nodes were positive for metastasis. Lymph node metastasis occurred in 11 of 44 (25.0%) patients with early gastric cancer and in 1051 of 1412 (74.4%) patients with advanced gastric cancer. The largest number of lymph node metastases was found in No.3 station [653 cases (44.8%)], followed by No.6 [437 cases(30.0%)], No.7 [345 cases (23.7%)], No.1 [304 cases (20.9%)], No.4sb [290 cases (19.9%)]. No.14v lymph node metastasis was observed in 23 cases, of whom No.6 (16 cases, 69.6%), No.8a (15 cases, 65.2%) and No.3 (12 cases, 52.2%) developed simultaneous metastasis. As for different locations of gastric cancer, stations with more lymph node metastasis in 309 patients with proximal gastric cancer were No.3 (133 cases, 43.0%), No.1 (96 cases, 31.1%), No.2 (90 cases, 29.1%) and No.7 (89 cases, 28.8%); in 144 patients with middle gastric cancer were No.3 (68 cases, 47.2%), No.6 (50 cases, 34.7%), No.7 (40 cases, 27.8%) and No.4sb (38 cases, 26.4%); in 700 patients with distal gastric cancer were No.3(287 cases, 41.0%), No.6 (265 cases, 37.8%), No.4sb (138 cases, 19.7%) and No.8a (138 cases, 19.7%); in 303 cases with diffuse-type gastric cancer were No.3 (165 cases, 54.4%), No.6 (100 cases, 33.0%), No.7 (88 cases, 29.0%), No.1 (84 cases, 27.7%) and No.4sb (72 cases, 23.8%). The incidence of lymph node skip metastasis was 7.2% (105/1456) in whole group. Positive lymph node metastasis was associated with tumor size (RR=2.016, 95%CI: 1.550-2.621, P=0.000), tumor differentiation(RR=1.631, 95%CI:1.405-1.894, P=0.000), tumor T staging (RR=1.886, 95%CI: 1.629-2.184, P=0.000), tumor M staging (RR=3.671, 95%CI:1.265-10.660, P=0.017) and radical surgery(RR=3.819, 95%CI: 2.023-7.207, P=0.000).</p><p><b>CONCLUSIONS</b>The main direction of peripheral lymph node drainage in gastric cancer is lesser curvature, and then the left gastric artery, the common hepatic artery and the peripheral lymph nodes of the celiac axis, and finally the peripheral lymph nodes of the abdominal aorta. Therefore the No.6 station lymph node adjacent to the perigastric area, the No.7, No.8 and No.9 lymph nodes should be the focus of the radical surgical dissection of gastric cancer. Tumor size, differentiation degree, invasion depth and distant metastasis have significant association with lymph node metastasis. For patients with adverse factors, radical surgery is necessary to ensure efficacy.</p>
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Objective To explore the probable mechanism of tinnitus and the accompanied symptoms us-ing RS-FMRI. Methods We recruited 10 adults with chronic tinnitus and 10 health adults for fMRI in the resting state. Then we compared the differences of regional homogeneity(REHO)maps and functional connectivity to the whole-brain maps with the auditory cortex as a region of interest between the two groups. Results The REHO maps of tinnitus group showed significant differences in the automated anatomical labeling brain map including the middle frontal_gyrus (right),superior frontal_gyrus (left),entorhinal cortex_(right),middle occipital_gyrus (right),middle occipital gyrus(bilateral),lingual gyrus(left)and cuneate lobe(left). The functional connectivity maps of tinnitus group showed significant differences in lingal_gyrus(left)of AAL brain regions. The p threshold value was<0.001 in all results. Conclusion Tinnitus may cause abnormal neural activity in several non-auditory brain regions,which may be the neurophysiological mechanism of tinnitus accompanied symptoms.
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Pituitary adenoma with cerebrospinal fluid rhinorrhea is rare clinically. In this paper, through the analysis of a pituitary adenoma patient with initial symptom of cerebrospinal fluid rhinorrhea, we look forward to provide evidence for clinical diagnosis, so that we can avoid misdiagnosis.
Subject(s)
Humans , Adenoma , Diagnosis , Cerebrospinal Fluid Rhinorrhea , Pituitary Neoplasms , DiagnosisABSTRACT
OBJECTIVE@#To evaluate the efficacy of endoscopic minitrephination combined with endoscopic frontal sinusotomy in the management of complex chronic frontal sinusitis.@*METHOD@#Twenty-six patients suffering from chronic frontal sinusitis with complex frontal drainage approach were analyzed. Eleven patients (13 sides) received endoscopic minitrephination combined with endoscopic frontal sinusotomy, while the other 15 patients (18 sides) received endoscopic frontal sinusotomy only. Postoperatively all cases were followed up to evaluate the efficacy.@*RESULT@#The ostia of frontal sinus were successfully opened in the group of patients received endoscopic minitrephination combined with endoscopic frontal sinusotomy without any complications. In the endoscopic frontal sinusotomy only group, three cases of complications were observed, one with the injury of anterior ethmoidal artery and the other two with the injury of papyraceous lamina. After 10 to 24 months of follow up postoperatively, the symptoms were relieved in all cases without recurrence. The combined surgery group with endoscopic minitrephination showed an endoscopic frontal sinus patency rate of 85%, and the endoscopic frontal sinusotomy only group exhibited an endoscopic frontal sinus patency rate of 83%.@*CONCLUSION@#Endoscopic minitrephination combined with endoscopic frontal sinusotomy is a simple, convenient, safe and effective method for management of complex chronic frontal sinusitis.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy , Follow-Up Studies , Frontal Sinus , General Surgery , Nose , General Surgery , Retrospective Studies , Trephining , MethodsABSTRACT
The case of the nodular fasciitis was with a short history and rapid growth speed. The lesion was nodular, not encapsulated. Histologically, the fibroblasts proliferated actively, with some mitoses. The reality of the nodular fasciitis is the proliferation of fibroblasts and myofibroblasts. This disease is a benign lesion. It is very important to make a different diagnosis between this lesion and sarcomas. Ultrasonography and MRI are important assistants in diagnosis of nodular fasciitis. This disease could be effectively treated by local excision with a low recurrence rate and a satisfactory prognosis.
Subject(s)
Aged , Humans , Male , Fasciitis , Head , Pathology , Neck , PathologyABSTRACT
OBJECTIVE@#To explore the management of the laryngeal injury.@*METHOD@#The forty five patients of laryngeal injury had been rescued. Twenty eight patients were treated with the tracheotomy and twenty four patients of them were treated with the laryngoplasty.@*RESULT@#All the patients were survived. Tracheostomy tube of twenty eight patients was taken away without the cicatricial structure of larynx.@*CONCLUSION@#With the reasonable management after the laryngeal injury, the injury could be cured in time without complications.