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Objective: To explore the effect of enhancing the rate of programmed intermittent epidural bolus (PIEB) on the labor analgesia and the dosage of ropivacaine supplement in the lying-in women, and to provide the basis for studing labor analgesia. Methods: One hundred and twenty-six women with a singleton pregnancy received labor analgesia with PIEB method and were randonly divided into low-rate group (n=60) and high-rate group (n= 66). Epidural infusion was given the initial loading dose of 10 mL (0.09 % ropivacaine+0.4 mg · L-1 sufentanil), followed by 100 mL pulse injection pump (0.09 % ropivacaine + 0.4 mg · L-1 sufentanil). Every 60 min, intermittent bolus of 10 mL was given; the patient were administered with the rates of 100 mL · L-1 (low-rate group) or 200 mL · L-1 (high-rate group). The drug administration time of patient-controlled epidural analgesia (PCEA) was set as 5 mL, and the locking time was set as 30 min. The initial pain visual analog scale (VAS) score, duration of labor, delivery mode, supplementary amount and frequency of ropivacaine, first supplementary time of ropivacaine, a mount of PCEA pump, maternal satisfaction score, maximum sensory block level, as well as the incidence of adverse events, such as nausea and vomiting, hypotension, respiratory depression and fever of the lying-in women in the analgesia period were recorded. Results: The initial pain VAS scores, duration of labor, natural delivery rates, assisted vaginal delivery rates and cesarean section rates of the patients in two groups had no significant differences (P> 0.05). There were no significant differences in the amount and frequency of supplementary, the first supplement time of ropivacaine, the amount of PCEA pump between two groups (P> 0.05). The satisfaction scores of the lying-in women in two groups had no significantly difference (P<0.05). The highest analgesia level in two groups was T7-T8, and no adverse events, such as nausea and vomiting, hypotension, respiratory depression and fever, were observed in all the lying-in women. Conclusion: Compared with low-rate PIEB labor analgesia, the effect of labor analgesia, times of need for supplemental analgesia and the consumption of ropivacaine per hour are not improved by high-rate PIEB.
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Objective: To analyze the clinical data and surgical treatment procedures of a patient vyith rare huge serous cystadenoma of broad ligament, to clarify its diagnostic and treatment characteristics, and to explore the present situation and advantages of laparoscope in the operation of broad ligament tumor. Methods: The patient vyas admitted to hospital due to abdominal distension for 2 years and aggravated ulness for 2 months. The diagnosis result vyas pelvic and abdominal mass arising from ovarian according to the preoperative color Doppler ultrasound and physical examination. Based on the laparotomy and intraoperative rapid pathological results, the patient was diagnosed as huge serous cystadenoma of broad ligament. The location of ureter and uteri artery and vein were carefully identified during the operation and they were ligated for hemostasis at the basal part of tumor. The operation was successful Results: The ultrasonography image of the huge serous cystadenoma of broad ligament was very similar to that of large ovarian tumor. The misdiagnosis rate of ultrasound was high, and CT and MRI were important for the identification of large broad ligament tumor; the accuracy rate of preoperative diagnosis could be improved by CT and MRI Carefully blunt separation close to the tumor surface during the operation could avoid the ureteral injury. The patient recovered well and discharged from hospital. Conclusion: The symptoms of huge serous cystadenoma of broad ligament patient are lack of specificity. The accuracy rate of preoperative diagnosis should be improved in combination with the medical history and imageological findings of the patient The operation plan should be chosen reasonably and the operation should be carefully performed to avoid the occurrence of secondary injuries.
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Approximately 3% of all head and neck neoplasms originate in the parotid gland and less than 1% are oncocytic. We present the rare case of a 63-year-old woman with oncocytic carcinoma of the parotid gland with facial nerve invasion and discuss the characteristics of this rare entity. Based on the results of medical history, physical examination, computed tomography and postoperative histopathological diagnosis, oncocytic carcinoma of the parotid gland was diagnosed. Treatment involved complete parotid gland removal and right neck dissection. Adjuvant radiotherapy and chemotherapy were followed by operation. As of 9 months following surgery, no recurrence has been identified, but long-term results are undefined.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Pathology , Therapeutics , Facial Nerve , Neck Dissection , Neoplasm Recurrence, Local , Parotid Gland , Pathology , Parotid Neoplasms , Pathology , Therapeutics , Radiotherapy, Adjuvant , Tomography, X-Ray ComputedABSTRACT
Objective To analyze the expressions of osteopontin (OPN)and chemokine (CXC-subfamily)receptor 4 (CXCR4)in different ovarian tissues,and to explore the role of OPN and CXCR4 in occurrence,development and metastasis of human ovarian cancer.Methods The expressions of OPN and CXCR4 in normal ovarian tissue (n=20),benign ovarian epithelial tumor (n=20)and epithelial ovarian cancers tissues (n=40)were detected by immunohistochemical SP method,and the expression rates of OPN and CXCR4 in epithelial ovarian cancer tissue with different clinical characteristics were analyzed.Results The positive expressions rate of OPN in epithelial ovarian cancer tissue was significantly higher than those in normal ovarian tissue and benign ovarian tumor tissue, and there were significant differences in the positive expression rates of OPN between different pathological stages (G1 ,G2 ,G3 )of epithelial ovarian cancer (P 0.05).There was no positive expression of CXCR4 protein in normal ovarian tissue and benign ovarian tumor tissues , but there was positive expression in epithelial ovarian cancer tissue.Besides,the expressions of CXCR4 protein were not significantly different among different pathological grades,different clinical stages and different histological types (P > 0.05).Conclusion The OPN and CXCR4 expression levels are correlated with the degrees of malignancy in epithelial ovarian tumor,therefore the CXCR4 and OPN expression pathways may be the new targets for ovarian cancer therapy.
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Objective:To investigate the sensitivity and the specificity of scorpions amplification refractory mutation system ( ARMS) in comparing with that of direct DNA sequencing in the detection of BRAF gene mutations in patients with papillary thyroid microcarcinoma.Methods:Direct sequencing and ARMS were used simultaneously to detect BRAF mutation status in 56 patients with PTMC.Results:BRAF mutations were identified in 46 cases with a mutation rate of 82.9%by ARMS,while in 18 cases with a mutation rate of 32.1%by direct sequencing.Besides,the sensitivity of ARMS was 100%and that of direct sequencing was 39.1%.There were significant differences of both mutation rate and sensitivity between two methods ( P<0.01 ).Conclusion: Compared to direct sequencing,ARMS gains a higher sensitivity in the detection of BRAF mutations in samples with tiny lesions.
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BACKGROUND:Embryonic stem cel s have the capacity of multi-differentiation potential, and have been utilized for the therapy of acute liver injury. However, the migration and proliferation of embryonic stem cel s after transplantation remains not wel characterized. OBJECTIVE:To track the transplanted embryonic stem cel s in repairing acute liver injury by bioluminescence imaging technology. METHODS:Murine embryonic stem cel s (D3) were transducted with a construct composed of firefly luciferase, monomeric red fluorescence protein and herpes simplex virus truncated thymidine kinase triple fusion reporter genes by lentivirus system. Stable D3 embryonic stem cel s integrating three report genes were screened. The undifferentiated embryonic stem cel s or differentiated embryonic stem cel s from the 6-day-old embryoid body were transplanted into acute liver injury model of SV129 mouse through spleen, and the transplanted cel s were monitored by bioluminescence imaging technology. RESULTS AND CONCLUSION:Reverse transcription PCR results showed that the expression level of Oct-4 and Nanog was not affected in embryonic stem cel s transducted with triple fusion reporter gene compared with wild-type embryonic stem cel s. The migration process of transplanted cel s was visualized by bioluminescence imaging technology. Teratomas were found in both triple fusion-embryonic stem cel s treatment group and triple fusion-embryoid body cel s treatment group at liver, and the teratoma formation could be suppressed by ganciclovir administration because ganciclovir can react with herpes simplex virus truncated thymidine kinase and trigger cel necrosis process. Histological analysis showed that teratomas comprised tissues from al three germ layers. These results demonstrate that triple gene fusion does not affect differentiation potential of embryonic stem cel s and it is risky to utilize embryonic stem cel s for cel therapy, because it affects repair of liver injury. The therapy strategy requires further improvement and real-time visualizing of embryonic stem cel s in vivo is absolutely necessary.