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BACKGROUND@#Pulmonary sclerosing pneumocytoma (PSP) is rare benign lung tumor which usually develops in middle-aged women without typical clinical and imaging findings. PSP consists of two basic cell types (surface cubic epithelial cells and round mesenchymal cells) and four histological types (hemorrhagic, sclerotic, solid and papillary). It grows slowly, but it can metastasize to distant organs. The pathology before surgery is easily misdiagnosed. This study aims to improve clinicians' understanding of PSP by discussing the clinical characteristics of the disease.@*METHODS@#This represents a retrospective study of thirty-five patients diagnosed with pulmonary sclerosing pneumocytoma by pathological examination from January 2011 to December 2019.@*RESULTS@#A total of 35 patients in this study, 12 cases were male and 23 cases were female, the average age is 51 years old. 7 cases were discovered accidentally by physical examination or routine chest computed tomography (CT), and 28 cases were found due to symptoms such as cough, sputum, hemoptysis and chest pain. The imaging changes is mainly featured with isolated or clear circular or round-like single nodule and lump in the lungs. In this group, 12 cases underwent percutaneous lung biopsy, only 7 cases were diagnosed with PSP. A total of 28 patients underwent surgery, 24 cases underwent rapid frozen pathological biopsy, only 5 cases diagnosed with PSP. Postoperative pathological examination results shows that 1 case was diagnosed with keratotic squamous cell carcinoma with partial PSP, and the rest were diagnosed with PSP. The surgical and non-surgical patients were followed up for 1 to 8 years after discharge, and the overall recovery was good. The patients were no recurrence and metastasis on chest CT review.@*CONCLUSIONS@#PSP is a clinically rare benign lung tumor, which is more common in middle-aged women. The clinical manifestations and imaging features are lack of significance. Percutaneous lung puncture pathological examination and intraoperative rapid frozen pathological sections often leads to misdiagnosis. Final diagnosis relies on postoperative pathological work-up for most cases.
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Objective: To summarize the research progress on the nerve root sedimentation sign of lumbar spinal stenosis. Methods: The recent domestic and foreign literature in recent years was reviewed. The definition, classification, and mechanism of nerve root sedimentation sign and the relation of nerve root sedimentation sign to diagnosis and treatment of lumbar spinal stenosis were summarized. Results: Nerve root sedimentation sign is a phenomena which is found in MRI images of lumbar spine. Its mechanism is mainly increased intraoperative epidural pressure. There are two types of classification and the classification in which nerve root sedimentation sign is classified into "positive" and "negative" is widely applied. It has high sensitivity and specificity in differential diagnosis patients with severe lumbar spinal stenosis and patients with nonspecific low back pain. As for treatment, the nerve root sedimentation sign is related to the surgical disc levels. However, it's not sure if the nerve root sedimentation sign is related to surgical outcome. In addition, a positive sedimentation sign turns negative after sufficient surgical decompression and a new positive sedimentation sign after sufficient decompression surgery could be used as an indicator of new stenosis in previously operated patients. Conclusion: For lumbar spinal stenosis, the nerve root sedimentation sign can be applied as an auxiliary diagnostic indicator, as a guidance for deciding the operated disc levels, and as a postoperative indicator for evaluating the effectiveness.
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Esophageal cancer is one of the most common malignant tumors in the digestive tract. Its morbidity and mortality rates are high. Local advanced esophageal cancer relapses easily after operation and has a poor prognosis. Operation-based comprehensive treatment plays an important role in reducing the recurrence rate and increasing the survival rate. Radiotherapy is an important part of comprehensive treatment. From conventional radiotherapy two dimeusional conformal (2DCRT) to three dimensional conformal ra-diotherapy (3DCRT), intensity modulated radiation therapy (IMRT), image guide radiation therapy (IGRT), and volumetric modulated arc therapy (VMAT), radiotherapy technologies have experienced significant development. This development optimized the dose distri-bution and improved the accuracy of radiation. It has also provided a new understanding of the methods of radiotherapy, such as pre-operation radiotherapy, post-operation radiotherapy, and radiotherapy combined with chemotherapy. The progress of radiotherapy re-search on esophageal cancer is reviewed in this paper.
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Objective To determine the optimum dose of oxycodone for anesthesia when combined with propofol in the patients undergoing induced abortion.Methods Three hundred patients, aged 18-40 yr, weighing 40-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective induced abortion, were randomly divided into 6 groups (n =50 each) using a random number table: fentanyl group (group F) and different doses of oxycodone groups (Q1-5 groups).In group F, fentanyl 1 μg/kg was intravenously injected.In Q1-5 groups, oxycodone hydrochloride 20, 40, 60, 100 and 150 μg/kg were intravenously injected, respectively.Propofol 2.5 mg/kg was intravenously injected 1 min later in all the patients, and the operation was started when the eyelash reflex disappeared.The occurrence of hypotension, bradycardia, body movement and respiratory depression during operation, and nausea and vomiting within 4 h after operation were recorded.The uterine contraction pain was assessed with numerical rating scale (NRS) at 30 min, 1 h and 4 h after operation.Patient's satisfaction was evaluated at 1 and 4 h after operation.Results With the prolongation of time, NRS score was gradually increased, and the degree of patient's satisfaction was gradually decreased in group F (P＜0.05).With the prolongation of time,NRS score was gradually decreased, and the degree of patient's satisfaction was gradually increased in Q1-2 groups (P＜0.05).There was no significant difference in NRS score and degree of patient's satisfaction between Q3-5 groups (P＞0.05).Compared with group F, NRS score was significantly decreased, and the degree of patient's satisfaction was increased at 4 h after operation in Q1-5 groups (P＜0.05).Compared with Q1-2 groups, NRS score was significantly decreased at 30 min and 4 h after operation, and the degree of patient's satisfaction was increased at 4 h after operation in Q3-5 groups (P＜0.05).Among the Q1-5 groups,the incidence of respiratory depression, body movement, and nausea and vomiting was the lowest in group Q4 (P＜0.05).Conclusion When combined with propofol, the optimum dose of oxycodone for anesthesia is 100 μg/kg in the patients undergoing induced abortion.
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Objective To explore the relationship between plasma Tumor necrosis factor-alpha(TNF-α),Interleukin-6(IL-6) levels and brain edema caused by hypertensive intracerebral henorrhage.Methods 62 patients with hypertensive intrscerebral hemorrhage( the observation group) and 50 healthy persons( the control group) were selected.The expression of plasma TNF-α and IL-6 were determined by ELISA pre-therapy and 1d,3d,7d,14d after treatment in two groups;The volume of cerebral edema was measured by CT.The relationship between plasma TNF-α,IL-6 levels and brain edema caused by hypertensive intracerebral hemorrhage were analyzed.Results Before treatment,the levels of TNF-α and IL-6 in the observation group were( 15.62 ±9.49)μg/L and (67.47 ±6.31 )ng/L,which were significandy higher than(8.28 ± 3.36) μg/L and(31.02 ± 3.51 ) ng/L of the control group( t =9.17,64.28,P =0.01 ),and Spearman analysis showed that the levels of TNF-α and IL-6 were positively correlated with the volume of cerebral edema(r=0.934,P=0.02;r=0.922,P =0.026).Conclusion There was an up-regulation of TNF-α and IL-6 levels in the plasma of patients with hypertensive intracerebral hemorrhage.TNF-α and IL-6 may promote the formation of cerebral edema during the course of hypertensive intracerebral hemorrhage.