RESUMEN
Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.
RESUMEN
Objective@#To explore the clinical study of different frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia.@*Methods@#The 70 elderly schizophrenics admitted to Kangning Hospital Affiliated to Wenzhou Medical University from February 2018 to August 2019 were randomly divided into observation group (35 cases) and control group (35 cases). High frequency repetitive transcranial magnetic stimulation was used in the observation group and low frequency repetitive transcranial magnetic stimulation was used in the control group. Both groups were treated for 4 weeks. The changes of clinical global impression (CGI), positive and negative syndrome scale (PANSS), cognitive function rating scale for schizophrenia (SCoRS), scale of social-skills for psychiatric inpatients(SSPI) and serum sex hormone levels before and after treatment were compared between the two groups.@*Results@#After treatment, the CGI and PANSS scores of the two groups were lower than those before treatment [observation group:(2.43 ± 0.37) scores vs. (5.61 ± 0.58) scores, (35.73 ± 6.57) scores vs. (79.95 ± 8.98) scores, t=27.346 and 23.512; control group: (3.37 ± 0.48) scores vs. (5.49 ± 0.62) scores, (40.91 ± 8.17) scores vs. (78.64 ± 9.63) scores, t=15.996 and 17.675, P<0.05]; after treatment, the CGI and PANSS scores of the observation group were lower than those of the control group (t=9.176, 2.923, P<0.05). After treatment, the SCoRS scores of the two groups was lower than those before treatment (observation group: t=12.822, control group: t=7.402, P<0.05); after treatment, the SCoRS score of the observation group was lower than that of the control group [(27.92 ± 5.41) scores vs. (34.25 ± 6.17) scores] (t=4.564, P<0.05). The SSPI scores of the two groups increased after treatment (observation group: t=9.252; control group: t=3.671, P<0.05); after treatment, the SSPI scores of the observation group were higher than those of the control group [(35.74 ± 3.27) scores vs. (30.85 ± 2.28) scores](t=7.257, P<0.05). After treatment, the serum testosterone and prolactin levels in the two groups were higher than those before treatment (observation group: t=13.853, 15.198; control group: t=10.075 and 9.225, P<0.05); after treatment, the serum testosterone and prolactin levels in the observation group were higher than those in the control group (t=5.693 and 7.202, P<0.05).@*Conclusions@#High frequency repetitive transcranial magnetic stimulation is superior to low frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia, and the improvement of sex hormone level is superior to low frequency repetitive transcranial magnetic stimulation, and the improvement of cognitive and social functions is superior to low frequency repetitive transcranial magnetic stimulation.
RESUMEN
Objective To explore the clinical study of different frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia.Methods The 70 elderly schizophrenics admitted to Kangning Hospital Affiliated to Wenzhou Medical University from February 2018 to August 2019 were randomly divided into observation group (35 cases) and control group (35 cases).High frequency repetitive transcranial magnetic stimulation was used in the observation group and low frequency repetitive transcranial magnetic stimulation was used in the control group.Both groups were treated for 4 weeks.The changes of clinical global impression (CGI),positive and negative syndrome scale (PANSS),cognitive function rating scale for schizophrenia (SCoRS),scale of social-skills for psychiatric inpatients(SSPI) and serum sex hormone levels before and after treatment were compared between the two groups.Results After treatment,the CGI and PANSS scores of the two groups were lower than those before treatment [observation group:(2.43 ± 0.37) scores vs.(5.61 ± 0.58) scores,(35.73 ± 6.57) scores vs.(79.95 ± 8.98) scores,t =27.346 and 23.512;control group:(3.37 ± 0.48) scores vs.(5.49 ± 0.62) scores,(40.91 ± 8.17) scores vs.(78.64 ± 9.63) scores,t =15.996 and 17.675,P ＜ 0.05];after treatment,the CGI and PANSS scores of the observation group were lower than those of the control group (t =9.176,2.923,P ＜ 0.05).After treatment,the SCoRS scores of the two groups was lower than those before treatment (observation group:t =12.822,control group:t =7.402,P ＜ 0.05);after treatment,the SCoRS score of the observation group was lower than that of the control group [(27.92 ± 5.41) scores vs.(34.25 ± 6.17) scores] (t=4.564,P＜0.05).The SSPI scores of the two groups increased after treatment (observation group:t=9.252;control group:t=3.671,P＜0.05);after treatment,the SSPI scores of the observation group were higher than those of the control group [(35.74 ± 3.27) scores vs.(30.85 ± 2.28) scores](t =7.257,P ＜ 0.05).After treatment,the serum testosterone and prolactin levels in the two groups were higher than those before treatment (observation group:t =13.853,15.198;control group:t =10.075 and 9.225,P ＜ 0.05);after treatment,the serum testosterone and prolactin levels in the observation group were higher than those in the control group (t=5.693 and 7.202,P＜0.05).Conclusions High frequency repetitive transcranial magnetic stimulation is superior to low frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia,and the improvement of sex hormone level is superior to low frequency repetitive transcranial magnetic stimulation,and the improvement of cognitive and social functions is superior to low frequency repetitive transcranial magnetic stimulation.
RESUMEN
Objective To explore the safety and feasibility of vagus nerve-preserving Da Vinci robotassisted radical gastrectomy for gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 12 gastric cancer patients who underwent vagus nerve-preserving Da Vinci robotassisted radical gastrectomy at the Southwest Hospital of the Third Military Medical University from January 2015 to November 2016 were collected.All patients underwent vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer.During operation,lymph node dissection of the pyloric region,the right side of the cardia and the superior margin of the pancreas were noticed,and other surgical procedures were the same as the traditional Da Vinci robot-assisted radical gastrectomy.Observation indicators:(1) intra-and post-operative situations:surgical methods,digestive tract reconstruction,operation time,volume of intraoperative blood loss,number of lymph node dissected,results of postoperative pathological examination,recovery time of gastrointestinal function,time for liquid diet intake,duration of postoperative hospital stay,short-term surgery-related complications (postoperative bleeding,anastomotic fistula,obstruction and intra-abdominal infection);(2)follow-up situations:postoperative long-term complications (gastric retention,alkaline reflux gastritis,dumping syndrome,gallbladder disease and cholelithiasis),postoperative quality of life (diet,upper abdominal discomfort,nausea,vomiting and diarrhea),postoperative nutritional status [body weight,hemoglobin (Hb),total protein (TP),albumin (Alb)] and tumor recurrence.Follow-up using telephone interview and outpatient examination was performed up to December 2016.Telephone interview included detecting diet of patients,digestive tract symptoms and body weight.Routine blood test,liver and kidney functions,tumor markers,chest X-ray,abdominal computed tomography (CT) or color Doppler ultrasound and gastroscopy of outpatient examinations were performed to detect tumor recurrence and metastasis.Measurement data with normal distribution were represented as x±s and measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative situations:all the 12 patients underwent successful vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer,without conversion to laparoscopic surgery or open surgery,including 2 patients with D1 lymphadenectomy,2 patients with extended D1 lymphadenectomy and 8 patients with D2 lymphadenectomy.Five and 7 patients underwent respectively Billroth Ⅰ anastomosis and Billroth Ⅱ anastomosis of digestive tract reconstruction.Operation time,volume of intraoperative blood loss and number of lymph node dissected of 12 patients were (247± 34) minutes,(94 ± 23) mL and 27 ± 7,respectively.Results of postoperative pathological examination showed that distal and proximal surgical margins of 12 patients were negative and achieved R0 resection;326 lymph nodes were dissected,6 patients didn't have lymph node metastasis and 18 positive lymph nodes were detected in 6 patients.Recovery time of gastrointestinal function,time for liquid diet intake and duration of postoperative hospital stay in 12 patients were (57±14)hours,(64± 14)hours and (7.3±0.9)days,respectively.There was no occurrence of short-term surgery-related complications.(2) Follow-up situations:12 patients were followed up by telephone interview (10 receiving outpatient exaninations) for 9 months (range,1-20 months).Of 12 patients with long-term complications,2 had loss of appetite,1 had diarrhea,without occurrence of cholelithiasis,cholecystitis,gastric retention and dumping syndrome.Of 10 patients receiving outpatient examinations,body weight,Hb,TP and Alb were (56± 12) kg,(126± 10) g/L,(69.9±5.1) g/L,(43.2±3.3)g/L at 1 month postoperatively and (52±13)kg,(126±10)g/L,(72.1±2.4)g/L,(45.2±1.6)g/L at 3 months postoperatively,respectively,with negative carcinoembryonic antigen.There was no tumor recurrence and metastasis in 12 patients.Conclusion Vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy is safe and feasible for gastric cancer,which has not affected the lymph node dissection and incidence of surgeryrelated complications,and it also can improve the postoperative quality of life and maintain good nutritional status.
RESUMEN
Purpose To investigate the expression of mismatch repair proteins MLH1,MSH2,MSH6 and PMS2 and their clinical significance in colorectal cancer.Methods Immunohistochemical analysis was used to detect MLH1,MSH2,MSH6 and PMS2 protein expression in formalin-fixed paraffin-embedded tissues from 102 colorectal cancer patients,and microsatellite instability (MSI) was tested in 20 cases.The relationship between MMR protein expression and clinical pathological features was also analyzed.Results 15 cases (14.7％) had MMR protein loss.The loss rate of MLH1,MSH2,MSH6 and PMS2 protein was 12.7％ (13/102),3.9％ (4/102),4.9％ (5/102) and 10.8％ (11/102),respectively.MLH1,MSH2,MSH6 and PMS2 protein losses were not related with gender,age,tumor size,depth of invasion and lymph node metastasis (P ＞ 0.05).MLH1 and PMS2 protein losses were related to histological differentiation (P ＜0.05).MSI was detected in 10 Lynch syndrome candidates.2 cases (2.0％)of high-frequency microsatellite instability (MSI-H) were identified,and the remaining 8 cases were MSS.However,10 cases without MMR expression abnormality all showed MSI-L/MSS.Conclusion Immunohistochemical detection of MLH1,MSH2,MSH6 and PMS2 can be used as primary screening for Lynch syndrome and its combination with MSI test can effectively increase the diagnostic rate in Lynch syndrome.
RESUMEN
Objective To explore the clinical efficacy of single-port Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective descriptive study was conducted.The clinical data of the first patient in China who underwent single-port radical gastrectomy of gastric cancer using Da Vinci robotic surgical system in the Southwest Hospital of the Third Military Medical University in June 2017 were collected.Patient underwent radical gastrectomy of gastric cancer using single-port Da Vinci robotic surgical system +D2 lymph node dissection + Billroth Ⅱ anastomosis.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and patients' survival.Follow-up using outpatient examination and telephone interview was performed to detect the patients' postoperative survival up to July 2017.Results (1) Intra-and postoperative situations:patient underwent radical distal subtotal gastrectomy of gastric cancer using single-port Da Vinci robotic surgical system.Operation time and volume of intraoperative blood loss were respectively 303 minutes and 100 mL.There was no intraoperative complication.The distances from tumor to proximal margin and distal margin were 5 cm and 6 cm.Number of lymph node dissected and length of abdominal incision were 51 and 3 cm.Time of gastric tube removal,time for out-of-bed activity,time of gastrointestinal function recovery,time of drainage tube removal and postoperative pain score were 17 hours,24 hours,36 hours,36 hours and 3,respectively.Patient took a little fluid diet after gastric tube removal.There was no occurrence of postoperative complication.Results of pathological examination showed that tumor invaded deep muscular layer,with 2 positive lymph nodes in No.3 and negative proximal and distal margins.Pathological staging was pT2N1M0 (Ⅱa staging).Duration of hospital stay was 6 days.(2) Follow-up and patients' survival:patient was followed up for 1 month,with a good survival.Conclusion The single-port Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.
RESUMEN
Objective To investigate the safety and feasibility of totally Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients who underwent radical gastrectomy of gastric cancer via totally Da Vinci robotic surgical system in the Southwest Hospital of Army Medical University between June 2016 and August 2017 were collected.Surgical methods were selected according to Expert consensus on enhanced recovery after gastrectomy for gastric cancer (2016 edition).Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Followup using outpatient examination and telephone interview was performed to detect the patients' postoperative survival and tumor recurrence and metastases up to September 2017.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were represented as median (range).Results (1) Surgical and postoperative situations:30 patients underwent radical gastrectomy of gastric cancer using totally Da Vinci robotic surgical system,without conversion to laparoscopic or open surgery.Of 30 patients,21 underwent distal subtotal gastrectomy including 1 with Billroth Ⅰ anastomosis and 20 with Billroth Ⅱ anastomosis,9 underwent total gastrectomy with Roux-en-Y anastomosis.Of 30 patients,1 underwent D1 radical gastrectomy,24 underwent D2 radical gastrectomy and 5 underwent D2+ radical gastrectomy.The number of lymph node detected,length of abdominal incision,operation time and time of digestive tract reconstruction were 34±12,(4.1 ±0.5)cm,(269±52) minutes and (49±9) minutes in 30 patients,including 31 ±21,(4.0±0.9) cm,(253±61) minutes,35 minutes (1 with Billroth Ⅰ anastomosis) and (38 ± 10) minutes (20 with Billroth Ⅱ anastomosis) in 21patients undergoing distal subtotal gastrectomy and 46± 12,(4.0±0.5) cm,(325±30) minutes,(64± 12) minutes in 9 patients undergoing total gastrectomy.The volume of intraoperative blood loss,postoperative pain score,time for out-of-bed activity,time of gastrointestinal function recovery,time for fluid food intake and time of drainage tube removal were (78±43) mL,2.5±0.5,(33±8) hours,(59± 13) hours,(66± 32) hours and (64±21) hours,respectively.Of 30 patients,2 with postoperative complications were cured by conservative treatment,including 1 of left lower lobe infection and 1 of abdominal abscess.Duration of postoperative hospital stay was (7± 5)days.(2) Follow-up:30 patients were followed up for 1.0-15.0 months,with a median time of 7.5 momths.During follow-up,2 patients died of tumor recurrence at postoperative half year and 1 year,1 patient still survived with tumor recurrence and other 27 patients had tumor-free survival.Conclusion The totally Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.
RESUMEN
Objective To investigate the safety and feasibility of totally Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients who underwent radical gastrectomy of gastric cancer via totally Da Vinci robotic surgical system in the Southwest Hospital of Army Medical University between June 2016 and August 2017 were collected.Surgical methods were selected according to Expert consensus on enhanced recovery after gastrectomy for gastric cancer (2016 edition).Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Followup using outpatient examination and telephone interview was performed to detect the patients' postoperative survival and tumor recurrence and metastases up to September 2017.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were represented as median (range).Results (1) Surgical and postoperative situations:30 patients underwent radical gastrectomy of gastric cancer using totally Da Vinci robotic surgical system,without conversion to laparoscopic or open surgery.Of 30 patients,21 underwent distal subtotal gastrectomy including 1 with Billroth Ⅰ anastomosis and 20 with Billroth Ⅱ anastomosis,9 underwent total gastrectomy with Roux-en-Y anastomosis.Of 30 patients,1 underwent D1 radical gastrectomy,24 underwent D2 radical gastrectomy and 5 underwent D2+ radical gastrectomy.The number of lymph node detected,length of abdominal incision,operation time and time of digestive tract reconstruction were 34±12,(4.1 ±0.5)cm,(269±52) minutes and (49±9) minutes in 30 patients,including 31 ±21,(4.0±0.9) cm,(253±61) minutes,35 minutes (1 with Billroth Ⅰ anastomosis) and (38 ± 10) minutes (20 with Billroth Ⅱ anastomosis) in 21patients undergoing distal subtotal gastrectomy and 46± 12,(4.0±0.5) cm,(325±30) minutes,(64± 12) minutes in 9 patients undergoing total gastrectomy.The volume of intraoperative blood loss,postoperative pain score,time for out-of-bed activity,time of gastrointestinal function recovery,time for fluid food intake and time of drainage tube removal were (78±43) mL,2.5±0.5,(33±8) hours,(59± 13) hours,(66± 32) hours and (64±21) hours,respectively.Of 30 patients,2 with postoperative complications were cured by conservative treatment,including 1 of left lower lobe infection and 1 of abdominal abscess.Duration of postoperative hospital stay was (7± 5)days.(2) Follow-up:30 patients were followed up for 1.0-15.0 months,with a median time of 7.5 momths.During follow-up,2 patients died of tumor recurrence at postoperative half year and 1 year,1 patient still survived with tumor recurrence and other 27 patients had tumor-free survival.Conclusion The totally Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.
RESUMEN
@# Objective To investigate the risk factors related with chronic stuttering of children lasting more than 6 months.MethodsThe data of 109 children of 2～10 years old with chronic stuttering lasting more than 6 months and 68 children with developmental stuttering lasting less than 6 months were analyzed.ResultsThe minor symptom and escape behavior in the stuttering children group were significantly more than children in the control group. The risk factors related with chronic stuttering showed by Logistic regression analysis were as follows: care about their stuttering, not professional advice and training, the attitude of parents on stuttering, family history, incorrect rectifying methods, few family members, improper family bring-up environment.ConclusionChildren with minor symptom and escape behavior concurrent with stuttering, care about their stuttering and with family record, are susceptible to chronic stuttering. Following factors are found important to chronic stuttering: professional advice and training, the attitude of parents to stuttering, methods of parents correcting stuttering, number of family members, bring-up environment of family.