ABSTRACT
Objective To discuss the anatomical characteristics of the syndesmotic ligament based on MRI images, and to provide anatomical basis for clinical syndesmotic ligament injury and ligament reconstruction. Methods Totally 228 cases of MRI data from diseased person enrolled in the Orthopedics and Traumatology Department of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2010 to May 2021 were retrospectively studied. Measurement of corresponding geometrical data of the ligaments in syndesmosis were analysed. Results The average length of the syndesmosis anterior ligament was (9. 75±3. 54) mm, the average width (7. 27±3. 09) mm, and the average thickness (2. 50± 0. 93 ) mm. The angle with the horizontal plane was ( 47. 49 ± 14. 60) ° ; The average length of the posterior syndesmosis ligament of the lower tibia and fibula was (8. 94±2. 43) mm, the average width was (6. 70±2. 80) mm, the average thickness was (2. 32±1. 10) mm, and the angle with the horizontal plane was (40. 84±13. 13)°; the average length of the inferior transverse ligament was (9. 81±3. 21) mm, the average width was (2. 28±1. 51) mm, and the angle with the horizontal plane was 14. 59° ± 8. 02°; the average length of the inferior tibiofibular syndesmosis interosseous ligament was (12. 92±4. 77) mm, and the average width was (3. 28±1.99) mm. The anatomical data of the anterior, posterior, inferior transverse, and interosseous ligaments of the lower tibiofibular syndesmosis, male and female, were compared, and the differences were not statistically significant. Conclusion Studying the anatomical structures and characteristics of the syndesmotic ligament and analyzing the effect of the syndesmotic ligament on the stability of the ankle joint can offer effective diagnostic means or suggestions of syndesmosis injuries in the clinically diagnose and treat.
ABSTRACT
Triple-negative breast cancer (TNBC) is not amenable to current targeted therapies and carries a poor prognosis; however, a specific systemic regimen cannot yet be recommended. The optimal duration of oxaliplatin (OXA) and S-1 combinatorial chemotherapy in patients with advanced breast cancer is not currently known and is likely to be patient-specific based on efficacy and toxicity. In the present study, 52 patients with advanced TNBC received OXA and S-1 chemotherapy. The efficacy and toxicity were observed. The results showed that the median number of regimens was 4 (range 2-6). The therapeutic efficacy was evaluated in all patients. The complete response, partial response, overall response and disease control rates were 3.8, 30.8, 34.6 and 69.2%, respectively. Four patients were lost to follow-up, and the median follow-up time was 13.7 months. The median progression-free survival time was 6.7 months [95% confidence interval (CI), 4.5-9.0] and the median overall survival (OS) time was 13.3 months (95% CI, 9.1-17.5). From the subgroup analysis, it was found that the median OS time of patients with stage IV disease and ≥2 metastases was significantly shorter than that of patients with stage IIIC disease and only 1 metastasis [11.3 vs. 22.7 months, P=0.010 (stage IV vs. stage IIC); 11.3 vs. 15.7 months, P=0.048 (≥2 vs. 1 metastasis)]. The main grade 3/4 toxic effects were neutropenia (11.5%), nausea (7.7%) and nerve toxicity (3.8%). The other toxic effects were mainly of grades 1-2 and included diarrhea, liver dysfunction, stomatitis, anemia and hand-foot syndrome. In conclusion, OXA combined with S-1 is an effective and tolerable regimen for the treatment of patients with advanced TNBC.
ABSTRACT
OBJECTIVE: To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain. METHODS: Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment. RESULTS: In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P> 0.05). Baseline pain score of patients with moderate pain in treatment and control group was 4.9±0.8 and 5.1±0.8, respectively; and decreased to 1.8±1.1 and 1.2±1.1 after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P =0.028). Average daily consumption of oxycodone prolonged- release tablets was (54.0±19.6) mg and (44.7± 18.7) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were 8.3±1.1 and 8.3±1.1, respectively; and pain intensity after treatment decreased to 2.9±1.0 and 2.3±1.0. Pain intensity was significantly reduced in the treatment group, with statistical significance (P =0.026). Average daily consumption of oxycodone prolonged-release tablets was (132.0±42.2) mg and (110.7±33.9) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026). CONCLUSION: Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.
