A rare massive presentation of catamenial hemothorax

Catamenial hemothorax is a rare manifestation of thoracic endometriosis syndrome. It is commonly seen associated with pelvic endometriosis in nulliparous reproductive-age women. Most cases are minor and self-limiting. We present a case of a 32-year-old woman who presented with prolonged worsening dyspnea and was found to have a massive hemothorax on evaluation.     

3D-CRT 低剂量区 V5体积的大小对非小细胞肺癌患者肺功能的影响

目的：探讨3D-CRT 低剂量区 V5体积的大小对非小细胞肺癌患者肺功能的影响。方法：收集我院肿瘤科2014年4月～2015年10月收治的46例首次行三维适形放射治疗且顺利完成治疗的非小细胞肺癌患者，对每例患者分别在治疗前以及治疗后的1、3个月进行肺功能检测，分析3D-CRT 低剂量区 V5体积的大小与肺功能变化之间的关系。结果：放疗后1个月的 FEV1％、FVC％值明显高于放疗前且差异均具有显著性。放疗后1个月、3个月的 DLCO％值明显低于放疗前，且放疗前的与放疗后3个月的差异具有显著性；V5≦45％、45％55％三组放疗前后的 FEV1％值和 FVC％值比较差异均不具有显著性。V5≦45％、45％55％三组放疗前后的 DLCO％值均呈逐渐下降趋势，且 V5>55％组的放疗前后 DLCO％值比较差异具有显著性。而 V5≦45％组和45％55％时，DLCO％值降低的趋势更加显著。     

Preparing IR for COVID-19: The Singapore Experience

This paper describes country-wide special measures undertaken for interventional radiology staff during the current coronavirus disease 2019 (COVID-19) pandemic. Although each interventional radiology service around the world faces unique challenges, the principles outlined in this article will be useful when designing or strengthening individual practices and integrating them within wider hospital and national measures. Moving beyond the current outbreak, these measures will be useful for any future infectious diseases which are likely to arise.     

Epidemiologic Characteristics of Work-related Eye Injuries and Risk Factors Associated with Severe Eye Injuries: A Registry-based Multicentre Study

ABSTRACT

Purpose

Work-related eye injuries have been reported with a variety of epidemiologic and clinical characteristics. We aimed to identify epidemiologic characteristics of work-related eye injuries and risk factors associated with severe injury in a large metropolitan city.     

经鼻间歇正压通气防治早产儿呼吸窘迫综合征的临床研究

目的探讨经鼻间歇正压通气(NIPPV)在防治早产儿呼吸窘迫综合征(RDS)中的应用价值。方法选择2017年6月至2018年12月梧州市人民医院RDS早产儿90例,其中男性48例,女性42例;胎龄(29.03±0.58)周;出生体质量(996.91±98.52)g;病程(3.48±0.56)h;临床分级Ⅰ级58例,Ⅱ级32例;Apgar评分(6.85±1.06)分。依据随机数字表分为NIPPV组和持续气道正压通气(NCPAP)组,每组45例。NIPPV组给予NIPPV治疗,NCPAP组给予NCPAP治疗,若两组治疗后不能维持患儿生命体征则使用肺表面活性物质(PS)或行有创机械通气。结果NIPPV组和NCPAP组治疗12、24 h后和治疗结束时动脉血氧分压(PaO2)、氧合指数(OI)明显高于治疗前。NIPPV组治疗12、24 h后PaO2、OI明显高于NCPAP组,差异有统计学意义(P<0.05)。NIPPV组和NCPAP组治疗结束时PaO2、OI比较,差异无统计学意义(P>0.05);NIPPV组PS使用率(22.22%vs 44.44%)、有创通气率(17.78%vs 40.00%)、氧疗时间[(71.42±7.62)h vs(85.62±9.24)h]、有创通气时间[(46.78±5.32)h vs(55.27±6.14)h]、住院时间[(30.42±3.65)d vs(35.62±3.89)d]、并发症率(31.11%vs 53.33%)明显低于NCPAP组,差异有统计学意义(P<0.05)。结论NIPPV可有效改善RDS早产儿通气功能,有利于减少PS使用、有创通气及并发症,值得临床推广。     

电视辅助胸腔镜下解剖性肺切除治疗I期肺癌的临床效果

目的 探讨电视辅助胸腔镜下解剖性肺切除治疗Ⅰ期肺癌的临床效果。方法 采用回顾性研究方法,选取2015年5月至2017年1月广西医科大学附属肿瘤医院收治的I期肺癌患者84例,按照手术方法不同将患者分为两组:观察组和对照组,每组各42例。观察组患者实施电视辅助胸腔镜下解剖性肺切除术治疗,对照组患者给予传统开胸肺叶切除术治疗。比较两组患者的住院时间、切口长度、术中出血量、手术时间、1年和3年生存情况及生活质量评分(SF-36生活量表)变化。结果 观察组患者的住院时间短于对照组(6. 13±1. 46 vs. 10. 39±2. 41 d),切口长度小于对照组(4. 38±1. 09 vs. 11. 84±3. 25 cm),术中出血量少于对照组(284. 62±54. 21 vs. 397. 57±61. 49 ml),差异均具有统计学意义(P <0. 05);而两组手术时间比较(165. 28±33. 24 vs. 156. 39±30. 92 min),差异无统计学意义(P> 0. 05)。观察组患者的1、3年生存率[97. 62%(41/42)、90. 48%(38/42)]均高于对照组[88. 10%(37/42)、76. 19%(32/42)],但差异无统计学意义(P> 0. 05)。观察组患者的各项生活质量评分[精神健康(75. 42±6. 87 vs 61. 30±4. 15分)、情感职能(81. 38±7. 15 vs. 73. 49±5. 76分)、社会功能(82. 67±5. 78 vs. 75. 42±4. 35分)、一般健康状况(79. 49±6. 17 vs.70. 31±5. 04分)、精力(84. 37±5. 45 vs. 74. 13±6. 07分)、生理职能(86. 52±6. 88 vs. 76. 93±6. 42分)、躯体疼痛(83. 46±7. 49 vs. 74. 33±5. 79分)、生理功能(70. 39±4. 31 vs. 61. 38±3. 56分)]均高于对照组,且差异具有统计学意义(P <0. 05)。结论 与传统开胸肺叶切除术相比,电视辅助胸腔镜下解剖性肺切除治疗I期肺癌手术损伤更小、短期生存率更高,且有助于提高患者术后生活质量水平,这对改善患者预后有重要意义,值得临床推广应用。     

Chest wall pain following lung stereotactic body radiation therapy using 48 Gy in three fractions: A search for predictors

Purpose

Chest wall pain is an uncommon but bothersome late complication following lung stereotactic body radiation therapy. Despite numerous studies investigating predictors of chest wall pain, no clear consensus has been established for a chest wall constraint. The aim of our study was to investigate factors related to chest wall pain in a homogeneous group of patients treated at our institution.

Modern theatre design and usage: do joint replacements need laminar flow?

Since the introduction of laminar flow to theatre systems by Charnley, it has become a necessity in arthroplasty surgery. His initial work in the 1960s and 70s created improvements in terms of reducing overall rates of periprosthetic joint replacement, but it has been hard to ascertain if this stems from the laminar flow itself or improvements in asepsis and the utilization of perioperative antibiotics. The aim of this paper is therefore to establish if laminar flow is still a necessary addition to modern theatre design, particularly in joint replacement surgery, irrespective of other surgical factors. A wide variety of studies were utilized to form an objective analysis of whether laminar flow is essential to asepsis in theatre design. It explores a number of smaller earlier studies and ends with two large trials which provide evidence that laminar flow may in fact have a deleterious effect on the potential for peri-prosthetic joint infection (PJI). The article discusses potential reasons for these findings and seeks to explain them in context of overall asepsis during joint replacement surgery.     

可切除肺癌预后预测模型的构建及生存分析

目的 探讨构建的可切除肺癌预后预测模型在患者生存及预后预测中的价值。方法 选择山西省肿瘤医院2007年1月至2018年9月原发性肺癌患者2 267例,患者均行一次肺癌手术治疗,无第二原发肿瘤。选取性别、年龄、职业、肿瘤部位、病理类型、手术路径、手术方式、肿瘤分期、治疗方案为预后影响因素。采用Cox比例风险模型构建预后指数(PI)方程,计算每例患者的PI值。根据PI值的不同范围,划分低、中、高危预后组,对各组生存情况进行评估。结果 性别(RR=0.684,P=0.001)、年龄(RR=0.591,P<0.01)、职业(RR=1.439,P=0.001)、病理类型(RR=3.694,P<0.01)、手术路径(RR=0.734,P=0.001)、肿瘤分期(RR=0.352,P=0.007)为可切除肺癌患者预后独立影响因素。其中,女性、≤65岁、胸腔镜手术、肿瘤分期Ⅰ期为预后保护因素,其预后不良风险分别降低31.6%、40.9%、26.6%、64.8%;农民、腺鳞癌为预后危险因素,其预后不良风险分别增加43.9%、269.4%。PI方程为:∑βixi=-0.380 X1-0.526 X2+0.364 X31+1.307 X55-0.309 X6-1.045 X81(X1代表性别,X2代表年龄,X31代表职业为农民,X55代表病理类型为腺鳞癌,X6代表手术路径,X81代表肿瘤分期Ⅰ期)。PI<-1为低危组,PI≥-1且≤-0.5为中危组,PI>-0.5为高危组。1、3、5年生存率低危组分别为96.8%、87.0%、77.9%,中危组分别为91.8%、82.2%、61.7%,高危组分别为86.5%、61.7%、50.3%,各组间生存率差异具有统计学意义(P<0.05)。结论 可切除肺癌预后预测模型能够预测可切除肺癌患者的预后风险及相应生存率,帮助临床医师评估预后及制订后续治疗方案。