经动脉药盒化疗治疗转移性黑色素瘤病人的护理

[目的]总结经动脉药盒化疗治疗转移性黑色素瘤病人的护理。[方法]对10例转移性黑色素瘤病人行动脉药盒植入术,利用动脉药盒进行化疗,并做好治疗前、中、后的护理。[结果]10例病人中1例出现化疗药物外渗终止治疗,其余均能按计划完成治疗。[结论]掌握动脉药盒植入后的护理操作方法是行动脉灌注化疗的关键,有利于治疗的顺利进行。     

Utilization of retrieved oocytes as an index of the efficiency of superovulation strategies for in-vitro fertilization treatment

An analysis of 581 in-vitro fertilization treatment cycles was carried out to determine the pattern of utilization of retrieved oocytes. Patients were divided into five groups depending on the number of retrieved oocytes. The mean fertilization rate of 57% was broadly similar amongst the groups but the proportion of retrieved oocytes that produced embryos of a quality suitable for transfer or cryopreservation (the cycle efficiency index) fell significantly with increase in the retrieved oocyte number. However, the pregnancy rate increased with the number of retrieved oocytes (13-38%). It is important to determine the point at which advantages of multifollicular development are outweighed by the potential for complications. Increased utilization of retrieved oocytes will decrease the need for production of a large number of oocytes.      

Closed blunt-trocar 5 mm-port for primary cannulation in laparoscopic surgery: A safe technique

Primary cannulation of the peritoneal cavity is a critical part of laparoscopic surgery. The aim of this study was to evaluate the safety and applicability of a direct blunt-port primary cannulation. The peritoneal cavity was accessed by direct trocar-port insertion at sites other than the umbilicus and avoiding abdominal scars. A 5-mm port with a smooth blunt tip conical trocar was employed using a closed technique. The closed blunt trocar-port technique for primary cannulation of the peritoneal cavity was applied in 503 of 524 patients (96%) who underwent laparoscopic surgery between 2002 and 2005. Some 199 patients (38%) had abdominal scars of previous surgery. There were no major complications, but minor complications occurred in 3 patients (0.6%). No bowel or retroperitoneal vascular injuries were encountered. The closed introduction of a blunt-tipped 5-mm port, conical-trocar is a simple technique for primary cannulation in laparoscopic surgery that allows safe and rapid access to the peritoneal.     

抗NMDAR脑炎血清抗NMDAR抗体阴性患者临床分析

目的 探讨血清抗N-甲基-D-天冬氨酸受体(NMDAR)抗体阴性的抗NMDAR脑炎患者的临床表现特征、治疗及其预后特点.方法 收集郑州大学第一附属医院2013-09—2019-12确诊为抗NMDAR脑炎的60例患者,根据其血清中抗NMDAR抗体的情况分为血清抗体阴性组和阳性组,分析2组临床表现特征、辅助检查、治疗及预后...     

Renal Cell Carcinoma metastasizing to Larynx: A Case Report

Renal Cell Carcinoma (RCC) is a malignant tumor occurring in 5th-6th decade of life with an increasing incidence reported in the US but stable in Europe. The metastasis of RCC to head and neck region is infrequent and very rarely seen in larynx. Very few cases of RCC metastasizing to larynx are reported in literature. We report a case of RCC in a middle aged male with metastasis to larynx, 7 years after initial diagnosis and nephrectomy. These unusual tumor metastases have unique pathobiology and route of metastasis, and there can be a long interval from initial diagnosis of primary tumor. The diagnosis of metastatic RCC in unusual locations is often not easy. Treatment options include metastasectomy, radiotherapy and systemic chemotherapy but with a poor outcome. A differential diagnosis should always be considered in metastatic head and neck tumors. The need for prompt accurate diagnosis, risk stratification at initial primary diagnosis, surveillance, and long term regular follow up is emphasized. Key words: Metastatic RCC, Laryngeal metastasis, Royal Hospital Oman, Metastatic Ca, metachronous metastasis.     

冠心病患者无症状心肌缺血阈的分析

目的：探讨冠心病患者无症状心肌缺血阈的临床意义。方法：应用24h动态心电监测，检测62例冠心病患者心肌缺血阈值、MIT的变异度、每次缺血发作持续时间和ST段最大位移，以及昼夜缺血次数。结果：共检出506次心肌缺血，93．5％在ST段压低时心率加快，夜间心肌缺血阈值较低，但缺血时间及ST段压低程度明显重于昼间。结论：心肌缺血有不同的机制，应根据情况给予不同的治疗。     

Measurement of circulating levels of VEGF-A, -C, and -D and their receptors, VEGFR-1 and -2 in gastric adenocarcinoma

AIM： TO analyze the serum levels and prognostic significance of vascular endothelial growth factor （VEGF） -A, -C, and -D, and their receptors, VEGFR-1 and -2 in gastric adenocarcinomas. METHODS： The serum levels of VEGF family members were measured in 76 control subjects and 76 patients with gastric adenocarcinoma using an enzyme-linked immunosorbent assay （ELISA）. These measurements were correlated with clinco-pathological features and survival rates. RESULTS： The serum levels of VEGF-A and its receptor, VEGFR-1, were significantly higher in patients with gastric cancer than in healthy donors （t = 2.3, P = 0.02 and t = 4.2, P 〈 0.0001, respectively）. In contrast, the serum levels of VEGF-D were significantly higher in control subjects than in patients （t = 2.9, P = 0.004）. There was no significant difference in serum levels of VEGF-C and VEGFR-2 between patients and controls. VEGF-C was associated with advanced tumor stage and presence of metastasis. VEGFR-1 was associated with metastasis, advanced overall stage,tumor differentiation and survival. VEGFR-2 levels were associated with poor tumor differentiation. There was no significant prognostic value for any of the VEGF family members or their receptors except for VEGFR-1 where high levels were associated with a poor overall survival. CONCLUSION： Serum VEGF levels vary significantly in the same cohort of patients with variable clinicopathological features and prognostic values. The simultaneous measurement of VEGF receptors levels in sera may overcome the limitations of a single biomarker assay.