Cumulative Recurrence Rate and Risk Factors for Recurrent Abdominal Wall Endometriosis after Surgical Treatment in a Single Institution

PurposeThis study aimed to evaluate the cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis (AWE) after surgical treatment.Materials and MethodsA retrospective cohort study was conducted at a single gynecological surgery center between January 2004 and December 2020. Patients who were surgically treated and followed up for at least 6 months after surgery were selected.ResultsEighteen patients with pathologically diagnosed AWE were included in this study. The median follow-up duration was 22.5 months (range, 6–106). The median age was 37 years (range, 22–48), and 33.3% of the patients were nulliparous. Among the patients included in our study, 55.6% complained of a mass with cyclic pain, and 27.8% had a palpable mass. In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence. The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively. There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment.ConclusionThe recurrence rate of AWE appears to be correlated with the follow-up duration. There was no statistically significant risk factor for the recurrence of AWE. Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE. The findings of the current study may help healthcare providers in counselling and managing patients with AWE.     

肾细胞癌转移灶局部干预的评估：M.R.C.C评分系统

目的：本研究提出一个标准化的评分系统来评估转移性肾细胞癌的临床状况,并根据该评分系统评估对肾细胞癌转移灶进行局部干预的效果。方法：回顾性分析本中心按照M.R.C.C评分应进行局部干预的转移性肾细胞癌患者的临床资料,按是否干预,将所有应干预的患者分为两组,比较其生活质量和肿瘤特异性生存时间。结果：干预组的癌痛评分显著低于非干预组,生活质量评分显著高于非干预组,干预组肿瘤特异性生存时间较非干预组显著延长。结论：M.R.C.C评分系统可以有效评估对肾细胞癌转移灶进行局部干预的必要性及可行性,按照评分要求进行局部干预可以提高转移性肾癌患者的生活质量并延长患者的生存。     

Developing an Institutional Protocol Guideline for Laparoscopy-Assisted Distal Gastrectomy

Background  The technical difficulty of lymph node dissection in laparoscopy-assisted distal gastrectomy (LADG) remains a barrier for extending the indication for this modality and limits its widespread clinical practice. The aim of this study was to evaluate our institutional guidelines for LADG, limiting the indications for this modality to only clinical stage T1N0 or T1N1 gastric cancer. Methods  From January 2002 to October 2006, a total of 294 cases of LADG and 664 cases of open distal gastrectomy (ODG) for clinical T1N0 or T1N1 gastric cancer were performed at the National Cancer Center, Korea. The two groups’ clinicopathologic characteristics, surgical outcome, morbidity, and survival were compared. Results  The mean operating time for the LADG group was significantly longer than that for the ODG group (265.8 ± 56.3 vs. 171.4 ± 43.1 minutes, P < .001). The mean number of retrieved lymph nodes in the LADG group was higher than that of the ODG group (39.5 ± 14.7 vs. 37.2 ± 12.9, P = .017). The postoperative hospital stay was shorter in the LADG group (8.0 ± 3.3 vs. 10.5 ± 4.1 days, P < .001). The complications rate was lower for the LADG group than that for the ODG group (6.8% vs. 11.3%, P = .032). The overall survival rate was not significantly different between the two groups (P = .880). Conclusions  Before considering expanding the indications for LADG, developing a carefully thought-out guideline and conducting an audit are mandatory.     

Surgical Complications and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer

Background Information on surgical complications of laparoscopy-assisted distal gastrectomy (LADG) and their risk factors is limited in the literature despite increasing popularity of this procedure. This study was performed to identify the surgical complications and their associated risk factors of LADG in early gastric cancer. Methods LADG was performed in 347 gastric cancer patients from January 2002 to December 2006 at the Korean National Cancer Center by four surgeons with ample experience of open gastric surgery before LADG. LADG indications for cases of gastric cancer at our institution are preoperatively diagnosed cT1N0 or cT1N1, except in cases with an absolute indication for endoscopic resection. Lymph node dissection of more than D1 + β was performed in all patients. Intraoperative and postoperative complications were reviewed and their risk factors were retrospectively analyzed by prospective database information. Results Forty complications occurred in 34 patients (9.8%), but there was no mortality. Intraoperative complications occurred in nine patients (2.6%), and open conversion was performed in eight (2.3%) of these patients. Early and late postoperative complications occurred in 21 (6.1%) and 10 (2.9%) patients, respectively. The most serious complication was vascular injury resulting in bleeding or organ ischemia, which occurred in seven patients. Degree of lymph node dissection and surgical inexperience were found to be risk factors of surgical complication (P = .023, odds ratio 2.832, 95% confidence interval 1.155–6.946 vs. P = .028, odds ratio 2.975, 95% confidence interval 1.127–7.854). Conclusions Lymph node dissection during LADG should be performed cautiously to prevent surgical complications like vascular injuries, especially during the surgeon’s early learning period.     

Effects of Combination of Calcium and Aspirin on Azoxymethane-Induced Aberrant Crypt Foci Formation in the Colons of Mice and Rats

Human intervention studies have suggested an exciting synergistic action between calcium supplementation and aspirin intake in reducing the risk of colorectal cancer. The aim of this study was to determine whether such a synergy can be demonstrated on azoxymethane (AOM)-induced colon aberrant crypt foci (ACF) formation in mice and rats. Female CF-1 mice and male F344 rats were injected subcutaneously with AOM and then received diet treatments for 8 wk. The basal control diet contained high fat (20% mixed lipids by weight) and low calcium (1.4 mg/g diet) to mimic the average Western diet. The treatment diets contained enriched calcium (5.2 mg calcium/g diet), aspirin (0.2 mg aspirin/g diet), or calcium plus aspirin (5.2 mg calcium plus 0.2 mg aspirin/g diet). Treatment with calcium, aspirin, or their combination significantly decreased the number of total ACF and aberrant crypt per mouse (by 43–59%) or rat (by 23–38%), but statistically significant differences among the 3 groups were not observed. A hint of additivity between calcium and aspirin was observed in mice but not in rats. These results indicate that the combination of calcium and aspirin did not produce a synergistic effect on the ACF formation in AOM-treated mice and rats.     

Caveolin-1在宫颈癌组织中的表达及意义

目的：研究Caveolin-1在宫颈癌组织中的表达情况,探讨其在宫颈癌发生发展中的作用机制。方法：采用免疫组化法检测40例宫颈浸润癌、9例原位癌及20例癌旁正常组织中Caveolin-1的表达情况,并分析Caveolin-1的表达与宫颈癌临床病理学参数之间的关系。结果：Caveolin-1在宫颈癌旁正常组织及血管内皮细胞中广泛表达（100%）,9例宫颈原位癌组织中Caveolin-1阳性表达者8例（88.9%）,40例宫颈浸润癌组织中Caveolin-1阳性表达者29例（72.5%）, 三者比较,差别有统计学意义。在Ⅰ、Ⅱ期宫颈浸润癌中Caveolin-1阳性表达率分别为85．7％和41．7％,两者比较,差别有统计学意义。在宫颈高、中、低分化鳞癌中Caveofin-1阳性表达率分别为93．3％、66．7％、50．0％,三者比较,差别有统计学意义。Caveolin-1在淋巴结转移癌中阳性表达率为50．0％,淋巴结无转移癌中阳性表达率为90．9％,两者比较,差别有统计学意义。结论：Caveolin-1在宫颈癌中的表达降低,提示其表达的降低可能参与了宫颈癌的发生、发展过程。Caveolin-1的表达与宫颈癌的临床分期有关,随着分期的增高,Caveolin-1表达降低。Caveolin-1的表达与宫颈癌的病理分级有关,随着分级的降低,Caveolin～1的表达降低。Caveolin-1的表达与宫颈癌有无淋巴结转移有关,在有淋巴结转移组中Caveolin-1的表达降低。Caveolin-1在血管内皮细胞中广泛表达,可能参与了肿瘤血管的生成,对肿瘤的发生、发展、浸润和转移产生了一定的影响。     

风湿性瓣膜病二尖瓣与主动脉瓣置换术1154例长期效果分析

目的　评价风湿性联合瓣膜病二尖瓣与主动脉瓣双瓣置换术的近期与远期疗效 ,分析影响手术疗效的因素。　方法　回顾性分析 1981年 5月～ 2 0 0 1年 5月 2 0年间 ,115 4例风湿性心脏病患者行双瓣膜置换术的临床资料和长期随访结果 ,其中二尖瓣与主动脉瓣均为狭窄病变者 2 5 3例 ,二尖瓣狭窄合并主动脉瓣关闭不全者 345例 ,二尖瓣关闭不全合并主动脉瓣狭窄者 119例 ,二尖瓣与主动脉瓣均为关闭不全者 437例 ;合并三尖瓣病变的占 5 4 0 0 %( 75 7例 ) ,其中器质性病变 7 2 7%( 84例 ) ,功能性关闭不全 5 8 31%( 6 73例 ) ;合并中度以上肺动脉高压者 339例 ;术前NYHA心功能分级Ⅲ级与Ⅳ级者分别为 873例和 186例。应用侧倾碟瓣或双叶机械瓣施行瓣膜置换术 ,合并三尖瓣功能或器质性病变者 ,同期行瓣膜成形手术。　结果　本组患者术后住院病死率为 6 5 0 %( 75 / 115 4)。早期死亡的主要原因为低心排出量综合征、顽固性心律失常、肾功能或呼吸功能衰竭 ,以及抗凝有关的出血等。长期生存 10 79例 ,随访时间为 8个月～ 2 0年 ,平均随访时间为 4 5 %病人·年。晚期死亡 6 6例 ( 0 39%病人·年 ) ;5、10与 15年累计生存率分别为 ( 89 46± 1 35 ) %、( 86 5 0± 1 91) %与 ( 6 7 86±6 16 ) %。生存的 92 9例患     

High Physical Activity is Associated with an Improved Lipid Profile and Resting Heart Rate among Healthy Middle-aged Chinese People

Objective To investigate the effects of physical activity (PA) on dyslipidemia and elevated resting heart rate (RHR) in a large-scale cross-sectional study in China. Methods We recruited community-based individuals who were 40-60 years old using a cluster sampling method. The PA levels of the participants were classified as low, moderate, or high, using the International Physical Activity Questionnaire. Dyslipidemia was defined as the detection of abnormalities in lipid indicators, and 4 lipid parameters were evaluated using fasting blood samples. Multivariate logistic regression analyses were used to evaluate the associations of PA with dyslipidemia and RHR. Results A total of 10,321 participants (38.88% men) were included in this study. The percentages of individuals with high, moderate, and low PA levels were 46.5%, 43.9%, and 9.6%, respectively. In both men and women, high PA provided odds ratios of 0.88 [95% confidence interval (CI): 0.83, 0.94] for dyslipidemia and 0.82 (95% CI: 0.73, 0.92) for elevated RHR, compared to participants with low PA. Conclusion Our data suggested that substantial health benefits (related to dyslipidemia and elevated RHR) occurred at higher intensity PA, with greater energy consumption, in middle-aged Chinese people, and particularly in men.     

双胎输血综合征宫内治疗后供血胎和受血胎预后的比较

[目的]评价双胎输血综合征(TTTS)经不同治疗方式,包括羊水减量术(SA)、双极脐带电凝减胎术(BCC)和胎盘吻合血管激光凝固术(LCPV)后,供血胎和受血胎的临床结局.[方法]回顾性分析2008年1月至2013年12月在我院诊断治疗的双胎输血综合征93例,追踪妊娠结局和新生儿情况,分析比较供血胎和受血胎的临床结局.[结果]不同治疗方式组中严重的TTTS(TTTSⅢ期及以上)所占比例分别是:羊水减量术组50.0％(27/54),脐带电凝减胎术组93.9％(31/33),胎盘吻合血管激光凝固术组83.3％(5/6),P＜0.001,因此,3种治疗方式妊娠结局比较时仅纳入TTTSⅢ期及以上病例.SA组、BCC组和LCPV组双胎总体存活率分别是53.7％、24.2％和60.0％,P=0.002.SA组、BCC组和LCPV组分娩孕周中位数分别是31e(20+3～38+2)、28+5(20+2～38+6)和27+6((23+3～37+4)周,其差异无统计学意义(P=0.204).SA组胎膜早破的发生率是29.6％而BCC组和LCPV组胎膜早破的发生率分别是32.3％和60.0％,P=0.410.LCPV组28周前分娩的比例较SA组和BCC组高(分别是60.0％、18.5％和48.4％;P=0.033).TTTS双胎中受血胎存活率是44.1％(41/93)而供血胎存活率是46.2％(43/93),P=0.768;受血胎神经系统发育迟缓发生率是2.4％(1/41)而供血胎神经系统发育迟缓发生率是11.6％(5/43),其差异无统计学意义(P=0.202).[结论]胎盘吻合血管激光凝固术可提高TTTS的总体存活率;TTTS受血胎和供血胎的预后无明显差异.