Objective To summarize the clinical characteristics and surgical treatment experience of 1 106 patients with cardiac myxoma. Methods Clinical data of 1 106 patients with cardiac myxoma who underwent surgical treatment in Beijing Anzhen Hospital from 2002 to 2018 were retrospectively analyzed. There were 749 (67.7%) females and 357 (32.3%) males. Results The highest incidence rate was at the age of 51-70 years. The location of the disease was: left atrium in 987 (89.2%) patients, right atrium in 99 (9.0%) patients, left ventricle in 10 (0.9%) patients, right ventricle in 8 (0.7%) patients. There were 1 013 patients of heart classification (NYHA) Ⅰ-Ⅱ and 93 patients of Ⅲ-Ⅳ. There were 301 patients with cerebral infarction and 57 patients with peripheral arterial embolism. Tumor size was closely related to hemodynamic symptoms (P≤0.05), but not to peripheral vascular embolism (P>0.05). Two (0.2%) patients died in hospital and 306 patients were followed up, with a follow-up rate of 27.7%. The median follow-up time was 7 years (range, 1-18 years). One patient died of all causes, and 23 patients recurred, with a recurrence rate of 2.1%. Among 23 recurrent patients, 15 (65.2%) patients were atypical myxoma and 8 (34.8%) patients were typical myxoma. There was no statistical difference in aortic clamping time, ICU stay time, ventilator-assisted breathing time, postoperative hospital stay time, postoperative mortality, or cardiac ejection fraction at discharge between the reoperation in 23 recurrent patients and the first operation in 1 083 non-recurrentpatients. Conclusion Cardiac myxoma is more common in middle-aged and elderly women, and it often occurs in the left atrium. The size of cardiac myxoma can affect the hemodynamic changes. Surgical treatment is effective. Atypical myxoma is more common in recurrent patients, and the effect is still satisfactory through surgical treatment.
Objective To discuss the clinicopathologic risk factors related to local recurrence of rectal cancer after radical surgery. Methods The complete clinicopathologic data of 368 patients with rectal cancer from January 2004 to April 2011 in this hospital were retrospectively analyzed by univariate and multivariate analysis methods. Results There were 73 cases suffered from local recurrence and accounted for 19.84% （73/368） of rectal cancer during the same period. Univariate analysis results showed that gender， tumor from anal margin， tumor circumference， TNM staging， histology type， vessel infiltration， tumor perforation， stomal leak， and chemoradiotherapy were associated with postoperative recurrence （P＜0.05）. Multivariate analysis results showed that tumor from anal margin， tumor circumference， TNM staging， histology type， vessel infiltration， tumor perforation， and chemoradiotherapy were prognostic factor for local recurrence of rectal cancer （P＜0.05）. Conclusions There are many factors related to postoperative local recurrence， but the most dangerous factor is vessel infiltration.
目的 探讨乳腺癌改良根治术后影响局部复发与远处转移的相关因素。方法 对陕西省汉中市铁路中心医院略阳医院2000年3月至2007年3月期间行乳腺癌改良根治术且资料完整的637例原发性乳腺癌患者的临床资料进行回顾性分析。结果 66例（10.36%）患者术后发生局部复发和远处转移，其中局部复发50例（7.85%），远处转移16例（2.51%）；术后3～4年内发生复发与远处转移者47例（71.21%）。术后复发和远处转移与患者年龄、肿瘤大小、腋窝淋巴结转移情况、TNM分期、激素受体（ER/PR）表达情况及术后是否接受正规的辅助治疗有关，与患者有无家族史无关。结论 肿瘤大小、腋窝淋巴结转移情况、TNM分期、ER/PR表达情况及术后是否接受正规的辅助治疗是影响乳腺癌改良根治术后复发与远处转移的危险因素，重视乳腺癌术后随访，规范乳腺癌的手术方式，强化乳腺癌的综合治疗是降低乳腺癌改良根治术后复发与远处转移率的主要措施。
Objective To summarize the role of the relationship between liver cancer and cellular immunological function, and the role of immune therapy in clinical application. Methods To analyze the relationship between liver cancer and cellular immunological function, and the present research situation of immune therapy for liver cancer in clinical application retrospectively via review the related domestic and foreign literatures. Results The cellular immune dysfunction existed in all liver cancer patients. The state of body’s cellular immunological function is closely related with the arising and development of liver cancer, and the lowness of cellular immunological function is an important factor of hepatocellular carcinoma hard to cure or recurrence and metastasis. Immune therapy plays an important role in the treatment of liver cancer by adjusting the body’s cellular immunological function. Conclusions Liver cancer is closely related with the body’s cellular immunological function. Immune therapy is expected to offer a new way for the treatment of liver cancer, which can also be used as an important auxiliary treatment way.
Objective To introduce the surgical technique and results of total mesorectal excision (TME) for rectal cancer. Methods Reviews.Results As a result of TME, local recurrence rates have declined from 20%-30% to 3%-8%, 5-year survival rate have risen to 75%, and the rates of sphincter preservation have risen too.Conclusion Total mesorectal excision reduces the local recurrence rates and raise the survival figures after excision of rectal cancer. Patients have a high quality of life.
Optic neuritis (ON) is one of the symptom of a central nervous system demyelinating, systemic or infectious disease. The pathogenetic mechanism of ON is still not completely clear, and its core is inflammation and immune that occurred in the optic nerve axons, and apoptosis of RGC was induced. Few patients experience recurrent episodes after treatment, presenting a remission - recurrence course of polyphasic disease, named recurrent ON (RON). Two forms of RON have been assigned: recurrent isolated optic neuritis, which is a chronic corticosteroid-dependent optic neuropathy with intermittent acute relapses, and recurrent isolated optic neuritis, which is a non-progressive relapsing ON without steroid dependence. Recurrence of ON causes cumulative damage to the optic nerve lesions and impaired visual signal transmission, thus causing irreversible damage to vision. Therefore, it is very important to have a deep understanding of the pathogenesis of ON and the clinical characteristics of RON, so as to better conduct clinical treatment.
【摘要】 目的 了解肿瘤复发患者希望水平及其影响因素。 方法 2010年10-12月采用Herth希望量表和自制的一般情况调查表,对302例肿瘤复发患者进行问卷调查,并对相关影响因素进行分析。 结果 肿瘤复发患者希望总体均分为（31.14±5.56）分,7.95%（24例）的患者希望评分为低等水平,74.50%（225例）的患者希望评分为中等水平,17.55%（53例）的患者希望评分为高等水平。肿瘤复发患者希望水平得分的主要影响因素有:婚姻状况、工作状况、医疗费用支付情况、肿瘤类型以及无瘤生存时间。其中,与未婚患者相比,离异患者希望水平较低；与在职患者相比,退休患者希望水平较高；在医疗费用的支付方式上,自费所占的比例越大,患者希望水平越低；与其他肿瘤类型相比,以乳腺癌患者希望水平最低；此外,患者无瘤生存时间越长,其希望水平就越低。 结论 尽管肿瘤复发患者希望水平受多种因素的影响,但多数患者仍对现状和未来充满希望,其希望仍维持在较高水平。【Abstract】 Objective To explore the level of hope and the influential factors of hope in patient with tumor recurrence. Methods A total of 302 patients with tumor recurrence were enrolled. The patients were investigated by Herth Hope Scale and self-designed questionnaire. Results The average level of hope in patients with tumor recurrence was 31.14±5.56; of the total patients，7.95% (24 patients) had low level, 74.50% (225 patients) had media level and 17.55% (53 patients) had high level of hope. Parts of demographic characteristics had significant influences on level of hope and specifically: patient devoiced had lower level of hope than patients married (F=-1.868，Plt;0.05); patients retired had higher level of hope than patients on job (F=2.004，Plt;0.005); patients with greater own proportion of medical expense had lower level of hope than patients with smaller own proportion of medical expense (F=-0.937，Plt;0.05); patients with breast cancer had lower level of hope than patients with other type of cancer (F=-10.824，Plt;0.001); and finally, patients with longer free survival time had lower level of hope than patients with shorter free survival time (F=-1.930，Plt;0.001). Conclusion Parts of demographic characteristics have significant influences on level of hope in patients with tumor recurrence, but most patients still have high level of hope.
ObjectiveTo investigate the surgical skills and clinical effects of the laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in treatment of recurrent inguinal hernia with plug prefix mesh. MethodsThe clinical data such as operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications of 87 patients with recurrent inguinal hernia reoperated in laparoscopic TAPP after inguinal hernioplasty with plug prefix mesh (recurrent hernia group), in the Department of Gastroenterology and Hernia surgery of the First Affiliated Hospital of Kunming Medical University from January 2011 to December 2013, were retrospectively analyzed, which were compared with the 834 incipient inguinal hernia patients operated first by TAPP (incipient hernia group) at the same time. ResultsThe operations were completed successfully in all of the 921 patients without conversion to open surgery. The operation time and intraoperative blood loss in the recurrent hernia group were significantly more than those in the incipient hernia group (P=0.000, P=0.000), the postoperative hospital stay had no signifcant difference between two groups (P=0.057). No recurrences were observed in the recurrent hernia group and incipient hernia group for following-up of (31±4) months and (28±6) months, respectively. Compared with the incipient hernia group, the rates of postoperative pain on day 30 and seroma on day 1 and 3 were higher in the recurrent hernia group (P=0.001, P=0.040, P=0.003, respectively). There were no severe complications such as collateral damage, foreign body sensation, incision infection, intestinal obstruction and so on in the two groups. ConclusionsThe laparoscopic TAPP inguinal hernia repair is safe and effective for patients with recurrent inguinal hernia with plug prefix mesh. More skills are required to reduce the complications. The operation time and intraoperative blood loss in reoperated patients with recurrent inguinal hernia are more than those in patients with incipient inguinal hernia. The rates of seroma on day 1 and 3 are also higher.
Objective To improve the knowledge on dynamic benign central airway stenosis through two typical cases. Methods The clinical features, imaging findings, and bronchial morphologic changes of two cases characterized by dynamic benign central airway stenosis were retrospectively analyzed. The etiologies for the two cases were tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC), respectively. Results Central airway stenosis and reversible airway obstruction were common clinical characteristics for the two cases. However, there were identifiable differences on imaging findings and bronchial morphologic changes between the two cases. Multidetector computed tomography showed sabre-sheath trachea and narrowed trachea in coronal position for TBM, while small sized trachea in exhalation phase and narrowed trachea in sagittal position for EDAC. Bronchoscopy displayed narrowed airway, swelling mucosa, and the absence of annular cartilage for TBM, while crescent airway with membranacea part protruding to lumen in inspiration phase, and the integrity of annular cartilage for EDAC. Conclusion Multidetector computed tomography and bronchoscopy examinations are valid methods to distinguish TBM and EDAC, which are both characterized by dynamic benign central airway stenosis.