Objective To provide a current language for clinical and pathological discription of gastric cancer. Methods The literature in recent years on the distribution of lymph nodes and staging of gastric cancer were reviewed. Results The lymph nodes of gastric cancer are distributed near the blood vessel and organs of gastric milieu. To ensure radical gastrectomy rational and scientific, the anatomic structure of gastric milieu should be familiarized. Conclusion The excellent outcome of surgery will be achieved by the effective dissection and removel of lymph nodes in gastric cancer.
Sleep electroencephalogram (EEG) is an important index in diagnosing sleep disorders and related diseases. Manual sleep staging is time-consuming and often influenced by subjective factors. Existing automatic sleep staging methods have high complexity and a low accuracy rate. A sleep staging method based on support vector machines (SVM) and feature selection using single channel EEG single is proposed in this paper. Thirty-eight features were extracted from the single channel EEG signal. Then based on the feature selection method F-Score's definition, it was extended to multiclass with an added eliminate factor in order to find proper features, which were used as SVM classifier inputs. The eliminate factor was adopted to reduce the negative interaction of features to the result. Research on the F-Score with an added eliminate factor was further accomplished with the data from a standard open source database and the results were compared with none feature selection and standard F-Score feature selection. The results showed that the present method could effectively improve the sleep staging accuracy and reduce the computation time.
【Abstract】Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳa and stage Ⅳb. And the stage Ⅳa patients should be treated by radical operation, and the stage Ⅳb by palliative operation.
ObjectiveTo analyze the value of internal mammary lymph node biopsy via intercostal space in staging and adjuvant therapy of breast cancer. MethodsThe clinical data of 305 breast cancer patients received any kind of radical mastectomy from may 2003 to January 2014 in the Jinan Military General Hospital of PLA were analyzed retrospectively. The patient age, axillary lymph node, and internal mammary lymph node status were integrated to investigate the changing of staging and postoperative adjuvant therapy of the breast cancer. ResultsThese 305 patients were divided into neoadjuvant chemotherapy group and non-neoadjuvant therapy group. There were 67 patients in the neoadjuvant chemotherapy group, including 45(67.2%) patients with axillary lymph node positive, 23(34.3%) patients with internal mammary lymph node positive. There were 23(34.3%) patients who had a change of pathology lympy node (pN) staging and 8(11.9%) patients who had a change of the pTNM staging. Meanwhile, there were 238 patients in the non-neoadjuvant chemotherapy group, including 155(65.1%) patients with axillary lymph node positive, 30(12.6%) patients with internal mammary node positive. There were 30(12.6%) patients who had a change of the pN staging and 23(9.66%) patients who had a change of the pTNM staging. There was a significant difference in the metastasis rate of the internal mammary lymph node (χ2=15.7, P < 0.05) or the changing ratio of the pTNM staging (χ2=5.3, P < 0.05) in two groups. ConclusionsInternal mammary lymph node status could affect pN staging of breast cancer, so do the pTNM staging (TNM, pathology tumor, lymph node, metastasis). The internal mammary lymph node status could guide the postoperative adjuvant radiative therapy by reducing excessive treatment of the internal mammary lymph node area, also could enhance the individual accurate therapy.
ObjectiveTo elucidate the correlation between radiological tumor size (RTS) and pathological tumor size (PTS), and to evaluate the accuracy of clinical T staging. Methods Data on patients who underwent complete resection between September 2018 and June 2019 were retrospectively collected. The correlation between RTS and PTS was analyzed by and we assessed the agreement between clinical and pathologic T staging. Results Finally, 1 880 patients were included. There were 778 males and 1 102 females at average age of 57±11 years. In the entire cohort, the RTS and PTS was 19.1±13.5 mm and 17.7±14.0 mm, respectively (P<0.001). The RTS and PTS showed a strong linear correlation with the Pearson’s correlation coefficient calculated as 0.897. The mean RTS was significantly larger than PTS (P<0.001) in tumors≤3 cm, but significantly smaller in tumors>4 cm. The overall concordance rate between clinical and pathological T staging was 65.6%. Clinical staging failed to detect T4 disease in 29.4% (5/17) of patients. Male patients and the presence of cavities within nodules were independent significant factors leading to inaccurate clinical T staging. Conclusions The correlation between the tumor sizes measured on thin-section computed tomography and pathologic specimens varies with the real tumor size. Methods and techniques for improving clinical T staging accuracy is in urgent need.
Objective To approach histologically the degree of choroidal invasions of retinoblastoma and their relations with metastasis and prognosis. Methods The pathological sections of 297 enucleated eyeballs with retinoblastom from June 1985 to 1995 were reviewed under light microscope.For the sake of assessing the risk factors of the prognosis of the disease,the graduation of the choroidal invasion was in vestigated in particular,and the follow-up of this genesis were performed as well. Results According to the degree of affection of the intraocular tissues from the tumor cells especially the choroid as the crucial structure,the choroidal invasions were classified into the following 5 categories:0，prereactive phase of retinal pigment epithelium(144/297,48.48%).Ⅰ，reactive phase of retinal pigment epithelium(81/297，27.27%).Ⅱ, early phase of choroidal invasion( 29/297,9.76%).Ⅲ, middle phase of choroidal invasion(17/297,5.72%).Ⅳ， advanced phase of choroidal in vasion(26/297,8.75%).24.24% of cases were found in phases Ⅱ-Ⅳ (so called choroidal invasion).The mortality in patients with phases 0～Ⅲ was found to be 0.4% in the average follow-up period of 51.8 months,and inpatients with phase Ⅳ was found to be 12.0%. Conclusion The retinoblastoma patient with the advanced phase of choroidal invasion (choroida l invasion with great extent) had relative high metastatic rate and poor prognos is. (Chin J Ocul Fundus Dis,1999,15:88-90)
目的 探讨腹腔镜结肠癌根治术的临床效果。方法 应用腹腔镜外科技术对25例结肠癌患者实施腹腔镜结肠癌根治术。结果 本组25例手术时间110～310 min，平均195 min； 术中出血量约100～350 ml，平均约180 ml； 术后胃肠功能恢复时间1～4 d，平均 1.7 d。所有标本残端无肿瘤细胞残留、浸润。所有病例术后未出现出血、吻合口漏和狭窄并发症，仅有2例出现伤口感染。术后住院6～10 d，平均7.5 d； 术后19例随访2～38个月，平均13个月，其中2例于手术后第12个月和14个月因肿瘤广泛转移、衰竭而死亡； 余17例随访期间均未发现有转移复发及切口种植。结论 腹腔镜结肠癌根治术具有微创、安全、术后恢复快、肿瘤根治彻底等优点，值得临床推广应用。
Sleep stage scoring is a hotspot in the field of medicine and neuroscience. Visual inspection of sleep is laborious and the results may be subjective to different clinicians. Automatic sleep stage classification algorithm can be used to reduce the manual workload. However, there are still limitations when it encounters complicated and changeable clinical cases. The purpose of this paper is to develop an automatic sleep staging algorithm based on the characteristics of actual sleep data. In the proposed improved K-means clustering algorithm, points were selected as the initial centers by using a concept of density to avoid the randomness of the original K-means algorithm. Meanwhile, the cluster centers were updated according to the 'Three-Sigma Rule' during the iteration to abate the influence of the outliers. The proposed method was tested and analyzed on the overnight sleep data of the healthy persons and patients with sleep disorders after continuous positive airway pressure (CPAP) treatment. The automatic sleep stage classification results were compared with the visual inspection by qualified clinicians and the averaged accuracy reached 76%. With the analysis of morphological diversity of sleep data, it was proved that the proposed improved K-means algorithm was feasible and valid for clinical practice.
Objective To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction. Methods From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT . Results The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000). Conclusions MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.
Objective To investigate the expression of Jumonji domain-containing protein 3 ( JMJD3) in lung cancer tissue. Methods The cancer tissue slides from 53 lung cancer patients with different TNMstages were immunostained with JMJD3 antibody. The relationship between the expression of JMJD3 and type of pathology, TNM stage, survival time was analyzed. Results 94. 3% lung cancer tissue expressed JMJD3 protein. The expression of JMJD3 was negatively correlated with TNMstage( r = - 0. 347,P =0. 002) . The patients with decreased JMJD3 expression had shorter survival time than the patients with high JMJD3 expression ( X2 = 17. 83, P = 0. 001) . Conclusion Decreased expression of JMJD3 may promote the lung cancer progression.