Thirty patients of primary cholangiolithiasis were treated by the use of a rigid choledochoscope passing through the left lateral liver lobe for removal. 20 cases of them were manipulated with mini-incisions, the stones in 14 patients (70.0%) were completely removed. In the remaining 10 cases of conventional laparotomy, left lateral liver incised in 4, left lateral lobectomy in 6 before rigid choledochoscopic lithotomy; the stons were completely removed in eight patients (80.0%). No case had complications, the short-term effect of the method is obviously better than that of other various operative treatments. It has the advantages of less trauma, less pain, and quick recovery. It is a economical and effective new technique and has prospects of application.
Liver cancer is one of the world’s most prevalent malignancies, and is also the third leading cause of cancer death in China. Hepatitis and cirrhosis background is a major feature of liver cancer patients in China, which makes specific requirements that suits the national conditions in many aspects of prevention and control like screening diagnosis, treatment options, and prognosis follow-up. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition), which is based on China’s practice, proposes liver cancer staging in line with China’s national conditions and forms a multi-disciplinary joint diagnosis and treatment model based on surgical treatment. Liver transplantation is included in liver cancer as one of the surgical treatments option. It also emphasizes the support of evidence-based medicine. The Specifications for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) may have laid a solid foundation for future diagnosis and treatment of liver cancer in China.
ObjectiveTo investigate the clinical features of primary tracheal or pulmonary malignant glomus tumor (MGT).MethodsA patient with primary tracheal MGT was reported. Wanfang, CNKI, Embase, Ovid, Cochrance and PubMed databases were searched with key words "tracheal malignant glomus tumor" and " pulmonary malignant glomus tumor” both in English and in Chinese for literature of primary tracheal or pulmonary MGT. Their clinical manifestations, imaging findings, bronchoscopic findings, pathological findings, especially immunohistochemical characteristics, diagnosis and differential diagnosis, treatment, and prognosis of primary tracheal or pulmonary MGT were summarized.ResultsThis male patient who manifested as cough, chest tightness, shortness of breath and dyspnea was diagnosed as tracheal MGT and received a treatment of radiofrequency ablation and cryotherapy under bronchoscopy. He refused to receive the chemotherapy and died after two months with a lung metastases. A total of 17 cases of primary tracheal or pulmonary MGT were retrieved in 16 articles, of which 5 were primary in the trachea and 12 were primary in the lung. Their clinical manifestations, imaging findings, and bronchoscopic findings were non-specific. The diagnosis relied on pathology, especially immunohistochemical staining. The preferred treatment of tracheal MGT may be surgical resection, the prognosis was acceptable. Treatment of lung MGT included lobectomy or airway interventional treatment and its prognosis was poor. The treatment of primary tracheal or pulmonary MGT needed early treatment. Because the curative effect of airway interventional treatment and chemotherapy was dubious, surgical plan should be first considered.ConclusionsBoth of primary tracheal and primary pulmonary MGT are rare. They usually lack specific clinical manifestations, laboratory tests, and imaging, and are easy to be misdiagnosis or miss diagnosis. The diagnosis can be confirmed by the results of biopsy for pathological analysis, especially by the immunohistochemical staining analysis. The treatment of tracheal and pulmonary MGT need further study.
【Abstract】ObjectiveTo evaluate the value of MR imaging with a contrast-enhanced multi-phasic isotropic volumetric interpolated breath-hold examination (VIBE) in diagnosis of primary liver carcinoma. MethodsThirty-two consecutive patients with surgical-pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two-dimensional (2D) T1WI and T2WI images were acquired before administration of Gd-DTPA for contrast enhancement. Then, contrast-enhanced multi-phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non-enhanced T1WI, enhanced T1WI and enhanced 3D-VIBE images (P＜0.05). The hepatic arterial anatomy of 30 patients （93.8%） and the portal venous structure of 31 patients （96.9%） were clearly depicted on enhanced 3D-VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.ConclusionHigh-quality 3D-VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.
The serum level of testosterone (T), estradiol (E2) and progesterone (P) in 86 cases with primary liver cancer (PLC) (male：76 cases; female：10 cases) was determined by RIA method. The result showed that for male cases, serum level of T and ratio of T/E２ in operation group and nonoperation group was significantly higher than that in benign hepatic diseases group (BHD group) and normal control group (NC group), but the value of E２ obviously lower than the later two groups. After tumor resection, the level of E2 increased, while serum level of T and value of T/E２ decreased, which had no significant difference as contrasted with BHD group and NC group. The serum level of T,E2 in female PLC group made no difference to BHD group and NC group, but the value of T/E2 much higher than NC group. No obvious changes of the serum level of progesterone can be observed in both male and female cases. Our research showed that high serum testosterone level and low estradiol level may be concerned with PLC. The possibility and importance of sex hormone imbalance on initializing and developing of PLC is suggested.
摘要:目的: 比较咪达普利与培哚普利对原发性高血压患者的的降压效果和不良反应。 方法 :将入选的60例1～2级高血压病患者,随机分为2组,咪达普利组,每日晨起口服咪达普利(5～10 mg,1次/d),培哚普利组,每日晨起口服培哚普利(4～8 mg,1次/d)。治疗4周,观察2组治疗前、后的血压,记录不良反应。 结果 :经治疗后咪达普利与培哚普利组血压均明显下降(Plt;0.05),组间差异无统计学意义(P＞0.05);总不良反应发生率咪达普利组16.8%,培哚普利组20%,而咪达普利组的咳嗽发生率为6.8%,培哚普利组为16.8%。 结论 :咪达普利和培哚普利均能有效降压,二者降压效果相似,但咪达普利的咳嗽发生率较低。Abstract: Objective: To compare the antihypertensive efficacy and safety of imidapril versus peridopril in patients with essential hypertension. Methods : Selected 60 patients with mild to moderate essential hypertension, in which divided two groups by random.They were administered imidapril 5～10 mg once daily or and peridopril 4～8 mg once daily for 4 weeks. During the curative period of 4 weeks, the antihypertensive efficacy and adverse reaction were observed. Results :The blood pressure drecreased prominently in both groups after four weeks treament(Plt;0.05), but there was no significant difference in antihypertensive efficacy between the two groups(P＞0.05). The occurrence of the total adverse reaction in imidapril and peridopril groups was 16.8% and 20%, respectively, while the occurrence of the cough in two groups was 6.8% and 16.8%, respectively. Conclusion :Both imidapril and peridopril exert favourable and similar hepotensive effect, however the cough occurrence of imidapril is lower than that of peridopril.