ObjectiveTo evaluate the clinical experiences and treatment effectiveness of chronic venous insufficiency with venous ulcer in lower limb. MethodsSeventy-eight patients (88 limbs) suffering lower limb chronic venous insufficiency with venous ulcer from May 2004 to April 2011 in this hospital were analyzed retrospectively. All the patients had undergone high ligation for great saphenous vein plus endovenous laser treatment plus subfascial endoscopic perforator vein surgery (SEPS). ResultsPostoperative complications included 3 cases of subfascial haematoma; 2 cases of pneumohypoderma; 3 cases of numbness in anterior tibial and ankle areas. All the ulcers healed between 4 to 6 weeks. Follow up period was between 6 months to 5 years. There was only one recurrence due to residual varicose from ankle area. The mean operation time was 20 min (15－30 min) in SEPS, the average blood loss was 2 ml (1－5 ml), and the mean duration of postoperative hospitalization was 5 d (2－8 d). ConclusionsSEPS is a first treatment choice for CVI with venous ulcer. It has less invasiveness, lower chances for bleeding, shorter operation time, quicker recovery, and fewer complications.
目的 研究乳腺癌患者雌激素受體（ER）、孕激素受體（PR）、人表皮生長因子受體2（HER-2）表達情況及免疫組織化學分子亞型分布。 方法 對2003年1月－2008年9月四川大學華西醫院病理科3 365例乳腺癌病理報告存檔資料進行激素受體（ER/PR）、HER-2表達情況及免疫組織化學分子亞型分布進行分析。 結果 3 365例確診的乳腺癌患者中，ER陽性1 824例（54.2%），PR陽性1 841例（54.7%），HER-2過表達284例（8.4%）。相關分析顯示ER與PR表達呈正相關（P＜0.001），HER-2與ER、PR表達均呈負相關（P＜0.001）。免疫組織化學分子亞型結果顯示luminal A型最常見，為1 993例（59.2%）；basal-like型為623例（18.5%）；HER-2過表達型為169例（5.0%）；luminal B型最少，為115例（3.4%）；未分類的為465例（13.8%）。 結論 乳腺癌患者激素受體及HER-2表達有特殊性，激素受體陽性率＞50%，HER-2陽性率在不同研究中顯示出不同的結果，尚需進一步研究；ER、PR與HER-2具有良好的相關性；免疫組織化學分子亞型中luminal A型最常見。
Objective To investigate the causal relationship between resistin and multiple myeloma (MM). Methods A two-sample Mendelian randomization analysis was conducted using genetic variants (SNPs) associated with resistin as instrumental variables and MM genome-wide association study (GWAS) data as the outcome event. Five analysis methods, including inverse-variance weighted (IVW), MR-Egger, weighted median, weighted model, and simple model were used to assess the causal impact of resistin on the risk of MM. Results None of the five analysis methods showed a causal relationship between resistin and multiple myeloma (P>0.05). Sensitivity analysis indicated consistent and robust results, with no evidence of horizontal pleiotropy, heterogeneity, outliers, or individual SNPs influencing the findings. Conclusion This Mendelian randomization study provides no support for a causal relationship between resistin and the risk of multiple myeloma.
ObjectiveTo explore the percutaneous hollow screw internal fixation combined with cementoplasty in the treatment of periacetabular metastasis. Methods A retrospective study was performed on 16 patients with periacetabular metastasis who were treated with percutaneous hollow screw internal fixation combined with cementoplasty between May 2020 and May 2021. There were 9 males and 7 females. The age ranged from 40 to 73 years, with an average of 53.6 years. The tumor involved around the acetabulum, and 6 cases were located on the left and 10 cases on the right. Operation time, frequency of fluoroscopy, bed rest time, and complications were recorded. Before operation, and at 1 weeks, 3 months after operation, the visual analogue scale (VAS) score was used to evaluate the pain degree, the short-form 36 health survey scale (SF-36) score was used to evaluate the quality of life. At 3 months after operation, the Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate the functional recovery of patients. During follow-up, the loosening of internal fixator and bone cement leakage were observed by X-ray film. Results All patients were performed operation successfully. The operation time ranged from 57 to 82 minutes, with an average of 70.4 minutes. The frequency of intraoperative fluoroscopy was 16-34 times, with an average of 23.1 times. After operation, 1 case of incision hematoma and 1 case of scrotal edema occurred. All patients felt the pain relieved after operation. The patients started walking at 1-3 days after operation, with an average of 1.4 days. All patients were followed up 6-12 months (mean 9.7 months). The VAS and SF-36 scores significantly improved after operation when compared with the preoperative scores, and the scores at 3 months after operation were significant better than those at 1 week after operation (P<0.05). At 3 months after operation, the MSTS score ranged from 9 to 27, with an average of 19.8. Among them, 3 cases were excellent (18.75%), 8 cases were good (50%), 3 cases were fair (18.75%), and 2 cases were poor (12.5%). The excellent and good rate was 68.75%. And 11 patients returned to normal walking, 3 had mild claudication, and 2 had obvious claudication. Radiological examination showed that there were 2 cases of bone cement leakage after operation, and there was no internal fixator loosening or displacement. Conclusion Percutaneous hollow screw internal fixation combined with cementoplasty can effectively relieve pain and improve the quality of life of patients with periacetabular metastasis.
Objective To compare the feasibility， safety， and efficiency of laparoscopic total extraperitoneal （TEP）hernia repair surgery and laparoscopic transabdominal preperitoneal （TAPP） hernia repair surgery. Methods The clinical data of 95 patients with inguinal hernia who underwent laparoscopic TEP hernia repair surgery （TEP group） and TAPP hernia repair surgery （TAPP group） from Mar. 2010 to Oct. 2013 in our hospital were retrospectively analyzed， and clinical parameters including operation time， intraoperative blood loss， postoperative hospital stay， postoperative comp-lication， and operation cost of 2 groups were compared. Results All the procedures were successful， none of them was converted to open surgery. There was no significant difference between TEP group and TAPP group when considering operation time 〔（65±16） min vs.（68±17） min〕， intraoperative blood loss 〔（7.0±1.2） mL vs. （8.0±1.4） mL〕， visual pain analogue scale 〔（2.0±1.1） score vs. （1.8±1.1） score〕， postoperative hospital stay 〔（3.1±1.4） d vs. （3.3±1.2） d〕，and time to release to regular activities 〔（4.2±1.0） d vs. （4.5±1.2） d〕， P＞0.05. But the operation cost of TEP group was significantly lower than that of TAPP group 〔（8 033±536） yuan vs. （9 632±643） yuan， P=0.007〕. There were 6 atients （6.3%， 6/95） suffered complications， 3 cases in TEP group and 3 cases in TAPP group， including 3 cases of seroma or hematoma in scrotum， 1 case of transient neurapraxia， and 3 cases of urinary retention. There was no signi-ficant difference in incidence rate of postoperative complication between the 2 groups （P=1.000）. All patients were followed-up for 1-35 months 〔（20.0±10.2） months〕 without recurrence and chronic pain. Conclusions TEP and TAPP hernia repair surgery are feasible， safe， effective， and minimally invasive technique for inguinal hernioplasty. There are advantages and disadvantages of both TAPP and TEP hernia repair surgery， but there is no statistically significant difference regarding intraoperative and postoperative complications.