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小细胞未分化型肺癌脉络膜转移一例

Research progress on rodent models of secondary lymphedema

Objective To summarize the research progress of rodent models of secondary lymphedema (SL) and provide a reference for selecting appropriate animal models in SL research. Methods Recent literature on rodent SL models at home and abroad was comprehensively analyzed, summarizing model categories, development techniques, strengths, and weaknesses. Results Current research primarily utilizes rats and mice to establish SL models. The main model types include hind limb, forelimb, tail, and head/neck models. The hind limb model is the most frequently employed, typically requiring surgery combined with irradiation to induce stable chronic edema. Forelimb models primarily simulate upper limb lymphedema, but exhibit relatively rapid edema resolution. Tail models offer operational simplicity and are predominantly used for studying acute edema mechanisms and interventions; however, they demonstrate poor clinical relevance. Emerging head/neck models provide a valuable tool for investigating head and neck cancer-associated lymphedema. These models exhibit variations in lymphedema duration, degree of fibrosis, and edema incidences. Conclusion Existing models still fall short in faithfully replicating the chronicity, fibrosis, fat deposition, and complex microenvironment characteristic of human chronic lymphedema. Future research must integrate multidisciplinary approaches, optimize model construction strategies, and explore novel modeling approaches to more accurately mimic the human disease and advance SL prevention and treatment research.

胃癌脉络膜转移一例

Fundus angiography in metastatic carcinomas of choroid

Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill-defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA. (Chin J Ocul Fundus Dis, 2002, 18: 92-95)

Progress in Surgical Treatment of Secondary Tricuspid Insufficiency

Abstract： Tricuspid insufficiency founded in the setting of left-sided heart disease is usually secondary tricuspid insufficiency caused by tricuspid valve annular dilation. Some patients had rheumatic tricuspid valve diseases. Tricuspid valve repair rather than valve replacement is recommend for functional tricuspid regurgitation. Linear annuloplasty and ring annuloplasty are two main tricuspid valve repair methods. However, the indications for treatment of secondary tricuspid regurgitation remain controversial. The optimal surgical repair technique to eliminate secondary tricuspid regurgitation remains challenging. In this article, we review the assessment of tricuspid valve lesions, criteria for correction, and surgical management of secondary tricuspid insufficiency.methods. However, the indications for treatment of secondary tricus

Forensic Pathologic Analysis of Traumatic Brain Injury

【摘要】 目的 探讨颅脑损伤(BI)死亡的法医病理学特点,以及继发性脑干损伤、并发症的发生与死亡之间的因果关系。方法 从性别、年龄、致伤方式、损伤类型、生存时间、死亡原因等方面,对四川大学华西法医学鉴定中心1998年1月-2008年12月127例BI死亡尸检案例进行回顾性统计研究分析。结果 127例法医病理学检案中,原发性BI死亡51例(402%),继发性脑干损伤死亡61例(480%),并发症死亡15例(118%),其中伤后12 h内死亡者直接死因均为严重原发性脑损伤,存活12 h～1周者直接死因以继发性脑干损伤居多,生存时间超过1周者约半数死于并发症。结论 在BI案例的死亡原因确定时,应在全面系统的病理学检验基础上,结合案情及临床资料进行综合分析。【Abstract】 Objective To explore the characteristics of forensic pathology in traumatic brain injury and the relationships between secondary brainstem damage, complications and the causes of death. Methods 127 cases were reviewed from gender, age, manner of injury, survival time and the direct causes of death from January 1998 to December 2008. Results Of the 127 cases, the key direct cause of death was secondary brainstem damage, followed by severe primarily brain injury and complications. For those who died within 12 hours after injury, the direct cause was severe primarily brain injury; for those who survived between 12 hours to one week, secondary brainstem damage was in the majority of the causes and for those who survive more than one week time, complication was an important cause. Conclusion In the cases of traumatic brain injury, we should take comprehensive and systematic examination of forensic pathology, and refer to clinical data at the same time to determine the direct cause of death.

Clinical analysis of puncturing epigastrium subcutaneous tissue transplantation of parathyroid gland in treatment of secondary hyperparathyroidism

ObjectiveTo assess the clinical efficacy of percutaneous transplantation of parathyroid glands into the subcutaneous tissue of the epigastrium for treating malignant secondary hyperparathyroidism (SHPT). MethodsThe clinical data of the patients with SHPT who were treated by puncturing the subcutaneous tissue of the epigastrium and transplanting parathyroid glands in the Xuzhou Central Hospital from January 2020 to June 2022 were collected retrospectively. The preoperative and postoperative parathyroid hormone (PTH) level, calcium ion concentration, alkaline phosphatase (ALP) level, and phosphorus ion concentration, as well as postoperative follow-up results were analyzed. The data analysis was conducted using SPSS 23.0 software, with a testing level of 0.01. ResultsA total of 21 patients successfully underwent this surgery, including 12 males and 9 females, with a median age of 48 years old and a range of 32–71 years old. The dialysis time was (8.62±2.27) years, and 12 patients had hypertension, 9 patients had anemia, 17 patients had bone pain, and 11 patients had skin itching. On day 1 after treatment, the PTH level decreased from (1 893.23±539.30) ng/L to (5.99±3.50) ng/L (P<0.001), the calcium ion concentration decreased from (2.52±0.31) mmol/L to (2.24±0.35) mmol/L (P=0.003), and the phosphorus ion concentration decreased from (2.25±0.71) mmol/L to (1.76±0.38) mmol/L (P=0.006) as compared with the values before surgery. Although the ALP level decreased from (321.78±151.01) U/L to (229.32±89.32) U/L, there was no statistically significant difference (P=0.016). Among the 12 patients with hypertension before surgery, 6 patients improved and reduced the use of antihypertensive drugs after surgery; among the 9 patients with anemia, 3 patients improved before discharge; 17 patients with bone pain showed markedly relief before discharge; and 9 patients with skin itching improved before discharge. There were no complications such as hoarseness, choking cough when drinking water, or incision infection after the operation. All 21 patients were followed up for 6–12 months. The parathyroid hormone levels of the 21 patients all dropped to the normal level within 12 months after the operation. Among them, 3 patients recovered to the normal level at the 3rd month after the operation, 16 patients recovered to the normal level at the 6th month after the operation, and 2 patients recovered to the normal level at the 12th month after the operation. The time to return to the normal level was (5.86±2.70) months. No serious complications occurred in all patients, and there was no recurrent case during follow-up period. Conclusion From the analysis results of our study, parathyroid autotransplantation into the subcutaneous tissue of the epigastrium via puncture is a safe and effective method for patients with SHPT.

超声辅加绘图技术在继发性甲状旁腺功能亢进手术前定位中的应用价值

目的探讨超声辅加绘图技术对继发性甲状旁腺功能亢进甲状旁腺术前定位的效果。方法前瞻性收集 2017 年 6 月至 2018 年 6 月期间在吉林大学中日联谊医院甲状腺外科行手术治疗的继发性甲状旁腺功能亢进患者 20 例，术前由术者亲自操作超声检查。前 5 例（超声组）仅行超声检查，后 15 例（超声辅加绘图组）采取超声辅加手绘标记技术，记录术前定位与术中甲状旁腺位置的符合率。结果超声组的超声识别率为 77.78%（14/18），病理诊断符合率为 100%（18/18）；超声辅加绘图组的超声识别率为 93.85%（61/65），病理诊断符合率为 100%（65/65）。2 组的超声识别率比较差异有统计学意义（χ2=0.850，P<0.05），超声辅加绘图组的超声识别率较高。超声组患者的手术时间长于超声辅加绘图组（t=0.876，P=0.041）。2 组患者术后均未出现喉返神经损伤，术后复查喉镜均未出现声带麻痹。结论对继发性甲状旁腺功能亢进患者，术前超声辅加绘图技术定位甲状旁腺快速而准确，在临床制定手术方案、术中精准切除甲状旁腺及缩短手术时间方面有一定的应用价值。

Guidelines interpretation of the American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism

Secondary and tertiary hyperparathyroidism are common complications in patients with chronic kidney disease, especially in end stage renal disease. Surgery is an important method for the treatment of secondary and tertiary hyperparathyroidism. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism is the first evidence based guideline focus on renal hyperparathyroidism surgical management. Recommendations using the best available evidence by a panel of 10 experts in secondary and tertiary renal hyperparathyroidism constructed this guideline, which provides evidence-based, individual and optimal surgical management of secondary and tertiary renal hyperparathyroidism. This paper made a guideline interpretation on the indications of surgery, imaging examination, preoperative and perioperative management, relevant evaluation and treatment during perioperative period, and intraoperative parathyroid hormone monitoring during operation, and so on.

异基因造血干细胞移植后继发性纯红细胞再生障碍性贫血患者的护理

【摘要】 目的 总结异基因造血干细胞移植（allo-PBSCT）后发生继发性纯红细胞再生障碍性贫血（PRCA）的护理，以提高对此类患者的护理。 方法 对2007年1月-2008年12月收治的2例allo-PBSCT后发生PRCA患者的护理进行回顾性总结。 结果 allo-PBSCT后发生PRCA较少见，但在此过程中存在的严重贫血可能会危及患者生命。 结论 allo-PBSCT后发生PRCA的护理关键是针对贫血的各项护理措施。