本文报告了一例肝内胆管癌(Intrahepatic Cholangiocarcinoma, ICC)患者出现骨转移和罕见扁桃体转移的病例。ICC是原发性肝癌的一种,起源于肝内二级胆管至肝内最小胆管分支的恶性肿瘤,具有高度侵袭性和转移性,常见转移部位包括肝内、肺...本文报告了一例肝内胆管癌(Intrahepatic Cholangiocarcinoma, ICC)患者出现骨转移和罕见扁桃体转移的病例。ICC是原发性肝癌的一种,起源于肝内二级胆管至肝内最小胆管分支的恶性肿瘤,具有高度侵袭性和转移性,常见转移部位包括肝内、肺、骨等。骨骼是肝癌转移的第三大常见部位,发生骨转移后2年生存率低于5%。本病例患者在确诊时已存在多处骨转移,治疗过程中出现双下肺微小结节及扁桃体转移。免疫组化及基因检测结果支持肝内胆管癌转移的诊断,患者接受了综合抗肿瘤治疗,包括化疗、免疫联合靶向治疗、放疗和对症支持治疗。最终,患者因全身多发转移、呼吸衰竭等并发症死亡。本病例强调了ICC的高侵袭性和多样的转移路径,提示临床医生在诊治过程中需考虑罕见转移部位,并加强多学科综合治疗策略的应用。This case report presents a patient with intrahepatic cholangiocarcinoma (ICC) who developed bone metastases and rare tonsillar metastasis. ICC, a type of primary liver cancer, originates from the secondary intrahepatic bile ducts to the smallest branches of the intrahepatic bile ducts and is characterized by high invasiveness and metastatic potential. Common metastatic sites include the liver, lungs, and bones, with the skeleton being the third most common site of liver cancer metastasis. The 2-year survival rate for patients with bone metastases is less than 5%. At diagnosis, the patient had multiple bone metastases and later developed small nodules in both lower lungs and tonsillar metastasis during treatment. Immunohistochemistry and genetic testing supported the diagnosis of ICC metastasis. The patient underwent comprehensive antitumor therapy, including chemotherapy, immunotherapy combined with targeted therapy, radiotherapy, and supportive care. Ultimately, the patient succumbed to complications such as widespread metastasis and respiratory failure. This case underscores the high invasiveness and diverse metastatic pathways of ICC, highlighting the need for clinicians to consider rare metastatic sites and to employ multidisciplinary treatment strategies.展开更多
Potential energy surfaces(PESs), vibrational frequencies, and infrared spectra are calculated for NF_(3)^(+) using ab initio calculations, based on UCCSD(T)/cc-p VTZ combined with vibrational configuration interaction...Potential energy surfaces(PESs), vibrational frequencies, and infrared spectra are calculated for NF_(3)^(+) using ab initio calculations, based on UCCSD(T)/cc-p VTZ combined with vibrational configuration interaction(VCI). Based on an iterative algorithm, the surfaces(SURF) program adds automatic points to the lattice representation of the potential function, the one-dimensional and two-dimensional PESs are calculated after reaching a convergence threshold, finally the smooth image of the potential energy surface is fitted. The PESs accurately account for the interaction between the different modes, with the mode q_(6) symmetrical stretching vibrations having the greatest effect on the potential energy change of the whole system throughout the potential energy surface shift. The anharmonic frequencies are obtained when the VCI matrix is diagonalized. Fundamental frequencies, overtones, and combination bands of NF_(3)^(+) are calculated, which generate the degenerate phenomenon between their frequencies. Finally, the calculated anharmonic frequency is used to plot the infrared spectra.Modal antisymmetric stretching ν_(5) and symmetric stretching ν_(6) exhibit a phenomenon of large-intensity borrowing. This study can provide data to support the characterization in the laboratory.展开更多
鼻腔及鼻窦恶性黑色素瘤来源于鼻腔黏膜的树状突黑色素细胞,其发生率占头颈部恶性肿瘤的2%左右。该类肿瘤因恶性程度高,易复发和转移,由此预后较差。且大多数共识中未提及鼻腔黑色素瘤术后复发的治疗方案,所以如何选择适当的治疗方法,...鼻腔及鼻窦恶性黑色素瘤来源于鼻腔黏膜的树状突黑色素细胞,其发生率占头颈部恶性肿瘤的2%左右。该类肿瘤因恶性程度高,易复发和转移,由此预后较差。且大多数共识中未提及鼻腔黑色素瘤术后复发的治疗方案,所以如何选择适当的治疗方法,最大限度提高鼻腔及鼻窦恶性黑色素瘤患者的生存期及生活质量一直是临床的难点。本例为一例鼻腔黏膜恶性黑色素瘤术后复发的患者,结合文献复习,对该疾病初诊疗进行回顾分析,以期为此类患者的临床诊疗提供参考。Nasal and paranasal malignant melanomas originate from dendritic melanocytes in the nasal mucosa, accounting for approximately 2% of malignant tumors in the head and neck region. These tumors are highly malignant, prone to recurrence and metastasis, resulting in poor prognosis. Current consensus guidelines often lack detailed treatment protocols for recurrent nasal melanoma post-surgery. Thus, selecting the most appropriate treatment to maximize survival and quality of life for patients with nasal and paranasal malignant melanoma remains a clinical challenge. This report details a case of recurrent nasal mucosal malignant melanoma following surgery. A review of the literature is conducted to analyze initial diagnosis and treatment strategies, providing clinical insights for managing similar cases.展开更多
病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略...病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略感疼痛,该患者围术期肺栓塞风险高危。诊断方法:CT肺动脉血管成像示双肺段及段以下层面肺动脉多发栓塞。双下肢血管超声示双侧小腿肌静脉内径增宽伴血栓形成(完全填充型)。治疗方法:予抗凝治疗。临床转归:这是1例术前存在下肢深静脉血栓,于部分肾切除术后出现了肺栓塞的病例,予抗凝治疗,患者预后良好。Case Summary: Pulmonary embolism secondary to partial nephrectomy is an extremely rare postoperative complication. This case report describes a 61-year-old female patient with a history of deep vein thrombosis (DVT) in the lower extremities, who was admitted with a diagnosis of “right renal mass for 10 days.” Symptoms and Signs: On the third day following “retroperitoneal laparoscopic partial nephrectomy of the right kidney,” the patient suddenly developed chest tightness, shortness of breath, profuse sweating, and fatigue, with slight pain in the precordial area. This patient was identified as high-risk for perioperative pulmonary embolism. Diagnostic Methods: CT pulmonary angiography revealed multiple emboli in the segmental and subsegmental branches of the pulmonary arteries in both lungs. Bilateral lower extremity vascular ultrasound indicated widened diameters of the calf muscle veins with complete thrombus formation. Treatment Methods: Anticoagulant therapy was administered. Clinical Outcome: This case involves a patient with pre-existing lower extremity deep vein thrombosis who developed a pulmonary embolism following partial nephrectomy. The patient was treated with anticoagulant therapy and had a favorable prognosis.展开更多
文摘本文报告了一例肝内胆管癌(Intrahepatic Cholangiocarcinoma, ICC)患者出现骨转移和罕见扁桃体转移的病例。ICC是原发性肝癌的一种,起源于肝内二级胆管至肝内最小胆管分支的恶性肿瘤,具有高度侵袭性和转移性,常见转移部位包括肝内、肺、骨等。骨骼是肝癌转移的第三大常见部位,发生骨转移后2年生存率低于5%。本病例患者在确诊时已存在多处骨转移,治疗过程中出现双下肺微小结节及扁桃体转移。免疫组化及基因检测结果支持肝内胆管癌转移的诊断,患者接受了综合抗肿瘤治疗,包括化疗、免疫联合靶向治疗、放疗和对症支持治疗。最终,患者因全身多发转移、呼吸衰竭等并发症死亡。本病例强调了ICC的高侵袭性和多样的转移路径,提示临床医生在诊治过程中需考虑罕见转移部位,并加强多学科综合治疗策略的应用。This case report presents a patient with intrahepatic cholangiocarcinoma (ICC) who developed bone metastases and rare tonsillar metastasis. ICC, a type of primary liver cancer, originates from the secondary intrahepatic bile ducts to the smallest branches of the intrahepatic bile ducts and is characterized by high invasiveness and metastatic potential. Common metastatic sites include the liver, lungs, and bones, with the skeleton being the third most common site of liver cancer metastasis. The 2-year survival rate for patients with bone metastases is less than 5%. At diagnosis, the patient had multiple bone metastases and later developed small nodules in both lower lungs and tonsillar metastasis during treatment. Immunohistochemistry and genetic testing supported the diagnosis of ICC metastasis. The patient underwent comprehensive antitumor therapy, including chemotherapy, immunotherapy combined with targeted therapy, radiotherapy, and supportive care. Ultimately, the patient succumbed to complications such as widespread metastasis and respiratory failure. This case underscores the high invasiveness and diverse metastatic pathways of ICC, highlighting the need for clinicians to consider rare metastatic sites and to employ multidisciplinary treatment strategies.
基金Project supported by the National Natural Science Foundation of China (Grant Nos.52002318 and 22103061)。
文摘Potential energy surfaces(PESs), vibrational frequencies, and infrared spectra are calculated for NF_(3)^(+) using ab initio calculations, based on UCCSD(T)/cc-p VTZ combined with vibrational configuration interaction(VCI). Based on an iterative algorithm, the surfaces(SURF) program adds automatic points to the lattice representation of the potential function, the one-dimensional and two-dimensional PESs are calculated after reaching a convergence threshold, finally the smooth image of the potential energy surface is fitted. The PESs accurately account for the interaction between the different modes, with the mode q_(6) symmetrical stretching vibrations having the greatest effect on the potential energy change of the whole system throughout the potential energy surface shift. The anharmonic frequencies are obtained when the VCI matrix is diagonalized. Fundamental frequencies, overtones, and combination bands of NF_(3)^(+) are calculated, which generate the degenerate phenomenon between their frequencies. Finally, the calculated anharmonic frequency is used to plot the infrared spectra.Modal antisymmetric stretching ν_(5) and symmetric stretching ν_(6) exhibit a phenomenon of large-intensity borrowing. This study can provide data to support the characterization in the laboratory.
文摘鼻腔及鼻窦恶性黑色素瘤来源于鼻腔黏膜的树状突黑色素细胞,其发生率占头颈部恶性肿瘤的2%左右。该类肿瘤因恶性程度高,易复发和转移,由此预后较差。且大多数共识中未提及鼻腔黑色素瘤术后复发的治疗方案,所以如何选择适当的治疗方法,最大限度提高鼻腔及鼻窦恶性黑色素瘤患者的生存期及生活质量一直是临床的难点。本例为一例鼻腔黏膜恶性黑色素瘤术后复发的患者,结合文献复习,对该疾病初诊疗进行回顾分析,以期为此类患者的临床诊疗提供参考。Nasal and paranasal malignant melanomas originate from dendritic melanocytes in the nasal mucosa, accounting for approximately 2% of malignant tumors in the head and neck region. These tumors are highly malignant, prone to recurrence and metastasis, resulting in poor prognosis. Current consensus guidelines often lack detailed treatment protocols for recurrent nasal melanoma post-surgery. Thus, selecting the most appropriate treatment to maximize survival and quality of life for patients with nasal and paranasal malignant melanoma remains a clinical challenge. This report details a case of recurrent nasal mucosal malignant melanoma following surgery. A review of the literature is conducted to analyze initial diagnosis and treatment strategies, providing clinical insights for managing similar cases.
文摘病史摘要:继发于部分肾切除术的肺栓塞是极少见的术后并发症,本病例报道一例61岁的女性患者,既往有下肢深静脉血栓病史,入院诊断“右肾占位10天”。症状体征:在“后腹腔镜右肾部分切除术”术后3天突发胸闷、气短、大汗、乏力,心前区略感疼痛,该患者围术期肺栓塞风险高危。诊断方法:CT肺动脉血管成像示双肺段及段以下层面肺动脉多发栓塞。双下肢血管超声示双侧小腿肌静脉内径增宽伴血栓形成(完全填充型)。治疗方法:予抗凝治疗。临床转归:这是1例术前存在下肢深静脉血栓,于部分肾切除术后出现了肺栓塞的病例,予抗凝治疗,患者预后良好。Case Summary: Pulmonary embolism secondary to partial nephrectomy is an extremely rare postoperative complication. This case report describes a 61-year-old female patient with a history of deep vein thrombosis (DVT) in the lower extremities, who was admitted with a diagnosis of “right renal mass for 10 days.” Symptoms and Signs: On the third day following “retroperitoneal laparoscopic partial nephrectomy of the right kidney,” the patient suddenly developed chest tightness, shortness of breath, profuse sweating, and fatigue, with slight pain in the precordial area. This patient was identified as high-risk for perioperative pulmonary embolism. Diagnostic Methods: CT pulmonary angiography revealed multiple emboli in the segmental and subsegmental branches of the pulmonary arteries in both lungs. Bilateral lower extremity vascular ultrasound indicated widened diameters of the calf muscle veins with complete thrombus formation. Treatment Methods: Anticoagulant therapy was administered. Clinical Outcome: This case involves a patient with pre-existing lower extremity deep vein thrombosis who developed a pulmonary embolism following partial nephrectomy. The patient was treated with anticoagulant therapy and had a favorable prognosis.
