BACKGROUND Vascular malformations(VMs)arise as a result of errors in the process of angiogenesis and are usually present at birth,but may not become apparent until after birth.However,giant VMs of the head and face ar...BACKGROUND Vascular malformations(VMs)arise as a result of errors in the process of angiogenesis and are usually present at birth,but may not become apparent until after birth.However,giant VMs of the head and face are uncommon,with few reported cases,and the prognosis for their surgical intervention is unclear.CASE SUMMARY A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal scalp.After admission,computed tomography(CT)angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous malformation.Furthermore,cerebral angiography showed a right temporal lobe VM with multiple vessels supplying blood.The patient underwent surgery to remove the malformed vessels and the eroded skull.Two hours after the surgery,the patient's right pupil was dilated,and an urgent CT scan of the skull showed a right subdural haematoma under the incision,which was urgently removed by a second operation.After surgery,we gave continuous antibiotic anti-infection treatment,and the patient recovered well and was discharged two weeks later.CONCLUSION Surgical removal of giant haemangiomas is risky and adequate preoperative(including interventional embolisation)and intraoperative preparations should be made.展开更多
目的基于超声检查与血脂相关指标构建子宫肌瘤发病的预测模型,并对其预测价值进行验证。方法选取女性体检者6333例,统计子宫肌瘤发病情况,根据是否发生子宫肌瘤分为观察组与对照组,比较2组临床资料、超声检查指标[超声特征、子宫动脉收...目的基于超声检查与血脂相关指标构建子宫肌瘤发病的预测模型,并对其预测价值进行验证。方法选取女性体检者6333例,统计子宫肌瘤发病情况,根据是否发生子宫肌瘤分为观察组与对照组,比较2组临床资料、超声检查指标[超声特征、子宫动脉收缩期峰值血流速度(peak systolic velocit,PSV)、血流阻力指数(resistance index,RI)、搏动指数(pulsation index,PI)]、血脂相关指标[三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholestero,LDL-C)、总胆固醇(total cholesterol,TC)、血浆致动脉硬化指数(atherogenic index of plasma,AIP)、三酰甘油-葡萄糖指数(triglyceride glucose index,TyG)],构建列线图预测模型,并进行验证。结果经选取标准筛选后,共纳入女性体检者4812例作为入组对象,超声诊断发生子宫肌瘤1065例,子宫肌瘤发病率为22.13%,其中肌壁间肌瘤854例,占80.19%,浆膜下肌瘤156例,占14.65%,黏膜下肌瘤55例,占5.16%;平均子宫肌瘤数目(4.18±1.02)个,平均最大肌瘤直径(6.64±1.89)cm。观察组子宫动脉PSV、PI高于对照组,RI低于对照组(P<0.05);2组HDL-C水平差异无统计学意义(P>0.05),TG、LDL-C、TC、AIP、TyG水平高于对照组(P<0.05);Logistic回归分析,子宫动脉PSV、RI、PI、TG、LDL-C、TC、AIP、TyG是子宫肌瘤发病的独立影响因素(P<0.05);根据上述超声与血脂相关指标构建子宫肌瘤发病的列线图预测模型,校准曲线显示,该预测模型一致性指数为0.827,具有较好的一致性;Hosmer-Lemeshow拟合优度检验显示,P=0.710>0.05,该预测模型拟合度较好;受试者工作特征曲线(receiver operating characteristic,ROC)分析,该预测模型预测子宫肌瘤发病的曲线下面积(area under curve,AUC)为0.912(95%CI:0.837~0.994),敏感度为92.02%,特异度为90.74%。结论基于超声检查参数子宫动脉PSV、RI、PI与血脂指标TG、LDL-C、TC、AIP、TyG构建子宫肌瘤发病预测模型具有可行性,且预测价值较为可靠。展开更多
BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was...BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was to report the new application of the Ilizarov technique,which successfully treated talipes equinovarus in adults after triceps surae intramuscular hemangioma.CASE SUMMARY A 29-year-old woman treated with the Ilizarov technique for talipes equinovarus in the right leg after triceps surae intramuscular hemangioma surgery.The equinus deformity was roughly corrected after 2 years of follow-up,without significant secondary sequelae.CONCLUSION Talipes equinovarus caused by postoperative sequelae of intramuscular hemangioma was successfully corrected by the Ilizarov technique.The Ilizarov technique may be used for treating talipes equinovarus caused by various causes.展开更多
BACKGROUND Rotationplasty is often performed for malignant tumors,but type BIIIb rotationplasty is rarely reported,and there needs to be more evidence of the procedure and treatment.The purpose of this case study was ...BACKGROUND Rotationplasty is often performed for malignant tumors,but type BIIIb rotationplasty is rarely reported,and there needs to be more evidence of the procedure and treatment.The purpose of this case study was to report a new direction in the use of type BIIIb rotationplasty in treating patients with limb salvage and longterm non-healing infections.CASE SUMMARY Case 1:A 47-year-old man underwent radiotherapy for hemangioendothelioma in his left thigh,resulting in a femoral fracture.Despite the use of plates,intramedullary nailing,and external fixators,the femoral bone failed to unite due to infectious nonunion.Multiple operations were unable to control the infection,leaving the patient immobile.We performed a modified tibia-pelvic-constrained hip rotationplasty,utilizing a constrained prosthetic hip between the tibia and pelvis following a femur resection.Two years post-surgery,the patient was able to walk with the prosthetic device without any signs of recurring infection.The corresponding functional scores were 72 points for the Musculoskeletal Tumor Society(MSTS),53 for the Functional Mobility Assessment(FMA),93 for the Toronto Extremity Salvage Score(TESS),and 56 for the MOS 36-item short form health survey(SF-36).Case 2:A 59-year-old woman presented with liposarcoma in her left thigh.Magnetic resonance imaging revealed tumors in the medial,anterior,and posterior femur muscles,encircling the femoral vessels and nerves.Fortunately,there were no symptoms of sciatic dysfunction,and the tumor had not invaded the sciatic nucleus.After one year of follow-up,the patient expressed satisfaction with limb preservation post-type BIIIb rotationplasty.The corresponding functional scores were 63 points for the MSTS,47 for the FMA,88 for the TESS,and 52 for the SF-36.CONCLUSION Our study suggests that type BIIIb rotationplasty may be an alternative to amputation in patients with incurable infections.For malignant tumors of the lower extremities without invasion of the sciatic nerve,type BIIIb rotationplasty remains an excellent alternative to amputation.This surgical method may prevent amputation,improve functional outcomes,and facilitate biological reconstruction.展开更多
文摘BACKGROUND Vascular malformations(VMs)arise as a result of errors in the process of angiogenesis and are usually present at birth,but may not become apparent until after birth.However,giant VMs of the head and face are uncommon,with few reported cases,and the prognosis for their surgical intervention is unclear.CASE SUMMARY A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal scalp.After admission,computed tomography(CT)angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous malformation.Furthermore,cerebral angiography showed a right temporal lobe VM with multiple vessels supplying blood.The patient underwent surgery to remove the malformed vessels and the eroded skull.Two hours after the surgery,the patient's right pupil was dilated,and an urgent CT scan of the skull showed a right subdural haematoma under the incision,which was urgently removed by a second operation.After surgery,we gave continuous antibiotic anti-infection treatment,and the patient recovered well and was discharged two weeks later.CONCLUSION Surgical removal of giant haemangiomas is risky and adequate preoperative(including interventional embolisation)and intraoperative preparations should be made.
文摘目的基于超声检查与血脂相关指标构建子宫肌瘤发病的预测模型,并对其预测价值进行验证。方法选取女性体检者6333例,统计子宫肌瘤发病情况,根据是否发生子宫肌瘤分为观察组与对照组,比较2组临床资料、超声检查指标[超声特征、子宫动脉收缩期峰值血流速度(peak systolic velocit,PSV)、血流阻力指数(resistance index,RI)、搏动指数(pulsation index,PI)]、血脂相关指标[三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholestero,LDL-C)、总胆固醇(total cholesterol,TC)、血浆致动脉硬化指数(atherogenic index of plasma,AIP)、三酰甘油-葡萄糖指数(triglyceride glucose index,TyG)],构建列线图预测模型,并进行验证。结果经选取标准筛选后,共纳入女性体检者4812例作为入组对象,超声诊断发生子宫肌瘤1065例,子宫肌瘤发病率为22.13%,其中肌壁间肌瘤854例,占80.19%,浆膜下肌瘤156例,占14.65%,黏膜下肌瘤55例,占5.16%;平均子宫肌瘤数目(4.18±1.02)个,平均最大肌瘤直径(6.64±1.89)cm。观察组子宫动脉PSV、PI高于对照组,RI低于对照组(P<0.05);2组HDL-C水平差异无统计学意义(P>0.05),TG、LDL-C、TC、AIP、TyG水平高于对照组(P<0.05);Logistic回归分析,子宫动脉PSV、RI、PI、TG、LDL-C、TC、AIP、TyG是子宫肌瘤发病的独立影响因素(P<0.05);根据上述超声与血脂相关指标构建子宫肌瘤发病的列线图预测模型,校准曲线显示,该预测模型一致性指数为0.827,具有较好的一致性;Hosmer-Lemeshow拟合优度检验显示,P=0.710>0.05,该预测模型拟合度较好;受试者工作特征曲线(receiver operating characteristic,ROC)分析,该预测模型预测子宫肌瘤发病的曲线下面积(area under curve,AUC)为0.912(95%CI:0.837~0.994),敏感度为92.02%,特异度为90.74%。结论基于超声检查参数子宫动脉PSV、RI、PI与血脂指标TG、LDL-C、TC、AIP、TyG构建子宫肌瘤发病预测模型具有可行性,且预测价值较为可靠。
基金Supported by Zhangzhou Natural Science Foundation Projects in 2019,No.ZZ2019J19。
文摘BACKGROUND Postoperative complications of triceps surae intramuscular hemangioma surgery with talipes equinovarus have rarely been described,and the evidence for treatment is limited.The purpose of this case study was to report the new application of the Ilizarov technique,which successfully treated talipes equinovarus in adults after triceps surae intramuscular hemangioma.CASE SUMMARY A 29-year-old woman treated with the Ilizarov technique for talipes equinovarus in the right leg after triceps surae intramuscular hemangioma surgery.The equinus deformity was roughly corrected after 2 years of follow-up,without significant secondary sequelae.CONCLUSION Talipes equinovarus caused by postoperative sequelae of intramuscular hemangioma was successfully corrected by the Ilizarov technique.The Ilizarov technique may be used for treating talipes equinovarus caused by various causes.
基金Supported by the Army Logistics Scientific Research Projects,No.CNJ16C013.
文摘BACKGROUND Rotationplasty is often performed for malignant tumors,but type BIIIb rotationplasty is rarely reported,and there needs to be more evidence of the procedure and treatment.The purpose of this case study was to report a new direction in the use of type BIIIb rotationplasty in treating patients with limb salvage and longterm non-healing infections.CASE SUMMARY Case 1:A 47-year-old man underwent radiotherapy for hemangioendothelioma in his left thigh,resulting in a femoral fracture.Despite the use of plates,intramedullary nailing,and external fixators,the femoral bone failed to unite due to infectious nonunion.Multiple operations were unable to control the infection,leaving the patient immobile.We performed a modified tibia-pelvic-constrained hip rotationplasty,utilizing a constrained prosthetic hip between the tibia and pelvis following a femur resection.Two years post-surgery,the patient was able to walk with the prosthetic device without any signs of recurring infection.The corresponding functional scores were 72 points for the Musculoskeletal Tumor Society(MSTS),53 for the Functional Mobility Assessment(FMA),93 for the Toronto Extremity Salvage Score(TESS),and 56 for the MOS 36-item short form health survey(SF-36).Case 2:A 59-year-old woman presented with liposarcoma in her left thigh.Magnetic resonance imaging revealed tumors in the medial,anterior,and posterior femur muscles,encircling the femoral vessels and nerves.Fortunately,there were no symptoms of sciatic dysfunction,and the tumor had not invaded the sciatic nucleus.After one year of follow-up,the patient expressed satisfaction with limb preservation post-type BIIIb rotationplasty.The corresponding functional scores were 63 points for the MSTS,47 for the FMA,88 for the TESS,and 52 for the SF-36.CONCLUSION Our study suggests that type BIIIb rotationplasty may be an alternative to amputation in patients with incurable infections.For malignant tumors of the lower extremities without invasion of the sciatic nerve,type BIIIb rotationplasty remains an excellent alternative to amputation.This surgical method may prevent amputation,improve functional outcomes,and facilitate biological reconstruction.
