Z-plasty for uterus-to-abdominal-wall fistula

Objective:Uterus-to-abdominal-wall fistula is a very rare complication after uterine-incision delivery over the last decades.It can even lead to death.Mainly,the fistula occurs when big tension and critical infection exist within the incision of uterus and abdominal wall.Methods:The authors described the clinical presentation,pathology of uterus-to-abdominal-wall fistula,and reported their experience in 6 cases who underwent Z-plasty operation for this rare complication from January 1998 to January 2008.Results:All flaps survived completely and all the wounds in abdominal walls healed very well.The six cases were followed up for 1 to 5 years,and no fistula recurrence occurred.Conclusion:Z-plasty technique is a very simple and efficient approach to repair uterus to abdominal fistula after uterine-incision delivery.

基于FAERS数据库的雷莫芦单抗不良事件信号的挖掘与分析

目的 挖掘雷莫芦单抗相关不良反应风险信号,为其在临床安全使用提供参考。方法 检索美国食品药品管理局不良事件报告系统(FAERS)数据库中2014年1月1日—2023年2月1日雷莫芦单抗报告的不良事件(AE)报告,采用报告比值比(ROR)法和比例报告比值比(PRR)法进行联合检验,采用国际医学用语词典首选术语(PT)和系统器官分类(SOC)对AE进行分类统计和描述性分析。结果 共收集到雷莫芦单抗为首要怀疑药物的AE报告1 786份,报告中患者中位年龄66岁,65岁以上患者占比60.46%;男性患者占绝大部分;主要上报国家是日本;部分患者为超说明书适应症用药;严重AE占比54.82%。采用ROR法和PRR法分析,获得123个PT信号,涉及18个SOC,其中有52个PT信号说明书中未记载。本研究挖掘的雷莫芦单抗的主要AE与说明书记载一致,包括高血压、蛋白尿、周围性水肿、骨髓抑制、出血、穿孔等。而伤口愈合并发症、化脓性肉芽肿、脑干出血、间质性肺疾病、腹膜炎等说明书未记载的AE,其报告数较多、信号较强,临床使用时应加以警惕。结论 对数据库中雷莫芦单抗真实世界报告的AE信息进行挖掘和分析,有助于发现新的AE风险信号,提示临床对其加以关注,从而保障患者用药安全。