Primary splenic angiosarcoma(PSA) is the most unusual type of malignancy with early multifocal metastasis through hematogenous spread. PSA is generally believed to originate from splenic sinusoidal vascular endotheliu...Primary splenic angiosarcoma(PSA) is the most unusual type of malignancy with early multifocal metastasis through hematogenous spread. PSA is generally believed to originate from splenic sinusoidal vascular endothelium with a high rate of metastasis and to have a poor prognosis. Its etiology and pathogenetic mechanisms have not yet been clearly described. Thus far, only approximately 200 cases have been reported. PSA has variable symptomatology with the potential to present with life-threatening complications. The diagnosis of PSA is challenging; and often late. PSA should be considered in the differential diagnosis of patients with splenomegaly and anemia of unknown etiology. Surgical treatment with splenectomy is considered the only curative intervention for potential long-term disease-free survival. Early diagnosis and treatment are very important. It is important that clinical doctors improve the understanding of PSA. Herein, we report one rare case of PSA with hepatic metastases, along with a review of the current literature.展开更多
BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for...BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for adjuvant therapy.This rare case may provide a reliable therapeutic regime for a better prognosis.CASE SUMMARY A 49-year-old female who complained of right-upper quadrant abdominal pain was diagnosed as having PSA with splenic rupture and liver metastasis.After splenectomy and liver tumor resection,she received sorafenib and camrelizumab therapy.After 15 mo of follow-up,she is in good condition,without recurrence or any identified metastasis.CONCLUSION Immunotherapy combined with targeted therapy could be a potential option for the adjuvant therapy of PSA.展开更多
[Objectives]To observe the clinical efficacy of Shenling Baizhu Powder in the treatment of primary nephrotic syndrome(PNS)featuring damp abundance due to splenic asthenia.[Methods]40 patients with PNS were randomly di...[Objectives]To observe the clinical efficacy of Shenling Baizhu Powder in the treatment of primary nephrotic syndrome(PNS)featuring damp abundance due to splenic asthenia.[Methods]40 patients with PNS were randomly divided into treatment group(n=19)and control group(n=21).In the treatment group and the control group,methylprednisolone tablets were taken orally and cytoxan(CTX)was given intravenously for treatment;in the treatment group,based on oral administration of methylprednisolone tablets and intravenous drip of cytoxan(CTX),oral administration of traditional Chinese medicine(addition and subtraction of Shenling Baizhu Powder)was added.Urine routine,24-hour urinary protein,renal function and serum albumin were re-examined after 4 weeks of treatment.[Results]The total effective rate of the treatment group was significantly higher than that of the control group(89.47%vs 61.90%,P<0.05).After treatment,both groups could effectively reduce the levels of 24-hour urinary protein(P<0.05),serum creatinine(P<0.05)and urea nitrogen(P<0.05),and increase the level of serum albumin(P<0.05),but the degree of improvement in the treatment group was significantly higher than that in the control group(P<0.05),and the difference was statistically significant(P<0.05).[Conclusions]Methylprednisolone combined with addition and subtraction of Shenling Baizhu Powder could effectively reduce urinary protein,improve edema symptoms,shorten the course of hormone use and reduce adverse reactions in the treatment of PNS featuring damp abundance due to splenic asthenia.展开更多
目的探讨脾部分栓塞术联合肝动脉化疗栓塞术在原发性肝癌伴脾功能亢进中的临床疗效及应用价值。方法80例原发性肝癌伴脾功能亢进患者,采用简单化随机法将所有患者分为对照组和实验组,每组40例。对照组患者实施肝动脉化疗栓塞术,实验组...目的探讨脾部分栓塞术联合肝动脉化疗栓塞术在原发性肝癌伴脾功能亢进中的临床疗效及应用价值。方法80例原发性肝癌伴脾功能亢进患者,采用简单化随机法将所有患者分为对照组和实验组,每组40例。对照组患者实施肝动脉化疗栓塞术,实验组患者在对照组的基础上联合脾部分栓塞术。比较两组患者临床疗效、不良反应发生情况以及手术前后谷丙转氨酶(ALT)、总胆红素(TBIL)、白细胞计数(WBC)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。结果实验组治疗总有效率95.0%高于对照组的77.5%,差异具有统计学意义(P<0.05)。实验组患者术前ALT为(55.57±8.56)U/L、TBIL为(24.25±3.12)μmol/L,术后7 d ALT为(33.27±4.08)U/L、TBIL为(17.58±2.15)μmol/L;对照组患者术前ALT为(55.29±8.37)U/L、TBIL为(24.64±3.15)μmol/L,术后7 d ALT为(49.68±6.65)U/L、TBIL为(22.12±2.86)μmol/L。与术前比较,术后7 d两组患者ALT、TBIL水平均有所改善,且与对照组比较,实验组患者的ALT、TBIL水平改善效果更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。实验组患者术前WBC为(2.48±0.26)×10^(9)/L、PLT为(64.36±10.15)×10^(9)/L,术后7 d WBC为(6.57±1.18)×10^(9)/L、PLT为(117.38±18.15)×10^(9)/L;对照组患者术前WBC为(2.39±0.18)×10^(9)/L、PLT为(64.51±10.22)×10^(9)/L,术后7dWBC为(3.68±0.53)×10^(9)/L、PLT为(83.16±12.86)×10^(9)/L。与术前比较,术后7 d两组患者的WBC、PLT水平均有所升高,且与对照组比较,实验组患者的WBC、PLT水平升高幅度更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。实验组患者术前PT为(19.26±2.24)s、APTT为(54.35±8.12)s,术后7 d PT为(10.27±1.88)s、APTT为(31.63±4.15)s;对照组患者术前PT为(19.29±2.26)s、APTT为(54.26±8.10)s,术后7 d PT为(16.56±2.05)s、APTT为(44.32±6.86)s。与术前比较,术后7 d两组患者的PT、APTT均有所缩短,且与对照组比较,实验组患者PT、APTT缩短幅度更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。两组患者术中、术后均未出现严重不良反应,实验组不良反应发生率7.5%低于对照组的27.5%(P<0.05)。结论肝动脉化疗栓塞术联合脾部分栓塞术能够有效改善原发性肝癌伴脾功能亢进患者的肝功能、血常规,促进患者的凝血功能恢复,且安全性良好,值得临床推广应用。展开更多
基金Department of Gastroenterology,the First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou,Zhejiang Province,China
文摘Primary splenic angiosarcoma(PSA) is the most unusual type of malignancy with early multifocal metastasis through hematogenous spread. PSA is generally believed to originate from splenic sinusoidal vascular endothelium with a high rate of metastasis and to have a poor prognosis. Its etiology and pathogenetic mechanisms have not yet been clearly described. Thus far, only approximately 200 cases have been reported. PSA has variable symptomatology with the potential to present with life-threatening complications. The diagnosis of PSA is challenging; and often late. PSA should be considered in the differential diagnosis of patients with splenomegaly and anemia of unknown etiology. Surgical treatment with splenectomy is considered the only curative intervention for potential long-term disease-free survival. Early diagnosis and treatment are very important. It is important that clinical doctors improve the understanding of PSA. Herein, we report one rare case of PSA with hepatic metastases, along with a review of the current literature.
基金Supported by the Natural Science Foundation of Jiangxi Province (No. 20192BAB215012 and No. 20212BAB206027)the Health Commission of Jiangxi Province (No. 20203206)
文摘BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for adjuvant therapy.This rare case may provide a reliable therapeutic regime for a better prognosis.CASE SUMMARY A 49-year-old female who complained of right-upper quadrant abdominal pain was diagnosed as having PSA with splenic rupture and liver metastasis.After splenectomy and liver tumor resection,she received sorafenib and camrelizumab therapy.After 15 mo of follow-up,she is in good condition,without recurrence or any identified metastasis.CONCLUSION Immunotherapy combined with targeted therapy could be a potential option for the adjuvant therapy of PSA.
基金Natural Science Research Project of Guangxi University of Chinese Medicine(2015LX037).
文摘[Objectives]To observe the clinical efficacy of Shenling Baizhu Powder in the treatment of primary nephrotic syndrome(PNS)featuring damp abundance due to splenic asthenia.[Methods]40 patients with PNS were randomly divided into treatment group(n=19)and control group(n=21).In the treatment group and the control group,methylprednisolone tablets were taken orally and cytoxan(CTX)was given intravenously for treatment;in the treatment group,based on oral administration of methylprednisolone tablets and intravenous drip of cytoxan(CTX),oral administration of traditional Chinese medicine(addition and subtraction of Shenling Baizhu Powder)was added.Urine routine,24-hour urinary protein,renal function and serum albumin were re-examined after 4 weeks of treatment.[Results]The total effective rate of the treatment group was significantly higher than that of the control group(89.47%vs 61.90%,P<0.05).After treatment,both groups could effectively reduce the levels of 24-hour urinary protein(P<0.05),serum creatinine(P<0.05)and urea nitrogen(P<0.05),and increase the level of serum albumin(P<0.05),but the degree of improvement in the treatment group was significantly higher than that in the control group(P<0.05),and the difference was statistically significant(P<0.05).[Conclusions]Methylprednisolone combined with addition and subtraction of Shenling Baizhu Powder could effectively reduce urinary protein,improve edema symptoms,shorten the course of hormone use and reduce adverse reactions in the treatment of PNS featuring damp abundance due to splenic asthenia.
文摘目的探讨脾部分栓塞术联合肝动脉化疗栓塞术在原发性肝癌伴脾功能亢进中的临床疗效及应用价值。方法80例原发性肝癌伴脾功能亢进患者,采用简单化随机法将所有患者分为对照组和实验组,每组40例。对照组患者实施肝动脉化疗栓塞术,实验组患者在对照组的基础上联合脾部分栓塞术。比较两组患者临床疗效、不良反应发生情况以及手术前后谷丙转氨酶(ALT)、总胆红素(TBIL)、白细胞计数(WBC)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。结果实验组治疗总有效率95.0%高于对照组的77.5%,差异具有统计学意义(P<0.05)。实验组患者术前ALT为(55.57±8.56)U/L、TBIL为(24.25±3.12)μmol/L,术后7 d ALT为(33.27±4.08)U/L、TBIL为(17.58±2.15)μmol/L;对照组患者术前ALT为(55.29±8.37)U/L、TBIL为(24.64±3.15)μmol/L,术后7 d ALT为(49.68±6.65)U/L、TBIL为(22.12±2.86)μmol/L。与术前比较,术后7 d两组患者ALT、TBIL水平均有所改善,且与对照组比较,实验组患者的ALT、TBIL水平改善效果更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。实验组患者术前WBC为(2.48±0.26)×10^(9)/L、PLT为(64.36±10.15)×10^(9)/L,术后7 d WBC为(6.57±1.18)×10^(9)/L、PLT为(117.38±18.15)×10^(9)/L;对照组患者术前WBC为(2.39±0.18)×10^(9)/L、PLT为(64.51±10.22)×10^(9)/L,术后7dWBC为(3.68±0.53)×10^(9)/L、PLT为(83.16±12.86)×10^(9)/L。与术前比较,术后7 d两组患者的WBC、PLT水平均有所升高,且与对照组比较,实验组患者的WBC、PLT水平升高幅度更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。实验组患者术前PT为(19.26±2.24)s、APTT为(54.35±8.12)s,术后7 d PT为(10.27±1.88)s、APTT为(31.63±4.15)s;对照组患者术前PT为(19.29±2.26)s、APTT为(54.26±8.10)s,术后7 d PT为(16.56±2.05)s、APTT为(44.32±6.86)s。与术前比较,术后7 d两组患者的PT、APTT均有所缩短,且与对照组比较,实验组患者PT、APTT缩短幅度更明显,均恢复至正常水平,差异具有统计学意义(P<0.05)。两组患者术中、术后均未出现严重不良反应,实验组不良反应发生率7.5%低于对照组的27.5%(P<0.05)。结论肝动脉化疗栓塞术联合脾部分栓塞术能够有效改善原发性肝癌伴脾功能亢进患者的肝功能、血常规,促进患者的凝血功能恢复,且安全性良好,值得临床推广应用。
