BACKGROUND This case report demonstrates the simultaneous development of a gastrointestinal stromal tumour(GIST)with arteriovenous malformations(AVMs)within the jejunal mesentery.A 74-year-old male presented to the de...BACKGROUND This case report demonstrates the simultaneous development of a gastrointestinal stromal tumour(GIST)with arteriovenous malformations(AVMs)within the jejunal mesentery.A 74-year-old male presented to the department of surgery at our institution with a one-month history of abdominal pain.Contrast-enhanced computed tomography revealed an AVM.During exploratory laparotomy,hyperspectral imaging(HSI)and indocyanine green(ICG)fluorescence were used to evaluate the extent of the tumour and determine the resection margins.Intraoperative imaging confirmed AVM,while histopathological evaluation showed an epithelioid,partially spindle cell GIST.CASE SUMMARY This is the first case reporting the use of HSI and ICG to image GIST intermingled with an AVM.The resection margins were planned using intraoperative analysis of additional optical data.Image-guided surgery enhances the clinician’s knowledge of tissue composition and facilitates tissue differentiation.CONCLUSION Since image-guided surgery is safe,this procedure should increase in popularity among the next generation of surgeons as it is associated with better postoperative outcomes.展开更多
BACKGROUND Novel strategies are needed for improving guided bone regeneration(GBR) in oral surgery prior to implant placement, particularly in maxillary sinus augmentation(GBR-MSA) and in lateral alveolar ridge augmen...BACKGROUND Novel strategies are needed for improving guided bone regeneration(GBR) in oral surgery prior to implant placement, particularly in maxillary sinus augmentation(GBR-MSA) and in lateral alveolar ridge augmentation(LRA). This study tested the hypothesis that the combination of freshly isolated, unmodified autologous adipose-derived regenerative cells(UA-ADRCs), fraction 2 of plasma rich in growth factors(PRGF-2) and an osteoinductive scaffold(OIS)(UAADRC/PRGF-2/OIS) is superior to the combination of PRGF-2 and the same OIS alone(PRGF-2/OIS) in GBR-MSA/LRA.CASE SUMMARY A 79-year-old patient was treated with a bilateral external sinus lift procedure as well as a bilateral lateral alveolar ridge augmentation. GBR-MSA/LRA was performed with UA-ADRC/PRGF-2/OIS on the right side, and with PRGF-2/OIS on the left side. Biopsies were collected at 6 wk and 34 wk after GBRMSA/LRA. At the latter time point implants were placed. Radiographs(32 mo follow-up time) demonstrated excellent bone healing. No radiological or histological signs of inflammation were observed. Detailed histologic,histomorphometric, and immunohistochemical analysis of the biopsies evidenced that UA-ADRC/PRGF-2/OIS resulted in better and faster bone regeneration than PRGF-2/OIS.CONCLUSION GBR-MSA with UA-ADRCs, PRGF-2, and an OIS shows effectiveness without adverse effects.展开更多
BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique tha...BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.展开更多
BACKGROUND Secondary cardiac involvement by lymphoma has received limited attention in the medical literature, despite its grave prognosis. Although chemotherapy improves patients' survival, a subgroup of treated ...BACKGROUND Secondary cardiac involvement by lymphoma has received limited attention in the medical literature, despite its grave prognosis. Although chemotherapy improves patients' survival, a subgroup of treated patients dies suddenly due to myocardial rupture following chemotherapy initiation. Reducing the initial chemotherapy dose with dose escalation to standard doses may be effective in minimizing this risk but the data are limited. We report on the successful management of a patient with disseminated diffuse large B-cell lymphoma(DLBCL) involving the heart using such approach.CASE SUMMARY An 18-year-old male presented to our hospital with six months history of progressive dyspnea, orthopnea and cough. On physical examination, the patient was found to have a plethoric and mildly edematous face, fixed elevation of the right internal jugular vein, suggestive of superior vena cava obstruction, and a pelvic mass. Investigations during admission including a thoracoabdominal computed tomography(CT) scan with CT guided biopsy of the pelvic mass,echocardiography and cardiac magnetic resonance imaging led to the diagnosis of disseminated DLBCL with cardiac involvement. The patients were successfully treated with chemotherapy dose reduction followed by dose escalation to standard doses, under the guidance of cardiac imaging. The patient completed chemotherapy and underwent a successful bone marrow transplant. He is currently in remission and has a normal left ventricular function.CONCLUSION Imaging-guided chemotherapy dosing may minimize the risk of myocardial rupture in cardiac lymphoma. Data are limited. Management should be individualized.展开更多
[Basckground]This case report presented a methodology for immediate implantation in the esthetic zone with a facial bone defect along with flap surgery,guided bone regeneration,and non-submerged healing.[Case presenta...[Basckground]This case report presented a methodology for immediate implantation in the esthetic zone with a facial bone defect along with flap surgery,guided bone regeneration,and non-submerged healing.[Case presentation]A 27-year-old female patient was complaining of the aesthetic complication that was caused via metallic staining of the neck of ceramic crowns in the maxillary right anterior region for one year.She has experienced immediate implantation along with flap surgery,guided bone regeneration(GBR),and non-submerged healing.The torque of the implant reached to the 35 N·cm to confirm primary stability.Six months after surgery,the healing abutment and the implant were fixed,the gingiva was healthy in the surgical area,and the nearby teeth and the opposite teeth were normal.[Results]The results of cone-beam computer tomography(CBCT)revealed that bone defects were filled with the newly formed bone.At the same time,the final impressions accomplished,and an all-ceramic crown was fit-placed.As a whole,the patient satisfaction rate was high.[Conclusions]Immediate implant placement with flap surgery,GBR,and non-submerged healing with a facial bone wall defect in the esthetic zone is an achievable process.展开更多
BACKGROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth(SNT).Due to the large variation in location and morphology,the extraction of impacted SNTs i...BACKGROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth(SNT).Due to the large variation in location and morphology,the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications.This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates.CASE SUMMARY In January 2022,a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth#36.Clinical examination showed a deep carious lesion with pulpal involvement in tooth#36 and lingual swelling of the bilateral mandibular posterior area.Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars.Based on these findings,the patient was diagnosed with bilateral,multiple impacted SNTs and tooth#36 chronic pulpitis.A root canal treatment and an all-ceramic crown restoration for tooth#36 were performed.An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs.During the operation,the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures.At 3-month follow-up,regeneration of bone and soft tissues was visible.CONCLUSION The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.展开更多
Basis of seventy-seven case records of twenty-six diseases in Linzheng Zhinan Yi'an(Guide to Clinical Practice),analyze and distinguish them into four types.They are disorder of the mother-organ affecting the chil...Basis of seventy-seven case records of twenty-six diseases in Linzheng Zhinan Yi'an(Guide to Clinical Practice),analyze and distinguish them into four types.They are disorder of the mother-organ affecting the child-organ,disorder of the child-organ affecting the mother-organ,over restraint and reverse restraint.The essence of this article is to recognize the pathological transmission among the Zang-fu organs according to the theory of five elements.展开更多
BACKGROUND Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures.However,reports of pulmonary artery foreign bodies during femoral vei...BACKGROUND Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures.However,reports of pulmonary artery foreign bodies during femoral vein puncture are rare,and there is no description of this complication from the guidewire surface flows into the pulmonary artery during a pulse ablation in a patient with atrial fibrillation.CASE SUMMARY We described a case in which a linear foreign body suddenly appeared on fluoroscopy image during pulsed ablation of atrial fibrillation.Multiposition angiography showed that the foreign body was currently lodged in the pulmonary artery but was hemodynamically stable.We then chose to use an interventional approach to remove the foreign body from the pulmonary artery.This foreign body was subsequently confirmed to be from the hydrophilic coating of the guidewire surface.This may be related to the difficulties encountered during the puncture of the femoral vein.This is a rare and serious complication of femoral vein puncture.Therefore,we reported this case in order to avoid a similar situation.CONCLUSION Mismatches between interventional devices from different manufacturers used for femoral venipuncture may result in pulmonary artery foreign bodies.展开更多
目的评估在个性化3D打印导板引导下,行经椎体内截骨术、脊柱内固定术治疗重度脊柱后凸手术的矫形率、椎弓根钉位准确性和治疗效果。方法本研究为单中心非随机性临床试验研究,样本涵盖2018年12月至2023年6月期间接受经椎体内截骨术的19...目的评估在个性化3D打印导板引导下,行经椎体内截骨术、脊柱内固定术治疗重度脊柱后凸手术的矫形率、椎弓根钉位准确性和治疗效果。方法本研究为单中心非随机性临床试验研究,样本涵盖2018年12月至2023年6月期间接受经椎体内截骨术的19例患者(男性8例,女性11例)。其中7例患者为导板组,采用计算机辅助设计(CAD)技术进行术前手术规划和术中个性化3D打印导板引导,12例患者为传统组,采用传统置钉矫正。术后评估包括后凸Cobb角、脊柱矫正率、钉位准确性和Oswestry功能障碍指数问卷调查(Oswestry Dysfunction Index,ODI)。结果研究纳入患者19例,平均年龄48.0岁。平均随访26.4(9~54个月)。所有患者均获得相对满意的矫正效果,导板组平均矫正率为96.83%,传统组为86.61%。导板组与传统组平均术中出血量(857 vs 1045 mL)和平均手术时间(344 vs 402 min)差异无统计学意义,平均住院时间(11 vs 18 d)差异具有统计学意义(P<0.05)。本研究共置钉278枚,其中导板辅助置钉70枚,97.1%为A级或B级;传统组置钉208枚,其中93.8%为A级或B级。术后CT/X线检查显示导板组与传统组后凸畸形矫正均达到一定程度矫正,2组的平均矫正角度(43.37°vs 36.10°)差异无统计学意义;而导板组的矫正率显著高于传统组(96.83%vs 86.61%,P<0.01);ODI评分导板组显著低于传统组(P<0.05)。结论在脊柱截骨术中,利用计算机辅助技术进行术前规划、手术模拟和个性化3D打印导板的辅助,能够改善术后矫形率,提高置钉的准确性,改善严重脊柱后凸畸形患者的生活质量。展开更多
文摘BACKGROUND This case report demonstrates the simultaneous development of a gastrointestinal stromal tumour(GIST)with arteriovenous malformations(AVMs)within the jejunal mesentery.A 74-year-old male presented to the department of surgery at our institution with a one-month history of abdominal pain.Contrast-enhanced computed tomography revealed an AVM.During exploratory laparotomy,hyperspectral imaging(HSI)and indocyanine green(ICG)fluorescence were used to evaluate the extent of the tumour and determine the resection margins.Intraoperative imaging confirmed AVM,while histopathological evaluation showed an epithelioid,partially spindle cell GIST.CASE SUMMARY This is the first case reporting the use of HSI and ICG to image GIST intermingled with an AVM.The resection margins were planned using intraoperative analysis of additional optical data.Image-guided surgery enhances the clinician’s knowledge of tissue composition and facilitates tissue differentiation.CONCLUSION Since image-guided surgery is safe,this procedure should increase in popularity among the next generation of surgeons as it is associated with better postoperative outcomes.
文摘BACKGROUND Novel strategies are needed for improving guided bone regeneration(GBR) in oral surgery prior to implant placement, particularly in maxillary sinus augmentation(GBR-MSA) and in lateral alveolar ridge augmentation(LRA). This study tested the hypothesis that the combination of freshly isolated, unmodified autologous adipose-derived regenerative cells(UA-ADRCs), fraction 2 of plasma rich in growth factors(PRGF-2) and an osteoinductive scaffold(OIS)(UAADRC/PRGF-2/OIS) is superior to the combination of PRGF-2 and the same OIS alone(PRGF-2/OIS) in GBR-MSA/LRA.CASE SUMMARY A 79-year-old patient was treated with a bilateral external sinus lift procedure as well as a bilateral lateral alveolar ridge augmentation. GBR-MSA/LRA was performed with UA-ADRC/PRGF-2/OIS on the right side, and with PRGF-2/OIS on the left side. Biopsies were collected at 6 wk and 34 wk after GBRMSA/LRA. At the latter time point implants were placed. Radiographs(32 mo follow-up time) demonstrated excellent bone healing. No radiological or histological signs of inflammation were observed. Detailed histologic,histomorphometric, and immunohistochemical analysis of the biopsies evidenced that UA-ADRC/PRGF-2/OIS resulted in better and faster bone regeneration than PRGF-2/OIS.CONCLUSION GBR-MSA with UA-ADRCs, PRGF-2, and an OIS shows effectiveness without adverse effects.
文摘BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.
文摘BACKGROUND Secondary cardiac involvement by lymphoma has received limited attention in the medical literature, despite its grave prognosis. Although chemotherapy improves patients' survival, a subgroup of treated patients dies suddenly due to myocardial rupture following chemotherapy initiation. Reducing the initial chemotherapy dose with dose escalation to standard doses may be effective in minimizing this risk but the data are limited. We report on the successful management of a patient with disseminated diffuse large B-cell lymphoma(DLBCL) involving the heart using such approach.CASE SUMMARY An 18-year-old male presented to our hospital with six months history of progressive dyspnea, orthopnea and cough. On physical examination, the patient was found to have a plethoric and mildly edematous face, fixed elevation of the right internal jugular vein, suggestive of superior vena cava obstruction, and a pelvic mass. Investigations during admission including a thoracoabdominal computed tomography(CT) scan with CT guided biopsy of the pelvic mass,echocardiography and cardiac magnetic resonance imaging led to the diagnosis of disseminated DLBCL with cardiac involvement. The patients were successfully treated with chemotherapy dose reduction followed by dose escalation to standard doses, under the guidance of cardiac imaging. The patient completed chemotherapy and underwent a successful bone marrow transplant. He is currently in remission and has a normal left ventricular function.CONCLUSION Imaging-guided chemotherapy dosing may minimize the risk of myocardial rupture in cardiac lymphoma. Data are limited. Management should be individualized.
文摘[Basckground]This case report presented a methodology for immediate implantation in the esthetic zone with a facial bone defect along with flap surgery,guided bone regeneration,and non-submerged healing.[Case presentation]A 27-year-old female patient was complaining of the aesthetic complication that was caused via metallic staining of the neck of ceramic crowns in the maxillary right anterior region for one year.She has experienced immediate implantation along with flap surgery,guided bone regeneration(GBR),and non-submerged healing.The torque of the implant reached to the 35 N·cm to confirm primary stability.Six months after surgery,the healing abutment and the implant were fixed,the gingiva was healthy in the surgical area,and the nearby teeth and the opposite teeth were normal.[Results]The results of cone-beam computer tomography(CBCT)revealed that bone defects were filled with the newly formed bone.At the same time,the final impressions accomplished,and an all-ceramic crown was fit-placed.As a whole,the patient satisfaction rate was high.[Conclusions]Immediate implant placement with flap surgery,GBR,and non-submerged healing with a facial bone wall defect in the esthetic zone is an achievable process.
基金Supported by National Natural Science Foundation of China,No.81970972Applied Basic Research Projects of the 920th Hospital of Joint Logistics Support Force,No.2020YGB06。
文摘BACKGROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth(SNT).Due to the large variation in location and morphology,the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications.This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates.CASE SUMMARY In January 2022,a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth#36.Clinical examination showed a deep carious lesion with pulpal involvement in tooth#36 and lingual swelling of the bilateral mandibular posterior area.Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars.Based on these findings,the patient was diagnosed with bilateral,multiple impacted SNTs and tooth#36 chronic pulpitis.A root canal treatment and an all-ceramic crown restoration for tooth#36 were performed.An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs.During the operation,the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures.At 3-month follow-up,regeneration of bone and soft tissues was visible.CONCLUSION The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.
文摘Basis of seventy-seven case records of twenty-six diseases in Linzheng Zhinan Yi'an(Guide to Clinical Practice),analyze and distinguish them into four types.They are disorder of the mother-organ affecting the child-organ,disorder of the child-organ affecting the mother-organ,over restraint and reverse restraint.The essence of this article is to recognize the pathological transmission among the Zang-fu organs according to the theory of five elements.
基金Supported by the Natural Science Foundation of Shanxi Province,No.20210302123346Shanxi Provincial Health Commission“Four batch”Science and Technology Innovation Project of Medical Development,No.2021XM45.
文摘BACKGROUND Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures.However,reports of pulmonary artery foreign bodies during femoral vein puncture are rare,and there is no description of this complication from the guidewire surface flows into the pulmonary artery during a pulse ablation in a patient with atrial fibrillation.CASE SUMMARY We described a case in which a linear foreign body suddenly appeared on fluoroscopy image during pulsed ablation of atrial fibrillation.Multiposition angiography showed that the foreign body was currently lodged in the pulmonary artery but was hemodynamically stable.We then chose to use an interventional approach to remove the foreign body from the pulmonary artery.This foreign body was subsequently confirmed to be from the hydrophilic coating of the guidewire surface.This may be related to the difficulties encountered during the puncture of the femoral vein.This is a rare and serious complication of femoral vein puncture.Therefore,we reported this case in order to avoid a similar situation.CONCLUSION Mismatches between interventional devices from different manufacturers used for femoral venipuncture may result in pulmonary artery foreign bodies.
基金Humanities and Social Sciences Youth Foundation of Ministry of Education"Research on Related Issues of Guiding Cases Creation"(21YJC820004)Theory and Application Research Project of the People’s Procuratorate of Hubei Province"Research on Key Issues of Judicial System Reform of Procuratorial Organs"(HJ2023A12)。
文摘目的评估在个性化3D打印导板引导下,行经椎体内截骨术、脊柱内固定术治疗重度脊柱后凸手术的矫形率、椎弓根钉位准确性和治疗效果。方法本研究为单中心非随机性临床试验研究,样本涵盖2018年12月至2023年6月期间接受经椎体内截骨术的19例患者(男性8例,女性11例)。其中7例患者为导板组,采用计算机辅助设计(CAD)技术进行术前手术规划和术中个性化3D打印导板引导,12例患者为传统组,采用传统置钉矫正。术后评估包括后凸Cobb角、脊柱矫正率、钉位准确性和Oswestry功能障碍指数问卷调查(Oswestry Dysfunction Index,ODI)。结果研究纳入患者19例,平均年龄48.0岁。平均随访26.4(9~54个月)。所有患者均获得相对满意的矫正效果,导板组平均矫正率为96.83%,传统组为86.61%。导板组与传统组平均术中出血量(857 vs 1045 mL)和平均手术时间(344 vs 402 min)差异无统计学意义,平均住院时间(11 vs 18 d)差异具有统计学意义(P<0.05)。本研究共置钉278枚,其中导板辅助置钉70枚,97.1%为A级或B级;传统组置钉208枚,其中93.8%为A级或B级。术后CT/X线检查显示导板组与传统组后凸畸形矫正均达到一定程度矫正,2组的平均矫正角度(43.37°vs 36.10°)差异无统计学意义;而导板组的矫正率显著高于传统组(96.83%vs 86.61%,P<0.01);ODI评分导板组显著低于传统组(P<0.05)。结论在脊柱截骨术中,利用计算机辅助技术进行术前规划、手术模拟和个性化3D打印导板的辅助,能够改善术后矫形率,提高置钉的准确性,改善严重脊柱后凸畸形患者的生活质量。
