BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnorm...BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young woman.CASE SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 deletion.Upon arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting dullness.Ascites were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral adnexa.Blood tests showed elevated CA-125 levels.Paracentesis was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian cancer.The patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian tube.Subsequently,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current condition.CONCLUSION This study demonstrates a rare correlation between a chromosome 4q abnormality and HGSC.UBE2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer development.In addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.展开更多
BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology researc...BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology research,and some scholars believe that the origin of ovarian malignant tumors is the fallopian tubes.Primary fallopian tube cancer is the lowest incidence of malignant tumors in the female reproductive system.There are only a few reports in the literature,but the mortality rate is very high.But in clinical practice,fallopian tube cancer is very common,but in most cases,it is classified as ovarian cancer.CASE SUMMARY We report a 54 years old postmenopausal woman who was hospitalized with a lower abdominal mass and underwent surgical treatment.The final pathological confirmation was low-grade serous carcinoma of the right ovary and low-grade serous carcinoma of the left fallopian tube.No special treatment was performed after the surgery,and the patient was instructed to undergo regular follow-up without any signs of disease progression.CONCLUSION The prognosis of LGSOC is relatively good,over 80%of patients still experience disease recurrence.展开更多
Stress corrosion cracking (SCC) behavior of P 110 tubing steel in simulated C02 injection well annulus environments was investigated through three-point bent tests, potentiodynamic polarization and EIS measurements....Stress corrosion cracking (SCC) behavior of P 110 tubing steel in simulated C02 injection well annulus environments was investigated through three-point bent tests, potentiodynamic polarization and EIS measurements. The results demonstrate that SCC of P110 tubing steel could occur in acidulous simulated environment, and the sensitivity of SCC increases with the decrease ofpH, as well as increase of sulfide concentration and total environmental pressure. Both anodic dissolution and hydrogen embrittlement make contributions to the SCC. Adequate concentration of corrosion inhibitor can inhibit the occurrence of SCC on account of the inhibition of localized anodic dissolution and cathodic hydrogen evolution.展开更多
BACKGROUND Endometriosis is a common gynecological disorder that affects women of reproductive age.It is characterized by a cancer-like invasion of the extra-uterine endometrium and exhibits a strong association with ...BACKGROUND Endometriosis is a common gynecological disorder that affects women of reproductive age.It is characterized by a cancer-like invasion of the extra-uterine endometrium and exhibits a strong association with ovarian clear cell cancer and endometrioid cancer.Endometriosis-associated fallopian tube endometrioid adenocarcinoma synchronized with endometrial adenocarcinoma was rarely reported.CASE SUMMARY A 49-year-old woman was referred to our hospital complaining about abnormal vaginal bleeding for three years following unsatisfactory medication.Intraop-erative frozen sections unexpectedly unveiled an endometrioid cancer of the left fallopian tube with superficial invasion surrounded by diffuse endometriosis synchronized with endometrioid endometrial cancer.CONCLUSION It was difficult to make a differential diagnosis when confronted with incidental findings of fallopian tube cancer lesions synchronized with endometrial cancer.The key differential diagnosis of primary endometriosis-associated endometrioid adenocarcinoma of the fallopian tube from endometrial adenocarcinoma invol-vement relies on the pathological identification of malignant transformation in fallopian tube endometriosis disease.展开更多
Since convective boiling or highly subcooled single-phase forced convection in micro-channels is an effective cooling mechanism with a wide range of applications, more experimental and theoretical studies are re- quir...Since convective boiling or highly subcooled single-phase forced convection in micro-channels is an effective cooling mechanism with a wide range of applications, more experimental and theoretical studies are re- quired to explain and verify the forced convection heat transfer phenomenon in narrow channels. In this experimental study, we model the convective boiling behavior of water with low latent heat substance Freon 113 (R-113), with the purpose of saving power consumption and visualizing experiments. Both heat transfer and pressure drop characteris- tics were measured in subcooled and saturated concentric narrow gap forced convection boiling. Data were obtained to qualitatively identify the effects of gap size, pressure, flow rate and wall superheat on boiling regimes and the tran- sition between various regimes. Some significant differences from unconfined forced convection boiling were found, and also, the flow patterns in narrow vertical annulus tubes have been studied quantitatively.展开更多
BACKGROUND Mesonephric adenocarcinoma(MNAC)is an extremely rare malignancy in the female genital tract.Only a few cases have been reported in the literature,and most of them occurred in the cervix,with extremely rare ...BACKGROUND Mesonephric adenocarcinoma(MNAC)is an extremely rare malignancy in the female genital tract.Only a few cases have been reported in the literature,and most of them occurred in the cervix,with extremely rare cases in the uterine body and ovary.MNAC has never been reported to arise in the fallopian tube.CASE SUMMARY A 45-year-old woman was referred to our institution with a history of abdominal pain.Ultrasound revealed a cystic and solid mass in left adnexal region.The patient underwent complete staging surgery when intraoperative pathological examination demonstrated that the mass was malignant.The final histological and immunohistochemical results confirmed the diagnosis of MNAC originating from the fallopian tube.Then she received four cycles of combination chemotherapy with carboplatin plus paclitaxel.The tumor recurred with hepatic metastases 4 mo after initial surgery,and second resection of the tumors in the liver plus partial hepatectomy was performed.She was supplemented with five courses of a new combination chemotherapy with gemcitabine plus carboplatin,and there was no evidence of recurrence within the 22-mo follow-up period after the second surgery.CONCLUSION MNAC originating from the fallopian tube is an extremely rare and high malignancy with a poor prognosis.It can be very aggressive,even at early stage.Little is known about the clinical characteristics,pathological diagnosis,prognosis,and optimal management strategy of MNAC originating from the fallopian tube.Herein we report the first case of primary MNAC deriving from the fallopian tube.展开更多
BACKGROUND The indwelling nasogastric tube is commonly used for supplying enteral nutrition to patients who are unable to feed themselves,and accurate positioning is essential in the indwelling nasogastric tube in the...BACKGROUND The indwelling nasogastric tube is commonly used for supplying enteral nutrition to patients who are unable to feed themselves,and accurate positioning is essential in the indwelling nasogastric tube in the body of the aforementioned patients.In clinical practice,abdominal radiography,auscultation,and clinical determination of the pH of the gastric juice are routinely used by medical personnel to determine the position of the tube;however,those treatments have proved limitations in specific cases.There are few case reports on the precise positioning of the nasogastric tube in patients with coronavirus disease 2019(COVID-19),for whom a supply of necessary nutrition support is significant throughout the process of treatment.CASE SUMMARY A 79-year-old patient,diagnosed with COVID-19 at the stage of combined syndromes with severe bacterial lung infection,respiratory failure,multiple comorbidities,and a poor nutritional status,was presented to us and required an indwelling nasogastric tube for enteral nutrition support.After pre-treatment assessments including observation of the patient’s nasal feeding status and examination of the nasal septal deviation,inflammation,obstruction,nasal leakage of cerebrospinal fluid,and other disorders that might render intubation inappropriate,we measured and marked the length of the nasogastric tube to be placed and delivered the tube to the intended length in the standard manner.Then further scrutiny was conducted to ensure that the tube was not coiled in the mouth,and gentle movements were made to avoid damage to the esophageal mucosa.However,back draw of the gastric juice using an empty needle failed,and the stethoscope could not be used for auscultation due to the specific condition presented by the internal organs of the patient,and the end of the tube was placed in saline with no bubbles spilling out.Therefore,it was not possible to determine whether the nasogastric tube was placed exactly in the stomach and no nutrient infusion was performed for the time being.Subsequently,the ultrasound probe was utilized to view the condition of the patient’s stomach,where the nasogastric tube was found to be translucent and running parallel to the esophagus shaped as“=”.The pre-conditions were achieved and 100 mL nutritional fluid was fed to the patient,who did not experience any discomfort throughout the procedure.His vital signs were stable with no adverse effects.CONCLUSION We achieved successfully used ultrasound to position the nasogastric tube in a 79-year-old patient with COVID-19.The repeatable ultrasound application does not involve radiation and causes less disturbance in the neck,making it advantageous for rapid positioning of the nasogastric tube and worthy of clinical promotion and application.展开更多
BACKGROUND Hilar cholangiocarcinoma(CC)is a common malignant tumor with high malignancy and poor prognosis.Most patients have lost the opportunity to undergo radical surgery when diagnosed.Although palliative drainage...BACKGROUND Hilar cholangiocarcinoma(CC)is a common malignant tumor with high malignancy and poor prognosis.Most patients have lost the opportunity to undergo radical surgery when diagnosed.Although palliative drainage or biliary stent placement is a preferable choice,the tumor cannot be controlled.This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage,thereby prolonging the survival time of patients.CASE SUMMARY A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice.He was admitted to the hospital because of the recurrence of jaundice.Preoperative imaging and pathological biopsy revealed hilar CC(Bismuth-Corlette type IIIa).First,the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved.To further treat hilar CC and remove the biliary drainage tube as far as possible,the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation.After 1 mo of brachytherapy,the re-examination revealed that the obstructive lesions disappeared,and the drainage tube was finally removed.During the following 10 mo of follow-up,the patient's hilar CC did not recur.CONCLUSION The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.展开更多
BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we de...BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)technique.CASE SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 years.Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx.Tumor excision was arranged.However,we encountered CICO during anesthesia induction.An endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway.The patient did not experience desaturation despite sudden loss of definite airway.During tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the patient.The arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation afterward.CONCLUSION Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.展开更多
BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also increased.Total resection of the gastric tube with lymph node ...BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also increased.Total resection of the gastric tube with lymph node dissection is considered a radical treatment,but GTC surgery is more invasive and involves a higher risk of severe complications or death,particularly in elderly patients.CASE SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y(R-Y)reconstruction.The tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric ring.Endoscopic submucosal resection was not indicated because the primary lesion was submucosally invasive,was undifferentiated type,surrounded the pyloric ring,and had invaded the duodenum.Resection of distal gastric tube with R-Y reconstruction was safely performed,with preservation of the right gastroepiploic artery(RGEA)and right gastric artery(RGA).CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.展开更多
BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a...BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.展开更多
In this paper, boiling heat transfer in a vertical annulus with inner side heated with and without air introduction is experimentally studied. Results show that boiling heat transfer is significantly enhanced by the i...In this paper, boiling heat transfer in a vertical annulus with inner side heated with and without air introduction is experimentally studied. Results show that boiling heat transfer is significantly enhanced by the introduction of air. When air is introduced into the liquid with a temperature below boiling point, the enhancement of heat transfer is also detected. It is concluded from the study that the heat transfer enhanced by introduction of inert gas is due to the liquid vaporization at the gas-liquid interface near the wall, which removes a large amount of latent heat and lowers the interfacial temperature considerably. Thus the gas-liquid interface acts as a 'heat sink'and the heat transfer is augmented significantly.展开更多
The main failure modes of tubing and casing in current service conditions are represented in this study.The progress of the tubing and casing application technology and the problems that should be focused on during ap...The main failure modes of tubing and casing in current service conditions are represented in this study.The progress of the tubing and casing application technology and the problems that should be focused on during application are introduced,with special attention paid to the reliability of the pipe string design and the connection sealing properties.The necessary work that should be undertaken in future research is also summarized.展开更多
BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY Thi...BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY This case report describes the rare situation wherein a surgeon inadvertently detached the inflatable tube of an endotracheal tube during a tonsillectomy,and positive pressure ventilation could not be provided.While reintubation may increase the risk of respiratory tract infection and aspiration,patients with a difficult airway might die due to apnea.The best treatment method is to optimize the damaged tracheal tube junction to avoid secondary intubation and ensure patient safety.An intravenous needle and cannula were used to repair the damaged gap in the current case.Following the repair,the anesthesia machine showed no indication of low tidal volume,and there was no deflation of the endotracheal tube cuff.Subsequently,the patient was transferred to the postanesthesia recovery room,and the tracheal tube was removed with satisfactory results.CONCLUSION Using an intravenous needle to repair a break in the inflatable tube surrounding an endotracheal tube is safe and reliable.展开更多
BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to t...BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to the intensive care unit for aspiration pneumonia and respiratory failure.When confirming the position of the jejunal tube by X-ray,we found that the feeding tube had been placed into the chest.The complications was a disaster,though the misplacement of jejunal feeding tube are uncommon.CONCLUSION We introduced a way of ultrasound-guided jejunum feeding tube placement to avert the disaster,which was convenient and economical.展开更多
BACKGROUND Afferent loop syndrome(ALS)is a rare mechanical complication that occurs after reconstruction of the stomach or esophagus to the jejunum,such as Billroth II gastrojejunostomy,Roux-en-Y gastrojejunostomy,or ...BACKGROUND Afferent loop syndrome(ALS)is a rare mechanical complication that occurs after reconstruction of the stomach or esophagus to the jejunum,such as Billroth II gastrojejunostomy,Roux-en-Y gastrojejunostomy,or Roux-en-Y esophagojejunostomy.Traditionally,an operation is the first choice for benign causes.However,for patients in poor physical condition who experience ALS soon after R0 resection,the type of treatment remains controversial.Here,we present an efficient conservative method to treat ALS.CASE SUMMARY Case 1 was a 69-year-old male patient who underwent total gastrectomy with Roux-en-Y jejunojejunostomy.On postoperative day(POD)10 he developed symptoms of ALS that persisted and increased over 1 wk.Case 2 was a 59-yearold male patient who underwent distal gastrectomy with Billroth II gastrojejunostomy.On postoperative day POD 9 he developed symptoms of ALS that persisted for 2 wk.Both patients underwent fluoroscopic-guided nasointestinal tube placement with maintenance of continuous negative pressure suction.Approximately 20 d after the procedure,both patients had recovered well and were discharged from hospital after removal of the tube.At 3-mo follow-up,there were no signs of ALS in these two patients.CONCLUSION This is the first report of treating postoperative ALS by fluoroscopic-guided nasointestinal tube placement.Our cases demonstrate that this procedure is an effective and safe method to treat ALS that relieves patients’symptoms and avoids complications caused by other invasive procedures.展开更多
BACKGROUND Trauma is one of the leading causes of death in the pediatric population.Bronchial rupture is rare,but there are potentially severe complications.Establishing and maintaining a patent airway is the key issu...BACKGROUND Trauma is one of the leading causes of death in the pediatric population.Bronchial rupture is rare,but there are potentially severe complications.Establishing and maintaining a patent airway is the key issue in patients with bronchial rupture.Here we describe an innovative method for maintaining a patent airway.CASE SUMMARY A 3-year-old boy fell from the seventh floor.Oxygenation worsened rapidly with pulse oxygen saturation decreasing below 60%,as his heart rate dropped.Persistent pneumothorax was observed with insertion of the chest tube.Fiberoptic bronchoscopy was performed,which confirmed the diagnosis of bronchial rupture.A modified tracheal tube was inserted under the guidance of a fiberoptic bronchoscope.Pulse oxygen saturation improved from 60%to 90%.Twelve days after admission,right upper lobectomy was performed using bronchial stump suture by video-assisted thoracic surgery without complications.A follow-up chest radiograph showed good recovery.The child was discharged from hospital three months after admission.CONCLUSION A modified tracheal tube could be selected to ensure a patent airway and adequate ventilation in patients with bronchial rupture.展开更多
BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with...BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy,for which he had been operated on twice,was referred to our hospital for chronic otitis,cholesteatoma and a middle ear mass.Computed tomography(CT)scan and magnetic resonance imaging(MRI)revealed a eustachian tube teratoma,in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue.The mass was removed completely under general anesthesia by mastoidectomy.As of last follow-up(2 years post-surgery),the disease had not relapsed.CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma.Complete surgical resection provided excellent prognosis.展开更多
BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a repor...BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a reportedly lower incidence in adults.CASE SUMMARY This study reports an adult patient(male,56 years)who suffered from intracranial aneurysm and subarachnoid hemorrhage and underwent aneurysm clipping following hospitalization.One month post onset of the disease,the patient underwent ventriculoperitoneal shunt due to hydrocephalus.The peritoneal end of the shunt tube was displaced in the peritoneal cavity 9 years after the aneurysm clipping.The peritoneal end of the shunt tube was removed and ventriculoperitoneal shunt was re-performed after anti-inflammatory treatment.CONCLUSION Shunt tube displacement has a low incidence in adults.In order to avoid shunt tube displacement,there is a need to summarize its causative factors and practice personalized medicine.展开更多
BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the inv...BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.展开更多
文摘BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young woman.CASE SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 deletion.Upon arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting dullness.Ascites were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral adnexa.Blood tests showed elevated CA-125 levels.Paracentesis was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian cancer.The patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian tube.Subsequently,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current condition.CONCLUSION This study demonstrates a rare correlation between a chromosome 4q abnormality and HGSC.UBE2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer development.In addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.
文摘BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology research,and some scholars believe that the origin of ovarian malignant tumors is the fallopian tubes.Primary fallopian tube cancer is the lowest incidence of malignant tumors in the female reproductive system.There are only a few reports in the literature,but the mortality rate is very high.But in clinical practice,fallopian tube cancer is very common,but in most cases,it is classified as ovarian cancer.CASE SUMMARY We report a 54 years old postmenopausal woman who was hospitalized with a lower abdominal mass and underwent surgical treatment.The final pathological confirmation was low-grade serous carcinoma of the right ovary and low-grade serous carcinoma of the left fallopian tube.No special treatment was performed after the surgery,and the patient was instructed to undergo regular follow-up without any signs of disease progression.CONCLUSION The prognosis of LGSOC is relatively good,over 80%of patients still experience disease recurrence.
基金Project(2012AA040105)supported by the High-tech Research and Development Program of ChinaProject(2014CB643300)supported by National Basic Research Program of ChinaProject(51741034)supported by National Natural Science Foundation of China
文摘Stress corrosion cracking (SCC) behavior of P 110 tubing steel in simulated C02 injection well annulus environments was investigated through three-point bent tests, potentiodynamic polarization and EIS measurements. The results demonstrate that SCC of P110 tubing steel could occur in acidulous simulated environment, and the sensitivity of SCC increases with the decrease ofpH, as well as increase of sulfide concentration and total environmental pressure. Both anodic dissolution and hydrogen embrittlement make contributions to the SCC. Adequate concentration of corrosion inhibitor can inhibit the occurrence of SCC on account of the inhibition of localized anodic dissolution and cathodic hydrogen evolution.
文摘BACKGROUND Endometriosis is a common gynecological disorder that affects women of reproductive age.It is characterized by a cancer-like invasion of the extra-uterine endometrium and exhibits a strong association with ovarian clear cell cancer and endometrioid cancer.Endometriosis-associated fallopian tube endometrioid adenocarcinoma synchronized with endometrial adenocarcinoma was rarely reported.CASE SUMMARY A 49-year-old woman was referred to our hospital complaining about abnormal vaginal bleeding for three years following unsatisfactory medication.Intraop-erative frozen sections unexpectedly unveiled an endometrioid cancer of the left fallopian tube with superficial invasion surrounded by diffuse endometriosis synchronized with endometrioid endometrial cancer.CONCLUSION It was difficult to make a differential diagnosis when confronted with incidental findings of fallopian tube cancer lesions synchronized with endometrial cancer.The key differential diagnosis of primary endometriosis-associated endometrioid adenocarcinoma of the fallopian tube from endometrial adenocarcinoma invol-vement relies on the pathological identification of malignant transformation in fallopian tube endometriosis disease.
基金Supported by the 973 Project of China (G1999022308) and the Knowledge Innovation Program of the Chinese Academy of Sciences (KJCX2-SW-L05)
文摘Since convective boiling or highly subcooled single-phase forced convection in micro-channels is an effective cooling mechanism with a wide range of applications, more experimental and theoretical studies are re- quired to explain and verify the forced convection heat transfer phenomenon in narrow channels. In this experimental study, we model the convective boiling behavior of water with low latent heat substance Freon 113 (R-113), with the purpose of saving power consumption and visualizing experiments. Both heat transfer and pressure drop characteris- tics were measured in subcooled and saturated concentric narrow gap forced convection boiling. Data were obtained to qualitatively identify the effects of gap size, pressure, flow rate and wall superheat on boiling regimes and the tran- sition between various regimes. Some significant differences from unconfined forced convection boiling were found, and also, the flow patterns in narrow vertical annulus tubes have been studied quantitatively.
文摘BACKGROUND Mesonephric adenocarcinoma(MNAC)is an extremely rare malignancy in the female genital tract.Only a few cases have been reported in the literature,and most of them occurred in the cervix,with extremely rare cases in the uterine body and ovary.MNAC has never been reported to arise in the fallopian tube.CASE SUMMARY A 45-year-old woman was referred to our institution with a history of abdominal pain.Ultrasound revealed a cystic and solid mass in left adnexal region.The patient underwent complete staging surgery when intraoperative pathological examination demonstrated that the mass was malignant.The final histological and immunohistochemical results confirmed the diagnosis of MNAC originating from the fallopian tube.Then she received four cycles of combination chemotherapy with carboplatin plus paclitaxel.The tumor recurred with hepatic metastases 4 mo after initial surgery,and second resection of the tumors in the liver plus partial hepatectomy was performed.She was supplemented with five courses of a new combination chemotherapy with gemcitabine plus carboplatin,and there was no evidence of recurrence within the 22-mo follow-up period after the second surgery.CONCLUSION MNAC originating from the fallopian tube is an extremely rare and high malignancy with a poor prognosis.It can be very aggressive,even at early stage.Little is known about the clinical characteristics,pathological diagnosis,prognosis,and optimal management strategy of MNAC originating from the fallopian tube.Herein we report the first case of primary MNAC deriving from the fallopian tube.
基金Supported by Chongqing Medical Scientific Research Project,No.2020FYYX046。
文摘BACKGROUND The indwelling nasogastric tube is commonly used for supplying enteral nutrition to patients who are unable to feed themselves,and accurate positioning is essential in the indwelling nasogastric tube in the body of the aforementioned patients.In clinical practice,abdominal radiography,auscultation,and clinical determination of the pH of the gastric juice are routinely used by medical personnel to determine the position of the tube;however,those treatments have proved limitations in specific cases.There are few case reports on the precise positioning of the nasogastric tube in patients with coronavirus disease 2019(COVID-19),for whom a supply of necessary nutrition support is significant throughout the process of treatment.CASE SUMMARY A 79-year-old patient,diagnosed with COVID-19 at the stage of combined syndromes with severe bacterial lung infection,respiratory failure,multiple comorbidities,and a poor nutritional status,was presented to us and required an indwelling nasogastric tube for enteral nutrition support.After pre-treatment assessments including observation of the patient’s nasal feeding status and examination of the nasal septal deviation,inflammation,obstruction,nasal leakage of cerebrospinal fluid,and other disorders that might render intubation inappropriate,we measured and marked the length of the nasogastric tube to be placed and delivered the tube to the intended length in the standard manner.Then further scrutiny was conducted to ensure that the tube was not coiled in the mouth,and gentle movements were made to avoid damage to the esophageal mucosa.However,back draw of the gastric juice using an empty needle failed,and the stethoscope could not be used for auscultation due to the specific condition presented by the internal organs of the patient,and the end of the tube was placed in saline with no bubbles spilling out.Therefore,it was not possible to determine whether the nasogastric tube was placed exactly in the stomach and no nutrient infusion was performed for the time being.Subsequently,the ultrasound probe was utilized to view the condition of the patient’s stomach,where the nasogastric tube was found to be translucent and running parallel to the esophagus shaped as“=”.The pre-conditions were achieved and 100 mL nutritional fluid was fed to the patient,who did not experience any discomfort throughout the procedure.His vital signs were stable with no adverse effects.CONCLUSION We achieved successfully used ultrasound to position the nasogastric tube in a 79-year-old patient with COVID-19.The repeatable ultrasound application does not involve radiation and causes less disturbance in the neck,making it advantageous for rapid positioning of the nasogastric tube and worthy of clinical promotion and application.
文摘BACKGROUND Hilar cholangiocarcinoma(CC)is a common malignant tumor with high malignancy and poor prognosis.Most patients have lost the opportunity to undergo radical surgery when diagnosed.Although palliative drainage or biliary stent placement is a preferable choice,the tumor cannot be controlled.This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage,thereby prolonging the survival time of patients.CASE SUMMARY A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice.He was admitted to the hospital because of the recurrence of jaundice.Preoperative imaging and pathological biopsy revealed hilar CC(Bismuth-Corlette type IIIa).First,the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved.To further treat hilar CC and remove the biliary drainage tube as far as possible,the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation.After 1 mo of brachytherapy,the re-examination revealed that the obstructive lesions disappeared,and the drainage tube was finally removed.During the following 10 mo of follow-up,the patient's hilar CC did not recur.CONCLUSION The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.
文摘BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)technique.CASE SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 years.Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx.Tumor excision was arranged.However,we encountered CICO during anesthesia induction.An endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway.The patient did not experience desaturation despite sudden loss of definite airway.During tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the patient.The arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation afterward.CONCLUSION Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.
文摘BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also increased.Total resection of the gastric tube with lymph node dissection is considered a radical treatment,but GTC surgery is more invasive and involves a higher risk of severe complications or death,particularly in elderly patients.CASE SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y(R-Y)reconstruction.The tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric ring.Endoscopic submucosal resection was not indicated because the primary lesion was submucosally invasive,was undifferentiated type,surrounded the pyloric ring,and had invaded the duodenum.Resection of distal gastric tube with R-Y reconstruction was safely performed,with preservation of the right gastroepiploic artery(RGEA)and right gastric artery(RGA).CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.
文摘BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.
文摘In this paper, boiling heat transfer in a vertical annulus with inner side heated with and without air introduction is experimentally studied. Results show that boiling heat transfer is significantly enhanced by the introduction of air. When air is introduced into the liquid with a temperature below boiling point, the enhancement of heat transfer is also detected. It is concluded from the study that the heat transfer enhanced by introduction of inert gas is due to the liquid vaporization at the gas-liquid interface near the wall, which removes a large amount of latent heat and lowers the interfacial temperature considerably. Thus the gas-liquid interface acts as a 'heat sink'and the heat transfer is augmented significantly.
文摘The main failure modes of tubing and casing in current service conditions are represented in this study.The progress of the tubing and casing application technology and the problems that should be focused on during application are introduced,with special attention paid to the reliability of the pipe string design and the connection sealing properties.The necessary work that should be undertaken in future research is also summarized.
文摘BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY This case report describes the rare situation wherein a surgeon inadvertently detached the inflatable tube of an endotracheal tube during a tonsillectomy,and positive pressure ventilation could not be provided.While reintubation may increase the risk of respiratory tract infection and aspiration,patients with a difficult airway might die due to apnea.The best treatment method is to optimize the damaged tracheal tube junction to avoid secondary intubation and ensure patient safety.An intravenous needle and cannula were used to repair the damaged gap in the current case.Following the repair,the anesthesia machine showed no indication of low tidal volume,and there was no deflation of the endotracheal tube cuff.Subsequently,the patient was transferred to the postanesthesia recovery room,and the tracheal tube was removed with satisfactory results.CONCLUSION Using an intravenous needle to repair a break in the inflatable tube surrounding an endotracheal tube is safe and reliable.
基金Supported by The Science and Technology Project of Taizhou,No.1902KY02.
文摘BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to the intensive care unit for aspiration pneumonia and respiratory failure.When confirming the position of the jejunal tube by X-ray,we found that the feeding tube had been placed into the chest.The complications was a disaster,though the misplacement of jejunal feeding tube are uncommon.CONCLUSION We introduced a way of ultrasound-guided jejunum feeding tube placement to avert the disaster,which was convenient and economical.
基金Supported by National Natural Science Foundation of China,No.81772642Capital’s Funds for Health Improvement and Research,No.CFH2018-2-4022Wu Jieping Medical Foundation,No.320.6750.15276.
文摘BACKGROUND Afferent loop syndrome(ALS)is a rare mechanical complication that occurs after reconstruction of the stomach or esophagus to the jejunum,such as Billroth II gastrojejunostomy,Roux-en-Y gastrojejunostomy,or Roux-en-Y esophagojejunostomy.Traditionally,an operation is the first choice for benign causes.However,for patients in poor physical condition who experience ALS soon after R0 resection,the type of treatment remains controversial.Here,we present an efficient conservative method to treat ALS.CASE SUMMARY Case 1 was a 69-year-old male patient who underwent total gastrectomy with Roux-en-Y jejunojejunostomy.On postoperative day(POD)10 he developed symptoms of ALS that persisted and increased over 1 wk.Case 2 was a 59-yearold male patient who underwent distal gastrectomy with Billroth II gastrojejunostomy.On postoperative day POD 9 he developed symptoms of ALS that persisted for 2 wk.Both patients underwent fluoroscopic-guided nasointestinal tube placement with maintenance of continuous negative pressure suction.Approximately 20 d after the procedure,both patients had recovered well and were discharged from hospital after removal of the tube.At 3-mo follow-up,there were no signs of ALS in these two patients.CONCLUSION This is the first report of treating postoperative ALS by fluoroscopic-guided nasointestinal tube placement.Our cases demonstrate that this procedure is an effective and safe method to treat ALS that relieves patients’symptoms and avoids complications caused by other invasive procedures.
文摘BACKGROUND Trauma is one of the leading causes of death in the pediatric population.Bronchial rupture is rare,but there are potentially severe complications.Establishing and maintaining a patent airway is the key issue in patients with bronchial rupture.Here we describe an innovative method for maintaining a patent airway.CASE SUMMARY A 3-year-old boy fell from the seventh floor.Oxygenation worsened rapidly with pulse oxygen saturation decreasing below 60%,as his heart rate dropped.Persistent pneumothorax was observed with insertion of the chest tube.Fiberoptic bronchoscopy was performed,which confirmed the diagnosis of bronchial rupture.A modified tracheal tube was inserted under the guidance of a fiberoptic bronchoscope.Pulse oxygen saturation improved from 60%to 90%.Twelve days after admission,right upper lobectomy was performed using bronchial stump suture by video-assisted thoracic surgery without complications.A follow-up chest radiograph showed good recovery.The child was discharged from hospital three months after admission.CONCLUSION A modified tracheal tube could be selected to ensure a patent airway and adequate ventilation in patients with bronchial rupture.
基金Shandong Province Key Research and Development Program Project,No.2018GSF118041Shandong Medical and Health Science and Technology Development Plan,No.2017WS740.
文摘BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy,for which he had been operated on twice,was referred to our hospital for chronic otitis,cholesteatoma and a middle ear mass.Computed tomography(CT)scan and magnetic resonance imaging(MRI)revealed a eustachian tube teratoma,in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue.The mass was removed completely under general anesthesia by mastoidectomy.As of last follow-up(2 years post-surgery),the disease had not relapsed.CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma.Complete surgical resection provided excellent prognosis.
基金National Natural Science Foundation of China,No.81773161 and No.81572472.
文摘BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a reportedly lower incidence in adults.CASE SUMMARY This study reports an adult patient(male,56 years)who suffered from intracranial aneurysm and subarachnoid hemorrhage and underwent aneurysm clipping following hospitalization.One month post onset of the disease,the patient underwent ventriculoperitoneal shunt due to hydrocephalus.The peritoneal end of the shunt tube was displaced in the peritoneal cavity 9 years after the aneurysm clipping.The peritoneal end of the shunt tube was removed and ventriculoperitoneal shunt was re-performed after anti-inflammatory treatment.CONCLUSION Shunt tube displacement has a low incidence in adults.In order to avoid shunt tube displacement,there is a need to summarize its causative factors and practice personalized medicine.
文摘BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.