Objective To discuss the effect of three-dimensional (3D) printing individualized model and guide plate in bone tumor surgery. Methods Between October 2015 and December 2016, 3D printing individualized model and guide plate for making preoperative surgical planning and intraoperative treatment were used in 5 patients of bone tumor. All the patients were male, with a median age of 32 years (range, 9-58 years). There were 1 case of cystic echinococcosis at left pelvis and pathological fracture of the proximal femur; 1 case of left iliac bone osteoblastoma associated with aneurysmal bone cyst; 1 case of fibrous dysplasia of the left femur (sheep horn deformity) with pathological fracture; 1 case of metastatic carcinoma of right calcaneus (tumor staging was T2N0M0); and 1 case of Ewing sarcoma of left femur (tumor staging was T2N0M0). The disease duration ranged from 1 month to 10 years (mean, 2.25 years). Results The operation was completed successfully. The operation time was 2.6-7.5 hours (mean, 4.9 hours). The intraoperative blood loss was 200-2 500 mL (mean, 1 380 mL). The intraoperative fluoroscopy times was 1-6 times (mean, 3.8 times). There was no infection after operation, and the blood supply and nerve function were good. All the patients were followed up 3-16 months (mean, 5.4 months). No loosening or breaking of the internal fixator occurred. According to Enneking scoring system, the limb function score was 15-26 (mean, 21); and the results were excellent in 2 cases, good in 2 cases, and fair in 1 case. Conclusion 3D printing technology can make the implementation of the better preoperative planning and evaluation in bone tumor surgery, and it provides a new reference for individualized treatment in patients with bone tumor.
Objective To evaluate the efficacy of multiple minimally invasive therapy and individualized treatments combination in severe acute pancreatitis. Methods The data of sixty-seven patients with severe acute pancreatitis between September 1998 and October 2008 undergoing multiple minimally invasive therapy and individualized treatments were analyzed retrospectively. The changes of APACHE Ⅱ score, CT score, WBC count, total bilirubin, AST, blood glucose, amylase, lypase, C-reactive protein, tumor necrosis factor-α, blood urea nitrogen, creatinine, and oxygenation index (PaO2/FiO2) were observed and compared between before and after treatment. Time of abdominal pain relieved, laparotomy rate, mortality rate, recovery rate, hospital stay, and cost of hospitalization were also observed. Results All the detected indexes improved significantly after treatments compared with those before treatments （Plt;0.001）. Time of abdominal pain relieved was (20.17±14.16) h. Laparotomy rate was 6.0% （4/67）. Mortality rate was 7.5% （5/67）. Recovery rate was 92.5% （62/67）. Hospital stay was (30.85±28.37) d and cost of hospitalization was (59 295.78±34 564.44) yuan. Conclusions Multiple minimally invasive therapy and individualized treatments for cases of severe acute pancreatitis with different causes, course, severity of disease, and complications, could significantly improve the clinical indexes and recovery rate of severe acute pancreatitis.
ObjectiveTo summarize the experience in the treatment of anastomotic leakage after laparoscopic D2 radical gastrectomy.MethodThe clinicopathologic data of 11 patients with anastomotic leakage after the laparoscopic D2 radical gastrectomy in the Nanchong Central Hospital from May 2016 to January 2018 were analyzed retrospectively.ResultsAmong the 11 patients with anastomotic leakage, 3 were grade Ⅱ leakages and 8 were grade Ⅲa leakages. There were no symptoms in the 3 cases of anastomotic leakage, which were confirmed only by the gastrointestinal radiography and were healed after 7 d of conservative treatment. Among the 8 patients with the clinical symptoms, 5 cases were treated by the endoscopic drainage and negative pressure suction for 60–90 d, 3 cases were treated by the endoscopic covered stent, 2 cases were cured after 30–60 d, and 1 case died of massive bleeding after 45 d.ConclusionsDue to differences of location, time, limitation, and size of anastomotic leakage after laparoscopic D2 radical gastrectomy, individualized treatment should be performed according to specific situation of patients in local treatment. Endoluminal covered stent has certain clinical application value.
Objective To investigate the relationship between single nucleotide polymorphism (SNP) and therapy response of some conventional chemotherapy drugs in breast cancer, and to explore the value of SNP in guiding individualized treatment. Methods Pub-Medline and Chinese CHKD periodical electronic databases were searched. Representative researches in this field were sorted out and concluded. Results Varied genes related to drug metabolism have SNP phenomenon, which are closely associated with interindividual diversity in drug response. Race, section, environment, and drug-drug or gene-gene interactions may have effect on the association.Conclusion The study on SNP has important application prospect in optimizing the individual drug-delivery. However, the combinatorial analyses of multi-SNPs and multi-genes and the prospective studies with large-scale samples and random controls are still needed.
Objective To evaluate the importance of "one-stop" hybrid operating room in the individualized treatment of aortic pathology. Method We retrospectively analyzed the clinical data of 247 patients of aortic pathology who were operated in the hybrid operating room in our hospital from January 2013 through December 2014. There were 193 males and 54 females at age of 24-83(54±12) years. Results Thoracic or abdominal endovascular aortic repair (TEVAR/EVAR) was applied in 132 patients, including 122 simple patients and 10 complexes. Fenestrated TEVAR was applied in 61 patients. Hybrid operation was done in 54 patients. Perioperative death occurred in 9 patients (3.6%). Perioperative complication rate was 11.7% (29/247) . The patients were followed up for one year. During follow-up, five patients were dead. The one-year survival rate was 98.0% (242/247) . Conclusions "One-stop" individualized treatment of aortic pathology shows its advantage, yet long-term result still needs to be followed up.
结直肠癌是一种严重威胁我国国民生命的恶性肿瘤，近年来其发病率呈不断上升的趋势。根据WHO报告的资料［1］显示，我国结直肠癌死亡率2005年比1991年增加70.7%，年均增加4.71%。尽管对结直肠癌的病因学研究和以手术切除、放射治疗和化学药物治疗为主的综合治疗取得了一定进展，但结直肠癌的治疗仍然面临巨大挑战。对不同个体采用相同的治疗方案不仅不能提高治疗效果，而且造成医疗资源的浪费，甚至给患者带来伤害。目前，个体差异与疗效的关系越来越受到临床医生和研究者的重视。随着循证医学的不断发展，结直肠癌的个体化治疗日益成为临床治疗及基础研究的重点。结直肠肿瘤多学科协作(multidisciplinary team，MDT)诊治模式的运用为结直肠癌个体化诊治提供了新的平台［2］。....................
Chronic obstructive pulmonary disease (COPD) is one of the common chronic airway disorders, which accounts for the third to fourth cause of death worldwide. Recently, the focuses of researches are on the multi-factorial risks for development of COPD, mechanisms related to COPD development, early detection and early intervention of COPD, individualized use of long-term maintenance medications as well as phenotypes of acute exacerbation of COPD and their corresponding management. There are huge amount of COPD patients with variety of risk factors or different phenotypes in China, which makes it possible to establish a network for cohort study or real life registration study of COPD. The results will provide new information on the characteristics of COPD in China. Individualized treatment could be recommended according to the phenotypes or endotypes information. All these new findings or progresses could provide impetus for improvement of the ability of research and clinical management of COPD to the worldwide top level.
ObjectiveTo investigate diagnosis and treatment of rupture of pancreatic cystic disease. MethodThe clinical data of 20 patients who were diagnosed as pancreatic cystic disease combined with rupture in the First Affiliated Hospital of Harbin Medical University from June 2011 to December 2015 were analyzed retrospectively. Results① For the 5 patients with pancreatic cystic tumor, 3 patients of them received distal pancreatectomy and 2 patients of them received Whipple procedure. For the 15 patients with pancreatic pseudocyst, 2 patients received ultrasound-guided cyst puncture and drainage, 2 patients received endoscopic retrograde pancreatic drainage (ERPD), 2 patients received ERPD plus ultrasound-guided cyst puncture and drainage, 1 patient received pancreatic external drainage, 3 patients received pancreatic cyst-gastric anastomosis, 5 patients received pancreatic cyst-jejunal Roux-en-Y anastomosis. ② Pancreatic fistula occurred in 3 patients (Grade A 2 cases, Grade B 1 case), delayed gastric emptying was found in 1 patient, peritoneal effusion occurred in 1 patient. ③ Eighteen of them were followed up from 3 to 60 months with an average 25.6 months, 2 patients recurred and non-surgical treatments were taken. ConclusionsHow to correctly identify pancreatic cystic tumor with pancreatic pseudocyst is premise of treatment. Pancreatic cystic disease combined with rupture requires urgent therapy. Based on clinical manifestations, optimal selection might achieve a better prognosis.