目的 探讨十二指肠良性肿瘤的诊断与治疗。方法 对1992~1998年间收治的10例患者的临床资料行回顾性总结分析。 结果术前经纤维十二指肠镜确诊7例 ，上消化道X线钡餐确诊3例。肿瘤位于十二指肠降部7例，球部3例。其中6例行手术治疗，4例因心肺脑等严重合并症行保守治疗。手术为十二指肠肿瘤局部切除连同周围肠壁组织部分切除。术后病理报告2例为平滑肌瘤，2例为布鲁氏纳氏腺瘤，2例为间质瘤。结论 十二指肠良性肿瘤可引发严重并发症，如出血、腹痛、肠梗阻、穿孔等，并约有15%的病例可发生恶变。一经诊断，应及早手术治疗，手术一般宜行局部切除。
目的 探讨十二指肠良性肿瘤的手术治疗方式及术后早期营养管理的效果。方法 回顾性分析2009年1月至2011年12月期间我科收治的15例十二指肠良性肿瘤患者的临床资料，根据肿瘤的生长部位及肿瘤大小实施不同的手术方式，术后早期给予肠内营养治疗及消化液回输，观察术后患者并发症发生率及术后2个月内的返院情况。结果 15例患者中2例患者肿瘤位于十二指肠乳头下、直径2.5cm和2.0cm，2例位于降部与水平部交界处、直径2.3cm和2.5cm，1例位于十二指肠升部、直径3.5cm，该5例患者行十二指肠节段切除并空肠吻合术。4例患者肿瘤位于十二指肠乳头、直径1.0～2.0cm，3例位于乳头上缘、直径1.5～1.8cm，2例位于球部与降部交界处、直径2.0cm和1.8cm，1例位于十二指肠乳头下、直径1.2cm，该10例患者均行肿瘤局部切除术（位于乳头部的肿瘤同时行乳头成形术）。围手术期无死亡病例。1例（1/15）发生胃排空障碍，经禁食、减压及营养支持治愈出院。术后住院时间为7～10d，平均8d。术后2个月患者均接受随访，恢复良好，无返院患者。结论 手术切除是十二指肠良性肿瘤的首选治疗手段，手术方式取决于肿瘤的生长部位和大小，术后早期营养管理安全、有效。
From 1976 to 1991, 34 cases of benign tumors of femoral neck were received in our department and 29 cases were treated surgically with either free bone graft (18 cases) or vascularized bone graft (11 cases). Fibrous dysplasia of bone and bone cyst had a high incidence in this group (75%)and most of the patients were over 30 years old. Because the femoral neck had its own anatomical characteristics and was biomechanically important and in order to accelerate. The graft healing and prevent the occurrence of pathological fracture, the choice of operations should depend on the extent of the lesion, the thickness of the cortical bone of the affected past,and the presence or absence of complications.
Objective To study the clinical significance of central pancreatectomy in treatment of benign tumor of neck and body of pancreas. Methods The clinical data of 29 patients with benign tumor of pancreas were reviewed retrospectively in our hospital during the past 5 years. Results There was no perioperative death. Mean of operative time was （165±45） min （125-270min）， mean of blood loss was （173±88） mL （50-450mL）. The pathological diagnosis of all the patients were benign. Pancreatic fistula occurred in 10 patients. One patient with bleeding after operation was treated with another two operations. Twenty-one patients were followed-up with the time ranged from 3 months to 4 years （average 16 months）. There were no complications related to diabetes. Conclusion Central pancreatectomy is reasonable for patients with benign tumor of pancreas， it could well preserve the endocrine and exocrine function of pancreas， and improve the quality of life of patients.
目的 分析肝脏良性肿瘤的临床诊断、治疗及治疗效果。方法 对川北医学院附属医院2008年2月至2011年2月期间收治并经术后病理学检查证实为肝脏良性肿瘤的156例患者的临床资料进行回顾性分析。结果 156例患者中肝血管瘤119例，肝细胞腺瘤13例，肝内胆管囊腺瘤3例，肝局灶结节性增生9例，肝淋巴管瘤4例，肝血管平滑肌脂肪瘤3例，肝炎性假瘤5例。3例肝局灶结节性增生患者行保守治疗，随访1年，其肿瘤大小和肝功能均无明显变化； 余153例患者行手术治疗，全部切除了病灶，病灶切除率为100％，术后随访6～48个月，平均24个月，均无死亡及复发。结论 肝脏良性肿瘤的症状不典型，缺乏特异性表现，易误诊，应完善超声、CT及MRI检查，并结合病史进行综合分析。对于具有临床症状、肿瘤体积较大（肿瘤直径＞5cm）的肝脏良性肿瘤患者，应积极行手术治疗，术后密切随访。
Objective To explore the correlation between homocysteine （Hcy） level and the risk of breast cancer，and try to find a new method to reduce the risk factors and benefit for treatment of breast cancer. Methods From January2010 to December 2012， 245 cases of breast cancer （breast cancer group）， 109 cases of benign breast tumor （benign breast tumor group）， and 78 cases of healthy women （healthy control group） in the Sichuan Provincial People’s Hospital， who were in accordance with the inclusion criteria， were analyzed retrospectively. The difference of Hcy level was compared among three groups. Meanwhile the relation between Hcy level and patients’s age， blood glucose， serum creatinine， estrogen receptor （ER）， progesterone receptor （PR）， Ki-67 （%）， tumor diameter， or axillary lymph node status was analyzed.Results ① The Hcy level was significantly different among the breast cancer group， benign breast tumor group， and healthy control group （P＜0.001）. The Hcy level of the breast cancer group was significantly higher than those of the benignbreast tumor group （P＜0.001） or healthy control group （P＜0.001）， but the Hcy level was not significantly different bet-ween the benign breast tumor group and healthy control group （P=0.082） . ② The Hcy levels of different types of the breastcancer （type of Luminal A， Luminal B， Her-2， and triple negative） were significantly higher than those of the benign breast tumor group （except for Her-2 type， P＜0.05） or healthy control group （P＜0.05）. ③Plasma Hcy level of the patients with benign and malignant breast tumor was positively correlated with age （r=0.197， P=0.004） or serum creatinine level （r=0.381， P＜0.001）， but not correlated with blood glucose （r=0.023， P=0.668）. ④Plasma Hcy level of the patients with malignant breast tumor was positively correlated with age （r=0.267， P=0.007） or serum creatinine level （r=0.341， P＜0.001）， but not correlated with blood glucose （r=-0.005， P=0.935）， tumor diameter （r=-0.049， P=0.443）， axillary lymph node status （r=-0.006， P=0.921）， or Ki-67 （%） （rs=-0.029， P=0.650）. Conclusions Plasma Hcy level of breast cancer patient is abnormally elevated， and it may have some relation with the occurrence of breast cancer.
Objective To improve the knowledge of pulmonary sclerosing hemangioma ( PSH)especially with bilateral multiple lesions of the lung. Methods The clinical data of 3 cases of PSH ( 1 case with bilateral multiple lesions in the lung) were analyzed, and the related literatures were reviewed. Results All of the 3 cases were females. A 22-year-old female patientwith bilateral multiple nodules in the lungs was complicated with thyroid multiple nodular goiter ( with hypothyroidism) , dysfunctional uterine bleeding ( with anemia) , nodular hyperplasia of the breast, and arteriovenous malformation over forearm. Thoracoscopicbiopsy of left lung and resection of the right pulmonary mass were performed and both the lesions were confirmed as PSH. The clinical manifestations of multiorgan diseases and the presence of PSH suggested Cowden syndrome in this patient. The other 2 cases aged 50 and 53 were asymptomatic with solitary pulmonary nodules identified incidentally. The accessory examinations for malignancies, infections, and autoimmune diseases showed no specific findings. Resection of the lesions were performed by thoracoscopic surgery and thoracotomy respectively, and the histopathological results proved to be PSH. Literature review showed that PSH typically occurred in middle-aged women without clinical symptoms and signs, often presenting as a pulmonary solitary nodule/mass identified incidentally. The differential diagnosis should include peripheral carcinoma, hamartoma, inflammatory pseudotumor and tuberculoma. Multiple PSH, which mainly presented as multiple well-defined nodules /masses of different size in the lungs, was rather rare, but easily confused with metastatic neoplasm. Lung biopsy by surgical operation was a common way to confirm the diagnosis, while FDP-PET and fine needle aspiration biopsy showed some defects. Surgical resection was an effective method of treatment, the residual lesions of multiple PSH should be monitored. Cowden syndrome may be considered if a PSH coexisting with abnormity of multiple organs such as thyoid, breast and vessels. Conclusions PSH should be considered during the differential diagnosis for solitary or multiple nodules /masses in the lung. Surgical biopsy is a common way to confirm the diagnosis. Local excision andnecessary follow-up are effective methods of treatment.
ObjectiveTo investigate the role of local pancreatectomy for benign and low-grade malignant pancreatic tumors.MethodThe clinical data of 45 patients with benign and low-grade malignant pancreatic tumors who underwent local pancreatectomy from January 2014 to June 2019 in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were analyzed.ResultsForty-five patients underwent the local enucleation or resection with negative margin. The pathological results showed that there were 17 cases of solid pseudopapilloma, 5 cases of mucinous cystadenoma, 4 cases of serous cystadenoma, 10 cases of islet cell tumor, 5 cases of nonfunctional neuroendocrine tumor, 4 cases of congenital cyst. There were 6 cases of head of pancreas, 26 cases of body of pancreas, 8 cases of tail of pancreas, 5 cases of uncinate process. The tumor was 1.2 to 9.0 cm in diameter with an average of 3.2 cm. Among them, the diameter was more than 5.0 cm in 9 cases. The incidence of pancreatic fistula after operation was 57.8%, 65.4% was grade A fistula, 34.6% was grade B fistula, and no grade C fistula occurred. The incidence of abdominal infection was 13.3%, incidence of abdominal hemorrhage was 6.7%. There was no secondary diabetes mellitus and pancreatic endo- and exocrine dysfunction, and no death case.ConclusionsPancreatic enucleation for benign and low-grade malignant pancreatic tumors after strict preoperative evaluation can effectively preserve the pancreatic endocrine function of patients. Although the incidence of pancreatic fistula is high, it is mostly biochemical fistula, and the incidence of serious complications is low.