Table of Content

  

10 July 2022
Volume 60 Issue 7

Clinical manifestations of adenomyosis

LENG Jinhua, SHI Jinghua

Journal of Shandong University (Health Sciences). 2022, 60(7):  1-5.  doi:10.6040/j.issn.1671-7554.0.2022.0433

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Adenomyosis is a common disease among women of childbearing age. The incidence rate is increasing while the pathogenesis is still unclear. Epidemiological investigation is biased by diagnostic criteria. The clinical manifestations are diverse, including progressive dysmenorrhea, abnormal uterine bleeding and infertility. It is also related to a variety of adverse pregnancy outcomes, affecting womens reproductive health and family relationship. In addition, adenomyosis can be complicated with a variety of hormone-dependent diseases, especially endometriosis. In such cases, the pain symptoms are more severe and diverse, and the pregnancy outcomes are poorer, further complicating the clinical manifestations.

Cracking the enigma of pathogenesis and pathophysiology of adenomyosis

GUO Sunwei, LIU Xishi

Journal of Shandong University (Health Sciences). 2022, 60(7):  6-19.  doi:10.6040/j.issn.1671-7554.0.2022.0356

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Adenomyosis, a condition resulting from the invasion of endometrial stromal and epithelial cells into the myometrium, is a common gynecological disease with an enigmatic pathogenesis and pathophysiology. Adenomyosis causes heavy menstrual blood loss and progressive dysmenorrhea, impacting negatively on the quality of life of the afflicted. Its clinical management is also a challenge. In this paper, we review the work mostly achieved by our team on this disease, hoping to summarize the pathogenesis, pathophysiology, diagnosis and treatment of adenomyosis, as well as the future direction of research.

Progress on the medical treatment of adenomyosis

PENG Chao, ZHOU Yingfang

Journal of Shandong University (Health Sciences). 2022, 60(7):  20-25.  doi:10.6040/j.issn.1671-7554.0.2022.0407

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Pain relief, bleeding reduction and fertility promotion are the main therapeutic goals of adenomyosis. The medical drugs for the treatment of adenomyosis are similar to those of endometriosis, including non-steroidal anti-inflammatory drugs, gonadotropin releasing hormone analogues(GnRH-a), compound oral contraceptives, progesterone drugs and traditional Chinese medicine. Adenomyosis is a chronic disease that requires long-term management.

Surgical treatment strategies of adenomyosis

ZHANG Xinmei, XU Ping

Journal of Shandong University (Health Sciences). 2022, 60(7):  26-31.  doi:10.6040/j.issn.1671-7554.0.2021.1551

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Adenomyosis is a common hormone-dependent and inflammatory disease in women of childbearing age, manifested with progressive dysmenorrhea, menorrhagia, infertility and uterine enlargement. The morbidity increases year by year and shows a younger trend. Surgical treatment of adenomyosis is often performed due to ineffectiveness or unwillingness of drug therapy and non-surgical techniques(including uterine artery embolization, high-intensity focused ultrasound therapy and radiofrequency ablation). Specific surgical strategy needs to be formulated individually according to the patients’ age, clinical symptoms, fertility requirements and the type and scope of lesions. At present, surgical procedures include hysterectomy, conservative adenomyomectomy/cytoreductive surgery, hysteroscopic transcervical resection of endometrium/endometrial ablation, and so on. This article reviews the applicable population, key points of operation and maintenance treatment scheme of various surgical procedures, in order to ensure individualized treatment and life-long management of the disease, maximize the curative effects and improve fertility.

Patient education and proper management of adenomyosis

YI Xiaofang, HUANG Jihua

Journal of Shandong University (Health Sciences). 2022, 60(7):  32-35.  doi:10.6040/j.issn.1671-7554.0.2022.0467

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Adenomyosis, one of the chronic gynecological diseases manifested by dysmenorrhea, heavy menstrual bleeding or infertility, negatively impacts the health of women of childbearing age. Patient education and proper management are important components of quality patient care. Advancement in digital medicine brings innovation in patient education materials and modalities. This review aims to strengthen ‘patient-centered’ value and increase patients knowledge on adenomyosis as well as compliance on management. Specific advice is provided to improve patients self-evaluation on the menstrual health and fertility, supplemented by well-designed clinical trials. In addition, the supporting roles of medical practitioners, partners, patients and society need to be pulled together to promote better outcome in long-term management of adenomyosis.

Latest research advances of high intensity focused ultrasound treatment for adenomyosis

AILI Aixingzi, GUO Zhengyu, ZHANG Xiaofei

Journal of Shandong University (Health Sciences). 2022, 60(7):  36-42.  doi:10.6040/j.issn.1671-7554.0.2022.0225

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Adenomyosis is a common chronic disease among women of reproductive age. In recent years, the prevalence rate has increased along with symptoms arising at a younger age. Traditional treatments are difficult to maneuver, followed with many complications and an extensive recovery time. Problems as how to relieve symptoms, reduce recurrence rate, shorten the wait time required for pregnancy, and restore endometrial receptivity have become urgent, especially for young women suffering from infertility. High intensity focused ultrasound(HIFU)is a novel non-invasive treatment method, whose safety and efficacy have been proved in clinical practice; it can be used as an effective step in the comprehensive treatment of adenomyosis

Treatment of adenomyosis complicated with infertility

YAN Lei, CHEN Zijiang

Journal of Shandong University (Health Sciences). 2022, 60(7):  43-47.  doi:10.6040/j.issn.1671-7554.0.2022.0166

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Adenomyosis can cause infertility and miscarriage, increase the miscarriage rate of in vitro fertilization intracytoplasmic sperm injection and embryo transfer(IVF-ET), reduce the live birth rate and clinical pregnancy rate, and increase obstetric and neonatal complications. Transvaginal ultrasound has become the first-line diagnostic method of adenomyosis, but the accuracy needs to be improved. The treatment of adenomyosis complicated with infertility includes drug, surgical, interventional therapy and assisted reproduction therapy, et al. IVF is generally recommended as the first choice, and GnRH-a and freeze-all strategy are also recommended. More research is needed to explore the diagnosis of adenomyosis, efficacy of non-IVF treatment, pretreatment of GnRH-a, and comparison of fresh versus frozen embryo transplantation.

Research progress of animal models of adenomyosis

WANG Guoyun, PAN Zangyu

Journal of Shandong University (Health Sciences). 2022, 60(7):  48-55.  doi:10.6040/j.issn.1671-7554.0.2022.0263

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Diagnosis of adenomyosis using ultrasound and magnetic resonance imaging

TAO Guowei, WANG Fang, DONG Xiangyi, XU Yaxuan, ZHAO Linli, HU Beibei

Journal of Shandong University (Health Sciences). 2022, 60(7):  56-65.  doi:10.6040/j.issn.1671-7554.0.2022.0214

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With the development of medical imaging technology, the role of ultrasound and magnetic resonance imaging(MRI)in the evaluation of adenomyosis has been increasingly recognized in clinical work. Transvaginal ultrasound(TVUS)remains the first-line diagnostic method for adenomyosis and MRI can serve as a complementary tool. The purpose of this study is to review the imaging-pathological correlation, classification, ultrasonic and MRI features, standardized description of adenomyosis, advances in ultrasound techniques, and classification evaluation of MRI.

Effects of Sdccag3 on the osseointegration in hyperlipidemia rats through Wnt pathway

YUAN Mengqi, HUO Fenglei, REN Huiping, GUO Qiushuang, LAN Jing

Journal of Shandong University (Health Sciences). 2022, 60(7):  66-73.  doi:10.6040/j.issn.1671-7554.0.2022.0183

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Objective To investigate the effects of serologically defined colon cancer antigen-3(Sdccag3)on the differentiation of bone marrow mesenchymal stem cells(BMSCs)and the osteointegration around implants in hyperlipidemia rats through Wnt signaling pathway in high lipid environment. Methods BMSCs were cultured in hyperlipidemia rat models and induced by high lipid environment. Sdccag3 expression was overexpressed/silenced by lentivirus vector. RT-PCR, Western blotting, Micro-CT, HE staining, Oil red O staining and immunofluorescence staining were used to assess the effects of high lipid environment and Sdccag3 on bone metabolism and BMSCs differentiation balance. Results Sdccag3 was overexpressed in BMSCs induced by high lipid osteogenesis, which inhibited lipid differentiation indexes peroxisome proliferators-activated receptors γ(FABP4)and peroxisome proliferators-activated receptors γ(PPAR-γ), up-regulated Wnt signaling pathway marker genes low density lipoprotein receptor-related protein 5(LRP5), low density lipoprotein receptor-related protein 6(LRP6), β-catenin, Wnt family member 5a(Wnt5a)and Wnt family member 5b(Wnt5b), and promoted osteogenic differentiation indexes alkaline phosphatase(ALP)and runt-related transcription factor 2(Runx2). In hyperlipidemia rats, overexpression of Sdccag3 up-regulated Wnt signaling pathway marker genes and inhibited peripheral lipid formation, while silencing LRP5 down-regulated Sdccag3, inhibited osteogenic differentiation and promoted lipid differentiation, which were consistent with silencing Sdccag3 expression. Conclusion Hyperlipidemia inhibits Sdccag3 expression. Overexpression of Sdccag3 inhibits adipogenic differentiation of BMSCs and decreases lipid formation around the implants in hyperlipidemia rats, promotes osteogenesis and expression of Wnt signaling pathway marker genes.

A network meta-analysis of first-line treatment options for patients with advanced driver-gene wild-type and PD-L1 negative non-squamous non-small cell lung cancer

QIN Jing, YANG Fei, CHEN Qian, XIA Handai, LIU Yanguo, WANG Xiuwen

Journal of Shandong University (Health Sciences). 2022, 60(7):  74-82.  doi:10.6040/j.issn.1671-7554.0.2022.0238

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Objective A network meta-analysis was performed to compare the efficacy and safety of first-line treatment regimens of advanced driver-gene wild-type and programmed death-ligand 1(PD-L1)negative non-squamous non-small cell lung cancer(NSCLC). Methods First-line treatment trials of advanced driver-gene wild-type non-squamous NSCLC were searched in PubMed, Cochrane Library, Embase database and ClinicalTrials.gov website. Randomized controlled trials(RCTs)comparing first-line treatment regimens including chemotherapy, immune checkpoint inhibitors(ICIs), antiangiogenic therapy and their combinations were included. StataMP 16.0 and R 4.1.0 were used for data analysis. Results A total of 10 RCTs were included, involving 5,731 patients and 10 treatment regimens. There was no statistically significant difference in overall survival(OS)and progression-free survival(PFS)among the treatment regimens(P>0.05). The regimen of pembrolizumab + chemotherapy had the longest OS, and the regimen of nivolumab+bevacizumab+chemotherapy had the longest PFS. The objective response rates(ORR)of atezolizumab+ chemotherapy and pembrolizumab+chemotherapy were higher than that of chemotherapy(OR=1.66, 95%CI: 1.07-2.59; OR=2.68, 95%CI: 1.40-5.11). In terms of allgrade adverse events(AEs), camrelizumab + chemotherapy was higher(AEs)than chemotherapy and sintilimab + chemotherapy(OR=1.05, 95%CI: 1.01-1.08; OR=1.05, 95%CI: 1.01-1.09). In terms of ≥3 grade AEs, there was no statistically significant difference among the treatment regimens(P>0.05). Conclusion For patients with advanced driver-gene wild-type PD-L1 negative non-squamous NSCLC, there was no significant difference in survival benefits among the existing first-line treatment regimens. The combination of immunotherapy and chemotherapy was more effective, but the adverse events were also more significant. A reasonable treatment regimen should be selected according to the individual conditions.

Effects of dexmedetomidine on intestinal-related injury during cardiopulmonary bypass

LI Rui, SHI Cunxian, YU Cuicui

Journal of Shandong University (Health Sciences). 2022, 60(7):  83-88.  doi:10.6040/j.issn.1671-7554.0.2022.0296

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Objective To investigate the effects of dexmedetomidine(DEX)on the intestinal barrier injury in patients with cardiopulmonary bypass. Methods A total of 60 patients undergoing cardiopulmonary bypass cardiac surgery were randomly divided into DEX group(n=30)and control group(n=30). The DEX group was given DEX intervention and the control group was given saline infusion of the same volume. Venous blood samples were collected before administration(T0), immediately after cardiopulmonary bypass(T1), 2 hours after operation(T2), 6 hours after operation(T3)and 24 hours after operation(T4). The levels of intestinal fatty acid binding protein(I-FABP), endotoxin(LPS), interleukin-6(IL-6)and interleukin-10(IL-10)were measured. The first defecation time, intensive care unit stay time, hospital stay, mortality and adverse reactions of the two groups were recorded. Results All 60 patients completed the study protocol, and no death or serious complications were observed. The levels of serum I-FABP, LPS, IL-6 and IL-10 in either group at different time points were significantly different(P<0.001), and the levels at T1-T4 were higher than those at T0. The levels of serum I-FABP, LPS, IL-6 and IL-10 were significantly different between the two groups(P=0.029; P=0.002; P=0.022; P=0.022), and the levels of I-FABP, LPS, IL-6 in DEX group at T1-T4 were lower than those in control group, but the levels of IL-10 were higher than those in control group. There were no significant differences in the first defecation time, ICU stay time and hospital stay between the two groups(P>0.05). Conclusion DEX can alleviate the damage of intestinal barrier in patients with cardiopulmonary bypass.

Mechanism of abnormal immune response of dendritic cells in immune thrombocytopenia

XIANG Yujiao, LIU Qiang, LIU Lu, SHI Yan

Journal of Shandong University (Health Sciences). 2022, 60(7):  89-97.  doi:10.6040/j.issn.1671-7554.0.2022.0069

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Objective To explore the genes affecting the dysfunction of dendritic cells in patients with primary immune thrombocytopenia(ITP), and to seek a new therapeutic approach for ITP. Methods A total of 8 ITP patients and 8 healthy controls were enrolled. Peripheral mononuclear cells were isolated and induced to differentiate into monocyte derived dendritic cells(moDCs)in vitro. The moDCs samples from 3 ITP patients and 3 healthy controls were selected respectively, then transcriptome sequencing was performed using Illumina Hiseq platform, and bioinformatics analysis was completed. The remaining moDCs samples were divided into control group, ITP group and ITP+rapamycin group. The activation of mammalian rapamycin target protein complex 1(mTORC1)signal pathway was detected with Western blotting, the expressions of surface molecules were detected with flow cytometry, and the cytokine secretions were detected with enzyme-linked immunosorbent assay(ELISA). Results Differential gene analysis showed that compared with the healthy controls, ITP patients had 161 significantly up-regulated genes and 320 significantly down-regulated genes(P<0.05). The differential genes were mainly concentrated in biological processes such as T cell differentiation, T cell costimulation, T cell activation and T cell receptor signaling pathway. Gene set enrichment analysis(GSEA)showed that the activity of mTORC1 signal pathway in moDCs of ITP patients was enhanced. Further validation found that the expression of phosphorylated mTOR and mTORC1 activation marker phosphorylated ribosomal protein S6 kinase(S6K)in moDCs of ITP patients were increased. The expressions of moDCs costimulatory molecules CD80 and CD86, and pro-inflammatory factors interleukin(IL)-6 and IL-12 were increased in ITP patients, while the expressions of IL-10 and transforming growth factor-β(TGF-β)were decreased. The mTORC1 inhibitor rapamycin inhibited the expressions of CD80, CD86, IL-6 and IL-12. Rapamycin upregulated the expression of IL-10, but did not affect the expression of TGF-β. Conclusion The mTORC1 signaling pathway is highly activated in moDCs of ITP patients, and the use of rapamycin can improve the immunomodulatory ability of moDCs. Therefore, mTORC1 signaling pathway may be a new target for regulating moDCs dysfunction in ITP patients.

Clinical significance of Rh phenotype distribution and irregular antibody screening in RhD negative blood donors in Jinan of Shandong Province

ZHOU Na, PAN Yingfang, SHAO Jingru, LI Jing, SONG Yonghong, XU Qun, LYU Hongjuan

Journal of Shandong University (Health Sciences). 2022, 60(7):  98-103.  doi:10.6040/j.issn.1671-7554.0.2021.1454

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Objective To investigate the phenotype distribution and irregular antibody screening of RhD negative blood donors in Jinan, Shandong Province, so as to provide data support for rational collection and supply of RhD negative blood. Methods Blood samples of RhD negative blood donors were collected from Shandong Blood Center from July 2020 to June 2021 and then irregular antibody screening and Rh phenotype confirmation were conducted. Results Among the 877 RhD negative blood donors who were initially confirmed, 55 cases were RhD variants blood donors, and 822 were confirmed RhD negative blood donors by three kind of anti-D reagents, 6(0.730%)of which were irregular antibody positive. Antibodies detected included 4 anti-D antibodies, 1 anti-M antibody and 1 anti-Le^a antibody. Positive rate of irregular antibody was much higher in female RhD negative blood donors than that in male. Conclusion Positive rate of irregular antibody in female RhD negative blood donors is much higher than that in male and the causes of antibody production are mostly natural and immune antibodies by pregnancy. Rh antigen phenotype detection and screening of irregular antibody for RhD negative blood donors are helpful for scientific and rational collection of RhD negative blood, which is of great significance for the clinical safety of blood transfusion.

Ultrasound characteristics and preoperative CA-125 level in the differential diagnosis of 51 cases of borderline ovarian and stage I malignant tumors

ZHANG Yixin, ZHAO Yuli, FENG Li

Journal of Shandong University (Health Sciences). 2022, 60(7):  104-109.  doi:10.6040/j.issn.1671-7554.0.2021.0819

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Objective To investigate the value of ultrasound characteristics combined with preoperative serum carbohydrate antigen 125(CA-125)levels in the differential diagnosis of borderline ovarian tumors(BOTs)and stage Ⅰ epithelial ovarian cancer(EOC). Methods Clinical data of 27 EOC and 24 BOT pathologically confirmed cases treated during June 2019 and June 2020 were retrospectively analyzed. Independent factors related to ovarian invasion, including clinical variables(menstrual status), ultrasound characteristics and CA-125 level, were analyzed with multivariate binary Logistic regression with stepwise selection of variables. Results Ultrasound findings showed masses with rough edges, ascites, and rich blood flow(blood flow score=4)were indicative of stage Ⅰ EOC, while papillary protrusions and partitions were present in BOT. The ratio of preoperative CA-125 >35 IU/mL or >100 IU/mL in stage Ⅰ EOC was much higher than that in BOT(81.5 vs 41.7%, P=0.003; 40.7 vs 8.3%, P=0.008). The sensitivity and specificity of serum CA-125 level for distinguishing BOT and stage Ⅰ EOC were 81.5% and 58.3%, respectively, indicating that CA-125 level had a certain diagnostic reference value. Multivariate Logistic regression showed that CA-125>100 IU/mL was a key independent factor distinguishing BOT from stage Ⅰ EOC, indicating that patients with CA-125 >100 IU/mL had almost 14.67 times greater likelihood of stage Ⅰ EOC compared patients with CA-125 ≤100 IU/mL(OR=14.67; 95%CI: 1.32-162.94; P=0.029). Conclusion Preoperative CA-125 >100 IU mL combined with ultrasound characteristics helps in the differential diagnosis of borderline ovarian tumor and stage Ⅰ epithelial ovarian cancer before surgery.

Efficacy of DC-CIK cells combined with EGFR-TKI for 35 elderly patients with advanced EGFR-mutant lung cancer

WANG Fuli, SUN Yinping, QIN Jie, RONG Jiansheng

Journal of Shandong University (Health Sciences). 2022, 60(7):  110-117.  doi:10.6040/j.issn.1671-7554.0.2021.1306

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Objective To investigate the clinical efficacy of dendritic cells-cytokine-induced killer cells(DC-CIK cells)combined with epidermal growth factor receptor-tyrosine kinase inhibitor(EGRF-TKI)for elderly patients with advanced EGFR-mutant lung cancer. Methods A total of 70 patients with stage IV lung cancer were divided into treatment group and control group. In the treatment group, 35 patients received DC-CIK cell therapy combined with gefitinib or erlotinib targeted therapy. In the control group, 35 patients received gefitinib or erlotinib targeted therapy. Results The disease control rate(DCR)of the treatment group and control group were 88.6% and 68.6%, respectively, with significant difference(P=0.041). The improvement rate of patients quality of life was significantly higher in the treatment group than in the control group(71.4% vs 45.7%, P=0.029). The 1-year, 2-year, and 3-year overall survival(OS)rates of the treatment group and control group were 62.9% vs 57.1%, 37.1% vs 31.4%, and 8.6% vs 2.9%, respectively, with no significant differences(P=0.217). The 1-year, 2-year, and 3-year progression-free survival(PFS)rates of the treatment group and control group were 57.1% vs 31.4%, 20.0% vs 5.7%, and 2.9% vs 0, respectively, with significant differences(P=0.005). Multivariate analysis showed that patients with adenocarcinoma(HR=0.178, 95%CI: 0.061-0.523)and well-differentiated cancer(HR=0.058, 95%CI: 0.015-0.228)had longer OS, and patients with adenocarcinoma(HR=0.271, 95%CI: 0.094-0.777)and well-differentiated cancer(HR=0.089, 95%CI: 0.029-0.272)also had longer PFS. There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion DC-CIK cells combined with EGRF-TKI can improve the disease control rate and patients quality of life, and prolong the PFS in elderly patients with advanced EGFR-mutant lung cancer.

Epidemiological characteristics of 689 patients with non-ST-segment elevation myocardial infarction

ZHANG Yufeng, XU Min, XING Xiuli, PANG Shuguang, HU Keqing

Journal of Shandong University (Health Sciences). 2022, 60(7):  118-122.  doi:10.6040/j.issn.1671-7554.0.2021.1549

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Objective To investigate the epidemiological characteristics of patients with non-ST-segment elevation myocardial infarction(NSTEMI), and to explore the characteristics and regularity of patients with non-ST-segment elevation myocardial infarction in chest pain center of the hospital in recent 3 years. Methods A total of 689 NSTEMI patients who visited the chest pain center of a certain hospital during Jan. 2018 and Dec. 2020 were selected as the study subjects. Frequency analysis, Chi-square test and Logistic regression analysis were performed based on patients gender, age, date and time of treatment, time of first medical contact and treatment strategy. Results The number of patients and constituent ratio increased with the increase of age. The 70-year group had the highest proportion, accounting for 53.4% of all cases. The proportion of male patients was higher than that of female patients. Patients in different seasons had statistically significant difference in day and night visit rates(χ2=12.627, P=0.006). Multinomial Logistic regression analysis showed that the season of visit, time of first medical contact and treatment strategy were the independent influencing factors of day and night visits(P<0.05). Conclusion The peak age, time period and seasonal distribution of patients have certain rules to follow, which can provide a basis for clinicians to identify high-risk patients and choose the best diagnosis and treatment strategy.

Cost-effectiveness analysis of staged excision compared with one-stage excision of facial pigmented nevus in children

LI Hongwen, ZHOU Zifu, WANG Song, HUO Ran

Journal of Shandong University (Health Sciences). 2022, 60(7):  123-128.  doi:10.6040/j.issn.1671-7554.0.2021.1347

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Objective To compare the clinical effectiveness of one-stage excision and staged excision in children with congenital facial nevus by using clinical health economics evaluation method and to evaluate their cost-effectiveness. Methods A retrospective analysis was performed on the clinical data of 58 children with congenital facial nevus who visited Shandong Provincial Hospital from June 2018 to June 2019. The patients were divided into one-stage excision group(n=30)and staged excision group(n=28)according to the surgical operation. The length, width and area of the scar six months after the surgery were collected to evaluate the effectiveness of the surgery. The direct, indirect costs of two groups were also collected. Cost-effectiveness was analyzed using incremental cost-effectiveness ratio(ICER). Results All the patients completed the operation successfully. The total cost of the staged excision group was significantly higher than that of the one-stage excision group ［14 769.99(13 971.52,14 769.99)yuan vs 7 824.52(6 620.51,8 445.64)yuan, P<0.001］. The postoperative area reduction of the scar in the staged excision group was 0.95(0.29,2.59)cm², which was higher than that in the one-staged group ［0.29(0.1,0.79)cm²; P=0.02］. The ICER analysis indicated that the patients in one-stage excision group spent 26 981.10 yuan for 1 cm² area reduction and the patients in staged excision group spent 15 547.36 yuan for 1 cm² area reduction. Conclusion Compared with the one-stage excision, the staged excision of congenital pigmented nevus on the face does not increase the length and width of the scar after the operation even for the wider lesions. Although staged excision increases extra costs for the patient, but it is still a better surgical treatment of pigmented nevi with a better ICER.

A case report of corneoscleral iron filing-like foreign body

REN Dazhuang, ZHOU Weiyan, ZHAO Bojun

Journal of Shandong University (Health Sciences). 2022, 60(7):  129-132.  doi:10.6040/j.issn.1671-7554.0.2021.1421

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Objective To investigate the clinical manifestations, imaging features and surgical method of a patient diagnosed with corneoscleral foreign body, in order to improve the diagnosis and treatment of this disease. Methods The clinical data of the patient were retrospectively analyzed, and relevant literature was reviewed. Results The patient was a 31-year-old male whose left eye was injured by the crashing of iron filing one month ago. After the injury, the foreign body was removed in a local hospital, but he still had a sensation of foreign body. Ophthalmological examination showed pus plug in the anterior chamber angle, but no obvious foreign body was detected. After orbital CT and ultrasound biomicroscopy(UBM)examination, corneoscleral foreign body was diagnosed and the foreign body was removed with surgery. Conclusion Corneoscleral foreign body is one of the common ophthalmic diseases, but it is hard to diagnose if the duration is long. For such patients, medical history should be collected timely and imaging examinations should be conducted to reduce the rate of misdiagnosis.