膝关节置换手术产生的创伤刺激常使患者术后承受着中到重度疼痛,这不仅使患者术后体验不佳,疼痛应激还会加重机体的内环境紊乱,对患者的术后康复产生不利的影响。现在多模式镇痛理念越来越多被应用到术后镇痛中,即将多种不同机制的镇痛药物和镇痛方法进行合理有效的结合,发挥最佳的镇痛效应。布比卡因脂质体作为一种具有稳定性和长效性特点的新型缓释局麻药在术后多模式镇痛中得到越来越多的应用,尤其是应用在膝关节置换术后镇痛。文章综述了布比卡因脂质体应用于膝关节置换手术后镇痛的应用进展情况。The traumatic stimulus produced by knee replacement surgery often causes patients to suffer from moderate to severe pain after surgery, which not only makes the patient’s postoperative experience poor, but also aggravates the internal environmental disorders of the body, which adversely affects the patient’s postoperative recovery. Nowadays, the concept of multimodal analgesia is more and more often applied to postoperative analgesia, which is to reasonably and effectively combine multiple analgesic drugs and analgesic methods with different mechanisms to exert the best analgesic effect. Liposomal bupivacaine, as a new type of sustained-release local anesthetic with stability and long-acting characteristics, has been increasingly used in postoperative multimodal analgesia, especially in postoperative analgesia after knee arthroplasty. This article reviews the progress of liposomal bupivacaine application for postoperative analgesia after knee replacement surgery.
腹壁子宫内膜异位症恶变的病例罕见,其发病机制尚未明确,利用基因检测可以为研究提供新方向,进一步完善诊断标准及治疗方案。本文报道1例腹壁子宫内膜透明细胞癌,并复习相关文献来介绍该疾病,以及了解其临床特征、诊断及鉴别诊断、治疗、预后因素,以提高该疾病的诊疗水平。The malignant transformation of abdominal endometriosis is rare, and its pathogenesis is not yet clear. The use of genetic detection can provide a new direction for research, and further improve the diagnostic criteria and treatment plan. This paper reports a case of clear cell carcinoma of abdominal wall endometrial, reviews relevant literature to introduce the disease, and understands its clinical features, diagnosis, differential diagnosis, treatment and prognostic factors, in order to improve the level of diagnosis and treatment of this disease.
卵巢是转移性肿瘤的好发部位,继发性卵巢肿瘤常来源于胃肠道(最常见)、乳房和泌尿生殖道。近年来肠来源继发性恶性肿瘤有逐渐上升趋势,其临床症状与影像学多无特异性表现。本研究以一例继发性卵巢肿瘤为例,通过讨论病史、疾病临床特征、手术与化疗方案及护理的影响,进一步指导患者诊疗及护理。The ovary is a common site for metastatic tumors, and secondary ovarian tumors often originate from the gastrointestinal tract (most commonly), breast, and urogenital tract. In recent years, secondary malignant tumors of enteric origin have been on the rise gradually, and their clinical symptoms and imaging findings are mostly non-specific. In this study, a case of secondary ovarian tumor was taken as an example to further guide the diagnosis, treatment and nursing of the patient by discussing the history, clinical features of the disease, the influence of surgery and chemotherapy and nursing.
类器官(organoids)是通过细胞分选和三维培养建立的创新体外模型,在妇科疾病建模、药物筛选及肿瘤个体化治疗中展现出重要价值。作为全球高发的妇科恶性肿瘤,子宫内膜癌(endometrial cancer)的发病率逐年上升且呈年轻化趋势。尽管类器官技术尚未进入临床转化阶段,但其为探索该疾病的精准治疗提供了全新平台。本文综述类器官在子宫内膜癌研究中的最新进展。Organoids are innovative in vitro models established through cell sorting and three-dimensional culture, demonstrating significant value in gynecological disease modeling, drug screening, and personalized cancer treatment. As a highly prevalent gynecological malignancy worldwide, the incidence of endometrial cancer is increasing year by year and showing a trend of younger age of onset. Although the organoid technology has not yet reached the stage of clinical translation, it provides a new platform for exploring the precise treatment of this disease. This paper reviews the latest progress of organoids in the research of endometrial cancer.
系统性红斑狼疮(SLE)是一种影响多个器官的全身性自身免疫疾病,其特点是免疫细胞、免疫因子和免疫途径的复杂相互作用导致各种临床表现。抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)是一组以中小血管坏死性炎症和外周血中出现ANCA为特征的自身免疫综合征。SLE/AAV重叠综合征(overlap syndrome, OS)一种混合表现的炎症性疾病,具有SLE和AAV的临床特征。在极少数情况下,SLE和AAV同时发病表现出更严重的临床症状。缺血性结肠炎(IC)是一组存在血管闭塞性或非闭塞性疾病的临床综合征,以结肠供血不足为特征。本文报告了1例SLE/AAV OS伴随缺血性结肠炎患者。经过血浆置换、足量激素冲击、免疫抑制剂环磷酰胺和硫酸羟氯喹、抑酸药、生长激素抑制类药物等治疗后,患者病情缓解。Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects multiple organs and is characterized by a complex interplay of immune cells, immune factors, and immune pathways leading to a variety of clinical manifestations. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune syndromes characterized by necrotizing inflammation of small and medium-sized blood vessels and the presence of ANCA in the peripheral blood. Overlap syndrome (OS) is a mixed manifestation of inflammatory disease with clinical features of SLE and AAV. In rare cases, the concurrent onset of SLE and AAV results in SLE/AAV OS, which exhibits more severe clinical symptoms. Ischemic colitis (IC) is a group of clinical syndromes in the presence of vaso-occlusive or non-occlusive disorders characterized by inadequate blood supply to the colon. In this article, we report a patient with SLE/AAV OS combined with ischemic colitis. After treatment with adequate hormonal shocks, the immunosuppressants cyclophosphamide and hydroxychloroquine sulfate, plasma exchange, acid-suppressing drugs, and anti-growth hormone analogs, the patient's condition resolved.
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