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简介：AbstractBackground:Post-operative pneumonia (POP) is a common complication of lung cancer surgery, and muscular tissue oxygenation is a root cause of post-operative complications. However, the association between muscular tissue desaturation and POP in patients receiving lung cancer surgery has not been specifically studied. This study aimed to investigate the potential use of intra-operative muscular tissue desaturation as a predictor of POP in patients undergoing lung cancer surgery.Methods:This cohort study enrolled patients (≥55 years) who had undergone lobectomy with one-lung ventilation. Muscular tissue oxygen saturation (SmtO2) was monitored in the forearm (over the brachioradialis muscle) and upper thigh (over the quadriceps) using a tissue oximeter. The minimum SmtO2 was the lowest intra-operative measurement at any time point. Muscular tissue desaturation was defined as a minimum baseline SmtO2 of <80% for >15 s. The area under or above the threshold was the product of the magnitude and time of desaturation. The primary outcome was the association between intra-operative muscular tissue desaturation and POP within seven post-operative days using multivariable logistic regression.The secondary outcome was the correlation between SmtO2 in the forearm and that in the thigh.Results:We enrolled 174 patients. The overall incidence of muscular desaturation (defined as SmtO2 < 80% in the forearm at baseline) was approximately 47.1% (82/174). The patients with muscular desaturation had a higher incidence of pneumonia than those without desaturation (28.0% [23/82] vs. 12.0% [11/92]; P = 0.008). The multivariable analysis revealed that muscular desaturation was associated with an increased risk of pneumonia (odds ratio: 2.995, 95% confidence interval: 1.080-8.310, P = 0.035) after adjusting for age, American Society of Anesthesiologists status, Assess Respiratory Risk in Surgical Patients in Catalonia score, smoking, use of peripheral nerve block, propofol, and study center.Conclusion:Muscular tissue desaturation, defined as a baseline SmtO2 < 80% in the forearm, may be associated with an increased risk of POP.Trial registration:No. ChiCTR-ROC-17012627.

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简介：AbstractGastric carcinoma is extremely rare in pregnancy and the prognosis for this malignancy tends to be dismal. We herein describe a case of gastric cancer in pregnancy to alert clinicians to this rare possibility. A 29-year-old woman developed abdominal spastic pain and diarrhea during the 26 weeks of gestation and her condition was confusing and hard to recognize. The patient was initially misdiagnosed as enterogastritis and inflammatory intestinal obstruction and was finally confirmed by exploratory laparotomy with intestinal and peritoneum metastases. Because the disease was not detected early enough and progressed rapidly, the pregnancy was terminated by cesarean section at 30 weeks of gestation, and then followed by systemic chemotherapy, but eventually succumbed to the lethal pneumonia. Therefore, it is of great significance to alert clinicians to note this rare possibility and to consider the differential diagnosis of this disease in pregnant women with a long course of gastrointestinal symptoms that cannot be explained by pregnancy alone, and cancer should be suspected and tested with sophisticated diagnostic procedures.

简介：摘要：目的：探讨肺部影像报告和数据数据系统（Lung-RADS）及CT征象对孤立性肺结节的定性诊断价值及追踪预后。方法：此次研究对象，为2015年1月至2018年1月，从院内体检及门诊偶然发现的孤立性肺结节患者中，筛选200例，所有患者均接受Lung-RADS分级、CT征象诊断，对所具诊断价值进行分析，并对病理证实的恶性肺结节患者治疗后、追踪其五年生存期。结果：恶性患者47例（病理证实），良性患者153例（主要依据5年追踪，少数为病理证实）；CT征象所具敏感性、特异度、准确性、阴性预测值、阳性预测值，高于Lung-RADS分级（P＜0.05）；同时CT征象+Lung-RADS分级，所具敏感性、特异度、准确性、阴性预测值、阳性预测值高于单一检测方式（P＜0.05）；45例手术，两例小细胞肺癌（病理证实后）化疗，47例肺癌死亡8例，5年生存率83%、远高于肺癌患者的平均5年生存率（约15%-17%）。结论：对孤立性肺结节患者采取Lung-RADS分级、CT征象联合诊断，所具价值较高，可为临床治疗提供支持，减少患者死亡、复发可能性。

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