New doctor-patient communication learning software to help interns succeed in communication skills.

BACKGROUND: Nowadays, the research of doctor-patient communication is becoming increasingly important not only in China but also around the world. METHODS: The study designs a type of learning software to train the interns to advance their communication skills, and whose validity for improving doctor-patient communication in self-controlled trials is evaluated. With the aid of the new learning software, the self-controlled tests were carried out among 183 interns to assess the quality of their communication skill acquisition. The learning effectiveness of the preparation stage, information collection, information given, patient understanding, and inquisition ending was evaluated with the Set Elicit Give Understand End (SEGUE) framework after 3 months of training. RESULTS: More interns (37.16% vs. 10.98%, P < 0.001) could accurately identify the psychosocial or emotional factors contributing to the diseases. An increased number of interns (42.62% vs. 10.40%, P < 0.001) were able to openly discuss lifestyle issues and prevention strategies with patients. The study also revealed that interns who had completed training tended to allow patients more time to describe their feelings and concerns about their illnesses. In addition, more of the trained interns roved capable of being caring and respectful to patients and showing empathetic communication behavior (53.01% vs. 26.59%, P < 0.001). CONCLUSIONS: The doctor-patient communication software may help the interns known more about communication skills.

Review of the pathophysiology, diagnosis, and therapy of vulvar leiomyoma, a rare gynecological tumor.

The objective of this article is to discuss the pathophysiology, diagnosis, differential diagnosis, and therapy of vulvar leiomyoma. We performed a review of all English-language reports of vulvar leiomyoma published in PubMed from 1978 to 2015 using the following search terms: "vulval leiomyoma," "vulvar leiomyoma," "vulval smooth muscle tumor," and "external genitalia smooth muscle tumor." Vulvar leiomyomas, which are rare benign monoclonal tumors, most commonly occur in the fourth and fifth decades of life. The genetics of vulvar leiomyoma remain undefined. Three principal histological patterns have been identified: spindled, epithelioid, and myxoid. Imaging tests such as ultrasound, endoscopic ultrasound, and magnetic resonance imaging are used in diagnosis. Surgical excision is the only curative treatment for vulvar leiomyomas. Establishment of a full differential diagnosis list and correct final diagnosis before surgery are essential for optimal clinical management. Although recurrence of vulvar leiomyoma is extremely rare, long-term follow-up of all cases is advisable.

A review of the postoperative lymphatic leakage.

Lymphatic complications are rare, but well-known phenomena, and have been described by many researchers. However, many diagnoses of lymphatic complications are found confusing due to different definition. A literature search in Pubmed was performed for studies postoperative lympatic complications. These complications divided into two parts: lymphatic leakage and lymphatic stasis. This review is about lymphatic leakage, especially, postoperative lymphatic leakage due to the injury of lymphatic channels in surgical procedures. According to polytrophic consequences, many types of postoperative lymphatic leakage have been presented, including lymph ascites, lymphocele, lymphorrhea, lymphatic fistula, chylous ascites, chylothorax, chyloretroperitoneum and chylorrhea. In this review, we focus on the definition, incidence and treatment about most of these forms of lymphatic complications to depict a comprehensive view of postoperative lymphatic leakage. We hold the idea that the method of treatment should be individual and personal according to manifestation and tolerance of patient. Meanwhile, conservative treatment is suitable and should be considered first.

Synchronous primary malignant neoplasms of the cervix and endometrium.

Synchronous multiple malignant neoplasms of the female genital tract are rare, particularly in the uterus. We herein present the case of a patient with synchronous cervical squamous epithelial carcinoma and endometrial adenocarcinoma, and discuss the diagnosis, treatment and prognosis. The patient underwent a cervical biopsy and fractional curettage of the endometrium, followed by abdominal staging surgery, including radical hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy. The diagnosis was stage Ib1 cervical cancer and stage Ia endometrial cancer, without lymph node metastases. There has been no recurrence during 1 year of followup. Synchronous genital tract neoplasms are more clinically complex compared with single neoplasms and it is crucial to focus on the differential diagnosis between primary and metastatic tumors during the diagnostic process. The treatment of synchronous genital tract neoplasms also differs significantly from that of single neoplasms, although the prognosis of patients with synchronous gynecological malignancies does not appear to be worse.

Sentinel lymph node mapping in gynecological oncology.

The intraoperative mapping of sentinel lymph nodes (SLNs) is part of the treatment strategy for a number of types of tumor. To retrospectively compare results from the mapping of pelvic SLNs for gynecological oncology, using distinct dyes, the present review was conducted to determine the clinical significance of SLN mapping for gynecological oncology. In addition, the present study aimed at identifying an improved choice for SLN mapping tracers in clinical application. Each dye exhibits demerits when applied in the clinical environment. The combination of radioisotopes and blue dyes was identified to exhibit the most accurate detection rate of SLN drainage of gynecological oncology. However, contrast agents were unable to identify whether a SLN is positive or negative for metastasis prior to pathologic examination; additional studies are required.

Perineal leiomyoma in a postmenopausal woman: A case report.

Leiomyomas in the female reproductive system are commonly located in the uterus and typically regress following the menopause. Vulval leiomyomas are rare, and to the best of our knowledge, perineal leiomyomas in postmenopausal women have not been previously reported in the literature. The present case describes a 60-year-old Chinese woman who experienced perineal tenderness and lumbosacral radiating pain. The patient, who went through the menopause 12 years previously, had presented with a painful perineal mass for 1 year, which was subsequently diagnosed as a postmenopausal perineal leiomyoma. The mass was locally resected, and histopathological examination of the lesion resulted in a diagnosis of benign epithelioid leiomyoma. Immunohistochemical staining identified that the leiomyoma was positive for estrogen receptor and negative for progesterone receptor expression. The patient was followed up for 1 year and did not experience any pain or recurrence. The symptoms of local and lumbosacral radiating pain are extremely rare and may be induced by peripheral nerve stimulation. The etiology of postmenopausal perineal leiomyoma may be associated with infection, dietary, stress and environmental factors, and the role of estrogen cannot be overemphasized in cases of postmenopausal leiomyoma.

Vaginal implantation metastasis of endometrial carcinoma: A case report.

Endometrial cancer is the most common malignancy of the female reproductive system. The three common spread patterns of endometrial cancer are local invasion, lymphatic spread and hematogenous spread. Vaginal metastasis occurs by submucosal lymphatic or vascular metastases in ~10% of patients with clinical stage I disease. Vaginal implantation metastasis of endometrial cancer is extremely rare. Here we present a case of endometrial carcinoma (International Federation of Gynecology and Obstetrics stage IA) spread to the vagina by implantation metastasis as opposed to any of the methods mentioned above. This conclusion was confirmed mainly from pathological examination. This case highlights the occurrence of vaginal implantation metastasis of endometrial carcinoma. Certain changes may be applied during surgery to prevent implantation metastasis in patients with endometrial cancer.

Primary mucinous adenocarcinoma of the vulva: A case report and review of the literature.

Primary vulvar cancer is a rare disease with an incidence of 2-3 per 100,000 women. The vast majority of vulvar carcinomas are of the squamous cell type (90%). Primary vulvar adenocarcinomas rank among the rare gynecological malignancies. We herein present a case of a vulvar mass near the vaginal orifice, the biopsy of which revealed a mucinous adenocarcinoma. Local excision was performed, followed by postoperative chemotherapy. The patient was asymptomatic and developed no recurrence during the 2 years of follow-up after surgery and chemotherapy. We consider local excision, with or without chemotherapy, to be an effective therapeutic approach to this type of tumor. However, further studies are required to support our conclusions for early-stage vulvar mucinous adenocarcinoma.