BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmon...BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.展开更多
The first-line treatment options for high-risk prostate cancer(PCa)are definitive external beam radiotherapy(EBRT)with or without androgen deprivation therapy(ADT)and radical prostatectomy(RP)with or without adjuvant ...The first-line treatment options for high-risk prostate cancer(PCa)are definitive external beam radiotherapy(EBRT)with or without androgen deprivation therapy(ADT)and radical prostatectomy(RP)with or without adjuvant therapies.However,few randomized trials have compared the survival outcomes of these two treatments.To systematically evaluate the survival outcomes of high-risk PCa patients treated with EBRT-or RP-based therapy,a comprehensive and up-to-date meta-analysis was performed.A systematic online search was conducted for randomized or observational studies that investigated biochemical relapse-free survival(bRFS),cancer-specific survival(CSS),and/or overall survival(OS),in relation to the use of RP or EBRT in patients with high-risk PCa.The summary hazard ratios(HRs)were estimated under the random effects models.We identified heterogeneity between studies using Q tests and measured it using I2 statistics.We evaluated publication bias using funnel plots and Egger's regression asymmetry tests.Seventeen studies(including one randomized controlled trial[RCT])of low risk of bias were selected and up to 9504 patients were pooled.When comparing EBRT-based treatment with RP-based treatment,the pooled HRs for bRFS,CSS,and OS were 0.40(95%confidence interval[CI]:0.24–0.67),1.36(95%CI:0.94–1.97),and 1.39(95%CI:1.18–1.62),respectively.Better OS for RP-based treatment and better bRFS for EBRT-based treatment have been identified,and there was no significant difference in CSS between the two treatments.RP-based treatment is recommended for high-risk PCa patients who value long-term survival,and EBRT-based treatment might be a promising alternative for elderly patients.展开更多
目的分析1990~2017年中国膀胱癌疾病负担的变化趋势。方法利用2017年全球疾病负担研究结果,采用膀胱癌发病率、死亡率、伤残调整寿命年(Disability-adjusted life year,DALY)、过早死亡损失寿命年(Years of life lost,YLL)、伤残损失寿...目的分析1990~2017年中国膀胱癌疾病负担的变化趋势。方法利用2017年全球疾病负担研究结果,采用膀胱癌发病率、死亡率、伤残调整寿命年(Disability-adjusted life year,DALY)、过早死亡损失寿命年(Years of life lost,YLL)、伤残损失寿命年(Years lived with disability,YLD)及其标化率对1990年和2017年间中国人群膀胱癌疾病负担情况进行描述。结果2017年中国膀胱癌发病例数为7.30万,标化发病率为3.89/10万,死亡例数为3.06万,标化死亡率为1.75/10万。与1990年相比,发病例数增加了164.49%,标化发病率增加了15.09%,死亡例数增加了92.45%,标化死亡率降低了23.58%。男性的发病率和死亡率要高于女性,并且随年龄的增加呈现上升趋势。相比1990年,2017年我国膀胱癌的DALY标化率降低了26.35%,YLL标化率降低了28.59%,YLD标化率增加了28.83%。1990~2017年,我国膀胱癌DALY率整体呈下降趋势,但男性DALY率仍高于女性。结论1990~2017年我国膀胱癌的标化发病率不断上升,标化死亡率呈下降趋势,男性和老年人群是膀胱癌疾病负担的高危人群。展开更多
基金the National Natural Science Foundation of China,No.81701888Science-Technology Support Plan Projects of Sichuan Province,No.2019YFS0239 and No.2023YFS0206.
文摘BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.
基金This work was supported in part by Phillip Gallo,D epartm ent of Microbiology and Immunology,Albert Einstein College of Medicine,New York,NY,USA.
文摘The first-line treatment options for high-risk prostate cancer(PCa)are definitive external beam radiotherapy(EBRT)with or without androgen deprivation therapy(ADT)and radical prostatectomy(RP)with or without adjuvant therapies.However,few randomized trials have compared the survival outcomes of these two treatments.To systematically evaluate the survival outcomes of high-risk PCa patients treated with EBRT-or RP-based therapy,a comprehensive and up-to-date meta-analysis was performed.A systematic online search was conducted for randomized or observational studies that investigated biochemical relapse-free survival(bRFS),cancer-specific survival(CSS),and/or overall survival(OS),in relation to the use of RP or EBRT in patients with high-risk PCa.The summary hazard ratios(HRs)were estimated under the random effects models.We identified heterogeneity between studies using Q tests and measured it using I2 statistics.We evaluated publication bias using funnel plots and Egger's regression asymmetry tests.Seventeen studies(including one randomized controlled trial[RCT])of low risk of bias were selected and up to 9504 patients were pooled.When comparing EBRT-based treatment with RP-based treatment,the pooled HRs for bRFS,CSS,and OS were 0.40(95%confidence interval[CI]:0.24–0.67),1.36(95%CI:0.94–1.97),and 1.39(95%CI:1.18–1.62),respectively.Better OS for RP-based treatment and better bRFS for EBRT-based treatment have been identified,and there was no significant difference in CSS between the two treatments.RP-based treatment is recommended for high-risk PCa patients who value long-term survival,and EBRT-based treatment might be a promising alternative for elderly patients.
文摘目的分析1990~2017年中国膀胱癌疾病负担的变化趋势。方法利用2017年全球疾病负担研究结果,采用膀胱癌发病率、死亡率、伤残调整寿命年(Disability-adjusted life year,DALY)、过早死亡损失寿命年(Years of life lost,YLL)、伤残损失寿命年(Years lived with disability,YLD)及其标化率对1990年和2017年间中国人群膀胱癌疾病负担情况进行描述。结果2017年中国膀胱癌发病例数为7.30万,标化发病率为3.89/10万,死亡例数为3.06万,标化死亡率为1.75/10万。与1990年相比,发病例数增加了164.49%,标化发病率增加了15.09%,死亡例数增加了92.45%,标化死亡率降低了23.58%。男性的发病率和死亡率要高于女性,并且随年龄的增加呈现上升趋势。相比1990年,2017年我国膀胱癌的DALY标化率降低了26.35%,YLL标化率降低了28.59%,YLD标化率增加了28.83%。1990~2017年,我国膀胱癌DALY率整体呈下降趋势,但男性DALY率仍高于女性。结论1990~2017年我国膀胱癌的标化发病率不断上升,标化死亡率呈下降趋势,男性和老年人群是膀胱癌疾病负担的高危人群。
