BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the c...BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the continuous development of medical technology,laparoscopic minimally invasive surgery has shown great advantages for the treatment of patients with celiac disease.AIM To investigate the short-term efficacy of laparoscopic radical surgery and traditional laparotomy for the treatment of colorectal cancer,and the differences in the risk analysis of unplanned reoperation after operation.METHODS As the research subjects,this study selected 100 patients with colorectal cancer who received surgical treatment at the Yulin First Hospital from January 2018 to January 2022.Among them,50 patients who underwent laparoscopic radical resection were selected as the research group and 50 patients who underwent traditional laparotomy were selected as the control group.Data pertaining to clinical indexes,gastrointestinal hormones,nutrition indexes,the levels of inflammatory factors,quality of life,Visual Analog Scale score,and the postoperative complications of the two groups of patients before and after treatment were collected,and the therapeutic effects in the two groups were analyzed and compared.RESULTS Compared with the control group,perioperative bleeding,peristalsis recovery time,and hospital stays were significantly shorter in the research group.After surgery,the levels of gastrin(GAS)and motilin(MTL)were decreased in both groups,and the fluctuation range of GAS and MTL observed in the research group was significantly lower than that recorded in the control group.The hemoglobin(Hb)levels increased after surgery,and the level of Hb in the research group was significantly higher compared with the control group.After the operation,the expression levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein and the total incidence of complications were significantly lower in the research group compared with the control group.One year after the operation,the quality of life of the two groups was greatly improved,with the quality of life in the research group being significantly better.CONCLUSION Laparoscopy was effective for colorectal surgery by reducing the occurrence of complications and inflammatory stress reaction;moreover,the quality of life of patients was significantly improved,which warrants further promotion.展开更多
Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～...Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～5.6mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2mm^2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy p...展开更多
BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patient...BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.展开更多
AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years w...AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years who were treated at General Hospital of Lanzhou Military Region were enrolled.Among these,200 patients underwent LARG between October2008 and August 2012(LARG group);and 200 patients underwent ORG between March 2000 and September2008(ORG group).The short-term therapeutic benefits between the two groups were analyzed.RESULTS:The LARG procedure offered significantly better benefits to the patients compared to the ORG procedure,including less intraoperative blood loss(103.1±19.5 mL vs 163.0±32.9 mL,P【0.0001),shorter postoperative hospital stay(6.8±1.2 d vs 9.5±1.6 d,P【0.0001),less frequent occurrence of postoperative complications(6.5%vs 13.5%,P=0.02),shorter time to mobilization(1.0±0.3 vs 3.3±0.4 d,P【0.0001),shorter time to bowel opening(3.3±0.7 d vs 4.5±0.7 d,P【0.0001),and shorter time to normal diet(3.0±0.4 vs d 3.8±0.5 d,P【0.0001).However,LARG required a longer time to complete than the ORG procedure(192.3±20.9 min vs 180.0±26.9 min,P【0.0001).CONCLUSION:Compared to ORG,LARG is safer,more effective,and less invasive for treating gastric cancer,with better short-term efficacy.展开更多
BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after m...BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.展开更多
BACKGROUND Totally laparoscopic gastrectomy(TLG)entails both gastrectomy and gastrointestinal reconstruction under laparoscopy.Compared with laparoscopic assisted gastrectomy(LAG),TLG has been demonstrated in many stu...BACKGROUND Totally laparoscopic gastrectomy(TLG)entails both gastrectomy and gastrointestinal reconstruction under laparoscopy.Compared with laparoscopic assisted gastrectomy(LAG),TLG has been demonstrated in many studies to require a smaller surgical incision,result in a faster postoperative recovery and less pain and have comparable long-term efficacy,which has been a research hotspot in recent years.Whether TLG is equally safe and feasible for elderly patients remains unclear.AIM To compare the short-term efficacy of and quality of life(QOL)associated with TLG and LAG in elderly gastric cancer(GC)patients.METHODS The clinicopathological data of 462 elderly patients aged≥70 years who underwent LAG or TLG(including distal gastrectomy and total gastrectomy)between January 2017 and January 2022 at the Department of General Surgery,First Medical Center,Chinese PLA General Hospital were retrospectively collected.A total of 232 patients were in the LAG group,and 230 patients were in the TLG group.Basic patient information,clinicopathological characteristics,operation information and QOL data were collected to compare efficacy.Compared with those in the LAG group,intraoperative blood loss in the TLG group was significantly lower(P<0.001),and the time to first flatus and postoperative hospitalization time were significantly shorter(both P<0.001).The overall incidence of postoperative complications in the TLG group was significantly lower than that in the LAG group(P=0.01).Binary logistic regression results indicated that LAG and an operation time>220 min were independent risk factors for postoperative complications in elderly patients with GC(P<0.05).In terms of QOL,no statistically significant differences in various preoperative indicators were found between the LAG group and the LTG group(P>0.05).Compared with the laparoscopic-assisted total gastrectomy group,patients who received totally laparoscopic total gastrectomy had lower nausea and vomiting scores and higher satisfaction with their body image(P<0.05).Patients who underwent laparoscopic-assisted distal gastrectomy were more satisfied with their body image than patients in the totally laparoscopic distal gastrectomy group(P<0.05).CONCLUSION TLG is safe and feasible for elderly patients with GC and has outstanding advantages such as reducing intracorporeal blood loss,promoting postoperative recovery and improving QOL.展开更多
Objective： Cetuximab is an effective medicine for colorectal cancer bearing wild type Kras. However, few studies of cetuximab on patients with noncolorectal gastrointestinal cancer were available now. The aim of this...Objective： Cetuximab is an effective medicine for colorectal cancer bearing wild type Kras. However, few studies of cetuximab on patients with noncolorectal gastrointestinal cancer were available now. The aim of this study was to summarize the efficacy and safety profiles base-on the experiences of 16 patients with noncolorectal gastrointestinal cancer accepted cetuximab-contained regimens treatment. Methods： The clinical data of all patients with noncolorectal gastrointestinal cancer treated by cetuximab combined with chemotherapy and/or radiotherapy from October 1st 2006 to Jun 30th 2009 in Sun Yat-sen University Cancer Center were collected. Results： （1） A total of 16 patients enrolled, including gastric cancer, esophageal carcinoma, pancreatic cancer and cholangiocarcinoma （8, 6, 1 and 1, respectively）. The cetuximab was administered 92 cycles totally with median cycle of 4. （2） PR, SD and PD obtained in 4, 3 and 2 patients respectively in cetuximab ＋ chemotherapy group. The disease control rate, median l-rP and median OS were 77.8% （7/9）, 3.5 months and 3.5 months, respectively. （3） Both of patients in cetuximab ＋ radiotherapy group achieved PR with median TTP of 4 months and 7 months, with median OS of 14 and 28 months, respectively. （4） in evaluable patients, 3 PR obtained in first-line setting, 1 PD and 1 SD achieved in second-line setting, 2 SD and 1 PD appeared in third-line and more than third-line setting. （5） The commonly side effect was neutropenia, however, rash and hypomagnesemia were the common side effects related to cetuximab. Conclusion： Cetuximab-contained regimens show a promising disease control rate, especially in first-line setting, in patients with noncolorectal gastrointestinal cancer, and the side effects both related to cytotoxic agents and related to cetuximab itself is tolerable and manageable. Of course, more phase Ⅲ clinical trails are needed urgently.展开更多
Objective： The aim of the study was, （1） to observe the short-term efficacy and adverse reactions of icotinib hydrochloride on the treatment of advanced non-small cell lung cancer （NSCLC）; （2） to explore whethe...Objective： The aim of the study was, （1） to observe the short-term efficacy and adverse reactions of icotinib hydrochloride on the treatment of advanced non-small cell lung cancer （NSCLC）; （2） to explore whether there is difference in the efficacy of icotinib hydrochloride among the subgroups of sex, age, smoking history, classification of CEA, histological type, multi-line treatment and PS score. Methods： The study was conducted to collect 138 patients taking icotinib hydrochloride with advanced non-small cell lung cancer in hospitals of Dalian （China） from September 1st 2011 to June 14th 2012. All patients had taken icotinib hydrochloride （125 mg three times a day） until the disease was progressed or the adverse reactions could not be tolerated. During the period of taking it, other anti-tumor treatments were forbidden. We observed the symptoms, such as cough, short breath, hemoptysis, pain. The objective efficacy was evaluated by RECIST criteria, and the adverse reactions related to the treatment was assessed on the basis of NCl-CTC 3.0. Results： Of all patients, CR was 1 （0.7%）, PR was 59 （42.8%）, SD was 37 （26.8%）, PD was 41 （29.7%）. And ORR was 43.5% （60/138）, DCR 70.3% （97/138）. The DCR of females was 83.5% （71/85） versus 49.1% （26/53） of males. The difference of ORR and DCR between the two subgroups had statistical significance （X2 = 8.065, P = 0.05; X2 = 18.577, P = 0.000）. The difference of ORR and DCR between the subgroups of patients after or before 70 years old had no statistical significance. The difference of ORR and DCR between the subgroups of smoking and non-smoking had statistical significance （X2 = 8.492; X2 = 13.602）. The difference of ORR and DCR between the CEA subgroups had statistical significance （X2 = 14.141; X2 = 14.160）, showed 81 patients with abnormal CEA before the treatment with ORR 56.8.0% （46/81）, DCR 81.5% （66/81）; 57 patients of normal CEA before the treatment with ORR 24.6% （14/57）, DCR 52.6% （30/57）. The 36 patients （26.1%） using icotinib hydrochloride as the first-line treatment, 78 patients （56.5%） using icotinib hydrochloride as the second-line, 20 patients （14.5%） using icotinib hydrochloride as the third-line, and 4 patients （2.9%） with tyrosine kinase inhibitor （TKI） resistance, there was statistical difference of DCR among the multi-groups above （~2 = 11.734, P = 0.008）. ORR was 31.1% （14/45） versus DCR 53.3% （24/45） in 45 patients with PS 3-4 points, and ORR was 49.4% （46/93） versus DCR 78.5% （73/93） in 93 patients with PS 0-2 points, and there was statistical difference （X2 = 4.156; X2 = 9.149）. The main adverse reactions were rash （26.8%）, diarrhea （13.8%）, mild liver function abnormal （10.9%）. Conclusion： The short-term efficacy of icotinib hydrochloride on the treatment of advanced NSCLC is positive, and the relevant adverse reactions are mild. The efficacy is better when the patient is female, non-smoker, treated as first-line, with higher CEA before treatment and lower PS scores.展开更多
Objective: to evaluate the short-term effect of emergency interventional therapy in patients with acute myocardial infarction. Methods: a total of 140 patients with acute myocardial infarction admitted to our hospital...Objective: to evaluate the short-term effect of emergency interventional therapy in patients with acute myocardial infarction. Methods: a total of 140 patients with acute myocardial infarction admitted to our hospital from January 2017 to January 2019 were selected as the research object. They were divided into the observation group and the control group according to the different treatment methods. The patients in the observation group were treated with emergency PCI intervention, while the patients in the control group were treated with conventional thrombolytic therapy, and were compared. Results: the study found that the success rate of the patients in the observation group after PCI operation was significantly higher than that in the control group, and the occurrence rate of death was significantly lower than that in the control group. The incidence of complications in the observation group was lower than that in the control group in terms of sudden death, heart failure and myocardial infarction recurrence. At the same time, through the comparison of the postoperative reexamination data of the two groups of patients, it was found that the postoperative physical recovery status of the patients in the observation group was significantly better than that of the patients in the control group, and the above-mentioned comparative data were statistically significant (P < 0.05). Conclusion: the implementation of emergency PCI operation for patients with acute myocardial infarction has obvious short-term effect and high survival rate. It not only effectively reduces the occurrence rate of complications, but also significantly improves the impaired cardiac function of patients and accelerates the recovery of patients' health, which is worthy of promotion.展开更多
Background:Bipolar transurethral enucleation of the prostate(B-TUEP)is a well-established surgical treatment for benign prostatic hyperplasia(BPH);however,its efficacy may vary depending on patient characteristics.Mag...Background:Bipolar transurethral enucleation of the prostate(B-TUEP)is a well-established surgical treatment for benign prostatic hyperplasia(BPH);however,its efficacy may vary depending on patient characteristics.Magnetic resonance imaging(MRI)with radiomics analysis can offer comprehensive and quantitative information about prostate characteristics that may relate to surgical outcomes.This study aimed to explore the value of MRI and radiomics analysis in predicting the short-term efficacy of B-TUEP for BPH.Materials and methods:A total of 137 patients with BPH who underwent B-TUEP at 2 institutions were included.Radiological features were measured in the MRIs,and the radiomics score was developed from 1702 radiomics features extracted from the prostate and transitional zone regions of interest.Three prediction models were developed and validated based on clinical-radiological features,radiomic features,and their combinations.The models were evaluated using the area under the receiver operating characteristic curve,calibration curve,and decision curve analysis.Results:The combination model exhibited the highest area under curve in both the training set(0.838)and the external validation set(0.802),indicating superior predictive performance and robustness.Furthermore,the combination model demonstrated good calibration(p>0.05)and optimal clinical utility.The combination model indicated that a highermaximum urine flow rate,lower transitional zone index,and higher radiomics score were associated with an increased risk of poor efficacy.Conclusions:Magnetic resonance imaging with radiomic analysis can offer valuable insights for predicting the short-term efficacy of BTUEP in patients with BPH.A combination model based on clinical and radiomics features can assist urologists in making more precise clinical decisions.展开更多
Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hosp...Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.展开更多
Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urolo...Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.展开更多
Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two im...Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two imaging methods in different injury grades and different cartilage subregions,and provide evidence-based basis for the accurate diagnosis of clinical cartilage injury.Methods:Clinical and imaging data of 286 patients with knee joint lesions admitted to the Affiliated Hospital of Xiangtan Medicine and Health Vocational College from January 2020 to June 2023 were collected retrospectively.All patients underwent both traditional MRI sequences and T2 Mapping sequences.The knee joint cartilage was divided into 14 subregions.Two senior radiologists independently diagnosed the images of the two imaging technologies using a blind method and recorded the cartilage injury grades.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and area under the receiver operating characteristic curve(AUC)of the two technologies for diagnosing cartilage injury were calculated and compared,and the differences in their diagnostic efficacy in different injury grades and different subregions were analyzed.Results:A total of 4004 cartilage subregions from 286 patients were included in the analysis,including 1836 injured subregions and 2168 normal subregions.The overall sensitivity(89.7%),accuracy(91.2%),and AUC(0.946)of T2 Mapping quantitative imaging for diagnosing cartilage injury were significantly higher than those of traditional MRI(76.3%,82.5%,and 0.852 respectively),with statistically significant differences(p<0.001);there was no significant difference in specificity between the two(93.5%vs 90.8%,p=0.062).Subgroup analysis showed that T2 Mapping had the most significant diagnostic advantage in early cartilage injury(Grade 1),with sensitivity(78.5%)33.2%higher than that of traditional MRI(45.3%)(p<0.001).Conclusion:The diagnostic efficacy of T2 Mapping quantitative imaging for knee joint cartilage injury is significantly superior to that of traditional MRI,especially in the detection of early cartilage injury and accurate evaluation of weight-bearing area injury.Data verify its clinical applicability and reliability.It can be used as an important supplementary method to traditional MRI,and is recommended for the early diagnosis,grading evaluation,and clinical follow-up of cartilage injury.展开更多
The highly dynamic nature,strong uncertainty,and coupled multiple safety constraints inherent in carrier aircraft recovery operations pose severe challenges for real-time decision-making.Addressing bolter scenarios,th...The highly dynamic nature,strong uncertainty,and coupled multiple safety constraints inherent in carrier aircraft recovery operations pose severe challenges for real-time decision-making.Addressing bolter scenarios,this study proposes an intelligent decision-making framework based on a deep long short-term memory Q-network.This framework transforms the real-time sequencing for bolter recovery problem into a partially observable Markov decision process.It employs a stacked long shortterm memory network to accurately capture the long-range temporal dependencies of bolter event chains and fuel consumption.Furthermore,it integrates a prioritized experience replay training mechanism to construct a safe and adaptive scheduling system capable of millisecond-level real-time decision-making.Experimental demonstrates that,within large-scale mass recovery scenarios,the framework achieves zero safety violations in static environments and maintains a fuel safety violation rate below 10%in dynamic scenarios,with single-step decision times at the millisecond level.The model exhibits strong generalization capability,effectively responding to unforeseen emergent situations—such as multiple bolters and fuel emergencies—without requiring retraining.This provides robust support for efficient carrier-based aircraft recovery operations.展开更多
Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional ...Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.展开更多
Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysi...Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT.DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.展开更多
Background The extended thymectomy for myasthenia gravis （MG） is currently available, but in 20%-40% of the patients the results were not satisfactory. There are no ideal indicators forecasting surgical results befo...Background The extended thymectomy for myasthenia gravis （MG） is currently available, but in 20%-40% of the patients the results were not satisfactory. There are no ideal indicators forecasting surgical results before operation. The surface enhanced laser desorption ionization-time of flight-mass spectroscopy （SELDI-TOF-MS） is a currently new technique for detection of protein profiles, and some progresses have been made in cancer diagnosis and efficacy evaluation, but there is no report on efficacy forecasting of MG surgery. This study aimed to establish an efficacy prognosis model for forecasting the efficacy of surgery for MG by analysis of serum protein profiles of MG patients before surgery. Methods Fifty-six MG patients 6 months after extended thymectomy were enrolled in the study. They were classified into effective or non-effective groups according to symptoms and medication. Their pre-operative blood samples were analyzed for protein profiles by the SELDI-TOF MS technique, and protein peaks were identified for establishment of the efficacy prognosis model of MG surgery. Additional 100 MG patients were subjected to model validation and their pre-operation protein profiles reviewed for post-operative results. The results were compared with those of the post-operative follow-up so as to validate the prognosis model. Results For the model establishment, symptoms were improved in 33 patients and not improved in 18 patients, with an effective rate of 64.7%. Five （8.9%） patients were lost to follow-up. Within the molecular weight range of 1 000 to 20 000, 3 specific protein peaks were found to be significantly different between the effective and non-effective groups, ie M4110-76, M3394-58, and M1258-55. Using the efficacy prognosis model constructed with these data, the accuracy rate of classification was 87.9% for the effective group, and 83.3% for the non-effective group, with a total accuracy rate of 86.3%. For the model evaluation, 2 （8.9%） patients were lost to follow-up, 62 patients were effective and 36 were non- effective. By comparing with the real results of follow-up with 65 effective and 33 non-effective patients with an effective rate of 66.3%, the accuracy rate of prediction by the prognosis model was 86.2% for the effective group, and was 81.8% for the non-effective group with a total accuracy rate of 84.5%. Conclusions By protein profiles analysis of pre-operative blood samples taken from MG patients with the SELDI-TOF MS technique, protein peaks correlated with surgery efficacy in MG patients can be found for primary forecasting short-term efficacy of surgery for MG patients.展开更多
Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,...BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.展开更多
文摘BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the continuous development of medical technology,laparoscopic minimally invasive surgery has shown great advantages for the treatment of patients with celiac disease.AIM To investigate the short-term efficacy of laparoscopic radical surgery and traditional laparotomy for the treatment of colorectal cancer,and the differences in the risk analysis of unplanned reoperation after operation.METHODS As the research subjects,this study selected 100 patients with colorectal cancer who received surgical treatment at the Yulin First Hospital from January 2018 to January 2022.Among them,50 patients who underwent laparoscopic radical resection were selected as the research group and 50 patients who underwent traditional laparotomy were selected as the control group.Data pertaining to clinical indexes,gastrointestinal hormones,nutrition indexes,the levels of inflammatory factors,quality of life,Visual Analog Scale score,and the postoperative complications of the two groups of patients before and after treatment were collected,and the therapeutic effects in the two groups were analyzed and compared.RESULTS Compared with the control group,perioperative bleeding,peristalsis recovery time,and hospital stays were significantly shorter in the research group.After surgery,the levels of gastrin(GAS)and motilin(MTL)were decreased in both groups,and the fluctuation range of GAS and MTL observed in the research group was significantly lower than that recorded in the control group.The hemoglobin(Hb)levels increased after surgery,and the level of Hb in the research group was significantly higher compared with the control group.After the operation,the expression levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein and the total incidence of complications were significantly lower in the research group compared with the control group.One year after the operation,the quality of life of the two groups was greatly improved,with the quality of life in the research group being significantly better.CONCLUSION Laparoscopy was effective for colorectal surgery by reducing the occurrence of complications and inflammatory stress reaction;moreover,the quality of life of patients was significantly improved,which warrants further promotion.
文摘Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～5.6mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2mm^2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy p...
文摘BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.
文摘AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years who were treated at General Hospital of Lanzhou Military Region were enrolled.Among these,200 patients underwent LARG between October2008 and August 2012(LARG group);and 200 patients underwent ORG between March 2000 and September2008(ORG group).The short-term therapeutic benefits between the two groups were analyzed.RESULTS:The LARG procedure offered significantly better benefits to the patients compared to the ORG procedure,including less intraoperative blood loss(103.1±19.5 mL vs 163.0±32.9 mL,P【0.0001),shorter postoperative hospital stay(6.8±1.2 d vs 9.5±1.6 d,P【0.0001),less frequent occurrence of postoperative complications(6.5%vs 13.5%,P=0.02),shorter time to mobilization(1.0±0.3 vs 3.3±0.4 d,P【0.0001),shorter time to bowel opening(3.3±0.7 d vs 4.5±0.7 d,P【0.0001),and shorter time to normal diet(3.0±0.4 vs d 3.8±0.5 d,P【0.0001).However,LARG required a longer time to complete than the ORG procedure(192.3±20.9 min vs 180.0±26.9 min,P【0.0001).CONCLUSION:Compared to ORG,LARG is safer,more effective,and less invasive for treating gastric cancer,with better short-term efficacy.
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.
基金Supported by National Basic Research Program of China,No.2019YFB1311505National Natural Science Foundation of China,No.81773135 and No.82073192+2 种基金Natural Science Foundation of China for Youth,No.82103593Natural Science Foundation of Beijing for Youth,No.7214252Program of Military Medicine for Youth,No.QNF19055.
文摘BACKGROUND Totally laparoscopic gastrectomy(TLG)entails both gastrectomy and gastrointestinal reconstruction under laparoscopy.Compared with laparoscopic assisted gastrectomy(LAG),TLG has been demonstrated in many studies to require a smaller surgical incision,result in a faster postoperative recovery and less pain and have comparable long-term efficacy,which has been a research hotspot in recent years.Whether TLG is equally safe and feasible for elderly patients remains unclear.AIM To compare the short-term efficacy of and quality of life(QOL)associated with TLG and LAG in elderly gastric cancer(GC)patients.METHODS The clinicopathological data of 462 elderly patients aged≥70 years who underwent LAG or TLG(including distal gastrectomy and total gastrectomy)between January 2017 and January 2022 at the Department of General Surgery,First Medical Center,Chinese PLA General Hospital were retrospectively collected.A total of 232 patients were in the LAG group,and 230 patients were in the TLG group.Basic patient information,clinicopathological characteristics,operation information and QOL data were collected to compare efficacy.Compared with those in the LAG group,intraoperative blood loss in the TLG group was significantly lower(P<0.001),and the time to first flatus and postoperative hospitalization time were significantly shorter(both P<0.001).The overall incidence of postoperative complications in the TLG group was significantly lower than that in the LAG group(P=0.01).Binary logistic regression results indicated that LAG and an operation time>220 min were independent risk factors for postoperative complications in elderly patients with GC(P<0.05).In terms of QOL,no statistically significant differences in various preoperative indicators were found between the LAG group and the LTG group(P>0.05).Compared with the laparoscopic-assisted total gastrectomy group,patients who received totally laparoscopic total gastrectomy had lower nausea and vomiting scores and higher satisfaction with their body image(P<0.05).Patients who underwent laparoscopic-assisted distal gastrectomy were more satisfied with their body image than patients in the totally laparoscopic distal gastrectomy group(P<0.05).CONCLUSION TLG is safe and feasible for elderly patients with GC and has outstanding advantages such as reducing intracorporeal blood loss,promoting postoperative recovery and improving QOL.
基金Supported by a grant from the Major Science and Technology Project of "National Significant New Drug Creation" (No. 2008ZX09312-002)
文摘Objective： Cetuximab is an effective medicine for colorectal cancer bearing wild type Kras. However, few studies of cetuximab on patients with noncolorectal gastrointestinal cancer were available now. The aim of this study was to summarize the efficacy and safety profiles base-on the experiences of 16 patients with noncolorectal gastrointestinal cancer accepted cetuximab-contained regimens treatment. Methods： The clinical data of all patients with noncolorectal gastrointestinal cancer treated by cetuximab combined with chemotherapy and/or radiotherapy from October 1st 2006 to Jun 30th 2009 in Sun Yat-sen University Cancer Center were collected. Results： （1） A total of 16 patients enrolled, including gastric cancer, esophageal carcinoma, pancreatic cancer and cholangiocarcinoma （8, 6, 1 and 1, respectively）. The cetuximab was administered 92 cycles totally with median cycle of 4. （2） PR, SD and PD obtained in 4, 3 and 2 patients respectively in cetuximab ＋ chemotherapy group. The disease control rate, median l-rP and median OS were 77.8% （7/9）, 3.5 months and 3.5 months, respectively. （3） Both of patients in cetuximab ＋ radiotherapy group achieved PR with median TTP of 4 months and 7 months, with median OS of 14 and 28 months, respectively. （4） in evaluable patients, 3 PR obtained in first-line setting, 1 PD and 1 SD achieved in second-line setting, 2 SD and 1 PD appeared in third-line and more than third-line setting. （5） The commonly side effect was neutropenia, however, rash and hypomagnesemia were the common side effects related to cetuximab. Conclusion： Cetuximab-contained regimens show a promising disease control rate, especially in first-line setting, in patients with noncolorectal gastrointestinal cancer, and the side effects both related to cytotoxic agents and related to cetuximab itself is tolerable and manageable. Of course, more phase Ⅲ clinical trails are needed urgently.
文摘Objective： The aim of the study was, （1） to observe the short-term efficacy and adverse reactions of icotinib hydrochloride on the treatment of advanced non-small cell lung cancer （NSCLC）; （2） to explore whether there is difference in the efficacy of icotinib hydrochloride among the subgroups of sex, age, smoking history, classification of CEA, histological type, multi-line treatment and PS score. Methods： The study was conducted to collect 138 patients taking icotinib hydrochloride with advanced non-small cell lung cancer in hospitals of Dalian （China） from September 1st 2011 to June 14th 2012. All patients had taken icotinib hydrochloride （125 mg three times a day） until the disease was progressed or the adverse reactions could not be tolerated. During the period of taking it, other anti-tumor treatments were forbidden. We observed the symptoms, such as cough, short breath, hemoptysis, pain. The objective efficacy was evaluated by RECIST criteria, and the adverse reactions related to the treatment was assessed on the basis of NCl-CTC 3.0. Results： Of all patients, CR was 1 （0.7%）, PR was 59 （42.8%）, SD was 37 （26.8%）, PD was 41 （29.7%）. And ORR was 43.5% （60/138）, DCR 70.3% （97/138）. The DCR of females was 83.5% （71/85） versus 49.1% （26/53） of males. The difference of ORR and DCR between the two subgroups had statistical significance （X2 = 8.065, P = 0.05; X2 = 18.577, P = 0.000）. The difference of ORR and DCR between the subgroups of patients after or before 70 years old had no statistical significance. The difference of ORR and DCR between the subgroups of smoking and non-smoking had statistical significance （X2 = 8.492; X2 = 13.602）. The difference of ORR and DCR between the CEA subgroups had statistical significance （X2 = 14.141; X2 = 14.160）, showed 81 patients with abnormal CEA before the treatment with ORR 56.8.0% （46/81）, DCR 81.5% （66/81）; 57 patients of normal CEA before the treatment with ORR 24.6% （14/57）, DCR 52.6% （30/57）. The 36 patients （26.1%） using icotinib hydrochloride as the first-line treatment, 78 patients （56.5%） using icotinib hydrochloride as the second-line, 20 patients （14.5%） using icotinib hydrochloride as the third-line, and 4 patients （2.9%） with tyrosine kinase inhibitor （TKI） resistance, there was statistical difference of DCR among the multi-groups above （~2 = 11.734, P = 0.008）. ORR was 31.1% （14/45） versus DCR 53.3% （24/45） in 45 patients with PS 3-4 points, and ORR was 49.4% （46/93） versus DCR 78.5% （73/93） in 93 patients with PS 0-2 points, and there was statistical difference （X2 = 4.156; X2 = 9.149）. The main adverse reactions were rash （26.8%）, diarrhea （13.8%）, mild liver function abnormal （10.9%）. Conclusion： The short-term efficacy of icotinib hydrochloride on the treatment of advanced NSCLC is positive, and the relevant adverse reactions are mild. The efficacy is better when the patient is female, non-smoker, treated as first-line, with higher CEA before treatment and lower PS scores.
文摘Objective: to evaluate the short-term effect of emergency interventional therapy in patients with acute myocardial infarction. Methods: a total of 140 patients with acute myocardial infarction admitted to our hospital from January 2017 to January 2019 were selected as the research object. They were divided into the observation group and the control group according to the different treatment methods. The patients in the observation group were treated with emergency PCI intervention, while the patients in the control group were treated with conventional thrombolytic therapy, and were compared. Results: the study found that the success rate of the patients in the observation group after PCI operation was significantly higher than that in the control group, and the occurrence rate of death was significantly lower than that in the control group. The incidence of complications in the observation group was lower than that in the control group in terms of sudden death, heart failure and myocardial infarction recurrence. At the same time, through the comparison of the postoperative reexamination data of the two groups of patients, it was found that the postoperative physical recovery status of the patients in the observation group was significantly better than that of the patients in the control group, and the above-mentioned comparative data were statistically significant (P < 0.05). Conclusion: the implementation of emergency PCI operation for patients with acute myocardial infarction has obvious short-term effect and high survival rate. It not only effectively reduces the occurrence rate of complications, but also significantly improves the impaired cardiac function of patients and accelerates the recovery of patients' health, which is worthy of promotion.
基金supported by a grant from the Basic and Applied Basic Research Foundation of Guangdong Province,China(grant no.2019A1515010386).
文摘Background:Bipolar transurethral enucleation of the prostate(B-TUEP)is a well-established surgical treatment for benign prostatic hyperplasia(BPH);however,its efficacy may vary depending on patient characteristics.Magnetic resonance imaging(MRI)with radiomics analysis can offer comprehensive and quantitative information about prostate characteristics that may relate to surgical outcomes.This study aimed to explore the value of MRI and radiomics analysis in predicting the short-term efficacy of B-TUEP for BPH.Materials and methods:A total of 137 patients with BPH who underwent B-TUEP at 2 institutions were included.Radiological features were measured in the MRIs,and the radiomics score was developed from 1702 radiomics features extracted from the prostate and transitional zone regions of interest.Three prediction models were developed and validated based on clinical-radiological features,radiomic features,and their combinations.The models were evaluated using the area under the receiver operating characteristic curve,calibration curve,and decision curve analysis.Results:The combination model exhibited the highest area under curve in both the training set(0.838)and the external validation set(0.802),indicating superior predictive performance and robustness.Furthermore,the combination model demonstrated good calibration(p>0.05)and optimal clinical utility.The combination model indicated that a highermaximum urine flow rate,lower transitional zone index,and higher radiomics score were associated with an increased risk of poor efficacy.Conclusions:Magnetic resonance imaging with radiomic analysis can offer valuable insights for predicting the short-term efficacy of BTUEP in patients with BPH.A combination model based on clinical and radiomics features can assist urologists in making more precise clinical decisions.
文摘Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.
文摘Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
基金Application Research of MRI Physiological Quantitative Imaging Technology in the Diagnosis of Cartilage Injury(Project No.:RCYJ2021-04)。
文摘Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two imaging methods in different injury grades and different cartilage subregions,and provide evidence-based basis for the accurate diagnosis of clinical cartilage injury.Methods:Clinical and imaging data of 286 patients with knee joint lesions admitted to the Affiliated Hospital of Xiangtan Medicine and Health Vocational College from January 2020 to June 2023 were collected retrospectively.All patients underwent both traditional MRI sequences and T2 Mapping sequences.The knee joint cartilage was divided into 14 subregions.Two senior radiologists independently diagnosed the images of the two imaging technologies using a blind method and recorded the cartilage injury grades.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and area under the receiver operating characteristic curve(AUC)of the two technologies for diagnosing cartilage injury were calculated and compared,and the differences in their diagnostic efficacy in different injury grades and different subregions were analyzed.Results:A total of 4004 cartilage subregions from 286 patients were included in the analysis,including 1836 injured subregions and 2168 normal subregions.The overall sensitivity(89.7%),accuracy(91.2%),and AUC(0.946)of T2 Mapping quantitative imaging for diagnosing cartilage injury were significantly higher than those of traditional MRI(76.3%,82.5%,and 0.852 respectively),with statistically significant differences(p<0.001);there was no significant difference in specificity between the two(93.5%vs 90.8%,p=0.062).Subgroup analysis showed that T2 Mapping had the most significant diagnostic advantage in early cartilage injury(Grade 1),with sensitivity(78.5%)33.2%higher than that of traditional MRI(45.3%)(p<0.001).Conclusion:The diagnostic efficacy of T2 Mapping quantitative imaging for knee joint cartilage injury is significantly superior to that of traditional MRI,especially in the detection of early cartilage injury and accurate evaluation of weight-bearing area injury.Data verify its clinical applicability and reliability.It can be used as an important supplementary method to traditional MRI,and is recommended for the early diagnosis,grading evaluation,and clinical follow-up of cartilage injury.
基金supported by the National Natural Science Foundation of China(Grant No.62403486)。
文摘The highly dynamic nature,strong uncertainty,and coupled multiple safety constraints inherent in carrier aircraft recovery operations pose severe challenges for real-time decision-making.Addressing bolter scenarios,this study proposes an intelligent decision-making framework based on a deep long short-term memory Q-network.This framework transforms the real-time sequencing for bolter recovery problem into a partially observable Markov decision process.It employs a stacked long shortterm memory network to accurately capture the long-range temporal dependencies of bolter event chains and fuel consumption.Furthermore,it integrates a prioritized experience replay training mechanism to construct a safe and adaptive scheduling system capable of millisecond-level real-time decision-making.Experimental demonstrates that,within large-scale mass recovery scenarios,the framework achieves zero safety violations in static environments and maintains a fuel safety violation rate below 10%in dynamic scenarios,with single-step decision times at the millisecond level.The model exhibits strong generalization capability,effectively responding to unforeseen emergent situations—such as multiple bolters and fuel emergencies—without requiring retraining.This provides robust support for efficient carrier-based aircraft recovery operations.
文摘Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.
文摘Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT.DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.
文摘Background The extended thymectomy for myasthenia gravis （MG） is currently available, but in 20%-40% of the patients the results were not satisfactory. There are no ideal indicators forecasting surgical results before operation. The surface enhanced laser desorption ionization-time of flight-mass spectroscopy （SELDI-TOF-MS） is a currently new technique for detection of protein profiles, and some progresses have been made in cancer diagnosis and efficacy evaluation, but there is no report on efficacy forecasting of MG surgery. This study aimed to establish an efficacy prognosis model for forecasting the efficacy of surgery for MG by analysis of serum protein profiles of MG patients before surgery. Methods Fifty-six MG patients 6 months after extended thymectomy were enrolled in the study. They were classified into effective or non-effective groups according to symptoms and medication. Their pre-operative blood samples were analyzed for protein profiles by the SELDI-TOF MS technique, and protein peaks were identified for establishment of the efficacy prognosis model of MG surgery. Additional 100 MG patients were subjected to model validation and their pre-operation protein profiles reviewed for post-operative results. The results were compared with those of the post-operative follow-up so as to validate the prognosis model. Results For the model establishment, symptoms were improved in 33 patients and not improved in 18 patients, with an effective rate of 64.7%. Five （8.9%） patients were lost to follow-up. Within the molecular weight range of 1 000 to 20 000, 3 specific protein peaks were found to be significantly different between the effective and non-effective groups, ie M4110-76, M3394-58, and M1258-55. Using the efficacy prognosis model constructed with these data, the accuracy rate of classification was 87.9% for the effective group, and 83.3% for the non-effective group, with a total accuracy rate of 86.3%. For the model evaluation, 2 （8.9%） patients were lost to follow-up, 62 patients were effective and 36 were non- effective. By comparing with the real results of follow-up with 65 effective and 33 non-effective patients with an effective rate of 66.3%, the accuracy rate of prediction by the prognosis model was 86.2% for the effective group, and was 81.8% for the non-effective group with a total accuracy rate of 84.5%. Conclusions By protein profiles analysis of pre-operative blood samples taken from MG patients with the SELDI-TOF MS technique, protein peaks correlated with surgery efficacy in MG patients can be found for primary forecasting short-term efficacy of surgery for MG patients.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
基金Supported by the Wu Jieping Medical Fund,No.320.6750.2022-09-14the Climbing Fund of PhD Workstation,Zhangzhou Affiliated Hospital of Fujian Medical University,No.PDB202412。
文摘BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.
