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
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 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
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec...Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.展开更多
Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy live...Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.展开更多
This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
Load forecasting is of great significance to the development of new power systems.With the advancement of smart grids,the integration and distribution of distributed renewable energy sources and power electronics devi...Load forecasting is of great significance to the development of new power systems.With the advancement of smart grids,the integration and distribution of distributed renewable energy sources and power electronics devices have made power load data increasingly complex and volatile.This places higher demands on the prediction and analysis of power loads.In order to improve the prediction accuracy of short-term power load,a CNN-BiLSTMTPA short-term power prediction model based on the Improved Whale Optimization Algorithm(IWOA)with mixed strategies was proposed.Firstly,the model combined the Convolutional Neural Network(CNN)with the Bidirectional Long Short-Term Memory Network(BiLSTM)to fully extract the spatio-temporal characteristics of the load data itself.Then,the Temporal Pattern Attention(TPA)mechanism was introduced into the CNN-BiLSTM model to automatically assign corresponding weights to the hidden states of the BiLSTM.This allowed the model to differentiate the importance of load sequences at different time intervals.At the same time,in order to solve the problem of the difficulties of selecting the parameters of the temporal model,and the poor global search ability of the whale algorithm,which is easy to fall into the local optimization,the whale algorithm(IWOA)was optimized by using the hybrid strategy of Tent chaos mapping and Levy flight strategy,so as to better search the parameters of the model.In this experiment,the real load data of a region in Zhejiang was taken as an example to analyze,and the prediction accuracy(R2)of the proposed method reached 98.83%.Compared with the prediction models such as BP,WOA-CNN-BiLSTM,SSA-CNN-BiLSTM,CNN-BiGRU-Attention,etc.,the experimental results showed that the model proposed in this study has a higher prediction accuracy.展开更多
The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell i...The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell inflammation model in vitro,and the inflammatory cytokines of Interleukin-6 (IL-6) and NO were detected to observe the inhibitory effect of baby moisturizer in vitro.The non-toxic concentration of baby moisturizer was detected by MTT assay,the level of IL-6 in RAW264.7 cells supernatant was detected by ELISA kits,and the level of NO in RAW 264.7 cells supernatant was detected by Griess reagent.Dexamethasone was used as the positive control.At the same time,the hydration of the stratum corneum,transepidermal water loss (TEWL),erythema index,the redness of skin (a^(*) value) and the proportion of redness area in facial cheekbones were detected after using the baby moisturizer for 28 days.The experiment results showed that the baby moisturizer at a non-toxic concentration of 0.3 mg/mL,could significantly reduce IL-6 and NO in RAW264.7 cells supernatant,meanwhile it could significantly enhance the hydration of the stratum corneum,and reduce the TEWL,erythema index,the redness of skin (a^(*) value) and the proportion of redness area.In conclusion,the baby moisturizer (0.3 mg/mL) can restrain inflammatory cytokines in vitro and can also significantly improve human facial skin irritation,which can be considered to have soothing efficacy.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.
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.
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.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.
文摘Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
文摘Load forecasting is of great significance to the development of new power systems.With the advancement of smart grids,the integration and distribution of distributed renewable energy sources and power electronics devices have made power load data increasingly complex and volatile.This places higher demands on the prediction and analysis of power loads.In order to improve the prediction accuracy of short-term power load,a CNN-BiLSTMTPA short-term power prediction model based on the Improved Whale Optimization Algorithm(IWOA)with mixed strategies was proposed.Firstly,the model combined the Convolutional Neural Network(CNN)with the Bidirectional Long Short-Term Memory Network(BiLSTM)to fully extract the spatio-temporal characteristics of the load data itself.Then,the Temporal Pattern Attention(TPA)mechanism was introduced into the CNN-BiLSTM model to automatically assign corresponding weights to the hidden states of the BiLSTM.This allowed the model to differentiate the importance of load sequences at different time intervals.At the same time,in order to solve the problem of the difficulties of selecting the parameters of the temporal model,and the poor global search ability of the whale algorithm,which is easy to fall into the local optimization,the whale algorithm(IWOA)was optimized by using the hybrid strategy of Tent chaos mapping and Levy flight strategy,so as to better search the parameters of the model.In this experiment,the real load data of a region in Zhejiang was taken as an example to analyze,and the prediction accuracy(R2)of the proposed method reached 98.83%.Compared with the prediction models such as BP,WOA-CNN-BiLSTM,SSA-CNN-BiLSTM,CNN-BiGRU-Attention,etc.,the experimental results showed that the model proposed in this study has a higher prediction accuracy.
文摘The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell inflammation model in vitro,and the inflammatory cytokines of Interleukin-6 (IL-6) and NO were detected to observe the inhibitory effect of baby moisturizer in vitro.The non-toxic concentration of baby moisturizer was detected by MTT assay,the level of IL-6 in RAW264.7 cells supernatant was detected by ELISA kits,and the level of NO in RAW 264.7 cells supernatant was detected by Griess reagent.Dexamethasone was used as the positive control.At the same time,the hydration of the stratum corneum,transepidermal water loss (TEWL),erythema index,the redness of skin (a^(*) value) and the proportion of redness area in facial cheekbones were detected after using the baby moisturizer for 28 days.The experiment results showed that the baby moisturizer at a non-toxic concentration of 0.3 mg/mL,could significantly reduce IL-6 and NO in RAW264.7 cells supernatant,meanwhile it could significantly enhance the hydration of the stratum corneum,and reduce the TEWL,erythema index,the redness of skin (a^(*) value) and the proportion of redness area.In conclusion,the baby moisturizer (0.3 mg/mL) can restrain inflammatory cytokines in vitro and can also significantly improve human facial skin irritation,which can be considered to have soothing efficacy.
