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【Objective】 To investigate the clinical characteristics and treatment strategy of giant multilocular prostatic cystadenoma(GMPC). 【Methods】 The clinical data of a GMPC patient treated in our hospital in July 2021 were retrospectively analyzed. The patient was 73 years old. The clinical manifestations were urgent urination and frequent urination. The prostate specific antigen (PSA) increased slightly. MRI showed giant cystic solid space occupying lesion of the prostate. Domestic and foreign cases of prostate cystadenoma from 2000 to 2021 were retrieved for literature review. 【Results】 Transabdominal laparoscopic radical prostatectomy was performed successfully. The postoperative pathological diagnosis was GMPC. Two weeks after operation, the urinary catheter was removed, and there was no discomfort such as urinary frequency or urinary incontinence. After follow-up for more than 8 months, there was no tumor recurrence or metastasis. 【Conclusion】 There are still some disputes about the oncological characteristics and diagnosis and treatment of GMPC, and there is a lack of long-term follow-up results. Laparoscopic prostatectomy is safe and feasible. Most patients have a good prognosis after surgical treatment. It is necessary to formulate an individualized standard treatment plan based on surgery combined with different patients’ conditions to actively improve the prognosis.
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Bladder prolapse is a common disease in female,which seriously affects the physical and mental health of patients. At present,numerous treatment methods can improve the condition to some extent,but the therapeutic effect is still not satisfactory. This paper probes into the etiology of bladder prolapse from the perspective of biomechanics,explores the relationship between bladder prolapse and stress injury,and proposes corresponding treatment strategies for better management of this disease.
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The incidence of pulmonary disease caused by nontuberculous mycobacteria infection (NTM-PD) shows a growing trend. The treatment of NTM-PD is of low cure rate, high mortality and recurrence rate at present, it is necessary to promote the high-quality clinical therapeutic research. Based on the clinical guidelines, clinicians should carry out high-quality clinical research of NTM-PD treatment, focusing on the current urgent problems, especially the time of treatment initiation, optimization of treatment regimens, as well as prevention and rehabilitation strategies.
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Objective:To analyze the risk factors of clinically significant bleeding in patients with severe acute pancreatitis (SAP).Methods:The clinical data of SAP patients who were managed at Changhai Hospital affiliated to Naval Medical University from January 1, 2014 to October 31, 2022 were retrospectively analyzed. Twenty-nine SAP patients with clinically significant bleeding were classified to form the bleeding group. There were 23 males and 6 females, aged (56.25±14.01) years old. Another 116 SAP patients with similar general data but with no clinically significant bleeding during the same hospitalization period were included to form the non-bleeding group based on a ratio of 1∶4. There were 94 males and 22 females, aged (56.14±13.96) years old in this non-bleeding group. The general data, modified CT severity index (MCTSI), bedside index for severity of acute pancreatitis (BISAP) and other clinical data of the two groups were collected to determine the risk factors of bleeding in SAP patients.Results:Of the 29 patients with bleeding, 6 had gastrointestinal bleeding, 14 had intra-abdominal bleeding, and 9 had mixed bleeding sites, 15 were cured and discharged, and 14 died. All the 29 SAP patients with bleeding received treatment using drugs. In addition, 8 patients underwent successful hemostasis using digital subtraction angiography, 3 underwent successful endoscopic hemostasis, 2 underwent successful surgical hemostasis, and 2 underwent successful conservative drug hemostasis. Multivariate logistic regression analysis showed that SAP patients with higher MCTSI ( OR=1.824, 95% CI: 1.187-2.802), longer prothrombin time (PT) ( OR=3.431, 95% CI: 1.470-8.007) and higher BISAP ( OR=2.286, 95% CI: 1.054-4.957) had an increased risk of bleeding (all P<0.05). Conclusion:The prognosis of SAP patients was compromised with bleeding. High MCTSI, prolonged PT, and high BISAP were independent risk factors for bleeding in SAP patients.
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Cancer stem cells (CSCs) are a class of cells with self-renewal, differentiation, and tumorigenic potential in tumors. It is currently believed that the resistance of CSCs to chemotherapy and radiotherapy is an important cause of tumor recurrence and metastasis. Researchers have found that related factors in many signaling pathways endow CSCs with the ability to adapt to changes in the microenvironment, including inflammatory factors, hypoxia, low pH, and a lack of nutrients. In recent years, the mechanism of CSCs' resistance to therapy has been studied, mainly including the drug efflux mediated by the ATP-binding cassette transporter, the effect of aldehyde dehydrogenase 1 (ALDH1) activity on tumor stem cells, the enhancement of DNA damage repair and degradation of reactive oxygen species, autophagy, activation of development-related pathways, stimulation of the microenvironment, and EMT. The targeting strategies for CSCs include targeting signaling pathway inhibitors, targeting multidrug resistance, DNA damage repair, ALDH, targeting the tumor microenvironment, immunotherapy, etc. In this review, the research progress in CSCs treatment resistance and related treatment strategies was reviewed.
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With the aging and lifestyle changes of the residents in arsenicosis area, the disease spectrum has also undergone significant changes, and coexistence of chronic diseases in arsenicosis has become a primary threat to residents health. In the future, basic study from a new perspective should be deepen, to explore new pathways for integrated prevention and treatment of chronic diseases of arsenicosis, and build a whole management model of "screening, management, prevention, treatment and study" to guarantee the prevention and treatment of chronic diseases of arsenicosis.
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Cellular senescence is a biological process associated with the degeneration of cell structure and function, which contribute to age-related diseases. Atherosclerosis is a chronic inflammatory disease that can cause a variety of cardiovascular disorders. In this article, we review the effects of cellular senescence on the development of atherosclerosis through diverse physiopathological changes, focusing on the alterations in senescent organelles and the increased senescence-associated secretory phenotype (SASP), and exploring the relevant therapeutic strategies for atherosclerosis by clearing senescent cells and reducing SASP, to provide new insights for the treatment of atherosclerosis.
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Humans , Aging , Atherosclerosis , Cardiovascular Diseases , Cellular Senescence , Chronic Disease , Senescence-Associated Secretory PhenotypeABSTRACT
Many countries in the world have faced with coronavirus disease 2019 (COVID-19) epidemic since December 2019, while the proportion of elderly patients with COVID-19 in severe and death cases is relatively high. At present, China is in the rapid development stage of population aging, and the demand of the elderly for medical care, health care, nursing and life services far exceeds that of other people. Especially in the period of COVID-19, it is particularly urgent to summarize more experience and methods in time to reduce the infection rate, the incidence of critical illness, and the mortality rate. Therefore, this review combines the existing research results with clinic experience of diagnosis and treatment for senile infectious diseases, summarizes the clinical characteristics and puts forward the prevention strategies of elderly COVID-19 patients, which provide evidence for effective prevention and treatment of COVID-19 in elderly patients, improvement of cure rate, and reduction of severe incidence rate and mortality.
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Aged , Humans , Betacoronavirus , China , Coronavirus Infections , Diagnosis , Mortality , Therapeutics , Pandemics , Pneumonia, Viral , Diagnosis , Mortality , TherapeuticsABSTRACT
Gastric polyps are common precancerous diseases. With the intensive study on the characteristics of different types of gastric polyps in recent years, only 1.7% of the gastric polyps were found to have dysplasia and cancer, and most of the dysplasia and cancer were found in polyps larger than 1 cm. Traditional idea suggests that polyps should be removed immediately, but routine removal of all polyps results in an increased financial burden on patients. At present, there are controversies about whether endoscopic treatment is necessary for different pathological types and small gastric polyps.
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Humans , Hyperplasia , Polyps , Precancerous Conditions , Stomach NeoplasmsABSTRACT
Melanoma is a malignant tumor of melanocyte origin, and BRAF mutations occur in about 50% of melanoma patients clinically. BRAF inhibitors can target mutated BRAF sites, thus rapidly inhibiting the proliferation and promoting apoptosis of tumor cells. However, the subsequent rapid occurrence of drug resistance events seriously restricted the continuous use of such drugs, so it is of great importance to explore the mechanism of BRAF inhibitors resistance. This paper introduces the research progress of BRAF inhibitor resistance in melanoma in recent years, in order to provide some references for the follow-up research and clinical application.
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@#<p style="text-align: justify;"><strong>Objectives:</strong> This research study aims to conduct a systematic review and critical appraisal of the quality of the existing peer-reviewed journal literature looking into the economic evaluation of control strategies used in parasitic diseases (i.e., STH and schistosomiasis).</p><p style="text-align: justify;"><strong>Methods:</strong> Database searches were conducted in Embase, Science Direct, Medline, CINAHL, Econ Lit, and Academic Search Elite, by using search keywords or phrases. Using the predefined inclusion and exclusion criteria, a review of published online articles between January 1990 and December 2012 was conducted. Aside from the set of good practice guidelines in conducting economic evaluations, assessment of the quality of economic evaluations was also carried out following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.</p><p style="text-align: justify;"><strong>Results:</strong> Given the inclusion and exclusion criteria set by this review, we systematically reviewed thirteen shortlisted samples of economic analysis studies. The current systematic review shows a wide variety of methodological approaches across studies, including differences in the type of economic evaluation, perspective, time horizon, approach, and adjustments for timing and certainty used.</p><p style="text-align: justify;"><strong>Conclusions:</strong> In general, the economic evaluation studies that have been examined in this review have complied with the set of criteria of good practice in conducting an economic evaluation and that it can be considered helpful in making decisions and in understanding the economics of controlling these parasitic diseases.</p>
Subject(s)
Cost-Benefit Analysis , SchistosomiasisABSTRACT
In recent years,the incidence of gastric cancer has been decreasing year by year in the world,but the incidence of adenocarcinoma of esophagogastric junction (AEG) has shown a significant upward trend,especially in western countries such as Europe and America.The prognosis of AEG is poor,therefore,it is extremely necessary to establish AEG's best diagnosis and treatment strategies to improve the long-term outcome of AEG.Nowadays,the most commonly used AEG classification is the Siewert classification proposed by German scholars in 1987,which is based on the anatomical features of the esophagogastric junction.It provides guidance for the choice of surgical methods.Compared with European and American countries,Siewert type Ⅱ or type Ⅲ are more common in Asian countries,and are mainly treated as the proximal gastric cancer.Compared with gastric tumors in other areas,AEG has obvious differences and specialities in anatomy,physiology and pathology,and there is still much controversy in the field of surgical and comprehensive treatment.
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Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity; therefore, it should be effective for CLBP in older adults.
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Objective Carbapenem-resistant Enterobacteriaceae infections is becoming a major challenge to clinicians, which resulted in extremely high mortality owing to the limited antibiotics option.It is urgently to explore strategies to manage such bacterial infections.So far,the research is mainly focused on the research and development of new drugs,as well as the re-evaluation of classic antimicrobial drugs and the combined treatment regimens.Tigecycline is available in our country,but the clinical effect is still doubtful.Polymyxin has a good effect on drug sensitivity test in vitro,but the clinical dosing has not been established.Carbapenems combining with other drugs as optimizing treatment program is also being explored.Carbapenemase-inhibitor combination has not yet listed on Chinese market.In the mean time,it is urgent to prevent and to control carbapenem-resistant Enterobacteriaceae bacterial infection.
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Acute aortic syndrome(AAS) is a lethal disease with acute onset and a high mortality rate as well as a higher incidence rate especially in an aging population. The diagnostic techniques of AAS have been improving in recent years. Many serum biomarkers have been shown to have the potential of further clinical implication. Advancement of imaging techniques has also improved the accuracy of early diagnosis. Although traditional treatment modality involving open surgery is life-saving, it still has a high mortality rate and a high major morbidity rate. The increasing utilization of endovascular techniques has greatly improved the prognosis of AAS, while it still need further optimization to be applied in different subgroups of patients.
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It is great value to analyze the pathogenesis of Alzheimer's disease for the formulation and research of prevention and treatment strategies. The change of zang-fu meridians and collaterals is the essential rule of the pathogenesis of internal injury and miscellaneous diseases. Based on the analysis of the physiological basis of the aging changes of zang-fu meridians and the relationship between dementia and the abnormal function of zang-fu meridians and collaterals, this paper systematically explored the relationship between the changes of zang-fu meridians and the pathogenesis of dementia. It is considered that the change of zang-fu meridians and collaterals is the basic law of its pathogenesis development. Therefore, it is proposed that strengthening Qi is the essential principle throughout the whole process of dementia, and dredging channels and collaterals and maintaining normal function of meridians and collaterals are the key to block the pathogenesis evolution of dementia.
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Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.
Subject(s)
Humans , Male , Brain , Conversion Disorder , Counseling , Diagnosis , Drug Therapy , Extremities , Gait , Hypnosis , Lower Extremity , Neurologic Manifestations , Paraparesis , Transcranial Magnetic StimulationABSTRACT
Objective: To analyze the current situation and treatment strategies of insulin allergy at home and abroad to provide reference for medical staffs to diagnose and treat the anaphylaxis.Methods: The literatures on insulin allergy in recent ten years were searched to analyze the present situation statistically and summarize the treatment strategies.Results: In recent ten years, the cases of insulin allergy were reported repeatedly.The insulin allergy mainly affected skin and its accessories, causing local allergic reactions (redness itching, induration and so on).General allergic reactions occurred rarely, but were life-threatening in severe situations.Conclusion: Medical staffs should grasp the ability of diagnosis and treatment of insulin allergy to ensure the medical safety and effectiveness for patients.
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The intention of neoadjuvant chemotherapy in breast cancer is to shrink the tumors in locally advanced disease and to improve the degree of cure of operation (security). Therefore, it is expected to improve quality of life and survival for patients. Additionally, neoadjuvant chemotherapy is administered based on the observable primary tumor. Thus, the timely assessment of tumor response to chemotherapeutic drugs provides a basis for subsequent treatment. Currently, however, the treatment concept of breast cancer requires whole process management. It requires clinicians to develop the overall treatment strategy according to tumor biological information of patients, as well as timely and reasonable adjustment of the subsequent treatment based on the response to neoadjuvant chemotherapy. These are new problems arising from neoadjuvant chemotherapy.
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Small cell lung cancer(SCLC) is a type of neuroendcorine cancer with high growth fraction, early metastatic spread and poor prognosis, accounting for approximately 15％ of all newly diagnosed lung cancer cases.Patients with SCLC are generally treated with platinum-based chemotherapy in combination with radiotherapy.Despite good responses to chemotherapy in the early stage of treatment, patients develop drug resistance and recurrence soon.There has been limited success with the targeted approaches in clinical trials completed in the past several years.Novel targeted and more effective treatment strategies for SCLC are in urgent need With increasing translational research and a better understanding of the molecular basis of small cell lung cancer, a number of new targeted drugs such as kinase inhibitors, angiogenesis inhibitors, apoptosis inducers, proteasome inhibitors, epigenetic regulators, immune checkpoint inhibitors have been developed and investigated in various preclinical studies.Some of them have entered clinical trials.At the same time, a number of novel treatment strategies such as immunotherapy and combination treatment receive attention.This review summarizes potentially molecular targeted therapies that have been developed and employed recently, and ongoing and future clinical trials in attempt to improve patient outcomes in SCLC, and meanwhile to invite future potential SCLC new treatment strategies.