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The 2023 American Society of Clinical Oncology Genitourinary (ASCO-GU) Cancers Symposium reported on the research progress in the field of precision diagnosis and evaluation, molecular detection, clinical treatment, and exploration of new drugs/mechanisms for prostate cancer. This article interprets and reviews important studies to help clinical treatment decisions.
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The purpose of this article is to review the mechanism and intervention strategies of alexithymia， in order to provide a new direction for clinical treatment and research of alexithymia. Alexithymia is not only related to a variety of psychosomatic diseases， but also exists in mental diseases such as depression， anxiety and eating disorders， which seriously affects the quality of life of patients. This article reviews alexithymia and its mechanism in different diseases from cognition， neurological and social-psychological factors， and summarizes the intervention strategies， aiming to provide references for the clinical treatment of alexithymia.
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This document is the revised edition of the previously issued Shanghai Expert Consensus on Clinical Protocol for Traditional Chinese Medicine Treatment of COVID-19 among the Elderly Population. Based on the clinical experience and the Protocol for Diagnosis and Treatment of COVID-19 (Trial 9th Edition), this revised edition provides treatment approaches and recommendations to proactively cope with Omicron variant and increase the therapeutic efficacy for coronavirus disease 2019 among the elderly population in Shanghai, China.
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Aged , Humans , COVID-19/drug therapy , China , Clinical Protocols , Consensus , Medicine, Chinese Traditional , SARS-CoV-2ABSTRACT
INTRODUCCIÓN: El tratamiento psicoterapéutico desde la perspectiva de la Psicología a través de la Terapia Cognitivo-Conductual (TCC) tiene en su cuna clínica una mirada refinada sobre los fenómenos de la cognición. OBJETIVO: Esta investigación analizó la perspectiva clínica de la terapia cognitivoconductual (TCC) que aparece en la literatura científica publicada sobre el tratamiento de la depresión. MÉTODO: A través de una revisión bibliográfica sobre el tema en la Plataforma Académica de Google y la Biblioteca Electrónica Científica (SciELO) en los años 2010-2020. RESULTADOS Y DISCUSIONES: La literatura muestra que la resolución de los atolladeros de una manera más asertiva, la reestructuración cognitiva y la directiva y el proceso psicoterapéutico enfocado se entienden como una contribución a la eficacia del tratamiento. Se observó que, entre las técnicas existentes en la TCC, algunas son más eficaces, a saber: conceptualización cognitiva, registro de pensamientos disfuncionales, psicoeducación, reestructuración cognitiva, cuestionamiento socrático, capacitación en aptitudes sociales y deberes. CONSIDERACIONES FINALES: En el presente estudio se abordó la prevalencia de los trastornos depresivos, sus perspectivas de desarrollo, signos y síntomas, así como la gestión del tratamiento, y puede inferirse que la TCC y los instrumentos técnicos que utiliza corroboran el progreso de la psicoterapia y la reestructuración cognitiva de los individuos depresivos, atenuando los síntomas, en asociación con el uso de drogas psicotrópicas.
INTRODUCTION: The psychotherapeutic treatment from the perspective of Psychology through Cognitive-Behavioral Therapy (CBT) has in its clinical cradle a refined look at the phenomena of cognition. OBJECTIVE: This research analyzed the clinical perspective of cognitive-behavioral therapy (CBT) discussed in the published scientific literature on the treatment of depression. METHOD: Through a bibliographic review on the Google Scholar Platform and the Scientific Electronic Library (SciELO) in the years 2010-2020. RESULTS AND DISCUSSIONS: The literature shows that resolving deadlocks more assertively, cognitive restructuring, and the focused psychotherapeutic process are understood as contributing to the effectiveness of treatment. It was noted that among the existing techniques in CBT, some are more effective, namely: cognitive conceptualization, recording of dysfunctional thoughts, psychoeducation, cognitive restructuring, socratic questioning, social skills training, and homework. FINAL CONSIDERATIONS: This study has addressed the prevalence of depressive disorders, their developmental prospects, signs, and symptoms, as well as the management of treatment, and it can be inferred that CBT and the technical tools used by it corroborate the progress of psychotherapy and cognitive restructuring of depressive individuals, attenuating the symptoms, in partnership with the use of psychotropic drugs.
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Depression , Psychology , TherapeuticsABSTRACT
El Tumor Desmoplásico Intraabdominal de células pequeñas y redondas es un tumor agresivo, poco frecuente, el pronóstico es pobre y presenta una supervivencia total de 15% a los 5 años. Se presenta el caso clínico de un paciente con diagnóstico de Tumor Desmoplásico, sometido a cirugía citoreductora y quimioterapia intraperitoneal hipertérmica internado durante 46 días en el Hospital de Clínicas de la Facultad de Ciencias Médicas, donde recibió un tratamiento multidisciplinario. El tratamiento kinésico inició posterior a la cirugía y continuó de manera ambulatoria logrando finalmente la marcha independiente, completándose un total de 20 sesiones. La evolución clínica kinésica quirúrgica demostró la importancia del trabajo interdisciplinario desde el primer contacto con el paciente. A pesar del desenlace desfavorable del paciente, en el tiempo de recuperación post quirúrgico se pudo acceder a las terapéuticas logrando importantes resultados respecto a la independencia física. El reporte presentado corresponde al tercer caso de esta patología, sometido a cirugía en el Hospital de Clínicas de la Facultad de Ciencias Médicas, el aporte de este informe nos permite valorar el manejo integral de un paciente oncológico.
The desmoplastic small round cell tumor is a rare aggressive tumor, the prognosis is poor and it has a total survival of 15% at 5 years. We presented the clinical case of a patient with a diagnosis of desmoplastic tumor, who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, hospitalized for 46 days, where he received multidisciplinary treatment.Physical Therapy treatment began after surgery and continued on an outpatient basis, finally achieving independent walking, completing a total of 20 sessions. The clinical evolution demonstrated the importance of interdisciplinary work from the first contact with the patient. Despite the unfavorable outcome of the patient, in the post-surgical recovery time, therapeutics could be accessed, achieving important results regarding physical independence. The report presented corresponds to the third case of this pathology, submitted to surgery at the Hospital de Clínicas of the Faculty of Medical Sciences, the contribution of this report allows us to assess the comprehensive management of an oncological patient.
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Desmoplastic Small Round Cell Tumor , Cytoreduction Surgical Procedures , Neoplasms , Clinical Evolution , DiagnosisABSTRACT
Objective:To explore the clinical effect and application value of simultaneous modulated accelerated radiotherapy (SMART) in the suspicious positive lymph nodes of head and neck.Methods:From January 2017 to February 2019, 60 patients with suspected positive lymph nodes in the head and neck in the Hanzhong Central Hospital of Shaanxi Province were divided into experimental group and control group according to different treatment plans, and 30 patients in each group were included. In the experimental group, 63.36 to 66.66 Gy patients were treated with SMART, while in the control group, 54.12 to 60.06 Gy patients were treated with conventional neck prophylactic radiation. In order to evaluate the feasibility of the method, the change of the short diameter of the largest cross section of the suspicious positive lymph nodes in the two groups were observed, and the adverse reactions in the treatment of the two groups were analyzed.Results:There was no significant difference between the two groups before treatment ( P>0.05). After treatment, the size of short diameter of lymph nodes in the two groups was smaller than that before treatment. The maximum short diameter of the largest cross section of lymph nodes in the experimental group was smaller than that before treatment: (0.43 ± 0.07) cm vs. (0.72 ± 0.10) cm, and the difference was statistically significant ( P<0.05). In the control group, the maximum short diameter of the largest cross section of lymph node decreased after treatment, and the difference was not statistically significant ( P>0.05). After treatment, the reduction of the short diameter in the experimental group was more obvious than that in the control group. The maximum short diameter of the largest cross section between the two groups: (0.43±0.07) cm vs. (0.66±0.08)cm was statistically significant ( t = 11.523, P<0.05). Before treatment, hemoglobin (HGB) levels of the two groups were in the normal physiological range, and there was no significant difference between the two groups ( P>0.05); the white blood cell (WBC) levels of the two groups at different time after treatment were compared: in the first week (7.83 ± 2.53) × 10 9/L vs. (8.26 ± 3.16) × 10 9/L, in the third week (7.14 ± 3.65) × 10 9/L vs. (7.08 ± 2.53) × 10 9/L, in the fifth week (5.47 ± 2.81) × 10 9/L vs. (6.41 ± 2.57) × 10 9/L, and in the seventh week (4.36 ± 2.59) × 10 9/L vs. (4.98 ± 1.64) × 10 9/L, and there were statistical differences ( P<0.05), which indicated that the WBC index levels of the two groups were gradually decreased during the treatment, and the decreased degree of the experimental group was higher than that of the control group. The levels of HGB and PLT were maintained in the normal physiological range before and after treatment, and there was no significant difference between the two groups ( P>0.05). The main complications in the treatment of the experimental group were xerostomia and stomatitis. The adverse reactions in the control group were pain in the target area of radiotherapy. There was no significant difference between the two groups ( P>0.05). Conclusions:The application of IMRT is an effective method for the treatment of occult lymph node metastasis, and it is also a therapeutic diagnostic method, which can provide evidence for the study of the law of lymph node metastasis in the head and neck. The safety and tissue tolerance of IMRT in the treatment of suspicious positive lymph nodes in the head and neck are good, which can be used for the suspicious lymph nodes in the head and neck. The treatment of positive lymph nodes and the evaluation of patients′ prognosis provide an effective way of clinical treatment.
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Rheumatoid arthritis （RA） is a common immune-mediated inflammatory autoimmunity disease. Due to its clinical characteristics， RA is classified into the category of "Bi syndrome" in traditional Chinese medicine. Huangqi Guizhi Wuwutang （HGW）， originated from Synopsis of Golden Chamber Jinkui Yaolue， is composed of Astragali Radix， Cinnamomi Ramulus， Paeonial actiflora， Zingiberis Rhizoma Recens， and Jujubae Fructus. It has been used for treatment of blood "Bi syndrome" in clinical practice， and nowadays， it is also widely used for treatment of RA or RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome. In 2018， HGW was collected in the Catalogue of Ancient Classical Prescriptions （the First Batch）. In order to provide insight for standardized clinical medication and lay a solid foundation for its further development， we herein reviewed literatures of clinical and animal studies on HGW treatment in RA. According to the basic pathogenesis of RA， HGW can be used for treatment of general RA， RA with wind-cold-dampness Bi syndrome or Qi and blood deficiency Bi syndrome alone or in combination with other drugs. The mechanisms of HGW were related to inhibition of inflammatory cytokines expression， inhibition of lipid peroxidation of synovium， and promotion of apoptosis. However， many issues in the current research still needed to be addressed， such as lack of standardization of drug compatibility and dosage， lack of standardization of clinical trial scheme，undefined drug interaction and unclear safety on the combination of Chinese medicine with chemistry drugs， lack of proper syndrome animal model， and limited study about molecular mechanisms. We propose that future research should focus on the standardization of the clinical trial scheme and RA syndrome of HGW， clarify the principle of drug compatibility and dosage， drug interaction and safety. In terms of mechanistic study， the research should focus on animal models of RA syndrome using multiple dimensions such as genetics， transcription， and metabolism.
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In recent years, targeted therapy has become the standard treatment for advanced non-small cell lung cancer (NSCLC), but this treatment method has very limited effect on patients with epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins) mutation. This insertion mutation is the third most common mutation in EGFR. It shrinks the drug binding pocket and gives tumors inherent resistance to available EGFR tyrosine kinase inhibitors (TKIs), resulting in the limited efficiency of the first and second generation of EGFR tyrosine. So far, no targeted therapy has been approved for NSCLC patients with EGFR exon 20 insertion mutations, and there are still no drugs that have met clinical needs. In this case, new treatment strategies using new EGFR TKIs or bispecific antibodies may establish new treatment standards for these patients in the future. In this review, we will summarize all relevant exon 20 insertions reported so far on the structure of EGFR and its influence on EGFR inhibitor sensitivity, as well as the treatment strategies of exon 20 insertions in NSCLC patients, hoping to be a clinical treatment for reference.
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The main causes of death for paraquat poisoning are irreversible pulmonary fibrosis, respiratory failure and even multiple organ failure. Currently, the main clinical treatment methods are gastric lavage, catharsis, blood purification and symptomatic supportive treatment, but the effectiveness is not satisfactory. It has made some progress in clinical treatment of paraquat poisoning and the study of molecular mechanisms at home and abroad. The article simply reviews in the clinical treatment of pulmonary fibrosis induced by paraquat poisoning such as blood purification, antioxidants, glucocorticoid, Chinese medicine treatment, and the molecular mechanism research such as epithelial-mesenchymal transition, Wnt/β- catenin pathway, the NF-κB pathway and Akt-Nrf-2 pathways.
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Based on national health insurance policy, traditional Chinese medicine (TCM) clinical practice and newly revealed pathological changes in Coronavirus Disease 2019 (COVID-19), the early TCM utilization was recommended to promote blood circulation and protect respiratory system. The fermented Ophiocordyceps powder preparations (Bailing tablets or capsules) are the top choice to inhibit the cytokine storm, relieve lung fibrosis and kidney damage.
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Salivary adenoid cystic carcinoma (SACC) is a common malignant tumor in the oral and maxillofacial region and accounts for approximately 3%-5% of all head and neck carcinomas. SACC always occurs in the palatal salivary gland and parotid gland. The tumor has the characteristics of strong invasion, perineural invasion, high hematogenous metastasis, and low lymph node metastasis rate. The biological characteristics of SACC determine the specificity of clinical treatment. Thus far, few clinical trials have investigated the efficacy of systemic therapy owing to the rarity of SACC with lung metastasis. Moreover, long-term results are poor, and no consensus on standard treatment has been reached yet. This systematic review aims to provide a retrospective analysis of treatment options and prognosis for SACC with lung metastasis and evidence for future clinical treatment.
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Humans , Carcinoma, Adenoid Cystic , Diagnosis , Cell Line, Tumor , Neoplasm Invasiveness , Prognosis , Retrospective Studies , Salivary Gland Neoplasms , DiagnosisABSTRACT
@#Topical ophthalmic nonsteroidal anti-inflammatory drugs(NSAIDs)are used to treat ocular surface and anterior segment inflammation as well as postoperative management of pain and inflammation. As a new generation of NSAIDs, because of its unique molecule structure, bromfenac is both a kind of potent anti-inflammatory drug and a lipophilic molecule that can penetrate ocular tissues and as a result increase the duration of action. Bromfenac has an extensive global safety record as an anti-inflammatory drug, as well as in the management of ocular pain and inflammation following cataract and refractive surgery. Apart from the functions mentioned above, nowadays researchers have also discovered other ophthalmic applications of bromfenac sodium, and therefore reach a conclusion that bromfenac sodium eye drops are safe, effective and convenient in terms of ophthalmic treatment.This review summarizes recent application progress of bromfenac sodium eye drops in ophthalmology, and then gives prospect about its future application, hoping to provide a new idea for the clinical treatment in ophthalmology in the future.
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In recent years, as the level of economic life has improved, the incidence of gestational diabetes mellitus has increased year by year. Gestational diabetes mellitus (GDM) has been a serious threat to maternal and newborn health. The pathogenesis of gestational diabetes is not very clear, and may be closely associated with insulin resistance, genetic susceptibility, inflammatory response, metabolic disorders. According to the gestational diabetes diagnostic standard,24-28 weeks pregnant women keep an empty stomach over 8 h, taken 75 g oral glucose directly, and then receive the oral glucose tolerance test. GDM is diagnosed as fasting blood-glucose> 5.1 mmol · L-1,1-hour postprandial blood glucose>10.0 mmol · L-1,and 2-hour postprandial blood glucose>8.5 mmol · L-1. Western medicine treatment is mainly based on diet, exercise, drugs, education, monitoring and insulin therapy according to blood glucose. Meanwhile, GDM is a type of diabetes in traditional Chinese medicine. GDM is prevented and treated with diets and traditional method sports and Chinese herbs. Therefore, integrated Chinese and western medicine therapy can maximize the curative effect, reduce the incidence of gestational diabetes mellitus, and effectively improve the adverse outcome and prognosis of patients with gestational diabetes mellitus from mother to child.
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@#Diabetic retinopathy is one of the serious complications of diabetes, which often results in decreased vision, visual field defects, vitreous hemorrhage,even traction retinal detachment, and blindness in the end. The disease is a major cause of blindness in diabetics, which seriously affects the quality of patients' life. This article reviews new progress in laser, drug and gene treatment of diabetic retinopathy.
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A s an important member of the body' s innate immunity and the pioneer of anti-tumor immunity, natural killer (NK) cells play a vital role in tumor immunity. Therefore, NK cell-based anti-tumor immunotherapy has increasingly become an emerging field of scientific research. NK cells have a cytotoxic effect on a variety of tumor types, and early clinical means to enhance T cell toxicity can also activate NK cells to exert a dual anti-tumor effect. This review summarizes the role of NK cells in anti-tumor immunity and its related mechanisms, and summarizes monoclonal antibodies .cytokine therapy and adoptive therapy targeting NK cells. In addition, this review clarifies the status and trends of NK cell immunotherapy and provides ideas and lessons for clinical research.
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OBJECTIVE: To explore the treatment of malignant arrhythmia induced by acute poisoning. METHODS: To analyze the treatment of 11 cases of malignant arrhythmia caused by acute poisoning. The therapeutic effect of malignant arrhythmia treated by drug, electrical cardioversion and detoxification was observed. RESULTS: The arrhythmias in the patients included premature ventricular beats, ventricular tachycardia, ventricular fibrillation, sinus tachycardia, sinus bradycardia, atrial premature beats, and ST-T changes. After treatment with cardioerter drug such as amiodarone, lidocaine, esmolol and other drugs, electric defibrillation, removeing poisons with hemoperfusion and specific antidotes, and multiple organ protection symptomatic treatment, 10 cases were successfully rescued and 1 case died. CONCLUSION: Malignant arrhythmias caused by acute poisoning could be given combined treatment with anti-arrhythmias and relief of etiology.
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Accurate evaluation of Crohn's disease is critical for determination of a therapeutic plan.Computed tomography (CT)/magnetic resonance imaging (MRI) can not only display the intraluminal and intraperitoneal inflammation objectively,but also reveal accurately the affected mesentery and related complications comprehensively,which attracted more and more attention in recent years.This review discussed the choice of CT/MRI examination methods,their roles in determining the severity of intestinal and mesenteric inflammation,the nature of intestinal stenosis,the extent of fistula,abscess and cellulitis,and the value in diagnosing postoperative complications,in order to investigate the application value of CT/MRI examination in clinical diagnosis and treatment of Crohn's disease.
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Accurate evaluation of Crohn′s disease is critical for determination of a therapeutic plan. Computed tomography (CT)/magnetic resonance imaging (MRI) can not only display the intraluminal and intraperitoneal inflammation objectively, but also reveal accurately the affected mesentery and related complications comprehensively, which attracted more and more attention in recent years. This review discussed the choice of CT/MRI examination methods, their roles in determining the severity of intestinal and mesenteric inflammation, the nature of intestinal stenosis, the extent of fistula, abscess and cellulitis, and the value in diagnosing postoperative complications, in order to investigate the application value of CT/MRI examination in clinical diagnosis and treatment of Crohn′s disease.
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Brachythrapy is a technique to implant radioactive isotype into or near tumors.The obvious properties of brachytherapy are a very high dose distribution of center,and rapid dose attenuation with the increasing of distance.Brachytherapy generally includes three major categories:low dose rate,high dose rate and pulse dose rate.The most significant clinical value of brachytherapy is that it could create dose distribution to tumor tissues,but decreased radiation injury of normal tissues close to tumor.The development of the clinical brachytherapy technique is always involved in the radiobiological characteristics.The basic concepts involving clinical brachytherapy radiobiology mainly includes:dose-rate effect,repair of radiation injury,re-oxygenation,cell cycle redistribution and repopulation.An amount of translational medical approach is needed to guide the application of clinical brachytherapy by exploring the interaction between brachytherapy radiobiology and clinical brachytherapy effect,as well as taking advantage of brachytherapy radiobiological characteristics.The ultimate goal is to improve tumor local control rate,reduce the occurrence of adverse reactions,and improve patients' overall survival.
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Virtual reality technology can simulate the real scene. It provides an ideal learning materials and the en-vironment as well as make up for the disadvantage of current medical education without the constraints of time and space constraints. It will not only improve clinical conditions and clinical treatment,but also promote the develop-ment of medicine. This article aims to introduce and evaluate the application and research of virtual reality in the medical field.