ObjectiveTo identify the predictive factors for pathological complete response （pCR）in elderly patients with breast cancer undergoing neoadjuvant therapy （NAT）.Methods A retrospective analysis was conducted on elderly patients with breast cancer （≥65 years） who received NAT at the Department of Breast of Sichuan Cancer Hospital from October 2014 to December 2023. The correlation between clinicopathological characteristics and pCR was analyzed. Univariate analysis was performed using the chi-square test or Fisher’s exact test， while multivariate analysis was conducted by binary logistic regression.ResultsA total of 132 older patients were included in this study， of whom 22 achieved a pCR，with an overall pCR rate of 16.7%. Univariate analysis showed statistically significant associations of higher pCR rates with hormone receptor （HR） negativity （P=0.004）， human epidermal growth factor receptor 2（HER2） positivity （P＜0.001）， and high Ki67 expression （P=0.013）. Multivariate analysis revealed that HR negativity （odds ratio ［OR］=3.244； 95% confidence interval ［CI］: 1.010～10.421； P=0.048） and HER2 positivity （OR=17.907； 95%CI: 5.180～61.908； P＜0.001） were independent predictive factors for pCR in elderly patients with breast cancer undergoing NAT. Subgroup analysis suggested a significant correlation of pCR rate with molecular subtypes based on HR and HER2 status （P＜0.001）. In HER2-positive breast cancer，the pCR rate was significantly higher in patients who received anti-HER2 therapy than in those who did not（60.0% vs 23.1%， P=0.031）.ConclusionHR negativity and HER2 positivity are independent predictive factors for pCR in elderly patients with breast cancer receiving neoadjuvant therapy.
Background To investigate the outcome and prognosis after Unicondylar knee arthroplasty (UKA) in patients with medial compartment arthritis of the knee combined with anterior cruciate ligament(ACL) dysfunction. Methods A total of 122 patients diagnosed with knee osteoarthritis and treated with medial mobile platform unicondylar replacement at our center from January 2019 to December 2021 were retrospectively included in the study, and were divided into two groups according to ACL function, namely the normal ACL function group (ACLF) and the poor ACL function (N-ACLF) group. The postoperative results and prognosis of the two groups were evaluated and compared. Results This study included 122 patients who underwent UKA surgery. There were no statistical differences in preoperative and postoperative posterior tibial tilt angle, knee mobility, KOOS, and prognosis between the two groups (P > 0.05). Conclusion For medial compartment arthritis of the knee combined with ACL malfunction, surgery resulted in pain relief, improved quality of life and a good prognosis for such patients. It is hoped that clinicians will perform UKA in patients with ACL dysfunction after a comprehensive evaluation to improve their quality of life.
患者男性，43岁，因“吞咽困难、反酸2年”于2019年11月11日入院，患者2年前无明显诱因出现吞咽困难，进食馒头、面条等固体食物时明显，有时伴胸骨后疼痛、恶心、呕吐，呕吐物为进食食物，服用“奥美拉唑、枸橼酸铋钾”后症状改善不明显。既往高血压病史10余年，血压最高可达160/120 mmHg，平素服用“苯磺酸氨氯地平片5 mg 1/日”，未规律监测血压。于我院行上消化道泛影葡胺造影诊断意见示：贲门失弛缓症（achalasia，AC）（）。该患者临床诊断为贲门失弛缓症，Eckardt评分7分，临床分级Ⅲ级。入院后规律服用降压药物，血压控制良好。患者无内镜下治疗禁忌，2019年11月15于中国人民解放军联勤保障部队第九六〇医院消化内科行超声内镜检查示：贲门部位固有肌层增厚，其余各层次回声分界清晰连续；中段食管固有肌层回声尚清晰连续（）。后行经口内镜下肌切开术（peroral endoscopic myotomy，POEM）（）。术后暂禁食，常规抑酸、补液等治疗。术后第2天开始进食流食，进食顺畅，无胸痛、反流等不适。POEM术后第4天，患者未遵医嘱进食油条，进食中吞咽顺畅，无明显不适，半天后出现饮水时吞咽困难，无明显胸痛，无呕血、黑便，复查上消化道泛影葡胺造影示：食管扩张、食管下端狭窄。术后第5天复查胃镜示：食管管腔迂曲，见少量食物残留，距门齿25 cm原隧道开口部位见钛夹留置，原隧道部位隆起明显，呈蓝色改变，触压有波动感，下段管腔狭窄，齿状线清，贲门松弛，开闭正常（）。考虑隧道内迟发性出血，隧道内血肿形成，遂于内镜下行隧道内血肿清除术：距门齿30 cm原隧道顶端dual刀切开顶端黏膜，建立隧道口，可见大量陈旧性淤血流出，流出后观察黏膜隆起处较前明显缩小，进入隧道内观察可见部分血凝块沉积（），充分冲洗后观察未见活动性渗血部位（），尝试用网篮清理部分血凝块，用甲硝唑注射液冲洗隧道腔，无出血，置放钛夹封闭隧道口（）；留置胃管于胃内。术后持续监测血压、鼻饲饮食，给予营养、补液治疗，患者生命体征平稳，无不适。内镜下隧道开窗减压及血肿清除术后第6天恢复半流质饮食，进食顺畅，无吞咽困难，Eckardt评分3分，临床分级Ⅰ级。2021年3月26日门诊复查上消化道泛影葡胺造影、胃镜（），患者手术部位愈合良好，出院后无吞咽困难、反流、恶心、呕吐等症状。我科医师电话随访2年，患者一般状况良好，未再出现吞咽困难等症状，Eckardt评分0分。
OBJECTIVE:To investigate the effect of the integration pattern of hospital-community on the grade-based management for hypertension in elders.METHODS:We randomly chosen 218 (male, n=121; female, n=97) primary senile hypertension patients from a Community Health Service Center of District in Changsha City, from June, 2013 to December, 2013. Based on the risky factors, the subjects were divided into three groups and every group received grade-based management on blood pressure with a integration pattern of hospital-community for six months. According to the HILL-BONE high blood pressure compliance scale and the self- designed blood pressure monitoring form, we assessed the effect of compliance and blood pressure control on senile hypertension patient.RESULTS:Hypertension treatment rate for the elders ranged from 22.9% to 88.1% (P<0.01). The levels of blood pressure of the subjects were significantly decreased compared with baseline. The level of diastolic blood pressure in the low, average, high and very high-risk group was decreased by 17, 20 and 23 mmHg, respectively (P<0.01). The level of systolic blood in the low, average, high and very high-risk group was decreased by 6, 5 and 7 mmHg, respectively (P<0.01). The compliance rate of HILL-BONE hypertension rose from 54.5% to 87.4% (P<0.01).CONCLUSION:The integration pattern of hospital-community with the grade-based management for hypertension significantly improved the senile hypertension control rate and compliance of drug treatment. The rational for drug usage rate rose obviously. The integration pattern of hospital-community with the grade-based management for elders deserves to spread.
Objective:To investigate the clinical features of patients with spontaneous hypotension syndrome.Methods:The clinical data of 75 patients with idiopathic hypocranial pressure syndrome admitted to Department of Neurosurgery, Seventh Medical Center, PLA General Hospital from January 2011 to January 2021 were retrospectively analyzed. The differences in gender and age distribution were analyzed, and the imaging characteristics were summarized.Results:The mean age of the patients was (43.67±10.30) years, and there were 24 males (32.0%) and 51 females (68.0%). The mean hospital stay was (8.79±6.12) days. The majority (56/75, 75.0%) cases of typical orthostatic headache were improved in the decubitus position. The rate of cervical spondylosis in females was higher than that in males (P=0.02). All patients underwent magnetic resonance imaging [58 (77.3%) cases underwent contrast-enhanced examination], which suggested spontaneous hypotension syndrome in 32 cases (42.7%). There was pituitary enlargement in 15 (20.0%) cases, meningeal enhancement in 28 (37.3%), subdural effusion/hemorrhage in 9 (12.0%), and decent of cerebellar tonsils in 6 (8.0%). Fifty-seven cases underwent lumbar puncture, of which 43 (84.3%) had a cranial pressure < 60 mmH2O, 8 (15.7%) had a cranial pressure ≥ 60 mmH2O, and 6 had no cranial pressure recorded. One case was misdiagnosed. Seventy-four cases were treated with infusion (2000-3000 ml/d) and symptomatic treatment, of which 52 (69.3%) were completely improved, 19 (25.3%) were improved, and 4 (5.3%) were not improved at discharge.Conclusion:The onset peak age of spontaneous?intracranial? hypotension is between 30 and 50 years old, and the proportion of females is about twice that of males. The rate of cervical spondylosis in females is higher than that in males. Cranial enhanced MRI is an effective test for definite diagnosis. The vast majority of patients recover better with conservative rehydration.
Objective:To investigate the relationship between serum microRNA-22 (miR-22) and heat shock protein family B (small) member 1 (HSPB1) levels and the prognosis of patients with acute Stanford type A aortic dissection (ATAAD).Methods:A total of 145 patients with ATAAD admitted to our hospital from January 2020 to May 2022 (ATAAD group) were selected and divided into either a death group (22 cases) or a survival group (123 cases) according to their in-hospital survival status, and another 52 healthy individuals who underwent physical examination during the same period were selected as a control group. Clinical data of ATAAD patients were collected and serum miR-22 and HSPB1 levels were measured by qPCR and enzyme-linked immunosorbent assay. Multi-factor logistic regression was used to analyze the factors influencing death in ATAAD patients, and ROC curve analysis was performed to assess the predictive value of serum miR-22 and HSPB1 levels for death in ATAAD patients.Results:Serum miR-22 levels were lower in the ATAAD group than in the control group, and HSPB1 levels were higher than those in the control group (P＜0.05). Multifactorial logistic regression analysis showed that increased age (OR=1.077, 95% CI: 1.001 to 1.158), myocardial infarction (OR=2.963, 95% CI: 1.156 to 7.597), shock (OR=3.178, 95% CI: 1.209 to 8.359), pericardial effusion (OR=2.684, 95% CI: 1.067 to 6.751), and elevated HSPB1 (OR=1.256, 95% CI: 1.013 to 1.557) were independent risk factors for death in ATAAD patients, and elevated miR-22 (OR=0.417, 95% CI: 0.196 to 0.888) was an independent protective factor (P＜0.05). ROC curve analysis showed that the area under the curve values of serum miR-22 and HSPB1 levels alone and in combination for predicting death in ATAAD patients were 0.792, 0.782, and 0.873, respectively, with sensitivities of 81.82%, 59.09%, and 86.36% and specificities of 73.98%, 88.62%, and 76.42%, respectively.Conclusion:Decreased serum miR-22 levels and increased HSPB1 levels are independently associated with a poor prognosis in ATAAD patients and can be used as an auxiliary predictor of poor prognosis in ATAAD patients.
Objective:To investigate the correlation between the neutrophil/high-density lipoprotein ratio (NHR) and lower extremity atherosclerotic disease (LEAD) in middle-aged and elderly people.Methods:A total of 644 middle-aged and elderly inpatients treated at the Department of Vascular Medicine, Peking University Shougang Hospital from January 2016 to October 2017 were selected. According to brachial and ankle index, the patients were divided into either a non-LEAD group (n=578) or an LEAD group (n=66). Data collected at baseline included participants' demographic data, lifestyle, disease history, routine blood examination, and biochemistry examination. Pearson correlation analysis was used to analyze the correlation between NHR and LEAD. ROC curves were plotted to determine the predictive performance of NHR for LEAD. Multivariate Logistic regression was used to analyze the influencing factors of LEAD. One-way analysis of variance was used to compare the vascular function of different NHR groups.Results:There was no significant difference in age, sex, smoking history, drinking history, hypertension, diabetes, hyperuricemia, medication history, MON, TC, TG, AST, ALT, TBIL, DBIL, Cr, hsCRP, or HCY between the non-LEAD group and the LEAD group (P＞0.05). WBC and NEU in the LEAD group were significantly higher than those in the non-LEAD group, while LYM, LDL, and HDL in the non-LEAD group were significantly higher than those in the LEAD group (P＜0.05 or P＜0.01). Pearson correlation analysis showed that there was a negative correlation between NHR and ABI in the middle-aged and elderly population (P＜0.01). Multivariate Logistic regression showed that NHR was an independent risk factor for LEAD (P＜0.05). One-way ANOVA showed that there were significant differences in ABI, CAVI, and CF-PWV among the groups with different levels of NHR (P＜0.05). ABI in the high NHR group was smaller than that in the low NHR group, while CAVI and CF-PWV were higher in the high NHR group.Conclusion:The increase of NHR in middle-aged and elderly people is associated with LEAD, which has important value in predicting the incidence of LEAD in this population.
Heparin-binding protein (HBP) is a kind of granule protein produced by neutrophils in response to external stimuli. It plays a crucial role in increasing vascular permeability, chemotaxis, and regulating inflammatory response In recent years, studies have found that HBP can be used as an early predictor of sepsis. In addition, it has been confirmed that HBP can be used to evaluate the disease severity and prognosis in sepsis patients. This review focuses on the clinical value of HBP in sepsis.
Objective:To observe the distribution characteristics of ectopic parathyroid glands and explore the difference of 99mTc-MIBI SPECT/CT and ultrasonography in the detection of ectopic parathyroid glands.Methods:A retrospective review was performed on patients with secondary hyperparathyroidism in the outpatient or inpatient department of China-Japan Friendship Hospital from July 2013 to July 2018. Of 358 patients who underwent 99mTc-MIBI SPECT/CT and ultrasound examinations, 38 had ectopic parathyroid glands. The clinical data of the patients were collected to analyze the distribution characteristics of ectopic parathyroid glands and compare the detection of ectopic parathyroid glands by 99mTc-MIBI SPECT/CT and ultrasound.Results:Among the 358 patients, 38 cases of ectopic parathyroid glands were detected, with a detection rate of 10.61%. The distribution of ectopic parathyroid glands is as follows: the anterior mediastinum and thymus (25, 65.8%), the lower inferior lobe of the thyroid gland (2, 5.3%), the posterior cricoid cartilage (1, 2.6%), the lateral middle lobe of the thyroid gland (1, 2.6%), the supraclavicular fossa (1, 2.6%), the carotid sheath (1, 2.6%), the posterior superior sternocleidomastoid (1, 2.6%), the submandibular gland (1, 2.6%), the piriform fossa (1, 2.6%), the greater horn of the hyoid bone (1, 2.6%), the tracheoesophageal sulcus (2, 5.3%), the lateral central thyroid gland (1, 2.6%), and the subclavian artery (1, 2.6%). For the 38 cases of ectopic parathyroid glands found by SPECT/CT, only 13 (34.2%) were found by ultrasound, of which 4 (16.0%) were located in the anterior mediastinum and thymus (4/25, 16.0%) and 9 (69.2%) were located in other sites, suggesting that the efficiency of ultrasonography in the detection of ectopic parathyroid glands in deeper locations (anterior mediastinum and thymic gland) was low. The 38 patients underwent a total of 60 surgical operations (including 46 cases of general surgery, 7 cases of thoracoscopic surgery, and 7 cases of ultrasonic-guided microwave thermal ablation), and there were 10 patients who did not remove their ectopic parathyroid glands and needed to be operated again. All the unremoved parathyroid glands were ectopic in the thorax.Conclusion:The high incidence of ectopic parathyroid is still the main reason for the failure of parathyroid gland surgery. 99mTc-MIBI SPECT/CT is an ideal examination method for finding ectopic parathyroid glands. For the detection of mediastinal or thymic ectopic parathyroid glands, 99mTc-MIBI SPECT/CT is superior to ultrasound.
Objective:To compare the high cardiovascular risk factors among young social physical examinees, young medical workers, and young patients with myocardial infarction.Methods:110 young people who underwent physical examination and were hospitalized in the First Central Hospital of Baoding City from November 2019 to July 2021 were selected for research. They were divided into the group of young social physical examiners (50 young people who underwent physical examination in the physical examination center of our hospital), the group of young medical workers (10 young employees of our hospital), and young patients who died of myocardial infarction (55 young patients with acute myocardial infarction were diagnosed in our hospital, 5 cases were excluded in the process, and 50 actual researchers). Analyze and compare the cardiovascular status of young social physical examiners, young medical workers and young patients with myocardial infarction, and compare the high-risk factors of cardiovascular disease in young people.Results:According to the returned questionnaire and the tests conducted, overweight as one of BMI weight grades did not differ significantly in the three groups (P＞0.05). In the young social physical examinee group, the number of cases who had an age <30, normal weight grade (one of BMI weight grades), no history of metabolic disease, no history of early smoking and early alcohol consumption, and no history or family history of other cardiovascular diseaseswassignificantly morethan that of the young medical worker group and the young myocardial infarction patient group. The number of cases who had an age >30, obesity (one of BMI weight grades), history of metabolic disease, history of early smoking and early drinking, history or family historyof other cardiovascular diseasewas significantly more in the young myocardial infarction patient group than in the young social physical examinee group and the young medical worker group (P＜0.05). Compared with the young social physical examineegroup, the expression levels of IL-10 and IL-37 in the young medical worker group were significantly decreased (P＜0.05). Compared to the youth medical worker group, the expression of IL-10 and IL-37 was increased in the young myocardial infarction patient group (P＜0.05). Logistic regression analysis demonstrated that metabolic disease, previous smoking, other cardiovascular diseases, and previous drinking were the main high risk cardio vascular factors.Conclusion:History of metabolic disease, history of smoking, history of drinking, and history of other cardiovascular diseases are high-risk factors affecting the occurrence of cardiovascular diseases in young people. Young people are advised to eat a balanced diet, avoid excessive smoking and drinking, strengthen exercise, and prevent the occurrence of cardiovascular diseases. This study provides some reference for the clinical diagnosis and treatment of cardiovascular diseases in young people.
Objective:To investigate the relationship of umbilical artery ultrasonography parameters, neutrophil to lymphocyte ratio (NLR), and soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PLGF) ratio with adverse pregnancy outcomes in patients with pregnancy induced hypertension syndrome (PIH).Methods:A total of 100 PIH patients who gave birth in the Fifth Affiliated Hospital of Guangzhou Medical University from April 2020 to April 2021 were selected as an observation group, and 100 healthy pregnant women in the same period were selected as a control group. Umbilical artery ultrasound and NLR and sFlt-1/PLGF ratio in the late pregnancy were compared between the two groups, and adverse pregnancy outcomes were recorded.Results:The pulse index (PI), resistance index (RI), and systolic/diastolic velocity ratio (S/D) in the observation group were significantly higher than those in the control group (P＜0.05). The percentage of subjects with an abnormal S/D was higher in the observation group than in the control group (33.00% vs 9.00%, P＜0.05). NLR and sFlt-1/PLGF ratio in the observation group were significantly higher than those in the control group (P＜0.05). The percentages of subjects with premature delivery, fetal distress, low birth weight infants, and Apgar <7 points at 1 min in the observation group were significantly higher than those in the control group (P＜0.05). Pearson correlation analysis showed that abnormal PI, RI, S/D, NLR, and sFlt-1/PLGF ratio were positively correlated with adverse pregnancy outcome in PIH patients (r=0.511, 0.495, 0.524, 0.533, and 0.606, respectively, P＜0.01). The a rea under the ROC curve (AUC) values of PI, RI, S/D, NLR, and sFlt-1/PLGF ratio for predicting adverse pregnancy outcomes in PIH patients were 0.833 [95% confidence interval (CI): 0.786~0.904], 0.814 (95%CI: 0.754~0.877), 0.864 (95%CI: 0.773~0.924), 0.820 (95%CI: 0.754~0.854), and 0.870 (95%CI: 0.763~0.892), respectively; the sensitivities were 74.11%, 72.19%, 76.32%, 70.25%, and 78.52%, and the specificities were 72.18%, 84.37%, 87.65%, 80.33%, and 82.51%, respectively. The AUC of umbilical artery ultrasound parameters combined with NLR and sFlt-1/PLGF ratio in predicting adverse pregnancy outcomes in PIH patients was 0.940 (95%CI: 0.825~0.984), with a sensitivity of 88.56% and specificity of 97.41%.Conclusion:The proportion of patients with abnormal PI, RI, S/D, and umbilical artery ultrasound parameters in PIH pregnant women is significantly higher than that of healthy pregnant women. Umbilical artery ultrasound combined with NLR and sFlt-1/PLGF ratio has appreciated predictive value for adverse pregnancy outcomes of PIH.
Carotid body tumor (CBT) is a paraganglioma, which is mainly characterized by painless mass in the neck. Because CBT often wraps around important blood vessels and nerves in the neck, the operation is difficult and risky. This paper reports the diagnosis and treatment of a case of Shamblin Ⅱ CBT, and reviews the literature to discuss the etiology, clinical manifestations, diagnosis and classification, and surgical treatment of CBT, with an aim to provide a basis for standardized diagnosis and treatment of this tumor.
Objective:To identify the risk factors for synchronous multiple early esophageal cancer (EEC) and high grade intraepithelial neoplasia (HGIN).Methods:The medical records of patients with synchronous multiple EEC and HGIN for endoscopic submucosal dissection (ESD) at the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2022 were collected. There were 137 single cases and 24 synchronous multiple cases. The t-test or Mann-Whitney U test and the chi-square test or Fisher exact probability test were used to compare the differences in general clinical characteristics (age, gender, smoking, drinking, hypertension, diabetes, coronary heart disease, abdominal operation history, and family history of gastrointestinal cancer) and pathological characteristics (pathological location, pathological type, infiltration depth, endoscopic classification, lesion length and diameter, and whether there were intestinal metaplasia and erosive gastritis) between the two groups. The independent risk factors for synchronous multiple EEC and HGIN were identified by Logistic regression analysis.Results:Patients with multiple lesions were more likely to have a family history of gastrointestinal tumors (Z2=7.149, P=0.008). When patients were complicated with gastrointestinal metaplasia at the same time, the probability of multiple lesions was higher (P=0.011). Logistic regression analysis showed that family history of gastrointestinal tumors (P=0.009, odds ratio [OR]=3.592, 95% confidence interval CI: 1.375~9.379) and concurrent gastrointestinal metaplasia (P=0.010, OR=22.194, 95%CI: 2.083~236.438) were risk factors for multiple lesions, while other general clinical data and lesion location were not related to multiple lesions.Conclusion:Patients with a family history of gastrointestinal tumors and intestinal metaplasia have a higher risk of suffering synchronous multiple EEC and HGIN. It is recommended to conduct more detailed endoscopic observation, careful endoscopic evaluation, and close follow-up after operation.
Objective:To explore the risk factors and remedial measures for failure of anal preservation caused by inadequate distal resection margin in laparoscopic surgery for low rectal cancer.Methods:A retrospective analysis was performed on 203 patients who were diagnosed as having low rectal cancer (preoperatively staged as T1-4aN0-2M0) at our center from October 2017 to June 2019 and underwent laparoscopic rectal cancer surgery. Among the patients included, 165 underwent laparoscopic Dixon surgery for low rectal cancer (Dixon group) and 38 underwent salvage intersphincteric anal sphincteric resection (sISR group) due to distal resection margin (DRM) <1 cm, which resulted in the failure of anus function preservation. Using the chi-square test and multivariate regression analysis, the association of gender, body mass index (BMI), tumor distance to the anus, tumor size, tumor center location, mesorectal fat area (MFA), and intertubercle distance (IT) with DRM＜1 cm was statistically analyzed to identify the risk factors for failure of anal preservation. Duration of hospitalization, hospitalization cost, and the incidence of complications were compared between the two groups. Wexner score was used to compare the anal function of the two groups after stoma closure. The metastasis rate and recurrence rate at 2 years after operation were compared between the two groups.Results:BMI, IT, MFA, distance between tumor and anal margin, and location of tumor center were significantly associated with DRM＜1 cm (P＜0.05). There was no significant difference in average length of hospitalization, average hospitalization cost, or the incidence of postoperative complications between the two groups (P＜0.05). Wexner score was used to evaluate the anal function after stoma closure, and there was no statistical difference between the two groups (P＞0.05). There was no statistical difference in 2-year metastasis rate or recurrence rate between the two groups (χ2=0.772, P=0.084).Conclusion:BMI, IT, MFA, tumor distance to anal margin, and tumor center location in low rectal cancer patients may lead to DRM＜1 cm resulting in the failure of anal preservation in laparoscopic Dixon surgery for low rectal cancer, and sISR can preserve the anal function of patients again, without increasing the average length of hospital stay, hospitalization costs, postoperative complications, and the disease 2-year recurrence rate and metastasis rate after surgery.
Objective:To determine the current situation regarding emergency rescue training among Chinese college students, in order to provide insight for future training programs.Methods:Questionnaires were collected online from college students in different regions of China (excluding Hong Kong, Macao, and Taiwan). Measurement data are expressed as the mean±standard deviation, and counting data are expressed as percentages (%). Binary and multiple logistic regression models were used to analyze the passing rate of emergency rescue training and the influencing factors of training effect.Results:A total of 2037 questionnaires were collected, of which 2032 were valid. The student training rate reached 73.9%. Among the students who did not receive training, 63.4% reported that the school did not organize such training program, 34.5% did not have time to attend the training, 31.7% did not pay attention to the training, and 2.1% believed that the training was meaningless. Under the premise of mastering first aid knowledge and skills, 73.0% of students reported that they were willing to rescue strangers and 83.0% were willing to rescue people that they knew. Of the students who did not want to provide help, 84.0% were worried about their ability, 44.0% worried about taking responsibility, 13.0% worried about infectious diseases, 14.0% were afraid of touching "dead people", and other reasons accounted for 4.0%. The passing rate of training reached 94.0%, and training effect and grade were influencing factors on the the passing rate. Among the students who received training, 49.0% believed that the training effect was good, with major and retraining being the influencing factors of training effect. Satisfaction with training content was lowest in the "retraining process" and highest in the "practicability of training knowledge and skills". With regard to first aid knowledge and skill proficiency, "cardiopulmonary resuscitation" was the highest, and "infant cardiopulmonary resuscitation", "infant airway foreign body obstruction exclusion", and "snake bite" were lower.Conclusion:The training rate, passing rate, rescue intention, and training intention of Chinese college students are high, and the training effect is good, but some knowledge and skills of emergency rescue need to be strengthened.
Objective:To summarize the clinical features of primary pulmonary lymphoepithelioma-like carcinoma by performing a literature review of case reported in the last 30 years.Methods:Using "primary pulmonary lymphoepithelioma-like carcinoma" as the key word, CNKI (China National Knowledge Infrastructure), Wanfang Database, Viper database, and PubMed were searched for cases reported from January 1988 to June 2020.Results:A total of 44 articles involving 179 patients were included in this study. There were 83 male and 96 female patients women, and 132 patients had no smoking history. Cough and expectoration were the most common clinical manifestations. Some patients were asymptomatic and were discovered in the physical examination. Among the 179 LELC patients, 173 had a single lesion. There were 93 cases of left lung involvement and 82 cases of right lung involvement. Tumors occurred more frequently in the right middle lobe (24.6%) and left lower lobe (31.8%). The serological positive rate of EB virus was 82.4%, and the genetic positive rate was low. Pathology showed nests of tumor cells with large vacuolated nuclei with abundant lymphocytic infiltrates. The positive rate for CK was 100% (75/75). The positive rates for CK5/6, P63, and P40 were 94.4% (68/72), 88.6% (62/70), and 83.9% (26/31), respectively. The positive rate of EBER in situ hybridization (ISH) was 95.5% (127/133). Surgery and chemoradiotherapy were recommended. The longest survival was 134 months.Conclusion:PPLELC occurs mostly in middle-aged people and non-smokers. The most common manifestations are cough and sputum, with some patients being asymptomatic. Tumors occur more frequently in the right middle lobe and left lower lobe, which are not easy to differentiate from common lung cancer types. The diagnosis of PPLELC depends on pathology, and immunohistochemistry may result in confusion with squamous cell carcinoma easily. The serological detection rate of EBV is high. Positive EBER ISH is helpful to diagnosis. The main therapeutic methods are surgery and chemoradiotherapy. Targeted therapy has little benefit and the efficacy of immunotherapy remains to be studied.
Interleukin (IL)-8 is the first discovered chemotactic cytokine, and its expression is up-regulated in a variety of solid tumors such as colorectal cancer, breast cancer, melanoma, and ovarian cancer. Recent studies have shown that the IL-8-CXCR1/2 axis can promote the infiltration of immunosuppressive cells, such as myeloid-derived suppressor cells, into the tumor microenvironment, angiogenesis, epithelial-mesenchymal transition, and the acquisition of stem-like phenotypes by activating JAK/STAT, PI3K/Akt, and other signaling pathways. These signaling pathways can further promote tumor growth, invasion, metastasis, and drug resistance. Recently, IL-8 is considered to be a key factor in the regulation of the tumor microenvironment. More and more preclinical data suggest that blockade of the IL-8-CXCR1/2 axis can enhance the tumor killing function of T cells and NK cells. The combining of inhibition of the IL-8-CXCR1/2 axis with immune checkpoint inhibitors may be a promising treatment strategy for tumor. Here, we review the role of the IL-8-CXCR1/2 signaling pathway in tumor occurrence, development, metastasis, and immunosuppression, and the research and clinical trials of drugs targeting the IL-8-CXCR1/2 signaling pathway.
Objective:To explore the effect of auricular seed pressing combined with percutaneous electrical acupoint stimulation on acute pain in elderly patients after knee arthroplasty.Methods:One hundred and twelve elderly patients who underwent knee arthroplasty at our hospital from December 2019 to December 2021 were included in this study. They were randomly divided into either a control group or a study group, with 56 cases in each group. Both groups of patients received knee arthroplasty and routine analgesia after operation, and the study group additionally underwent auricular seed pressing combined with percutaneous electrical acupoint stimulation. The indexes of postoperative recovery, degree of pain, pain threshold, knee function and range of motion, immune function, and adverse reactions were compared between the two groups.Results:The time to first ambulation, the dosage of postoperative analgesic drug, the time of indwelling drainage tube, and the days of hospitalization in the study group were all lower than those in the control group (P＜0.05). The VAS scores of the study group were lower than those of the control group at 1, 3, and 5 days postoperatively (P＜0.05). The VAS scores of the study group were lower than those of the control group at 3, 5, and 7 days postoperatively (P＜0.05). HSS score and ROM in study group were higher than those in the control group 7 days after operation (P＜0.05). The percentages of CD3+ T cells and CD4+ T cells in the study group were higher than those in the control group, and the percentage of CD8+ T cells was lower than that in the control group on the 7th day after operation (P＜0.05). The total incidence of adverse drug reactions was 8.93%, lower than that in the control group (23.21%; P＜0.05).Conclusion:Auricular seed pressing combined with transcutaneous electrical acupoint stimulation in elderly patients undergoing total knee arthroplasty can effectively increase postoperative pain threshold, alleviate pain, improve knee function and immune function, and reduce the adverse reaction after operation.
The efficacy of rituximab for minimal change disease (MCD) is still controversial. Here we report a case of refractory MCD treated with rituximab. A young man was diagnosed with nephrotic syndrome for 3 years, and MCD was confirmed by kidney biopsy. He achieved partial remission after treatment with glucocorticoids and tacrolimus, but the disease relapsed after dosage reduction. Furthermore, the patient was intolerant to glucocorticoids in later stage. Then, he was treated with rituximab but achieved a poor effect. In addition, a review of the relevant literature was performed.
