Objective To observe the diagnostic value of serum irisin levels in hypertensive patients with severe obstructive sleep apnea syndrome(OSAS).Methods A total of 156 hypertensive patients were selected.According to apnea hypopnea index(AHI),the patients were divided into severe OSAS group(79 cases)and non-severe OSAS group(77 cases).The baseline data,polysomnography(PSG)and ambulatory blood pressure monitoring(ABPM)were collected and serum irisin levels were measured.The baseline data and serum irisin levels of the two groups were compared,and the correlation between serum irisin levels and various indicators,as well as receiver operating characteristic(ROC)curve of serum irisin levels were analyzed.Results There were no significant differences in body mass index(BMI),office systolic blood pressure(SBP),office diastolic blood pressure(DBP)and 24-h mean SBP and DBP between the two groups(P>0.05).The age,male proportion,abdominal circumference,neck circumference,AHI in severe OSAS group were higher than those in non-severe OSAS group;the severe OSAS group had lower lowest oxygen saturation(LSpO2)and mean blood oxygen saturation(MSpO2)than those in non-severe OSAS group;the differences were statistically significant(P<0.05).The median serum irisin level in 156 patients was 25.17 ng/ml,the median serum irisin level in the severe OSAS group was 14.94(4.45,28.93)ng/ml,and the median serum irisin level in the non-severe OSAS group was 42.34(21.93,74.31)ng/ml.The median serum irisin level was significantly different between the two groups(P<0.001).In 156 hypertensive patients,serum irisin level was negatively correlated with age and AHI(r=-0.175,-0.359;P=0.029,0.000<0.05),and was positively correlated with MSpO2(r=0.188,P=0.020<0.05).ROC curve analysis showed that the critical value of serum irisin concentration was 38.07 ng/ml,the area under the curve(AUC)was 0.761,the sensitivity was 86.08%(68/79),the specificity was 61.04%(47/77),the positive predictive value was 69.39%(68/98),and the negative predictive value was 81.03%(47/58).Conclusion In hypertensive population,the serum irisin concentration of OSAS patients is negatively correlated with the severity of OSAS.Serum irisin level can be used as a diagnostic index for severe OSAS patients.
Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with many anticancer therapies and can negatively impact patients' quality of life and potentially limit the effectiveness of chemotherapy. Currently, CINV can be prevented in most patients with guideline-recommended antiemetic regimens. However, clinicians do not always follow guidelines, and patients often face difficulties adhering to their prescribed treatments. Therefore, approaches to increase guideline adherence need to be implemented. NEPA is the first and only fixed combination antiemetic, composed of netupitant (oral)/fosnetupitant (intravenous) and palonosetron, which, together with dexamethasone, constitute a triple antiemetic combination recommended for the prevention of CINV for patients receiving highly emetogenic chemotherapy and for certain patients receiving moderately emetogenic chemotherapy. Thus, NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines. This review provides an overview of CINV, evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and real-world practice, and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials. Moreover, we review the utility of NEPA in controlling nausea and preserving patients' quality of life during chemotherapy, two major concerns in managing patients with cancer.
总结按摩治疗瘢痕的研究进展,为临床治疗和未来科研方向提供依据和思路.本文通过检索运用按摩疗法治疗瘢痕的相关文献,整理总结按摩治疗瘢痕的具体操作方法和效果.研究证实按摩治疗瘢痕有效,联合其他疗法效果更佳,不仅能减轻甚至完全修复瘢痕,还能从多个角度帮助改善患者生活质量,包括瘢痕引起的疼痛、瘙痒、失眠,关节、皮肤、肌肉粘连导致的功能障碍,甚至瘢痕导致的心理异常,如焦虑、抑郁.但目前研究多存在证据质量低、评价指标少且不规范等问题.临床治疗上对于瘢痕的治疗,应当在创面愈合后尽早采取按摩联合其他疗法介入.未来研究上,仍需更多大样本随机对照试验进行按摩治疗瘢痕的机理研究以提升按摩治疗瘢痕的质量.
Objective To study the effect of milrinone combined with levosimendan in the treatment of severe low cardiac output syndrome after heart valve replacement.Methods A total of 58 patients with severe low cardiac output syndrome after heart valve replacement were randomly divided into a control group and an observation group,with 29 cases in each group.The control group was treated with milrinone injection,and the observation group was treated with levosimendan on the basis of the control group.Both groups were compared in terms of hemodynamic indexes[heart rate(HR),central venous pressure(CVP),left ventricular ejection fraction(LVEF)]before and after treatment,dosage of vasoactive drugs(dopamine,epinephrine),and incidence of complications.Results After treatment,HR and CVP in both groups were lower than those before treatment in this group,and LVEF was higher than that before treatment in this group;HR of(81.29±3.69)beats/min and CVP of(7.48±0.92)cm H2O(1 cm H2O=0.098 kPa)in the observation group were lower than those of(96.85±5.52)beats/min and(11.05±1.16)cm H2O in the control group;LVEF of(60.84±6.43)% in the observation group was higher than that of(52.08±4.35)% in the control group;the difference were statistically significant(P<0.05).The doses of epinephrine of(0.03±0.01)μg/(kg·min)and doses of dopamine of(5.68±0.36)μg/(kg·min)in the observation group were lower than those of(0.19±0.04)and(8.23±0.72)μg/(kg·min)in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 6.90%,which was lower than that of 27.59% in the control group,and the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of patients with severe low cardiac output syndrome after cardiac valve replacement,the combination of milrinone and levosimendan has an ideal effect,which has the value of further promotion and application.
Objective To analyze the effectiveness and safety of laparoscopic right hemicolectomy in the treatment of colon cancer.Methods A total of 60 patients with colon cancer who underwent surgical treatment were divided into the control group and the observation group according to the difference of surgical methods,with 30 cases in each group.The control group underwent open surgery,and the observation group underwent laparoscopic right hemicolectomy.The operative indexes,postoperative complications,local tumor recurrence,and distant metastasis were compared between the two groups.Results The operative duration of(198.76±24.59)min in the observation group was longer than that of(145.23±27.45)min in the control group;the observation group had incision length of(5.42±1.07)cm,postoperative exhaust time of(25.01±7.89)h and hospital stay of(6.44±1.09)d,which were shorter than those of(19.24±2.64)cm,(62.12±12.24)h and(10.07±2.11)d in the control group;the intraoperative blood loss of(55.01±15.27)ml in the observation group was less than that of(137.56±34.54)ml in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 6.67%,which was significantly lower than that of 30.00% in the control group,and the difference was statistically significant(P<0.05).At 2 years after surgery,there was no statistically significant difference in rate of local tumor recurrence and distant metastasis rate between the two groups(P>0.05).Conclusion Laparoscopic right hemicolectomy for colon cancer patients can optimize surgical indicators and shorten postoperative rehabilitation time,and the incidence of postoperative complications,long-term local recurrence rate and metastasis rate are lower,so the effectiveness and safety of surgical treatment can be guaranteed,and the application value is higher than that of open surgery.
