Objective The aim of this study was to evaluate the safety and efficacy of intramuscular injection of either mitomycin C or dexamethasone with endoscopic dilation for benign esophageal strictures after esophageal surgery or endoscopic submucosal dissection. Methods Patients with benign esophageal strictures were retrospectively enrolled in this study and divided into three groups: mitomycin C group (mitomycin C injection with endoscopic dilation, dexamethasone group (dexamethasone injection and dilation) and dilation group (physiological saline injection and dilation). The patients' characteristics, locations of lesions, number of previous dilations, esophageal diameters after dilation, grades of dysphagia before and after the procedure and dysphagia‐free period during the follow‐up period were recorded. Results Altogether 74 patients including 25 in the mitomycin C group, 25 in the dexamethasone group and 24 in the dilation group were enrolled. The diameter of the esophagus before the procedure was 3.32 ± 0.90 mm, 3.92 ± 1.55 mm and 3.70 ± 1.30 mm, respectively, while that was increased to 12.77 ± 1.62 mm, 12.14 ± 1.28 mm and 12.73 ± 1.42 mm after endoscopic dilation in the mitomycin C, dexamethasone and conventional dilation groups. The dysphagia‐free period was 4.88 ± 1.66 months in the mitomycin C group, 4.02 ± 1.77 months in the dexamethasone group and 2.41 ± 1.26 months in the dilation group ( P < 0.05). Conclusion Intramuscular injection of mitomycin C or dexamethasone may prolong the dysphagia‐free period and decrease the frequency of repeat dilations compared with conventional endoscopic dilations in patients with benign esophageal strictures.
Objective To analyze the level of serum total bilirubin(sTB)in patients with inflammatory bowel disease(IBD)and explore the relationship between sTB and the disease condition.Methods A total of 165 patients with IBD diagnosed in Nanjing Hospital of Chinese Medicine from January 2019 to September 2020 were selected,including 80 patients with Crohn's disease(CD group)and 85 patients with ulcerative colitis(UC group),and 163 healthy subjects were collected as control group.The levels of sTB,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and hemoglobin(Hb)in IBD patients were detected,and the changes of sTB levels in IBD patients and their differences in different pathological ranges were analyzed.To investigate the association of sTB with the severity of disease activity(modified Mayo score in UC patients,simplified CDAI score in CD patients),ESR,CRP,and Hb in IBD patients.Results Compared with the control group,the sTB levels in CD group[(9.48±3.29)μmol/L]and UC group[(10.14±5.11)μmol/L]were significantly decreased(P<0.001).There was no significant difference in sTB level between CD group and UC group(P>0.05).In UC patients,there was a statistically significant difference in sTB levels among patients with different lesion ranges(H=7.793,P=0.020),namely rectal lesion group(E1)[9.90(7.30,13.70)μmol/L],left half colon lesion group(E2)[10.70(6.70,15.90)μmol/L]and extensive colon group(E3)[6.80(5.10,11.70).Correlation analysis results showed that sTB in UC patients was negatively correlated with improved Mayo score(r=-0.359,P=0.001),CRP(r=-0.496,P<0.001)and ESR(r=-0.483,P<0.001),and positively correlated with Hb level(r=0.534,P<0.001).In CD patients,sTB was negatively correlated with simplified CDAI score(r=-0.578,P<0.001),pos-itively correlated with Hb level(r=0.375,P<0.001),and had no correlation with CRP and ESR level(P>0.05).Conclusion The sTB level of IBD patients is decreased,and the analysis of sTB level of IBD patients is helpful to evaluate the degree of disease ac-tivity of patients,and can provide a new reference index for judging the scope of UC lesions.
Objective Systemic immune inflammation index（SII） has clinical value in evaluating the degree of inflammation and prognosis in many diseases. The purpose of this study is to explore the value of SII in evaluating the disease activity of rheumatoid arthritis（RA）. Methods 179 patients with RA who were hospitalized in the Department of Rheumatology and Immunology of Shengjing Hospital Affiliated to China Medical University from January 2021 to November 2021 were involved in the statistical analysis. RA patients were divided into disease remission group（n=40） and disease activity group（n=139） according to DAS28 score. Clinical and laboratory data were recorded and compared between the two groups, and the correlation of inflammatory indexes was analyzed. ROC curve of SII, NLR, PLR was drawn to predict the disease activity and analyze the evaluation value of SII for RA disease activity.Results The levels of SII, NLR, PLR, ESR, CRP, N, PLT and WBC in the disease activity group were higher than those in the disease remission group; SII, NLR and PLR were positively correlated with ESR, CRP and DAS28 scores respectively; SII, NLR and PLR had certain significance in predicting the disease activity of RA and the predictive significance of SII was better than NLR and PLR. The AUC, sensitivity and specificity of SII were 0.777, 0.849 and 0.600 respectively. Conclusion SII has certain clinical value in evaluating the disease activity of RA.
乳腺癌已超越肺癌跃升为女性最常见的癌症,由于影像诊断技术和各种化疗及靶向药物的出现,乳腺癌脑转移患者日益增多,以HER2 阳性型最多.但目前乳腺癌脑转移的发病机制尚不明确,治疗手段较局限,预后极差.文章就HER2阳性晚期乳腺癌脑转移的诊治进展作一综述,为期为临床诊疗提供依据.
目的 应用中医耳穴压豆技术治疗慢性肩关节运动性软组织损伤患者,观察 15 min后和 24h后的临床疗效.方法 对 100 例慢性肩关节运动性软组织损伤患者,应用耳穴压豆技术进行治疗,分别比较患者耳穴压豆治疗前及治疗后的视觉模拟评分(VAS)、NEER肩关节功能评分、患侧肩部温度及肩关节活动度的变化.结果 耳穴压豆治疗 15 min后和 24 h后VAS评分[(3.13±0.98)、(2.48±0.52)分]较治疗前[(6.04±1.16)分]均明显下降(P＜0.01);NEER评分[(80.18±2.33)、(83.40±2.53)分]显著较治疗前[(50.99±6.43)分]明显升高(P＜0.01);治疗 15 min后的肩部温度明显高于治疗前(P＜0.01);治疗后肩关节各方向活动度均较治疗前有显著提高(P＜0.01).结论 耳穴压豆可以快速减轻慢性肩关节运动性软组织损伤患者的疼痛,增加关节活动度,且操作安全简单,依从性好,适合推广.
