ABSTRACT
Objective:To characterize the clinical and epidemiological changes, treatments, and prognoses of primary esophageal small cell carcinoma (PESC). Methods:A retrospective analysis was conducted using the clinical epidemiology data of 529 PESC patients se-lected from the clinical databases of 500,000 esophageal and gastric cardiac carcinomas of the Henan Key Laboratory for Esophageal Cancer Research (1992-2015). Among these patients, 241 cases were included in the survival analysis. The five-year survival rate was calculated using Kaplan-Meier analysis, and the differences in survival rates were compared using the Log-rank analysis model. Re-sults:All 529 PESC cases were analyzed, which accounted for 0.2%of esophageal cancers diagnosed in the same period. The incidence of PESC increased annually (R2=0.574). The survival rates for 1-, 2-, 3-, and 5-year of 241 PESC patients were 55%, 40%, 29%, and 9%, respectively, and the median survival time was 21.9 months. On the basis of the VALSG criteria of lung small cell carcinoma, a statisti-cal difference was observed in the overall survival rates for limited and extensive diseases (P=0.003), with the median survival time of 24.3 and 17.5 months, respectively. Furthermore, significant differences were observed on survival with various treatment modalities (P=0.004). The median survival time of PESC patients treated with combined surgery and radiochemotherapies (28.8 months) was lon-ger than those with either chemotherapy (17.8 months, P=0.015) or chemoradiotherapy (14.5 months, P=0.004). In limited disease pa-tients, the median survival time was longer in patients treated with surgery (27.7 months) than in those without surgery (16.2 months, P=0.007). Notably, the biopsy diagnosis before surgery for PESC was only 40.8%. Conclusion:PESC is a rare malignant carcinoma with increasing incidence. PESC presents poor prognosis, and the survival rate can be improved through combined therapies based on sur-gery. A high misdiagnosis rate for PESC is observed before surgery with biopsy.
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Objective: To study the effect of antidepressant in treatment of patients with PSD (post-stroke depression) Method: 121 patients with PSD in their rehabilitation period were stratified by results of HAMD and then randomly divided into two groups, the study group (n=64) received Paroxetine 20 mg daily, the control group (n=57) received placebo After 4 months, the result was assessed with HAMD, CSS and ADL (activity of daily living) Result: In the period of rehabilitation of stroke, the degree of neurological impairment (CSS score) was positively correlated to depression (r=0 99, P
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Objective To analysis the time of acute cerebral stroke occurrence. Methods The occurrence time of 2675 patients with cerebral infarction (1925 cases,CI group) and intracerebral hemorrhage(750 cases,ICH group) were statisticed by 1 time unit per 2 h from 0∶00. Results There was a time-curve with double peaks of stroke occurrence,like as circadian rhythms of blood pressure in 24 h. ⑴ In CI group,the first peak was 6∶00~10∶00, the second peak was 18∶00~22∶00. The value of the first peak was higher than that of the second(P