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The migraine, tension-type headache and cluster headache are common primary headaches in clinic. The accurate diagnosis and standardized treatment are important to reduce the disability, chronification and medication overuse of primary headache. With the development of clinical research on primary headache, more and more evidence-based medical data provide guidance for clinical diagnosis and treatment. Particularly, new research progresses have been made in the field of both medication and non-drug treatments of primary headache. Above all, Headache Group of Chinese Society of Neurology drafted the Chinese practice guidelines for diagnosis and treatment of migraine, tension-type headache and cluster headache. The purpose of these guidelines is to improve the understanding, management, standardized diagnosis and treatment of primary headaches.
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ABSTRACT Introduction: Fatigue impairs exercise activity in high school students, and it is detrimental to explore aerobic training when fatigue cannot be alleviated. This factor limits the ability to exploit the full potential of young athletes for soccer. Objective: Implement a healthy development protocol for soccer application in high school. Methods: This article used a literature review among other research methods. The analysis was devoted to aerobic training for endurance in soccer for students in high school. The specific methods of implementing the developed protocol in high schools were studied. Finally, effective measures for improving students' physical fitness were presented. Results: Judging from the situation, the duration of each training session in high school soccer is closely related to the coaches' ability. High-level coaches tend to organize the duration of training according to the perceived effects in soccer practice, considering the physical and technical characteristics of the sport itself. Conclusion: Soccer endurance training can also promote the long-term development of soccer education while meeting students' actual exercise needs. It is important to carry out soccer aerobic training applied to high school. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: A fadiga prejudica a atividade do exercício físico nos alunos do ensino secundário, sendo prejudicial explorar os treinos aeróbicos quando a fadiga não pode ser aliviada. Esse fator limita a capacidade de explorar o máximo potencial de jovens atletas para o futebol. Objetivo: Implementar um protocolo de desenvolvimento sadio para a aplicação do futebol no ensino médio. Métodos: Este artigo utilizou a revisão bibliográfica entre outros métodos de investigação. A análise foi dedicada ao treino aeróbico para a resistência no futebol dos estudantes no ensino médio. Estudou-se os métodos específicos de implementação do protocolo elaborado nas escolas de ensino médio. Finalmente, foram apresentadas as medidas eficazes para melhorar a condição física dos estudantes. Resultados: A julgar pela situação em tela, a duração de cada sessão de treino no futebol do ensino médio está intimamente relacionada com a capacidade dos treinadores. Os treinadores de alto nível tendem a organizar a duração do treino de acordo com os efeitos perceptíveis na prática do futebol, considerando as características físicas e técnicas do próprio esporte. Conclusão: A formação de resistência no futebol pode também promover o desenvolvimento a longo prazo da educação futebolística ao mesmo tempo em que satisfaz as necessidades reais de exercício físico dos estudantes, sendo de grande importância realizar a formação do treino aeróbico no futebol aplicado ao ensino médio. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: La fatiga perjudica la actividad del ejercicio en los estudiantes de secundaria, y es perjudicial explorar el entrenamiento aeróbico cuando la fatiga no se puede aliviar. Este factor limita la capacidad de explotar el máximo potencial de los jóvenes deportistas para el fútbol. Objetivo: Implementar un protocolo de desarrollo saludable para la aplicación del fútbol en la escuela secundaria. Métodos: Este artículo utilizó, entre otros métodos de investigación, la revisión de la literatura. El análisis se dedicó al entrenamiento aeróbico de resistencia en el fútbol para estudiantes de secundaria. Se estudiaron los métodos específicos de aplicación del protocolo elaborado en los institutos. Por último, se presentaron las medidas eficaces para mejorar la aptitud física de los alumnos. Resultados: A juzgar por la situación en la pantalla, la duración de cada sesión de entrenamiento en el fútbol de la escuela secundaria está estrechamente relacionada con la capacidad de los entrenadores. Los entrenadores de alto nivel tienden a organizar la duración del entrenamiento en función de los efectos percibidos en la práctica del fútbol, teniendo en cuenta las características físicas y técnicas del propio deporte. Conclusión: El entrenamiento de la resistencia en el fútbol también puede promover el desarrollo a largo plazo de la educación futbolística al tiempo que satisface las necesidades reales de ejercicio físico de los estudiantes, y es de gran importancia llevar a cabo la formación del entrenamiento aeróbico en el fútbol aplicado a la escuela secundaria. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Migraine is a complex disorder of brain function. The hypothalamus has been identified to play a crucial role in attack generation and secretes various neuropeptides. The orexinergic system plays a role in energy metabolism, arousal, sleep, stress and pain modulation. These disorders are closely related to clinical symptoms of migraine. Therefore, the study of the mechanism of hypothalamic orexinergic system in migraine may provide a new perspective for treatment. This article discusses the relationship between hypothalamic orexin system and migraine premonitory symptoms, and briefly summarizes the possible role and mechanism of hypothalamic orexin system in migraine.
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Guideline or consensus for the vaccination of children with special conditions like immunocompromised children may be more suitable for pediatricians.However, the vaccination of children in China is mainly performed by general practitioners or child health care practitioners in community health service centers.They need to master the screening knowledge of contraindications and precautions for the vaccination of children, and make the decision to referral to specialists.Based on the technical guidelines for Immunization of National Health Commission of the People′s Republic of China, Best Practices Guidance of the Advisory Committee on Immunization Practices and contraindications and precautions proposed by the Immunization Action Coalition, 20 suggestions for primary screening of children with vaccination contraindications and referral recommendations for primary care providers were developed by experts from the Integration of Medicine and Prevention in Children of Health Commission of Shenzhen Municipality.
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The dynamic analysis of the implantation process of a new vena cava filter was carried out by finite element analysis method to reveal the influence of the angle, length, width and thickness of the filter rod on its mechanical properties and the inner wall of the blood vessel. The results showed that the high-stress and high-strain areas of the filter were mainly concentrated in the connection between the filter rod and the filter wire. With the increase of the angle of the filter rod, the maximum equivalent stress and the maximum elastic strain on the filter wall decreased, while the maximum equivalent stress on the vascular wall increased. With the increase of the length of the filter rod, the maximum equivalent stress and strain peak of the filter wall increased, but the maximum equivalent stress of the vessel wall decreased. With the increase of the width and thickness of the filter rod, the maximum equivalent stress of the filter wall, the maximum elastic strain and the maximum equivalent stress of the vessel wall all showed an upward trend. The static safety factor of all filter models was greater than 1, and the structure after implantation was safe and reliable. The results of this study are expected to provide a theoretical basis for the structural optimization and deformation mechanism of the new type vena cava filter.
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Finite Element Analysis , Vena Cava Filters , Vena Cava, InferiorABSTRACT
As lactate is elevated due to lactate metabolic disorder in liver failure, recent studies have shown that blood lactate has a high value in predicting the prognosis of liver failure. With reference to the research findings in recent years, this article introduces the prediction model of LiFe score and reviews the advances in the clinical application of blood lactate level in patients with liver failure in China and foreign countries. It is believed that a high lactate level is an independent risk factor for poor prognosis of liver failure patients, and it is proposed that lactate can be used as an important indicator to evaluate the severity and prognosis of liver failure and further optimize the scoring system for the prognosis of related liver diseases.
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The mechanical properties of nitinol iliac vein stent (NIVS) have been studied by many scholars at home and abroad, but the study on the mechanical properties of iliac vein stent under different release scales has not been reported yet. Based on the finite element analysis method, the mechanical properties of three self-developed NIVS were studied to reveal the influence of stent diameters (12, 14, 16 mm) and different release scales (80%, 90%) on its strength, fatigue life and vein wall biomechanical properties. With an increases in the release scales, the equivalent elastic strain, fatigue strength safety factors, and vessel wall equivalent stress exhibited a downward trend, while the most stressed cross-section coincided with the arc of stent-connecting rods. Through 30, 60 and 90 days' animal test, a narrowed vascular model was established in the iliac veins of 12 pigs, and the developed iliac vein stents were implanted to comprehensively evaluate the safety and effectiveness of the stent, and at the same time the mechanical properties of stents were verified to provide important reference for the type inspection and clinical trials of follow-up products.
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Animals , Alloys , Finite Element Analysis , Iliac Vein , Stents , Stress, Mechanical , SwineABSTRACT
Vena cava filter is a filter device designed to prevent pulmonary embolism caused by thrombus detached from lower limbs and pelvis. A new retrievable vena cava filter was designed in this study. To evaluate hemodynamic performance and thrombus capture efficiency after transplanting vena cava filter, numerical simulation of computational fluid dynamics was used to simulate hemodynamics and compare it with the commercialized Denali and Aegisy filters, and in vitro experimental test was performed to compare the thrombus capture effect. In this paper, the two-phase flow model of computational fluid dynamics software was used to analyze the outlet blood flow velocity, inlet-outlet pressure difference, wall shear stress on the wall of the filter, the area ratio of the high and low wall shear stress area and thrombus capture efficiency when the thrombus diameter was 5 mm, 10 mm, 15 mm and thrombus content was 10%, 20%, 30%, respectively. Meanwhile, the thrombus capture effects of the above three filters were also compared and evaluated by in vitro experimental data. The results showed that the Denali filter has minimal interference to blood flow after implantation, but has the worst capture effect on 5 mm small diameter thrombus; the Aegisy filter has the best effect on the trapping of thrombus with different diameters and concentrations, but the low wall shear stress area ratio is the largest; the new filter designed in this study has a good filtering and capture efficiency on small-diameter thrombus, and the area ratio of low wall shear stress which is prone to thrombosis is small. The low wall shear stress area of the Denali and Aegisy filters is relatively large, and the risk of thrombosis is high. Based on the above results, it is expected that the new vena cava filter designed in this paper can provide a reference for the design and clinical selection of new filters.
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Humans , Blood Flow Velocity , Hemodynamics , Software , Thrombosis , Therapeutics , Vena Cava Filters , Vena Cava, InferiorABSTRACT
Objective@#Clinical evidences of surgically treated stage M1b non-small cell lung cancer (NSCLC) patients were limited. This study aimed to summarize the clinical data of these patients to explore the prognostic factors of this population.@*Methods@#From January 1999 to December 2012, the clinical data of 40 stage M1b NSCLC patients, including 24 males and 16 females, who underwent surgery were collected by Cancer Hospital, Chinese Academy of Medical Sciences. Kaplan-Meier method, log rank test and Cox risk regression model were used to analyze the prognose of these patients and their influence factors.@*Results@#A total of 40 patients were available for survival analysis. The Survival rates of the whole population at 1, 3 and 5 years were 70.0%, 40.0% and 22.5%, respectively. The median survival time (MST) was 31.5 months. The outcomes of 23 patients underwent primary tumor resection and local treatment of metastatic site (MST: 41.5 months) were significantly better than those of 13 patients with only primary tumor resection (MST: 15.5 months) and 4 patients with thoracic exploration (MST: 14.5 months) (P<0.05). Multivariate analysis showed that patients without pleural effusion, brain metastasis, chemotherapy and targeted therapy had a statistically better survival (P<0.05).@*Conclusions@#The overall survivals of surgically treated stage M1b NSCLC patients appear encouraging, and some selected patients may even achieve a long-time survival. Multimodality treatment including surgical lung resection and radical treatment of metastasis should be considered for these patients.
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Cerebral small vessel disease (CSVD) is an imaging and clinical syndrome caused by intracranial small vessel lesions.Studies have confirmed that CSVD is closely associated with the stroke outcomes.The overall burden is a concept based on a single imaging marker of CSVD,which can comprehensively reflect the severity of brain injury and identify high-risk stroke patients.This article reviews the correlation between the overall burden of the CSVD imaging and the stroke outcomes.
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Objective To explore the effect of spinal sagittal balance on secondary vertebral fracture after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods The data were reviewed of the patients with single segmental OVCF who had undergone PKP at Department of Spine Surgery,Second Hospital of Lanzhou University from March 2014 to December 2015.Of them,21 had secondary vertebral fracture after PKP.As an observational group,they were matched with another 21 patients without secondary vertebral fracture after PKP as a control group (ratio:1:1) for age,gender,body mass index (BMI) and bone mineral density (BMD).Their standard standing plain radiographs of the whole spine were used to measure the parameters of spine-pelvis sagittal balance.The 2 groups were compared in sagittal balance parameters.Results The sagittal vertical axis (26.86 ± 33.55 mm) and thoracic kyphosis (47.62° ± 10.73°) in the observational group were significantly larger than those (4.05 ± 31.93 mm and 41.10 °±8.17°) in the control group (P ＜0.05);the lumbar lordosis (35.29°±8.77 °),sacral slope (22.71 ° ± 5.80°) and pelvic incidence (45.38° ± 7.49°) in the former were significantly smaller than those in the control group (41.71°±9.19°,27.43°±5.29° and 51.19°±8.44°) (P ＜0.05);there were no significant differences between the 2 groups in pelvic tilt or thoracolumbar kyphosis (P ＞ 0.05).Conclusions The OVCF patients with larger sagittal vertical axis,larger thoracic kyphosis and smaller lumbar lordosis may be more likely to suffer secondary vertebral fracture after PKP.A larger pelvic incidence may be a protective factor against secondary vertebral fracture after PKP for OVCF patients.
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Objective To investigate the effect of ulinastatin on postoperative clinical outcomes in pa-tients undergoing elective laparoscopic colectomy. Methods 454 patients underwent elective laparoscopic colecto-my from January 2015 to September 2017 were included in this retrospective study. Patients were divided into 2 groups:ulinastatin group and control group. Propensity score matching was applied to balance the preoperative baseline differences between 2 groups. 155 patients in each group were successfully matched. Mixed linear model was used to exam the effect of ulinastatin on various clinical indicators within 3 days after the surgery,including in-flammation indicators(white blood cell counts,C reactive protein),liver function indicators(alanine transami-nase,aspartate transaminase,total bilirubin),renal function indicators(serum creatinine,blood urea nitrogen). Postoperative hospital length of stay was compared between 2 groups using student's t-test. Results Ulinastatin group showed significantly reduced postoperative white blood cell count and ? reactive protein level (P = 0.036 and 0.025)compared with the control group. The average mean inhibitory effects were 1.04×109/L and 23.93 mg/L respectively,which was 11.1% and 29.9% lower than that of the control group. Procalcitonin,transaminases,total bilirubin,serum creatinine,blood urea nitrogen levels and postoperative hospital length of stay showed no signifi-cant difference between the two groups(P > 0.05). Conclusion Ulinastatin can significantly reduce the level of inflammation response after laparoscopic colectomy,which is beneficial to the fast recovery.
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Objective To explore the advantages and disadvantages of regional citrate anticoagulation (RCA) mode by comparing to non-anticoagulation mode for continuous renal replacement therapy (CRRT)in patients with acute kidney injury (AKI) at high risk of bleeding.Methods The criterion for inclusion of patients was stage 3 of AKI selected according to Kidney Disease Improving Global Outcomes guideline.And those patients had high risk factors of bleeding as well as such as post-major opertion,coagulopathy (prothrombin time or activated partial thromboplastin time ＞ 1.5 times the normal control,or prothrombin time ＞ 18 s,activated partial thromboplastin time ＞ 60 s),thrombocytopenia (＜ 50 × 109/L),and combined therapy with anticoagulant,antiplatelet or thrombolytic drugs.The CRRT was initiated within 4 h after randomization.The exclusion criteria was severe liver failure (serum total bilirubin ＞ 171 μmmol/L).Continuous venovenous hemodiafiltration mode was employed in both groups,and the filter was changed routinely every 72 h,unless clotting developed in the extracorporeal circuit.Because the commercial calcium-free dialysate was not available in the market,this dialysate was prepared by the intensive care unit (ICU) nurses.Results Thirty two patients were equally divided in those two groups,and most of them were admitted to ICU after major surgery.There were no significant differences between the groups in data of blood gas analysis,hepatic/renal/coagulative functions,electrolyte,hemoglobin and platelet count before or after CRRT.The filter was more durable in RCA mode than that in non-RCA mode determined through Kaplan-Meier curve analysis (x2 =9.707,P =0.002),with the mean time (h) 36.01 (26.61-45.42)vs.22.04 (18.35-25.73).More packed red blood cells and platelet were required in non-RCA mode than those in RCA mode during CRRT.There was no significant difference in ICU mortality between RCA mode and non-RCA mode with 7/16 vs.9/16,P =0.724.Severe blood loss and malignant arrhythmia events did not occur in both modes.The body temperature,systemic electrolyte,post-filter ionized calcium levels and the ratio of total to ionized systemic calcium were basically preserved at a target range in RCA group during CRRT.Conclusions RCA-CRRT is a safe and effective mode for AKI patient with high risk of bleeding,which can extend the durability of filter,and lower the risk of blood loss.However,the study failed to show a mortality benefit with the RCA mode,and it could also increase the workload of nurses under the current domestic setting.
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Objective To explore the advantages and disadvantages of regional citrate anticoagulation (RCA) mode by comparing to non-anticoagulation mode for continuous renal replacement therapy (CRRT)in patients with acute kidney injury (AKI) at high risk of bleeding.Methods The criterion for inclusion of patients was stage 3 of AKI selected according to Kidney Disease Improving Global Outcomes guideline.And those patients had high risk factors of bleeding as well as such as post-major opertion,coagulopathy (prothrombin time or activated partial thromboplastin time ＞ 1.5 times the normal control,or prothrombin time ＞ 18 s,activated partial thromboplastin time ＞ 60 s),thrombocytopenia (＜ 50 × 109/L),and combined therapy with anticoagulant,antiplatelet or thrombolytic drugs.The CRRT was initiated within 4 h after randomization.The exclusion criteria was severe liver failure (serum total bilirubin ＞ 171 μmmol/L).Continuous venovenous hemodiafiltration mode was employed in both groups,and the filter was changed routinely every 72 h,unless clotting developed in the extracorporeal circuit.Because the commercial calcium-free dialysate was not available in the market,this dialysate was prepared by the intensive care unit (ICU) nurses.Results Thirty two patients were equally divided in those two groups,and most of them were admitted to ICU after major surgery.There were no significant differences between the groups in data of blood gas analysis,hepatic/renal/coagulative functions,electrolyte,hemoglobin and platelet count before or after CRRT.The filter was more durable in RCA mode than that in non-RCA mode determined through Kaplan-Meier curve analysis (x2 =9.707,P =0.002),with the mean time (h) 36.01 (26.61-45.42)vs.22.04 (18.35-25.73).More packed red blood cells and platelet were required in non-RCA mode than those in RCA mode during CRRT.There was no significant difference in ICU mortality between RCA mode and non-RCA mode with 7/16 vs.9/16,P =0.724.Severe blood loss and malignant arrhythmia events did not occur in both modes.The body temperature,systemic electrolyte,post-filter ionized calcium levels and the ratio of total to ionized systemic calcium were basically preserved at a target range in RCA group during CRRT.Conclusions RCA-CRRT is a safe and effective mode for AKI patient with high risk of bleeding,which can extend the durability of filter,and lower the risk of blood loss.However,the study failed to show a mortality benefit with the RCA mode,and it could also increase the workload of nurses under the current domestic setting.
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Objective@#The present study was designed to evaluate the protective effects of oligomeric proanthocyanidins (OPC) in mice exposed to paraquat (PQ) , and to explore the molecular mechanism.@*Methods@#Four experimental groups were designed. Control group: 10 BALB/c mice were intraperitoneally injected with normal saline) . PQ group: 10 BALB/c mice were intraperitoneally injected with PQ (100 mg/kg) . PQ+OPC group: 10 BALB/c mice were administered with OPC (100 mg/kg) for 1 h before PQ (100 mg/kg) expo-sure. OPC group: 10 BALB/c mice were intraperitoneally injected with OPC (100 mg/kg) . The peripheral blood samples or lung tissue samples were collected at the designed time points for measuring the levels of oxi-dative stress indicators, the related protein levels of nuclear factor-kappa B (NF-κB) pathway and nuclear fac-tor erythroid related factor-2 (Nrf2) pathway.@*Results@#Compared with the control group, the level of reactive oxygen species (ROS) , the content of malondialdehyde (MDA) in the PQ group were significantly induced, and the activity of superoxide dismutase (SOD) in the PQ group was decreased in the peripheral blood. As com-pared with the PQ group, the level of ROS and the content of MDA in the PQ+OPC group were significantly re-duced, the activity SOD in the PQ+OPC group was increased in the peripheral blood; the level of ROS and the content of MDA were also reduced in lung tissues in the PQ+OPC group. Moreover, compared with the con-trol group, the phosphorylation of IκBα and the expression of NF-κB p65 were increased in lung tissues in the PQ group. The phosphorylation of IκBα and the expression of NF-κB p65 were decreased in lung tissues in the PQ+OPC group as compared with the PQ group. In addition, compared with the control group, the expressions of HO-1 and Nrf2 were increased in lung tissues in OPC group, and these were decreased in lung tissues in PQ groups. Furthermore, the expressions of HO-1 and Nrf2 were also increased in lung tissues in PQ+OPC as com-pared with the PQ group.@*Conclusion@#OPC could alleviate PQ-induced systemic toxicity in mice by regulating oxidative stress via NF-κB and Nrf2 pathway.
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Objective@#To investigate the efficacy of tyrosine kinase inhibitor (TKI) treatment on non-small cell lung cancer (NSCLC) patients with postoperative recurrence who harbored uncommon EGFR mutations, and discuss the relationship between TKI treatment and prognosis.@*Methods@#A total of 39 relapsed NSCLC patients after surgery with EGFR uncommon mutations who were detected at Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and December 2013 were retrospectively analyzed in this study. Twenty patients were treated with EGFR-TKI after recurrence and 19 cases were not. The clinical characteristics of patients with EGFR uncommon mutations were evaluated, and the prognosis of TKI-treatment group and non-TKI treatment group was compared.@*Results@#In 39 relapsed NSCLC patients with EGFR uncommon mutations, insertion mutations and point mutations were included. The highest frequency of EGFR uncommon mutation happened in exon 20 (20/39, 51.3%). A total of 13 uncommon point mutations were detected in exon 18, 20 and 21. The most frequent rare point mutations located in exon 21, and there were 7 different point mutation sites in exon 21. G719S/C/A mutation in exon 18 was the most common type of point mutation (14/25, 56.0%). Survival after postoperative recurrence in TKI treatment group was obviously better than that in non-TKI treatment group, the median time after recurrence were 44 months and 23 months, respectively (P=0.044). However, the postoperative overall survival showed no differences between two groups (48 months vs 43 months, P=0.129).@*Conclusion@#NSCLC patients with postoperative recurrence who harbored rare EGFR mutations should be treated with TKI agent.
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Objective@#To evaluate the safety and effectiveness of the Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length <10 mm.@*Methods@#This study was a retrospective analysis. From January 2010 to May 2015, 22 consecutive abdominal aortic aneurysm patients with proximal neck length <10 mm were treated with endovascular aortic repair by Endurant stent graft in Department of Vascular Surgery, Zhongshan Hospital, Fudan University. There were 19 (86.3%) male cases, aging from 57 to 84 years. All patients underwent preoperative CT angiography and the anatomic parameters of abdominal aortic aneurysm were measured. All patients performed standard endovascular aortic repair first and if there was obvious proximal typeⅠ endoleak, the CUFF or the chimney technology were applied to observed the perioperative technical and the clinical success rate. During follow-up, the incidence of adverse events and the reintervention rate were observed.@*Results@#These 22 cases had proximal neck length 5 to 9 mm with the average of (7.2±1.4) mm. Immediate endoleak occurred in 5 patients with 4 cases of proximal typeⅠ endoleak, 3 cases were implanted proximal CUFF, 1 case implanted CUFF and left renal artery chimney. One case died perioperatively, the clinical success rate was 95.4%, the technical success rate was 77.3%. During the follow-up of 6 to 54 months, there was 1 case with delayed proximal type-1 endoleak, during operation the patient had no endoleak, but disappeared 6 months later without further intervention. So the incidence of adverse event was 4.5% and reintervention rate was 0.@*Conclusion@#The Endurant stent graft for abdominal aortic aneurysm cases with proximal neck length < 10 mm is safe and effective.
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Hormone replacement therapy (HRT), involving giving sex steroid hormones such as estrogen alone or with a progestogen, is widely used in postmenopausal women.HRT helps to relieve menopausal symptoms and has also been shown to prevent osteoporosis.Although most observational studies have showed that HRT can reduce the risks of cardio-cerebrovascular diseases, the subsequent randomized controlled trials were inconsistent with the results.This article reviews the relationship between HRT and stroke from drug type, route of administration, estrogen dosage, and initiation time.
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Objective:To evaluate the prognosis of non-small cell lung cancer (NSCLC) patients with pleural dissemination after differ-ent surgical interventions. Methods:We retrospectively reviewed clinical and survival data of 153 NSCLC patients with pleural dissemi-nation who were diagnosed and treated in our hospital from May 2002 to May 2011. Results:The overall 3-and 5-year survival rates of all the patients are 38.5%and 24.2%, respectively, with a median survival time (MST) of 29.0 months. A total of 122 patients accept-ed primary tumor resection whereas the remaining 31 received pleural biopsy. The 5-year survival rate of the primary tumor resection group was 26.2%with a MST of 29.0 months and 16.1%for the pleural biopsy group with a MST of 24.0 months. The survival analysis showed no significant differences in the prognosis between the primary tumor resection and pleural biopsy groups (P>0.05). In the pri-mary tumor resection group, different surgical interventions (with or without lymph nodes dissection, with or without metastatic nod-ules resection, lobe, or partial lobe resection) had no effect on prognosis (P>0.05). Conclusion:Patients with pleural dissemination had poor prognosis. Different surgical interventions showed no survival benefits for patients with NSCLC regarding pleural dissemination. The role of surgery was to rule out or confirm pleural dissemination. The definite value of surgery still needs further exploration.
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Objective To discuss clinical characteristics and surgical treatment of patients with pulmo?nary inflammatory myofibroblastic tumor(PIMT). Methods From April 2010 to June 2015 in Beijing Tiantan Hospital Affiliated to Capital Medical University, there were 15 cases patients diagnosed as PIMT and trea?ted. The clinical datas of the patients were analyzed retrospectively. The main clinical manifestations,pathological results,clinical treatment and prognosis of the patients and follow?up outcome were analyzed. Results There were 10 males and 5 females,at the age of 39 to 6 8 years old with the median age of 52. Among the 15 cases of patients with PIMT,1 case was recurrence,14 cases were initial treatment. The treatment reason was due to the abnormal physical examination,or cough and sputum with blood,or chest pain,or chest tightness or fever. Chest CT showed that the mass was round or class round, lobulated, part of them showed the burr shape edge. Immunohistochemistry showed that Vimentin positive and smooth muscle actin positive. All patients accept?ed the open chest or thoracoscope surgery. The main operations concluded partial resection,lobectomy or lobecto?my with lymph node eradication. No perioperative death occured,no complications such as postoperative bleed?ing,bronchial pleural fistula and other complications happened. The average follow?up time was from 8 to 58 months. Follow?up rate was 100. 0%(15/15). There was no tumor recurrence. Conclusion The clinical mani?festations of the pulmonary inflammatory myofibroblastic tumor is complex. The PIMT should be confirmed by pathologic examination,the main treatment is surgical resection with good prognosis and lower recurrence.