ABSTRACT
Pulmonary nodule is a key window for moving ahead the diagnosis and treatment of lung cancer. Traditional Chinese medicine （TCM） can delay the transformation of lung nodules into lung cancer， improve the prognosis of patients， effectively fill the treatment gap during the follow-up period of pulmonary nodules， and has been applied it in the whole cycle and multi-dimensional management of pulmonary nodules. This paper discussed the construction ideas and feasible paths of the whole process management diagnosis and treatment system of pulmonary nodules in TCM， proposed the diagnosis and treatment database of TCM for pulmonary nodules based on the social module of “family-community-hospital”. Through artificial intelligence， we can develop， improve and promote the multi-level and multi-modal “disease-symptom combination” risk prediction model and effectiveness evaluation system of pulmonary nodules. At the same time， the biological connotation of the prevention and treatment of pulmonary nodules by TCM is excavated， which provided empirical evidence for the construction of TCM diagnosis and treatment system， in order to further improve the quality and diagnosis and treatment level of the whole course management of pulmonary nodules.
ABSTRACT
Esophageal squamous cell carcinoma is one of the malignant tumors with a high incidence in China. The main pathological anatomy is the obstruction of the diseased esophagus. Nutritional disorders and a series of relevant pathophysiological changes are the main factors affec-ting the safe implementation of treatment and the long-term survival of patients. Therefore, timely correction of nutritional disorders is the main component of treatment. The ideal treatment for locally advanced esophageal squamous cell carcinoma is induction systemic treatment followed by surgery. The outstanding problems in clinical management of esophageal carcinoma are that only short-term attention is paid to postoperative nutrition support, ignoring preoperative nutrition along with the major anticancer treatment, the rehabilitation of patients' swallowing function after surgery, as well as nutrition and weight management. The author reviews the unique role of tube feeding with element enteral nutrition during the whole course of treatment of esophageal cancer, in order to provide reference for its standardized management.
ABSTRACT
In China, hepatocellular carcinoma (HCC) accounts for about 50% of cases in the world, which is still challenging. The implementation of multi-disciplinary treatment (MDT) and whole course management of HCC are conducive to improve the prognosis of patients, so as to achieve the goal of increasing by 15% of overall survival of HCC patients as proposed by the "Healthy China 2030" . The standardized management of HCC includes several key points, such as exact diagnosis of the HCC, selection of proper treatment methods, individual postoperative adjuvant therapy and regular follow-up. MDT is the key measure to implement the standardized and whole course management of HCC. Herein, the author tends to summary the experience on standardized management of HCC.
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Our endocrinology teaching group has carried out the application and exploration of mobile APP teaching mode based on Superstar learning. Through the questionnaire survey, students thought there was no significant difference between mobile APP teaching and traditional teaching in knowledge understanding and memory. But the classroom atmosphere of mobile APP teaching was relaxed and active, which helps to improve learning interest and self-learning ability, and the problems after class can be solved by feedback in time. Through the sharing of experience on the whole course management in endocrinology mobile APP teaching, it is expected to provide positive reference for the mobile teaching mode of medical education in the future.
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Background: Helicobacter pylori (Hp) is closely associated with peptic ulcer, gastric cancer and other gastrointestinal diseases. Eradication therapy is the main approach to prevent and treat Hp-associated diseases, and patient management is crucial for improving the efficacy of eradication therapy. Aims: To explore the effect of whole-course management on medication adherence and reexamination rate of Hp eradication therapy. Methods: Patients who received Hp eradication therapy in the Hp Specialist Clinic of the First Affiliated Hospital of Soochow University from June 2020 to November 2020 were recruited consecutively. One hundred and twelve patients who received eradication therapy between June 2020 and August 2020 were served as the control group, and 112 patients who received eradication therapy between September 2020 and November 2020 were served as the observation group. Patients in control group were informed only the medication method and reexamination time, while patients in observation group were given the whole-course management composed of informing medication method and reexamination time plus following up online by WeChat and reminding the reexamination by WeChat and by phone. Patients in both groups received a 14-day bismuth quadruple therapy, and were told to undergo
ABSTRACT
Hormone-sensitive prostate cancer with visceral metastasis is a difficulty in clinical diagnosis and treatment. We treated a patient with hormone-sensitive prostate cancer with visceral metastasis and managed it under the multi-disciplinary treatment model (MDT). A 55-year-old man presented to the hospital complaining of increased prostate-specific antigen (PSA) found in the physical examination for 2 days. At admission, the PSA was 389.2ng/ml, and 68Ga-PSMA PET/CT showed metastatic malignant lesions of the prostate, with lymph node metastasis, lumbar vertebral metastases and liver tubercles. Transrectal prostate puncture biopsy: prostate adenocarcinoma, Gleason score of 4+ 5=9. The patient has no history of androgen deprivation therapy (ADT) and diagnosed as metastatic hormone-sensitive prostate cancer (mHSPC). Then the patient received total androgen blockade therapy (CAB regimen). After MDT discussion, metastatic prostate cancer was diagnosed based on the liver histopathology of percutaneous biopsy. After the second MDT discussion, the regimen was changed to abirone plus ADT. After 6 months, the blood PSA was controlled at a level between 0.003 to 0.006 ng/ml, and the testosterone was less than 2.5ng/dl. Re-examination of 68Ga-PSMA PET/CT showed that lower signal of radionuclide in all lesions, especially no more abnormal uptake lesions were identified in the liver.
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Objective: To explore the effect of MDT nutrition management on the radiotherapy process of elderly patients with esophageal cancer. Methods: From January 2018 to September 2019, 60 elderly patients with esophageal squamous cell carcinoma were selected, and randomly divided into the control group (Group A, 30 cases) and the experimental group (Group B, 30 cases). All the groups received radiotherapy in The First Hospital of Shanxi Medical Univesity. The Group A was treated with routine nutrition intervention and the Group B with multidisciplinary team (MDT) nutrition intervention. Body mass index (BMI), nutritional status, the incidence of adverse reactions and treatment time were eraluated respectively. Results: The patient-generated subjective global assessment (PG-SGA) score and the incidence of moderate to severe malnutrition in Group A (86.3%) were significantly higher than those in Group B (70%); the PG-SGA score after radiotherapy was higher than that before radiotherapy in both groups, and it was evidently higher in Group A (P<0.05). Total protein (TP), albumin (ALB) and prealbumin (PA) decreased first and then increased in Group A, but they increased steadily or gradually in Group B. WBC and Hb decreased significantly in Group A compared with those in Group B (P< 0.05). In comparison with Group A, the levels of ALB, PA, TP and BMI in Group B were increased after radiotherapy (P<0.05), the incidence of acute mucosal reaction above grade II (13.3%) and myelosuppression (26.3%) was lower (P<0.05), the quality of life was better (P<0.05) and the total treatment time was shorter [(41.97±2.59) d] (P<0.05). Conclusions: The total course of MDT nutrition management significantly improved malnutrition, reduced the incidence of adverse reactions and total treatment time, and improved the quality of life.
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At present,peripherally inserted central catheter (PICC) and totally implantable access port (TIAP) are most commonly used for the medium-term and long-term ccntral vcnous infusion in China,which is mainly adopted for long-term repeated chemotherapy,nutritional support and other clinical treatments.As an advanced infusion route,this technique needs to be further popularized in clinical practice to benifit the majority of patients.However,in aspect of the implantation,use,maintenance,and the diagnosis and treatment of complications of long-term central venous access,there are still a lot of problems,to which sufficient attention should be paid.Standard implantation and maintenance are of great importance for the safe implantation of central venous access and long-term safe use.This paper aims to make a comprehensive review concerning the problems of long-term indwelling of central venous access,the basic solutions,and the whole course management of central venous access.In order to promote the technique of central venous access to continually develop,the multidisciplinary collaborative team with tacit cooperation,standardized system and regulatory process should be emphasized.