Résumé
A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma (PGDLBL) by PET/CT examination, gastroscopy, biopsy and histopathological analysis at a regular physical check in April, 2016. The patient received R-CO chemotherapy (rituximab, cyclophosphamide, and vincristine) and radiotherapy subsequently, with enteral nutritional treatment through 3-cavity nasogastric tube due to development of pyloric obstruction. To satisfy patient's strong desire of eating by himself, we performed surgery of exploratory laparotomy and Roux-en-Y gastric bypass (RGB) to relieve pylorus obstruction. Postoperatively, the patient resumed oral feeding, supplemented by nasogastric tube feeding at 1350 - 1550 Kcal daily. He is now 94 years old with fairly well nutrition and normal communication. The outcome of 4 year follow-up suggests that nutritional treatment and palliative medicine are important for improving prognosis and life-quality of very elderly patients with end-stage tumors apart from the effective chemotherapy, radiotherapy, and surgery.
Résumé
Objective To investigate and evaluate serum level of heparanase in diabetic patients with acute coronary syndrome.Methods Forty-six diabetic patients with acute coronary syndrome(ACS) were enrolled as DM+ACS group,as well as,52 patients with ACS were studied as ACS group,27 diabetic patients as DM group,and 28 health volunteers served as normal control group.CRP,MMP-9 and heparanase in serum were measured with ELISA.The receiver operating characteristic curves of CRP,MMP-9 and heparanase were produced and the cutoff values were determined.Results The serum level of heparanase was significantly higher in DM+ACS group than in the ACS group,DM group and normal control group.The areas under the curve(AUC) of ROC were 0.941,0.813 and 0.967 respectively.Significant difference of AUC were observed between groups.The serum level of heparanase was significantly higher in DM+AMI subgroup than in DM+UAP subgroup.Conclusion Serum heparanase is related with the development of acute coronary syndrome in diabetic patients.Serum heparanase can be used as a more effective serological indicator for the plaque destabilization and rypture in diabetic patients than CRP and MMP-9.