With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is risin...With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is rising, mainly affecting women with a high mortality rate. According to the clinical treatment effect, early diagnosis and early treatment can effectively control the mortality of breast cancer and improve patient’s quality of life. Ultrasound radiomics is an emerging field that can extract quantitative high-dimensional data from ultrasound images. Recently, ultrasound radiomics has been widely used in the clinical treatment of breast cancer. This paper analyzed the research progress of ultrasound radiomics in the diagnosis and treatment of breast cancer.展开更多
BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,qualit...BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.展开更多
Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis an...Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.展开更多
The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues ...The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,展开更多
Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The ...Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.展开更多
Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging ...Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging due to the great differences in the diagnosis and treatment of gastric cancer in different regions.The Gastric Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of gastric cancer.The Gastric Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of gastric cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of gastric cancer patients.A panel of experts with gastrointestinal cancer surgery,gastrointestinal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of gastric cancer.The authors then utilized a modified Delphi approach to generate consensus recommendations.展开更多
Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma (ICC) and extrahe...Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC). ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.展开更多
BACKGROUND Congenital factor VII deficiency(FVIID)is a rare autosomal recessive genetic disorder.The clinical manifestations of this deficiency vary greatly.Predicting the risk of bleeding during and after childbirth ...BACKGROUND Congenital factor VII deficiency(FVIID)is a rare autosomal recessive genetic disorder.The clinical manifestations of this deficiency vary greatly.Predicting the risk of bleeding during and after childbirth of pregnant women with congenital FVIID is difficult.Recombinant factor VIIa is the most common replacement therapy for FVIID.However,no unified diagnosis and treatment plan for pregnant women with congenital FVIID has been established.CASE SUMMARY We report the clinical history of a pregnant woman who was considered to have congenital FVIID.Recombinant factor VIIa was prophylactically administered to the pregnant woman at the time of cervical fully opening.She successfully delivered a live infant without any complications,such as postpartum hemorrhage,neonatal abnormalities,and so on.CONCLUSION Prophylaxis of recombinant factor VIIa during delivery can effectively reduce the incidence of postpartum hemorrhage among pregnant women with congenital FVIID associated with a high risk of bleeding.展开更多
On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol ...On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.展开更多
Background: As the global novel coronavirus pneumonia (NCP) remains severe, elderly people are at high risk for NCP and osteoporotic vertebral compression fractures, with high complications and mortality. How to treat...Background: As the global novel coronavirus pneumonia (NCP) remains severe, elderly people are at high risk for NCP and osteoporotic vertebral compression fractures, with high complications and mortality. How to treat patients and protect medical staff from infection, and at the same time strictly prevent the occurrence of clustered transmission events in the hospital, the establishment of perfect pre-hospital emergency measures and infection prevention and control strategy is the first element to ensure success. Objective: To establish the diagnosis and treatment and infection protection strategy for Osteoporotic vertebral compression fractures (OVCF) patients undergoing minimally invasive percutaneous kyphoplasty (PKP) surgery during the prevention and control of COVID-19, so as to ensure the stable, orderly and safe medical treatment. Methods: A total of 583 OVCF patients were admitted to the First Affiliated Hospital of Hebei North University during the epidemic prevention and control period from January 2020 to July 2022. After urgent and outpatient strict standardized screening, 382 patients met the inclusion criteria, including 112 males and 270 females, aged (70.50 ± 5.49) years. The preoperative visual analogue scale (VAS) score was 6.92 ± 1.86. Preoperative Oswestry disability index (ODI) was 74.67 ± 4.84. The satisfaction rate was (45.89 ± 3.67) %. According to the clinical diagnostic criteria and classification, 367 patients were diagnosed as ordinary OVCF, including 156 cases of mild compression and 226 cases of moderate compression. The clinical classification of 15 patients with OVCF diagnosed as COVID-19 was type I, including 10 cases of mild COVID-19 and 5 cases of common COVID-19. All patients were treated with PKP. Results: All patients were followed up at 1 day, 1 month and 3 months after operation, VAS (2.01 ± 0.56, 0.45 ± 0.11, 0 ± 0), ODI (45.41 ± 4.15, 10.22 ± 2.73, 4.03 ± 1.57) and satisfaction (90.12%, 95.57%, 99.23%) were significantly improved compared with those before operation (p < 0.05), and the original medical diseases were not aggravated. In this group, 15 cases of OVCF diagnosed with COVID-19 were given priority to treat COVID-19 under strict three-level protection in the designated isolation ward. PKP was carried out after the condition was stable, and the areas, items and personnel in contact with patients during the perioperative period must be strictly and thoroughly disinfected. The patient had a good prognosis, no complications, no cross-infection in the hospital, and no infection rate among medical staff. Conclusions: The implementation of the diagnosis and treatment and infection protection strategy for OVCF patients undergoing minimally invasive PKP surgery during the prevention and control of COVID-19 has a guiding role in preventing the spread of infection, improving the cure rate, promoting rapid recovery, reducing complications and reducing mortality.展开更多
Dear Editor,I am Dr.Jia X from the Department of Ophthalmology,Second Xiangya Hospital,Central South University,Changsha,China.I write to present a rare case report of 9p deletion syndrome with congenital infantile gl...Dear Editor,I am Dr.Jia X from the Department of Ophthalmology,Second Xiangya Hospital,Central South University,Changsha,China.I write to present a rare case report of 9p deletion syndrome with congenital infantile glaucoma in an infant,accompanying with an effective method of both diagnosis and treatment.展开更多
Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for ...Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.展开更多
BACKGROUND Since December 2019,many cases of pneumonia caused by novel coronavirus have been discovered in Wuhan,China,and such cases have spread nationwide quickly.At present,coronavirus disease 2019(COVID-19)is a wo...BACKGROUND Since December 2019,many cases of pneumonia caused by novel coronavirus have been discovered in Wuhan,China,and such cases have spread nationwide quickly.At present,coronavirus disease 2019(COVID-19)is a worldwide pandemic.What are the clinical features of this disease?What is the clinical diagnosis and how should such patients be treated?As a clinician,mastery of the clinical characteristics,basic diagnosis,and treatment methods of COVID-19 are required to provide help to patients.CASE SUMMARY A 42-year-old male patient with a cough lasting 6 d without obvious cause,as well as fever and fatigue for 1 d,was admitted to Hankou Hospital on January 22,2020 and transferred to Huoshenshan Hospital on February 4.The main clinical symptoms were dry cough,fatigue,and fever.He was diagnosed with COVID-19.From the 4th d of admission,the patient’s condition gradually worsened,with increased respiratory rate and body temperature.Peripheral blood lymphocytes decreased progressively.On the 8th d of admission,the patient’s highest temperature was 40.7°C,and oxygen saturation was 83%despite high-flow oxygen inhalation.Chest computed tomography results showed that the virus progressed rapidly.The number of lesions significantly increased with expanded scope and increased density.The distribution of lesions advanced from peripheral to central.In addition to nasal catheter oxygen inhalation and symptomatic support,antiviral drugs were used throughout the treatment.On January 22,oseltamivir phosphate capsules were given orally(75 mg,twice daily)for 6 d.On January 24,three tablets of lopinavir and ritonavir were added orally(twice daily).After 6 d,this was changed to 0.2 g(two tablets)arbidol,taken orally(three times daily)for 5 d.During the severe stage,methylprednisolone was given(40 mg)once every 12 h,immunoglobulin(20 g)was administered by intravenous drip infusion once daily,and thymosin(1.6 mg)was injected subcutaneously once daily combined with immunotherapy.On February 2,symptoms decreased,various indicators improved,and pulmonary inflammation was obviously reduced.Throat swabs on February 4 and 9 were negative for novel coronavirus nucleic acid.After 19 d in the hospital,the patient was successfully treated and discharged.CONCLUSION COVID-19 in young adults can be successfully treated with active treatment.We report a typical case of COVID-19,analyze its clinical characteristics,summarize its clinical diagnosis and treatment experience,and provide a reference for clinical colleagues.展开更多
The three-month-old infant, born in Xiaogan City, Hubei Province , was hospitalized due to fever for 4 hours on January 26, 2020 .The throat swab test was positive for SARS-CoV-2 nucleic acid, and the final diagnosis ...The three-month-old infant, born in Xiaogan City, Hubei Province , was hospitalized due to fever for 4 hours on January 26, 2020 .The throat swab test was positive for SARS-CoV-2 nucleic acid, and the final diagnosis was COVID-19. The condition was improved after 17 days hospitalization treatment, the infant was cured and discharged. The infant had fever, cough and foaming at the mouth. Physical examination: lipstick, no cyanosis, pharyngeal congestion, stable breathing, clear breath sounds in both lungs, no obvious rales. The infant was from Hubei, the epidemic area, with fever and respiratory symptoms. The peripheral blood leukocyte was not high. The chest X-ray showed that the right lung texture was slightly thickened, which seems to be a bit of sheet shadow. The throat swab COVID-19 nucleic acid test was positive. The diagnosis of COVID-19 was established and complied with general type. The infant was treated with paramivir, azithromycin and ceftazidime, ambroxol, atomization and sputum suction. The infant was cured and discharged On February 11,2020.展开更多
Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jiangha...Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jianghan module Hospital from February 6,2020 to February 26,2020 were gathered,and the cases with/without fever were retrospectively analyzed in epidemiology,clinical manifestation,blood routing,hypersensitive C-reactive protein(hs-CRP),pathogens serological testing,chest CT and drugs treatment.Results:For 312 fever cases,the average age was(47.6±10.9)years old,male was 128 cases(41%),the mean peak fever was 38(36.8,38.6)℃,fever lasting was 2(0,3)days,131cases(28.7%)had Huanan seafood market exposure history,90 cases(28.8%)had closely contact with COVID-19 patients,20cases(6.4%)had hypertension history,10 cases(3.2%)had diabetes,5cases(1.6%)had coronary heart disease.Main symptoms of fever group including dry cough of 260cases(83.3%),of 104cases(33.3%),blood sputum of 9cases(2.9%),chest tightness 20cases(19.6%),shortness of breath of 87cases(27.9%),weak of 105cases(33.7%),diarrhea of 43cases(13.8%),sleep disorders of 61cases(19.6%),among fever cases with sputum and shortness of breath more rather without fever,and two groups were statistically significantly difference(P<0.05).In fever group,WBC(109/L)[4.34(3.69,5.26)than 5.11(4.22,6.22),P<0.001],NEUT(109/L)[2.67(2.1,3.49)than 2.88(2.37,3.9),P<0.05],LYM(109/L)[0.9(0.8,1.1)than 1.36(1.03,1.85),P<0.001),PLT(109/L)/(106,188)134-189(132,224),P<0.001)were lower than normal group,while WBC<4.0×109/L[108(34.6%)than 24(16.6%),P<0.001)],LYM<1.0×109/L[189(60.6%)than 31(21.4%),P<0.001)],PLT<100×109/L[45(14.4%)than in 2(1.4%),P<0.001)and hs-CRP(mg/L)[14(6.83,32)than 3.4(0.96,10.75),P<0.001)were higher than normal group,and pathogens serological examination of 36cases shown influenzaⅠ/Ⅱvirus IgM antibody positive in 3cases(8.3%),respiratory syncytial virus IgM antibody positive in 2 cases(5.6%),mycoplasma pneumoniae IgM antibody positive(11.1%),4 cases of adenovirus IgM antibody positive(11.1%),but 4 pathogens of fever group and normal group were no statistical difference(P>0.05).According to early onset of chest CT examination,there were no change of 11cases(2.4%),unilateral lung lesions of 93cases(20.4%),bilateral lung lesions of 353 cases(77.2%),ground glass shadow of 228 cases(73.1%),high density shadow patch of 65 cases(20.8%),consolidation shadow of 6 cases(1.9%),while fever group compared with normal group,there were no statistically significant difference(P>0.05).Logistic regression analysis showed that LYM(OR=0.24,95%CI=0.139~0.415,P<0.001),LYM<1.0 x 109/L(OR=5.12,95%CI=3.07~8.65,P<0.001),PLT<100×109/L(OR=6.1,95%CI=1.36~27.33,P<0.05),and the hs-CRP(OR=1.03,95%CI=1.02~1.05,P<0.001)were fever independent impact factors in mild COVID-19.Aiming at COVID-19 treatment,Chinese medicine usage had 416cases(91%),antiviral drugs had 328cases(71.8%),and antibiotics had 172cases(37.6%),furthermore,fever group using antiviral and antibiotic drugs was higher than normal group(P<0.05),and compared to low fever group,high fever group used more antibiotic drugs(P<0.05).Conclusions:Mild COVID-19 patients with early onset had epidemiological characteristics,and fever,dry cough,expectoration and shortness of breath were main symptoms,and chest CT often involved bilateral lung lesions,ground glass shadow and patch density shadow.The fever patients in WBC,LYM,PLT,hs-CRP index changed significantly and could affect on anti-infective therapy selection.展开更多
Heart failure (HF) is a common disease associated with increasing age. B-type natriuretic peptide (BNP), is a cardiac neurohormone, and is released as prepro BNP and then enzyrnatically cleaved to the Ntenninal-proBNP...Heart failure (HF) is a common disease associated with increasing age. B-type natriuretic peptide (BNP), is a cardiac neurohormone, and is released as prepro BNP and then enzyrnatically cleaved to the Ntenninal-proBNP (NT-proBNP) and BNP upon ventricular myocyte stretch. Blood measurements of BNP have been used to identify patients with I-IF. The BNP assay is currently used as a diagnostic and prognostic aid in HF. In general, a BNP level below 100 pg/mL excludes acutely decompensated HF and levels > 500 pg/ml indicate decompensation. Recombinant human BNP (hBNP, nesiritide) is an approved intravenous treatment for acute,decompensated -HF. Nesiritide given in supraphysiologic doses causes vasodilation, natriuresis, diuresis, and improved symptoms over the course of a 48-hour infusion. This paper will sort out the literature concerning the use of this peptide both as a diagnostic test and as an intravenous therapy.展开更多
The similarities and differences between"Novel Coronavirus Infected pneumonia in Hunan province(trial second edition)"and"Novel Coronavirus Infected pneumonia(Trial seventh edition)"released by the...The similarities and differences between"Novel Coronavirus Infected pneumonia in Hunan province(trial second edition)"and"Novel Coronavirus Infected pneumonia(Trial seventh edition)"released by the National Health Commission and their ideas were interpreted based on"suiting measures to three factors".①In Hunan program,the third version of the trial adjustment more suitable for local characteristics of the disease;②The prevention program population classification is clear,support,eliminate pathogenic factors of the primary and secondary distinct;③The cause of disease is prominent,damp and toxin are mixed with dryness,and the treatment is mainly to moisten the lung and clear away heat,and the prescription is mostly Xinliang light agent.展开更多
Introduction Deafness is one of the most common otologic diseases and a major disease that greatly impacts the Chinese population. From the Second National Sample Survey of Disabled Persons, it is estimated that there...Introduction Deafness is one of the most common otologic diseases and a major disease that greatly impacts the Chinese population. From the Second National Sample Survey of Disabled Persons, it is estimated that there are 27,800,000 hearing disabled persons in China, about 2.14% of展开更多
基金This paper is a science and technology project of Qingyang City,“Comparative Study of Different Parts of Daylily based on the Association of Composition,Antibacterial,and Antioxidant.”(No.:QY-STK-2022B-146)Research on the Effects of Carvacrol on Autophagy,Apoptosis and Invasion,and Migration of Triple-Negative Breast Cancer Cells and its Mechanism(No.:2021B-279)Research Results of the Innovation Fund Project of Gansu Provincial Universities“Study on Antioxidant Activity of Stem and Leaf Extracts of Daylily.”(No.2022A-129)。
文摘With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is rising, mainly affecting women with a high mortality rate. According to the clinical treatment effect, early diagnosis and early treatment can effectively control the mortality of breast cancer and improve patient’s quality of life. Ultrasound radiomics is an emerging field that can extract quantitative high-dimensional data from ultrasound images. Recently, ultrasound radiomics has been widely used in the clinical treatment of breast cancer. This paper analyzed the research progress of ultrasound radiomics in the diagnosis and treatment of breast cancer.
文摘BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.
文摘Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.
文摘The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,
文摘Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.
基金supported by“Beijing Municipal Administration of Hospitals Incubating Program”(No.PX2018043)。
文摘Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging due to the great differences in the diagnosis and treatment of gastric cancer in different regions.The Gastric Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of gastric cancer.The Gastric Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of gastric cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of gastric cancer patients.A panel of experts with gastrointestinal cancer surgery,gastrointestinal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of gastric cancer.The authors then utilized a modified Delphi approach to generate consensus recommendations.
文摘Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC). ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.
基金Supported by Natural Science Foundation of Guangxi,No.2018JJB140171Medical Excellence Award Funded by the Creative Research Development Grant from the First Affiliated Hospital of Guangxi Medical University(2020)+1 种基金Development and Application of Appropriate Medical and Health Technologies in Guangxi,No.S2018111Self-funded Scientific Research Project of Guangxi Health Commission,No.Z20190512.
文摘BACKGROUND Congenital factor VII deficiency(FVIID)is a rare autosomal recessive genetic disorder.The clinical manifestations of this deficiency vary greatly.Predicting the risk of bleeding during and after childbirth of pregnant women with congenital FVIID is difficult.Recombinant factor VIIa is the most common replacement therapy for FVIID.However,no unified diagnosis and treatment plan for pregnant women with congenital FVIID has been established.CASE SUMMARY We report the clinical history of a pregnant woman who was considered to have congenital FVIID.Recombinant factor VIIa was prophylactically administered to the pregnant woman at the time of cervical fully opening.She successfully delivered a live infant without any complications,such as postpartum hemorrhage,neonatal abnormalities,and so on.CONCLUSION Prophylaxis of recombinant factor VIIa during delivery can effectively reduce the incidence of postpartum hemorrhage among pregnant women with congenital FVIID associated with a high risk of bleeding.
基金The 3rd Session of National TCM Master/National Famous TCM Doctor Inheritance Studio Construction Project of National Administration of Traditional Chinese Medicine[Guo Zhong Yi Yao Ban Ren Jiao Han(2018)119].
文摘On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.
文摘Background: As the global novel coronavirus pneumonia (NCP) remains severe, elderly people are at high risk for NCP and osteoporotic vertebral compression fractures, with high complications and mortality. How to treat patients and protect medical staff from infection, and at the same time strictly prevent the occurrence of clustered transmission events in the hospital, the establishment of perfect pre-hospital emergency measures and infection prevention and control strategy is the first element to ensure success. Objective: To establish the diagnosis and treatment and infection protection strategy for Osteoporotic vertebral compression fractures (OVCF) patients undergoing minimally invasive percutaneous kyphoplasty (PKP) surgery during the prevention and control of COVID-19, so as to ensure the stable, orderly and safe medical treatment. Methods: A total of 583 OVCF patients were admitted to the First Affiliated Hospital of Hebei North University during the epidemic prevention and control period from January 2020 to July 2022. After urgent and outpatient strict standardized screening, 382 patients met the inclusion criteria, including 112 males and 270 females, aged (70.50 ± 5.49) years. The preoperative visual analogue scale (VAS) score was 6.92 ± 1.86. Preoperative Oswestry disability index (ODI) was 74.67 ± 4.84. The satisfaction rate was (45.89 ± 3.67) %. According to the clinical diagnostic criteria and classification, 367 patients were diagnosed as ordinary OVCF, including 156 cases of mild compression and 226 cases of moderate compression. The clinical classification of 15 patients with OVCF diagnosed as COVID-19 was type I, including 10 cases of mild COVID-19 and 5 cases of common COVID-19. All patients were treated with PKP. Results: All patients were followed up at 1 day, 1 month and 3 months after operation, VAS (2.01 ± 0.56, 0.45 ± 0.11, 0 ± 0), ODI (45.41 ± 4.15, 10.22 ± 2.73, 4.03 ± 1.57) and satisfaction (90.12%, 95.57%, 99.23%) were significantly improved compared with those before operation (p < 0.05), and the original medical diseases were not aggravated. In this group, 15 cases of OVCF diagnosed with COVID-19 were given priority to treat COVID-19 under strict three-level protection in the designated isolation ward. PKP was carried out after the condition was stable, and the areas, items and personnel in contact with patients during the perioperative period must be strictly and thoroughly disinfected. The patient had a good prognosis, no complications, no cross-infection in the hospital, and no infection rate among medical staff. Conclusions: The implementation of the diagnosis and treatment and infection protection strategy for OVCF patients undergoing minimally invasive PKP surgery during the prevention and control of COVID-19 has a guiding role in preventing the spread of infection, improving the cure rate, promoting rapid recovery, reducing complications and reducing mortality.
基金Supported by the Natural Science Foundation of China(No.81370913)
文摘Dear Editor,I am Dr.Jia X from the Department of Ophthalmology,Second Xiangya Hospital,Central South University,Changsha,China.I write to present a rare case report of 9p deletion syndrome with congenital infantile glaucoma in an infant,accompanying with an effective method of both diagnosis and treatment.
文摘Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.
文摘BACKGROUND Since December 2019,many cases of pneumonia caused by novel coronavirus have been discovered in Wuhan,China,and such cases have spread nationwide quickly.At present,coronavirus disease 2019(COVID-19)is a worldwide pandemic.What are the clinical features of this disease?What is the clinical diagnosis and how should such patients be treated?As a clinician,mastery of the clinical characteristics,basic diagnosis,and treatment methods of COVID-19 are required to provide help to patients.CASE SUMMARY A 42-year-old male patient with a cough lasting 6 d without obvious cause,as well as fever and fatigue for 1 d,was admitted to Hankou Hospital on January 22,2020 and transferred to Huoshenshan Hospital on February 4.The main clinical symptoms were dry cough,fatigue,and fever.He was diagnosed with COVID-19.From the 4th d of admission,the patient’s condition gradually worsened,with increased respiratory rate and body temperature.Peripheral blood lymphocytes decreased progressively.On the 8th d of admission,the patient’s highest temperature was 40.7°C,and oxygen saturation was 83%despite high-flow oxygen inhalation.Chest computed tomography results showed that the virus progressed rapidly.The number of lesions significantly increased with expanded scope and increased density.The distribution of lesions advanced from peripheral to central.In addition to nasal catheter oxygen inhalation and symptomatic support,antiviral drugs were used throughout the treatment.On January 22,oseltamivir phosphate capsules were given orally(75 mg,twice daily)for 6 d.On January 24,three tablets of lopinavir and ritonavir were added orally(twice daily).After 6 d,this was changed to 0.2 g(two tablets)arbidol,taken orally(three times daily)for 5 d.During the severe stage,methylprednisolone was given(40 mg)once every 12 h,immunoglobulin(20 g)was administered by intravenous drip infusion once daily,and thymosin(1.6 mg)was injected subcutaneously once daily combined with immunotherapy.On February 2,symptoms decreased,various indicators improved,and pulmonary inflammation was obviously reduced.Throat swabs on February 4 and 9 were negative for novel coronavirus nucleic acid.After 19 d in the hospital,the patient was successfully treated and discharged.CONCLUSION COVID-19 in young adults can be successfully treated with active treatment.We report a typical case of COVID-19,analyze its clinical characteristics,summarize its clinical diagnosis and treatment experience,and provide a reference for clinical colleagues.
基金Hainan Science and Technology Department Project(No.ZDYFXGF2020007)
文摘The three-month-old infant, born in Xiaogan City, Hubei Province , was hospitalized due to fever for 4 hours on January 26, 2020 .The throat swab test was positive for SARS-CoV-2 nucleic acid, and the final diagnosis was COVID-19. The condition was improved after 17 days hospitalization treatment, the infant was cured and discharged. The infant had fever, cough and foaming at the mouth. Physical examination: lipstick, no cyanosis, pharyngeal congestion, stable breathing, clear breath sounds in both lungs, no obvious rales. The infant was from Hubei, the epidemic area, with fever and respiratory symptoms. The peripheral blood leukocyte was not high. The chest X-ray showed that the right lung texture was slightly thickened, which seems to be a bit of sheet shadow. The throat swab COVID-19 nucleic acid test was positive. The diagnosis of COVID-19 was established and complied with general type. The infant was treated with paramivir, azithromycin and ceftazidime, ambroxol, atomization and sputum suction. The infant was cured and discharged On February 11,2020.
文摘Objective:To investigate the relationship between clinical manifestations,blood testing,chest CT,treatment and fever of 457mild cases of COVID-19.Methods:A tatal of 457cases of mild COVID-19 diagnosed in Wuhan Jianghan module Hospital from February 6,2020 to February 26,2020 were gathered,and the cases with/without fever were retrospectively analyzed in epidemiology,clinical manifestation,blood routing,hypersensitive C-reactive protein(hs-CRP),pathogens serological testing,chest CT and drugs treatment.Results:For 312 fever cases,the average age was(47.6±10.9)years old,male was 128 cases(41%),the mean peak fever was 38(36.8,38.6)℃,fever lasting was 2(0,3)days,131cases(28.7%)had Huanan seafood market exposure history,90 cases(28.8%)had closely contact with COVID-19 patients,20cases(6.4%)had hypertension history,10 cases(3.2%)had diabetes,5cases(1.6%)had coronary heart disease.Main symptoms of fever group including dry cough of 260cases(83.3%),of 104cases(33.3%),blood sputum of 9cases(2.9%),chest tightness 20cases(19.6%),shortness of breath of 87cases(27.9%),weak of 105cases(33.7%),diarrhea of 43cases(13.8%),sleep disorders of 61cases(19.6%),among fever cases with sputum and shortness of breath more rather without fever,and two groups were statistically significantly difference(P<0.05).In fever group,WBC(109/L)[4.34(3.69,5.26)than 5.11(4.22,6.22),P<0.001],NEUT(109/L)[2.67(2.1,3.49)than 2.88(2.37,3.9),P<0.05],LYM(109/L)[0.9(0.8,1.1)than 1.36(1.03,1.85),P<0.001),PLT(109/L)/(106,188)134-189(132,224),P<0.001)were lower than normal group,while WBC<4.0×109/L[108(34.6%)than 24(16.6%),P<0.001)],LYM<1.0×109/L[189(60.6%)than 31(21.4%),P<0.001)],PLT<100×109/L[45(14.4%)than in 2(1.4%),P<0.001)and hs-CRP(mg/L)[14(6.83,32)than 3.4(0.96,10.75),P<0.001)were higher than normal group,and pathogens serological examination of 36cases shown influenzaⅠ/Ⅱvirus IgM antibody positive in 3cases(8.3%),respiratory syncytial virus IgM antibody positive in 2 cases(5.6%),mycoplasma pneumoniae IgM antibody positive(11.1%),4 cases of adenovirus IgM antibody positive(11.1%),but 4 pathogens of fever group and normal group were no statistical difference(P>0.05).According to early onset of chest CT examination,there were no change of 11cases(2.4%),unilateral lung lesions of 93cases(20.4%),bilateral lung lesions of 353 cases(77.2%),ground glass shadow of 228 cases(73.1%),high density shadow patch of 65 cases(20.8%),consolidation shadow of 6 cases(1.9%),while fever group compared with normal group,there were no statistically significant difference(P>0.05).Logistic regression analysis showed that LYM(OR=0.24,95%CI=0.139~0.415,P<0.001),LYM<1.0 x 109/L(OR=5.12,95%CI=3.07~8.65,P<0.001),PLT<100×109/L(OR=6.1,95%CI=1.36~27.33,P<0.05),and the hs-CRP(OR=1.03,95%CI=1.02~1.05,P<0.001)were fever independent impact factors in mild COVID-19.Aiming at COVID-19 treatment,Chinese medicine usage had 416cases(91%),antiviral drugs had 328cases(71.8%),and antibiotics had 172cases(37.6%),furthermore,fever group using antiviral and antibiotic drugs was higher than normal group(P<0.05),and compared to low fever group,high fever group used more antibiotic drugs(P<0.05).Conclusions:Mild COVID-19 patients with early onset had epidemiological characteristics,and fever,dry cough,expectoration and shortness of breath were main symptoms,and chest CT often involved bilateral lung lesions,ground glass shadow and patch density shadow.The fever patients in WBC,LYM,PLT,hs-CRP index changed significantly and could affect on anti-infective therapy selection.
文摘Heart failure (HF) is a common disease associated with increasing age. B-type natriuretic peptide (BNP), is a cardiac neurohormone, and is released as prepro BNP and then enzyrnatically cleaved to the Ntenninal-proBNP (NT-proBNP) and BNP upon ventricular myocyte stretch. Blood measurements of BNP have been used to identify patients with I-IF. The BNP assay is currently used as a diagnostic and prognostic aid in HF. In general, a BNP level below 100 pg/mL excludes acutely decompensated HF and levels > 500 pg/ml indicate decompensation. Recombinant human BNP (hBNP, nesiritide) is an approved intravenous treatment for acute,decompensated -HF. Nesiritide given in supraphysiologic doses causes vasodilation, natriuresis, diuresis, and improved symptoms over the course of a 48-hour infusion. This paper will sort out the literature concerning the use of this peptide both as a diagnostic test and as an intravenous therapy.
基金National Key Basic Research and Development Program(No.2013CB532001)The fourth Batch of National TCM Outstanding Talents Program(No.National Office of Traditional Chinese Medicine(2017)124)
文摘The similarities and differences between"Novel Coronavirus Infected pneumonia in Hunan province(trial second edition)"and"Novel Coronavirus Infected pneumonia(Trial seventh edition)"released by the National Health Commission and their ideas were interpreted based on"suiting measures to three factors".①In Hunan program,the third version of the trial adjustment more suitable for local characteristics of the disease;②The prevention program population classification is clear,support,eliminate pathogenic factors of the primary and secondary distinct;③The cause of disease is prominent,damp and toxin are mixed with dryness,and the treatment is mainly to moisten the lung and clear away heat,and the prescription is mostly Xinliang light agent.
文摘Introduction Deafness is one of the most common otologic diseases and a major disease that greatly impacts the Chinese population. From the Second National Sample Survey of Disabled Persons, it is estimated that there are 27,800,000 hearing disabled persons in China, about 2.14% of