Comparative analysis of breast and lung cancer survival rates and clinical trial enrollments among rural and urban patients in Georgia

Objectives:Rural patients have poor cancer outcomes and clinical trial(CT)enrollment compared to urban patients due to attitudinal,awareness,and healthcare access differential.Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers.The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients.Our hypotheses are that for both cancer types,urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.Methods:We compared breast and lung cancer patients’survival rates and enrollment ratios in clinical trials between rural(RUCC 4-9)and urban counties in Georgia at a Comprehensive Cancer Center(CCC).To assess these differences,we carried out a series of independent samples t-tests and Chi-Square tests.Results:The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients,failing to substantiate our hypothesis.While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC,no significant variation was observed based on rural or urban classification.Conclusion:These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers.Further,the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

Nab-paclitaxel plus capecitabine as first-line treatment for advanced biliary tract cancers:An open-label,non-randomized,phase II clinical trial

BACKGROUND Biliary tract cancers(BTCs)are a heterogeneous group of tumors with high malignancy,poor prognosis,and limited treatment options.AIM To explore the efficacy and safety of nab-paclitaxel plus capecitabine as first-line treatment for advanced and metastatic BTCs.METHODS This open-label,non-randomized,double-center,phase II clinical trial recruited systemic therapy-naive patients with unresectable or metastatic BTCs between April 2019 and June 2022 at Beijing Cancer Hospital and the First Hospital of China Medical University.Eligible patients were administered nab-paclitaxel(150 mg/m^(2),day 1)and capecitabine(2000 mg/m^(2),twice daily,days 1-7)in 14-day cycles until experiencing intolerable toxicity or disease progression.The primary outcome was the objective response rate(ORR).The secondary outcomes included the disease control rate(DCR),overall survival(OS),progression-free survival(PFS),and safety.RESULTS A total of 44 patients successfully completed the trial,with a median age of 64.00 years(interquartile range,35.00-76.00),and 26(59.09%)were females.Tumor response assessment was impeded for one patient due to premature demise from tumor hemorrhage.Among the remaining 43 patients undergoing at least one imaging assessment,the ORR was 23.26%[95%confidence interval(CI):11.80%-38.60%],and the DCR was 69.77%(95%CI:53.90%-82.80%).The median OS was 14.1 months(95%CI:8.3-19.9),and the median PFS was 4.4 months(95%CI:2.5-6.3).A total of 41 patients(93.18%)experienced at least one adverse event(AE),with 10 patients(22.73%)encountering grade≥3 AEs,and the most frequent AEs of any grade were alopecia(79.50%),leukopenia(54.55%),neutropenia(52.27%),and liver dysfunction(40.91%),and no treatment-related deaths were documented.CONCLUSION Nab-paclitaxel plus capecitabine may be an effective and safe first-line treatment strategy for patients with advanced or metastatic BTCs.

Machine learning applications in healthcare clinical practice and research

Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.

Proposal for a new classification of anorectal abscesses based on clinical characteristics and postoperative recurrence

BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.

Clinical comprehensive treatment protocol for managing diabetic foot ulcers:A retrospective cohort study

BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.

Clinical efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for large kidney stones:A retrospective comparative study

BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.

Exploration of Therapeutic Measures and Clinical Efficacy for Recurrent Respiratory Infections in Children

Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.

Investigation of the Clinical Diagnostic Significance of the T-Cell Test for Tuberculosis combined with Erythrocyte Sedimentation Test in Pulmonary Tuberculosis

Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.

Influence of hyperbaric oxygenation treatment (HBOT) on clinical outcomes (recurrent myocardial infarction and survival rate) during five-year monitoring period after acute myocardial infarction

Surgical treatments of acute myocardial infarction (MI) possess a high clinical effectiveness, but there are fixed limitations, related to the patient’s state, which are limited by medical resources and organizational problems. The development of new medical technologies provides a better and effective non-surgical treatment of acute MI and increases long-term prognosis in this category of patients. The study aims to investigate the influence of hyperbaric oxygenation treatment on clinical outcomes (survival rate and recurrent myocardial infarction (rMI)) during the five-year period of monitoring. The study involved 697 patients who suffered from acute MI, having undergone the standard treatment. The patients were randomly divided into two groups: Group 1 (reference, n = 363);Group 2 (test, n = 334). Patients of Group 2 were given the traditional treatment, accompanied with HBOT (isopression for forty minutes at a working pressure of 0.03 MPa). HBOT was applied first through the fifth day following MI. The treatment course included six cycles, once per day. The clinical assessment was focused on clinical outcome: rMI and mortality related to cardiovascular events. HBOT application that accompanied the acute MI with traditional pharmacotherapy has been proved to reduce rMI within five years following inpatient discharge (rMI rate was 14% in the reference group and 5.4% in the test group, χ2 = 13.3, р < 0.05). The combination of HBOT with traditional methods in treating acute MI makes it possible to raise the five-year survival rate from 84.4% up to 95.9%.

The Effect of Luteal-Phase Support with Triptrolin Administration on Implantation and Clinical Pregnancy Rate in Assisted Reproductive Technology

Background: Luteal phase support with GnRH agonist administration has been shown to be effective in improving the outcome of assisted reproductive technology. The goal of this study was to evaluate the effect of single dose Triptrolin (a GnRH agonist) on the probability of the clinical pregnancy rate following embryo transfer (ET) in assisted reproductive techniques (ART). Methods: In this double blinded randomized clinical trial, 340 infertile women who were candidates for intra-cytoplasmic sperm injection (ICSI) were randomly assigned to receive GnRH agonist (Triptrolin) in the luteal phase or placebo. In the intervention group, 0.1 mg Triptrolin was injected subcutaneously, while the control group received normal saline. The clinical pregnancy and implantation rate were compared between the two groups using chi-2 and t-test. P-values less than 0.05 were considered significant. The registration number of this clinical trial is IRCT 2014030916912N1. Results: Administration of 0.1 mg Triptrolin on day 6 after oocyte pick up showed no superiority over placebo in implantation (16.9% - 14%, P = 0.40) and clinical pregnancy rates (32% - 29%, P = 0.66), but the rate of clinical pregnancy was higher in women who were below 27 years of age and those with PCO. Conclusion: Administration of Triptrolin was not superior to placebo for luteal phase support.

不同治疗方案对卵巢储备功能正常年轻女性夫精人工授精妊娠结局的影响

目的探讨不同治疗方案对年龄<35岁卵巢储备功能正常女性夫精人工授精(AIH)妊娠结局的影响。方法回顾性分析2015年1月至2021年8月在本中心行AIH助孕的年龄<35岁卵巢储备功能正常女性的3024个周期的临床资料。根据治疗方案分为6组:自然周期组(NC组,n=380)、克罗米芬组(CC组,n=57)、CC联合促性腺激素(Gn)组(CC+Gn组,n=78)、Gn组(n=1712)、来曲唑组(LE组,n=430)以及LE联合Gn(LE+Gn组,n=367),比较各组患者的一般情况和妊娠结局,并采用多因素Logistic回归分析影响AIH临床妊娠率及活产率的相关因素。结果一般情况比较:6组间体质量指数(BMI)、窦卵泡数(AFC)、基础卵泡刺激素(FSH)水平、优势卵泡数、不孕因素整体比较有统计学差异(P<0.05),而女方年龄、不孕年限、不孕类型及精液处理方式比较均无统计学差异(P>0.05)。妊娠结局比较:6组患者间临床妊娠率和活产率整体比较有统计学差异(P<0.05),其中LE+Gn组的临床妊娠率和活产率显著高于NC组(分别为20.7%vs.9.5%;16.3%vs.7.4%)(P<0.05);6组间流产率、异位妊娠率及多胎率比较无统计学差异(P>0.05)。多因素Logistic回归分析结果显示,矫正混杂因素后,LE+Gn治疗方案和优势卵泡数均是临床妊娠和活产的保护因素(OR>1,P<0.05),而不孕年限是临床妊娠和活产的危险因素(OR<1,P<0.05)。结论LE联合Gn方案可显著提高AIH的临床妊娠率和活产率,可作为年龄<35岁卵巢储备功能正常女性AIH助孕的首选治疗方案。

不同首发年龄精神分裂症患者临床特征及影响因素

目的:探讨不同首发年龄精神分裂症患者的临床特征,以及社会人口学影响因素。方法:根据美国精神障碍诊断与统计手册第5版的精神分裂症诊断标准,选取15~70岁患者2016例,由精神科医生采用简明国际神经精神访谈、精神症状维度评定量表(CRDPSS)和阳性与阴性症状量表(PANSS)进行诊断和评估。以18岁和25岁作为精神分裂症早发、中发及晚发的分组界值。采用方差分析、多重相关分析和多重线性回归的方法进行统计分析。结果:早发型患者的PANSS量表总分(73.8±28.0)和CRDPSS量表总分(11.7±5.4)均为最高。女性、受教育程度高、汉族、首发年龄较早、起病形式较慢等特征与PANSS量表和CRDPSS量表总分及其各维度分数正关联(标化回归系数:0.04~0.47),收入水平和吸烟与PANSS量表和CRDPSS量表总分及其各维度分数负关联(标化回归系数:-0.04~-0.14)。结论:早发型精神分裂症患者的症状严重程度更高,女性、受教育水平高、早发病、慢性起病是精神分裂症患者症状严重的危险因素。

子宫内膜癌增强MRI定量参数变化与临床特征的关系及对预后的预测价值分析

目的 探究子宫内膜癌(EC)增强MRI定量参数变化与临床特征关系,分析其对预后的预测价值。方法 选取2019年3月~2022年3月本院收治的EC患者98例作为研究组,另选同期子宫内膜良性病变患者98例作为对照组。比较两组增强MRI定量参数[速率常数(K_(ep))、容量转移常数(K^(trans))、血管外细胞外间隙容积比(V_(e))]。比较研究组不同临床特征患者增强MRI定量参数,分析其与临床特征相关性。比较研究组不同预后患者增强MRI定量参数,分析其对预后的预测价值。结果 研究组K_(ep)、K^(trans)、V_(e)高于对照组(P<0.05);K_(ep)、K^(trans)、V_(e)病理分期、淋巴结转移、宫颈间质累及情况、子宫肌层浸润深度呈正相关,而与分化程度呈负相关(p<0.05)预后不良者K_(ep)、K^(trans)、V_(e)高于预后良好者,且与预后不良显著相关(P<0.05);K_(ep)、K^(trans)、V_(e)联合预测预后不良的AUC大于各参数独独预测(P<0.05)。结论 EC患者增强MRI定量参数K_(ep)、K^(trans)、V_(e)升高,且与临床特征、预后密切相关,联合检测各参数对预后不良具有一定预测价值。

补体C3水平对冻融胚胎移植妊娠结局的早期预测价值

目的探讨补体C3对冻融胚胎移植(F-ET)妊娠结局的早期预测价值。方法前瞻性收集378个F-ET周期相关资料,依据补体C3预测F-ET妊娠结局的最佳截断值分为A组(补体C3≤1.05)120个周期;B组(补体C3>1.05)258个周期,比较两组结局。分析B组补体C3预测F-ET自然流产的最佳截断值。结果年龄是F-ET妊娠成功的危险因素(P<0.05);补体C3和胚胎类型是F-ET妊娠成功的保护因素(P<0.05)。补体C3对F-ET妊娠结局的受试者工作特征曲线(ROC)曲线下面积为0.702,最佳截断值为1.05 g/L,其预测临床妊娠灵敏度为87.60%、特异度为52.00%。B组临床妊娠率(67.05%)和胚胎着床率(52.75%)明显高于A组,差异有统计学意义(P<0.05)。补体C3早期预测F-ET后自然流产最佳截断值为1.32 g/L,ROC曲线下面积为0.760,灵敏度为69.00%、特异度为81.20%。结论补体C3对早期预测F-ET妊娠结局有一定的临床意义,当补体C3超过1.32 g/L可能会导致自然流产率升高。

头戴式手术录像系统在游离皮瓣修复重建手术教学中的应用

目的探讨头戴式手术录像系统应用于游离皮瓣修复重建手术的教学效果。方法纳入2022年6月至2023年12月在上海第九人民医院整复外科进行进修学习的进修医生45名,随机分为试验组(n=23)和对照组(n=22)。两组均采用术前小讲课教授基础理论知识和手术步骤。手术内容上试验组通过手术录像观摩,录像直接取自手术者的头戴式录像装置并配以解说,而对照组采用传统室内手术观摩的方式。比较两组学员的基本理论考核、手术步骤考核成绩和教学满意率。结果试验组手术步骤考核成绩和教学满意率均高于对照组,差异有统计学意义(P<0.05),而基本理论考核成绩两组差异无统计学意义(P>0.05)。结论头戴式微型摄像系统教学能明显提高学员对于皮瓣重建手术的学习效果并提升教学满意度,具有一定的推广意义。

甲状腺微小乳头状癌微波消融术后疗效评估的影响因素分析

目的:探讨超声引导下微波消融治疗甲状腺微小乳头状癌(PTMC)的临床疗效及结节体积的影响因素。方法:纳入行微波消融治疗的低危PTMC患者63例,于术后1 d和1、3、6、12个月进行随访,对临床疗效及结节体积进行观察;根据结节吸收情况分为结节消失组(19例)与结节未消失组(43例),分析影响结节体积的相关因素。结果:63例均一次性完全消融成功,1例因颈部淋巴结转移转行外科手术。术后疼痛1例、出血2例、声音改变1例,对症处理后均恢复正常,无其他不良反应及并发症。微波消融后结节体积短时间内急剧增大,术后6个月时结节体积恢复至术前水平,19例结节术后12个月完全吸收,其中4例发生在术后6个月。2组在有无微小钙化灶、与最近被膜的距离、甲状腺影像报告和数据系统(TI-RADS)分类、术后1 d结节体积、消融时间、消融热量及性别方面差异均无统计学意义(均P>0.05);2组年龄、术前结节体积、单位体积能量差异均有统计学意义(均P<0.05)。结论:超声引导下微波消融治疗低危PTMC的效果良好,安全性高。年轻患者、小病灶及单位体积能量高的患者微波消融术后结节吸收效果好。

膀胱癌患者根治术后合并前列腺偶发癌的临床病理特征分析

目的分析膀胱癌患者根治术后合并前列腺偶发癌的临床病理特征。方法回顾性分析行膀胱癌根治术75例患者的临床资料,所有患者术前均未被诊断为前列腺癌,统计术后前列腺偶发癌的发生率。另收集患者的年龄、膀胱癌分期等资料,统计对比合并前列腺偶发癌与未合并前列腺偶发癌患者各项临床资料的差异;同时统计分析合并前列腺偶发癌患者的病理特点;于术后进行随访,统计所有患者的生存率。结果75例患者中,合并前列腺偶发癌的共有18例,发生率为24.00%(18/75);合并前列腺偶发癌的患者年龄高于未合并前列腺偶发癌患者,有统计学差异(P<0.05);而两组术前的国际前列腺症状评分(IPSS)、生活质量综合评定问卷(GQOLI-74)、前列腺特异抗原(PSA)相比,无统计学差异(P>0.05);18例合并前列腺偶发癌的患者其临床分期大部分局限于pT_(2)内,其中pT_(1)有10例(55.56%),pT_(2)有5例(27.78%),pT 3有3例(16.67%);采用Gleason score评分对患者评估,其中<7分11例(61.11%)、=7分5例(27.78%)、>7分2例(11.11%);术后随访成功60例,生存率为80.00%(60/75),其中11例死于膀胱癌,4例死于其他疾病。结论膀胱癌根治术后前列腺偶发癌的发生率较高,大多局限于pT_(2)内,且Gleason score评分多数≤7分,前列腺偶发癌的发生对膀胱癌患者总体生存率无显著影响。

腹部超声辅助经阴道超声检查诊断异位妊娠的应用价值

目的观察腹部超声辅助经阴道检查应用于异位妊娠孕妇的诊断价值。方法回顾性分析2021年1月—2023年1月佛山市妇幼保健院100例疑似异位妊娠孕妇的临床资料,以上患者均先实施腹部超声检查,而后行经阴道超声检查。观察不同检查方式的诊断符合率,对不同检查方式的声像图特征进行分析。结果腹部超声检查符合率为80.0%,误诊率为12.0%,漏诊率为8.0%;经阴道超声检查符合率为87.0%,误诊率为10.0%,漏诊率为3.0%;联合超声检查符合率为98.0%,误诊率为0,漏诊率为2.0%;联合超声检查诊断符合率高于腹部超声检查、经阴道超声检查,差异有统计学意义(P<0.05)。联合超声检查宫内假孕囊、附件区域包块分别为56.0%、69.0%;腹部超声检查宫内假孕囊、附件区域包块分别为28.0%、47.0%,经阴道超声检查宫内假孕囊和附件区域包块分别为47.0%、63.0%。联合超声检查下宫内假孕囊、附件区域包块的诊断阳性率高于经阴道超声检查、腹部超声检查,差异有统计学意义(P<0.05)。结论在异位妊娠临床诊断工作中,腹部超声辅助下实施经阴道超声检查可以获得比较高的诊断符合率。因此必要时可将腹部超声检查、经阴道超声检查联合使用,可以显著减少误诊、漏诊。

葫芦灸对肛周脓肿术后提高临床愈合效果的探讨

目的 探究葫芦灸对肛周脓肿术后提高临床愈合效果的作用。方法 方便选取2021年1月—2022年12月临沂市中医医院收治的94例肛周脓肿患者为研究对象,均经手术治疗,依据随机数表法分为对照组与观察组,每组47例。对照组采用常规术后治疗方法,观察组在对照组基础上使用葫芦灸治疗方法。对比两组干预后的总有效率、疼痛评分、生活质量、临床指标、并发症发生率。结果 观察组干预后总有效率和生活质量评分高于对照组,差异有统计学意义(P均<0.05)。观察组愈合时间短于对照组及治疗24 h后渗液量少于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率(2.13%)低于对照组(17.02%),差异有统计学意义(χ^(2)=4.424,P<0.05)。结论 肛周脓肿患者术后给予葫芦灸治疗,可显著提高愈合效果,缩短治疗时间,有效改善患者生活质量,效果显著。