Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.

Association of fatigue with short-term prognosis in young and middle-aged patients with coronary heart disease

Background:To investigate the effect of fatigue on the short-term prognosis of young and middle-aged patients with coronary heart disease(CHD).Methods:A cross-sectional,observational survey was distributed at a tertiary hospital in Suzhou,China.Patients were assessed for fatigue and their prognosis was assessed at 3 and 6 months after discharge.General Information Questionnaire,Fatigue Scale and Seattle Angina Questionnaire(SAQ)were used for the survey.The Cox proportional hazard model was used to analyze the impact of fatigue on the occurrence of major adverse cardiac events(MACEs)at 3 and 6 months after discharge.Multiple linear regression models were used to analyze the effect of fatigue on health-related quality of life(HRQoL)at 3 and 6 months after discharge.Results:199 patients were followed up with in the end.43 patients(21.6%)with MACE three months after discharge had a total SAQ score of(399.76±39.61).The overall SAQ score was(425.14±22.66)and 52 patients(26.1%)experienced MACE six months after discharge.Fatigue was identified as a risk factor for MACE 6 months after discharge by the Cox proportional hazard model(HR=2.939,95%CI:0.177~0.655,P=0.001)and as an independent risk factor for quality of life 3 and 6 months after discharge by multiple linear regression(P<0.001).Conclusions:In individuals who are young or middle-aged and have coronary heart disease,fatigue is a risk factor for the short-term prognosis.It is advised that clinical professionals prioritize patient fatigue assessment and improve management of fatigue symptoms.

Psychosocial Adaptation Level and Work Participation Rate of Young and Middle-aged Patients with Coronary Heart Disease after PCI

[Objectives]The research aimed to understand the psychosocial adjustment to illness of young and middle-aged patients with coronary heart disease after PCI and their participation situation in work.[Methods]210 young and middle-aged patients aged 18-59 years with coronary heart disease treated by PCI in a tertiary hospital of Suzhou from July of 2020 to November of 2022 were selected,and general information of patients in three days after operation was registered.Self-report psychosocial adjustment to illness scale(PAIS-SR)was used to investigate the psychosocial adjustment to illness of patients in 1,3 and 6 months after operation and the participation rate of work.[Results]The psychosocial adjustment to illness of young and middle-aged patients with coronary heart disease after PCI was different in gender,age,education level,marital status,hypertension,diabetes,postoperative cardiac color Doppler ultrasound results(left ventricular ejection fraction)and the number of stents(P<0.05).[Conclusions]The psychosocial adjustment to illness of young and middle-aged patients with coronary heart disease after PCI needs to be improved.The psychosocial adjustment to illness of men is higher than that of women.The older the age is,the lower the psychosocial adjustment to illness is.The psychosocial adjustment to illness of patients with high educational background is higher than those with low educational background,while the psychosocial adjustment to illness of married people is higher than unmarried people.The psychosocial adjustment to illness of patients with hypertension and/or diabetes is lower.

Correlation of blood uric acid level with the degree of anxiety as well as the neurotransmitter and cytokine secretion in young and middle-aged patients with anxiety disorder

Objective:To study the correlation of blood uric acid level with the degree of anxiety as well as the neurotransmitter and cytokine secretion in young and middle-aged patients with anxiety disorder.Methods: The young and middle-aged patients diagnosed with generalized anxiety disorder in our hospital between March 2015 and February 2018 were selected as the anxiety group, and the healthy subjects receiving physical examination during the same period were selected as the control group. Peripheral blood was collected to determine the contents of uric acid, neurotransmitters and cytokines, and Hamilton Anxiety Scale (HAMA) was adopted to judge the degree of anxiety.Results: The blood uric acid level of anxiety group was obviously higher than that of control group and the higher the HAMA scores, the more significant the rising of blood uric acid levels;serum 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA), interleukin-1α (IL-1α), IL-17 and interferon-γ (IFN-γ) contents of anxiety group were significantly higher than those of control group whereas neuropeptide Y (NPY), IL-4 and transforming growth factor-β (TGF-β) contents were significantly lower than those of control group;blood uric acid level of the anxiety group was positively correlated with 5-HT, NE, DA, IL-1 , IL-17 and IFN-γ contents, and negatively correlated with NPY, IL-4 and TGF-β contents.Conclusion: The rise of blood uric acid level in young and middle-aged patients with anxiety disorder is related to the aggravation of anxiety degree as well as the abnormal secretion of neurotransmitters and cytokines.

Experience of Treating Hypertension from Liver and Spleen Among Middle-Aged and Young Patients:A Summary

Qi deficiency of the spleen and stomach,transportation,phlegm and dampness generate endogenous and turbid phlegm that violates the position of yang clearance.As a result,dizziness cis resulted.The author believes that the incidence of middle-aged and young patients with hypertension is mostly related to the dysfunction of liver and spleen.Liver depression and qi stagnation is the beginning of the onset;spleen deficiency and dyskinesia is the norm of the onset;and liver and spleen imbalance is the origin of the onset.It is advocated that regulating the liver and spleen to restore the rise and fall,harmonizing qi and blood and preventing lesions are the main treatment methods for the treatment of middle-aged and young people’s hypertension,which is conducive to the development of more clinical diagnosis and treatment ideas for hypertension amomg middle-aged and young people.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China,2002–2019,and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.

Correlation of three grades with carotid atherosclerotic plaque by the ultrasound in middle-aged patients with hypertension

Objective:To explore the correlation of different hypertension grades with carotid atherosclerotic plaque in middle-aged patients with hypertension.Methods:A total of 300 patients with primary hypertension who were admitted in the Cardiology Department and Neurology Department of our hospital from January, 2015 to September, 2016 were included in the study and divided into 3 groups with 100 cases in each group according to the hypertension grade criteria. Moreover, 100 normal individuals who came for physical examinations were served as the control group. TCD was used to detect MCA, ACA, PCA, VA1, and BA. CDFI was used to detect CCA, ICA, ECA, and VA2. EDV, PSV, PI, and RI were detected, respectively. The nitrate reductase colorimetric method was used to detect NO, MDA, and SOD.Results:PSV and EDV in the internal carotid artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05);moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. PSV and EDV in the vertebral artery system in patients with hypertension were significantly reduced (P<0.05), while PI and RI were significantly increased (P<0.05);moreover, with the increasing of hypertension grading, PSV and EDV were gradually reduced, while PI and RI were increased. SOD and NO in patients with hypertension were significantly lower than those in the control group (P<0.05), while MDA was significantly higher than that in the control group (P<0.05);moreover, with the increasing of hypertension grading, SOD and NO were gradually reduced, while MDA was gradually increased.Conclusions: TCD in combined with CDFI can make a comprehensive evaluation of hemodynamic indicators of intracranial and extracranial vessels in patients with hypertension, and is of great significance in the early detection of intracranial and extracranial arteriosclerosis.

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke （59.6%） was the primary stroke type found in the young group, while ischemic stroke （60.0%） was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction （such as friendship） improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

Etiological and clinicopathologic characteristics of intrahepatic cholangiocarcinoma in young patients

AIM:To investigate the prevalence,risk factors,and clinicopathologic characteristics of intrahepatic cholangiocarcinoma(ICC)in young patients.METHODS:A retrospective analysis was performed in ICC patients referred to the Eastern Hepatobiliary Surgery Hospital in Shanghai,China.Among 317 consecutively enrolled patients,40 patients were aged ≤40 years(12.61%).We compared the risk factors and clinicopathologic characteristics of these patients(groupⅠ:n=40)with those aged>40 years(group Ⅱ:n=277).RESULTS:Group I had distinct features compared with groupⅡ,including a low frequency of hepatolithiasis(P=0.000);a high positive rate of serum hepatitis B surface antigen(P=0.000)and hepatitis B virus(HBV)associated cirrhosis(P=0.038);a high frequency ofα-fetoprotein(>400μg/L)(P=0.011);a low frequency of carbohydrate antigen 19-9(>37 U/mL)(P=0.017);and a high frequency of liver histological inflammation(P=0.002).Although there was no significant difference between the two groups in regards to hepatic schistosomiasis,alcohol-associated cirrhosis and cirrhosis due to other causes(P>0.05),they only occurred in the elderly group.CONCLUSION:The risk factors are significantly different between young and elderly ICC patients.HBV and HBV-associated cirrhosis are the most important risk factors for young ICC patients.

Clinical characteristics of young patients with early Barrett’s neoplasia

BACKGROUND Esophageal adenocarcinoma(EAC)and high-grade dysplasia(HGD)may appear in young patients with Barrett's esophagus(BE).However,characteristics of Barrett's-related neoplasia in this younger population remain unknown.AIM To identify clinical characteristics that differ between young and old patients with early-stage Barrett's-related neoplasia.METHODS We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC(pT1)and HGD at a tertiary-referral center between 2001 and 2017.Baseline characteristics,drug and risk factor exposures,clinicopathological staging of EAC/HGD and treatment outcomes[complete eradication of neoplasia(CE-N),complete eradication of intestinal metaplasia(CE-IM),recurrence of neoplasia and recurrence of intestinal metaplasia]were retrieved.Multivariate analyses were performed to identify factors that differed significantly between older and younger(≤50 years)patients.RESULTS We identified 450 patients with T1 EAC and HGD(74%and 26%,respectively);45(10%)were≤50 years.Compared to the older group,young patients were more likely to present with ongoing gastroesophageal reflux disease(GERD)symptoms(55%vs 38%,P=0.04)and to be obese(body mass index>30,48%vs 32%,P=0.04).Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms[odds ratio(OR)2.00,95%confidence interval(CI)1.04-3.85,P=0.04]and to be obese(OR 2.06,95%CI 1.07-3.98,P=0.03)whereas the young group was less likely to have a smoking history(OR 0.39,95%CI 0.20-0.75,P<0.01)compared to the old group.However,there were no significant differences regarding tumor histology,CE-N,CE-IM,recurrence of neoplasia and recurrence of intestinal metaplasia(mean follow-up,44.3 mo).CONCLUSION While guidelines recommend BE screening in patients>50 years of age,younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms.

Prognostic factors of young patients with colon cancer after surgery

瞄准：由 univariate 并且多在一个癌症中心以内与结肠癌调查 96 个年轻病人的预示的因素变量分析。方法：有结肠癌的 723 个病人的一个总数在 10 年的一个时期期间通过手术被对待。90 他们中的六个是 40 岁或 younger.R0， R1 和 R2 手术在 69 被执行(71.9%) ， 4 (4.1%) 并且 23 个病人(24%) 分别地。左半结肠切除术在 7 个病人在 43 个病人，在 37 个病人的正确的半结肠切除术，在 9 个病人的横向的冒号切除术和低前面的切除术被执行。考克斯多，变量回归分析被执行识别幸存的预言者。结果：操作死亡是 0% ， 54 个病人由于肿瘤的出现或转移在操作以后在 111 瞬间以内死了。肝，肺和骨头转移分别地发生在 3， 1 和 5 个病人。为所有病人的吝啬的生存时间是 5.01 瞬间和全面 3-,5- 和 10- 年幸存评估的 77.9 +/- 分别地是 66.68% ， 58.14% 和 46.54% 。在 univariate 幸存分析，耐心的年龄，手术的类型，激进的切除术，输血，组织学的类型，肿瘤的直径，肿瘤侵略的深度，淋巴的侵略，远转移，肝转移和 TNM，舞台被发现是在有结肠癌的年轻病人的幸存的预言者。在艇长回归分析，输血和淋巴的侵略作为幸存的独立预示的因素被决定。结论：年龄，操作的类型，激进的切除术，输血，组织学的类型，肿瘤的直径，肿瘤侵略的深度，淋巴的侵略，远转移和 TNM 舞台是在有在外科以后的结肠癌的年轻病人的幸存的预言者。

Pulmonary Embolism in Young Patients: About 24 Cases at the Cardiology Department of Dakar Principal Hospital in Senegal

Introduction: Pulmonary embolism is a relatively common life-threatening cardiovascular emergency. It remains a diagnostic problem because of its nonspecific clinical signs. Objective: The general objective was to study pulmonary embolism in young patients admitted to the cardiology department of Dakar Principal Hospital in Senegal. Methodology: This was a retrospective, descriptive and analytical study in the cardiology department of the Dakar Principal Hospital over a period of two (02) years from January 1, 2015 to December 31, 2016 in young patients admitted for pulmonary embolism. Results: We collected 24 patients with a hospital prevalence of 2.18%. The average age was 42.29 years ± 8.41 years with a male predominance (sex ratio of 1.6). The Wells probability score was low in 54.16% of patients and medium in 45.83%. Functional signs were dominated by chest pain (83.33% of cases) followed by dyspnea (79.16% of cases). The thromboembolic risk factors found were gynecological-obstetrical in 16.6% of cases followed by prolonged bed rest. One case of thrombophilia was present with a deficiency of protein C and antithrombin III. The electrocardiogram recorded sinus tachycardia in 29.16% of patients;the Mac Ginn White sign (S1Q3T3) was found in 25% of cases. Echocardiography showed pulmonary arterial hypertension in 12.48% of cases, dilation of the right ventricle and a paradoxical septal motion in 14.28% of cases. CT pulmonary angiography showed 63.63% of cases with bilateral pulmonary embolism;it was unilateral in 22.72% of cases. Long-term anticoagulation was based on acenocoumarol 4 mg (66.7%) and Rivaroxaban (33.3%). 62.5% of the patients were seen at the 3rd month, when a checking was made to evaluate the tolerance of the treatment, and the evolution of the patient. Conclusion: Pulmonary embolism is not a rare condition in young subjects but is often underdiagnosed. Gyneco-obstetrical factors are predominant in this age group. Direct oral anticoagulants are more and more prescribed in our countries.

Oxidative Stress During Antituberculous Therapy in Young and Elderly Patients

Using allantoin (ATN ) as a marker for reactive oxygen species (ROS), oxidative stress during antituberculous (anti-TB) therapy was compared in 10 young and 9 elderly patients.Before treatment, ATN plasma concentrations in patients were similar to that of volunteers. Administration of a combination of isoniazid (INH ), rifampicin (RIF) and pyrazinamid e (PZA) increased plasma ATN in both groups of patients. ATN concentrations (M± SE) at six hours were higher (P <0.05 ) in elderly than in young patients on day one,8.22 ± 1.50 vs 1.89 ± 0.98 μg/mL); day 30, (5.85 ± 0.82 vs 0.87 ± 0.57 μg/mL; and day 90, (4.84 ± 1.24 vs 0.52 ± 0.50μg/mL). Because total amount of ATN excreted was similar in both groups on the three occasions, more ATN was formed in elderly than young patients. In conclusion, there was more oxidative stress in elderly than young patients. It is thereby suggested that Anti-TB drugs induce formation of ROS and elderly patients are at a greater risk of toxicity probably because of poor antioxidant mechanisms

Clinicopathologic Characteristics and Surgical Outcome of Gastric Cancer in Patients Younger than 36 Years of Age

OBJECTIVE This study was designed to determine theclinicopathologic features of young patients who underwentgastrectomy for gastric cancer and to improve the clinicalmanagement of this disease.METHODS From 1981 to 2000,among 1,830 gastric cancerpatients were admitted in our hospital for surgical treatment,66of them were<36 years of age.The clinicopathologic data of theseyoung patients were collected and reviewed.RESULTS The male:female ratio was 1.2:1.Most tumors werelocated in the lower third of the stomach(63.1%).The overall5-year survival rate of 66 cases was 28.7%.The 5-year survivalrates in the patients with early stages and with advanced stages ofgastric carcinoma were 77.8%(7/9)and 21.1%(12/57),respectively.Unfavorable prognostic factors associated with poor 5-yearsurvival included the degree of the invasion in the gastric wall(P<0.05),and curability of resection(non-curative vs.curative;P<0.05).CONCLUSION Gastric cancer in young adults tends to be moreadvanced presentation when diagnosed.However,young patientswith early gastric cancer can tolerate radical treatments well.Itis important to promptly make a precise diagnosis for gastriccarcinoma in young patients and to treat it in early stage.

Factors associated with financial support in old age for young and middle-aged rural residents in China

This study examined the factors associated with financial support in old age from three primary mechanisms-personal savings,family support,and social insurance-to explore the implications for the future development of China's rural social welfare system.Cross-sectional surveys of 1392 young and middle-aged rural residents were conducted in July and August2012.The results showed that while social insurance was increasingly acceptable,personal savings and family support still had fundamental value.Combining the three mechanisms,the rural old-age welfare system presented nontraditional features.China's new rural endowment insurance is discussed as a means to address the need for financial support among the rural aging population.

Cardiac MRI: Luxury or Necessity, beyond the Electrocardiogram and Biology in the Management of Acute Coronary Syndrome in Young Patients? About 2 Cases Reports in Sub-Saharan Environment

Introduction: Precordial pain is a common reason for admission in cardiology, and has many causes. Acute myocarditis in its pseudo-infarctoid form is sometimes difficult to differentiate from myocardial infarction. Cardiac magnetic resonance imaging (MRI) helps to differentiate these two disease entities. We report the respective cases of two young patients, one presenting with myocarditis whilst the other with myocardial infarction. Case Report: We present the cases of two patients. The first who had a recent history of febrile syndrome is a 23-year-old who stopped smoking 3 months prior to presentation whilst the second is a 22-year-old professional footballer with a history of stress with no other cardiovascular risk factors. They were respectively admitted in our emergency department for a constrictive, intense chest pain. Physical examination was normal. The chest pain in both patients was associated with elevated cardiac markers, primary repolarisation abnormalities on ECG, wall motion abnormalities as well as left ventricular systolic dysfunction on transthoracic echocardiography. Coronary angiograms were normal in both patients. In the first patient, MRI concluded with an acute myocarditis with apical akinesia extending to the anterior wall, a T2 hypersignal indicative of myocardial edema, and uptake of a nodular heterogeneous contrast without affecting the sub-endocardial layers on the late enhancement sequences. In the second patient, MRI showed an appearance consistent with acute extensive infarction in the antero-apical region with severe hypokinesia and late quasi-transmural enhancement, impairment of the anterior papillary muscle of the mitral valve and a reduced left ventricular ejection fraction at 33%. In addition to analgesics, the first patient was treated with perindopril and bisoprolol, and the second patient received antithrombotic and anticoagulant treatment. There was clinical improvement in both patients. Conclusion: Cardiac MRI is a useful diagnostic tool for the precise diagnosis of precordial pain with elevated cardiac enzymes, especially in young patients.

Bladder Cancer in Young Patients: Management and Outcomes

Background and Objective: Bladder cancer frequently occurs between the ages of 50 years and 70 years and rarely occurs before the age of 40 years. It accounts for 1% - 4% of all cases of cancer. This study focuses on the clinical, etiological, histological, therapeutic, and evolutive profiles of patients with bladder cancer aged less than 45 years. Materials and Methods: This retrospective study was carried out over seven years (from January 2014 to December 2020) on 15 patients below 45 years of age who were being treated for bladder cancer. The diagnosis was made in all patients via cystoscopy and abdominal computerized tomography, while the nature, grade, and degree of infiltration were determined via endoscopic resection and pathology. Results: The mean age of the 15 patients in this study was 34.4 ± 5.19 years. In 86.6% of cases, the patients had macroscopic hematuria as the main presenting complaint. Twelve patients (80%) had bladder tumors that did not infiltrate the muscle. These patients were followed up clinically. In 86.6% of cases, there was a single tumor with a mean diameter of 2.53 cm. In four patients (26.6%), mitomycin was started early. The overall rates of tumor recurrence and progression were 26.6% and 20%, respectively. Conclusion: Bladder cancer also occurs in young people, with similar clinical and epidemiological profiles as exists in elderly patients. The prognosis of bladder cancer in young people depends on the treatment method chosen by the physician.

Treatment options for irreparable postero-superior cuff tears in young patients

Rotator cuff tears(RCTs) occur more commonly with advanced age,with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs.Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population,and the incidence of irreparable RCTs in young patients is still unknown.Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs,such as rotator cuff debridement,partial rotator cuff repair,biceps tenotomy/tenodesis,rotator cuff grafting,latissimus dorsi tendon transfer,and reverse shoulder arthroplasty.After being thoroughly investigated in open surgery,arthroscopic techniques for latissimus dorsi tendon transfer have been recently described.They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.

Evaluation the effect of fertility-preserving surgery on young patients with malignant ovarian tumors

Objection:To evaluate the impact of fertility-preserving surgery and adjuvant chemotherapy on survival and fertility of young patients with ovarian malignant tumors.Methods:Retrospective analysis of 39 patients with ovarian malignant germ cell tumors,23 patients with malignant epithelial tumors and 4 patients with sexual cord mesenchymal tumors receiving conser-vative treatments.Results:Two patients lost follow-up(we do not statistics them).Fifty-nine among 64 patients were alive up to now(92.19%).The overall survival rate for ovarian epithelial malignancies,malignant germ cell tumors and sexual cord mes-enchymal tumors were 95.45%,89.47% and 100% respectively.Fifteen patients received second operation and recurrence was found in 6 patients.Among the 59 surviving patients,53 patients have normal menstruation.Thirteen patients among 20 patients who want to pregnant have 15 pregnancies and 9 successful deliveries.Conclusion:The management of fertility-preserving surgery on patients with ovarian malignant germ cell tumors,whatever the FIGO staging is,is a safe option.For patients with ovarian epithelial carcinomas,fertility-preserving surgery only confined to low-stage(stage I),low-grade(G1),and patients who want keep fertility function seriously.Cisplatinum-based combination chemotherapy is necessary.Standardized chemotherapy has no affection on fertility function.