Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

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.

Reduced delay in diagnosis of odontogenic keratocysts with malignant transformation:A case report

BACKGROUND In rare cases,odontogenic keratocysts(ODs)transform into squamous cell carcinoma.Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years.In this article,we report a case of malignancy derived from OD with a five-day delay in diagnosis.CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan,China with complaints of moderate pain,recurrent swelling,and pus discharge around her left maxillary lateral incisor for over 10 years.Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck.Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar.The patient was clinically diagnosed with OD.Enucleation rather than marsupialization was performed given the risk factors of long history,recent aggravated pain,and massive bony destruction.Malignant transformation of OD was confirmed by pathologists 3 d after the operation.Radical surgery was performed,and lymph node metastasis was observed.The patient was subjected to postoperative radiotherapy and synchronous chemotherapy,and no local recurrence or distant metastasis was noted at one-year follow-up.CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD,especially when patients present with a long history,massive cyst,chronic inflammation,recent persistent infections,aggravated pain,numbness around the cystic lesion,and lymph node enlargement.

Advances in Diagnosis and Treatment of Neuropsychiatric Systemic Lupus Erythematosus

1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone to concurrent,so early diagnosis and treatment of NPSLE is extremely important.

Value of autofluorescence bronchoscope in diagnosis of central type lung cancer

Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010,29 patients (23 men,6 women,median age 62. 2 years,range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea,1 at

Echocardiography in Diagnosis and Prevention of the Coronary Artery Lesions in Kawasaki Disease

Kawasaki disease (muco-cutaneous lymph node syndrome, MCLS) was first reported by Kawasaki in 1967. It was characteried by nonvascular polymorphous rash, fever, ulcer in oral mucosa, edema of hands of feet, cervix lymphadenopathy and desquamations in peripheral extremities. Because of unknown pathogens, no lab examination was available as a single easily recognized diagnostic marker; the diagnosis is

CLINICAL VALUE OF URINARY AND SERUM PSEUDOURIDINE IN DIAGNOSIS AND MONITORING OF PRIMARY LIVER CANCER

Urinary and serum pseudouridine concentrations were determined by high-performance liquid chromatography in 80 patients with primary liver cancer, 32 with benign space occupying lesions of the liver, 42 with liver cirrhosis and 40 healthy subjects. Their mean urinary and serum pseudouridine levels were 39.2=11.5 nmol / /μmol creatinine and 3.4 ± 1.3 μmol / L, 24.5 = 5.4 nmol / μmol creatinine and 2.5 = 0.5 μmol / L, 22.8 ± 7.8 nmol / μmol creatinine and 2.3 = 0.4 μmol / L, 26.4 ± 4.6 nmol / μmol creatinine and 2.3 = 0.4 μmol / L, respectively. Exceeding the mean plus 2SD of pseudouridine of healthy control was considered as positive value for the diagnosis of primary liver cancer. Thus the positivity of urinary and serum pseudouridine in hepatoma was 71.3% and 70.0%, respectively. The positive rate of combined pseudouridine and alpha-fetoprotein assay was 91.3% in patients with hepatoma. Besides, pseudouridine levels could elevate before positive localization and reduce to normal levels after tumor resection. The results showed that the determination of pseudouridine is of clinical significance in the diagnosis and monitoring of primary liver cancer.

VALUE OF POLYMERASE CHAIN REACTION ASSAY IN DIAGNOSIS OF INTESTINAL TUBERCULOSIS AND DIFFERENTIATION FROM CROHN'S DISEASE

It is difficult to make a precise diagnosis of intestinal tuberculosis and to differentiate it from Crohn's disease. For evaluating Polymerase Chain Reaction (PCR) assay in these two aspects, 36 specimens of intestinal tuberculosis from surgical resections and endoscopic biopsies and 26 Crohn's disease samples were subjected to PCR assay. 21 specimens of normal colon tissue surrounding cancer were used as the control. Oligonucleotides derived from the IS 6110 sequence, which is repeated in M. tuberculosis chromosome and highly specific for the M. tuberculosis complex, were used as a primer. The amplified PCR products were detected by examination of ethidium-bromide-stained polyacrylamide gels. The specificity of PCR products was confirmed by digestion with Sal 1 restrictive endonuclease and southern blot hybridization using digoxigenin-labeled probe. The results showed that the M. tuberculosis DNA was identified in 27 / 36 intestinal tuberculosis, but none of 26 Crohn's disease. Acid fast bacilli were only found in 16 / 36 intestinal tuberculosis. In conclusion, as a rapid, sensitive, and specific pathogenic method in diagnosis of intestinal tuberculosis, PCR assay has been developed in this study, and is considered valuable in the differentiation between intestinal tuberculosis and Crohn's disease.

Value of magnifying endoscopy with narrow-band imaging in diagnosis of 124 early gastric neoplastic lesions

Objective To investigate the value of intervening part(IP)ratio under magnifying endoscopy with narrowband imaging(ME-NBI)in the diagnosis of early gastric neoplastic lesions.Methods From September 2012 to May 2015,a total of 124 patients with suspected superficial gastric neoplastic lesions under white light endoscope(WLI)were enrolled,87 male with mean age of(63.

Consultation, Diagnosis and Treatment Delays for Breast Cancer among Patients Followed up at the YaoundéGeneral Hospital, Cameroon

Introduction: Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. Materials and Methods: This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the initial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). Results: The delays (median, IIQ) were: (5.1 months;IIQ: 1.7 - 12.4), (25 days;IIQ: 10 - 67), (27 days;IIQ: 13 - 63), (2.2 months;IIQ: 1.2 - 5.8) and (9.9 months;IIQ: 4.4 - 17.6) respectively for consultation, diagnosis, treatment, health system and overall delays. The risks associated with a delay in initial consultation of greater than 3 months were (OR;95% CI): unschooled patients (2.01;1.66 - 2.40);monthly income below the minimum wage (2.70;1.81 - 5.96);unemployment (2.14;1.02 - 3.24) and absence of a family history of cancer (2.44;1.66 - 6.10). The main reasons for a late first consultation were: ignorance (60.2%), financial challenges (17.6%) and a preference for alternative treatment (11.1%). Conclusion: The consultation, diagnosis and treatment delays for breast cancer are very often long in our setting than those reported in developed countries. Both patients’ and institutional factors are demonstrated. There is a need to increase public awareness on the value of early diagnosis of breast cancer. Also, health system should be improved to enable early diagnosis and treatment of this affection.

Impact of time to diagnosis on the occurrence of cardiogenic shock in MIS‑C post‑COVID-19 infection

Background In multisystem inflammatory syndrome in children(MIS-C),diagnostic delay could be associated with severity.This study aims to measure the time to diagnosis in MIS-C,assess its impact on the occurrence of cardiogenic shock,and specify its determinants.Methods A single-center prospective cohort observational study was conducted between May 2020 and July 2022 at a tertiary care hospital.Children meeting the World Health Organization MIS-C criteria were included.A long time to diagnosis was defined as six days or more.Data on time to diagnosis were collected by two independent physicians.The primary outcome was the occurrence of cardiogenic shock.Logistic regression and receiver operating characteristic curve analysis were used for outcomes,and a Cox proportional hazards model was used for determinants.Results Totally 60 children were assessed for inclusion,and 31 were finally analyzed[52%males,median age 8.8(5.7-10.7)years].The median time to diagnosis was 5.3(4.2-6.2)days.In univariable analysis,age above the median,time to diagnosis,high C-reactive protein,and high N-terminal pro-B-type natriuretic peptide(NT-proBNP)were associated with cardiogenic shock[odds ratio(OR)6.13(1.02-36.9),2.79(1.15-6.74),2.08(1.05-4.12),and 1.70(1.04-2.78),respectively].In multivariable analysis,time to diagnosis≥6 days was associated with cardiogenic shock[adjusted OR(aOR)21.2(1.98-227)].Time to diagnosis≥6 days had a sensitivity of 89% and a specificity of 77% in predicting cardiogenic shock;the addition of age>8 years and NT-proBNP at diagnosis≥11,254 ng/L increased the specificity to 91%.Independent determinants of short time to diagnosis were age<8.8 years[aHR 0.34(0.13-0.88)],short distance to tertiary care hospital[aHR 0.27(0.08-0.92)],and the late period of the COVID-19 pandemic[aHR 2.48(1.05-5.85)].Conclusions Time to diagnosis≥6 days was independently associated with cardiogenic shock in MIS-C.Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity,especially in older children.