Esophageal cancer is a common gastrointestinal cancer,and the incidence in China is the highest in the world. Esophagectomy represents the gold standard for patients with resectable esophageal cancer,but postoperative morbidity and mortality rates remain high. In recent years,there have been many reports on the pathogenesis of morbidity and mortality after esophagectomy without reaching any concrete conclusion. This review focuses on the pathogenesis,prophylaxis and therapeuticsof pulmonary infection after esophageal cancer resection.
The bone marrow mononuclear cell(BMMNC) subset comprises mesenchymal stem cells, hematopoietic stem cells, endothelial progenitor cells. These cells can differentiate into cardiomyocytes, vascular endothelial cells and smooth muscle cells, and they can also release a wide array of cytokines that exert their effects on surrounding cells, including inducing neovascularization, preventing apoptosis of home cells and homing of endogenous systemic repairing cells. Many trials have been developed to evaluate the effect of bone marrow mononuclear cell transplantation in treating ischemia heart diseases in this country and others. Several routes have been used to deliver these cells to human myocardium or to the coronary circulation in these trials, such as intracoronary injection, intravenous infusion, direct injection into the ventricular wall, or transepicardial/transendocardial infusions,and the cells are constructed into fragmented cell sheets to improve cell retention, or some cytokines are used to enhance therapeutic effect. Although the results of the recent clinical trials in this area are rather conflicting, these therapeutic approaches seem to be promising forthe treatment of ischemic heart disease. In this review, many aspects of bone marrow mononuclear cell transplantation in myocardial infarction are summarized such as the mechanism, delivery routes, retaining of cells, homing, survival and future development, etc.
目的探讨继发性阴茎癌的临床特点及诊治方法。方法 回顾性分析成都军区总医院全军普外中心收治的1例直肠癌术后36个月发生阴茎转移患者的临床资料,并结合国内、外46例文献报道的资料(1988~2010年),对其发病情况、临床表现、转移途径、诊断、治疗和预后进行总结。 结果阴茎转移癌以泌尿系来源最多见(51.05%),其次为消化系统来源(36.17%); 多发生在原发肿瘤术后5~18个月,部分表现为首发症状; 转移灶多位于阴茎体部或根部(87.23%),多表现于单发结节(48.94%),部分为多发结节(29.97%); 25.53%伴有异常阴茎勃起; 常伴有其他部位转移(55.32%)。对单纯继发性阴茎癌不伴其他脏器转移者行部分或全部阴茎切除,术后辅以放疗、化疗和内分泌治疗能够提高治疗效果,延长生存期; 非手术治疗的患者,多因其他部位转移不能手术,绝大多数生存期在1年内。结论对阴茎出现单个或多个结节或伴有异常勃起的肿瘤患者,要考虑阴茎继发性转移的可能; 活检可明确诊断; 手术切除、辅以放化疗及内分泌治疗可延长患者的生存期。
目的 探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)后新发椎体骨折的发生率及危险因素。 方法 回顾分析2004年1月-2009年1月行经PVP治疗的80例骨质疏松伴椎体压缩骨折的患者的临床资料,随访7~54个月,了解患者的疗效和预后。 结果 术后80例中14例(17.5%)30个椎体新发椎体骨折,其中相邻椎体占46.7%(14/30)。有无新发椎体骨折两组间及相邻和非相邻椎体骨折两组间,体重指数(body mass index,BMI)比较差异均统计学意义(Plt;0.05),而年龄、性别、骨折椎体个数、PVP手术椎体个数、骨水泥注射剂量、身高下降比较差异无统计学意义(Pgt;0.05)。经logistic回归分析发现低体重指数(BMI≤18.5 kg/m2)是PVP术后新发椎体骨折的独立危险因素。术后患者均给予抗骨质疏松药物治疗,58.8%(47/80)的患者能坚持抗骨质疏松药物治疗1年以上。采用KaplanMeier法计算术后第1年新发椎体压缩骨折的发生率为8.6%。低新发椎体骨折发生率与患者术后坚持抗骨质疏松治疗相关。 结论 低体重指数是PVP术后新发椎体骨折的独立危险因素,与PVP手术本身无关。术后坚持抗骨质疏松药物治疗能够降低新发椎体骨折的发生。
Objective To explore the clinical efficacy of levetiracetam (LEV) in preventing recurrence of complex febrile seizures. Methods 100 children with complex febrile seizures who visited Wuxi Children's Hospital from January 2017 to January 2020 were randomly divided into two groups, observation group (n=50, treated with oral LEV), including 28 males and 22 females, with an average age of (1.57±0.42) years; control group (n=50, treated with oral diazepam), including 26 males and 24 females, with an average age of (1.58±0.39) years. The incidence of adverse reactions, the recurrence rate, EEG changes and neural development after the treatment in both groups were observed. Results After treatment, the incidence of adverse reactions in the observation group was 4.00%, which was significantly lower (P<0.05) than that in the control group (18%). The recurrence rate of the observation group was 2.00%, which was significantly lower (P<0.05) than that in the control group (14%). The incidence of abnormal EEG in the two groups after treatment was lower than that before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). The results of neurodevelopmental assessment in both two groups were in the normal range before and after treatment, and there was no significant change (P>0.05). Conclusions LEV is effective in the treatment and prevention of complex febrile seizures recurrence, with high safety, less adverse reactions and improved prognosis.