Search

支气管类癌的诊断与治疗

目的　探讨支气管类癌的临床特点、病理特征、诊疗和预后。　方法　分析首都医科大学附属北京友谊医院1999年1月至2012年1月治疗12例支气管类癌（bronchial carcinoid） 患者的临床资料，其中男7例，女5例；年龄33～69 （49.3±12.4） 岁。主诉为咳嗽、咳痰4例，胸痛3例，痰中带血1例，刺激性干咳1例，另外3例系体检发现；病灶位于右肺7例，左肺5例；中心型病变7例，周围型病变5例。12例中肺叶切除术10例，全肺切除术2例。　结果　全组患者无严重手术并发症，无围手术期死亡。术后免疫组织化学确诊典型类癌8例，不典型类癌4例；12例中8例获得有效随访，随访时间1～76个月，其中典型类癌患者5例，均生存；不典型类癌3例，2例生存，1例死于远处转移。　结论　支气管类癌行支气管镜检查半数可见肿物多隆起于支气管表面，边界清楚、表面光滑，行正电子发射断层扫描（PET）可见病灶处放射性浓聚；术后行免疫组织化学检查可确诊；手术切除可获长期生存，预后主要与病理类型、有无远处转移等有关。

Ⅰ型神经纤维瘤病合并腹腔恶性外周神经鞘瘤一例

纵隔巨大脂肪瘤一例

循证医学与知识转化

循证医学研究的结论日益增多，如何对其结论进行综合利用是研究者面临的问题。知识转化是指知识在研究者和用户构成的一个相互作用的复杂系统内，进行交换、合成和合乎伦理的应用，通过改善健康、改进服务、提高产品质量以及加强卫生保健系统来加速各方从研究中获益的过程。循证医学与知识转化关系紧密，现对其进行简要阐述。

清热化痰法治疗慢性阻塞性肺疾病急性加重期的研究进展

慢性阻塞性肺疾病（COPD）是临床多发病，急性加重期的有效防控是疾病预后的关键所在。中医对COPD有较好的治疗效果，其中清热化痰法是主要的治疗方法，现就清热化痰法近年在COPD的治疗研究作一综述。

Clinical research progress on brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide

Brain natriuretic peptide (BNP) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were the main members of the natriuretic peptide family. BNP has the effects of diuretic sodium, reducing sympathetic nervous system activity, dilating blood vessels, and improving the pathological remodeling of heart. Plasma BNP/NT-proBNP levels have been widely used in the diagnosis, severity assessment, prognosis prediction and treatment guidance of heart failure. In recent years, BNP/NT-proBNP has become a research hotspot in the diagnosis and and prognosis judgment of atrial fibrillation, recurrence of atrial fibrillation after radiofrequency ablation and cardioversion and congenital heart disease in infants and children, prediction of postoperative complications, and drug development. This article reviews the latest advances in clinical application and research progress on BNP/NT-proBNP.

巨淋巴结增生症的临床特点及外科治疗

目的　探讨巨淋巴结增生症（castleman’s disease，CD）的临床特点及外科治疗方法。 方法 分析2005年10月至2010年3月首都医科大学附属北京友谊医院收治9例巨淋巴结增生症患者的临床资料，其中男7例、女2例，平均年龄51.8岁。出现临床症状2例，包括咳嗽、胸闷、发热、乏力、盗汗等，其他为体检发现。9例患者术前均行胸部X线片、胸部CT、单光子发射计算机断层成像术（SPECT） 和腹部B超检查。接受手术切除治疗。 结果　在临床分型中，单中心型CD 5例，多中心型CD 4例；病理分型中，透明血管型6例，浆细胞型1例，混合型2例。由于瘤体血供丰富，术中出血较多，平均出血量514.4 ml，最多2 500 ml。5例单中心型CD患者均生存，无复发；多中心型CD 4例，随访3～5年，4例均生存，其中2例分别于术后1年、3年后复发，再次行手术切除，术后病理结果与第1次手术相同。 结论　CD的诊断主要依靠影像及病理学，而最后确诊还应以病理学为准。无论哪种类型的CD外科切除均为有效的治疗方法，单中心型CD手术切除病变可达到彻底治愈的目的，而多中心型CD手术切除后仍有复发可能，应适当联合化疗、放疗等其他治疗手段。

乙醛脱氢酶1与肿瘤干细胞相关性研究

【摘要】　乙醛脱氢酶（acetaldehyde dehydrogenase，ALDH）广泛存在于不同组织中，是一类具有高度氧化活性的胞浆酶类。随着肿瘤干细胞理论的提出，ALHD1被发现为多种肿瘤干细胞的表面标志，在肿瘤的诊断、治疗、判断预后等方面发挥一定作用。现就ALDH1在不同肿瘤的具体作用及在放化疗耐药方面的机制作一综述。

Advances in anticoagulant therapy for hepatocirrhosis with portal vein thrombosis

ObjectiveTo summarize the occurrence and development of hepatocirrhosis complicated with portal vein thrombosis (PVT), and summarize the status and prospect of anticoagulant treatment.MethodThe literatures and guidelines on the treatment of hepatocirrhosis complicated with PVT were collected and reviewed.ResultsPVT was one of the most common complications in patients with hepatocirrhosis. Its pathogenesis was complicated, and the coagulation function of patients with hepatocirrhosis was poor. In addition, patients with severe complications such as esophageal and gastric varicose bleeding (EVB) were often complicated. According to the current study, the formation of PVT was mainly related to the coagulation mechanism of patients, hemorheology changes of blood vessels, and their own factors. Treatment methods included drug therapy, interventional therapy, and surgical treatment. However, there was still controversy on anticoagulant therapy for hepatocirrhosis with PVT, and there was no complete consensus on anticoagulant indications, drug selection, course of treatment, and safety monitoring.ConclusionPVT should be treated with anticoagulant therapy under certain indications, but to ensure its safety and effectiveness, prospective large sample randomized controlled trials are still needed.

Risk analysis of myocarditis induced by immune checkpoint inhibitors: a real-world study based on the open FDA database

ObjectiveTo investigate the risk of myocarditis caused by immune checkpoint inhibitors (ICI). MethodsThe adverse reaction (ADR) reports on myocarditis caused by atelizumab, duvalizumab, pabolizumab, and navulizumab were downloaded from the FDA Adverse Event Reporting System (FAERS) from January 1, 2014 to September 30, 2022. The relevant analysis was conducted on the gender, age, medication dosage, and occurrence time of ICI related myocarditis patients. ResultsA total of 1 892 reports of myocarditis induced by ICI were included. The proportion of myocarditis caused by ICI was higher in males than in females (1.9∶1). The incidence of myocarditis in patients with basic diseases such as diabetes and heart disease, and in the age group 65-75 was relatively high. The incidence of myocarditis caused by navulizumab was high within 30 days with the use of conventional doses, and that of the other three drugs were high within 31 to 90 days. And the incidence of myocarditis is higher when used in combination than when used alone. ConclusionDifferent varieties of ICI can lead to the occurrence of myocarditis, and male, elderly, underlying diseases, and combination therapy may be risk factors for myocarditis caused by ICI.