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目的:分析代谢综合征及其组分与肺癌恶性程度的相关性。方法:收集2017年01月至2019年04月我院收治的285例肺癌患者,根据是否合并代谢综合征,分为单纯肺癌组195例和肺癌合并代谢综合征组90例;根据是否合并心脑血管疾病,将90例代谢综合征合并肺癌患者分为肺癌并代谢综合征伴心脑血管疾病组65例及不合并心脑血管疾病组25例。采用独立样本t检验分析两组患者间的年龄差异;卡方检验分析两组患者性别、吸烟史、病理类型、肿瘤分期的差异;Logistic回归分析代谢综合征各组分与肺癌肿瘤分期的相关性。结果:肺癌合并代谢综合征组患者的肿瘤分期明显高于单纯肺癌组,且存在显著性差异(P<0.05);血压异常(P=0.000)和血脂异常(P=0.042)对于肿瘤分期有显著影响,血糖异常(P=0.429)和体质量指数(P=0.518)对肿瘤分期无显著影响;合并心脑血管疾病者其肿瘤分期较未合并基础疾病者无明显差异(P=0.234)。结论:肺癌伴有代谢综合征者肿瘤恶性程度高,高血压和高血脂是肿瘤分期的危险因素,合并心脑血管疾病者肿瘤分期与未合并者无统计学差异。  相似文献   
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Background: Transarterial chemoembolization (TACE) is one of the locoregional treatments for intermediate-stage hepatocellular carcinoma (HCC). Multidetector computed tomography (MDCT) is a widely used diagnostic tool for HCC. It can also evaluate tumor size, tumor number, and tumor invasion. This study aimed to determine the median survival time in intermediate-stage HCC patients who underwent TACE and to find out  prognostic factors influencing patients’ survival time after TACE. Methods: A computerized search of medical record database in Maharaj Nakorn ChiangMai Hospital from January 2016 to December 2019 revealed 187 intermediate-stage HCC patients who received TACE as the first-line treatment. Results: The median survival time of patients in this study was 9.9 months (95% CI: 8.3-11.6). The patients with aspartate aminotransferase-to-platelet ratio (APRI) less than 0.5 had a significantly better median survival time as compared with patients with APRI ratio more than 0.5; (13.2 months versus 9.9 months, p-value < 0.05). Univariate and multivariate Cox regression analysis demonstrated that tumor number > 7 and tumor size > 5 centimeters (cm) could be considered as independent parameters predicting poor overall survival time in the sufferers (HR 2.64 95%CI 1.68-4.15 and HR 2.38 95%CI 1.32-4.31, respectively). Conclusion: Based on our findings, patients with intermediate-stage HCC who received TACE had a lower median survival time compared to previous studies. However, we identified APRI less than 0.5, tumor size less than 5 cm, and tumor number less than 7 as prognostic factors improving survival time in intermediate-stage HCC patients.  相似文献   
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Background and aimsRuptured hepatocellular carcinoma (rHCC) generally has a very poor prognosis and is currently classified as T4 in the tumor–node–metastasis (TNM) staging system. In this study, we aimed to demonstrate the actual impact of rHCC, as well as the positive effect of hepatectomy in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A rHCC.MethodsWe enrolled 86 patients with rHCC after surgery and 526 patients with non-rHCC after surgery or transcatheter arterial chemoembolization (TACE). Survival curves were plotted using the Kaplan–Meier method to compare the postoperative prognosis of patients with rHCC with that of patients with non-rHCC. Univariate and multivariate Cox regression analyses were used to identify the risk factors affecting patient survival.ResultsBCLC stage 0/A rHCC treated with surgery had a worse prognosis than BCLC stage 0/A non-rHCC treated with surgery (overall survival [OS]: hazard ratio [HR] = 3.12 [2.24–4.34], P < 0.001; recurrence-free survival [RFS]: HR = 2.26 [1.65–3.09], P < 0.001). Rupture was an independent prognostic factor in patients with BCLC stage 0/A rHCC (OS: HR = 1.685 [1.416–2.006], P < 0.001; RFS: HR = 1.484 [1.267–1.737], P < 0.001), and patients with BCLC stage 0/A rHCC who underwent surgery had a comparable prognosis to patients with BCLC stage B HCC who underwent surgery or TACE (OS: P = 0.78).ConclusionsPatients classified as having BCLC stage 0/A rHCC can achieve comparable outcomes to patients with BCLC stage B HCC after hepatectomy. However, not all patients with rHCC should be classified as T4 in the TNM staging system.  相似文献   
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孙静雅 《武警医学》2022,33(10):881-884
 目的 分析新型半导体激光联合康复新液治疗Ⅲ期/C级牙周炎患者的临床效果。方法 选取2021年1-10月在武警特色医学中心口腔颌面科牙周组就诊且诊断为Ⅲ期/C级牙周炎患者60例,常规进行牙周非手术治疗,即行龈上洁治术、龈下刮治术及根面平整。术后采用自体比对,根据牙列的左右相对应分成对照组和试验组。两组均进行康复新液袋内冲洗含漱;试验组在此基础上加入新型半导体激光治疗。比较两组治疗的临床有效率,治疗前与治疗后1、3、6个月的牙周临床指数(牙龈指数、出血指数、探诊深度、附着水平)变化,治疗前及治疗6个月后牙槽骨高度变化。结果 治疗后试验组临床总有效率96.7%,高于对照组的90.0%(P<0.05);两组牙周临床指数均较前有所下降,试验组低于对照组,差异有统计学意义(P<0.05);治疗后6个月,试验组的牙槽骨高度明显增高,对照组前后对比,差异无统计学意义(P>0.05),两组间比较差异有统计学意义(P<0.05)。结论 新型半导体激光联合康复新液辅助治疗Ⅲ期/C级牙周炎患者的临床效果显著,值得推广。  相似文献   
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The nasopharynx has been understudied relative to neighboring anatomical regions. It is a highly complex, integrated space whose function, development, and evolution remains unclear after nearly 5,000 years of study. Historically, most work on the nasopharynx was done with a focus on adjacent structures. It has most often been mentioned in relation to the middle ear (via the Eustachian tube) in ancient texts and has only later been given a designation as one of three portions of a tripartite pharynx among adult humans. As human dissection became practiced more widely in Renaissance Europe, understanding of the nasopharyngeal boundaries improved. With further advancements in the study of nasopharyngeal development, evolution, and anatomical variation from the 19th century up until the present, this region has been shown to be functionally vital and still complicated to define.  相似文献   
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目的 研究圣愈汤加味对进行期寻常型银屑病气血两虚证患者的临床疗效,并探讨其作用机制。方法 134例患者随机分为对照组和观察组,每组67例。对照组口服阿维A胶囊+当归补血丸,观察组口服阿维A胶囊+圣愈汤加味,疗程均为4周。观察两组治疗前后皮损面积与严重程度指数(PASI),皮肤病生活质量指数(DLQI),寻常型银屑病气血两虚证(中医证候)。检测两组血清生长因子[内皮细胞特异性分子-1(ESM-1),转化生长因子-β1(TGF-β1),血管内皮细胞生长因子(VEGF)],血流变学指标[高切血液黏度(HBV),低切血液黏度(LBV),红细胞沉降率(ESR)],血清及皮损处组织液中CC趋化因子受体6(CCR6),CC趋化因子配体20(CCL20), 单核细胞趋化蛋白4(MCP-4)。比较两组临床疗效、随访12个月复发情况,评价两组安全性。结果 研究期间对照组脱落3例,观察组脱落1例。观察组总有效率96.97%(64/66),高于对照组的81.25%(52/64)(χ2=5.064,P<0.05)。随访至少12个月,观察组复发率20.31%(13/64),低于对照组的51.92%(27/52)(χ2=6.038,P<0.05 )。与对照组治疗后比较,观察组PASI,DLQI,中医证候,ESM-1,TGF-β1,VEGF,HBV,LBV,ESR,CCR6,CCL20,MCP-4明显降低(P<0.05)。两组治疗期间均未见明显血、尿常规,心、肝、肾功能异常。观察组治疗期间不良反应发生率3.03%(2/66),低于对照组的26.56%(17/64)(χ2=5.764,P<0.05)。结论 圣愈汤加味可明显改善进行期寻常型银屑病气血两虚证患者的临床症状,复发率和不良反应发生率低。  相似文献   
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目的 研究美国癌症联合委员会(AJCC)第8版Ⅲ期胆囊癌(GBC)亚组分型的临床特征、治疗方式及预后。方法 收集3 485名AJCC第8版Ⅲ期胆囊癌患者的临床资料、随访结果并进行对比。绘制并比较ⅢA和ⅢB,T3N0M0(ⅢA)、T1~2N1M0(ⅢB)和T3N1M0(ⅢB)的Kaplan-Meier生存曲线。单因素和Cox多因素回归分析临床特征、治疗方案、Ⅲ期亚组分型与预后间的关系。结果 ⅢB期胆囊癌患者1年生存率(49.70%)高于ⅢA期(36.41%);T1~2N1M0(ⅢB)期胆囊癌患者1年生存率(65.52%)高于T3N0M0(ⅢA)期(36.41%)和T3N1M0(ⅢB)期(37.05%)。Cox多因素分析,年龄、肿瘤分级、肿瘤大小、手术方式、放疗、化疗、AJCC第8版TNM具体亚组分型和T分期是影响Ⅲ期GBC预后的独立相关因素(P<0.01)。结论 ⅢB期GBC总体生存预后优于ⅢA期;Ⅲ期GBC死亡风险:T1~2N1M0(ⅢB)相似文献   
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BackgroundThe low prevalence of peritoneal dialysis (PD) (9%) vs. hemodialysis (HD) (88.2%) is partly due to patient dropout from therapy.MethodsThis retrospective study identified patients who withdrew from PD between 2016 and 2018 in our program. We evaluated all other factors as controllable losses. Analysis included time on therapy at dropout (very early, early or late) and method of initiation (HD to PD conversion, unplanned PD, or planned start).ResultsEighty-three patients enrolled into our PD program. 27 dropped out; 24 were due to controllable factors, 3 due to death, with a median age at dropout of 52 years old. We determined psychosocial factors (PF) to be the largest controllable factor influencing dropout; contributing a 63% rate among all controllable factors. When considering time until dropout, 100% of very early dropout patients and 50% of late dropout patients did so due to PF. Among early dropout patients 67% dropped out due to other medical reasons. The mean time to dropout for PF, other, and infection (INF) were 13, 26, and 33 months, respectively. When considering type of initiation, we found PF to be the largest attributable factor with 50% of unplanned, 100% of planned, and 50% of conversions stopping therapy.ConclusionsOur study indicates that the primary reason for controllable loss from therapy was secondary to PF regardless of the time on therapy or the method of initiation to therapy.  相似文献   
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