根治术后病理T3期或切缘阳性前列腺癌的辅助放疗的系统综述和荟萃分析

研究背景:前列腺癌是西方国家男性最常见的非皮肤来源恶性肿瘤,病死率排第二位.根治性前列腺切除(RP)是临床局限性前列腺癌标准的外科治疗手段.     

Hormone therapy and cardiovascular disease – still much to be learnt

Results from the recent randomized clinical trials indicating that hormone therapy (HT) does not provide cardiovascular protection, but potential harm, are in profound disagreement with the sound evidence from numerous observational and experimental studies. While the observational studies have mainly assessed symptomatic recently menopausal women, the randomized trials have studied symptomless elderly postmenopausal women with established coronary heart disease or various risk factors for cardiovascular disease. Thus, the recent trials have revealed only that HT does not provide secondary cardiovascular benefits. Since primary cardiovascular benefits of HT are rational but not yet proven in clinical trials, new studies are in demand. Until more data from recently menopausal symptomatic women are available, we need to base our decisions on existing evidence and good clinical practice. Although the potential of HT to provide cardiovascular benefits is decreased by advancing age and time since menopause, this should not preclude the use of individualized HT in younger postmenopausal women.     

Primary and revision lumbar discectomy: A three-year review from one center

Background:

Despite variations in technique, the results of primary and revision lumbar discectomy have been good. The aim of this study was to retrospectively review cases of primary and revision lumbar discectomy performed in our institute over a three-year period.

Materials and Methods:

The case records of 273 patients who underwent lumbar discectomy between January 2001-2004 and fulfilled our inclusion and exclusion criteria were reviewed. Of these, 259 were primary discectomies and 14 were revision surgeries. Recurrence was defined as ipsilateral disc herniation at the previously operated level. Demographic parameters, magnetic resonance imaging of the disc, patient satisfaction and rate of recurrence were analyzed.

Results:

The primary surgery group had 52 (20.08%) contained and 207 (79.92%) extruded or sequestered discs, while the numbers in the revision group were three (21.43%) and 11 (78.57%) respectively. “Satisfactory” outcome was noted in 96.5% of the primary surgeries, with a recurrence rate of 3.5%. In the revision group 78.6% had “satisfactory” outcome. In 9.4% of the primary group we encountered complications, while it was 21.43% in the revision group.

Conclusions:

Lumbar discectomy is a safe, simple and effective procedure with satisfactory outcome in 96.5% of primary disc surgery and 78.6% of revision disc surgery.