宫颈癌患者术后下肢淋巴水肿发生状况及危险因素分析

目的分析宫颈癌患者术后下肢淋巴水肿发生情况及相关危险因素。方法应用妇科癌症淋巴水肿问卷电话调查492例手术治疗的宫颈癌患者下肢淋巴水肿发生情况,并分析术后下肢淋巴水肿的危险因素。结果宫颈癌患者术后下肢淋巴水肿发生率为20.93%,严重程度以Ⅰ度为主(占86.41%),中位发生时间为5.5个月。logistic回归分析表明,年龄、淋巴结清扫数目、术后辅助放疗、持续站立时间是术后下肢淋巴水肿发生的危险因素,规律运动锻炼是其保护因素(P0.05,P0.01)。243例术后联合放疗患者下肢淋巴水肿发生的危险因素为淋巴结清扫数目20枚及术后放疗开始时间45d(P0.05,P0.01)。结论下肢淋巴水肿是宫颈癌术后常见的并发症,年龄大、淋巴结清扫数目多、辅助放疗、长时间站立的患者是下肢淋巴水肿发生的高危人群。医护人员应做好高危人群筛查,及时给予健康教育,并积极探寻有效的预防干预措施,降低术后下肢淋巴水肿的发生率。     

Efficacy and safety of tacrolimus versus corticosteroid as initial monotherapy in adult-onset minimal change disease: a meta-analysis

Objective

The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus corticosteroid as initial monotherapy in adult-onset minimal change disease (MCD) patients.

Methods

Databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from the inception to March 20, 2021. Eligible studies comparing TAC monotherapy and corticosteroid as initial monotherapy for adult-onset MCD patients were included. Data were analyzed using Review Manager Version 5.3.

Results

Four randomized controlled trials (RCTs) involving 196 patients were included in the meta-analysis. For initial monotherapy for adult-onset MCD, TAC and corticosteroid had similar complete remission (OR 1.06, 95% CI 0.47–2.41, P?=?0.89), total remission (OR 1.30, 95% CI 0.39–4.35, P?=?0.67), relapse rate (OR 0.63, 95% CI 0.28–1.42, P?=?0.26). Main drug-related adverse effects of two therapeutic regimens had no difference concerning infection (OR 0.54, 95% CI 0.23–1.27, P?=?0.15), glucose intolerance (OR 0.55, 95% CI 0.16–1.84, P?=?0.33) and acute renal failure (OR 1.37, 95% CI 0.36–7.31, P?=?0.71).

Conclusion

TAC monotherapy is comparable with corticosteroid monotherapy in initial therapy of MCD. To further confirm the conclusion, more large multicenter RCTs are necessary.

     

Effective connectivity decreases in specific brain networks with postparalysis facial synkinesis: a dynamic causal modeling study

Brain Imaging and Behavior - Currently, the treatments for postparalysis facial synkinesis are still inadequate. However, neuroimaging mechanistic studies are very limited and blurred. Instead of...     

Reciprocal modulation between cigarette smoking and internet gaming disorder on participation coefficient within functional brain networks

Brain Imaging and Behavior - Many reports indicated that cigarette smoking was associated with internet gaming disorder (IGD). However, the underlying mechanism of comorbidity between smoking and...     

Comparative evaluation of low-level light therapy and ethinyl estradiol and desogestrel combined oral contraceptive for clinical efficacy and regulation of serum biochemical parameters in primary dysmenorrhoea: a prospective randomised multicentre trial

Lasers in Medical Science - We aimed to compare low-level light therapy with oral contraceptive pills for pain relief and serum levels of nitric oxide and prostaglandin E2 in patients with primary...     

Association of histological subtype with risk of recurrence in craniopharyngioma patients: a systematic review and meta-analysis

It is controversial whether there is a different risk of recurrence between two histological subtypes in craniopharyngioma (CP) patients. Some reported that adamantinomatous craniopharyngioma (ACP) had a higher risk of recurrence than papillary craniopharyngioma (PCP), but others reported that there is no significant difference between them. So, we conducted this systematic review and meta-analysis to determine the association between the histological subtype of CP and the rate of recurrence. A comprehensive literature search was undertaken in PubMed, EMBASE, and Web of Science for all English articles published up to November 2020. Recurrence data stratified by ACP and PCP were extracted from studies meeting inclusion criteria. A pooled analysis of the association between the histological subtype of craniopharyngioma and rates of recurrence was performed. Thirteen articles containing 974 patients were included. When stratified by two pathological subtypes, the total recurrence rate of ACP was 26.0% and PCP was 14.1%, which showed ACP associated with a higher risk of tumor recurrence than PCP (odds ratio [OR]?=?2.12, 95% confidence interval [CI]?=?1.36, 3.30, P?=?0.00). This is the first meta-analysis focusing on histological subtypes of CP. PCP associates with a lower risk of recurrence than ACP, indicating that ACP could act as one of recurrence risk factors for CP patients. Nevertheless, large sample size and well-designed multicenter studies in which the other clinical variables are controlled to determine the histological subtype of CP as an independent recurrence risk factor are needed.

     

Microwave ablation combined with doxorubicin enhances cell death via promoting reactive oxygen species generation in breast cancer cells

Purpose

To evaluate the mechanism for enhancing cell death induced by microwave ablation (MWA) combined with doxorubicin treatment in breast cancer cells.