HER-2阴性乳腺癌合并腋窝淋巴结转移新辅助化疗肿瘤退缩模式的影响因素

目的 了解人表皮生长因子受体-2（HER-2）阴性乳腺癌合并腋窝淋巴结转移的肿瘤退缩模式并分析其影响因素。方法 回顾性分析青岛大学医学院附属医院乳腺病诊疗中心2017年7月—2021年7月诊治的129例HER2阴性乳腺癌合并腋窝淋巴结转移病例,分析肿瘤退缩模式的影响因素。单因素、多因素分析分别采用χ2检验、二元回归分析。结果 HER2阴性、腋窝淋巴结转移乳腺癌,向心性退缩占62.02%,非向心性退缩占37.98%。单因素和多因素分析均显示,肿瘤分期与退缩模式差异有统计学意义(P＜0.05) 。结论 原发肿瘤越大、浸润程度越深,非向心性退缩可能性越大。临床中对于cT4的原发肿瘤,新辅助治疗后选择保乳手术应慎重     

A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia

BackgroundTransurethral split of the prostate (TUSP) is effective in treating benign prostatic hyperplasia (BPH). However, there is still a lack of research focusing on the optimal target population for TUSP. This study aimed to compare the efficacy of TUSP in patients with different prostate volumes or ages.MethodsThe study was a multicenter retrospective study. The outcomes of TUSP in BPH patients with different prostate volumes or different ages were compared. A total of 439 patients were included in the study. Patients were divided into two groups according to prostate volume, with a cut-off value of 50 mL. Similarly, the cut-off value for the age groups was 70 years. Baseline patient characteristics and perioperative outcomes were recorded. Follow-up was performed at 1, 6, and 12 months after surgery.ResultsThe mean age of the patients was 73.4 years, and the mean prostate volume was 51.2 mL. At 12-month follow-up after TUSP treatment, the patients’ International Prostate Symptom Scores (IPSS), quality of life (QoL) scores, and postvoid residual (PVR) volumes decreased significantly, while peak urinary flow rate (Qmax) increased significantly. Intraoperative hemoglobin (Hb) reduction was significantly lower in the small volume group than in the large volume group. The incidence of postoperative urinary urgency and transient incontinence was lower in the small volume group. IPSS score, PVR, and Qmax in the small volume group showed more remarkable changes at several time points compared to the preoperative period. Postoperative pain scores were higher in the small volume group than in the large volume group. There were no differences between the two groups in terms of long-term complications. The younger group showed greater variation in PVR and Qmax at some time points but less variation in QoL than the older group.ConclusionsTUSP is overall safe and effective in treating BPH. This study showed differences in the outcomes of TUSP in treating different prostate volumes or ages of BPH patients. The optimal surgical approach for BPH patients might be selected clinically based on a combination of prostate volume or patient age.     

Computed tomography and clinical parameters predict intracerebral hemorrhage expansion

This study aimed to evaluate the association of imaging signs, and to establish a predictive model through selecting highly relevant imaging signs in combination with clinical parameters for hematoma expansion.Intracerebral Hemorrhage (ICH) patients who received 2 consecutive noncontrast computed tomography scans were examined and recruited through January 2014 to December 2020. Demographic information and clinical characteristics were collected. Two experienced radiologists reviewed baseline noncontrast computed tomography images to assess the imaging characteristics. Correlation analysis was analyzed with Pearson and Spearman correlation tests. The association between clinical and imaging predictors with hematoma expansion was evaluated in multivariate models. Receiver operating characteristic (ROC) curve analysis was adopted to evaluate predictive performance.A total of 232 ICH patients, with mean age of 59.73 years, and 31% of female were included, among which, 32 patients occurred with hematoma expansion. For sex, ICH density, low density in hematoma, the midline shift, and Glasgow Coma Scale score, liquid level, H-tra, edema Cor, H Volume, time from onset to examination, there were significant differences between the 2 groups. As for imaging signs, only blend sign showed a significant difference, that patients with blend sign had a higher incidence of ICH expansion. The logistic analysis found that radiation attenuation, liquid level, the midline shift, Glasgow Coma Scale score, history of ischemic stroke, and smoking could predict the occurrence of ICH expansion.In summary, the model combined radiological characteristics with clinical indicators showed considerable predictive performance. Further validation is needed to verify the findings and help transfer to clinical practice.     

Successful treatment of pancreatic schwannoma by enucleation: A case report

Rationale:Pancreatic schwannomas are extremely rare and are difficult to diagnose preoperatively. Over the past 50 years, only 96 cases of pancreatic schwannoma have been reported in English literature. Herein, we report a case of pancreatic schwannoma treated with enucleation.Patient concerns:A 66-year-old woman visited a local hospital due to ventosities. Ultrasonography and computed tomography revealed a pancreatic mass. She visited our hospital for further diagnosis and treatment.Diagnosis and interventions:Magnetic resonance imaging revealed a tumor in the pancreatic body, and a solid pseudopapillary tumor was considered preoperatively. During the surgery, a pancreatic mass was found growing in the pancreatic body and tail. A successful tumor enucleation was performed. The mass was 7 × 6 × 3 cm in size with a thin capsule. Pathological examination revealed that the tumor was mainly composed of spindle-shaped cells with a palisading arrangement and no atypia. Both hypercellular and hypocellular areas were visible. Immunohistochemical staining showed that protein S-100 was strongly positive. The tumor was diagnosed as a benign schwannoma originating from the pancreatic body and tail.Outcomes:Postoperatively, the patient showed good recovery. During the 24-month follow-up period, the patient remained well and free of complications.Lessons:Pancreatic schwannomas are extremely rare and difficult to diagnose using imaging examinations. Enucleation is a safe and efficacious treatment for exophytic pancreatic schwannomas.     

口袋书联合歌诀教学法提高规培护士耳穴定位能力的研究

目的 探讨口袋书联合耳穴歌诀教学法对提高规培护士基础耳穴定位能力的效果,为临床提供一种新的教学方法.方法 采用前后对照研究方法,选取本院60名来源于省内外某3所西医护理学院毕业需要的规培护士,2018年入职的30名规培护士为对照组,2019年入职的30名规培护士为试验组.对照组采用常规教学方法,试验组在对照组基础上采用...     

糖尿病患者益处发现的研究进展

从益处发现的概念、测量工具、影响因素以及提高糖尿病患者益处发现的策略等方面进行综述,旨在为临床护理工作中提高糖尿病患者益处发现水平提供参考。     

超声造影与增强螺旋CT评估原发性肝癌非手术治疗的对比研究

目的:探讨超声造影在原发性肝癌非手术治疗评估中的价值.方法:对56例(64个病灶)经超声引导穿刺活检病理确诊的原发性肝癌患者进行非手术治疗.治疗后分别行超声造影和增强螺旋CT检查,以判断肿瘤的灭活程度,并对其判别能力进行比较.结果:超声造影发现46个病灶没有增强(46/64),18个病灶有部分增强(18/64).增强螺旋CT发现48个病灶没有增强(48/64),16个病灶有部分增强(16/64).与临床追踪结果比较,超声造影和增强螺旋CT对非手术治疗疗效判定的敏感性、特异性及准确率分别为94.4%,97.8%,96.9%和83.3%,97.8%,93.8%,差异有统计学意义(P＞0.05).结论:超声造影是判定非手术治疗原发性肝癌效果的一种敏感而有效的方法.对肝动脉插管栓塞化疗(TACE)疗效评估及少数血供不是特别丰富的病灶,超声造影具有较增强螺旋CT更重要的临床价值.     

一期前路病灶清除后路椎弓根螺钉内固定治疗胸腰椎结核

[目的]探讨一期前路病灶清除、钛网植骨、后路经椎弓根螺钉内固定治疗胸腰椎结核的临床疗效.[方法]自2002年1月至2006年6月收治46例胸腰椎结核患者,采用一期前路病灶清除、钛网植骨、后路经椎弓根螺钉内固定.根据术前、术后X线片分析植骨融合情况以及脊柱后凸畸形矫正的效果.[结果]本组46例均获得随访,随访时间1～3年,平均26个月.术后内固定无松动,植骨愈合,病灶无复发;愈合时间3～7个月;术前Cobb角平均35°,末次X线片随访复查Cobb角平均16.5°.[结论]一期前路病灶清除、钛网植骨、后路经椎弓根螺钉内固定治疗胸腰椎结核,既能彻底清除病灶,又能有效矫正脊柱后凸畸形,重建脊柱稳定,临床效果满意.     

Experimental study of methane hydrate generation characteristics in the presence of GO and Re-GO

The industrial application of hydrate technology is greatly hindered by its slow generation rate, low gas storage rate, harsh generation conditions, and poor environmental friendliness of traditional additives. In this paper, the kinetic and thermodynamic promotion effects of graphene oxide (GO) and recovered graphene oxide (Re-GO) on methane hydrate in different systems were studied by the constant volume methods. The promotion mechanism was analyzed from the micro perspectives of molecular physical properties, interfacial reaction, and nucleation sites. It is found that GO has an excellent kinetic and thermodynamic promotion effect on CH₄ hydrate generation. After the recovery process, the thermodynamic effect of Re-GO is basically unchanged, and the kinetic promotion effect is slightly reduced. Furthermore, it is verified that the GO material itself does not have a memory effect in hydrate formation. The results show that GO is an excellent accelerator of CH₄ hydrate formation with high recovery value, which provides essential data and an experimental basis for the research and application of graphene oxide and hydrate technology in energy storage and cold storage.

GO can be recycled after use. GO and Re-GO have both kinetic and thermodynamic promoting effects. Re-GO basically has the same thermodynamic effect and slightly lower kinetic effect as GO. GO does not have the memory effect in hydrate formation.