Objective To summarize the research progress of postmenopausal breast cancer and estrogen metabolites, which is aimed at providing the basis for early diagnosis and early treatment of postmenopausal breast cancer, at the same time, providing beneficial information for the future study. Methods In recent years, the literatures about postmenopausal breast cancer and estrogen metabolites were reviewed from the databases of WanFang, VIP, CNKI, PubMed, and so on, to make an review. Results Estrogen metabolites had a dual role for postmenopausal breast cancer, such as 2-hydroxyestrone (2-OHE1), 2-methoxyestrone1 (2-MeOE1), and 4-methoxyestrone1 (4-MeOE1) played a protective role for postmenopausal breast cancer, but 4-hydroxyestrone (4-OHE1) and 16α-hydroxyestrone (16α-OHE1) played a carcinogenic role for postmenopausal breast cancer, so it needed to be further studied. Conclusions Estrogen metabolites may be a reliable predictor for the risk of postmenopausal breast cancer, it is not only to provide clues for the mechanism of postmenopausal breast cancer, but also provide new train of thought for early diagnosis and treatment of postmenopausal breast cancer.
急性肺损伤( ALI) 及急性呼吸窘迫综合征( ARDS) 是各种肺内外致病因素导致的急性呼吸衰竭, 以进行性呼吸困难和顽固性低氧血症为特征, 常继发于休克、创伤、严重感染以及大面积烧伤等疾病。病理以双肺弥漫性的渗出为特点。病情进展迅速, 预后极差, 具有很高死亡率。治疗时需要纠正缺氧, 以保证组织氧供。传统的常规机械通气( CMV) 在改善氧合、呼吸力学参数以及肺内炎症反应的同时, 导致肺损伤, 即呼吸机相关性肺损伤( VALI) 。近年认为, 采用高频振荡通气( HFOV) 代替CMV 能明显避免产生VALI, 并能改善ALI/ARDS的呼吸系统顺应性和氧合作用, 减轻肺内炎症反应和VALI, 利于急性损伤肺内塌陷和闭塞的小气道和肺泡重新开放。并且有人提出HFOV 与部分液体通气( PLV)联用( HFOV-PLV) 可进一步改善气体交换, 抑制肺组织的炎性反应, 减少肺损伤及氟碳化合物( PFCs) 用量, 稳定全身血液循环, 减少中枢神经系统( CNS) 并发症[ 1] 。
Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
ObjectiveTo explore risk factors for sarcopenia after radical gastrectomy for gastric cancer in older patients. MethodsOlder patients who underwent radical gastrectomy for gastric cancer at Tangshan People’s Hospital from January 2022 to June 2023 were retrospectively collected. The occurrence of sarcopenia was recorded, and factors influencing its development were analyzed. Factors with statistical significance in univariate analysis and clinical relevance were included in a multivariate binary logistic regression model. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of significant predictors for sarcopenia occurrence. ResultsA total of 300 older patients underwent radical gastrectomy for gastric cancer were enrolled. Sarcopenia occurred in 74 patients (incidence rate: 24.67%). Multivariate binary logistic regression analysis identified the following independent risk factors for sarcopenia (all P<0.05): American Society of Anesthesiologists (ASA) classification Ⅲ, postoperative chemotherapy, geriatric nutritional risk index (GNRI) <89, body mass index (BMI) <18.5 kg/m2, lack of exercise habits, and lower values of serum total protein, grip strength, skeletal muscle mass index (SMI), 6-meter walking speed, and short physical performance battery (SPPB) score. Among these, factors with an area under the ROC curve (AUC) >0.7 were serum total protein, SMI, and 6-meter walking speed. The combined model integrating all ten factors achieved an AUC of 0.937 (sensitivity 96.65%; specificity 89.71%; Youden index 0.864). ConclusionsThis study reveals a high incidence of sarcopenia after radical gastrectomy in older patients with gastric cancer. The risk of sarcopenia is multifactorial, involving surgical tolerance (ASA classification), postoperative therapy (chemotherapy), nutritional status (GNRI and BMI), exercise habits, and various muscle-related functional indicators (serum total protein, grip strength, SMI, walking speed, and SPPB score). The combined predictive model shows potential for early identification of high-risk patients.
Objective To investigate the diagnostic value of strain elastography (SE) and virtual touch tissue image quantification (VTIQ) technique in determining the nature of cervical lymph nodes in patients with lung cancer. Methods A total of 124 patients with lung cancer combined with cervical lymph node enlargement were selected for this study. All patients underwent routine ultrasound examination, using SE to detect lymph nodes and scored them, and using VTIQ technique fro measurement of lymph node shear wave velocity (SWV). Pathological results were taken as gold standards. Non-metastatic lymph nodes were included in the benign group, while metastatic lymph nodes were included in the malignant group. Receiver operating characteristic (ROC) curve was generated. The optimal cutoff value of SWV was determined for predicting metastatic lymph nodes, the area under curve (AUC) of SE and VTIQ technique was compared, and the diagnostic efficacy of SE and VTIQ technique for benign and malignant lymph nodes was analyzed. Results Among the 124 patients, 28 cases of benign lymph nodes had an SE score of 2 - 3, and 59 cases of malignant lymph nodes had an SE score of 4 - 5. The accuracy, sensitivity, and specificity of SE were 70.2%, 75.6%, and 60.9%, respectively. The maximum, minimum, median, and mean values of SWV in the malignant lymph nodes were significantly higher than those in the benign lymph nodes in VTIQ technique testing (P<0.05). Based on the ROC curve analysis, the mean value of SWV had the highest diagnostic efficiency, and its cutoff value of 3.18 m/s was used as the diagnostic criterion for predicting malignant lymph nodes. The accuracy, sensitivity, and specificity of the VTIQ technique in diagnosing malignant lymph nodes were 85.5%, 92.3%, and 73.9%, respectively. The AUC of SE and VTIQ technique were 0.713 and 0.896, respectively, indicating higher diagnostic value of VTIQ technique. Conclusions Both SE and VTIQ technique have high accuracy in determining the nature of cervical lymph nodes in lung cancer patients. Compared with SE, VTIQ technique showed superior diagnostic performance, and SWVmean has the best diagnostic performance. It can provide a new non-invasive examination method for evaluating the nature of cervical lymph nodes in lung cancer patients in clinical practice.