Uveal melanoma is the most common primary intraocular malignancy in adults. Although it is relatively rare, it is extremely malignant, with poor treatment effect. The current treatment for primary lesions can achieve ideal local control, but there are still nearly half of the patients with distant metastasis. This article reviews the epidemiology, genetic status, diagnosis, treatment and prognosis of uveal melanoma in combination with recent advances in diagnostic and therapeutic techniques.
High-grade gliomas are the most common malignant primary central nervous system tumors with poor prognosis. The operation based on the principle of maximum safe resection of tumors, combined with radiation therapy and chemotherapy, is the primary treatment method. This treatment only delays the progression of high-grade gliomas, and almost all patients eventually develop disease progression or relapse. With the development of molecular biology, immunology, and genomics, people have a deeper understanding of the pathogenesis of gliomas. Targeted therapy, immunotherapy, and other comprehensive treatments are expected to become potential treatments for high-grade gliomas. This article reviews the current status of medical treatment of primary and recurrent high-grade gliomas, and the research progress of high-grade gliomas in targeted therapy and immunotherapy.
Metastatic renal cell carcinoma accounts for 20%-30% of newly diagnosed renal cell carcinoma and its prognosis is poor. It is not sensitive to radiotherapy or chemotherapy, and traditional cytokine therapy has limited efficacy in patient with metastatic renal cell carcinoma. In recent years, with the emergence of targeted drugs and immune checkpoint inhibitors, the survival of patients with metastatic renal cancer has been greatly improved. This article reviews treatment and research progress of metastatic renal cell carcinoma. It mainly introduces the medical treatment, including cytokine therapy, targeted therapy and emerging immunotherapy, and further analyzes the value of cytoreductive nephrectomy in the context of targeted therapy. The purpose of this article is to provide evidence for reasonable choices of treatment regimens in order to better guide clinical treatment.
Objective To investigate the prognostic differences and decision-making role in postoperative radiotherapy of four molecular subtypes in pT1-2N1M0 stage breast cancer. Methods The clinicopathological data of 1526 patients with pT1-2N1M0 breast cancer treated at West China Hospital of Sichuan University between 2008 and 2018 were retrospectively analyzed. χ2 test was used to compare the clinicopathological features among patients with different molecular subtypes. Kaplan-Meier survival analysis and log-rank test were used to draw the survival curves and compare the overall survival (OS) and breast cancer-specific survival (BCSS) among patients with different molecular subtypes. Cox regression model was used to determine the influencing factors of OS of patients after radical mastectomy. Results Among the 1526 patients with pT1-2N1M0 breast cancer, there were 674 cases (44.2%) of Luminal A subtype, 530 cases (34.7%) of Luminal B subtype, 174 cases (11.4%) of human epidermal growth factor receptor 2 (Her-2) overexpression subtype, and 148 cases (9.7%) of triple-negative subtype. The 5-year OS rates of Luminal A, Luminal B, Her-2 overexpression and triple negative patients were 98.6%, 94.3%, 95.5% and 91.2%, respectively (χ2=11.712, P=0.001), and the 5-year BCSS rates were 99.3%, 94.6%, 95.5% and 92.5%, respectively (χ2=18.547, P<0.001). Multiple Cox regression analysis showed that menstrual status [hazard ratio (HR)=0.483, 95% confidence interval (CI) (0.253, 0.923), P=0.028] and whether endocrine therapy [HR=2.021, 95%CI (1.012, 4.034), P=0.046] were prognostic factors for the 5-year OS rate of breast cancer patients after radical mastectomy (P<0.05). However, it failed to reveal that Luminal subtypes and postoperative radiotherapy were prognostic factors for the 5-year OS rate (P>0.05). Conclusions In pT1-2N1M0 breast cancer patients, the 5-year OS rate and 5-year BCSS rate in triple-negative patients are the lowest. The relationship between Luminal classification, postoperative radiotherapy and survival in patients after radical mastectomy needs further study in the future.
Objective To explore the feasibility and safety of 2 μm thulium laser in thoracoscopic wedge resection. Methods The clinical data of 137 patients who underwent thoracoscopic wedge resection with thulium laser (as a thulium laser group, 64 patients, including 22 males, 42 females, average age of 58.39±10.40 years) and staplers (as a stapler group, 73 patients, including 33 males, 40 females, average age of 60.79±10.96 years) in thoracic Department of Xuanwu Hospital between April 2016 and August 2018 were retrospectively analyzed. In the study, the intraoperative blood loss, the operative time, chest tube duration, daily amount of fluid leak, hospital stay and hospitalization costs were compared between two groups. Results The intraoperative blood loss of the thulium laser group (16.05±23.67 mL) was significantly shorter or lower than that of the stapler group (28.56±32.09 mL) (P=0.011). Besides, the post operation hospital stay and hospitalization costs of the thulium laser group (4.72±2.49 d, 37 127.33±9 302.14 yuan) were also significantly shorter or lower than those of the stapler group (5.67±2.02 d, 49 545.76±13 831.93 yuan) (P=0.015, P=0.000). Furthermore, no statistical difference was found between the thulium laser group and the stapler group in the operative time (116.38±41.91 min vs. 108.36±47.25 min), total hospital stay (10.13±2.98 d vs. 11.05±3.26 d), daily amount of fluid leak (138.38±72.23 mL vs. 152.7±77.54 mL), chest tube duration (2.89±2.34 d vs. 3.52±1.48 d) and the frequency of postoperative fever (0.89±1.55 times vs. 1.23±1.70 times). Conclusion Applying 2 μm thulium laser to thorascopic wedge resection is safe and feasible. Besides, 2 μm thulium laser can achieve a similar result to that of the standard technique by using staplers.
【摘要】目的评价双氯芬酸钠滴眼液在准分子激光上皮下角膜磨镶术(LASEK)中的临床应用价值。方法2008年7月2009年3月行LASEK术患者80例160眼,屈光度范围-4.86D±2.15D(-1.25D～-6.50D),随机分为双氯芬酸钠滴眼液组(试验组)和对照组,对两组术后角膜刺激症状、上皮愈合情况进行对比观察和统计学分析。结果试验组术后第1、3天角膜刺激症状明显轻于对照组(P＜0.05),上皮愈合速度较对照组更快(P＜0.05)。结论在LASEK术中合理使用双氯芬酸钠滴眼液,可明显减轻术后患者角膜刺激症状,促进角膜上皮的更快愈合。
【摘要】 目的 探讨研究静脉滴注丹参注射液发生不良反应的类型及因素，为临床用药提供依据。 方法 对2007年1月-2010年12月82例因静脉滴注丹参注射液发生不良反应的患者资料进行回顾分析，并对其相关因素进行分析。 结果 男性的不良发生率高于女性，不良反应发生年龄多为中、老年患者，并且不良反应多发生在输液30 min内，多为Ⅰ型过敏反应。 结论 对丹参注射液应严格控制生产工艺流程，临床用药要掌握适应证，以避免不良反应的发生。【Abstract】 Objective To investigate the types and factors of adverse reactions caused by intravenous infusion of Danshen injection, in order to provide basis for clinical drug application. Methods We retrospectively analyzed the clinical records of 82 patients with adverse reaction to intravenous infusion of Danshen injection from January 2007 to December 2010. Results Adverse reaction incidence was higher in males than females, and it mainly occurred in patients of middle or old ages. Most of the adverse reactions happened within 30 minutes of the infusion. Type-I allergic reaction was more commonly observed. Conclusion In order to avoid the occurrence of adverse reactions, Danshen injection production process should be strictly controlled, and indications should be considered carefully in clinical medication.