Objective To understand breast cancer 1 (BRCA1) gene and relationship between BRCA1 gene and breast cancer, and analyze its effect on clinical comprehensive therapy of breast cancer. Method The domestic and international studies relevant BRCA1 and breast cancer in recent years were reviewed and summarized. Results BRCA1, a tumor suppressor gene, its mutations caused structural changes and functional abnormalities, which were closely related to breast cancer. And the expression situation and mutation of BRCA1 were associated with the therapeutic effect. Conclusions Mutation of BRCA1 is closely related to occurrence and development of breast cancer in female. Comprehensive therapy ideas should be found in clinical therapy according to expression or mutation of BRCA1. Further research on BTCA1 is beneficial to explore gold standard for treatment of breast cancer.
Objective To evaluate the cl inical significance of the combination of intensified anti-tuberculosis treatment, posterior transpedicular screw system internal fixation, intertransverse bone grafting, and anterior approach focus debridement for the treatment of thoracolumbar tuberculosis. Methods From January 2005 to December 2007, 20 patients with thoracolumbar tuberculosis (T10-L3) were treated. There were 13 males and 7 females aged 21-64 years old (average 44 years old). The course of disease was 3 months to 3 years (average 10 months). The focus involved single vertebrae bodies in 8 cases, two vertebrae bodies in 9 cases, and three vertebrae bodies in 3 cases. The preoperative Cobb angle was 9-35° (average 26.7°). The neurological function was evaluated according to the Frankel grading criterion, there were 2 cases of grade B, 5 of grade C, 7 of grade D, and 6 of grade E. Vertebral body defect index score: 9 cases of 1-2 points, 7 cases of 2-3 points, and 4 cases above 3 points. After receiving the systemic five-drug treatment of anti-tuberculosis for 2-3 weeks, the patients underwent the posterior transpedicular screw system internal fixation and intertransverse bone grafting, and then received tuberculosis focus debridement via anterior approach, nerve decompression, and bone grafting fusion. Results The time of operation averaged 210 minutes and the mean blood loss during operation was 650 mL. Postoperatively, 2 patients had mild belting sensation in their thorax and 2 patients had mild pneumothorax. Their symptoms rel ived 2-3 weeks later without specific treatment. All the patients were followed up for 12-23 months. X-ray films showed that all the patients achieved successful bony fusion 6-18 months after operation, and the Cobb angle was 7-21° (average 15.2°) 12 months after operation without aggravation. The Frankel gradingsystem was used to assess the postoperative neurological function, 1 patient in grade B before operation was improved to grade C after operation, 1 patient in grade B was improved to grade D, 1 patient in grade C was improved to grade D, 4 patients in grade B were improved to grade E, and 7 patients in grade D were improved to grade E. All of the incisions healed and erythrocyte sedimentation rate became normal 2 weeks to 3 months after operation. All the patients showed no obvious abnormity in l iver and kidney function. There was no recurrence of tuberculosis. Conclusion It seems that the systemic drug treatment of antituberculosis before and after operation, the thorough debridement of focus during operation, and the effective and rel iable wayto reconstruct for the spinal stabil ity are the key points for the treatment of spinal tuberculosis.
Heart failure (HF) is a symptoms caused by various diseases. As the myocardial contractility and/or diastolic weakening, the cardiac output decreased, when it can not satisfy the needs of the body, a series of symptoms and signs occurs. HF is an end-stage performance of heart disease, and is also a major factor of mortality. The morbidity of heart failure increased as peoples enter the aging. Despite the continuous improvement of drug treatment,the morbidity and mortality of HF remains high. At present, nondrug treatment of heart failure get more and more attention to clinicians. Surgical methods gets more innovation.Medical intervention has been introducted new auxiliary facilities, and genetics and stem cell technology bring new hope to it’s treatment. This article reviews the HF surgery, nterventional treatment and its related gene and cell therapy and research recently.
目的总结炎性肌纤维母细胞瘤的生物学特性，提高对该疾病的综合治疗水平。 方法分析1例来源于结肠术后4个月复发的炎性肌纤维母细胞瘤病例的诊治过程并复习文献。 结果结肠来源的炎性肌纤维母细胞瘤是一种较少见的疾病，单纯手术切除存在复发可能。本例患者结合药物治疗，随访6个月，残余肿瘤大小无明显变化。 结论结肠炎性肌纤维母细胞瘤手术切除后，需结合肿瘤的病理分型及免疫组化结果，选择合适的辅助治疗方式，并定期密切随访。
目的 观察内镜下食管静脉曲张套扎术联合药物治疗肝硬化食管静脉曲张出血的临床疗效。 方法 回顾性分析2007年2月－2010年8月56例确诊为肝硬化食管静脉曲张出血患者，随机分为联合治疗组和对照组，各28例。对照组行胃镜下套扎术联合生长抑素、泮托拉唑；联合治疗组行内镜下套扎术联合生长抑素、泮托拉唑、普萘洛尔等药物治疗。观察所有食管静脉曲张出血患者1、3、6、12、18个月后随访，两组近期再出血率、食管曲张静脉消失率及复发率、不良反应及并发症的情况。 结果 联合治疗组曲张静脉消失率、不良反应及并发症与对照组比较，差异无统计学意义（P＞0.05）；联合治疗组近期再出血及食管静脉曲张复发等发生率明显低于对照组，差异有统计学意义（P＜0.05）。 结论 食管静脉曲张套扎术联合药物是治疗食管静脉曲张出血一种安全有效的方法，疗效确切，提高了患者生存率。
ObjectiveTo understand the current situation in the treatment of hepatic echinococcosis. MethodThe literatures about operation treatment, drug treatment, and the clinical pathway of hepatic echinococcosis were reviewed. ResultsCurrently, with the continuous development of surgical techniques and the application of minimally invasive surgery, the operative treatments of hepatic echinococcosis had made a great progress, it was still the preferred treatment for the disease. Liver transplantation was made as the final choice. The use of aspiration, sclerotherapy or interventional technique brought a hope for patients intolerant to laparotomy. Moreover, chemotherapy drugs, Chinese herbal medicine, and drug combinations also achieved a very good effect in the treatment of hepatic echinococcosis. The clinical pathway provided a good direction for the treatment of hepatic echinococcosis. ConclusionFor the treatment of hepatic echinococcosis various, we should choice a reasonable treatment according to the specific circumstances of patients, to achieve the best therapeutic effect with minimal trauma.
Objective To investigate the rate of pulmonary function test, medication treatment, and relevant factors among patients with chronic obstructive pulmonary disease (COPD) aged 40 years or older in community of Guangdong Province, and to provide evidences for targeted intervention of COPD. Methods A multistage stratified cluster sampling was conducted in the community residents, who participated in the COPD surveillance project of in Guangdong Province during 2019 to 2020. A total of 3384 adults completed questionnaire and pulmonary function test. The Rao-Scott χ2 test based on complex sampling design, and non-conditional Logistic regression were used to explore possible influencing factors of pulmonary function test and medication treatment in COPD patients. Results Out of the 3384 adults, 288 patients with COPD were confirmed, including 253 males (87.8%) and 35 females (12.2%), and 184 patients (60.4%) were over 60 years old or more. The pulmonary function test rate was 10.7% [95% confidence interval (CI) 6.8% - 14.6%], and medication treatment rate was 10.6% (95%CI 7.0% - 14.1%). The results showed that wheezing, awareness of COPD related knowledge and pulmonary function test were related to whether COPD patients had pulmonary function test (P<0.05). Wheezing and personal history of respiratory diseases were related to medication treatment rate (P<0.05). Conclusions The rates of pulmonary function test and medication treatment among COPD patients aged 40 years or older are low. Health education about COPD should be actively carried out, and the screening of individuals with a history of respiratory diseases and respiratory symptoms should be strengthened so as to reduce the burden of COPD diseases.
ObjectiveTo investigate the drug use,symptoms and lung function of asthma patients in communities. MethodsA cooperation project of "Cohort Study in Putuo District Health Survey" was conducted by Shanghai Putuo People's Hospital and the Harvard School of Public Health from August 2007 to January 2010 .Home questionnaires were collected in the communities in 13 residential quarters in Changzheng town,Ganquan town in Putuo District,Shanghai. ResultsA total of 27 042 respondents was inquired,in which there were a total of 488 asthma patients with the total prevalence rate of 1.80 percent. 189 cases (47.49%) frequently used anti-asthma drugs in nearly a year,and 209 cases (52.51%) less frequently used anti-asthma drugs. In the patients frequently using anti-asthma drugs,FEV1%pred was (65.30±25.78)% with FEV1%pred ≥80% in 50 cases (32.68%).St. George score was 36.80±28.02 in this subgroup.More symptoms presented in 129 cases(69.73%)in the past year. In the patients less frequently using anti-asthma drugs,FEV1%pred was (81.55±19.01)% with FEV1%pred ≥80% in 99 cases (56.57%). St. George score was 7.61±15.56.There were symptoms presented in 42 cases (20.59%) in the past year. ConclusionMore than half asthmatic patients do not receive regular medicine treatment in communities in Shanghai. Some patients still suffer from asthma symptoms long with poor St. George score and lung function although frequently using anti-asthma medication,suggesting asthma treatment is not standard.