简介:AbstractBackground:Although de novo stage IV breast cancer is so far incurable, it has entered an era of individualized treatment and chronic disease management. Based on systemic treatment, whether the surgical resection of primary or metastatic foci of de novo stage IV breast cancer can bring survival benefits is currently controversial. We aimed to explore the clinicopathological factors and current status of the management of de novo stage IV breast cancer in China to provide a reference for clinical decisions.Methods:Based on the assistance of Chinese Society of Breast Surgery, a retrospective study was conducted to analyze the clinical data of patients with de novo stage IV breast cancer in 33 centers from January 2017 to December 2018. The relationship between basic characteristic (age, menstrual status, family history, reproductive history, pathological type, estrogen receptor [ER] status, progesterone receptor [PR] status, human epidermal growth factor receptor 2 [HER2] status, Ki-67 percentage, and molecular subtype), and metastasis sites (lung metastasis, liver metastasis, and bone metastasis) was examined by Pearson Chi-square tests.Results:A total of 468 patients with de novo stage IV breast cancer were enrolled. The median age of the enrolled patients was 51.5 years. The most common pathological type of primary lesion was invasive carcinoma (97.1%). Luminal A, luminal B, HER2 overexpressing, and triple-negative subtypes accounted for 14.3%, 51.8%, 22.1%, and 11.8% of all cases, respectively. Age, PR status, and HER2 status were correlated with lung metastasis (χ2= 6.576, 4.117, and 8.643 and P = 0.037, 0.043, and 0.003, respectively). Pathological type, ER status, PR status, and molecular subtype were correlated with bone metastasis (χ2 = 5.117, 37.511, 5.224, and 11.603 and P = 0.024, <0.001, 0.022, and 0.009, respectively). Age, PR status, HER2 status, Ki-67 percentage, and molecular subtype were correlated with liver metastasis (χ2= 11.153, 13.378, 10.692, 21.206, and 17.684 and P= 0.004, <0.001, 0.001, <0.001, and 0.001, respectively). Combined treatment with paclitaxel and anthracycline was the most common first-line chemotherapy regimen for patients with de novo stage IV breast cancer (51.7%). Overall, 91.5% of patients used paclitaxel-containing regimens. Moreover, 59.3% of hormone receptor-positive patients underwent endocrine therapy.Conclusions:In 2018, 1.07% of patients from all studied centers were diagnosed with de novo stage IV breast cancer. This study indicated that 95.1% of patients received systemic therapy and 54.2% of patients underwent surgical removal of the primary lesion in China.
简介:摘要目的检测原发性高血压视网膜III和IV级病变患者血清脂联素水平并分析其与视网膜病变的相关性。方法选择原发性高血压视网膜III和IV级病变患者(HRP组)和正常健康人(CON组)为研究对象,采用酶联免疫吸附法检测两组研究血清脂联素,分析HRP组患者视网膜病变与血清脂联素的相关性。结果HRP组原发性高血压视网膜III和IV级病变患者血清脂联素为2.4±0.8mg/L,CON组正常健康人血清脂联素为5.6±1.3mg/L,HRP组患者血清脂联素显著低于CON组正常健康人(P<0.05)。HRP组原发性高血压视网膜III病变患者血清脂联素为3.1±1.1mg/L,IV级病变患者血清脂联素为1.7±0.6mg/L,HRP组原发性高血压视网膜III病变患者血清脂联素显著高于IV级病变患者(P<0.05)。相关性分析表明,HRP组原发性高血压视网膜病变患者视网膜病变与血清脂联素呈负相关(P<0.05)。结论原发性高血压视网膜III和IV级病变患者血清脂联素显著降低,网膜病变与其呈负相关,可反应视网膜病变严重程度。
简介:摘要目的检测原发性高血压III和IV级视网膜病变患者血脂并研究其与视网膜病变的相关性。方法选择原发性高血压III和IV级视网膜病变患者(HRP组)和正常健康人(CON组)为研究对象,采用全自动生化仪检测两组研究对象血脂,分析HRP组患者视网膜病变与血脂的相关性。结果HRP组和CON组研究对象在BMI方面的差异无统计学意义(P>0.05),HRP组患者TC、TG、LDL和LP(a)均显著高于CON组正常健康人(均P<0.05),HDL显著低于CON组正常健康人(均P<0.05)。HRP组原发性高血压视网膜病变III级患者TC、TG、LDL和LP(a)显著低于视网膜病变IV级患者(均P<0.05),HDL显著高于视网膜病变IV级患者(均P<0.05)。结论原发性高血压III和IV级视网膜病变患者存在显著血脂异常,可反应视网膜病变严重程度及预后。
简介:摘要目的探讨分析中药益气养阴消癥通络方剂治疗IV期糖尿病肾病的疗效。方法选取我院在2017年1月~2017年12月期间就诊治疗的100例IV期糖尿病肾病患者,随机分为两组,对照组与实验组,每组患者各50例,两组患者在均接受基础治疗的情况下,对照组患者采用厄贝沙坦进行治疗,实验组患者采用中药益气养阴消癥通络方剂进行治疗。对两组患者进行为期6个月的观察,分别观察两组患者治疗前后的症状改善情况、尿液微量蛋白排泄率(mAlb)、24h尿蛋白定量(U-pro/24h)、血肌酐(Scr)、尿素氮(BUN)、空腹血糖(FPC)、胆固醇(TC)及甘油三酯(TG)等情况。结果根据实验数据可知,实验组采取中药益气养阴消癥通络方剂治疗的患者各项生理指标数据与症状改善情况明显高于对照组采用厄贝沙坦片进行治疗的患者,差异显著,P<0.05。结论通过实验证实了中药益气养阴消癥通络方剂对糖尿病肾病患者确实有确切的临床疗效,并且能有效降低患者各项生理指标数据,同时纠正患者异常糖、脂质低些紊乱以及肾脏血流动力学紊乱等情况,改善患者各项不良症状,提高患者的生存质量。
简介:摘要:目的 评价个体化营养管理在IV度骨髓抑制治疗中的作用和成本-效益分析。方法 选取东阳市人民医院肿瘤科在2018年1月至2019年12月收治的118例肿瘤放化疗后出现IV°骨髓抑制的患者作为研究对象,按随机数字表法将其分为分为传统营养治疗组(32例)和个体化营养治疗组(86例),采用统计学分析比较两组患者治疗前后相关的营养生化指标和营养治疗相关费用、住院天数等经济学指标。结果 个体化营养治疗组和传统营养治疗组治疗前血生化指标差异均无统计学意义(P>0.05);治疗后个体化营养治疗组患者前白蛋白、白蛋白营养生化指标均有提高,两组的血生化指标差异有统计学意义(P<0.05);传统营养治疗组的成本显著高于常规组,数据差异有统计学意义(P<0.05);实验组的营养支持效果﹑成本效果比﹑并发症发生率均显著低于传统组,差异有统计学意义(P<0.05)。结论 个体化营养治疗能以较低的医疗成本获得更为有效的营养治疗效果,具有更好的卫生经济学效益。