ObjectiveTo explore advances in clinical applications of circulating tumor DNA (ctDNA) for early diagnosis of breast cancer.MethodReviewed on the latest literatures about studies of advances in clinical applications of ctDNA for early diagnosis of breast cancer.ResultsctDNA was a cell-free DNA generated by tumor cells that contained tumor-associated mutations and could dynamically reflect the entire picture of the tumor genome. It was a very important potential tumor biomarker. ctDNA had been widely used in a variety of tumors for early diagnosis, curative effect assessment, and prognosis evaluation due to its advantages such as small trauma and real-time monitoring, and its role in breast cancer had attracted more and more attention.ConclusionEarly diagnosis is critical to improve the breast cancer patients’ overall survival rate and ctDNA plays an important role in early diagnosis and early detection of recurrence and metastasis of breast cancer.
目的 探討糖耐量異常患者的焦慮抑郁狀況及其與生活質量的相關性，為糖尿病相關心理問題的早期識別與干預提供參考。 方法 以2010年1月－2012年6月糖耐量異常患者145例為試驗組，健康人群147例作為對照組，兩組分別填寫焦慮自評量表（SAS）和抑郁自評量表（SDS），試驗組還需填寫世界衛生組織生活質量測定量表簡表（WHOQOL-BREF）并對其焦慮、抑郁得分與WHOQOL-BREF的各因子的相關性進行分析。 結果 145例患者中有51例（35.2%）存在抑郁情緒，47例（32.4%）存在焦慮情緒，焦慮合并抑郁情緒者29例（20%）。糖耐量異常患者焦慮、抑郁評分明顯高于對照組（P＜0.01），其生活質量多個領域評分低于對照組（P＜0.01），且生活質量與焦慮、抑郁情緒存在負相關（P＜0.05）。 結論 糖耐量異常患者焦慮、抑郁情緒明顯高于正常人群，其生活質量偏低，提示了對在該人群進行早期心理干預的必要性。
ObjectiveTo investigate the early effectiveness of proximal femur reconstruction combined with total hip arthroplasty (THA) in the treatment of adult Crowe type Ⅳ developmental dysplasia of the hip (DDH).MethodsBetween May 2015 and March 2018, 29 cases (33 hips) suffering from Crowe type Ⅳ DDH were treated with proximal femur reconstruction combined with THA. Of the 29 cases, there were 6 males (7 hips) and 23 females (26 hips), aged from 24 to 74 years with an average age of 44.9 years. The preoperative Harris hip score was 44.0±12.0. Gait abnormalities were found in all of the 33 hips with positive Trendelenburg sign, and the lower limb discrepancy was (3.8±1.6) cm. Preoperative X-ray films and CT both indicated serious anatomical abnormalities, including complete dislocation of the affected hip with significant move-up of the greater trochanter, abnormal development of the femoral neck, abnormal anterversion angle and neck-shaft angle, dysplasia of proximal femur and dysplasia of medullary cavity. The operation time, intraoperative blood loss, transfusion rate, and complications were recorded. The Gruen and DeLee-Charnley zoning methods were used to evaluate the aseptic loosening of the prosthesis on X-ray films. The Harris score was used to evaluate hip function. The lower limb discrepancy was calculated and compared with the preoperative value.ResultsThe operation time ranged from 80 to 240 minutes, with an average of 124.8 minutes. The intraoperative blood loss ranged from 165 to 1 300 mL, with an average of 568.4 mL. Seventeen patients (51.5%) received blood transfusion treatment. All the incisions healed by first intention without infection or deep vein thrombosis. All patients were followed up 19-53 months, with an average of 33 months. One patient had posterior hip dislocation because of falling from the bed at 4 weeks after operation, and was treated with manual reduction and fixation with abduction brace for 4 weeks, and no dislocation occurred during next 12-month follow-up. Two patients developed sciatic nerve palsy of the affected limbs after operation and were treated with mecobalamin, and recovered completely at 12 weeks later. Trendelenburg sign was positive in 3 patients and mild claudication occurred in 4 patients after operation. X-ray films showed that all the osteotomy sites healed at 3-6 months after operation, and no wire fracture was observed during the follow-up. The Harris score was 89.8±2.8 and lower limb discrepancy was (0.6±0.4) cm at last follow-up, both improved significantly (t=–22.917, P=0.000; t=11.958, P=0.000). The prosthesis of femur and acetabulum showed no obvious loosening and displacement, and achieved good bone ingrowth except 2 patients who had local osteolysis in the area of Gruen 1 and 7 around the femoral prosthesis, but no sign of loosening and sinking was observed.ConclusionThe treatment of Crowe Ⅳ DDH with proximal femur reconstruction and THA was satisfactory in the early postoperative period. The reconstruction technique of proximal femur can effectively restore the anatomical structure of proximal femur, which is one of the effective methods to deal with the deformity of proximal femur.
ObjectiveTo summarize the clinical experience of surgical resection of synchronous multiple ground-glass nodules (SMGN), and explore the individualized diagnosis and treatment strategy of SMGN.MethodsClinical data of 84 patients with SMGN who underwent thoracic surgery in Anhui Chest Hospital from July 2016 to August 2018 were analyzed retrospectively, including 18 males (21.4%) and 66 females (78.6%), aged 32-80 (55.6±10.3) years. The results of operation and the information of GGNs were analyzed.ResultsExcept for 1 patient who was converted to thoracotomy due to extensive dense adhesion of thoracic, other patients underwent video-assisted thoracoscopic surgery successfully. All patients recuperated successfully after operation, without severe perioperative complications or death. Finally, 79 patients were diagnosed as malignant tumors (94.0%), and 5 patients of benign lesions (6.0%). A total of 240 GGNs were removed, among which there were 168 pGGNs, including 68 benign lesions (40.5%) and 100 malignant tumors (59.5%), and 72 mGGNs, including 2 benign nodules (2.8%) and 70 malignant tumors (97.2%). Nodules diameter (P<0.001), consolidation/maximum diameter of nodule ratio (P<0.001), vacuole sign (P<0.001), air bronchograms sign (P=0.001), spine-like process (P=0.001), pleural indentation sign (P<0.001), lobulation sign (P<0.001), and vascular convergence (P=0.002) were correlated with malignant tumor.ConclusionAnalysis of the imaging features of GGNs by thin-section CT scan and three-dimensional reconstruction is of great value in predicting the benign and malignant nodules, which can guide the surgical decision-making and preoperative planning. Through reasonable preoperative planning and following certain principles, simultaneous surgical treatment for SMGN is safe and feasible.