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find Author "张毅" 48 results
  • Molecular classification and treatment in breast cancer

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  • 肺结核合并重症肌无力误诊为肺癌合并重症肌无力一例

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • Diagnostic Value of Mandibular Fractures by Multiple Spiral Computed Tomography

    目的 探讨多层螺旋CT对下颌骨骨折的诊断价值。 方法 对2007年4月-2009年10月下颌骨不同部位骨折的45例患者进行多层螺旋CT轴位扫描,并行多平面、表面遮盖法等三维重建,对下颌骨骨折CT表现特征作回顾性分析。 结果 45例下颌骨骨折中,位于下颌体骨折24例,下颌角骨折5例,下颌升支骨折6例,髁部骨折13例,冠突骨折2例;颞下颌关节脱位中,单侧脱位3例,双侧脱位5例。 结论 多层螺旋CT能准确诊断下颌骨各部位骨折,对诊治方案具有重要价值。

    Release date:2016-09-08 09:49 Export PDF Favorites Scan
  • THE SIGNIFICANCE OF CYCLIN D1 AND P53 PROTEIN EXPRESSION IN BREAST CARCINOMA AND FIBROSARCOMA INDUCED BY DMBA IN RATS

    【Abstract】Objective To investigate the significance of cyclin D1 and p53 protein expression in synchronous breast carcinoma and fibrosarcoma in rats. Methods Immunohistochemical SP methods was used to study the expression of cyclin D1 and p53 in synchronous breast carcinoma and fibrosarcoma induced by DMBA in rats.Results There was no expression of cyclin D1 and p53 in normal breast tissue. In atypical hyperplasia of mammary, there was overexpression of cyclin D1(7/14) and no expression of p53. The overexpression of cyclin D1 and p53 were detected in breast carcinoma (8/18,7/18 respectively) and fibrosarcoma (9/14,5/14 respectively). There was no expression of cyclin D1 and p53 in adjacent sarcoma.The expression of cyclin D1 and p53 protein was associated with histological grading, and showed inverse relation between them. Conclusion There are cyclin D1 and p53 protein overexpression in the synchronous breast carcinoma and fibrosarcoma induced by DMBA in rats. Cyclin D1 may paticipate in the course of the carcinogenesis of breast carcinoma and fibrosarcoma in rats, and p53 protein overexpression may relate to the degree of malignancy of the tumors.

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
  • 75岁以上高龄食管、贲门癌患者的外科治疗

    目的 评价高龄食管、贲门癌患者手术切除对术后并发症发生、治疗及其预后的影响,总结治疗经验。 方法 回顾性分析1995年1月至2005年12月收治的376例食管、贲门癌患者的临床资料,选择75岁以上高龄食管、贲门癌患者54例作为研究对象,其中中下段食管癌31例、贲门癌23例。行右侧开胸食管癌切除颈部吻合2例,胸腔内吻合4例,左侧开胸主动脉弓下吻合37例,主动脉弓上吻合11例;1例合并左肝外侧段转移行左半肝部分切除。 结果 52例患者在术后24 h内发生高血压,血压最高达210/120 mm Hg,需静脉泵入硝酸甘油或压宁定治疗;38例发生急性心律失常,以快速心房颤动为主,静脉泵入胺碘酮后缓解;4例出现肺不张,经纤维支气管镜吸痰后恢复;3例出现不明原因的一过性胸闷、气促并有缺氧表现而不排除急性肺梗死(未作磁共振成像检查),其中2例经气管内插管呼吸机辅助呼吸后恢复,另1例给予普通吸氧后好转。术后常规给予经颈内静脉置管全静脉营养(30 kcol/kg·d);全部患者均无吻合口瘘、胸腔或纵隔感染、无幽门排除障碍。随访32例,1例术后4个月因吻合口狭窄在外院行支架植入, 2周后出现大呕血死亡,其余患者无近期内死亡及其它并发症。 结论 对高龄食管癌、贲门癌患者,虽然其本身合并症较多,术后并发症出现频率较高,但手术仍应为治疗的首选方法,可以提高患者的生活质量和生存期。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • 电视胸腔镜下扩大胸腺切除治疗重症肌无力

    目的 探讨电视胸腔镜下扩大胸腺切除治疗重症肌无力的特点及围术期管理,总结治疗经验。 方法 重症肌无力患者30例,根据改良Osserman分型,Ⅰ型15例,Ⅱa型10例, Ⅱb型5例。在全身麻醉下施行电视胸腔镜下扩大胸腺切除术,术中打开前上纵隔胸膜,暴露胸腺组织,用锐性和钝性方法游离完整切除胸腺左右叶及心包前脂肪。 结果 全组无手术死亡患者,手术时间60~100min,术中失血量60±20ml,无术中中转开胸止血。术后留置胸腔引流管时间为1~4d。术后病理:单纯胸腺增生19例,合并胸腺瘤11例。术后随访30例,随访时间2个月~3年;术后临床疗效评价:完全缓解8例(26.7%),明显改善9例(30.0%),部分改善8例(26.7%),无变化5例(16.7%),总有效率83.3%(25/30),大部分患者肌无力症状均有不同程度的改善。 结论 重症肌无力合并胸腺增生或胸腺瘤越早期手术治疗效果相对越好,且长期预后也较佳。且创伤小,对患者整体呼吸循环生理功能影响小,但远期疗效还待进一步随访。

    Release date:2016-08-30 06:10 Export PDF Favorites Scan
  • Relation Between Molecular Subtypes and Neoadjuvant Chemotherapy Efficacy in Breast Cancer

    ObjectiveTo explore the relation between the molecular subtypes and efficacy of neoadjuvant chemotherapy with docetaxel together with epirubicin(TE) in breast cancer. MethodsAccording to the inclusion and exclusion criteria, 239 patients with breast cancer who at least received 3 cycles of TE-based neoadjuvant chemotherapy from May 2011 to December 2012 in this hospital were included. Molecular subtypes were categorized into luminal A, luminal B, human epidermal growth factor receptor 2(HER-2) positive, and triple negative by the immunohistochemical results of estrogen receptor(ER), progesterone receptor(PR), HER-2, and Ki-67 status. The relevant indicators of the different molecular subtypes of breast cancer patients, such as pathological complete response(pCR) rate, age, and menstruation, etc. were analyzed. ResultsThere were 67(28.03%) patients with luminal A, 84(35.15%) luminal B, 21(8.79%) HER-2, and 67(28.03%) triple negative in these 239 patients with breast cancer. The differences of age, menstruation, axillary lymph node status etc. among the four molecular subtypes were not statistically significant(P > 0.05). The pCR rate of triple negative breast cancer(14.93%) was the highest among four subtypes, followed by luminal B(7.14%), HER-2 positive(4.76%) and luminal A(1.49%), there was a significant difference(P=0.027). ConclusionsComparing with luminal A, luminal B, and HER-2 positive breast cancers, triple negative breast cancer is the most sensitive to TE neoadjuvant chemotherapy, and it has the highest pCR rate. Therefore, different treatment should be selected according to molecular subtypes of breast cancer.

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  • Clinical significance of blood pressure variability in chronic kidney disease and hemodialytic patients

    Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.

    Release date:2018-10-19 01:55 Export PDF Favorites Scan
  • Home blood pressure tele-monitoring for hypertension management: advantages and prospects

    In recent years, the prevalence of hypertension in China has gradually increased. Although the awareness rate, treatment rate and control rate of hypertensive patients in China have been significantly raised, the overall level is still lower than that of western developed countries. In order to improve the rate of family blood pressure control, real-time warning of patients’ overall blood pressure level to doctors and the implementation of doctor-side medical intervention to patients are becoming a necessary condition. At present, the maturing home blood pressure tele-monitoring (HBPT) enhances the feasibility of increasing the interaction between doctors and patients. Randomized controlled trial evidence proves that remote monitoring can improve patient compliance and improve target blood pressure control rate. This paper introduces the relevant research results of HBPT in recent years, aiming to explore the advantages of HBPT for hypertension management and the prospect of further promotion and application.

    Release date:2019-12-19 11:19 Export PDF Favorites Scan
  • Home versus ambulatory versus office blood pressure monitoring in diagnosis and management of hypertension

    ObjectiveTo compare home blood pressure monitoring (HBPM) versus ambulatory blood pressure monitoring (ABPM) versus office blood pressure monitoring (OBPM) in diagnosis and management of hypertension, and to find the optimal blood pressure measurement and management.MethodsThe following were compared among three BP monitoring, such as cost-effectiveness, prognostic value of target organ damage (TOD), predictive value of the progress in chronic kidney disease (CKD) and blood pressure variety (BPV). ResultsCompared to OBPM, ABPM was the most cost-effective method in the primary diagnosis of hypertension, but HBPM was the optimal method in long-term and self-management in hypertension. In hypertensives, compared to OBPM, HBPM and ABPM, especially HBPM, had a stronger predictive value for cardiovascular events, stroke, end-stage renal dysfunction (ESRD) and all-cause mortality. In hypertensives with renal dysfunction, controlling HBPM and ABPM, especially controlling ABPM, was an effective way to slow the progress in renal dysfunction, to decrease cardiovascular events, and to decrease the need of dialysis. All BPV derived from OBPM, ABPM and HBPM had a predictive significance of cardiovascular events, and HBPM BPV performed the best.ConclusionCompared to OBPM, ABPM is the best method in primary diagnosis of hypertension and BP control in CKD patients, while HBPM is the best method in predicting and in evaluating BPV, as well as in long-term and self-management in hypertension.

    Release date:2020-03-13 01:50 Export PDF Favorites Scan
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