Primary malignant bone tumors are extremely rare. Osteosarcoma, chondrosarcoma, Ewing’s sarcoma, and myeloma are the most common malignancy in bone. Osteosarcoma and Ewing’s sarcoma are common in children and adolescents, and the tumors are high lethality due to the high rate of pulmonary metastasis. While chondrosarcoma, myeloma, and chordoma are more common in middle aged and elderly people. Japanese Orthopaedic Association (JOA) published the secondary clinical practice guideline on the management of primary malignant bone tumors. We put an emphasis on explanation some important issue of this guideline for help Chinese musculoskeletal tumor professionals in clinical practice.
In 1994, a statement on the performance of lung function testing was issued by the Association for Respiratory Technology & Physiology (ARTP), and it has been updated in 2020. In this paper, we introduced the updated content, including general procedures, normal value ranges and interpretations of obstructive ventilation dysfunction, precautions of lung function tests, and paediatric lung function testing. We also compared the differences between the ARTP statement and the lung function guidelines issued by the Chinese Thoracic Society (CTS) and put forward some appropriate suggestions from the viewpoint of our current situation. We expected it to provide valuable references for the normative update and application of pulmonary function tests in China.
Secondary and tertiary hyperparathyroidism are common complications in patients with chronic kidney disease, especially in end stage renal disease. Surgery is an important method for the treatment of secondary and tertiary hyperparathyroidism. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism is the first evidence based guideline focus on renal hyperparathyroidism surgical management. Recommendations using the best available evidence by a panel of 10 experts in secondary and tertiary renal hyperparathyroidism constructed this guideline, which provides evidence-based, individual and optimal surgical management of secondary and tertiary renal hyperparathyroidism. This paper made a guideline interpretation on the indications of surgery, imaging examination, preoperative and perioperative management, relevant evaluation and treatment during perioperative period, and intraoperative parathyroid hormone monitoring during operation, and so on.
ObjectiveTo explore the association between free fatty acid (FFA) and extent of severity of acute coronary syndrome (ACS). MethodsWe analyzed the clinical data of 93 ACS in-patients treated between July 2014 and May 2015, including 35 with acute ST-elevation myocardial infarction (STEMI), 34 with acute non STEMI (NSTEMI), and 24 with unstable angina (UA). Another 29 in-patients during the same period without coronary heart disease and heart failure and with normal results of electrocardiogram and myocardial damage markers were selected as the control. The statistical analysis of FFA collected within 24 hours after admission was conducted. ResultsThe FFA in the ACS group[(1.08±0.41) mmol/L] was significantly higher than that in control group[(0.51±0.15) mmol/L] (P < 0.01). The FFA in patients with STEMI, NSTEMI, and UA in ACS group was (1.32±0.38), (1.12±0.35, and (0.67±0.10) mmol/L, respectively; the FFA in STEMI and NSTEMI patients was much higher than that in the UA patients (P < 0.05), and the difference between STEMI and NSTEMI patients was not significant (P > 0.05). There were 58 NSTEMI and UA patients evaluated by Grace risk score, in whom 30 had Grace score≥140 with the FFA of (1.12±0.37) mmol/L and 28 had < 140 with the FFA of (0.73±0.17) mmol/L; the difference was significant (P < 0.05). There were 35 STEMI patients evaluated by Killip grade, in whom 16 were Killip I-II with the FFA of (1.17±0.37) mmol/L, and 19 were Killip III-IV with the FFA of (1.45±0.35) mmol/L; the difference was significant (P < 0.05). ConclusionElevated plasma FFA could be associated with ischemic risk and extent of severity of ACS.
ObjectiveTo analyze the association between the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (syndrome of phlegm-heat obstructing lung) and clinical indicators related to COPD. MethodAECOPD in-patients and out-patients were enrolled from the Third People's Hospital of Chengdu from January 2013 to January 2014. The patients were grouped to Tanre Syndrome and non-Tanre Syndrome according to their clinical symptoms, signs and tongue, pulse. All patients underwent the following tests including routine blood test, erythrocyte sedimentation rate, lung function, blood gas analysis, C-reaction protein (CRP), procalcitonin (PCT) and other clinically relevant indicators. The association between AECOPD and clinically relevant indicators were analyzed by using SPSS 19.0 software. ResultsA total of 194 AECOPD patients were included, of which 88 patients were syndrome of phlegm-heat obstructing lung and 106 were non syndrome of phlegm-heat obstructing lung according to the traditional Chinese medicine (TCM) classifications. The results of single factor analysis showed that age (Z=-4.848, P=0.000) and course of disease (Z=-2.455, P=0.014) were associated with syndrome of phlegm-heat obstructing lung. While further logistic regression analysis showed that age (r=0.090, P=0.000) and the level of CRP (r=-0.008, P=0.000) were associated with syndrome of phlegm-heat obstructing lung. ConclusionSyndrome of phlegm-heat obstructing lung is the major clinical TCM syndrome of AECOPD. Syndrome of phlegm-heat obstructing lung is associated with age and level of CRP.
In the American Heart Association’s Scientific Sessions 2021, the results of six clinical trials related to cardiovascular surgery were revealed. The PALACS trial demonstrated that posterior left pericardiotomy during open heart surgery was associated with a significant reduction in postoperative atrial fibrillation; the EPICCURE study found that injection of mRNA encoding vascular endothelial growth factor (VEGF-A mRNA) directly into the myocardium of patients undergoing elective coronary artery bypass grafting (CABG) improved patients’ heart function; the VEST trial once again proved the safety and potential value of external stent for vein graft. This article will interpret the above-mentioned three studies.
In November 2018, the American Heart Association (AHA) updated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Rather than a comprehensive revision of the 2015 edition guidelines, the 2018 AHA guidelines update was updated again according to the rule " the update of the guideline is whenever new evidence is available”, providing the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. The Pediatric Task Force of the International Liaison Committee on Resuscitation updated the guideline, reaffirming the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
In the late-breaking trials session of the American Heart Association’s Scientific Sessions 2021, which took place in November 2021, six clinical trials in cardiac surgery published their primary results. This review will look into three of them including the management of patients with moderate or less-than-moderate tricuspid regurgitation at the time of surgery for degenerative mitral regurgitation, timing of ticagrelor cessation before coronary artery bypass grafting, and long-term outcomes of ticagrelor-based antiplatelet therapy for secondary prevention of coronary artery bypass grafting.
In October 2020, the American Heart Association issued the 2020 edition of guidelines for cardiopulmonary resuscitation and cardiovascular first aid, which comprehensively revised cardiopulmonary resuscitation and emergency cardiovascular care guidelines related to adults, children, newborns, resuscitation education science and treatment system. According to the latest edition of International Liaison Committee on Resuscitation’s classes of recommendation and levels of evidence, relevant suggestions are put forward. This article interprets the main updated and revised content, including children’s basic and advanced life support and neonatal resuscitation, in order to better guide emergency personnel and improve the quality of cardiopulmonary resuscitation and cardiovascular first aid.
Objective To reveal the association between the single nucleotide polymorphism (SNP) of v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) gene rs17820943 locus and non-syndromic cleft l ip with or without cleft palate (NSCL/P) in the southern Chinese Han population. Methods Genotyping of MAFB gene rs17820943 polymorphism was carried out in 300 patients with NSCL/P, 354 normal controls, and an additional 168 case-parent trios with matrix-assisted laser desorption/ionisation time-of-fl ight (MALDI-TOF) mass spectrometry. Then based on the genotypingresults, both a case-control association study and a case-parent trio association study were performed. Results Significant differences were found in the allele and genotype frequencies of rs17820943 locus between case and control groups (Pallele=0.001 and Pgenotype=0.002, respectively). To be specific, the odds radio (OR) values and 95% confidence interval (95%CI) of allele T (frequencies of cases ∶ controls = 0.358 ∶ 0.448) and genotype TT (frequencies of cases ∶ controls = 0.110 ∶ 0.195) were ORT = 0.69 (95%CI: 0.55-0.86) and ORTT = 0.43 (95%CI: 0.26-0.70), respectively. Subsequent case-parent trio analysis also indicated an association between MAFB rs17820943 variant and the risk of NSCL/P (ORT vs. C = 0.55, 95%CI: 0.41-0.75, P value of transmission disequilibrium test was 0.000). Conclusion Polymorphism of MAFB gene rs17820943 locus is associated with NSCL/P in the southern Chinese Han population; MAFB rs17820943 variant may be a susceptible gene of NSCL/P.