ObjectiveTo explore the correlation between multiple clinicopathologic factors and perineural invasion in patients with pancreatic carcinoma.MethodsThe clinical data of 90 patients with pancreatic carcinoma in the Department of General Surgery of Shanghai Ninth People’s Hospital of Shanghai JiaoTong University School of Medicine from January 2012 to January 2020 were retrospectively collected. We collected clinical data such as patient medical records, surgical records, nursing records, examination reports, pathological reports, and studied the parameters that affect the occurrence of perineural invasion in patients with pancreatic carcinoma.ResultsAmong 90 patients with pancreatic carcinoma, 47 cases had perineural invasion and 43 cases had no perineural invasion. The univariate analysis results showed that perineural invasion was associated with abdominal pain and low back pain, levels of fasting blood glucose, glycosylated hemoglobin, CA19-9, carcinoembryonic antigen (CEA), and bilirubin, as well as tumor location, TNM stage, differentiation degree, lymph node metastasis, vascular cancer thrombus, peripheral invasion, and expression of p53 (P<0.05). Binary logistic regression analysis showed that abdominal or lower back pain, increased fasting blood glucose, tumor with invasion of surrounding tissues, and p53-positive expression were the independent risk factors for perineural invasion of pancreatic carcinoma (P<0.05).ConclusionPatients with pancreatic carcinoma have abdominal or lower back pain, elevated fasting blood glucose before surgery, tumor with surrounding tissue invasion, and p53-positive expression are independent risk factors for perineural invasion, which should be paid attention to.
Objective To investigate and analyze the incidence and clinical characteristics of malnutrition in patients with tuberculosis and type 2 diabetes. Methods four hundred patients with tuberculosis and type 2 diabetes were diagnosed in the tuberculosis Department of West China Hospital of Sichuan University from June 1, 2018 to April 30, 2023. The incidence and clinical characteristics of malnutrition were analyzed using the nutritional risk Screening 2002 score and the Global Malnutrition Leadership Initiative criteria. Results 170 patients (42.5%) were malnourished. In malnourished patients, 78 cases (45.9%) had fever, 132 cases (77.6%) had cough, 44 cases (25.9%) had hemoptysis, and 36 cases (21.2%) had night sweating. Compared with the non-malnourished patients, the difference was statistically significant (P<0.05). Lymphocyte count was (1.0±0.5)×109/L, albumin was (31.4±20.5)g/L; CD3 count 792.7±205.0, CD4 count 535.4±15.0, CD8 count 429.5±123.0, CD3%: 65.5%±11.1%, CD4%: 39.1%±9.6%, CD8%: 19.1%±9.6%, CD4/CD8: 1.3±0.2, which were significantly lower than those in the group without malnutrition. Pulmonary cavity occurred in 44 cases (25.9%), lesions in 2 - 4 lung fields in 76 cases (44.7%) and lesions in ≥5 lung fields in 52 cases (30.6%), all of which were significantly higher than those in the non-malnutrition group. The above differences were statistically significant.Conclusion We should pay more attention to the screening of malnutrition in patients with tuberculosis and type 2 diabetes. Patients with malnutrition have more obvious clinical symptoms, lower immunity, and more serious imaging lesions.
Technology in traditional Chinese medicine (TCM), which has a long history, provides excellent traditional culture and valuable spiritual wealth in China. TCM standardization technology will provide an important basis for guiding and evaluating the professional level and service quality of technicians in TCM. And it is also conducive to the sustainable development of TCM technology. However, at present, there is no relevant research on the development process of technical specifications for TCM. So, the urgent need is how to develop standardized technical specifications, and apply them to patients in practice. Therefore, this study first convened relevant experts, including TCM clinical experts, epidemiologists, methodology experts, etc., to form the core expert group, implementation group and quality assurance task group. According to the personnel functions, they are divided into technical specification steering committee, consensus expert group, secretariat group, external review group, evidence evaluation group, etc. Then, the initial entries are collected by systematically searching the current TCM technical guidelines, consensus and specifications and referring to the existing technical specifications. Finally, expert opinions were collected based on the Delphi survey, and the final reporting checklist of technical specifications for TCM was formed after consensus discussion. The study can provide evidence-based methodological guidance for the development of TCM technical specifications, and promote the standardization and internationalization of TCM technical specifications.