Medicine
-
Review Case Reports
The controversy of esophageal carcinosarcoma: A case report and brief review of literature.
Esophageal carcinosarcoma (ECS) is defined as a relatively rare malignant neoplasm with both epithelial carcinomatous and sarcomatous components. Besides, there were so many various controversies in ECS. This article describes a case of ECS that was effectively treated with radical esophagectomy and adjuvant chemotherapy. Also, we discuss the presentation, differential diagnosis, treatment, and prognosis of ECS. ⋯ It is generally treated by surgery, radiotherapy, and chemotherapy according to the protocols used for other esophageal cancers (EC). However, there is no recommended clinical treatment for ECS because of the rarity of the disease. Esophagectomy with extended lymphadenectomy followed by adjuvant chemotherapy with docetaxel, oxaliplatin, and capecitabine may be recommended treatment for ECS. Chemotherapy regimen with docetaxel, oxaliplatin, and capecitabine may be a suitable adjuvant therapy for ECS.
-
Comparative Study
Comparison of the psychometric properties of the EQ-5D-3L and SF-6D in the general population of Chengdu city in China.
The EQ-5D-3L and SF-6D are the most commonly used economic evaluation instruments. Data comparing the psychometric properties of the instruments are scarce in the Chinese population. This study compared the psychometric properties of these measures in the Chinese general population in Chengdu. ⋯ Both the EQ-5D-3L and SF-6D are valid economic evaluation instruments in the Chinese general population in Chengdu but do not seem to be interchangeable. The EQ-5D-3L has a higher ceiling effect and higher level of discriminant validity among different sociodemographic groups, and the SF-6D has a lower ceiling effect and higher level of discriminant validity in health condition groups. Users may consider the evidence in the choice of these instruments.
-
To investigate the risk factors of nosocomial pneumonia (NP) in elderly patients with acute cerebral infarction (ACI). In this study, 324 aged 70 years and over patients with ACI who were admitted to the inpatient department of TianJin First Hospital (China) from January 2012 to February 2018 were retrospectively analyzed. The patients were divided into NP group (80 patients) and non-NP group (244 patients) according to whether NP was occurred 48 hours after hospitalization. ⋯ Furthermore, elderly patients with ACI who had NP had worse clinical outcomes both during hospitalization and after discharge (P < .05). We identified significant risk factors for NP in elderly patients with ACI, including living alone, initial NIHSS score, malnutrition, a past pneumonia history, AF, CRP, and Renal function were associated with NP in elderly patients with ACI. The clinical course was worse and the duration of hospital stay was longer in NP patients than in non-NP patients.
-
Pulmonary hypertension (PH) is a complicated disease which has complex causes and poor outcome. Many factors are involved in the increase of pulmonary artery pressure. It is often difficult to identify the specific cause of a particular patient. However, identifying the etiology is of great importance for specifying treatment strategies and improving the prognosis of patients. ⋯ It is often difficult to define the cause of PH, but it is important for making the appropriate treatment at the same time.
-
Pedicle screws are commonly used to treat adolescent idiopathic scoliosis (AIS). Many studies have discussed the rates and effects of pedicle screw misplacement. In this study, to increase the accuracy rate, cannulated pedicle screws were inserted into the periapical vertebrae, highly rotated vertebrae, and vertebrae with very thin pedicles in a single patient group. We compared these results with those of a patient group who underwent conventional pedicle screw placement. ⋯ The use of cannulated screws to treat AIS decreases perforation and complication rates. Although it did not significantly lower the medial perforation rate, it dramatically reduced the lateral perforation rate. The use of cannulated screws enables intraoperative confirmation of placement accuracy. Our data suggest that cannulated pedicle screw use to treat AIS is safer and more efficient.