Objective
To summarize the description about the pure noninvasive breast carcinoman in guidelines.
Methods
The related guidelines and literatures about the pure noninvasive breast carcinoma were collected to make a review.
Results
Through reviewing the guidelines of breast carcinoma, including Chinese Anti Cancer Association (CACA), National Comprehensive Cancer Network (NCCN), St.Gallen, European Society for Medical Oncology Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up, as well as Japanese Breast Cancer Society Clinical Practice Guideline, we find that, the main treatment of noninvasive breast carcinoma is operation and the surgery for axillary is not recommended by most guidelines. The sentinel lymph node biopsy (SLNB) should be performed only when the invasive ductal carcinoma (IDC) is suspected or location of lesion would decrease the success of SLNB in the future. The radiotherapy should be advised to patients following conservation surgery. The patients with estrogen receptor (ER)-positive should undergo endocrine therapy. However, the using of endocrine therapy should be discussed with patient.
Conclusions
Although the prognosis of pure noninvasive breast carcinoma is better than invasive cancer, the research about it is still less, and the treatments recommended by guidelines are different. The more attention should be paid to the research about the pure noninvasive carcinoma.
Objective To summarize the gastrointestinal manifestations and diagnostic and therapeutic experience of hereditary angioedema (HAE), enhancing early recognition of this rare disease. Methods The clinical data, genotype analysis results, treatment process, and follow-up data of HAE patients who visited the Department of Gastroenterology and Hepatology of West China Hospital of Sichuan University between May 2023 and December 2024 due to abdominal pain were retrospectively collected and summarized for analysis. Results A total of 10 patients with abdominal HAE were included, including 2 males and 8 females. The age range of the patients was 30-71 years old, and 6 patients were found to have HAE through family screening. Most patients first developed the disease during adolescence or youth, and there was a significant time interval between the onset and diagnosis, ranging from 3 to 42 years. Patients mainly presented with gastrointestinal symptoms, with the first symptoms usually being abdominal pain (the most common) and vomiting, accompanied by nausea and other symptoms. Five patients were hospitalized multiple times due to severe gastrointestinal symptoms, and all patients had significantly reduced levels of complement C4, with a C1-esterase inhibitor function of less than 7%. Three patients had a C1-esterase inhibitor concentration below the normal range. All patients were detected with SERPING1 gene mutations. During the follow-up period, 6 patients received preventive treatment. Conclusion Gastrointestinal symptoms are one of the important clinical manifestations of HAE and are often misdiagnosed as other gastrointestinal diseases.
Objective To evaluate the relevant systematic reviews/meta-analyses that focused on the prevention and treatment of complications after impacted tooth extraction. Methods The systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction were searched in PubMed, The Cochrane Library, CBM, CNKI and WanFang Data from inception to September 30th, 2012, and a total of 15 professional journals and the references of included studies were also retrieved manually. Two reviewers screened the literature according to the inclusion criteria and extracted the data. Then the AMSTAR was used to evaluate the quality of the included studies, and the GRADE system was used to evaluate the quality of evidence. Results A total of twelve relevant systematic reviews/meta-analyses were included, of which five focused on the prevention and treatment of dry socket, six on the prevention of swelling, seven on the prevention and treatment of pain, six on the prevention of limitation of mouth opening, two on the prevention of infection, three on the prevention of bleeding, and one on the treatment of nerve damage after tooth extraction. Based on AMSTAR, seven studies were minor limitations and five studies were moderate limitations. Based on GRADE system, two was high quality of evidence, twelve were moderate, nine were low, and seven were very low. Conclusion Currently, the systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction can provide some references for clinical practice, which should be combined with the real condition by clinical doctors when making an evidence-based decision. However, it also suggests performing more high quality and large sample studies to prove this conclusion.
Objective To assess the improvement of different resistance training regimens on blood lipid metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Methods PubMed, ProQuest, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases were searched to collect randomized controlled trials of resistance training intervention to improve blood lipids and insulin resistance in patients with T2DM. The search time range was from the establishment of the databases to May 2023. Two reviewers assessed the risk of bias of the included studies using the Physiotherapy Evidence Database scale, and performed a network meta-analysis of the extracted data using Stata 16.0 software. Results In the end, 24 articles were included, and a total of 983 participants were enrolled. The result of network meta-analysis showed that high-frequency and moderate-intensity resistance exercise significantly improved the levels of insulin resistance [standardized mean difference=?1.71, 95% confidence interval (CI) (?2.75, ?0.67)], triglycerides [weighted mean difference (WMD)=?0.27 mmol/L, 95%CI (?0.51, ?0.04) mmol/L], and total cholesterol [WMD=?0.16 mmol/L, 95%CI (?0.20, ?0.12) mmol/L], but had no significant effect on improving the level of high-density lipoprotein [WMD=0.05 mmol/L, 95%CI (?0.02, 0.11) mmol/L] or low-density lipoprotein [WMD=?0.20 mmol/L, 95%CI (?0.42, 0.03) mmol/L]. The results of cumulative probability ranking showed that high-frequency and moderate-intensity resistance exercise was the best in improving insulin resistance, triglycerides, high-density lipoprotein and low-density lipoprotein levels. Conclusion Based on current evidence, high-frequency and moderate-intensity resistance exercise may be the best resistance exercise regimen to improve insulin resistance and lipid metabolism in patients with T2DM.
CT texture analysis (CTTA) can objectively evaluate the heterogeneity of tissues and their lesions beyond the ability of subjective visual interpretation by extracting the texture features of CT images, then performing analysis and quantitative and objective evaluation, reflecting the tissue micro environmental information. This article reviews the recent studies on the applications of CTTA in gastric cancers, in the aspects of identification of gastric tumors, prediction of stage, correlation with Lauren classification, prediction of occult peritoneal carcinomatosis, evaluation of efficacy and prognosis, and prediction of biomarkers. It is regarded that CTTA has a good application prospect in gastric cancers.
