Objective To explore the personnel framework strategy of multi-disciplinary treatment (MDT) for colorectal cancer. Methods Combined the characteristics of large public hospital, with recognized treatment pathway in international MDT for colorectal cancer and management of medical human resource, colorectal cancer MDT project team summarized a system of multi-disciplinary treatment-working for colorectal cancer of West China Hospital (MDT-CRC-WCH) by own management mechanism and subject feature. Results Based on the main four principles——whole, match, voluntary and interactive, MDT-CRC-WCH constructed reciprocation “concentric circle” with the team of directors, coordinators, colorectal surgeons, related professors, nursing and other assistants.Conclusion With construction of multi-layers, MDT for colorectal cancer is completing MDT personnel framework and suitable layers relation. And how to construct prolong active and innovative system of MDT human resource management needed more research.
ObjectiveTo unscramble personal data and its tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe way of words for description was used.ResultsThe definition and setting of 23 items with 18 categories for the personal data from DACCA in West China Hospital was performed. The relevant data label of each item and the structured way needed at the big data application stage were elaborated and the corrective precautions of classification items were described. The three classification items involved privacy attention were described in detailed.ConclusionsBased on description about personal data from DACCA in West China Hospital, it is provided a clinical standard and guide for analyzing of DACCA in future. It also could provide enough experience for construction of colorectal cancer database by staff from same occupation.
Objective To explore the whole constructive conception and organization structure strategy of multi-disciplinary team (MDT) for colorectal cancer (CRC). Methods Combined the characteristics of large public hospital, with recognized treatment pathway in MDT for CRC and the way of medical project construction, MDT for CRC project team summarized a system of MDT for CRC of West China Hospital (MDT-CRC-WCH) by own characteristics and subject feature. Results MDT for CRC summarized the 5 basic characteristics about profession, classification, interaction, optimization and fast. The project has the core competencies: system new operation types for colorectal cancer and volunteer culture. By the matrix organization structure, MDT set the main departments: database team, follow-up team, nursing team and public team. Conclusion With effective MDT whole construction and suitable organization structure, MDT will develop in long time.
Objective To summarize the research progress of postmenopausal breast cancer and estrogen metabolites, which is aimed at providing the basis for early diagnosis and early treatment of postmenopausal breast cancer, at the same time, providing beneficial information for the future study. Methods In recent years, the literatures about postmenopausal breast cancer and estrogen metabolites were reviewed from the databases of WanFang, VIP, CNKI, PubMed, and so on, to make an review. Results Estrogen metabolites had a dual role for postmenopausal breast cancer, such as 2-hydroxyestrone (2-OHE1), 2-methoxyestrone1 (2-MeOE1), and 4-methoxyestrone1 (4-MeOE1) played a protective role for postmenopausal breast cancer, but 4-hydroxyestrone (4-OHE1) and 16α-hydroxyestrone (16α-OHE1) played a carcinogenic role for postmenopausal breast cancer, so it needed to be further studied. Conclusions Estrogen metabolites may be a reliable predictor for the risk of postmenopausal breast cancer, it is not only to provide clues for the mechanism of postmenopausal breast cancer, but also provide new train of thought for early diagnosis and treatment of postmenopausal breast cancer.
急性肺損傷( ALI) 及急性呼吸窘迫綜合征( ARDS) 是各種肺內外致病因素導致的急性呼吸衰竭, 以進行性呼吸困難和頑固性低氧血癥為特征, 常繼發于休克、創傷、嚴重感染以及大面積燒傷等疾病。病理以雙肺彌漫性的滲出為特點。病情進展迅速, 預后極差, 具有很高死亡率。治療時需要糾正缺氧, 以保證組織氧供。傳統的常規機械通氣( CMV) 在改善氧合、呼吸力學參數以及肺內炎癥反應的同時, 導致肺損傷, 即呼吸機相關性肺損傷( VALI) 。近年認為, 采用高頻振蕩通氣( HFOV) 代替CMV 能明顯避免產生VALI, 并能改善ALI/ARDS的呼吸系統順應性和氧合作用, 減輕肺內炎癥反應和VALI, 利于急性損傷肺內塌陷和閉塞的小氣道和肺泡重新開放。并且有人提出HFOV 與部分液體通氣( PLV)聯用( HFOV-PLV) 可進一步改善氣體交換, 抑制肺組織的炎性反應, 減少肺損傷及氟碳化合物( PFCs) 用量, 穩定全身血液循環, 減少中樞神經系統( CNS) 并發癥[ 1] 。
Objective To explore the inhibitory mechanism of Imatinib mesylate on pulmonary fibrosis induced by bleomycin inmice. Methods A total of 120 C57BL/6 mice were randomly divided into four groups, ie. a control group, a model group, a dexamethasone group, and an Imatinib group. The model of pulmonary fibrosis was established by a single intratracheal instillation of bleomycin in the rats. Then dexamethasone or Imatinib were given intraperitoneally respectively. On day 7, 14, 21 after the treatment, 10 mice of each group were sacrificed respectively. The expressions of TGF-β1 and α-SMA in lung tissue were analyzed by immunohistochemistry. The mRNA expression of TGF-β1 was measured by RT-PCR. Results The expressions of TGF-β1 and α-SMA in lung tissue at each time point were significantly increased in the model group compared with the control group. And the expressions were obviously decreased in the dexamethasone group and the Imatinib group compared with the model group, with no significant differences between the two treatment groups. The expression of TGF-β1 was positively correlated with the α-SMA expression ( r= 0. 251, P lt;0. 05) . Conclusion The inhibitory effect of Imatinib on pulmonary fibrosis may be related to the inhibition of TGF-β1 and α-SMA expressions.
Objective The article explained how to build the data system and its running strategy in the mode of multi-disciplinary team （MDT） for colorectal carcinoma. Methods It illuminated the cause of the data system building, also described the essential composition of the data system and how to support the running of the data system, and it discussed the value feedback of the data system, lastly the author proposed the prospect of the data system building. Results The data system could work normally through consultation of doctors, follow-up, clinical support and appropriate implement of construction of information flow-sheet in colorectal carcinoma MDT mode. Conclusion As the foundation of colorectal carcinoma MDT, data system could show both medical and social value through change of medical mode.
Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
【摘要】 目的 觀察人類免疫缺陷病毒（HIV）感染后對人體各個系統的影響，為其診斷和治療提供經驗。 方法 回顧性分析2005年1月—2010年6月于華西醫院確診為HIV感染13例患者的臨床表現和相關實驗室指標。 結果 13例HIV感染患者均合并其他感染，以結核病最為常見；除有T淋巴細胞異常外，多數患者可合并出現血液學異常，包括貧血、白細胞和血小板降低；生化異常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出現風濕病癥狀和免疫學異常。 結論 HIV感染患者臨床表現復雜多樣，可合并出現多種感染和風濕病癥狀，血液學及免疫學異常也比較常見。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.