Malignant Tumor Patients Research Articles

Impact of adjuvant interstitial brachytherapy on lengths of stay, discharge disposition, and 30-/90-day readmission for malignant brain tumor patients: a national readmission database analysis

PurposeAdvances in interstitial brachytherapy for brain cancers have revived interest in this treatment platform. However, the impact of this therapy on hospital quality measures remains poorly characterized. Here, we utilized the National Readmission Database (NRD) to address this gap in knowledge by identifying associations between interstitial brachytherapy and hospital course, discharge disposition, and readmission rates.MethodsWe identified patients in the United States of America with malignant brain tumors who had undergone either craniotomies (C) for tumor resection or craniotomies augmented with adjuvant interstitial brachytherapy (C + IB) in the National Readmission Database (NRD, 2010–2018). Propensity-score weighting and survey regression techniques were used for analysis.ResultsOver the study period, the number of craniotomies with adjuvant interstitial brachytherapy (C + IB) steadily decreased. For brain metastasis (BM) patients, C + IB and C patients exhibited comparable length of hospital stay (aIRR: 1.01, CI95 0.86–1.18, p = 0.918) and routine discharge to home or self-care (aOR:0.95, CI95:0.61–1.50, p = 0.838). However, primary brain tumor (PBT) patients who underwent C + IB showed longer hospital stay (aIRR:1.43, CI95:1.03–1.99, p = 0.032) and were less likely to undergo routine discharge (aOR: 0.38, CI95:0.20–0.74, p = 0.005) relative to the C cohort. Despite these differences, C + IB and C patients showed comparable 30- or 90- day readmission risks. The profile of readmission diagnoses was also similar. Cost-analysis suggests that IB increased the median total charge by $19,184 (p = 0.003).ConclusionsOur NRD analysis suggests that adjuvant interstitial brachytherapy did not alter hospital course/readmission risk for brain metastasis patients. However, primary brain tumor patients who underwent this therapy showed longer hospitalization and an increased likelihood of non-routine discharge.

Difference in fecal and oral microbiota between pancreatic cancer and benign/low-grade malignant tumor patients

BackgroundSignificant gaps exist in understanding the gastrointestinal microbiota in patients with pancreatic cancer (PCA) versus benign or low-grade malignant pancreatic tumors (NPCA). This study aimed to analyze these microbiota characteristics and explore their potential use in distinguishing malignant pancreatic lesions.MethodsBetween September 2020 and May 2024, fecal and oral samples were collected from 121 patients undergoing surgical resection or diagnostic biopsy of pancreatic lesions, including 75 patients with PCA and 46 patients with NPCA, and 16s rRNA sequencing was performed. Random forest models based using fecal and oral microbiota data were developed to diagnose PCA and NPCA, with performance assessed using the leave-one-out cross validation method.ResultsThe Shannon index and PCoA analysis revealed significant differences in oral microbiota composition between PCA and NPCA (p < 0.001 and p = 0.001, respectively). Fecal microbiome richness differed significantly (p = 0.02), though composition similarity was noted (p = 0.238). LEfSe identified 16 and 23 genera with significant differences in fecal and oral microbiomes, respectively. Random forest classifiers based on fecal and oral microbiota achieved areas under the curves (AUCs) of 89.4% and 96.3%, respectively, for distinguishing PCA and NPCA. In the mucinous tumor cohort, oral and fecal microbiome classifiers outperformed CA19-9, yielding AUCs of 83.0% and 85.2%, respectively.ConclusionFecal and oral microbiota compositions were significantly different between PCA and NPCA patients. Random forest classifiers utilizing fecal and oral microbiota data effectively distinguish between benign or low-grade malignant and malignant pancreatic lesions.

Usage of Magnetic Resonance Imaging-Based Texture Analysis Features in Discrimination of Benign and Malignant Sinonasal Tumors

Aim: The objective of this study was to differentiate between benign and malignant sinonasal tumors using magnetic resonance imaging (MRI)-based texture analysis features. Materials and Method: Histopathologically proven benign or malignant sinonasal tumor patients were included in the study from MRI examinations performed between January 2013 and December 2020. Inclusion criteria included a tumor size of at least 1 cm and preoperative magnetic resonance imaging with axial T1W, axial fat-suppressed T2W, and axial T1W postcontrast sequences. After the images were transferred to a dedicated workstation, texture analysis calculations were performed. Differences between benign and malignant groups were compared. Results: The mean age of 37 patients (8 female, 29 male) included in the study was 50.8 ± 21.9 years. In our study, we found no statistically significant difference between malignant and benign sinonasal tumors in nine tissue analysis parameters obtained by MRI. Conclusion: MRI-based texture analysis needs identical MRI protocols for evaluating tumors. MRI-based texture analysis is not a useful diagnostic tool to discriminate between benign and malignant sinonasal tumors when specific pathologic types are not selected and scanning protocols are not identical.

Association of Preoperative Nutritional Status with Sarcopenia in Patients with Gastrointestinal Malignancies Assessed by Global Leadership Initiative in Malnutrition Criteria: A Prospective Cohort Study

Introduction: The Global Leadership Initiative in Malnutrition (GLIM) consensus highlights the importance of using the GLIM criteria as a standardized approach to diagnosing malnutrition, particularly in patients with cachexia. Although many existing studies have utilized the GLIM criteria to assess the association between malnutrition and malignant tumor patients, there remains relatively little research exploring the specific relationship between malnutrition and sarcopenia. This study aimed to investigate the correlation between malnutrition under the GLIM criteria and preoperative sarcopenia in patients with gastrointestinal malignancies. By looking into the relationship, we hope to find better ways to prevent and treat sarcopenia in these patients, which will lead to better clinical outcomes. Methods: In this study, we selected 210 patients with gastrointestinal malignant tumors from Northern Jiangsu People’s Hospital between June 2022 and July 2023. We diagnosed and graded the nutritional status of these patients using the GLIM criteria. At the same time, body composition analysis, calf circumference, and grip strength were detected in all patients to observe whether they had sarcopenia. Results: According to GLIM criteria, 30.1% of the patients were diagnosed with malnutrition, of which 25.1% were classified as moderate malnutrition and 15% as severe malnutrition. The risk of sarcopenia in patients with severe malnutrition was 2.5 times that of patients with good nutrition, and 1.19 times that of patients with moderate malnutrition. Patients with BMI <18.5 kg/m2 were 9.12 times more likely to develop sarcopenia than those with BMI ≥18.5 kg/m2. Due to inadequate nutrient intake and resultant malnutrition in patients with malignant tumors, muscle protein synthesis is affected, exacerbating muscle protein breakdown and leading to an overall decline in muscle strength and function. Conclusion: This study highlights the urgent need for nutritional screening in early gastrointestinal tumor patients, revealing a strong link between sarcopenia and malnutrition. Higher malnutrition levels, low BMI, and high nutritional risk significantly predict sarcopenia, with risk increasing alongside worsening malnutrition and disease stage.

Uncover visit-to-visit blood pressure variability as the hidden risk factor/predictor for coronary artery disease, stroke and malignant tumor in patients with type 2 diabetes

Visit-to-visit blood pressure variability is a factor for a series of cardiovascular diseases in hypertensive patients. Hypertension is a common complication of patients with type 2 diabetes mellitus. Our research demonstrated that blood pressure variability is more important than systolic blood pressure to be associated with the occurrence of coronary artery disease and stroke. However, the importance of visit-to-visit blood pressure variability was easily overlooked. The results aimed to inform the health professionals the significance of stability blood pressure variability in the blood pressure management for patients with type 2 diabetes.

A Meta-Analysis of the Effect of Modified Gastric Tube Length on Enteral Nutrition in Stroke Patients

Objective: To systematically evaluate the effect of modified length of gastric tube implantation in stroke patients. Methods: Randomized controlled studies on the effect of narrative therapy on negative emotions of malignant tumor patients were published in PubMed, EMbase, Web of Science, Cochrane Library, CNKY. Wanfang Data, VIP Database and CBM disc from database establishment to May 2021. RewMan 5.2 software was used for the meta-analysis. Results: Ten articles were included, involving 1140 patients in total. Results of meta-analysis showed that improved length of gastric tube implantation could reduce the incidence of aspiration pneumonia in stroke patients with enteral nutrition [OR = 0.18, 95% CI (0.10, 0.31), P &lt; 0.00001], reduce gastroesophageal reflux rate (OR = 0.13, 95% CI (0.04, 0.38), P &lt; 0.0002], the incidence of aspiration (OR = 0.23, 95% CI (0.11, 0.38), P &lt; 0.00001], the incidence of abdominal distension and diarrhea (OR = 0.13, 95% CI (0.06, 0.28), P &lt; 0.00001], the incidence of choking cough (OR = 0.20, 95% CI (0.07, 0.61), P &lt; 0.005], but no difference between the two groups in terms of reducing gastric residual (OR = 0.10, 95% CI (2.40, 2.60), P = 0.94]. Conclusions: The modified length of the gastric tube can replace the traditional length of the gastric tube in the application of stroke patients, can reduce the complications of enteral nutrition, is safe and feasible. However, due to the limitation of the quality and quantity of the included studies, we should be cautious about the results of this meta-analysis and expect to carry out more large-sample and high-quality randomized controlled trials for demonstration.

Trousseau syndrome with recurrent cerebral infarction as the first oneset in a gastrointestinal malignant tumor patient: A case report.

Trousseau syndrome (TS) is a thrombosis disorder characterized by a hypercoagulable state linked to underlying malignancies, resulting in various thrombotic events such as deep vein thrombosis, pulmonary embolism, and arterial thrombosis. This syndrome serves as a crucial indicator of malignancy and can often be the first sign of an underlying tumor. In this case, we report a case of gastrointestinal malignant tumor as the first onset, and analyzes its clinical characteristics to improve the clinicians' understanding of this kind of disease. A 69-year-old woman was admitted to the hospital 4 times in 1 month for cerebral infarction. The patient was admitted several times with a new cerebral infarction lesion and a high D-dimer level, a persistently positive fecal occult blood test, and a gastrointestinal tumor was later found. The patient was diagnosed with TS, attributed to her underlying malignancy. During hospitalization, the patients were treated with aspirin for antiplatelet, esomeprazole for protection of gastric mucosa, atorvastatin for lowering blood lipids, butylphthalein for improvement of collateral circulation, edaravone dextrocamphorol for scavenging oxygen free radicals, and betahistine hydrochloride tablets for preventing dizziness. The patient's condition improved significantly after initial treatment, but died of the tumor a year after discharge. Currently, TS has a complex and varied clinical presentation and is relatively difficult to diagnose, especially in patients with an unknown tumor history. Focus should be placed on patients with recurrent cerebral infarctions and increased D-dimer levels, and anticoagulation may be an effective treatment for patients with TS.

The Level of Circulating M-MDSCs as an Indicator for the Therapeutic Outcome of BNCT in End-Stage Malignant Brain Tumor Patients

PurposeBoron neutron capture therapy (BNCT) is a promising treatment modality for patients diagnosed with malignant brain tumors. It is currently used for emergency and compassionate purposes to treat end-stage malignant glioma or recurrent head and neck cancer patients in Taiwan. Understanding the factors influencing treatment response is crucial for optimizing patient care. This study aimed to investigate the association between tumor response and various parameters in end-stage malignant glioma patients following BNCT. Patients and MethodsFifteen patients with end-stage malignant brain tumors underwent a single fraction of BNCT. The treatment response was evaluated using cranial magnetic resonance imaging, and the association between treatment response and BNCT parameters was analyzed. Additionally, circulating myeloid-derived suppressor cell (MDSC) levels were measured by flow cytometry and correlated with patients’ survival. ResultsBNCT exhibited significant therapeutic efficacy in reducing tumor volume of these end-stage glioma patients, with 3 patients achieving complete response and 10 patients achieving partial response within 1 month, resulting in an impressive objective response rate of 80%. The median overall survival is 9 (1.77, 12.47) months, and the progression-free survival is 1.34 (0.53, 9.53) months. Kaplan-Meier analysis showed that the patients with complete response and partial response displayed better survival than those with stable disease. Treatment response was not significantly associated with initial tumor size, blood boron concentration, tumor-to-normal tissue ratio, or tumor-to-blood ratio. The ROC curve revealed a cut-off value of 5% of circulating M-MDSCs with a sensitivity of 66.67% and specificity of 73.33%, respectively, for predicting the glioma patient’s response to BNCT. ConclusionThis clinical study demonstrates that BNCT can reduce tumor burden, improve disease control, and prolong survival in end-stage glioma patients. Circulating M-MDSCs may serve as a predictive indicator for the treatment response of these patients following BNCT.

Epidemiology and survival of primary intracranial malignant tumor patients with drop metastasis: a population-based analysis.

Drop metastasis significantly impacts the survival of patients with primary intracranial malignant tumors. Using the information of collaborative stage from the SEER database, we aim to analyze the epidemiology and prognosis of primary intracranial malignant tumor patients with drop metastasis. We analyzed the distribution of patients and the frequency according to the demography and clinical characteristics of patients with drop metastasis. We also analyzed the survival of these patients with drop metastasis. Multivariate Cox proportional hazards models were used to analyze possible prognostic indicators. A total of 56,839 cases with primary intracranial malignant tumors were ultimately included in this cohort study. A total of 792 cases were confirmed to have drop metastasis. The average rate of drop metastasis was 1.4%. Most of the patients with drop metastases were diagnosed before ten years old. The three most common primary intracranial malignant tumors with drop metastasis were glioblastoma, embryonal/primitive/medulloblastoma, and anaplastic astrocytoma. Embryonal/primitive/medulloblastoma had the highest drop metastasis rate, at 11.6%. Tumors located in the infratentorial space and ventricles had a higher rate of drop metastasis than tumors in other locations. The prognosis for patients with drop metastasis is poor. Routine complete treatment (surgery of the primary tumor plus chemoradiotherapy) can significantly improve overall survival. We conducted a population-based analysis of primary intracranial malignant tumor patients with drop metastasis. Our study can help clinicians acquire general information on the epidemiology and survival of primary intracranial malignant tumor patients with drop metastasis.

Analysis of metalothionein in patients with malignant liver tumors.

Malignant liver tumors are highly aggressive with a poor prognosis. Metalothionein (MT) is a low-molecular intracellular protein, whose primary function is to regulate the homeostasis of heavy metals in many organisms. There are only few studies focusing on the molecular mechanisms of MT expression. Recent studies show its significant relations to carcinogenesis, spontaneous mutagenesis and efficiency of antitumor medicine. In previous studies, the increase of MT levels in cancer patients was proven. The aim of this work is to study MT as well as to increase the efficiency of malignant liver tumor diagnosis. In our pilot study (2022-2023) we observed a group of 15 patients with hepatocellular carcinoma (diagnosis C220) and a group of 15 patients with hepatoblastoma (diagnosis C222). The control group included 20 healthy probands. We developed our own modified method for the analysis. Blood serum samples of the probands were denaturated (99 ˚C, 20 min). MT was determined by an electrochemical method. Obtained data were stored and processed in the laboratory information system QINSLAB. In denaturated blood serum samples, we obtained voltametric curves of MT. We determined concentrations of MT by evaluating the area under the curve (AUC). To differentiate normal and abnormal concentrations of MT, blood samples of healthy probands were used (N = 20), with the average MT levels of 2.0 ± 1.3 µg/L and median 1.9 µg/L. In patients diagnosed with HCC, the average MT levels were 9.1 ± 6.5 µg/L and median 9.0 µg/L. The receiver operating characteristic (ROC) analysis showed AUC 0.864 (95% CI 0.736-0.992), sensitivity 0.74 and specificity 0.75. In patients diagnosed with hepatoblastoma, the average MT concentrations measured were 11.5 ± 7.5 µg/L and the median was 10.9 µg/L. The ROC analysis displayed AUC 0.868 (95% CI 0.751-0.993), sensitivity 0.84 and specificity 0.86. The correlation analysis showed correlation between MT and carcinoembryonic antigen (CEA) (r = 0.99), uric acid (r = -0.86) and potassium ions (r = -0.94). In this pilot study, we observed the association of MT levels in healthy probands and malignant liver tumor patients. Many previous studies show that MT concentrations are increasing as the illness progresses. We assume that this increase is connected to the high metabolic activity of cancer cells. This study will continue with collecting a larger number of samples.

Machine learning models based on CT radiomics features for distinguishing benign and malignant vertebral compression fractures in patients with malignant tumors.

Radiomics has become an important tool for distinguishing benign and malignant vertebral compression fractures (VCFs). It is more clinically significant to concentrate on patients who have malignant tumors and differentiate between benign and malignant VCFs. To explore the value of multiple machine learning (ML) models based on CT radiomics features for differentiating benign and malignant VCFs in patients with malignant tumors. This study retrospectively analyzed 78 patients with malignant tumors accompanied by VCFs, 45 patients with benign VCFs, and 33 patients with malignant VCFs. A total of 140 lesions (86 benign lesions, 54 malignant lesions) were ultimately included in this study. All patients were divided into training sets (n = 98) and validation sets (n = 42) according to the 7:3 ratio. The radiomics features were screened and dimensioned, and multiple radiomics ML models were constructed. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic performance. Five radiomics features were included in the model. All the ML models built have good diagnostic efficiency, among which the support vector machine (SVM) model performs better. The area under the curve (AUC), sensitivity, specificity, and accuracy in the training set were 0.908, 0.816, 0.883, and 0.857, respectively, while those in the validation set were 0.911, 0.647, 0.92, and 0.81, respectively. A variety of ML models built based on CT radiomics features have good value for differentiating benign and malignant VCFs in malignant tumor patients, and the SVM model has a better performance.

Acute kidney injury following implementation of an enhanced recovery after surgery protocol in gastrointestinal surgery for malignant tumor patients: incidence, outcome and predictive factors

Acute kidney injury following implementation of an enhanced recovery after surgery protocol in gastrointestinal surgery for malignant tumor patients: incidence, outcome and predictive factors

The impact of mindfulness intervention on negative emotions and quality of life in malignant tumor patients: a systematic review and meta-analysis.

This study aims to assess the effect of mindfulness intervention on negative emotions (anxiety and depression) and quality of life in malignant tumor patients. The databases, including CNKI, VIP, Wanfang, Chinese Biomedical Literature Database disc (CBMdisc), PubMed, Embase, Cochrane Library, and Web of Science (WoS), were searched from inception to January 2024. Randomized controlled trials examining the effects of mindfulness intervention on negative emotions and quality of life in malignant tumor patients were selected. Meta-analysis was conducted using RevMan 5.1. A total of 11 studies involving 993 patients were included. Compared with usual care, mindfulness intervention effectively reduced anxiety [SMD = -0.81, 95% CI (-1.01, -0.60), p < 0.00001], depression [SMD = -0.86, 95% CI (-1.01, -0.70), p < 0.00001], and improved patients' quality of life [SMD = 0.64, 95% CI (0.50, 0.78), p < 0.00001]. Mindfulness intervention can effectively alleviate negative emotions such as anxiety and depression in malignant tumor patients and positively impact their quality of life.

Increased Distress in Neurooncological Patients, a Monocentric Longitudinal Study: When to Screen Which Patient?

Neurooncological patients are well-known to experience an increased psycho-oncological burden with a negative impact on distress, therapy adherence, quality of life, and finally survival. But still, psycho-oncological screening and support is rare, with ongoing discussion about specific screening time points and impact factors. Therefore, we analysed the psycho-oncologic treatment demand at specific disease-related time points throughout therapy. In this longitudinal, prospective, single-centre study, patients with malignant brain tumours were screened for increased distress (using the Distress Thermometer), anxiety, depression (Hospital Anxiety and Depression Scale questionnaire), and health-related quality of life interference (EORTC QLQ C30-BN20 questionnaire) at specific longitudinal time points during therapy. The results were correlated with sociodemographic and clinical data. From 2013 to 2017, 2500 prospective screening data points from 512 malignant brain tumour patients were analysed. DT was identified as a significant predictor for psycho-oncological treatment demand (p < 0.001). Particularly significant time points concerning psycho-oncological burden were primary diagnosis and tumour recurrence. Next to these known factors, here, patients < 65 years old and female patients (p = 0.018 and p = 0.017) reflected increased screening results, whereas partnership and professional activity (p = 0.043; p = 0.017) were identified as contributing factors to a significantly decreased treatment demand. The increased need for psycho-oncological support for neurooncological patients is underlined. Psycho-oncological support should particularly be offered at the time points of primary diagnosis and tumour recurrence. To support the positive effect of caregivers, they should be involved at an early stage.

Effects of Raupya Suvarna Sutashekhara, a herbo-mineral-metallic formulation as adjunct Oral Ayurvedic Medicine on long-term survival in patients of malignant brain tumor

BackgroundThe incidence of brain tumors poses a significant threat, particularly with high-grade tumors that exhibit rapid growth and can significantly impair the patient's quality of life, despite treatment modalities. Ayurveda, a natural system of medicines helps to enhance health benefits when used as a complementary therapy in combination with conventional treatment through various herbal, herbo-mineral or herbo-mineral-metallic formulations. One of such formulations, Raupya Suvarna Sutshekhara (RSS), has Raupya bhasma and Suvarna bhasma (incinerated Silver and Gold respectively) ingredients and they are described as Rasayana (immunomodulatory) and possess Medhya (enhances the brain functions and intelligence) activity. ObjectiveThe study documents effects of Raupya Suvarna Sutshekhara in alleviating symptoms of malignant brain tumors. Materials and methodsThis retrospective cohort study was done for malignant brain tumor patients (n = 110) registered at our centre who were treated with Raupya Suvarna Sutshekhara 125 mg–250 mg (a herbo-mineral metallic formulation) as a treatment of choice of neural tonic along with supporting Ayurvedic medicines. Treatment response evaluation period ranged from 3 months to 5 years (median period 29 weeks). Clinical symptoms, weight, Karnofsky Performance Score (KPS), Quality of Life (QoL) score, and survival data with respect to treatment with RSS were analyzed. ResultsRSS showed a very significant (p < 0.001) effect on symptoms related to memory loss, headache, imbalance, loss of appetite, and generalized weakness while significant (p < 0.05) decrease in urinary incontinence, seizures, difficulty in thinking/articulating, and weakness in one part/side of the body. However, a not-quite significant change was seen in symptom confusion/disorientation. No significant improvement was seen in vision changes, facial numbness or tingling, swallowing difficulties, and tingling in extremities. Body weight and KPS also showed improvement. Patients with treatment between 2 and 5 years showed median survival up to 62 months. ConclusionsIt was observed that adjunct Ayurvedic treatment with RSS helped to reduce the severity of symptoms due to the tumor itself or side-effects of conventional treatments, maintain the quality of life of malignant brain tumor patients and has shown to increase survival with respect to the duration of the treatment.

Assessing treatment effects with adjusted restricted mean time lost in observational competing risks data

BackgroundAccording to long-term follow-up data of malignant tumor patients, assessing treatment effects requires careful consideration of competing risks. The commonly used cause-specific hazard ratio (CHR) and sub-distribution hazard ratio (SHR) are relative indicators and may present challenges in terms of proportional hazards assumption and clinical interpretation. Recently, the restricted mean time lost (RMTL) has been recommended as a supplementary measure for better clinical interpretation. Moreover, for observational study data in epidemiological and clinical settings, due to the influence of confounding factors, covariate adjustment is crucial for determining the causal effect of treatment.MethodsWe construct an RMTL estimator after adjusting for covariates based on the inverse probability weighting method, and derive the variance to construct interval estimates based on the large sample properties. We use simulation studies to study the statistical performance of this estimator in various scenarios. In addition, we further consider the changes in treatment effects over time, constructing a dynamic RMTL difference curve and corresponding confidence bands for the curve.ResultsThe simulation results demonstrate that the adjusted RMTL estimator exhibits smaller biases compared with unadjusted RMTL and provides robust interval estimates in all scenarios. This method was applied to a real-world cervical cancer patient data, revealing improvements in the prognosis of patients with small cell carcinoma of the cervix. The results showed that the protective effect of surgery was significant only in the first 20 months, but the long-term effect was not obvious. Radiotherapy significantly improved patient outcomes during the follow-up period from 17 to 57 months, while radiotherapy combined with chemotherapy significantly improved patient outcomes throughout the entire period.ConclusionsWe propose the approach that is easy to interpret and implement for assessing treatment effects in observational competing risk data.

Effect of ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation on gastrointestinal reactions of malignant tumor patients undergoing chemotherapy.

To observe the efficacy and safety of ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in patients with malignant tumors. Patients with malignant tumors and suffering from chemotherapy were randomly divided into control group (35 cases, 4 cases dropped off) and observation group (35 cases, 2 cases dropped off). The patients of the control group were treated by orally taking ondansetron hydrochloride tablets 8 mg/time, 3 times a day for 3 d, and those of the observation group treated by ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation of Zusanli(ST36), Neiguan(PC6), Tianshu(ST25), Zhongwan(CV12) and Guanyuan(CV4) once a day for a total of 3 d, based on the treatment of the control group. The patients' gastrointestinal reaction degree after the 1st , 2nd and the 3rd day of treatment were recorded. The Karnofsky performance status (KPS) score (0-100 points) was used for assessing the patients' quality of life. The TCM syndrome score (4 grades：no, mild, medium and severe, i.e. 0, 2, 4 and 6 points) was given according to the patients' severity of symptoms of spleen (stomach) qi deficiency (nausea and vomiting, abdominal distension after eating, belching, loss of appetite, weakness and laziness to speak, fatigue, and loose stool). The safety of the treatment was assessed by examining the patients' blood routine, liver function and kidney function, and the adverse reactions including blisters, allergies, burns and fainting during acupuncture treatment. After the 2nd and 3rd day of treatment, the patients conditions of vomiting and nausea in the observation group were significantly better than those of the control group (P<0.05). The TCM syndrome score and KPS score were significantly decreased in comparison with those of pre-treatment in both groups (P<0.05), and the TCM syndrome score was obviously lower in the observation group than in the control group (P<0.05). No significant differences were found between the two groups in the KPS score after the treatment , and in the levels of white blood cells (WBC), hemoglobin (HGB), platelets (PLT), absolute neutrophil count (ANC), alanine transaminase (ALT), aspartate aminotransferase (AST), creatinine(Cr), and blood urea nitrogen (BUN). The use of ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation is safe for CINV patients, and can effectively relieve nausea and vomiting and alleviate digestive symptoms.

Quantitative analysis of malignant brain tumor on MRI images

Longitudinal relaxation time (T1)- weighted, Transverse relaxation time (T2)- weighted and flair Magetic Resonance Imaging (MRI) sequences are used for the study of high grade malignant brain tumors and their surrounding edemas. This study aimed to examine the characteristic of MRI on malignant brain tumor and to evaluate the benefits of Flair and T2 (Transverse relaxation time) -weighted over the T1(Longitudinal relaxation time) -weighted sequence. A total of 25 patients of malignant brain tumors were selected for analysis including 16 women aged 1 to 75 (mean age, 38.31 years) and 9 men aged 1 to 75 (mean age, 19.5 years). All patients had the T1- weighted, T2- weighted and Flair MRI sequences. A Region based segmentation of MATLAB software was performed on each type of tumor and 3D volume was calculated by spheroid volume tool of MATLAB. For all the patients tumor volume was calculated in cubic millimeter and compared with other sequences.The Flair and T2- weighted images volumes were significantly larger than the T1 – weighted image volume. There was also statistical difference of volume occurred in MRI sequences. T2- weighted and Flair MRI sequences showed 100% more volume than T1- weighted in the age group between 51 to 75 years. Similarly, both T2-weighted and Flair MRI sequence showed 61% volume more than T1-weighted in the age groups betrwen 26 to 75 years. Our findings suggest that the volume produced by these techniques are distinct and not interchangeable. Flair and T2-weighted images proved efficient for the measurement of abnormal tissues and CSF fluid in the brain. On the other hand T1-weighted images efficiently locate the tumor in fat and white matter of the brain.

Step ladder VY advancement flap for lower eyelid reconstruction after resection eyelid malignant tumors

BackgroundIn oculoplastic surgery, reconstruction of a large defect after the removal of a massive malignant lower lid tumor still represents a unique challenge. We will report on this case, including a presentation of the case using step ladder V–Y advancement flap.MethodsDuring November 2018 to March 2023, five patients of lower eyelid malignant tumor had wide resection with safety margin and reconstructed using step ladder V–Y advancement flap. The flap was used step ladder V–Y advancement flap.ResultsNo complications, including ectropion deformity, occurred. This flap does not sacrifice healthy skin as seen with the cheek rotation flap, and the area of dissection is very small and can be performed in a short time.ConclusionsStep ladder V–Y advancement flap is highly useful in cases that require a reconstruction of a large defect after the removal of a massive malignant lower lid tumor from viewpoints of operating time, ease of procedure, aesthetics, and complications.

Expert consensus on the whole-course management of implantable venous access port in the upper arm of cancer patients (2024 edition)

As one of a major public health issue in China, the number of new cases and deaths of malignant tumors has been climbing year by year. Implantable venous access port (IVAP) is used as a safe infusion route in the treatment of malignant tumor patients such as infusion of antitumor drugs and intravenous nutrition. With the widespread application of ultrasound-guided Sedinger puncture techniques and intracardiac electrocardiogram positioning technology, IVAP in the upper arm has been recognized by the majority of medical personnel and cancer patients due to its advantages of hiding scars and completely avoiding the risk of hemothorax and pneumothorax. In order to standardize the clinical application of IVAP via the upper arm approach in cancer patients, improve the success rate of implantation, reduce complications and improve patient satisfaction, the Breast Cancer Expert Committee of the National Cancer Quality Control Center consulted guidelines and the latest evidence-based evidences and established the expert consensus on the whole-course management of implantable venous access port in the upper arm of cancer patients through literature research and expert discussions, in order to provide reference for the standard application of IVAP in the upper arm. The consensus mainly introduces the indications, contraindications, preoperative evaluation, implantation site, operation procedure, utilization and maintenance, complications and management, medical staff training and patient education of IVAP in the upper arm, in order to provide reference for clinical staff.