tbuckley/cabot-search huggingface dataset:
Time Trends in the Diagnosis of Colorectal Cancer With Obstruction, Perforation, and Emergency Admission After the Introduction of Population-Based Organized Screening
Authors: Kathleen M. Decker, Pascal Lambert, Zoann Nugent, Natalie Biswanger, Jewel Samadder, Harminder Singh
Journal: JAMA Network Open (2020)

Up to 30% of patients with a diagnosis of colorectal cancer (CRC) present as an emergency (an intestinal obstruction, perforation, or emergency hospital admission) (OPE). There are limited data about the association of organized, population-based colorectal cancer screening with the rate of emergency presentations.To examine the association of CRC screening with OPE at cancer diagnosis and time trends in the rate of OPE after the start of organized CRC screening using a highly sensitive fecal occult blood test.A historical cohort study was conducted among 1861 individuals 52 to 74 years of age with a diagnosis of CRC from January 1, 2007, to December 31, 2015, who lived in Winnipeg, Manitoba, a province with universal health care and an organized CRC screening program. Statistical analysis was performed from January 22, 2019, to February 26, 2020.Variables included prior CRC screening, era of diagnosis, cancer stage at diagnosis, tumor site in the colon, area level mean household income, primary care continuity of care, and comorbidity.The primary outcomes were defined as an OPE. Logistic regression was used to evaluate factors associated with OPE at CRC diagnosis. Trends over time were calculated using Joinpoint Regression.From 2007 to 2015, 1861 individuals 52 to 74 years of age (1133 men; median age, 65.1 years [interquartile range, 60.0-70.3 years]) received a diagnosis of CRC in Winnipeg. Most individuals had good continuity of care and moderate comorbidities. Overall, 345 individuals (18.5%) had an OPE. The rate of emergency hospital admissions decreased significantly from 2007 (the start of the organized, province-wide CRC screening program) to 2015 (annual change, -7.1%; 95% CI, -11.3% to -2.8%; P = .01). There was no change in the rate of obstructions or perforations or stage IV CRCs. Individuals who were up to date for CRC screening were significantly less likely to receive a diagnosis of an OPE (odds ratio, 0.38; 95% CI, 0.28-0.50; P < .001). The results were similar after adding emergency department visits and stage IV CRC at diagnosis to the outcome.This study suggests that the rate of emergency hospital admissions decreased over time for individuals who underwent CRC screening, but there was no change in the rate of obstructions and perforations. Individuals who were up to date for CRC screening were less likely to have a CRC diagnosis with an OPE.
Physician treatment preferences for metastatic triple negative breast cancer (mTNBC) in an era of immunotherapy.
Authors: Ajeet Gajra, Jeffrey Wojtynek, Igoni Dokubo, Yolaine Jeune-Smith, Jonathan Kish, Bruce A. Feinberg
Journal: Journal of Clinical Oncology (2020)

e13095 Background: TNBC accounts for 10-20% of all breast cancer and has poor prognosis. Guidelines now list atezolizumab with nab-paclitaxel (ANP) as preferred for mTNBC w/ PD-L1 expression &gt; 1%. We sought to assess current mTNBC prescribing and sequencing preferences for first-line (1L), second-line (2L), and third-line (3L) therapy among U.S. community oncologists (c-oncs). Methods: C-oncs were presented 4 hypothetical mTNBC clinical scenarios (CS 1-4) via web-based survey. CS differed by PD-L1 expression, menopausal status, prior adjuvant therapy and nature of metastases (bulky liver, lung, bone) but were otherwise uniform in terms of being asymptomatic, BRCA negative, with identical response extent and duration of each line of therapy. Respondents selected their preferred treatment for 1L, 2L, and 3L in each CS in the following categories: single agent (SA) chemotherapy, combination chemotherapy (CC), or ANP. The proportion of c-oncs selecting each treatment approach per CS for each line of therapy was calculated. We describe these preference patterns and how these may deviate from current guidelines. Results: 47 c-oncs participated from across the U.S. (northeast = 23%, midwest = 28%, south = 32%, west = 17%): mean years in practice was 22.7 and mean number of mTNBC patients under treatment was 18.8. The proportion of c-oncs preferring SA, CC or ANP per CS per line of therapy is listed in the table. Deviations from guidelines include preferences for: 1L ANP despite PD-L1 &lt; 1% (26% in CS 1 and 4); 1L CC (45%) in asymptomatic bone only disease (CS1); 2L CC (19-34%) in asymptomatic visceral metastases (CS 2, 3 and 4). The SA 2L (74%)/3L (90%) preferences: capecitabine (36% 2L; 18% 3L) and eribulin (24% 2L; 35% 3L). Gemcitabine + carboplatin was the preferred CC regimen in 2L (50%) and 3L (28%). Conclusions: There is deviation from current guidelines in the treatment preferences for mTNBC patients among c-oncs, specifically the preference for ANP in PD-L1 negative patients and CC in 2L and 3L for asymptomatic patients. [Table: see text]
Endothelial repairing function in patients with symptomatic middle cerebral arterial stenosis after stent implantation
Authors: Jiangli Su, Xinhong Xue, Lifeng Qi
Journal: BMJ (2015)

Objective
To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.


Method
Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation. Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting, including 14 cases with >50% stenosis and 1 case with MCA occlusion, and 43 patients had no restenosis (non-restenosis group). The number of endothelial progenitor cells (EPC) was examined by flow cytometry, the adhesion function of EPC was tested by adhesion assay, the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor(VEGF) levels were measured by ELISA. The relationship of endothelial repairing function with restenosis was analyzed.


Results
The MCA stent implantations were successfully performed in all patients. The EPC number (33.7±4.6 vs. 61.6± 6.4), adhesion activities (26.1±7.5 vs. 56.3±9.6), migration activities (12.0±3.9 vs. 21.4±6.5) and serum VEGF level [(56.7±14.6) vs. (89.6±17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t=18.48, 13.09, 6.34 and 7.73, all P<0.05).


Conclusion
For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability, and low serum VEGF level.


Key words: 
Middle cerebral artery; Stent; Stem cells, endothelial cells; Vascular endothelial growth factors; Constriction, pathologic
Comparison of 3 Treatment Strategies for Medication Overuse Headache
Authors: Louise Ninett Carlsen, Signe Bruun Munksgaard, Mia Nielsen, Ida Maria Storm Engelstoft, Maria Lurenda Westergaard, Lars Bendtsen, Rigmor Højland Jensen
Journal: JAMA Neurology (2020)

Medication overuse headache (MOH) is a disabling, globally prevalent disorder representing a well-known and debated clinical problem. Evidence for the most effective treatment strategy is needed.
The study on quality of life and related factors among patients with chronic hepatitis B in Wuhan area
Authors: 陈晓蓓, 龚作炯, 杨丽华, 孙小梅
Journal: BMJ (2007)

目的 了解影响武汉地区慢性乙型肝炎(CHB)患者生存质量的相关因素.方法 采用横断面调查方法,以健康状况问卷(SF-36)对2003年至2004年间在武汉大学人民医院感染科诊治的212例CHB患者进行调查.其中非治疗组51例;基础护肝组32例;抗病毒治疗组129例,包括干扰素组31例,拉米夫定组58例,联合抗病毒组40例.结果 212例患者的生存质量总分,自费者为515±150,部分报销者为554±132,两者差异有统计学意义(t=2.029,P=0.044).在抗病毒治疗分组中,完全应答组患者的生存质量总分为614±85,部分应答组患者为531±122,无应答组患者为473±170,完全应答组与部分应答组和无应答组间差异有统计学意义(F=18.681,P=0.0001).不同性别、年龄、婚姻状况及受教育程度对CHB患者生存质量的影响无统计学意义(P＞0.05).结论 医疗保险报销方式及有效的抗病毒治疗是影响CHB患者生存质量的因素。
Oncology nursing training: A blended teaching approach in resource-limited countries.
Authors: Mehrunnissa Taj, Benish Lalani, Nurani Madhani, Cornelia Ouma, Lydia Njumwa, Hafiza Ukani, Mildred Oluoch, Saleem Sayani, Fabiha Zaidi, Zeenat Sulaiman
Journal: Journal of Clinical Oncology (2020)

e19189 Background: Although cancer is a global health concern, resource-limited countries (RLCs) experience higher mortality and morbidity compared with high-income countries. Knowledge gaps and inadequate training are some of the many barriers to safe and effective patient care in RLCs. Oncology nursing as a subspecialty does not readily exist in many RLCs, such as Kenya and Tanzania; many of the nursing staff learn essential clinical skills on the job with no structured training. Advanced practitioners are critical in identifying knowledge deficits and elevating oncology nurses’ clinical skills for positive patient outcomes. Methods: We used a blended teaching approach (a combination of computer-led sessions and face-to-face interactions) to impart cancer education to the nursing staff working in the oncology departments at four hospitals in Kenya and Tanzania. The training focused on cancer biology, epidemiology, pharmacology, safe chemotherapy administration, side effect management, and patient education. Computer-based modules and face-to-face skills training on chemotherapy administration were conducted over a four-month period. Pre- and post-assessments were held for each training session, and clinical skills were evaluated in-person at the completion of the course. Finally, a comprehensive post-assessment was conducted immediately after the training, and again at 3- and 6-month intervals to evaluate knowledge gain and retention over time. Results: Of 21 participants across four sites, the mean scores for the first pre- and post-test were 71.43% and 90.48%, respectively ( p = .01), showing a significant improvement in knowledge. The post-tests after course completion and again at the 6-month interval showed mean values of 88.28% and 89.30%, respectively ( p = .36), indicating a sustained effect of our intervention and no diminution of knowledge at 6 months. The initial face-to-face skills’ training was followed by 3- and 6-month sessions via video chat. At the final 12-month face-to-face visit, we confirmed recommended policy and clinical practice changes in effect and developed a plan for sustainability measures. Conclusions: Blended teaching is an effective tool in improving knowledge, skills, and self-efficacy for clinicians practicing in RLCs. Advanced oncology practitioners can play an important role in assessing, designing, and implementing similar training courses in other areas of oncology, such as survivorship, and palliative care. The corresponding improvement in knowledge and skillsets could ultimately improve patient outcomes .
Comparing clinicopathologic feature and treatment outcome of patients who underwent surgical resection or liver transplant for nonalcoholic fatty liver disease (NAFLD)-related and non-NAFLD related hepatocellular carcinoma (HCC).
Authors: Surendra Pal Chaudhary, Lipika Goyal, Matthew L Chase, Andrew X. Zhu, Nikroo Hashemi, Stephanie Reyes, Kathleen E Corey, Joseph Misdraji, Jeffrey William Clark
Journal: Journal of Clinical Oncology (2020)

e16675 Background: NAFLD associated HCC is rapidly increasing in frequency worldwide. In this study, we evaluated potential differences in clinical characteristics and outcomes of patients who underwent surgery or liver transplant for NAFLD-associated HCC compared to HCC from other etiologies. Methods: Demographic, clinicopathological features and outcomes of patients with HCC who underwent liver resection or liver transplant at Massachusetts General Hospital and Brigham and Women’s Hospital were collected (January 2004 - April 2018). Of 713 patients screened, 481were eligible: 260 underwent resection [NAFLD (n = 61), viral (n = 150), cryptogenic (CC) (n = 49)]. 221 underwent transplant [(NAFLD (n = 14), viral (n = 201), CC (n = 6)]. Results: In the Resected cohort, NAFLD patients presented with median age of (71.5 years) compared with Viral (63.4) and Cryptogenic (68.4). NAFLD patients had significantly higher Body Mass Index (BMI) &gt; 28.8 39(66%) p = &lt; 0.001, while patients with cryptogenic HCC presented with large tumor size (&gt;5cm) 37(75%) p = 0.001. In multivariate analysis, tumor size 5cm (HR1.78,p = 0.002), R1 or R2 resection (HR 2.48, p = &lt; 0.001and 2.8,p = 0.007), low platelet count (HR 2.8,p = 0.002) and diabetes (HR 1.5,p = 0.025) were poor prognostic factors in resection cohort. Median overall survival (OS) was not significantly different between NAFLD, Cryptogenic and Viral (47.2, 69.7 and 69.0 months, p = 0.18) etiologies, respectively. In the Transplant cohort, NAFLD patients had a median age of 65.5 and cryptogenic, viral (61.3 and 58.5 years) respectively. NAFLD and Cryptogenic HCC patients compared with viral HCC patients had low AFP median 3.7, 3.9 and 7.5 ng/mL(p = 0.012) respectively. In multivariate analysis patients with perineural invasion (HR 20.7,p = 0.009), disease recurrence (HR 2.5,p = 0.001) and high AFP (HR 2.1,p = 0.001) were at higher risk of death among transplant patients. No significant difference in median OS was seen between NAFLD, cryptogenic and viral (69.1,92.3 and 88.0 months, p = 0.38). Conclusions: NAFLD patients had higher BMI and had a lower AFP than viral and CC. NAFLD had similar median OS following resection and transplant when compared to those with Viral and CC.
The basic strategy for prevention and treatment of coronary heart disease
Authors: 胡大一
Journal: BMJ (2006)

在过去的10年,针对冠心病终末期(有症状或有事件)患者的血管重建技术(经皮介入或冠状动脉旁路移植术)在我国有了长足的发展和推广.但冠心病是一个持续发展的疾病过程,在血管壁上存在多处弥漫病变,并且同一患者可有不止一处的不稳定性斑块.而我国目前对冠心病的防治实践中存在的一个关键问题是只重救治,而对发生心绞痛或心肌梗死之前不防,救治之后也不管.这种落后的模式忽略了病前预防,导致医疗资源严重浪费.基Y于半数左右的冠心病患者的初期临床表现为急性心肌梗死或心脏性猝死,只治不防的策略必然导致大量患者的突发死亡或致残.由于重救治、轻救治后的疾病管理,因此缺血与再梗死的发生率也高,并且很多患者逐渐进入慢性心力衰竭的队伍。
Genome-wide plasma cell-free DNA methylation profiling to identify high-performing biomarkers for early detection of hepatocellular carcinoma.
Authors: Xin-Rong Yang, Ao Huang, Yuying Wang, Jiaxi Peng, Ruijingfang Jiang, Zhilong Li, Yuan Jie, Jia Fan, Jian Zhou
Journal: Journal of Clinical Oncology (2020)

4600 Background: Hepatocellular carcinoma (HCC) represents the second most common cause of cancer deaths worldwide. □-fetoprotein (AFP) is the most common serological test used for screening and diagnosis of HCC. However, it is widely recognized that AFP has lower sensitivity with sub-optimal specificity. Tumor-originated circulating cell-free DNA (cfDNA) provides new opportunity for non-invasive detection of liver cancer. Methods: HCC-specific differentially methylated regions (DMRs) were identified by whole genome bisulfite sequencing (WGBS) in 44 pairs of HCC tissues and adjacent tissues. We then performed methylome profiling on cfDNA from HCC patients and healthy individuals by targeted bisulfite sequencing covering genome-wide CpG islands, shelves, and shores. We employed machine learning approaches to build diagnostic models based on cfDNA regional methylation level to classify the plasma of HCC (n = 140) from that of healthy individuals (n = 84). Further analyses were performed in the validation cohort, including 155 HCC patients, and a control group with 96 healthy individuals, 21 chronic hepatitis B infection (CHB)/liver cirrhosis (LC) patients and 34 patients with benign hepatic lesions (BHL). Area under the receiver operating characteristic curve (AUC-ROC) was used to evaluate diagnostic performance. Results: A random forest classifier achieved an AUC of 0.97 (sensitivity: 92.9%; specificity: 89.4%) with 10-fold cross-validation using a panel of 39 DMR markers. The AUC of the diagnostic panel was 0.93 (sensitivity: 81.3%; specificity: 90.7%) in validation cohort, and it performed equally well in detecting BCLC stage 0+A (AUC = 0.90; sensitivity: 74.7%) and AFP negative (AUC = 0.92; sensitivity: 79.4%) HCC, as well as differentiating HCC from CHB/LC and BHL. Based on these results, we have further developed a small targeted bisulfite sequencing panel covering 127 CpG sites for non-invasive diagnosis of HCC. The panel had similar performance in training and validation cohorts, an AUC of 0.96 (sensitivity: 90.7%, specificity: 88.2%) in the training set, and 0.91 (sensitivity: 80.0%, specificity: 88.7%) in the validation set. Conclusions: Our diagnostic panel with 39 DMR markers showed high sensitivity and specificity in HCC diagnosis as well as surveillance in high-risk populations for developing HCC. More importantly, simple diagnostic model show similar diagnostic performance for early HCC diagnosis, which was easily to transfer to clinical application in the future.
Nivolumab versus the standard of care for cancer therapy: A meta-analysis of 6 CHECKMATE trials comparing overall survival.
Authors: Ammar Al-Obaidi, Nathaniel Parker, Quoc Van Truong
Journal: Journal of Clinical Oncology (2020)

e15165 Background: Nivolumab (N) is an antineoplastic agent approved for multiple different tumor origins as well as tumor agnostic based on MSI status. Thus, understanding the tumor characteristics most predictive of response is essential. Living meta-analysis provides a method to continuously assimilate emerging trials. In this study, we created a living meta-analysis to compare the effect of N on overall survival (OS). Methods: Meta-analysis was conducted according to the PRISMA guidelines. PubMed and Cochrane databases, and conference abstracts (e.g. ASCO, ESMO), were searched for phase III CHECKMATE RCT’s that reported OS among cancer patients receiving N. Results: Six phase III trials involving 3,342 patients (1,826 in N arms) treated for 4 different types of cancer were retrieved. Median follow up was 12.1 months [range: 5.1-25.2]. Improved efficacy and safety were observed in all N arms compared to control groups (22.8% ORR; 17.4% grade 3-5 AE vs 15.1% ORR; 51% grade 4-5 AE). Treatment was N alone, SOC chemo, and N + chemo in four (33%), six (50%), and two (16%) arms, respectively. Primary endpoints were OS in the first-line setting in 50% of all arms. Excluding one RCT due to insufficient survival data, the mean median OS was 11.1 [95% CI: 7.5-14.4] vs 8.7 [95% CI: 5.1-13.2] months in the total populations for all N and control arms, respectively. N improved OS when used in any cancer type, setting, or therapy for advanced refractory or chemo-naive cancer patients. Also, efficacy of N was improved with PD-L1% (Table). Conclusions: Among all trials, N was associated with improved OS. Additional meta-analysis is ongoing with R software (version 3.3.3; R Fdn.). Random-effects models will be used to compare OS. Heterogeneity will be assessed with Cochrane Q-statistic and quantified with I 2 test via subgroup analyses for cancer type, setting, therapy, and PD-L1%. [Table: see text]
城市社区卫生服务站老年患者就诊原因及患病状况研究
Authors: 路孝琴, 贾庆春, 梁万年, Wun Yuke Tsan, 彭晓霞
Journal: BMJ (2004)

按照国际标准,我国已进入人口老龄化阶段[1] .然而, 老年人的卫生服务却远没有达到同步发展.在大力发展社区卫生服务的政策指引下,如何为老年人提供更经济有效的服务,是当前面临的重要课题.要解决这一问题,首先就需要明确老年患者对社区卫生服务的主观和客观需求,才能够有针对性地提供以需求为导向的服务,满足患者的需要和需求.我们从全科医学服务的特点出发,利用基层医疗国际分类(ICPC-2)这一标准化的资料收集和分类工具,在社区卫生服务站以生物-心理-社会医学诊疗模式收集患者的就诊原因和健康问题,进而分析患者的服务需求,为社区卫生服务站发展计划的制定、人员的培训等提供参考依据,以有效地提高医护效能。
Analysis of bleeding risk with concurrent treatment of VEGFR tyrosine kinase inhibitors (TKIs) and factor Xa inhibitors.
Authors: Tiffany L. George, Sandip H. Patel, Tzu-Fei Wang, Sherry Mori-Vogt, Edmund Folefac, Ming Yin
Journal: Journal of Clinical Oncology (2020)

e19305 Background: Tyrosine kinase inhibitors (TKIs) of vascular endothelial growth factor receptor (VEGFR) may interfere with the coagulation system making patients susceptible to both hemorrhage and thromboembolism. Some cancer patients require dual treatment with VEGFR TKIs and factor Xa inhibitors. However, the safety of such combination treatment (e.g. bleeding risk) has not been well characterized in the literature. Methods: This retrospective study identified metastatic cancer patients who received VEGFR TKIs (pazopanib, sunitinib, sorafenib, axitinib, regorafenib, vandetanib, lenvatinib, cabozantinib, tivozanib) and Xa inhibitors (low-molecular weight heparin [LMWH] or direct oral anticoagulants [DOACs]- rivaroxaban or apixaban) from 2001 to 2018 at the Ohio State University. We assessed bleeding risks of dual therapy vs factor Xa inhibitors alone, using the same patients as self-controls. We defined bleeding based on criteria from the International Society on Thrombosis and Haemostasis. Fisher’s exact test was used to compare distribution of bleeding severities and the Cox model was used to analyze bleeding risk. Results: A total of 86 patients were included for analysis, with a median age of 56 (range, 34-88). The patient population was predominantly of male gender (69.7%), Caucasian race (89.3%) and renal cell cancer type (48.9%). As some patients had been on both LMWH and DOAC at different time periods, we found that 81 patients received concurrent TKI and LMWH; 19 patients had concurrent TKI and DOAC. Overall, 25 patients developed 29 clinically significant bleeding events (including 8 major bleeding) during concurrent treatment, and 15 patients developed 17 clinically significant bleeding events (4 major bleeding) during factor Xa inhibitor alone over a median follow up of 63 days. We found a statistically higher bleeding risk with concurrent treatment (HR = 2.23, 95% CI, 1.13–4.42, p = 0.02) compared with Xa inhibitor alone. In a stratified analysis, concurrent VEGFR TKI plus LMWH or DOAC both showed a strong trend for elevated bleeding risk. Although there were increased bleeding events with concurrent treatment, there was no significant difference in the proportion of major bleeding (27.6% vs 23.5%, p = 0.76). Median time to first bleeding event was 56 days for concurrent therapy and 72 days for Xa inhibitor alone. Conclusions: Concurrent treatment of VEGFR TKI and factor Xa inhibitors is associated with significantly increased bleeding risk when compared with factor Xa inhibitors alone in metastatic cancer patients.
Significance of extravascular lung water in fluid management for patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Jiangquan Yu, Ruiqiang Zheng, Hua Lin, Nianfang Lu, Jun Shao
Journal: BMJ (2015)

Objective
To explore the correlations of extravascular lung water index (ELWI), oxygenation index and intrathoracic blood volume index (ITBI) in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) and examine the significance of ELWI in fluid management.


Methods
A total of 63 hospitalized AECOPD patients with respiratory failure were recruited from our hospital from October 2010 to April 2013. Pulse indicator continuous cardiac output (PiCCO) technology was employed to monitor ITBI and ELWI. We compared the relationship of ELWI, ITBI and oxygenation index. And simple correlation analysis was used for statistical processing.


Results
Significant negative correlation existed in ELWI and oxygenation index (r=-0.741, P<0.01). ELWI 14 ml/kg was defined as a cutoff value for subgroup analysis. A negative correlation existed between ELWI and oxygenation index in the subgroup with ELWI<14 ml/kg, but there was no significant difference (r=-0.524, P=0.080); in the subgroup with ELWI≥14 ml/kg, there was significant negative correlation (r=-0.952, P<0.01). No significant correlation existed between ELWI and ITBI (r=0.477, P=0.072). ITBI 1 000 ml/m2 was defined as a cutoff value for subgroup analysis. No significant difference existed in the subgroup with ITBI<1 000 ml/m2(r=0.332, P=0.117). However, significant positive correlation existed in the subgroup with ITBI≥1 000 ml/m2 (r=0.677, P<0.01).


Conclusion
Excessive extravascular lung water is an important factor for acute exacerbation of COPD leading to respiratory failure.


Key words: 
Extravascular lung water; Pulmonary disease, chronic obstructive; Fluid management
马方综合征合并巨大卵巢子宫内膜异位囊肿一例
Authors: 丁颖, 范光升
Journal: BMJ (2008)

患者女,37岁,孕2产2.因腹胀半年,发现盆腔包块,于2006年2月20日入院.患者半年前腹胀,无腹痛,扪及直径约12 cm包块.包块渐增大,B超提示盆腔巨大包块,患者要求手术入院.平素月经规律,无痛经、性交痛及慢性盆腔痛.既往1996年开腹剔除右卵巢囊肿,自诉内容物为暗红色陈旧血液,无病理报告。
治疗性生活方式改变在调脂治疗中的临床价值
Authors: 杨和爱, 徐军
Journal: BMJ (2008)

对于血脂异常的治疗主要包括非药物治疗和药物治疗两方面,治疗性生活方式改变(TLC)因其简便易行、安全有效,目前在调脂治疗中受到重视.我们对48例血脂异常患者进行了为期8周的TLC治疗观察,取得满意效果。