目的探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)患者新辅助治疗后行电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)和开胸手术的围手术期疗效差异。方法回顾性收集2020年6月—2022年5月上海市肺科医院新辅助治疗后行VATS或开胸手术NSCLC患者的临床资料,比较两组围手术期结果。结果共纳入260例患者,其中184例(70.8%)行VATS,76例(29.2%)行开胸手术。经倾向性评分匹配后VATS组113例(62.4%),开胸组68例(37.6%)。VATS具有与开胸相似的淋巴结清扫能力与术后并发症发生率(P>0.05),优点是手术时间更短(146.00 min vs.165.00 min,P=0.006)、术中失血量更少(50.00 mL vs.100.00 mL,P<0.001)、术中输血率更低(0.0%vs.7.4%,P=0.003)、术后3 d引流量更少(250.00 mL vs.350.00 mL,P=0.011;180.00 mL vs.250.00 mL,P=0.002;150.00 mL vs.235.00 mL,P<0.001)、术后引流时间(9.34 d vs.13.84 d,P<0.001)和术后住院时间(6.19 d vs.7.94 d,P=0.006)更短。结论NSCLC新辅助治疗后行VATS手术安全性高于开胸手术,并且术后恢复更好。
多发性硬化症(MS)作为一种中枢神经系统的炎性脱髓鞘疾病,给年轻人群带来了严重危害,已成为非创伤性残疾的首要原因。目前,学界普遍认为其致病机制是多因素共同作用的结果。本文深入探讨了可能触发MS的几种关键致病因素,主要涵盖遗传因素、病毒因素以及自身免疫因素等方面。此外,还对MS的疾病修饰治疗、对症治疗和间充质干细胞治疗方案进行了全面综述,详细分析了各种治疗方案的优缺点以及临床应用前景。通过对这些内容的研究,旨在为进一步理解MS的发病机制以及优化治疗策略提供有益的参考和依据。Multiple sclerosis (MS), as an inflammatory demyelinating disease of the central nervous system, has brought serious harm to young people and has become the leading cause of non-traumatic disability. At present, it is generally believed that the pathogenic mechanism is the result of the combined action of multiple factors. This article provides an in-depth discussion of several key pathogenic factors that may trigger MS, mainly covering genetic factors, viral factors, and autoimmune factors. In addition, the disease-modifying therapy, symptomatic treatment and mesenchymal stem cell treatment regimens of MS are comprehensively reviewed, and the advantages and disadvantages of each treatment regimen and the clinical application prospects are analyzed in detail. Through the study of these contents, it aims to provide a useful reference and basis for further understanding the pathogenesis of MS and optimizing treatment strategies.
甲型流感病毒因其高变异性和传播能力,能够引起全球性的大流行。目前,抗流感病毒药物是临床治疗流感的主要手段,这些药物通过阻断病毒的进入、复制和释放等环节发挥抗病毒作用。然而,流感病毒的变异和逃避免疫系统的能力促使科研人员不断分析新的甲型流感抗病毒药物。扎那米韦是一种有效的神经氨酸酶抑制剂,通过抑制病毒从宿主细胞中释放,从而限制其在体内的传播。随着流感病毒的不断变异和耐药性的增加,单一药物的治疗方案已经不足以应对当前的流感挑战。因此,开发与扎那米韦等神经氨酸酶抑制剂联合使用,成为当前抗流感药物研发的热点。本文综述了扎那米韦在治疗甲型流感方面的临床研究进展,重点关注了其对流感治疗作用,期望对流感临床药学应用发展提供新的用药治疗参考。Influenza A viruses are capable of causing a global pandemic due to their high mutability and transmissibility. Currently, anti-influenza virus drugs are the mainstay of clinical treatment for influenza, and these drugs exert their antiviral effects by blocking the entry, replication, and release of the virus. However, the ability of influenza viruses to mutate and evade the immune system has prompted researchers to continuously analyze new influenza A antiviral drugs. Zanamivir is a potent neuraminidase inhibitor that works by inhibiting the release of the virus from host cells, thereby limiting its spread through the body. As influenza viruses continue to mutate and increase drug resistance, single-drug regimens are no longer sufficient to meet the current influenza challenge. Therefore, the development of combinations with neuraminidase inhibitors, such as zanamivir, has become a hot topic in current anti-influenza drug development. This article reviews the clinical research progress of zanamivir in the treatment of influenza A, focusing on its therapeutic effect on influenza, and expects to provide new references for the development of influenza clinical pharmacy applications for drug therapy.
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