Background:Asians are diagnosed with breast cancer at a younger age than Caucasians are.We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-cons...Background:Asians are diagnosed with breast cancer at a younger age than Caucasians are.We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-conserving therapy.Methods:Medical records of 2492 patients treated with breast-conserving therapy between 1989 and 2012 were reviewed.The Kaplan-Meier method was used to estimate locoregional recurrence,breast cancer-free survival,and breast cancer-specific survival rates.These rates were then compared using log-rank tests.Outcomes and age were modeled by Cox proportional hazards.Fractional polynomials were then used to test for non-linear relationships between age and outcomes.Results:Patients≤40 years old were more likely to have locoregional recurrence than were older patients(Hazard ratio[HR]=2.32,P<0.001).Locoregional recurrence rates decreased year-on-year by 4%for patients with luminal-type breast cancers,compared with 8%for those with triple-negative cancers.Similarly,breast cancer-free survival rates increased year-on-year by 4%versus 8%for luminal-type and triple-negative cancers,respectively.Breast cancer-spe-cific survival rates increased with age by 5%year-on-year.Both breast cancer-free survival and breast cancer-specific survival rates in patients with luminal cancers exhibited a non-linear(“L-shaped”)relationship-where decreasing age at presentation was associated with escalating risks of relapse and death.The influence of age on overall survival was confounded by competing non-cancer deaths in older women,resulting in a“U-shaped”relationship.Conclusions:Young Asian breast cancer patients have a continuous year-on-year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold.展开更多
: Comprehensive studies on a stalagmite from the Panlong cave, Guilin, have shown that the isotopic records and sedimentary characteristics can reflect the changes of both palaeotemperatures and palaeorainfall, that i...: Comprehensive studies on a stalagmite from the Panlong cave, Guilin, have shown that the isotopic records and sedimentary characteristics can reflect the changes of both palaeotemperatures and palaeorainfall, that is to say, it is possible to get some information about the changes in climate of the area from the speleothem. The results suggest that: (1) the Younger Dryas event might have persisted in the area from 11 300 to 10 800 a B.P.; (2) from 9000 to 7000 a B.P., the climate got warmer and wetter, and the summer monsoon was gradually enhanced; (3) from 7000 to 4500 a B.P., the climate was warm and wet, and the summer monsoon prevailed; and (4) from 4500 a B.P. on, the summer monsoon was weakened and the modern climate pattern appeared, but there were several cold and dry periods, namely, from 4000 to 2500 a B.P., ca. 2400 a B.P. and < 1000 a B.P.展开更多
Migraines are generally considered a relatively benign neurological condition.However,research has shown an association between migraines and stroke,and especially between migraine with aura and ischaemic stroke.Patie...Migraines are generally considered a relatively benign neurological condition.However,research has shown an association between migraines and stroke,and especially between migraine with aura and ischaemic stroke.Patients can also suffer from migrainous infarction,a subset of ischaemic stroke that often occurs in the posterior circulation of younger women.The exact pathogenesis of migrainous infarct is not known,but it is theorised that the duration and local neuronal energy level from cortical spreading depression may be a key factor.Other factors contributing to migrainous infarct may include vascular,inflammatory,endothelial structure,patent foramen ovale,gender,oral contraceptive pill use and smoking.Vasoconstrictors such as the triptan and ergot class are commonly used to treat migraines and may also play a role.Migraine is also shown to be correlated to haemorrhagic stroke,although studies do not demonstrate causation versus association,and further studies are warranted.There are also some rare genetic diseases such as cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy,retinal vasculopathy with cerebral leukodystrophy and others,which can cause both migraines and infarcts.On imaging,many migraineurs are found to have white matter changes similar to those seen in patients with stroke.These may be caused in part by alterations in resting cerebral blood flow and vasoconstrictor use.In treating patients with migraines,it is important to identify and modify any vascular risk factors such as hypertension,smoking,oral contraceptive pill use and lifestyle factors.Further studies will determine if more aggressive treatment of migraines can ultimately lead to fewer strokes in this population.展开更多
AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comp...AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comparative purposes,the patients were divided into two groups:younger patients who were less than 40 years old(112 patients),and older patients who were 40 years old and older(1555 patients).In both groups,propensity scoring methods were used to select patients with similar disease statuses.A total of224 matched cases,with 112 patients in each group,were included in the final analysis.RESULTS:Compared to the older group,the younger group with gastric cancer had a significantly higher percentage of females(P=0.007),poorly differentiated or signet ring cell carcinoma(P<0.001),advanced T stage gastric cancer(P=0.045),and advanced tumornode-metastasis stage cancer(P=0.036).The older group with gastric cancer had more comorbidities(P<0.001).With the exception of the number of lymph node dissection(P<0.001)and retrieved lymph node(P=0.010),there were no statistically significant differences between the postoperative outcomes of the two groups.During the follow-up period,there were19 recurrences in the younger group and 11 recurrences in the older group.The overall five-year survival rates in the younger and older groups were 84.3%and89.6%,respectively(P=0.172).There were no significant differences(P=0.238)in the overall survival of patients with advanced T stage gastric cancer in the two groups,with five-year survival rates of 70.8%in the younger group and 79.5%in the older group.With regard to the age-adjusted survival rate,there was significant difference between the two groups(P=0.225).CONCLUSION:In spite of aggressive cancer patterns in the younger group with gastric cancer,the younger group did not have a worse prognosis than the older group in our study.展开更多
Dawei was in intensive care unit on a ventilator.He was declared brain death after a traffic accident.At visiting time,his younger brother Dayong told me their final decision to give up the subsequent treatment.“We ...Dawei was in intensive care unit on a ventilator.He was declared brain death after a traffic accident.At visiting time,his younger brother Dayong told me their final decision to give up the subsequent treatment.“We don’t have enough money and medical insurance,we can’t afford further treatment”,he said.展开更多
文摘Background:Asians are diagnosed with breast cancer at a younger age than Caucasians are.We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-conserving therapy.Methods:Medical records of 2492 patients treated with breast-conserving therapy between 1989 and 2012 were reviewed.The Kaplan-Meier method was used to estimate locoregional recurrence,breast cancer-free survival,and breast cancer-specific survival rates.These rates were then compared using log-rank tests.Outcomes and age were modeled by Cox proportional hazards.Fractional polynomials were then used to test for non-linear relationships between age and outcomes.Results:Patients≤40 years old were more likely to have locoregional recurrence than were older patients(Hazard ratio[HR]=2.32,P<0.001).Locoregional recurrence rates decreased year-on-year by 4%for patients with luminal-type breast cancers,compared with 8%for those with triple-negative cancers.Similarly,breast cancer-free survival rates increased year-on-year by 4%versus 8%for luminal-type and triple-negative cancers,respectively.Breast cancer-spe-cific survival rates increased with age by 5%year-on-year.Both breast cancer-free survival and breast cancer-specific survival rates in patients with luminal cancers exhibited a non-linear(“L-shaped”)relationship-where decreasing age at presentation was associated with escalating risks of relapse and death.The influence of age on overall survival was confounded by competing non-cancer deaths in older women,resulting in a“U-shaped”relationship.Conclusions:Young Asian breast cancer patients have a continuous year-on-year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold.
文摘: Comprehensive studies on a stalagmite from the Panlong cave, Guilin, have shown that the isotopic records and sedimentary characteristics can reflect the changes of both palaeotemperatures and palaeorainfall, that is to say, it is possible to get some information about the changes in climate of the area from the speleothem. The results suggest that: (1) the Younger Dryas event might have persisted in the area from 11 300 to 10 800 a B.P.; (2) from 9000 to 7000 a B.P., the climate got warmer and wetter, and the summer monsoon was gradually enhanced; (3) from 7000 to 4500 a B.P., the climate was warm and wet, and the summer monsoon prevailed; and (4) from 4500 a B.P. on, the summer monsoon was weakened and the modern climate pattern appeared, but there were several cold and dry periods, namely, from 4000 to 2500 a B.P., ca. 2400 a B.P. and < 1000 a B.P.
文摘Migraines are generally considered a relatively benign neurological condition.However,research has shown an association between migraines and stroke,and especially between migraine with aura and ischaemic stroke.Patients can also suffer from migrainous infarction,a subset of ischaemic stroke that often occurs in the posterior circulation of younger women.The exact pathogenesis of migrainous infarct is not known,but it is theorised that the duration and local neuronal energy level from cortical spreading depression may be a key factor.Other factors contributing to migrainous infarct may include vascular,inflammatory,endothelial structure,patent foramen ovale,gender,oral contraceptive pill use and smoking.Vasoconstrictors such as the triptan and ergot class are commonly used to treat migraines and may also play a role.Migraine is also shown to be correlated to haemorrhagic stroke,although studies do not demonstrate causation versus association,and further studies are warranted.There are also some rare genetic diseases such as cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy,retinal vasculopathy with cerebral leukodystrophy and others,which can cause both migraines and infarcts.On imaging,many migraineurs are found to have white matter changes similar to those seen in patients with stroke.These may be caused in part by alterations in resting cerebral blood flow and vasoconstrictor use.In treating patients with migraines,it is important to identify and modify any vascular risk factors such as hypertension,smoking,oral contraceptive pill use and lifestyle factors.Further studies will determine if more aggressive treatment of migraines can ultimately lead to fewer strokes in this population.
基金Supported by The Dong-A University Research Fund
文摘AIM:To understand the clinicopathological and prognostic features of gastric cancer in younger and older patients.METHODS:Between January 2002 and December2008,1667 patients underwent curative gastric surgery.For comparative purposes,the patients were divided into two groups:younger patients who were less than 40 years old(112 patients),and older patients who were 40 years old and older(1555 patients).In both groups,propensity scoring methods were used to select patients with similar disease statuses.A total of224 matched cases,with 112 patients in each group,were included in the final analysis.RESULTS:Compared to the older group,the younger group with gastric cancer had a significantly higher percentage of females(P=0.007),poorly differentiated or signet ring cell carcinoma(P<0.001),advanced T stage gastric cancer(P=0.045),and advanced tumornode-metastasis stage cancer(P=0.036).The older group with gastric cancer had more comorbidities(P<0.001).With the exception of the number of lymph node dissection(P<0.001)and retrieved lymph node(P=0.010),there were no statistically significant differences between the postoperative outcomes of the two groups.During the follow-up period,there were19 recurrences in the younger group and 11 recurrences in the older group.The overall five-year survival rates in the younger and older groups were 84.3%and89.6%,respectively(P=0.172).There were no significant differences(P=0.238)in the overall survival of patients with advanced T stage gastric cancer in the two groups,with five-year survival rates of 70.8%in the younger group and 79.5%in the older group.With regard to the age-adjusted survival rate,there was significant difference between the two groups(P=0.225).CONCLUSION:In spite of aggressive cancer patterns in the younger group with gastric cancer,the younger group did not have a worse prognosis than the older group in our study.
基金supported by grants from the Zhejiang Natural Science Foundation(LQ20H030005)the Zhejiang Health Technology Project(2019RC153 and 2020KY126)。
文摘Dawei was in intensive care unit on a ventilator.He was declared brain death after a traffic accident.At visiting time,his younger brother Dayong told me their final decision to give up the subsequent treatment.“We don’t have enough money and medical insurance,we can’t afford further treatment”,he said.
