This article summarizes the components,the formation and development of carotid atherosclerotic plaque,the factors affecting the stability of plaque,the mechanisms of plaquecaused ischemic cerebrovascular disease as well as the diagnosis of plaques and the treatmentstatus.

Objective:To compare the efficacy and safety of azacitidine alone or combined with half-course CAG (arorubicin + cytarabine + granulocyte colony stimulating factor) regimen and azacitidine combined with full-course CAG regimen in treatment of patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS).Methods:The clinical data of 51 patients with AML and MDS admitted to Datong Fifth People's Hospital from September 2019 to March 2022 were retrospectively analyzed. Among them, 17 patients received azacitidine alone 7-day regimen, 17 patients received azacitidine combined with half-course CAG regimen and 17 patients received azacitidine combined with full-course CAG regimen. The remission rate, adverse reaction rate and supportive treatment were compared among the three groups.Results:The objective remission rate (ORR) was 58.8% (10/17), 64.7% (11/17) and 70.6% (12/17) in azacitidine alone group, azacitidine combined with half course CAG group, and azacitidine combined with full course CAG group, respectively, and the difference was not statistically significant among the above groups ( P = 0.773). The main adverse reaction after treatment with azacitidine was bone marrow suppression,and 32 patients had grade 3-4 hematological side effects. The average time of agranulocytopenia was (15±5) d, 23 patients had infection and 11 cases had hemorrhage. There were no significant differences of the three groups in the hemorrhage incidence, the infection, incidence, agranulocytosis time, the amount of red blood cell infusion and the amount of platelet infusion (all P > 0.05). Except 1 patient died of acute left ventricular dysfunction after chemotherapy in the first cycle and 1 patient died of cerebral hemorrhage after chemotherapy in the third cycle, all the patients successfully completed the chemotherapy after active symptomatic support treatment and safely passed the bone marrow suppression period. Conclusions:Azacitidine alone, azacitidine combined with half-course CAG, azacitidine combined with full-course CAG regimens in the treatment of AML/MDS all show good curative effects, and their adverse reactions are similar to supportive treatment. Azacitidine combined with full-course CAG regimen has a relatively high effective rate.

Objective:To investigate the effect and adverse reactions of radiotherapy combined with targeted drugs for the treatment of multiple brain metastases (MBM) in patients with non-small cell lung cancer (NSCLC) and the changes in serum tumor marker levels.Methods:A retrospective cohort study was conducted. Eighty-six patients with NSCLC-MBM who were admitted to the Fifth People's Hospital of Datong from June 2019 to June 2022 were selected, and the patients were divided into the study group and the control group according to different treatment methods, with 43 cases in each group. The study group was given radiotherapy to the tumor primary focus combined with erlotinib or gefitinib targeted therapy, and the control group was given radiotherapy to the tumor primary focus based on conventional chemotherapy with pemetrexed combined with platinum-based drugs. The efficacy, overall survival rate and incidence of adverse reactions were compared between the two groups at 1 month after treatment; the levels of serum tumor markers S100-β, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA) were compared between the two groups before and after treatment.Results:The study group was aged (55±5) years old, ranging from 39 to 75 years old, including 15 (34.88%) males and 28 (65.12%) females; the control group was aged (54±5) years old, ranging from 38 to 72 years old, including 17 (39.53%) males and 26 (60.47%) females. The general data such as age and gender of patients were compared between the two groups, and the differences were not statistically significant (all P>0.05). The objective remission rate [53.49% (23/43) vs. 32.56% (14/43)] and disease control rate [93.02% (40/43) vs. 69.77% (30/43)] at 1 month after treatment, and 1-year overall survival rate [58.14% (25/43) vs. 46.51% (20/43)] of the study group were higher than those of the control group, and the differences were statistically significant ( χ2 values were 10.91, 5.76 and 11.02, respectively; P values were 0.001, 0.016 and 0.001, respectively). Before treatment, the differences in serum S100-β, CEA and SCCA levels between the two groups of patients were not statistically significant (all P > 0.05). At 1 month after treatment, the serum S100-β, CEA and SCCA levels of the study group were lower than those of the control group, and the differences were statistically significant (all P < 0.05). The proportion of patients with adverse reactions in the study group was lower than that in the control group [13.95% (6/43) vs. 39.53% (17/43)], and the difference was statistically significant ( χ2 = 8.35, P < 0.05). Conclusions:Radiotherapy combined with targeted drugs therapy may prolong the survival of NSCLC-MBM patients, reduce the occurrence of adverse reactions and decrease the levels of serum tumor markers, which is worthy of clinical promotion.

Objective:To compare the efficacy and safety of azacitidine combined with venetoclax or CAG regimen in the treatment of newly treated elderly patients with acute myeloid leukemia (AML).Methods:A retrospective cohort study was conducted. The clinical data of 34 newly treated elderly patients with AML treated in the Fifth People's Hospital of Datong from May 2018 to August 2023 were retrospectively analyzed. According to the treatment regimen, all patients were divided into venetoclax group (azacitidine + venetoclax, 17 cases) and CAG group (azacitidine + CAG regimen, 17 cases). The clinicopathological characteristics, efficacy, adverse reactions and survival of the both groups were compared.Results:There were no statistically significant differences in the clinical data of both groups (all P > 0.05). The complete remission (CR) rate and the objective response rate (ORR) in venetoclax group were higher than those in CAG group [CR: 70.6%(12/17) vs. 47.1% (8/17); ORR: 82.4% (14/17) vs. 64.7% (11/17)],while the differences in CR and ORR were not statistically significant (χ 2 = 2.00, P = 0.163; χ 2 = 2.00, P = 0.244). The follow-up time[ M ( Q1, Q3)] was 25.4 months (7.2 months, 60.3 months). At the end of follow-up, 19 of 34 patients survived (13 cases in venetoclax group and 6 cases in CAG group); 15 died (4 cases in venetoclax group and 11 cases in CAG group). The median overall survival (OS) time was 14.22 months (95% CI: 8.2-60.3 months) and 10.56 months (95% CI: 7.2-50.2 months), respectively in venetoclax group and CAG group;the median progression-free survival (PFS) time was 9.97 months (95% CI: 5.4-40.5 months) and 6.82 months (95% CI: 5.0-36.2 months), respectively, and there were no statistically significant differences in OS and PFS between the two groups (all P > 0.05). Grade 3-4 hematological adverse reactions occurred in 16 and 14 patients in venetoclax group and CAG group, respectively. There were no significant differences in granulocyte deficiency time, platelet deficiency time, infection and bleeding incidence between the two groups (all P > 0.05). Conclusions:Azacitidine combined with venetoclax or CAG regimen have better clinical efficacy and safety for newly treated elderly patients with AML.