With the popularization of CT technology, more and more multiple primary lung cancer, that is, the simultaneous presence of more than one primary cancer in the lungs, has been detected. Imaging can make a rough judgment, histopathology is still the diagnostic gold standard, and molecular genetics examination can better distinguish it from intrapulmonary metastatic cancer when necessary. At present, there is no unified treatment standard for multiple primary lung cancer. Surgery is the most important and effective means, and the surgical method needs to be personalized according to the size and distribution of the patient's lesions, one-sided lobectomy and the other side sublobar resection is considered safe and feasible. At the same time, local nonsurgical treatment is also an option or a supplement to surgical treatment. This article reviews the diagnosis and treatment of multiple primary lung cancer in recent years.

Anterior cervical discectomy and fusion is one of the classic procedures for the treatment of cervical spondylosis, and dysphagia is a common perioperative complication of this procedure, which affects patients′ recovery to different degrees. This paper summarizes and analyzes the perioperative assessment and interventions in the care of patients with dysphagia after anterior cervical discectomy and fusion, aiming to improve clinical nursing staff′s attention to dysphagia in patients after anterior cervical discectomy and fusion, and provide scientific basis for the prevention and treatment of high-risk groups.

Objective To study the association between white matter hyperintensities(WMH)and cognitive function in silent lacunar cerebral infarction patients and its risk factors.Methods One hundred and seventy-four silent lacunar cerebral infarction patients were included in this study. They underwent MRI to show the site and severity of their WMH,including degrees 0-3of periventricular WMH in 21,102,39,12patients respectively,and deep WMH in 19,53,86,16patients respectively.Then,their cognitive function scores were compared.Results The degree of WMH was significantly higher and the age was significantly older in silent lacunar cerebral infarction patients(P＜0.05).The situation memory,working memory and Simplified Intelligent State Scale score were significantly different in patients with different degrees of WMH in peripheral brain(P＜0.05,P＜0.01).The working memory was significantly different in patients with different degrees of WMH in deep brain(P＜0.05).Degrees 1and 2of periventricular WMH were the independent risk factors for the impaired working memory(β=-0.264,P=0.038;β=-0.325,P=0.011)while degree 3of periventricular WMH was the independent risk factor for the impaired cognitive function(β=-0.273,P=0.014).Conclusion The memory is easy to be impaired in silent lacunar cerebral infarction patients with WMH of aging brain.Periventricular WMH is the major risk factor for cognitive impairment.

The present study was designed to develop and evaluate glycyrrhetinic acid-graft-hyaluronic acid (HGA) conjugate for intravenous paclitaxel (PTX) delivery. Lyophilized PTX-loaded self-assembled HGA nanoparticles (PTX/HGAs) were prepared and characterized by dynamic light scattering measurements. Hemolysis test, intravenous irritation assessment, and in vitro and in vivo pharmacodynamic studies were carried out. B16F10 and HepG2 cells were used in the cell apoptosis analysis. The mouse MDA-MB-231 xenograft model was used for the evaluation of in vivo anticancer activity of the drugs, by the analysis of tumor growth and side effects on other tissues. PTX/HGAs showed high stability and good biocompability. Compared with PTX plus GA plus HA solution, PTX/HGAs displayed obvious superiority in inducing the apoptosis of the cancer cells. Following systemic administration, PTX/HGAs efficiently suppressed tumor growth, with mean tumor inhibition ratio (TIR) being 65.08%, which was significantly higher than that of PTX plus GA plus HA treatment. In conclusion, PTX/HGAs demonstrated inhibitory effects tumor growth without unwanted side effects, suggesting that HGA conjugates hold a great potential as a delivery carrier for cancer chemotherapeutics to improve therapeutic efficacy and minimize adverse effects.
Animals ; Antineoplastic Agents ; administration & dosage ; adverse effects ; chemistry ; Apoptosis ; drug effects ; Drug Carriers ; chemistry ; Drug Delivery Systems ; instrumentation ; methods ; Drug Synergism ; Female ; Glycyrrhetinic Acid ; chemistry ; Hep G2 Cells ; Humans ; Hyaluronic Acid ; chemistry ; Male ; Mice ; Paclitaxel ; administration & dosage ; adverse effects ; chemistry