Most of the early-stage lung cancers have no obvious symptoms, and most patients are already in the advanced stage when diagnosed, and the overall 5-year survival rate of lung cancer is only about 16%.
People with lung cancer have different symptoms of cough because of where, how, and how quickly the tumor grows. When the tumor cells grow in the larger airways, it is a paroxysmal irritating cough with no sputum or a little foamy sputum. Bronchioloalveolar carcinoma may have a large amount of serous sputum. If the tumor enlargement affects the drainage of sputum, the sputum volume increases and becomes mucopurulent in the event of secondary infection.
Due to the abundant blood vessels in tumor tissue, some patients with tumor necrosis may have blood in the sputum or intermittent bloody sputum. If the tumor invades larger blood vessels, it can cause massive hemoptysis. The tumor causes compression or partial obstruction of the trachea, and the airflow through the trachea can cause stridor. Tumors cause bronchial stenosis or extensive lung invasion leading to a reduction in the respiratory area, or metastasis to the pleura causing a large amount of pleural effusion, which may manifest as increasing chest tightness and shortness of breath.
If you suspect lung cancer, you should go to the hospital in time, and low-dose chest CT is recommended for screening. When necessary, bronchoscopy or needle biopsy is performed for pathological testing and genetic testing.
Carotid plaque is closely related to transient cerebral ischemia and ischemic stroke. Many middle-aged and elderly people feel a little worried when they find that they have carotid plaques on the physical examination report. Correct understanding of it and management of it can effectively prevent the occurrence of diseases.
Which screening method is better?
For the initial screening of plaque, ultrasound has more advantages than CT and MRI, so ultrasound is the first choice. Carotid ultrasound can display the extent of plaque involvement, intimal thickness, and blood flow velocity. CT, MRI and other methods may exaggerate the extent, nature, and severity of plaques, resulting in false positive results. If carotid ultrasound results suggest that the patient may have carotid artery stenosis, CT revascularization or magnetic resonance angiography is required to further evaluate the stenosis.
How often to check
the carotid plaque inspection cycle is related to the patient’s age, high-risk factors, plaque nature, the extent of involvement, and the thickness of the vascular intima. It is recommended that people over 55 years old have a carotid artery ultrasound every year. If there are high risk factors such as hypertension, hyperglycemia, hyperlipidemia or other atherosclerotic diseases, obesity, smoking and drinking, the screening interval needs to be shortened. Once unstable plaques are found, it is recommended that every 3-6 plaques be detected Monthly review.
Do I need treatment?
Once plaque is found, it is necessary to take anti-platelet drugs such as statin lipid-lowering drugs and aspirin according to the doctor’s order, and pay attention to the standardized treatment of hypertension and diabetes, in order to delay the progression of the disease. In addition to statins that can improve lipid metabolism, drugs such as ezetimibe can inhibit lipid absorption. If the above two types of oral drugs still cannot control blood lipids, PCSK9 inhibitors can be injected every 2 weeks or 1 month. Lipid lowering.
If amaurosis, drowsiness, dizziness and other symptoms suggestive of cerebral ischemia have occurred in the past 6 months, surgery should be considered on the basis of drug therapy. For asymptomatic patients, if the carotid artery stenosis exceeds 70%, surgery should also be considered.
In addition, unstable plaques are at risk of falling off at any time. Regardless of whether the symptoms of cerebral ischemia are obvious, intervention measures such as surgery or interventional surgery should be actively taken.
What is the meaning of hyperechoic and hypoechoic in the ultrasound report?
If ultrasound report shows hyperechoic, smooth surface, and regular shape, it is mostly hard plaque; if it shows hypoechoic or uneven echo, and the surface is not smooth, it is mostly a soft plaque . If it is a mixed echo, it means that the plaque echo is uneven, which generally indicates that the composition of the plaque is mixed, and there is a risk of falling off and forming a thrombus.
Is carotid plaque dangerous? To
assess the risk of carotid plaque, check whether the plaque is stable and whether there is carotid stenosis.
Stable plaques are generally hyperechoic, hyperechoic, and hard in texture. Because they are not easy to rupture and fall off, the risk of stroke is small. If the carotid artery stenosis caused by stable plaque is less than 50%, it will generally not affect the brain; if the carotid artery stenosis exceeds 50%, or even more than 70%, the risk increases accordingly.
Hypoechoic, mixed echogenic plaques are mostly unstable plaques. Unstable plaque may have the risk of ulceration and rupture. Platelets aggregate at the rupture to form thrombus. If the lipid core, debris, and thrombus fall off, embolizing the blood vessels in the brain, transient cerebral ischemia or ischemic stroke may occur. .
Will carotid plaques disappear?
A small number of patients who are in the early stage of plaque formation and have not yet developed vascular stenosis may shrink their plaques if they take antiplatelet drugs and lipid-lowering drugs strictly according to doctor’s orders, and control their lifestyle. For most patients, once the plaque forms, it progresses gradually and is generally difficult to reverse.
Although plaques are difficult to reverse, by improving living habits, preventing chronic diseases, and treating lipid-lowering drugs, unstable “soft plaques” may become relatively stable “hard plaques”, thereby reducing the risk of disease.
Surgery or stent is better for
surgical Both surgical methods and interventional methods have their own indications and limitations. If the patient’s blood vessels have unfavorable factors such as variation, deformity, stenosis, and excessive bending, it is not suitable for stent implantation, and surgery can be selected. Stenting may be evaluated in patients who cannot tolerate surgery or whose plaque cannot be resolved by surgery.
After the operation, it is not a once and for all. It is necessary to continue to maintain good living habits, insist on taking medicines, and control blood pressure, blood sugar, and blood lipids according to stricter standards to prevent plaques from forming again.
When I exercise every evening, I can almost see a middle-aged man in his 50s wearing myopia glasses. He runs around the 800-meter cement road outside the garden without stopping for more than ten laps. Running on the slopes, he put a towel over his shoulders, wiping the sweat from time to time. As I passed him, I could hear his gasping voice. I admire his perseverance, and at the same time, I am also worried about him. He already looked thin, and his complexion was not very good-looking, and he was not of a strong body type.
I know that he wants to run this way to exercise, through running to make the body strong. His original intentions must have been positive, but his super-intensive, overloaded exercise is a big mistake and a big mistake. People know the harm of overwork to the body, and they always think that long-term hard physical labor is overwork, but they don’t know that excessive exercise is also overwork. Excessive exercise not only does not help the body, but it can accelerate the deterioration of health.
In recent years, the research results of excessive exercise at home and abroad have confirmed that long-term excessive exercise can cause decreased immune function, joint muscle and ligament damage, arthritis, renal tissue damage, retinal detachment, and accelerated human aging. Negative consequences of divergence.
In the “Huangdi Neijing”, there is such a paragraph about health preservation: “The one who knows, the law is in yin and yang, in harmony with the number of techniques, eat and drink in moderation, daily life is constant, and do not work rashly, so he can form and spirit, and To the end of his days, he will pass his hundred years.” Among them, “do not work rashly” means that you should not be too tired, and you must work and rest in moderation, that is, “always want to work a little (little movement) but be very tired”, which means It is a summary of the experience of ancient people’s health care.
How to judge whether it is overloaded exercise mainly depends on two indicators: the first judgment index is self-feeling. Since the amount of exercise varies from person to person, self-feeling is the most direct indicator for judging whether exercise is excessive. If exercise can make you experience mild shortness of breath, feel some rapid heartbeat, slightly warm body, sweaty body, and feel relaxed and happy all over the body after exercise, this indicates that the exercise is moderate; if exercise makes you breathless, dizzy, sweating profusely It’s dripping, the heart is beating like it’s about to jump out, and the whole body is so heavy that you don’t want to move anymore after exercising, it must be overexertion. The second judging indicator is heart rate. Exercise can increase the heart rate to achieve the effect of exercise, but the heart rate must be kept within 150 beats per minute during exercise. This heart rate range can ensure that every contraction of the heart is effective and can provide an adequate supply of oxygen to the body that is exercising. Exceeding this heart rate, all organs of the body will be deprived of oxygen, and exercise will become harmful and unhelpful, which is excessive exercise.
If it is not for the special needs of the occupation, it is best not to exercise excessive intensity and overload for a long time. Excessive exercise is a taboo for health. Remember the ancient people’s health care experience: often want to work a little but get tired.