ABSTRACT
Brain metastases are common intracranial diseases featured with high incidence rate, difficult clinical treatment and poor prognosis. Especially for refractory brain metastases (large volume, multiple recurrence and metastatic tumors), it is difficult for conventional therapies to achieve ideal prognosis. Compared with conventional therapies, stereotactic radiosurgery (SRS) has the advantages of high accuracy, large fractional dose and low damage to the surrounding tissues, and has gradually become the primary choice for the treatment of brain metastases. SRS has a good effect in the treatment of refractory brain metastases, and can effectively inhibit tumor proliferation and improve the quality of life of patients. SRS combined with surgery, chemotherapy, molecular targeted therapy and immunotherapy can improve the local tumor control rate of patients with intractable brain metastasis, but whether it can improve the prognosis of patients is still controversial. The adverse reactions of combined therapies should also be concerned. Therefore, this article reviews the therapeutic effects of SRS in the treatment of refractory brain metastases, the strategies and progresses of combined treatment.
ABSTRACT
Objective: To study the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Methods: Electronic search was conducted to find studies about the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Data extraction and risk of bias assessment of included studies were conducted. RevMan5. 3 software was used fore Meta-analysis. Results: 6 clinical trials were qualified to the Meta-analysis. Compared to the control group, there was no significant change of skeletal measurments after treatment (P＞ 0. 05), and no significant change in dental measurments in chincup group (P＞ 0. 05) . While overbite, U1-PP (mm) and L1-MP (mm) were increased (P ＜ 0. 05), U1-NA (°) and L1-NB (°) decreased (P ＜ 0. 05) in the 3 groups of fixed palatal crib, bonded spur associated with the chincup and the removable palatal spur associated with the chincup. Conclusion: Chincup is not effective in the early treatment of the anterior open bite in patients with Angle class I malocclusion. But chincup combined with palatal spur or crib and have a positive effect on the closure of open bite through the palatal clination and extraction of the anterior teeth without influence of molar intrusion and skeletal change.
ABSTRACT
Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.Methods From January 2015 to January 2019,16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery,The Second Affiliated Hospital to Inner Mongolia Medical University.They were 14 men and 2 women with a mean age of 38.4 years (range,from 20 to 55 years).All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy.The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.Results All patients were followed up for a mean time of 12.6 months (range,from 6 to 30 months).The mean operation time was 68.4 minutes (range,from 52 to 96 minutes);the mean amount of hemorrhage during operation was 96.8 mL (range,from 48 to 122 mL);the mean period of bone union was 4.8 months (range,from 3 to 8 months).The postoperative mean AOFAS score was 75.3 points (range,from 43 to 91 points).Complications occurred in 4 cases,including one case of talus ischemic necrosis,one case of partial talus ischemic necrosis accompanied by tibial arthritis,one case of subtalar arthritis,and one case of combined tibial,talar and subtalar arthritis.All incisions obtained primary healing,with no complications like infection,screw breakage,delayed union or nonunion.Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
Objective@#To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.@*Methods@#From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.@*Results@#All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion.@*Conclusion@#Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
Gamma knife has the characteristics of high effectiveness, high safety and less complications in the treatment of primary trigeminal neuralgia. It can be used as the first treatment and repeated treatment. The treatment parameters such as irradiation dose, irradiation position, and irradiation length of the gamma knife can affect the efficacy and complications. In addition, the optimal treatment time, related treatment history and other clinically relevant factors of the patients need further research. This article reviews the factors related to the efficacy and complications of gamma knife treatment.
ABSTRACT
Objective To compare the efficacies and prognoses of stereotactic radiosurgery and fractionated stereotactic radiosurgery in treatment of brain metastases of lung cancer with diameter of 3-7 cm.Methods A retrospective study of 80 patients with brain metastases from lung cancer with diameter of 3-7 cm treated with gamma knife in our hospital from April 2010 to November 2016 was performed.There were 46 patients in stereotactic radiosurgery group and 34 in fractionated stereotactic radiosurgery group.The local tumor rate,incidence of complications,changes ofperitumoral edema,and Kamofsky Performance Status (KPS) scale scores at 3 months after operation were compared between the two groups.Multi-factor Cox regression model was used to analyze the factors influencing the short-term efficacy of patients.Kaplan-Meier survival analysis was used to evaluate the survival rate of patients.Results Three months after operation,the local tumor control rate and incidence of complications were 73.9％ and 21.7％ in the stereotactic radiosurgery group,and 94.1％ and 2.94％ in the fractionated stereotactic radiosurgery group,with significant differences (P＜0.05).As compared with those in the stereotactic radiosurgery group,the percentage of patients with increased grading ofperitumoral edema was significantly decreased and percentage of patients with increased KPS scores was significantly increased in fractionated stereotactic radiosurgery group (P＜0.05).Multivariate Cox analysis showed that tumor diameter was the only statistically significant risk factor for prognosis (P＜0.05).The median survival time was 13.6 months in the stereotactic radiosurgery group and 16 months in the fractionated stereotactic radiosurgery group.The one-year survival rate and accumulate survival rate showed no significant differences between the two groups (P＞0.05).Conclusion As compared with stereotactic radiosurgery therapy,fractionated stereotactic radiosurgery has more advantages in the treatment of lung cancer brain metastases with diameter of 3-7 cm.
ABSTRACT
Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.
ABSTRACT
Objective To examine the efficacy and safety of pregabalin in patients with neuropathic cancer pain (NCP).Methods A prospective randomized control multicenter trial was conducted in five hospitals;from January 2015 to January 2016,one hundred and twenty two eligible inpatients and outpatients were divided into pregablin treatment group (n=60) and control group (n=62).Patients in the pregablin group added pregablin to opiod background analgesia,while those in the control group raised opioid dose instead.The Numerical Pain Rating Scale (NRS) scores,paraesthesia scale scores,Hamilton's Depression (HAMD) scale scores,analgesia dose,patiends satisfaction,and adverse events were recorded 14 d after each treatment.Results After each treatment,the NRS scores were decreased by (2.3 ±1.1) and (1.3±1.5),the paraesthesia scale scores were decreased by (1.6±0.6) and (0.4±0.3),and the HAMD scale scores were decreased by (4.4±1.2) and (2.4±1.0) in the pregablin treatment group and control group,respectively,with significant differences (P＜0.05).Morphine dose for breakthrough pain in pregabalin group was statistically less than that in control group ([30.6±3.5] mg/d vs.[70.9±12.3] mg/d,P＜0.05).Patients satisfaction in the pregablin treatment group was significantly higher than that in the control group (P＜0.05).Pregabalin treatment group had less severe adverse effects (3/56,5％) as compared with control group (10/59,16.1％,P＜0.05).Conclusion Pregabalin has positive roles in patients with NCP already receiving opioid;pregabalin has better pain-control and mood improvement.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of Calcitriol soft capsules combined with Telmisartan tab-lets in the treatment of early diabetic nephropathy(DN),and the effect on the levels of inflammatory factors. METHODS:Totally 110 patients with early DN were randomly divided into observation group and control group. The control group was orally given Telmisartan tablets with the initial dose of 40 mg,qd,and the maximum dose was 80 mg,qd;the observation group was orally giv-en Calcitriol soft capsules 0.25μg based on the treatment of control group,qd. The course was 1 month. The clinical data was com-pared,including the clinical efficacy and 24 h urinary protein,serum creatinine(Scr),urinary albumin excretion rate(UAER),se-rum C reactive protein (CRP),tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) before and after treatment. The adverse reactions were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than con-trol group,with significant difference (P<0.05);the 24 h urinary protein,Scr,UAER,and levels of CRP,TNF-α and IL-6 in observation group were significantly lower than control group and before treatment,with significant differences(P<0.01 or P<0.05). There were no obvious adverse reactions in 2 groups. CONCLUSIONS:Calcitriol soft capsules combined with Telmisartan tablets has better efficacy than only Telmisartan tablets in the treatment of DN,and can more effectively improve the levels of CR, TNF-αand IL-6,which is helpful to delay progression of patients.
ABSTRACT
Objective To investigate the effect of hypobaric hypoxia postconditioning( HHP) on neurological func-tion prognosis in traumatic brain injury( TBI) rats. Methods 48 adult male Wistar rats were randomly divided into sham group(n=12),fpi group(n=18) and HHP group(n=18). The rat model of TBI was made by the method of fluid percussion injury( FPI) and rats in HHP group were submitted to HHP(360 Torr,2 h,3 trails spaced at 24 h) starting 3 h after FPI. The learning and memory abilitiy,motor coordination,anxiety and depression-like behaviors and surviving neurons of ipsilateral hippocampus were evaluated by Morris water maze( MWM) ,rotatord test,open-field test and hippocampus nissl stain respectly. Results Morris water maze:compared with sham and HHP group, learning and memory abilitiy of rats in fpi group were significantly decreased(F=4. 257 6,P0. 05);Rotatord test:compared with sham group,motor coordination of rats in HHP group were significantly decreased ( F=4. 335 , P0. 05 );Open-field test:compared with sham group, rats of fpi group showed significant anxiety and depression-like behavioral changes, whereas no difference was observed between sham and HHP group;Nissl stain:No difference of surviving neurons of ipsilateral hippocampus CA1 and CA3 re-gion was observed among three gourps at 3 d after FPI(P>0. 05). There were significantly fewer surviving neurons of ipsilateral hippocampus CA1 and CA3 region in fpi group than sham and HHP group at 24 d after FPI ( F =46. 758,5. 486,P<0. 05). Conclusion TBI induces learning and memory impairment,anxiety and depression-like behaviors and neurons death in hippocampus. HHP was first discovered having double effects on neurological func-tion prognosis in TBI rats. On the one hand,HHP can remove the impairment of learning and memory,anxiety and depression-like behaviors and neurons death in hippocampus;on the other hand,HHP impairs motor coordination at the same time.
ABSTRACT
OBJECTIVE: Computer has become an important tool in medical works. However, application ability of clinical physicians is imbalanced with the fast development of information technology (IT) system. Therefore, it is necessary to explore a bridge between researchers and integrate decentralized IT resources. Based on this survey, we provide some views concerning IT applying in medical procedures. METHODS: The correlated computer information was collected from a patient with coronary heart disease from early diagnosis, interventional therapy to coronary bypass surgery, until rehabilitation. The medical staffs were investigated from the general status, computer skills, knowledge structure, as well as the acceptance degree of computer application to measure computer skills. RESULTS: The correlated computer information was characterized by large soft variability, a large time span, and various date categories with more dynamic data or three-dimensional data. The investigation of computer knowledge demonstrated that the lack of IT knowledge resulted in poor outcome in their appointed tasks. From the view of self-assessment of IT knowledge, nursing staff and technician exhibited deficiency IT knowledge than doctors, who learned from department training, self-study or internet. Resident physicians and attending physicians were familiar with office system, so they were satisfied with IT skills. In contrary, nurses and majority of high-ranking professor or chief physicians were found difficult to study IT skills. However, most nurses were fond of their office system. The results also demonstrated that people aged 31 -40 years were easy to receive IT system. CONCLUSION: It is very important to enhance the cooperation between computer researchers and medical users for the treatment of coronary atherosclerotic heart disease.
ABSTRACT
OBJECTIVE:To provide a method for a scientific and rational formation of hospital drug purchase plan.METHODS:Based on the major factors influencing the drug purchase plans,a moving-average method(mathematical principle)was used to establish computational formula for hospital drug purchase plan model,which was then put into practice.RESULTS:The predicted amount calculated using the computation model could be used to track the actual consumption quantity rapidly;this model could auto-adjust the inventory and dynamically forecast the drug purchase amount.CONCLUSION:The computation model contributes to the scientific and reasonable formation of hospital drug purchase plan thus meeting the needs of majority clinical drugs.
ABSTRACT
OBJECTIVE Based on hospital information system operation platform,the antibacterial drugs utilization and control information system was designed to share prescriptions for antibacterial drugs and results for bacteria culture and drug sensitivity,to analyze pathogen composition and drug resistance trend,and supervise physicians to utilize antibacterial drugs properly. METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.Antibacterial drugs utilization software was integrated into resident physician's working stations.Antibacterial drugs utilization control software was installed into working stations for department of nosocomial infection. RESULTS The application of the information system strengthened control of antibacterial drugs utilization and could guide physicians to utilize antibacterial drugs properly. CONCLUSIONS Antibacterial drugs utilization and control information system could reinforce management of antibacterial drugs utilization,and facilitate to utilize antibacterial drugs properly and safely.
ABSTRACT
OBJECTIVE Based on hospital information system operating platform,the Nosocomial Infection Early Warning Information System is designed to study nosocomial infection concerning its risk factors,occurrence pattern,and control measures so that the epidemic of nosocomial infection could be early found and controlled effectively,the capability of nosocomial infection supervision could be steadily increased.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.To structure a reporting,early warning,and supervising network,nosocomial infection reporting card software was integrated into resident physician′s working stations,and early warning control software was installed into working stations for department of nosocomial infection.RESULTS The application of the information system could early warn and supervise occurring nosocomial infection cases,help to find the epidemic of nosocomial infection in time and take effectively control measures as soon as possible.CONCLUSIONS Nosocomial Infection Early Warning Information System could early warn and control nosocomial infection on-the-spot,increase efficiency of nosocomial infection management and improve quality of care.
ABSTRACT
OBJECTIVE To set up the infectious disease monitoring platform upon the hospital information system(HIS).In order to study the infectious disease′s early discovery,early reporting,early therapy and early control,to improve the hospital′s capability of prevention and cure of the infectious disease,generally improving the medical treatment quality.METHODS The computer technic was used to auto-collect,save,process the patient′s information.RESULTS To realize the information be shared;play a role in real time effective monitor;to provide the basic information of medical treatment,scientific research,education and management.CONCLUSIONS Realizing the scientific,standardized,systematized management of hospital infectious disease is becoming an important part in the whole HIS as the hospital medical treatment control system.
ABSTRACT
OBJECTIVE To learn the molecular epidemiologic character of 21 genotypes of human papillomavirus(HPV).METHODS Totally 500 samples from women genital tract secretion were monitored by flow-through hybridization and gene chip,then studying the molecular epidemiologic character of HPV included HPV6,11,16,18,31,33,35,39,42,43,44,45,51,52,53,56,58,59,66,68,and CP8304.RESULTS The total positive rate of 21 genotypes of HPV was 53% in women cervicitis patients,high-risk HPV genotypes were 60% in all positive samples.Among 21 genotypes of HPV,the positive rate of HPV11 was the first(12.4%),but HPV16 positive rate was the first among high-risk genotypes(11.2%).Among the positive rates in different stage of years,the 21-30 years old group was the highest,the 31-40 years old group was the second,total of two groups was 76.6%.CONCLUSIONS The molecular epidemiologic results can be used in development of HPV vaccine,and in prevention and cure of HPV infection.
ABSTRACT
Objective To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometrioms ( AWE). Methods 19 cases of AWE diagnosed at Shaoxing People' s Hospital from January 2005 to April 2009 were reviewed retrospectively. Results All patients had a history of cesarean section. Eleven patients (57.9%) had the typical complaint of an enlarging mass and pain during menstruation. All patients received surgical excision and postoperative adjuvant therapy of gonadotropin releasing hormone agonist (GnRHa) or Mifepristone treatment for 6 months. The diagnosis was confirmed by histological examination in all patients. At follow- up, ranging from 1 month to 3 years, there was 1 case of recurrence of endometrioms during a follow -up of 2 years. Conclusion AWE could be diagnosed easily by its typical clinical manifestations preoperatively. Sonography or MRI may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions, however it lacks specificness. Surgical excision is the only effective treatment, and complete and wide local excision is the key point to prevent recurrence. Combination surgical excision with postoperative adjuvant therapy might reduce the recurrence, although its effectiveness need being testified in the future.
ABSTRACT
OBJECTIVE To set up a multiple functional information system for prevention, health care and hospital infection management in order to substitute the primitive older methods.METHODS On the platform of hospital information system, to construct above mentioned system, adopting C/S framework, the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition, the front application program used Power Builder7 programming. The application software where collected all data about happened public health event, infectious disease epidemic situation and hospital information management was integrated into the each work station of the information system of hospital management, in order to form the report related to any department of the hospital, and control network. RESULTS System could come down with the public health event to which every hospital department could find the infectious disease case, hospital infection case, etc. to check, put in order, report, count, analyze, have a look around, inquire about, feedback, and form the monitoring chart with excellent pictures and texts. CONCLUSIONS This software is a medical quality control system of a hospital, can to meet suddenly public health event, infectious disease epidemic situation and hospital infection control, and raise working efficiency in real time to control hospital infection.
ABSTRACT
Objective:To study the protective effects of collagen peptide-chromium (Ⅲ) complex (CPCC) on alloxan-induced hepatic injury in mice. Method:The mice were divided into three groups (normal, model, CPCC) and given (po.) water, water and CPCC (Cr3+40?g/kg?d) respectively once a day. After 4 weeks, the model and CPCC groups were injected with alloxan. Then the levels of liver index, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) were measured. Activities of superoxide dismutase (SOD) ,glutathione peroxidase (GSH-Px) and contents of malondialdehyde (MDA) in liver were tested. Also liver pathological changes were observed. Results:CPCC could reduce the levels of liver index, serum levels of AST,ALT and ALP as well as contents of MDA and activities of SOD and GSH-Px in liver. Hepatocytes lesion was alleviated markedly. Conclusion:CPCC has protective effects on alloxan-induced hepatic injury in mice.
ABSTRACT
Objective To establish an effective method for inducing mouse bone marrow mononuclear cells(MNCs) to differentiate into hepatocytes.Methods MNCs were isolated by gradient density centrifugation,and the cells were cultured in Iscove's Modified Dulbecco's medium supplemented with 10 % new bovine serum(NBS),20 ng/ml hepatocyte growth factor(HGF),10 ng/ml fibroblast growth factor-4(FGF-4) and 10 ng/ml oncostatin m(OSM) for 21 days' induction.The medium was changed every 3 days.Results When MNCs were cultured with HGF,FGF-4 and OSM,cuboidal morphology was observed,and cells also expressed marker genes specific for liver cells in a time-dependent manner.?-fetoprotein(AFP) and cytokeratin 19(CK19) were expressed on the day 7,and CK18 and TAT were detected on the day 14-21,in common with the immunofluoresence results.Differentiated cells further demonstrated these cells also acquired functional characteristics of hepatocytes.Conclusion Mouse MNCs can differentiate into hepatocytes when induced by HGF,FGF-4 and OSM.