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Objective To investigate the clinical effect of acupuncture combined with five-step reduction method for treating intervertebral disc herniation (IDH). Methods A total of 80 patients meeting the requirement of IDH were selected and randomly divided into control group, acupuncture group, five-step reduction massage group and acupuncture combined five-step reduction method group. Each group included 20 subjects, who received two courses of treatment for 1 month. After the treatment, the therapeutic effects of acupuncture, five-step reduction massage, acupuncture combined with five-step reduction massage were evaluated. The observation indicators included back pain JOA scale, McGill pain scale, quality of life QOL scale, gravitational moment and muscle moment. Results After the intervention treatment, compared with control group, the JOA, McGill, QOL, gravitational moment and muscle moment of patients in acupuncture group, five-step reduction massage group, acupuncture combined five-step reduction method group were significantly improved (P<0.05), and the improvement effect in combined treatment group was more significant (P<0.01). Conclusions Acupuncture combined with five-step reduction method significantly improved the symptoms of lumbar disc herniation in swimmers.
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Objective:To explore the efficacy and safety of five-step 180W XPS greenlight photoselective vaporization of prostate (PVP)for large volume (≥80ml) benign prostatic hyperplasia.Methods:A total of 240 BPH patients (PV≥ 80 ml), treated with five-step 180W XPS PVP from June 2017 to May 2019 in our center, were reviewed retrospectively. The average age was (70.18±7.71) years old, and 129 cases were over 70 years old. The average body mass index was (24.91±2.98 )kg/m 2. The median international prostate symptom score (IPSS) was 23 (20, 26) and the quality of life (QOL) score was 5 (4, 5) points. Besides, the preoperative median prostate volume (PV) was 98.29 (86.49, 116.32) ml, the median maximum urinary flow rate (Q max)was 6 (4, 8) ml/s and postvoid residual urine volume (PVR) was 120 (30, 200) ml. All patients underwent 180W XPS five-step method PVP operation according to the following method. The first step is vaporization of 1-2 o′clock (left lobe) and 10-11 o′clock (right lobe) in order to establish operating channel. The second step is vaporization of the lateral lobe layer by layer from the ventral side to the dorsal side. The third step is channel establishment of 5/7 o′clock mid lobe parasulcus. The forth step is ablation of the middle lobe laterally. The fifth step is vaporization of the apex of the prostate and trimming. The IPSS score, QOL score, Q max and PVR were evaluated 12 months later after the PVP operation. Results:All the 240 cases were treated by five-step 180W XPS PVP operation successfully. The median operation time and laser time were 83 (73, 98.75) min and 66 (60, 76) min. Capsular perforation was found in 3 cases, which occurred in the trimming stage. There were 9 cases treated with TURP to stop bleeding, and no cases suffered blood transfusion. Twenty-two patients underwent bladder irrigation for 6 to 24 hours after the operation, and the median catheter indwelling time and post-operative hospital stay were 3 (3, 4) days and 4 (3, 5) days respectively. Twenty-six patients suffered urinary incontinence, including 22 cases of urinary incontinence and 4 cases of stress urinary incontinence. In addition, there was no severe hematuria, severe bladder irritation or urinary retention among the patients. The postoperative IPSS score was 5(4, 7), QOL score 1(1, 2), Q max 18(15, 20)ml/s and PVR 10(0, 30)ml, which were all significantly improved compared with those before surgery ( P<0.01). None second PVP surgery was performed. Conclusions:The five-step 180W XPS PVP operation has the advantages of improving lower urinary tract symptoms, less blood loss and low incidence of perioperative adverse events. It is easy to use, which is a reliable minimally surgery.
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Objective: Surgical operation is the main treatment for advanced adenocarcinoma of esophagogastric junction (AEG). Due to its special anatomic location and unique lymph node reflux mode, the surgical treatment of Siewert II AEG is controversial. Lower mediastinal lymph node dissection is one of the most controversial points and a standard technique has not yet been established. This study is aim to explore the safety and feasibility of five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph node dissection for Siewert type II AEG. Methods: A descriptive case series study was conducted. The intraoperative and postoperative data of 25 patients with Siewert type II AEG who underwent five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph node dissection in Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2019 to April 2021 were retrospectively analyzed. Five-step maneuver was as follows: In the first step, the subcardiac sac was exposed; the right pulmonary ligament lymph nodes and the anterior thoracic paraaortic lymph nodes were dissected cranial to inferior pericardium, left to left edge of thoracic aorta. In the second step, the left diaphragm was opened, and a 12 mm trocar was placed through the 6-7 rib in the left anterior axillary line. The supra-diaphragmatic nodes were dissected through the thoracic operation hole. In the third step, the left inferior pulmonary ligament was severed. The anterior fascia of thoracic aorta was incised to join the anterior space of thoracic aorta formed in the first step and then the lymphatic tissue was dissected upward until the exposure of left inferior pulmonary vein. In the fourth step, the posterior pericardium was denuded retrogradely from ventral side to oral side to the level of left inferior pulmonary vein, right to right pleura, and then the right pulmonary ligament lymph nodes were completely removed. In the fifth step, the esophagus was denuded, and the esophagus was transected 5 cm above the tumor using a linear stapler to complete the dissection of lower thoracic paraesophageal lymph nodes. Results: Operations were successfully completed in 25 patients without conversion, intra-operative complication and perioperative death. Total gastrectomy was performed in 19 cases and proximal gastrectomy in 6 cases. The mean operative time was (268.7±85.6) minutes, the mean estimated blood loss was (90.4±44.2) ml, the mean time of lower mediastinal lymph node dissection was (38.6±10.3) minutes, and the mean harvested number of lower mediastinal lymph node was 5.9±2.9. The length of esophageal invasion was >2 cm in 7 cases and ≤ 2 cm in 18 cases. Eight patients (33.0%) had lower mediastinal lymph node metastasis, including 3 cases with esophageal invasion >2 cm and 5 cases with esophageal invasion ≤ 2 cm. The mean time to postoperative first flatus was (5.5±3.1) days. The average time of postoperative thoracic drainage was (5.9±2.9) days. The mean hospital stay was (9.7±3.1) days. Two patients (8.0%) developed postoperative grade IIIa complications according to the Clavien-Dindo classification, including 1 case of pancreatic fistula and 1 case of pleural effusion, both of whom were cured by puncture drainage. Conclusions: Five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph nodes dissection for Siewert type II AEG is safe and feasible. Which can ensure sufficient lower mediastinal lymph node dissection to the level of left inferior pulmonary vein.
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Humans , Adenocarcinoma/surgery , Esophagogastric Junction , Laparoscopy , Lymph Node Excision , Retrospective StudiesABSTRACT
This study aimed to elucidate how body composition, force-generating capacity and jump performances are associated with 50-m sprint velocity in circumpubertal boys, in relation to sprint phases and maturation. One hundred thirty four circumpubertal boys were allocated to preadolescent or adolescent group on basis of the height at the peak height velocity of Japanese boys (154 cm) reported in literature: those with body heights over 154 cm as adolescent group and others as preadolescent group. Body composition was determined by bioelectrical impedance analysis. In addition to maximal voluntary isometric knee extension torque, the performances of counter movement jump (CMJ), rebound jump (RJ), standing long jump (SLJ) and standing 5-step jump (SFJ) were also measured. RJ-index was calculated by dividing height by contact time. The time of 50-m sprint was determined at 10-m intervals. Multiple regression analysis showed that in preadolescent boys, SFJ become a predictor for the sprint speed during acceleration phases, and SFJ, RJ-index and CMJ as predictors for the sprint speeds during maximal speed and deceleration phases. In the adolescent boys, age, CMJ, SLJ, and SFJ become a predictor for the sprint speed during acceleration phases, and torque relative to body mass, CMJ and SFJ were selected as predictors for the sprint speeds during maximal speed and deceleration phases. Thus, the current results indicate that force-generating capacity and jumping ability are determinants for sprint performance in circumpubertal boys, but the relative contribution of each of the two factors differs between preadolescent and adolescent stages and among the sprint phases.