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Objective To compare the survival outcomes between operative versus non-operative treatment of advanced intrahepatic cholangiocarcinoma.Methods This is a retrospective study.The data from 122 patients with intrahepatic cholangiocarcinoma treated at the Hunan People's Hospital,the Hepatobiliary Hospital and the Oncology Department from January 2012 to October 2017 were retrospective studied.87 patients who underwent radical surgery (anatomical hepatectomy + regional lymph node dissection) formed the operation group;35 patients who were treated with chemotherapy and/or radiotherapy and/or biological targeted therapy formed the non-operative group.The general characteristics of the two groups including age,sex,ALT,AST,CA19-9,liver function,Child's classification,AJCC staging,tumor number,vascular (hepatic artery,portal vein) invasion and regional lymph node metastasis rates were compared.The overall survival of the two groups was compared.Results There were no significant differences in age,sex,ALT,AST,CA19-9,liver function,Child's classification,AJCC staging,tumor number,vascular (hepatic artery,portal vein) invasion and regional lymph node metastasis rates (P＞0.05).The overall survival of the operation group was significantly longer than that of the non-operative group (P＜0.05).The mean overall survival for the 2 groups of patients were 32 months and 15 months respectively.The 1-year survival rates were 74.8％ and 58.7％,and the 3 year survival rates were 42.4％ and 6.5％,respectively.The 5 years survival rates were 12.3％ and 0,respectively.Conclusion Operative treatment resulted in better median survival,as well as 1-,3-and 5-year survival rates than non-operative treatment for patients with advanced intrahepatic cholangiocarcinoma.
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Objective To compare the difference of therapeutic effect of surgical operation and non-operation for acute damnification of elbow ulnar collateral ligament in rabbits.Methods A total of 81 New Zealand rabbits were randomly and equally divided into three groups(27 rabbits per group),ie,Group A(control group):the ulnar collateral ligaments of right elbow joint were only enclosed;Group B:the ulnar collateral ligaments of right elbow joint were severed and sutured;Group C:the ulnar collateral ligaments of right elbow joint were severed,without suture.The biomechanics was detected at time intervals of 3 and 6 weeks.Results Twelve weeks after transplantation,the displacements of the ligaments in Groups B and C were(6.06±0.4)mm and(7.72±0.44)mm,with statistical difference(P ＜ 0.05).The displacement of the ligaments in Group A was(5.87±0.46)mm,which was similar to that of Group B(P＞0.05).The maximum loads of the ligaments of Groups B and C were(68.23±5.64)N and (42.45±3.66)N respectively,with statistical difference(P＜0.05).The maximum load of the ligaments of Group A was(72.86±2.99)N,which was similar to that of Group B(P ＞ 0.05).The rigidities of the ligaments of Groups B and C were(11.33±1.52)N/mm and(5.52±0.67)N/mm respectively,with significant difference(P ＜ 0.05).The rigidities of the ligaments of Group A was(12.49±1.44)N/mm,which was similar to that of Group B(P ＞ 0.05).The power consumption of the ligaments of Groups B and C were(0.206±0.017)J and(0.163±0.013)J respectively,with statistical difference(P＜0.05).The power consumption of the ligaments of Group A was(0.213±0.010)J,which was similar to that of Group B(P＞0.05).Conclusion Surgical operation is more effective than the non-operation in dealing with acute damnification of the ulnar collateral ligaments of elbow ulnar collateral ligament in rabbits.
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Objective To investigate the technique and clinic value of non-operation management for ERCP-related peripancreatic and retroperitoneal abscess. Methods Five patients with post-ERCP peripancreatic and retroperitoneal abscess were reviewed. Guided by ultrasonic or CT, all the 5 pa-tients underwent puncture and the drainage tube was disposed to the lowest place of abscess. Non-op-eration managements for patients also included the use of anti-inflammatory drugs and enzyme activity inhibition drugs. Results All patients responded to the draining treatment and discharged from hospi-tal after complete recovery. There was no conversion to surgical intervention. Mean draining duration was 52. 4(20-90)d and average hospital stay was 91.8(35-165)d. Conclusion Puncture and drainage management is an effective and safe approach for post-ERCP peripancreatic and retroperitoneal ab-scess. It has advantages of less trauma, less pain, fast recovery and low rate of complications. Punc-ture point should be situated at the bottom or lowest position of abscess and drainage can achieve the best results.
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Objective To compare operative and non-operative treatments for intraarticular fractures of distal radius by meta-analysis. Methods The literature which had been published in English or Chinese from 1988 to 2008 on comparison between operative and non-operative treatments of intraartieular fractures of distal radius were searched for on line.Three Chinese papers and 2 English ones were eligibly included in this meta-analysis.The clinical data of the 5 papers were collected for comparing wrist function,reduction on X-rays,complications and patient's satisfaction. Results Operative treatment resulted in better reduction on X-rays,better wrist function and fewer complications but lower patient's satisfaetion than non-operative treatment. Conclusion The operative treatment should be recommended for intraarticular fractures of distal radius,but meanwhile the needs and expectations of the patient should be also addressed.
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Objective To evaluate the non-operation treatment of the severe acute pancreatitis(SAP).Methods 218 cases of SAP were analyzed retrospectively.Early operation was adopted before 1998(n=96)and early non-operation treatment was applied after 1998(n=122).Results 25 of 96 cases in operation group died (26.1%),while 9 of 122 cases in non-operation group died(7.4%).The complications was higher than in non-operation group(P＜0.01).Conclusion Early non-operation treatment is necessary for the early stage of SAP.
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12)is good after nonoperative treatment above 2 years.
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@#ObjectiveTo investigate correlative factors of non-operative treatment in the senile cataract, and provide gist for the health education measures.Methods1513 retiring old people had a whole medical examination, and the data was analyzed.ResultsThe proportion of binoculus cataract was 45.9%. Predilection age was 70～79 years old. Cognition information and iatrogenic effects were major risk factors in the non-operative therapeutic agents. Cataract was the third in the elder chronic disease.ConclusionMany senile patients with cataract have not enough knowledge about cataract operation although having better medical treatment and economy conditions. So the closed attention to the health education must be paid in the future.
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OBJECTIVE: To compare the degree of improvement of conduction block in carpal tunnel syndrome (CTS) between the patients who received operation and those who received conservative treatment. METHOD: Subjects included 33 hands of 27 CTS patients who received operation (operation group) and 20 hands of 17 patients who were managed conservatively (non-operation group). Median antidromic sensory responses were recorded with wrist and palm stimulation. The criterion for conduction block was more than 50% drop of baseline to negative peak amplitude of sensory nerve action potential with wrist stimulation compared to palm stimulation. The degree of conduction block was measured before and aftertreatment, and the improvement of conduction block was compared between the two groups. RESULTS: The degrees of conduction block were 59.9+/-14.3% in operation group and 60.5+/-14.5% in the non-operation group at initial evaluation. The improvements of conduction block were 32.1+/-15.1% (5~58.9%) in operation group and 7.8+/-19.8% (-27.3~36.7%) in non-operation group after treatment and the difference was statistically significant. CONCLUSION: The results suggest that operative treatment may be useful even in patients with carpal tunnel syndrome with conduction block.