Meta-analysis on the treatment of diabetic retinopathy by Yiqi Yangyin Huoxue method / 国际中医中药杂志

Objective:To systematically evaluate the clinical efficacy of Yiqi Yangyin Huoxue method for the treatment of diabetic retinopathy (DR).Methods:Clinical research literature about Yiqi Yangyin Huoxue method for the treatment of DR was retrieved from China Biomedical Literature Database (CBM), VIP information Chinese Periodical Service Platform (VIP), China National Knowledge Infrastructure (CNKI), Wanfang data, Cochrane Library and PubMed database from the establishment of the databases to December 31, 2021. RevMan5.3 software was used for meta-analysis.Results:A total of 18 articles were included, with a total of 1 487 patients. The results of meta-analysis showed that Yiqi Yangyin Huoxue method for the treatment of DR had curative effect advantages in improving the total clinical effective rate [ RR=1.31, 95% CI (1.21,1.41), P<0.001], the vision [ MD=0.12, 95% CI (0.07, 0.17), P<0.001], the level of whole blood reduced viscosity low shear [ MD=-2.80, 95% CI (-3.76, -1.84), P<0.001], the level of whole blood reduced viscosity high shear [ MD=-0.69, 95% CI (-1.15, -0.24), P=0.003], and plasma viscosity [ MD=-0.31, 95% CI (-0.51, -0.12), P=0.002], decreasing serum vascular endothelial growth factor [ SMD=-1.04, 95% CI (-1.26, -0.81), P<0.001], increasing TCM symptom score [ MD=-3.79, 95% CI (-6.16,-1.42), P=0.002], reducing the level of tumor necrosis factor-α [ SMD=-2.53, 95% CI (-3.55, -1.50), P<0.001] which were better than that of pure Western medicine ( P<0.05). Conclusion:The application of Yiqi Yangyin Huoxue method for the treatment of DR can improve vision, hemorheology and TCM symptoms, improve the total clinical response rate, and reduce the levels of VEGF and TNF-α, with high clinical safety.

Overview of the application of Qing therapy in the treatment of diabetes and its complications / 国际中医中药杂志

The basic pathogenesis of diabetes is yin deficiency as the root and dry heat as the symptoms, both of which are reciprocal causation. The occurrence and development of this disease is closely related to pathogenic heat, and pathogenic heat has different degrees of deficiency and excess, and is often cemented with tangible pathogenic factors, such as dampness, phlegm and blood stasis. Clinical application of Traditional Chinese Medicine treatment of the eight methods of "clearing therapy" in the treatment of diabetes and its complications has often achieved significant efficacy, which is specifically divided into Qingxie method (clearing heat and purging fire method), for the syndrome of excessive heat in the viscera, and the representative prescriptions are Dahuang Huanglian Xiexin Decoction and Longdan Xiegan Decoction; Qingli method (clearing heat and draining dampness method), for the accumulation of damp heat in the spleen and stomach, gastrointestinal, block triple energizer, and the representative prescription is Gegen Qinlian Decoction; Qinghua method (clearing heat and resolving phlegm, removing blood stasis method) for the disease caused by phlegm, the course of the disease is lingering, complex and changeable, or caused by blood stasis. The disease is various, more serious, with more experience in clinical use of self-made prescriptions; Qingbu method (clearing heat and nourishing method) is for the patients with diabetes for a long time. The pathogenic heat hurts yin and consumes qi, and the representative prescriptions are Baihu Jia Renshen Decoction, Huanglian Ejiao Decoction, and Yu'nyu Decoction.

Research progress in treatment of post-stroke depression with Bushen Shugan method / 国际中医中药杂志

Traditional Chinese Medicine (TCM) has its own unique features in the treatment of post-stroke depression (PSD). The kidney is the congenital foundation and is closely related to the brain. Kidney deficiency runs through the entire course of stroke. Liver regulates the normal operation of qi in the human body, which is closely related to depression syndrome. Kidney deficiency and liver depression affect each other. The treatment of PSD with the Bushen Shugan (tonifying the kidney and soothing the liver) method has achieved good efficacy in clinic. The method of tonifying kidney and soothing liver can not only reflect the holistic view of TCM and the association of viscera, but also coordinate the relationship between body and spirit. In the future, the development direction of PSD in TCM research should be to further strengthen the concept of co-regulation of body and spirit and integration of brain and viscera.

Research progress in the theoretical connotation and mechanism of the eliminating dampness-heat method for the treatment of chronic kidney disease / 国际中医中药杂志

This article aimed to explore the theoretical connotation and mechanism of clearing damp-heat method in the treatment of chronic kidney disease (CKD), provide theoretical support for clearing damp-heat method in the treatment of chronic kidney disease, and further explain the modern scientific connotation of "damp-heat impairing kidney". Modern Traditional Chinese Medicine (TCM) believes that damp-heat is an important pathogenesis of kidney damage. Clearing damp-heat method plays a key role in inhibiting CKD immune inflammatory response, improving oxidative stress and antagonizing renal fibrosis. The mechanism is mainly related to the regulation of TNF-α level, blocking NF-κB signaling pathway, inhibiting inflammatory cytokines, antagonizing TGF-β1 secretion and other pathways.

Effects of aromatherapy on anxiety symptoms in women with breast cancer: a systematic review / Efectos de la aromaterapia sobre los síntomas de ansiedad en mujeres con cáncer de mama: una revisión sistemática / Efeitos da aromaterapia nos sintomas de ansiedade em mulheres com câncer de mama: revisão sistemática

ABSTRACT Objective: to assess the effect of aromatherapy on anxiety symptoms in women undergoing treatment for breast cancer. Method: a systematic review, carried out from the PEOT strategy: what are the effects of aromatherapy in reducing anxiety symptoms in women undergoing treatment for breast cancer? The research was conducted in six databases and in eight other data sources. Randomized clinical trials without date and language restrictions were included. Results: the sample consisted of seven studies. Aromatherapy was applied by inhalation (57.1%) and massage (42.8%), and was adopted alone or in conjunction with other interventions, demonstrating a reduction in anxiety symptoms in 71.4% of studies. The predominance of lavender, bergamot, frankincense and sandalwood essential oils is highlighted for their anxiolytic, relaxing, sedative, invigorating, antidepressant and muscle tension reducing effects. Conclusion: aromatherapy showed positive and significant results in reducing anxiety symptoms in women undergoing treatment for breast cancer.

RESUMEN Objetivo: evaluar el efecto de la aromaterapia sobre los síntomas de ansiedad en mujeres en tratamiento por cáncer de mama. Método: revisión sistemática, basada en la estrategia PEOT: ¿Cuáles son los efectos de la aromaterapia en la reducción de los síntomas de ansiedad en mujeres en tratamiento por cáncer de mama? La investigación se llevó a cabo en seis bases de datos y en otras ocho fuentes de datos. Se incluyeron ensayos clínicos aleatorizados, sin restricción de fecha e idioma. Resultados: la muestra estuvo compuesta por siete estudios. La aromaterapia se aplicó por inhalación (57,1%) y masaje (42,8%), habiéndose adoptado sola o en conjunto con otras intervenciones, demostrando una reducción de los síntomas de ansiedad en el 71,4% de los estudios. Destaca el predominio de los aceites esenciales de lavanda, bergamota, incienso y sándalo por sus efectos ansiolíticos, relajantes, sedantes, tonificantes, antidepresivos y reductores de la tensión muscular. Conclusión: la aromaterapia ha mostrado resultados positivos y significativos en la reducción de los síntomas de ansiedad en mujeres en tratamiento por cáncer de mama.

RESUMO Objetivo: avaliar o efeito da aromaterapia sobre os sintomas da ansiedade em mulheres sob tratamento para câncer de mama. Método: revisão sistemática, realizada a partir da estratégia PEOT: quais os efeitos da aromaterapia na redução dos sintomas da ansiedade em mulheres sob tratamento para o câncer de mama? A pesquisa foi realizada em seis bases de dados e em oito outras fontes de dados. Incluiu-se ensaios clínicos randomizados, sem restrição de data e idioma. Resultados: a amostra foi composta por sete estudos. A aromaterapia foi aplicada por inalação (57,1%) e massagem (42,8%), tendo sido adotada sozinha ou em conjunto a outras intervenções, demonstrando redução dos sintomas da ansiedade em 71,4% dos estudos. Ressalta-se o predomínio dos óleos essenciais de lavanda, bergamota, olíbano e sândalo, pelos seus efeitos ansiolíticos, relaxantes, sedativos, revigorantes, antidepressivos e redutores da tensão muscular. Conclusão: a aromaterapia apresentou resultados positivos e significativos na redução dos sintomas da ansiedade em mulheres em tratamento para câncer de mama.

Protection of nontarget structures in prostatic artery embolization / Proteção de estruturas não alvo na embolização de artérias prostáticas

Abstract Objective: To describe the efficacy and safety of protective embolization during prostatic artery embolization, as well as to discuss its clinical relevance. Materials and Methods: This was a retrospective, observational, single-center study including 39 patients who underwent prostatic artery embolization to treat lower urinary tract symptoms related to benign prostatic hyperplasia between June 2008 and March 2018. Follow-up evaluations, performed at 3 and 12 months after the procedure, included determination of the International Prostate Symptom Score, a quality of life score, and prostate-specific antigen levels, as well as ultrasound, magnetic resonance imaging, and uroflowmetry. Results: Protective embolization was performed in 45 arteries: in the middle rectal artery in 19 (42.2%); in the accessory internal pudendal artery in 11 (24.4%); in an internal pudendal artery anastomosis in 10 (22.2%); in the superior vesical artery in four (8.9%); and in the obturator artery in one (2.2%). There was one case of nontarget embolization leading to a penile ulcer, which was attributed to reflux of microspheres to an unprotected artery. There were no complications related to the protected branches. All of the patients showed significant improvement in all of the outcomes studied (p < 0.05), and none reported worsening of sexual function during follow-up. Conclusion: Protective embolization can reduce nontarget embolization during prostatic artery embolization without affecting the results of the procedure. In addition, no adverse events other than those expected or previously reported were observed. Therefore, protective embolization of pudendal region is safe.

RESUMO Objetivo: Descrever a eficácia e a segurança da embolização de proteção na embolização de artérias prostáticas e discutir sua relevância clínica. Materiais e Métodos: Estudo retrospectivo, observacional, de um único centro, que inclui 39 pacientes submetidos a embolização de artérias prostáticas para tratamento de sintomas do trato urinário inferior relacionados a hiperplasia benigna da próstata, de junho de 2008 a março de 2018. O acompanhamento foi realizado em 3 meses e 12 meses, incluindo International Prostate Symptom Score, escore de qualidade de vida, antígeno prostático específico, ultrassom, ressonância magnética e urofluxometria. Resultados: Embolização de proteção foi realizada em 45 artérias: artérias retais médias em 19 (42,2%); artérias pudendas internas acessórias em 11 (24,4%); anastomoses com ramos da artéria pudenda interna em 10 (22,2%); artérias vesicais superiores em quatro (8,9%); e artéria obturatória em uma (2,2%). Houve um caso de embolização não alvo que provocou uma úlcera peniana, atribuída a refluxo de partículas para uma artéria não protegida. Não houve complicações relacionadas com os ramos protegidos. Os pacientes apresentaram melhora significativa em todos os resultados estudados (p < 0,05) e não relataram piora da função sexual durante o acompanhamento. Conclusão: Embolização de proteção pode ser realizada para diminuir embolização não alvo sem interferir nos resultados da embolização de artérias prostáticas. Além disso, não foi observado nenhum evento adverso diferente dos já esperados ou previamente publicados. A embolização de proteção na região pudenda é segura.

Transafferent nodal embolization for lymphocele treatment: case report

ABSTRACT Lymphoceles are collections of lymphatic fluid, mainly caused by major surgical approaches. Most lymphoceles are asymptomatic and limited, but some cases may require a medical management. Among the different techniques, transafferent nodal embolization has emerged as a minimally invasive option, with low morbidity and high resolubility, although it is not widespread in the Brazilian scenario. In this study, we report a case of lymphocele drained percutaneously, with maintenance of high output and requiring transafferent nodal embolization.

Fundamentos do método de Nise da Silveira: clínica, sociedade e criatividade / Foundamentals of the Nise da Silveira's method: clinic, society and creativity / Fundamentos del método Nise da Silveira: clínica, sociedad y creativida

O presente trabalho tem como objetivo apresentar as bases do método da psiquiatra brasileira Nise da Silveira, a partir de sua orientação para a leitura de imagens. Em uma perspectiva inter e transdisciplinar, Nise da Silveira reformulou os moldes da psiquiatria e as práticas terapêuticas no Brasil, sendo precursora da reforma psiquiátrica. Além disso, foi uma importante difusora da teoria junguiana e da produção de uma clínica politicamente engajada. A apresentação baseia-se em três dimensões que consideramos fundamentais para embasar os fundamentos epistemológicos e a práxis de seu trabalho, afeto catalizador, forças autocurativas do inconsciente e emoção de lidar. Através destes três princípios norteadores de seu trabalho, é possível ver como a produção teórica e sua clínica se dão através da construção de um saber que atravessa todos os saberes, que corresponde à complexidade do fenômeno estudado e da realidade psíquica. ■

The present work aims to present the bases of the method of the Brazilian psychiatrist Nise da Silveira, based on her orientation for the reading of images. In an inter and transdisciplinary perspective, Nise da Silveira reformulated the molds of psychiatry and therapeutic practices in Brazil, being a precursor to psychiatric reform. In addition, it was an important disseminator of Jungian theory and the production of a politically engaged clinic. The presentation is based on three dimensions that we consider fundamental to support the epistemological foundations and the praxis of her work, catalytic affection, self-healing forces of the unconscious and emotion of dealing. Through these three guiding principles of her work, it is possible to see how the theoretical production and her clinic takes place through the construction of a knowledge that crosses all knowledge, which corresponds to the complexity of the studied phenomenon and the psychic reality. ■

El presente trabajo tiene como objetivo presentar las bases del método de la psiquiatra brasileña Nise da Silveira, a partir de su orientación a la lectura de imágenes. En una perspectiva inter y transdisciplinaria, Nise da Silveira reformuló los moldes de la psiquiatría y las prácticas terapéuticas en Brasil, siendo precursora de la reforma psiquiátrica. Además, fue una importante divulgadora de la teoría de Jung y la producción de una clínica comprometida políticamente. La presentación se basa en tres dimensiones que consideramos fundamentales para sustentar los fundamentos epistemológicos y la praxis de su obra, el afecto catalizador, las fuerzas autocurativas del inconsciente y la emoción del trato. A través de estos tres principios rectores de su trabajo, es posible ver cómo la producción teórica y su clínica se da a través de la construcción de un conocimiento que atraviesa todo conocimiento, que corresponde a la complejidad del fenómeno estudiado y la realidad psíquica. ■

Hemorrhagic complications after percutaneous nephrolithotomy: angiographic diagnosis and management by transcatheter arterial embolization / Complicações hemorrágicas após nefrolitotripsia percutânea: diagnóstico angiográfico e tratamento por embolização arterial transcateter

Abstract Objective: To identify the main hemorrhagic complications after percutaneous nephrolithotomy, as well as the results obtained with transcatheter arterial embolization (TAE) at an interventional radiology center. Materials and Methods: This was a retrospective analysis of patients undergoing TAE for the treatment of hemorrhagic complications after percutaneous nephrolithotomy. All patients underwent computed tomography angiography (CTA). Results: We evaluated a total of nine patients. At emergency department readmission, the most common symptom was macroscopic hematuria, which was seen in five patients. Three patients had an isolated pseudoaneurysm, two had a pseudoaneurysm together with active bleeding (perirenal hematoma), and one had a pseudoaneurysm together with arteriocalyceal fistula. Arteriovenous fistula was diagnosed in three patients and was not seen in combination with other vascular lesions. We did not identify arteriocalyceal fistula in isolation. Five patients underwent TAE with 6 × 15 mm and 6 × 20 mm microcoils. Four patients underwent TAE with n-butyl-2-cyanoacrylate and ethiodized oil. Follow-up CTAs revealed no complications. Conclusion: Because of its high diagnostic accuracy, CTA provides the interventional radiologist with valuable data for individualized therapeutic planning. The TAE procedure is safe and effective. It can therefore be used as a first-line treatment for hemorrhagic complications resulting from percutaneous renal procedures.

Resumo Objetivo: Demonstrar as principais complicações hemorrágicas após nefrolitotripsia percutânea, bem como os resultados após o tratamento por embolização arterial transcateter (EAT) em um centro de radiologia intervencionista. Materiais e Métodos: Coleta e análise de dados retrospectivos de pacientes submetidos a EAT por complicações hemorrágicas após nefrolitotripsia percutânea. Resultados: O sintoma mais comum foi hematúria macroscópica, presente em cinco pacientes no momento da readmissão ao pronto-socorro, e nestes pacientes identificamos três pseudoaneurismas isolados, dois casos de combinação de pseudoaneurisma e sangramento ativo (hematoma perirrenal) e um caso de associação de pseudoaneurisma e fístula arteriocalicinal. Fístula arteriovenosa foi diagnosticada em três pacientes, não sendo observada em associação com outras lesões vasculares. Não identificamos fístula arteriocalicinal isolada, somente associada a pseudoaneurisma. Cinco pacientes foram submetidos a embolização por micromolas 6 × 15 mm e 6 × 20 mm. Quatro pacientes foram submetidos a embolização por Histoacryl e Lipiodol. Não observamos complicações pela angiotomografia computadorizada de controle. Conclusão: A angiotomografia computadorizada apresenta alta acurácia diagnóstica e guarnece o radiologista intervencionista de dados para um planejamento terapêutico individualizado. EAT é um procedimento seguro e eficaz e pode ser utilizado como primeira linha para o tratamento de complicações hemorrágicas resultantes de procedimentos percutâneos renais.

Transarterial radioembolization for liver tumors as neoadjuvant therapy: three case reports / Radioembolização transarterial hepática como terapia neoadjuvante: relato de três casos

ABSTRACT Transarterial radioembolization (TARE) with yttrium-90 microspheres is a palliative locoregional treatment, minimally invasive for liver tumors. The neoadjuvant aim of this treatment is still controversial, however, selected cases with lesions initially considered unresectable have been enframed as candidates for curative therapy after hepatic transarterial radioembolization. We report three cases in which the hepatic transarterial radioembolization was used as neoadjuvant therapy in an effective way, allowing posterior potentially curative therapies.

RESUMO A radioembolização transarterial hepática com microesferas de ítrio-90 é uma modalidade paliativa de tratamento locorregional minimamente invasiva. O objetivo neoadjuvante deste tratamento ainda é controverso, mas casos selecionados de lesões consideradas inicialmente irressecáveis reenquadram-se como candidatos à terapia curativa após a radioembolização transarterial hepática. Relatamos três casos em que a radioembolização transarterial hepática foi utilizada como terapia neoadjuvante de forma efetiva possibilitando aplicação posterior de terapias potencialmente curativas.

Indication rules of points based on the clinical literature research / 中国针灸

OBJECTIVE@#To summarize the indication rules of points (bilateral BL 31, 32, 33 and 34) based on the clinical literature research.@*METHODS@#The relevant articles of clinical research on the treatment with points were retrieved electronically from CNKI (1979 to 2017), VIP (1989 to 2017), CBM (1979 to 2017) and PubMed (1966 to 2017). The paper were collected and analyzed. The indications, common therapeutic methods, common acupoint combination, treatment frequency, treatment duration and therapeutic effects of points were summarized.@*RESULTS@#A total 160 articles were collected, of them, 43.75% (70/160) of the articles were related to the treatment of urinary diseases, followed by the gynecological diseases (34/160, 21.25%), proctologic diseases (23/160, 14.38%) and motor system diseases (16/160, 10.00%). Regarding the individual disease, the articles for post-stroke urination disorder were of the highest proportion (26/160, 16.25%), followed by neurogenic bladder induced by spinal injury (15/160, 9.38%), dysmenorrheal (14/160, 8.75%) and constipation (14/160, 8.75%). Regarding the therapeutic method, the electroacupuncture intervention accounts for 30.36% (34/112), followed by the common acupuncture (30/112, 26.79%), warm acupuncture (11/112, 9.82%) and therapy (9/112, 8.04%). The treatment was given commonly once a day. The point combinations and the treatment duration were different in terms of individual case. The effective rates of common disorders were up to over 75%.@*CONCLUSION@#In clinic, points are mainly used for the disorders in the urinary system, gynecological department, proctology department, motor system, andrology department, etc., or for particular diseases. The main indications are post-stroke urination disorder, neurogenic bladder induced by spinal injury, dysmenorrheal and constipation. Regarding the therapeutic method, electroacupuncture and common needling techniques are adopted generally. The treatment is given generally once a day. The point combination and treatment duration are different in individual case. The treatment with points is high in the effective rates for the common disorders, good in safety and less in adverse reactions.

Aspects of images in magnetic resonance of liver tumors treated with transarterial selective internal radiotherapy with yttrium-90 / Aspectos de imagens em exames de ressonância magnética de tumores hepáticos tratados com radioterapia interna seletiva transarterial com ítrio-90

ABSTRACT Transarterial selective internal radiation therapy with yttrium-90, also known as radioembolization, is a therapy based on the administration of resin or glass microspheres loaded with the radioisotope yttrium-90, via selective arterial catheterization of tumor-feeding vessels. It is classified as a type of locoregional therapy and its main goal is to treat patients with primary or secondary hepatic lesions that are unresectable and not responsive to other therapies. Since it is a new technology still restricted to very few hospitals in Brazil, but used in patients throughout the country, it is necessary to demonstrate the main aspects of hepatic lesions treated with selective internal radiation therapy found in magnetic resonance imaging, and to make specific considerations on interpretation of these images. The objective of this report is to demonstrate the main aspects of magnetic resonance imaging of unresectable primary or secondary hepatic lesions, in patients submitted to transarterial selective internal radiation therapy.

RESUMO A radioterapia interna seletiva transarterial com ítrio-90, também conhecida como radioembolização, é uma terapia baseada na administração de microesferas de resina ou vidro carregadas com o radioisótopo ítrio-90, via cateterismo arterial seletivo dos vasos nutridores do tumor. É classificada como um tipo de terapia locorregional e seu principal objetivo é tratar pacientes portadores de lesões hepáticas primárias ou secundárias irressecáveis e não responsivas a outras terapias. Por se tratar de uma nova tecnologia, portanto ainda restrita a pouquíssimos hospitais no Brasil (ainda que utilizada em todo país), é necessário demonstrar os principais aspectos de imagem das lesões hepáticas tratadas com radioterapia interna seletiva transarterial encontrados em exame de ressonância magnética, além de delinear considerações específicas de interpretação destas imagens. O objetivo deste relato é demonstrar os principais aspectos encontrados em ressonância magnética de lesões hepáticas irressecáveis, primárias ou secundárias, de pacientes submetidos à radioterapia interna seletiva transarterial.

Analysis of clinical pathological characteristics and treatment trend in colorectal laterally spreading tumor / 中华消化杂志

Objective To explore clinical pathological characteristics and treatment changed with time in patients with colorectal laterally spreading tumors (LST) from 2001 to 2015.Methods The clinical data of 549 patients with colorectal LST who received endoscopic resection or surgical operation between 2001 and 2015 were retrospectively collected.According to the time of diagnosis,patients were divided into 2001 to 2005,2006 to 2010 and 2011 to 2015 groups.The gender,age,lesion size and lesion subtypes,clinical pathologic features and their therapeutic methods were analyzed.Chi-square test was used for statistical analysis.Results The detective rates of colorectal LST in 2001 to 2005 period,2006 to 2010 period and 2011 to 2015 period were 0.38％ (50/13 319),(0.60％ (144/23 912) and 0.79％ (355/ 44 715),respectively,and the differences were statistically significant (x2 =29.34,P ＜ 0.01).During these three period,the male to female ratio was about 1:1,mean age about 59 years old,and the mean maximum diameter of the LST lesions remained about 30 mm.The percentages of granular type laterally spreading tumor (LST-G) in 2001 to 2005 period,2006 to 2010 period and 2011 to 2015 period were 82.4％(42/51),67.7％ (105/155) and 78.2％(283/262),respectively;while those of non-granular type laterally spreading tumor (LST-NG) were 17.6 ％ (9/51),32.3 ％ (50/155) and 21.8 ％ (79/362),respectively;and the differences were statistically significant (x2 =7.77,P =0.02).The proportions of LST located at the proximal colon in the three periods were 21.6 ％ (11/51),34.2 ％ (53/155) and 41.4 ％ (150/362),respectively;while the percentages of LST at distal colon were 78.4％ (40/51),65.8％ (102/ 155) and 58.6 ％ (212/362),respectively;and the differnces were statistically significant (x2 =8.61,P=0.01).The percentages of high grade neoplasia (HGN) in the three periods were 13.7 ％ (7/51),21.9 ％(34/155) and 48.6％(176/362),respectively;while the percentages of invasive carcinoma were 2.0％(1/51),5.2％ (8/155) and 8.3％ (30/362),respectively;and the differnces were statistically significantly (x2 =58.89,P＜0.01).The percentages of endoscopic mucosal resection (EMR) in the three periods were 56.9％(29/51),58.7％ (91/155) and 32.0％ (116/362),respectively;the percentages of endoscopic piecemeal mucosal resection (EPMR) were 41.2 ％ (21/51),23.9 ％ (37/155) and 14.1％ (51/362),respectively;the percentages of endoscopic submucosal dissection (ESD) were 0,12.3％ (19/155) and 46.1 ％ (167/362),respectively;the percentages of surgical operation were 0,5.2 ％ (8/155) and 7.7 ％ (28/362),respectively;and the differences were statistically significant (x2 =112.46,P＜ 0.01).Conclusions From 2001 to 2015,the clinical pathological features and therapeutic methods of colorectal LST changed along with time.The proportion of colorectal LST located at proximal colon increased,and the percentage of LST-G decreased.ESD became the primary treatment,and the proportion of pathological diagnosis of HGN and invasive carcinomas increased after operation.

Surgical solution to fragility fractures of the pelvis——cement augmented transiliac internal fixator / 中华创伤骨科杂志

Objective To describe and analyze a new method of treating fragility fractures of the pelvis in the elderly patients,a cement augmentable Transiliac Internal Fixator (TIFI).Methods We reviewed 196 patients older than 59 years with a pelvic ring fracture who had been treated in the period from January 2004 through November 2014.They were 11 men and 93 women,aged from 59 to 94 years (average,77.5 ± 7.6 years).By the Romens classification,there were 31 cases of type Ⅰ,39 ones of type Ⅱ,19 ones of type Ⅲ and 15 ones of type Ⅳ.The causes for fracture included fall from standing height (89 cases),fall from a height of less than 3 meters (8 cases) and absence of a definite trauma (7 cases).Of them,65 received conservative management and 39 surgery.TIFI was used in 17 patients in whom cannulated and perforated Schanz screws were placed from the posterior superior iliac spine to the anterior inferior iliac spine and fixated into the supraacetabular bone canal.Results Of the 65 patients receiving conservative management,on the day of discharge,one could sit on a wheel-chair,26 could walk,8 could go upstairs and downstairs,and 30 were not recorded.Of the 39 patients receiving surgery,on the day of discharge,6 could sit on a wheel-chair,26 could walk,one could go upstairs and downstairs,and 6 were not recorded.Of the 34 patients receiving fixation with Schanz screws,the sacro-iliac joint was penetrated by the screws in 2.In the 16 patients receiving fixation with Schanz screws plus cement augmentation,no cement leakage into the sacro-iliac joint was observed.The average length of TIFI placement was 100 ± 20 mm and the average length of connective rod 62 ± 16 mm.Of the 17 patients receiving TIFI fixation,postoperative haematoma occurred in 2,superfical wound infection in one,and deep infection or implant infection in none.Conclusions Fragility fractures of the pelvis in the elderly patients can be treated according to their Romens classifications.The new technique,TIFI,is a minimally invasive and safe treatment for fragility fractures of the pelvis.

The TCM diagnosis and treatment guideline of the wind of four fossae: a Delphi concensus study / 国际中医中药杂志

Objective To evaluate the common traditional Chinese medicine syndrome types, therapies and formulas of the wind of four fossae. This will provide reference for the formulation of the guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four fossae. Methods Delphi method using questionnaires were developed based on literature about TCM syndromes and treatment of the wind of four fossae. The questionnaire were sent to 25 experts nationwide for 2 rounds. The database of the collected data was established. The mean, full score ratio, rank sum and coefficient of variation were described and by SAS 6.12 statistical software. Results A total of 21 valid questionnaires were recovered in the first round and 23 valid questionnaires in the second round. The active coefficient of the experts was 84% and 92%, respectively. The results showed that syndromes of newborn heat, damp heat retention, spleen deficiency and blood dryness, wind dampness accumulating skin, blood deficiency and wind dryness demonstrated high concensus. The consistency scores' mean of 5 syndromes were 1.67, 1.90, 1.83, 1.71 and 1.90. The sum of degrees of 5 syndromes were 37, 40, 42, 36 and 40. The ratio of full scores of 5 syndromes were 0.81, 0.90, 0.87, 0.71 and 0.90. The coefficient of variations of 5 syndromes were 0.32, 0.16, 0.27, 0.27 and 0.16. The therapy of syndrome of newborn heat was clearing away the heart-fire and inducing diuresis by the sanxin daochi decoction; The therapy of syndrome of damp heat retention was clearing heat and removing dampness by longdan xiegan decoction; The therapy of syndrome of wind dampness accumulating skin was dispelling wind and eliminating dampness by xiaofeng san; The therapy of syndrome of spleen deficiency and blood dryness was enriching blood and moistening dryness by danggui decoction; The therapy of syndrome of blood deficiency and wind dryness was replenishing qi to invigorate the spleen and enriching blood to calm endogenous wind by shenling baizhu power and danggui decoction. Conclusion Questionnaire survey could quantify the opinions of experts, and provide reference for the establishment of guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four fossae.

Pathophysiologic mechanisms and therapeutic methods of sarcopenia in cancer cachexia / 中华临床营养杂志

Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

Efficacy of the Santhiflex™ method of psychomotor postural re-education in the treatment of chronic low back pain / Eficácia do método Santhiflex® de reeducação postural psicomotora (RPP) no tratamento da lombalgia crônica

Introduction Chronic low back pain is conceived of as a multifactorial syndrome that results in the loss of functional capacity. It affects the quality of life of an individual and its treatment requires a comprehensive therapeutic approach. Objective The aim of this study is to assess the efficacy of the Santhiflex™ Method in the treatment of chronic low back pain, as well as its effects on functional capacity, health-related quality of life and body posture. Materials and methods 20 patients with chronic low back pain were randomly distributed into two groups of 10: an experimental group, which was treated with the Santhiflex™ Method of psychomotor postural re-education; and a control group, which was given a lecture on postural orientation after the first evaluation. Results The obtained data were analyzed using standard statistical software, SPSS-17 for Windows (SPSS, Chicago, IL, USA) and the results were expressed as absolute and relative frequencies, and median with first and third quartiles. The nonparametric Wilcoxon test was used for within-group samples. Intergroup comparison was performed using the Mann-Whitney test. A value of p < 0.05 was considered statistically significant. There were significant differences in the main factors assessed. Discussion The findings demonstrated a significant total improvement in low back pain scores in the EG, whereas there was no significant change in the CG. Conclusion The Santhiflex™ Method is effective in the treatment of low back pain and has positive effects on functional capacity and health-related quality of life. .

Introdução A dor lombar crônica como síndrome multifatorial resulta na perda da capacidade funcional com repercussão na qualidade de vida, sendo necessária uma abordagem terapêutica integral. Objetivo Verificar a eficácia do método Santhiflex® no tratamento da dor lombar crônica e de sua repercussão na capacidade funcional, na qualidade de vida e na postura corporal. Materiais e métodos 20 pacientes portadores de lombalgia crônica foram distribuídos aleatoriamente em dois grupos de 10 indivíduos cada: o grupo experimental, que foi submetido ao tratamento com o Método Santhiflex® de reeducação postural psicomotora, e o grupo controle, que recebeu uma aula de orientação postural após a primeira avaliação. Resultados Os dados obtidos foram trabalhados no programa estatístico SPSS 17, sendo verificados a frequência absoluta e relativa, o valor mediana, o primeiro e o terceiro quartis. Foi utilizado o teste não paramétrico de Wilcoxon para amostras intragrupo e realizada a comparação intergrupo por meio do teste de Mann-Whitney, estabelecido o valor de p ≤ 0,05. Foram encontradas diferenças significativas entre os principais fatores avaliados. Discussão Os dados demonstram que houve melhora de significância total do nível de dor lombar no GE; já no GC, o nível de dor não sofreu alteração significativa. Conclusão O método Santhiflex® é eficaz no tratamento da dor lombar e em suas repercussões na capacidade funcional e na qualidade de vida, avaliadas neste estudo. .

Feasibility of the Transradial or the Transbrachial Approach in Various Neurointerventional Procedures / 신경중재치료의학

PURPOSE: The generally preferred vascular access for neurointerventional procedures is the transfemoral approach (TFA). In complicated cases such as patients with aortic diseases or tortuous vessels, transradial or transbrachial approaches (TRA or TBA) could be good alternatives. The purpose of this study is to review a single medical center experience using the alternative accesses. MATERIALS AND METHODS: We reviewed the medical records of 30 TRA and 10 TBA cases among 2,073 cases treated between January 2010 and July 2013. We reviewed and analyzed the frequency of TRA and TBA, the reason the operator had chosen the TRA or TBA, the category of the procedure, caliber of the sheath, the success rate, and the complications rates. RESULTS: The most common reason the non-TFA route was chosen was due to the patient's tortuous vascular system (n=24, 60%). The most common category of intervention was balloon angioplasty and/or stent placement (n=18, 45%). The largest caliber of the introducing sheath was 6 Fr in TRA and 7 Fr in TBA. Procedural success was achieved in 37 cases (success rate: 92.5%), and in three cases it failed. Six patients with complications were reported. Among them, four cases of minor complications (10%) occurred. There was no serious complication directly related to the access problem. CONCLUSION: Both TRA and TBA can be good alternative access routes when TFA is not appropriate in various neurointervential procedures.

Two Microcatheter Technique for Embolization of Arteriovenous Fistula with Liquid Embolic Agent / 신경중재치료의학

Problem with embolization of arteriovenous fistula (AVF) with liquid embolic agent is its over-penetration into the veins or regurgitation to the proximal feeder without reaching the shunt point. We present a technique that controls the flow of AVF during embolization. Two microcatheter technique consists of positioning one microcatheter close to the AVF for embolization, and with another microcatheter at the proximal feeding artery to control the AVF flow by coiling. Selective angiograms obtained using a distally positioned microcatheter before and after coiling, were compared how much stagnant effect was achieved. Using two microcatheter technique, AVF occlusion was achieved with good penetration of glue to the venous side of the AVF. Its advantage is the ability to push glue into the shunt without causing over-penetration of glue or its reflux along the feeder. Two microcatheter technique was safe and effective in glue embolization of AVF and also expected to be applied with other liquid embolic agent like Onyx.

Complex Coil Assisted Single Coil Embolization for Small Intracranial Aneurysm / 신경중재치료의학

The purpose of the technical note is to introduce the complex coil assisted coil embolization method in the treatment of intracranial small aneurysm, in order to enhance the safety of the procedure. The first microcatheter was navigated into the aneurysm sac and the ultrasoft coil was used as the embolization coil. If the embolizations coil could not stay within the aneurysm sac smoothly, such as coil herniation into parent artery during the delivery process. The second microcatheter would be navigated to the aneurysm level in the parent artery. Another complex coil was delivered within the parent artery via the second microcatheter to provide the neck bridge effect in order to enhance the stability of embolization coil. Besides, the protection coil will not disturb the parent artery flow. While the embolization coil was put into the aneurysm sac smoothly under the help of complex protective coil, the protective coil was then withdrawn gently. We use the most magnified view, dual-plane approach simultaneously to observe the stability of embolization coil. The embolization coil would be detached without any evidence of coil motion or vibration. The new method could provide the physiological protective method, without leaving any protective device such as stent within the parent artery.