ABSTRACT
Objective To carry out a meta-analysis on the published data to evaluate therapeutic effects of intact canal wall mastoidectomy and open mastoidectomy for cholesteatoma otitis media .Methods A comprehensive search was performed in VIP (1989-2015) ,WANFANG (1999-2015) ,CNKI (1994-2015) and CAJD databases to collect the randomized controlled trials (RCTs) on the intact canal wall mastoidectomy and open mastoidectomy treat cholesteatoma otitis media ,and to analyze the RCTs in meta -analysis method .Results 1 069 patients were analyzed in the 18 RCTs which met the inclusion criteria .Patients were followed up from 3 months to 7 years .The meta-analysis results suggested that ,compared with the open mastoidectomy group ,the patients had less operative time (test for overall effect :Z=15 .54 ,MD= -18 .36 ,95% CI(-24 .54 ,-12 .18) , P10 dB (test for overall effect:Z=2 .83 ,OR=2 .47 ,95% CI(1 .32 , 4 .61) ,P=0 .005) ,more patients with air-bone gaps <20 dB(Z=3 .05 ,OR=1 .60 ,95% CI(1 .18 ,2 .17) ,P=0 .002) ,but the recurrent rate is not different significantly (test for overall effect :Z= 1 .92 ,OR =1 .87 ,95% CI (0 .99 ,3 .53) ,P=0 .05) .Conclusion The illness is suitable to be treated by using the two surgical ways while the intact canal wall mastoidectomy treatment takes less operative time ,dry ear time and complications ,and improve hearing more significantly than the open mastoidectomy ,but the recurrent rate is not different significantly for trea‐ting cholesteatoma otitis media .
ABSTRACT
Objective To explore the effects of the therapeutic effects of interventional heated chemotherapy( IHC) for moderate and advanced huge primary hepatocellular carcinoma and compare with transcatheter arterial chemoembolization( TACE) . Methods The 68 pa-tients with moderate and advanced huge primary hepatocellular carcinoma accepted the treatment of IHC were considered as the observation group,and 32 patients managed TACE were regarded as the control group. The therapeutic effects,living quality,secondary surgery rates,The reduced level of serum AFP,survival rate,and toxic side effects of 2 groups were contrasted. Results The effective rate of observation group was obviously higher than that of control group (79. 4% vs 56. 3%,P <0. 05),and secondary surgery rates was increased(70. 6% vs 43. 8%,P<0. 01). The ratio of increased Karnofsky score was more than 20 in observation group,which was obviously higher than that of control group(35. 3% vs 12. 5%,P<0. 01). T The reduced level of serum AFP was more than 50% in observation group,which was higher than that of control group (52. 9% vs 25. 0%,P<0. 01). The survival rate of 12,18,24 months after treatment in control group was in-creased than that in control group individually (P<0. 01). Conclusion IHC is effective for huge primary hepatocellular carcinoma and in-creases the secondary surgery rates,which is one of the safe and effective methods for huge primary hepatocellular carcinoma.