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Objective To investigate the influence of age on perioperative clinical parameters, tumor resection effects and complications of patients with early stage gastric cancer for single lesion treated by ESD.Methods 60 patients with early stage gastric cancer for single lesion treated by ESD were chosen from January 2013 to July 2014 and divided into 2 groups including A group (35 patients) with < 60 years old and B group (25 patients) with ≥ 60 years old; and the operation time, intraoperative blood loss, hospital staying time, tumor curative resection and completed rate, the recurrence rate with follow-up and complications incidence of 2 groups were compared.Results All the patients were successfully performed the operation and no bleeding cases. There was no significant difference in the operation time, intraoperative blood loss, hospital staying time between 2 groups (P < 0.05). There was no significant difference in the tumor curative resection and completed rate between the 2 groups (P < 0.05). There was no significant difference in the recurrence rate with follow-up between 2 groups (P < 0.05). There was no signiifcant difference in the complications incidence between 2 groups (P < 0.05).Conclusion ESD is safe and feasible in the treatment of elderly patients with early stage gastric cancer for single lesion, and it is equivalent to short- and long-term efifcacy in non-elderly patients and not increase the operation time, the trauma degree and complications risk.
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The ketogenic diet (KD) is a special diet with high-fat, low-carbohydrate and moderate amount of protein. The KD therapy is a safe, potentially effective and important treatment of refractory childhood epilepsy in recent years. It has con-ifrmed clinical efifcacy and a generally good prognosis. The adverse reactions of KD treatment are normally less and transient. In this paper, the effective rate, patient compliance, adverse reactions and their causes of KD in treating children with refractory epilepsy were reviewed.
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Objective: To evaluate the long-term efifciency of percutaneous transluminal septal myocardial ablation (PTSMA) for treating the patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 66/94 (70.2%) HOCM patients received PTSMA in Shenyang PLA general hospital from 2001-10 to 2012-10 were retrospectively studied. The left ventricular out lfow gradient (LVOFG) was measured at before and after the operation, ECG and echocardiography were examined at 1 month, 6 months and 1 year after operation, and then examined once per year for (63.8±28.5) months. Results: There were 26 patients lost contact during follow-up period, 40 returned to routine clinical check-up and 2 patients died thereafter, 1 because of sudden death and 1 because of cerebral bleeding. The pre-operative average LVOTG was (102.7 ± 47.5) mmHg, compared with the values at 6 months post-operation and long term (>6 months) after operation (33.9 ± 30.2) mmHg and (29.7 ± 25.4) mmHg,P Conclusion: PTSMA may reduce LVOTG, IVS thickness and improve the clinical symptoms in HOCM patients, the long-term efifcacy is reliable.
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Objective To evaluate the clinical efifcacy of Matrine injection on malignant cancer pain treatment. Methods 100 patients in Central Hospital of Huanggang from February 2010 to April 2013 were randomly divided into two groups(control group and research group) for retrospective study(n=50). Based on the conventional treatment, control group were received three-step analgesic ladder, and research group were treated with matrine injections. The pain scores and Karn of sky scores were evaluated and compared before and after treatment in each group, and were compared between two groups. Results The pain score and Karn of sky score in research group after treatment were signiifcantly better than control group(P<0.05). Conclusion Matrine injection could relief pain level and improve patients' quality of life of malignant cancer patient.
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Objective To investigate the clinical efifcacy of estradiol on perimenopausal syndrome,and evaluate its safety. Methods 64 cases with perimenopausal syndrome collected in our hospital from January 2010 to January 2011 were used as observation group, and treated with Estradiol valerate. Another 64 cases during the same period were used as control group, and treated with conventional therapy. After treatment, the symptom improvement of both groups were evaluated by the scoring criteria of HAMD and Kupperman, and the related hormone levels were detected and recorded. Adverse reactions after treatment were also observed. Results Clinical results showed that the HAMD and Kupperman score of both groups in end of treatment were better than before treatment, and the improvement degree in observation group were better than control in. The differences were signiifcant (P<0.05). Test results showed that the improvement of various hormonal indicators in observation group were also better than that in control group, the diffierences were significant (P<0.05). 8 cases of adverse reactions were observed in observation group after treatment, 12 cases in control group. Adverse reactions included breast tenderness, vaginal bleeding and gastrointestinal discomfort. The side effects between both groups had no signiifcant difference. Conclusion The efifcacy of Estradiol on perimenopausal syndrome was obvious, it can improve the menopausal symptoms, with less adverse reactions, and improve the life quality of perimenopausal women.
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Objective: To evaluate the hybrid of drug eluting stent (DES) with bare metal stent (BMS) and exclusive DES implantation for treating the patients with multi-lesion coronary disease. Methods: A total of 6495 patients with multi-lesion coronary disease received elective PCI in our hospital from 2004-04 to 2006-10 were retrospectively studied. The patients were divided into 2 groups, Hybrid group, n=848 and Exclusive DES group, n=5647. With 1:1 propensity score matching, there were 823 pair of patients were ifnally studied. The clinical outcomes included 1, 2 years post-operative all cause death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), major adverse cardiac events (MACE) and in-stent thrombosis. The relative risks of all outcomes were assessed by Cox’s proportional-hazard model after propensity match. Results: With propensity match, Cox’s proportional-hazard model analysis indicated that compared with Exclusive DES group, Hybrid group had the higher risks of TLR (HR 2.38, 95%CI 1.50-3.70), TVR (HR 1.61, 95%CI 1.15-2.27), MACE (HR 1.37, 95%CI 1.02-1.85), all P0.05. Conclusion:Compared with exclusive DES, the hybrid of DES with BMS implantation had the higher risk of TLR, TVR and MACE for treating the patients with multi-lesion coronary disease.
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Objective To analysis the long-term retention rate of Levetiraceram (LEV) monotherapy or combination therapy of infant epilepsy. Methods The clinical data of patients with infant epilepsy treated by LEV had been retrospectively analyzed from July 2006 to June 2007. Results Sixty patients with infant epilepsy treated by LEV had been recruited, 20 cases with partial seizures, 19 cases with generalized seizures, 21 cases with epilepsy syndrome. Among them 21 cases was intractable epilepsy. The retention rates of LEV in 6-month, 1-year, 2-year, 3-year and 4-year were 95.5%, 75.0%, 60.0%, 51.7%, and 38.3%. The most common reason for withdrawal was lack of effect (43.2%). COX regression model suggested that duration>1 month (RR=2.91, 95%CI:1.16~7.30) and refractory epilepsy (RR=2.30, 95%CI:1.22~4.32) were risk factors of withdrawal (all P<0.05). After treatment, the seizure frequency signiifcantly reduced compared with baseline (P<0.01). To the end of the follow-up, the efifciency was 100%and the complete remission rate was 69.57%in 23 cases continued treatment. The main side effect were fatigue (56.0%), and sleep increased, irritability, and so on. Conclusions LEV monotherapy or combination therapy has well long-term retention rate, maintains well efifcacy and tolerability in infant epilepsy.
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Background and purpose: Because of the aggressive nature of hilar cholangiocarcinoma and the absence of effective adjuvant therapy, surgical radical resection offers hilar cholangiocarcinoma patients the only choice. Research focus include preoperative assessment, the use of preoperative biliary drainage, the range of hepatic resection, and the range of lymphadenectomy. To investigate the clinical experience and efifcacy of combined hepatectomy in the treatment of hilar cholangiocarcinoma. Methods: Two hundred and seven patients with hilar cholangiocarcinoma treated surgically in the First Afifliated Hospital of Kunming Medical University form Jan. 2007 to Oct. 2013 were retrospectively analyzed. Results:Of the 207 patients, 125 patients who received radical resection (R0 resection) and the curative resection rate was 60.4%. One hundred and iffty-six cases were treated in combined hepatectomy group, 51 cases in non-hepatectomy group, the rate of R0 resection was 70.5%in hepatectomy group and 29.4%in non-hepatectomy group, and the difference was signiifcant (P<0.01). Two patients died perioperatively, the main postoperative complications included hepatic function insufifciency and bile leakage. One hundred and seventy-two patients were followed up, the median survival time of the 102 patients who received R0 resection was 45 months, and the 1, 3, 5 year survival rates were 96.1%, 59.1%and 17.2%. The median survival time of the 70 patients who received R1-2 resection was 26 months, and the 1, 3 year survival rates were 81.3%and 19.2%, and none of the patient survived for over 5 years. The survival rate of patients who received R0 resection was signiifcantly higher than those who received R1-2 resection (χ2=39.121, P<0.01). In the hepatectomy group was awarded the R0 resection in patients with postoperative 1, 3, 5 year survival rate was 97.8%, 63.9% and 18.0%, in non-hepatectomy group received R0 resection in patients with postoperative 1, 3, 5 year survival rate was 83.3%, 20.8%and 8.3%. There were signiifcant differences in the postoperative survival rate between both group (χ2=5.988, P=0.014). Conclusion:Radical excision is the key to improve the long term survival. Combined hemihepatectomy and standardized lymph node resection has signiifcantly improved the radical resection rate and the efifcacy of treatment for hilar cholangiocarcinoma.
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Objective To analyze and explore the clinical efifcacy of Yixinshu capsule combined with isosorbide dinitrate tablets in the treatment of stenocardia. Method 72 patients with stenocardia in cardiovasology of Zizhong county people’s hospital of Sichuan province were randomly divided two groups,36 cases in each group. Control group was treated with isosorbide dinitrate tablets, experimental group was given both Yixinshu capsule and isosorbide dinitrate tablets. Clinical efifcacy, adverse reactions and patients’satisfaction in two groups were analyzed comparitively. Results After treatment, the total effective rate and satisfaction degree in experimental group were signiifcantly higher than control group.Incidence of adverse reactions of experimental groupwas signiifcantly lower than control group(P<0.05). Conclusion Clinical efifcacy of Yixinshu capsule combined with isosorbide dinitrate tablets in the treatment of stenocardia is signiifcantly higher than single isosorbide dinitrate tablets, with higher satisfaction degree and lower incidence of adverse reactions, which can be widely applied in clinic.
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Objective To investigate the clinical efifcacy of Chinese and western medicine on toxic diffuse goiter (Graves disease) diabetes mellitus. Methods 50 cases of Graves' disease and diabetes mellitus collected in Xianhe hospitol of Dongying city,Shandong Province from June 2010 to June 2011 were randomly divided into observation group(n=25) and control group(n=25). Control group was adopted conventional western medicine treatment. Based on western medicine treatment, observation group was, conducted dialectical types according to TCM theory, and used appropriate Chinese medicine to treatment. Efficacy of two groups after 8 weeks treatment were evaluated. Results The total effective rate in observation group was 90%, higher than 80% in control group(P<0.05). Compared with before treatment, insulin resistance index (HOMA-IR), TT 3, TT 4 levels were signiifcantly decreased, and TSH was signiifcantly increased in both two groups(P<0.01). The improvement of TT 3, TT 4, TSH in treatment group were more obvious than control group, and the difference was signiifcant (P<0.01). Conclusion The combination therapy was effective on patients with Graves' disease and diabetes.
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Objectives To investigate the treatment and curative effect on paranasal sinuses and bronchitis in children. Methods Treatment of 62 cases of paranasal sinuses and bronchiolitis was retrospectively analyzed. Antibiotics was used in conventional treatment group (n=23). On top of conventional treatment, conventional plus topical treatment group (n=39) was additionally treated with nasal inhaled corticosteroids, sinus puncture, adenoid or tonsil surgery, etc. Results In conventional treatment group and conventional plus topical treatment group, the total effective rate of treatment for more than 8 weeks was 86.96%and 100.00%respectively, the effective rate for those treated for 4-8 weeks was 39.13%and 61.54%respectively. There was signiifcant difference in the effective rate of treatment for more than 8 weeks and for 4-8 weeks (both P<0.05) between two groups. Signiifcant difference also existed between the effective rate of treatment for more than 8 weeks and for 4-8 weeks (P<0.05) in each group. Conclusions Childhood sino-bronchitis should be treated not only with conventional treatment, but also with cor-rect topical treatment for local pathological changes in nasal sinus and nasopharynx. Longer treatment is needed for children with recurrent chronic sino-bronchitis.