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Objective:To systematically evaluate of the impact of non-specific soft tissue manipulation on pain severity in patients with chronic neck pain.Methods:Trials included in Meta-analysis were determined by searching PubMed, Embase, Cochrane Library, Web of Science and 5 English databases in the U.S. Clinical Trial Registry. The search terms include the subject terms of neck pain, soft tissue treatment, massage, and myofascial release. Two reviewers independently selected studies, extracted data and assessed the quality of the studies. The included trials were assessed by using the Cochrane risk-of-bias tool. STATA statistical software 16.0 was used for statistical analysis. Additionally, subgroup analysis and sensitivity analysis were performed to analyze the sources of heterogeneity and assess the stability of research results. Begg funnel plot and Egger′s publication bias plot were used to assess potential publication bias.Results:This systematic review included a total of 12 randomized controlled trials (566 patients in total). The participants were 18 to 85 years old. Most of the included studies were of medium quality. This Meta-analysis validated the effectiveness of soft tissue manual therapy on alleviating pain symptoms in patients with chronic neck pain ( ES =-0.83, 95% CI -1.15 to -0.51, P = 0.001). The Begg funnel plot indicated that there may be potential publication bias. Conclusions:This Meta-analysis found that soft tissue manual therapy has a significant effect on alleviating the pain of patients with chronic neck pain. However, different pain assessment tools could have a certain impact on the Meta-analysis results.
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Objective@#To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus.@*Methods@#The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded.@*Results@#Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications.@*Conclusions@#SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.
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Objective To study the treatment of elderly depression and anxiety in the treatment of depression and anxiety. Methods 76 cases of senile depression and anxiety co-morbidity were selected from our hospital from January 2016 to January 2017, and were randomly divided into control group and experimental group, with 38 cases in each group. The patients in the control group were treated with escitalopram, and the patients in the experimental group were treated with ascitalopram. The treatment time for both groups was two months. Comparative analysis was made on the clinical indicators of the experimental group and the control group. Results After treatment, the score of HAMD score and HAMA score in the experimental group was significantly lower than that in the control group, and the score of the experimental group was significantly lower than that in the control group, the differences were statistically significant (P< 0.05). The effective treatment efficiency of the patients in the experimental group was 86.84 ％ compared with the control group (73.68％), the differences were statistically significant (P< 0.05). There were 9 cases and 10 cases of adverse reactions between the experimental group and the control group, but there was no significant difference in the incidence of adverse reactions. Conclusion The liver capsule joint resolve depression escitalopram citalopram treatment of senile depression and anxiety comorbidities better clinical effect, can significantly improve the condition, improve the treatment efficiency, further promotion and application of clinical significance.
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OBJECTIVE@#To analyze the conservative management and outcomes of pharyngocutaneous fistula after total laryngectomy.@*METHOD@#Twenty-one patients with postoperative fistulas were identified and treated by conservative therapy.@*RESULT@#Different treatment were given basing on the three stages of pharyngocutaneous fistula: drainage and cleaning stage, pressure bandaging stage and healing stage. Fourteen patients (66.7%) with the conservative therapy resumed oral feeding after closure of fistula, the other 7 patients had to be cured by further operation.@*CONCLUSION@#Management basing on the stages of pharyngocutaneous fistula can achieve satisfied outcome. It can provide important information for pharyngocutaneous fistula's treatment.
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Humanos , Carcinoma de Células Escamosas , Cirugía General , Fístula Cutánea , Terapéutica , Neoplasias Laríngeas , Cirugía General , Laringectomía , Enfermedades Faríngeas , Terapéutica , Complicaciones Posoperatorias , TerapéuticaRESUMEN
OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50~70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection. The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.