Clinical efficacy of precision liver resection for primary liver cancer.

AIM: Precision liver resection is considered the gold standard in liver surgery. Therefore, optimizing the resection of lesions and minimizing unnecessary time of liver ischemia and hypoxia have become focal points. METHODS: A total of 96 patients with primary liver cancer admitted to Cangzhou People's Hospital from January 2017 and December 2019 were included in this retrospective study, and divided into two groups according to the different surgical treatment, with 50 cases in the control group (conventional hepatic resection) and 46 cases in the observation group (precision liver resection). The surgical indicators, liver function, alpha-fetoprotein (AFP), complications, and three-year follow-up results were analyzed in the two groups. RESULTS: The operation time, intraoperative bleeding, hospital stay, and time of anal venting in the observation group were shorter than those in the control group (P<0.05). One week after surgery, AST, TBiL, ALT, and γ-GT levels decreased in both groups, with more significant decreases in the observation group than those in the control group (P<0.05). PCT and hs-CRP levels in the observation group were significantly lower than those in the control group (P<0.05) observation. The incidences of pleural effusion, bile leak, abdominal infection, pulmonary infection, as well as the total complication rates in the observation group were lower in the observation group than those in the control group (P<0.05). The follow-up data revealed that the observation group exhibited a lower recurrence rate observationand higher survival rate than the control group within 3 years, but these differences were not significant (P>0.05). CONCLUSION: Precision liver resection can effectively treat primary liver cancer, reduce the incidence of complications, and promote patient recovery after surgery.

Effects of Argatroban on Hcy, hs-CRP and FIB levels in patients with acute cerebral infarction.

OBJECTIVE: To evaluate the effects of argatroban on the levels of Hcy, hs-CRP and FIB in patients with acute cerebral infarction (ACI). METHODS: A retrospective analysis was performed on 382 patients with ACI who were hospitalized in the Department of Neurology of our hospital from January 2017 to December 2019. Among them, 158 patients received conventional treatment as the control group and 224 patients received combined treatment with argatroban as the study group. NHISS score, mRS score, Hcy, hs-CRP, FIB level, quality of life, adverse reactions were compared between the two groups after treatment. The levels of Hcy and hs-CRP in patients with different mRS scores were compared. RESULTS: A superior clinical efficacy of the study group was observed than the control group (p < 0.05). The study group witnessed a remarkably lower NHISS score, Hcy, hs-CRP and FIB level as compare to the control group (p < 0.05). The ADL and FMA scores in the study group were higher than those in the control group (p < 0.05). The levels of Hcy and hs-CRP in mRS 0-2 patients were lower than those in mRS 3-6 patients (p < 0.05). CONCLUSION: Argatroban in ACI patients can significantly enhance the clinical efficacy and improve the quality of life. It is closely related to the reduction of Hcy and hs-CRP levels, but the mechanism needs to be further studied.

Synergy of de-walled Ganoderma Lucidum spore powder (GLSP) on targeted therapy in advanced non-squamous non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutant: protocol for a randomized, double-blind, placebo-controlled study.

BACKGROUND: Osimertinib is regarded as a promising third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for advanced non-squamous non-small cell lung cancer (NSCLC) patients who developed T790M. However the adverse effects, primarily fatigue, remain an overwhelming deficiency of Osimertinib, hindering it from achieving adequate clinical efficacy for such NSCLC. Ganoderma lucidum has been used for thousands of years in China to combat fatigue, while Ganoderma Lucidum spores powder (GLSP) is the main active ingredient. The aim of this study is to investigate whether GLSP is sufficiently effective and safe in improving fatigue and synergizing with Osimertinib in non-squamous NSCLC patients with EGFR mutant. METHOD/DESIGN: A total of 140 participants will be randomly assigned to receive either de-walled GSLP or placebo for a duration of 56 days. The primary outcome measure is the fatigue score associated with EGFR-TKI adverse reactions at week 8, evaluated by the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer Patients (QLQ-C30). Secondary outcomes include evaluation of treatment effectiveness, assessment of quality of life (QoL), and exploration of immune indicators and gut microbiota relationships. Following enrollment, visits are scheduled biweekly until week 12. TRIAL REGISTRATION: China Clinical Trial Registry ChiCTR2300072786. Registrated on June 25, 2023.

[Analysis of clinical efficacy and risk factors of relapse in young patients with cervical instability treated by manipulation].

OBJECTIVE: To determine the clinical efficacy of different manipulation in the treatment of cervical instability in young people, and to analyze the risk factors of relapse of cervical instability in young people. METHODS: From March 2021 to June 2022, the clinical data of 120 young patients with cervical instability were retrospectively analyzed. According to the different treatment methods, they were divided into rotation group (60 cases, 3 cases of loss) and tendon group (60 cases, 5 cases of loss). There were 25 males and 32 females in rotation-traction manipulation group;age ranged from 22 to 44 years old with a median of 28 years old;course of disease ranged from 0.17 to 120 months with amedian of 22 months. There were 22 males and 33 females in tendon-regulating manipulation group;age ranged from 21 to 42 years old with a median of 27 years old;course of disease ranged from 0.23 to 180 months with a median of 24 months. Both groups were treated for 2 weeks, once every other day for 7 times, and were followed up for 1 year. The clinical efficacy of the two groups was evaluated, and the visual analogue scale (VAS), neck disability index (NDI) were observed before and after treatment. One year after the course of treatment, patients with effective treatment were followed up to make statistics on recurrence. Patients with recurrence were included in the recurrence group, while those without recurrence were included in the non-recurrence group. Factors that may affect symptom recurrence were analyzed, and univariate and multivariate Logistic regression analysis were performed. RESULTS: The 13 patients who failed the treatment (4 cases in the rotation-traction manipulation group and 9 cases in the tendon-regulating manipulation group) were not followed up. All the 99 patients who were effective in treatment were followed up ranged from 303 to 406 days with a median of 359 days. No complications occurred in all patients. There were significant differences in VAS and NDI between the two groups after treatment and before treatment (P<0.05), and there were significant differences in VAS and NDI between the two groups after treatment (P<0.05). Ninety-nine patients achieved follow-up, 56 (56.57%) relapsed and 43 (43.43%) did not. Univariate correlation analysis showed that NDI index, the time spent at the desk every day, the time spent using electronic products every day and angular displacement of anterior flexion before treatment in the relapse group were significantly higher than those in the non-relapse group (P<0.05). Logistic regression analysis showed that the time spent at the desk every day [OR=2.447, 95%CI(1.255, 4.771)], the time spent using electronic products every day [OR=1.892, 95%CI(1.066, 3.358)] and the angular displacement of anterior flexion of the cervical before treatment [OR=1.246, 95%CI(1.045, 1.485) ]were the risk factors for relapse. CONCLUSION: Both rotation-traction manipulation and tendon-regulating manipulation can effectively treat cervical instability in young people, and rotation-traction manipulation has more advantages than tendon-regulating manipulation in improving cervical pain and cervical dysfunction in patients. The time spent at the desk every day, the time spent using electronic products every day, and the increase of cervical flexion angle displacement will increase the risk of relapse in patients.

Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction.

BACKGROUND: Many studies have focused on the femoral tunnel technique and fixation method, but few studies have involved the tibial tunnel technique and fixation method. The all-inside technique is one of the new techniques that has been described in recent years. All-inside anterior cruciate ligament (ACL) reconstruction is based on a tibial socket instead of a full tunnel. This method has many potential advantages. AIM: To compare clinical outcomes of knee ACL autograft reconstruction using all-inside quadrupled semitendinosus (AIST) and traditional hamstring tendon (TBT) techniques. METHODS: From January 2017 to October 2019, the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed, including 67 males and 13 females. The patients had an average age of 24.3 ± 3.1 years (age range: 18-33 years). The AIST technique was used in 42 patients and the TBT technique was used in 38 patients. The time between operation and injury, operative duration, postoperative visual analogue scale (VAS) score and knee functional recovery were recorded and compared between the two groups. The International Knee Documentation Committee (IKDC) and Lysholm scoring system were used to comprehensively evaluate clinical efficacy. RESULTS: Eighty patients were followed for 24-36 mo, with an average follow-up duration of 27.5 ± 1.8 mo. There were no significant differences in the time between surgery and injury, operative duration, IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups. There were significant differences in VAS scores 1 d, 3 d, 7 d, 2 wk and 1 mo after surgery (P < 0.05). There was no significant difference in VAS score at 3 mo, 6 mo and 1 year after operation. CONCLUSION: The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique, but the postoperative pain was less with the AIST technique. Thus, the AIST technique is an ideal treatment choice for ACL reconstruction.

[Network Meta-analysis of Chinese medicine injection combined with conventional western medicine in treatment of stable angina pectoris].

This study aimed to systematically evaluate the efficacy and safety of different Chinese medicine injections combined with conventional western medicine for stable angina pectoris. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, and SinoMed were searched to collect randomized controlled trial(RCT) of Chinese medicine injection combined with conventio-nal western medicine in the treatment of stable angina pectoris from the inception of the databases to July 8, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Stata 15.1 was used for network Meta-analysis. A total of 52 RCTs were included, involving 4 828 patients treated by 9 Chinese medicine injections(Danhong Injection, Salvia Miltiorrhiza Polyphenol Hydrochloride Injection, Tanshinone Sodium Ⅱ_A Sulfonate Injection, Salvia Miltiorrhiza Ligustrazine Injection, Dazhu Hongjingtian Injection, Puerarin Injection, Safflower Yellow Pigment Injection, Shenmai Injection and Xuesaitong Injection). The network Meta-analysis showed that:(1)in terms of improving the efficacy of angina pectoris, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Xuesaitong Injection>Shenmai Injection>Puerarin Injection>Safflower Yellow Pigment Injection>Dazhu Hongjingtian Injection;(2)in terms of improving the efficacy of electrocardiogram(ECG), SUCRA followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Puerarin Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Shenmai Injection>Xuesaitong Injection>Safflower Yellow Pigment Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(3)in terms of increasing high-density lipoprotein cholesterol(HDL-C), SUCRA followed the order of conventional western medicine combined with Danhong Injection>Shenmai Injection>Safflower Yellow Pigment Injection>Xuesaitong Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(4)in terms of lowering low-density lipoprotein cholesterol(LDL-C), SUCRA followed the order of conventional western medicine combined with Safflower Yellow Pigment Injection>Danhong Injection>Shenmai Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection>Xuesaitong Injection;(5)in terms of safety, the overall adverse reactions of Chinese medicine injection combined with conventional western medicine were less than those of the control group. Current evidence indicated that Chinese medicine injection combined with conventional western medicine could improve the curative effect of stable angina pectoris with higher safety. Limited by the number and quality of included studies, the above conclusion needed to be verified by more high-quality studies.

[To evaluate the efficacy of Yishen Tongluo decoction combined with low-dose tadalafil in the treatment of diabetic erectile dysfunction with kidney deficiency and blood stasis syndrome].

OBJECTIVE: To observe the clinical efficacy of the combined treatment of Yishen Tongluo formula and low-dose tadalafil in diabetic erectile dysfunction. METHODS: A total of 80 patients with diabetic erectile dysfunction were randomly divided into two groups. The control group given tadalafil treatment, observation group in the control group given Yishen Tongluo Formula on the basis of treatment. The treatment period was 8 weeks. Erectile function were observed before and after treatment in the two groups patients-5 international questionnaire (IIEF - 5) score, erection quality scale (EQS) score, erectile hardness (EHS) score, TCM syndrome integral, content of serum homocysteine (HCY), endothelial function index ï¼»serum levels of prostaglandin I2 (PGI2)ï¼½ and endothelin (ET) content, a The changes of nitrogen oxide (NO), glucose and lipid metabolism indexes ï¼»triglyceride (TC), total cholesterol (TG)ï¼½ and oxidative stress related factors ï¼»total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px)ï¼½ were evaluated, and the clinical efficacy of the two groups was evaluated. RESULTS: In terms of overall efficacy rate, the observation group (79.4%) outperformed that of the control (48.7%, P< 0.01).After treatment, the IIEF-5 score, EQS score, EHS score, and serum levels of PGI2, NO, T-AOC and GSH-Px were higher than those before treatment in the two groups (P< 0.05). The TCM syndrome score and serum HCY, ET-1, TC and TG were lower than those before treatment (P< 0.05), and the comparison group's consequence was comparatively worse than the group under observation (P< 0.01). CONCLUSIONS: Yishen Tongluo Formula can dramatically enhance the erectile dysfunction andimprovement of glucose-lipid metabolism when adopted in together with low-dose tadalafil.

Analysis of clinical efficacy and risk factors of relapse in young patients with cervical instability treated by manipulation / 中国骨伤

OBJECTIVE@#To determine the clinical efficacy of different manipulation in the treatment of cervical instability in young people, and to analyze the risk factors of relapse of cervical instability in young people.@*METHODS@#From March 2021 to June 2022, the clinical data of 120 young patients with cervical instability were retrospectively analyzed. According to the different treatment methods, they were divided into rotation group (60 cases, 3 cases of loss) and tendon group (60 cases, 5 cases of loss). There were 25 males and 32 females in rotation-traction manipulation group;age ranged from 22 to 44 years old with a median of 28 years old;course of disease ranged from 0.17 to 120 months with amedian of 22 months. There were 22 males and 33 females in tendon-regulating manipulation group;age ranged from 21 to 42 years old with a median of 27 years old;course of disease ranged from 0.23 to 180 months with a median of 24 months. Both groups were treated for 2 weeks, once every other day for 7 times, and were followed up for 1 year. The clinical efficacy of the two groups was evaluated, and the visual analogue scale (VAS), neck disability index (NDI) were observed before and after treatment. One year after the course of treatment, patients with effective treatment were followed up to make statistics on recurrence. Patients with recurrence were included in the recurrence group, while those without recurrence were included in the non-recurrence group. Factors that may affect symptom recurrence were analyzed, and univariate and multivariate Logistic regression analysis were performed.@*RESULTS@#The 13 patients who failed the treatment (4 cases in the rotation-traction manipulation group and 9 cases in the tendon-regulating manipulation group) were not followed up. All the 99 patients who were effective in treatment were followed up ranged from 303 to 406 days with a median of 359 days. No complications occurred in all patients. There were significant differences in VAS and NDI between the two groups after treatment and before treatment (P<0.05), and there were significant differences in VAS and NDI between the two groups after treatment (P<0.05). Ninety-nine patients achieved follow-up, 56 (56.57%) relapsed and 43 (43.43%) did not. Univariate correlation analysis showed that NDI index, the time spent at the desk every day, the time spent using electronic products every day and angular displacement of anterior flexion before treatment in the relapse group were significantly higher than those in the non-relapse group (P<0.05). Logistic regression analysis showed that the time spent at the desk every day [OR=2.447, 95%CI(1.255, 4.771)], the time spent using electronic products every day [OR=1.892, 95%CI(1.066, 3.358)] and the angular displacement of anterior flexion of the cervical before treatment [OR=1.246, 95%CI(1.045, 1.485) ]were the risk factors for relapse.@*CONCLUSION@#Both rotation-traction manipulation and tendon-regulating manipulation can effectively treat cervical instability in young people, and rotation-traction manipulation has more advantages than tendon-regulating manipulation in improving cervical pain and cervical dysfunction in patients. The time spent at the desk every day, the time spent using electronic products every day, and the increase of cervical flexion angle displacement will increase the risk of relapse in patients.

Network Meta-analysis of Chinese medicine injection combined with conventional western medicine in treatment of stable angina pectoris / 中国中药杂志

This study aimed to systematically evaluate the efficacy and safety of different Chinese medicine injections combined with conventional western medicine for stable angina pectoris. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, and SinoMed were searched to collect randomized controlled trial(RCT) of Chinese medicine injection combined with conventio-nal western medicine in the treatment of stable angina pectoris from the inception of the databases to July 8, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Stata 15.1 was used for network Meta-analysis. A total of 52 RCTs were included, involving 4 828 patients treated by 9 Chinese medicine injections(Danhong Injection, Salvia Miltiorrhiza Polyphenol Hydrochloride Injection, Tanshinone Sodium Ⅱ_A Sulfonate Injection, Salvia Miltiorrhiza Ligustrazine Injection, Dazhu Hongjingtian Injection, Puerarin Injection, Safflower Yellow Pigment Injection, Shenmai Injection and Xuesaitong Injection). The network Meta-analysis showed that:(1)in terms of improving the efficacy of angina pectoris, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Xuesaitong Injection>Shenmai Injection>Puerarin Injection>Safflower Yellow Pigment Injection>Dazhu Hongjingtian Injection;(2)in terms of improving the efficacy of electrocardiogram(ECG), SUCRA followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Puerarin Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Shenmai Injection>Xuesaitong Injection>Safflower Yellow Pigment Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(3)in terms of increasing high-density lipoprotein cholesterol(HDL-C), SUCRA followed the order of conventional western medicine combined with Danhong Injection>Shenmai Injection>Safflower Yellow Pigment Injection>Xuesaitong Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(4)in terms of lowering low-density lipoprotein cholesterol(LDL-C), SUCRA followed the order of conventional western medicine combined with Safflower Yellow Pigment Injection>Danhong Injection>Shenmai Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection>Xuesaitong Injection;(5)in terms of safety, the overall adverse reactions of Chinese medicine injection combined with conventional western medicine were less than those of the control group. Current evidence indicated that Chinese medicine injection combined with conventional western medicine could improve the curative effect of stable angina pectoris with higher safety. Limited by the number and quality of included studies, the above conclusion needed to be verified by more high-quality studies.

Analysis of the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and the factors of postoperative brain dysfunction / 国际外科学杂志

Objective:To observe the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and to explore the factors affecting postoperative brain dysfunction.Methods:A retrospective Case-control study was conducted to select 168 hypertensive intracerebral hemorrhage patients who were treated with 3D printing assisted hematoma puncture and drainage in the People′s Hospital of Yuechi County from January 2020 to September 2022 as the observation group, and 125 hypertensive intracerebral hemorrhage patients who were treated with CT guided hematoma puncture and drainage in the People′s Hospital of Yuechi County at the same time as the control group. The clinical efficacy of the two groups of patients was compared. According to the occurrence of postoperative brain dysfunction, the patients in the observation group were divided into normal brain function group ( n=121) and brain dysfunction group ( n=47). The clinical data of age, preoperative cerebral hernia, blood loss, ventilator-assisted ventilation, postoperative Glasgow coma index score (GCS) and postoperative complications were compared between the two groups. Multivariate Logistic regression was used to analyze the factors affecting postoperative brain dysfunction in the observation group, and a line chart model was constructed and its predictive efficiency was evaluated. The measurement data of normal distribution is expressed as mean ± standard deviation ( ± s), and independent sample t-test is used for inter group comparison. Chi-square test was used for comparison between count data groups. Results:The proportion of the drainage tube in the hematoma, hematoma clearance rate at 3 and 7 days after surgery, total effective rate of treatment, and GCS score at 1 week after surgery in the observation group were 88.69%(149/168), 54.17%(91/168), 96.43%(162/168), 92.86%(156/168), and 10.72±3.45, respectively, the control group was 75.20%(94/125), 36.80%(46/125), 81.60%(102/125), 76.80%(96/125), and 9.08±3.22, respectively, the difference between the two groups was statistically significant ( P<0.05). Advanced age ( OR=1.983, 95% CI: 1.169-2.732, P=0.017), preoperative cerebral hernia ( OR=1.532, 95% CI: 1.113-2.139, P=0.029), bleeding volume ≥ 50 mL ( OR=2.538, 95% CI: 1.802-3.347, P=0.003), postoperative GCS score 3-5 ( OR=2.874, 95% CI: 2.265-3.449, P<0.001), postoperative hypoxemia ( OR=2.251, 95% CI: 1.673-2.842, P=0.010) and postoperative chronic hydrocephalus ( OR=1.642, 95% CI: 1.214-2.021, P=0.022) were risk factors for postoperative brain dysfunction, while ventilator-assisted ventilation ( OR=0.656, 95% CI: 0.132-0.828, P=0.038) was protective factors. The internal verification of the line chart model by Bootstrap resampling method shows that the model has high differentiation, accuracy and validity. Conclusion:The application of 3D printing-assisted localization in hematoma puncture and drainage can improve the puncture condition and the hematoma clearance rate and clinical effect of patients with hypertensive intracerebral hemorrhage. Advanced age, preoperative cerebral hernia and bleeding volume are related to postoperative brain dysfunction. Clinical attention should be paid to patients with risk indicators of postoperative brain dysfunction.

Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy.

Background: Cervical pregnancy (CP) is an uncommon type of ectopic pregnancy with a rising risk to life. Currently, there is no universal protocol for the safe and effective management of CP. This study aimed to investigate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) vs. uterine artery embolization (UAE) in the management of CP to develop a standard for the treatment of CP. Methods: From January 2015 to October 2021, 36 patients with CP were diagnosed, treated, and followed up at the Department of Gynecology of Third Xiangya Hospital of Central South University. A total of 11 patients were treated with HIFU followed by suction curettage under hysteroscopic guidance, and 25 patients were treated with UAE followed by suction curettage under hysteroscopic guidance. Medical records and pregnancy outcomes were retrospectively analyzed. Results: Compared to the UAE group, the HIFU group had a shorter interval time (1.5 ± 0.21 days vs. 2.6 ± 0.26 days), shorter duration of hospitalization (5.5 ± 0.31 days vs. 6.6 ± 0.21 days), shorter recovery time of menstruation (30.6 ± 7.09 days vs. 36.9 ± 5.54 days), fewer adverse reactions (0/11 vs. 9/25), and fewer postoperative complications (1/11 vs. 8/25). There were no significant differences in age, gravidity, parity, abortion, gestational age, cardiac pulsation, admission symptoms, hemoglobin level, largest diameter of the sac/mass, serum human chorionic gonadotropin (hCG) level at admission, hospitalization expenses, hospitalization days, blood loss during curettage, degree of hCG decline, residue after curettage, fertility requirement, and pregnancy outcomes. Conclusion: Both HIFU and UAE are safe and effective in the treatment of patients with CP. Compared to UAE, HIFU treatment for CP is a safer and more effective therapeutic schedule owing to the advantages of being more minimally invasive, shorter interval time, shorter hospitalization days and recovery time of menstruation, fewer adverse reactions, and fewer postoperative complications.

The effectiveness of drugs combined with individualized management for elderly patients with stage III pressure ulcers.

OBJECTIVE: To explore the effect of drugs in combination with individualized management for elderly patients with stage III pressure ulcers. METHODS: Sixty patients with stage III pressure sores at our hospital from August 2017 to December 2019 were selected as research subjects. The patients were equally divided between the study group (n = 30) and the control group (n = 30) by the random number table method. All enrolled patients received drug treatment, silver ion alginate and hydrocolloid and foam dressings once every 3 days, according to the patient's wound condition to shorten the healing time. After necrotic tissue and wounds were washed with normal saline, a silver ion alginate dressing was applied and the dressing was changed once a day. The study group had individualized management based on the above drug treatment as well as exercise, nutrition, and psychological management. The pressure ulcer scale for healing (PUSH) score and changes in the pressure ulcer area were compared between the two groups before treatment, at 1, 3, and 5 weeks of treatment. The wound healing rate was then calculated. RESULTS: With the progress of treatment time, the PUSH scores and pressure ulcer areas in both groups showed a significantly decreasing trend, and the wound healing rate was significantly increased (p < 0.05). The study group's PUSH scores and pressure ulcer areas were significantly lower when compared with the control group (p < 0.05) after one, three, and 5 weeks of treatment. The wound healing rate of the study group at three and 5 weeks was significantly faster than the control group (p < 0.05). CONCLUSION: Based on drug therapy (silver ion alginate, hydrocolloid dressing, and foam dressing) combined with individualized exercise, nutrition, and psychological management, older patients with stage III pressure ulcers had improved therapeutic wound healing.

Concealed incision for resection of classical preauricular fistula.

OBJECTIVE: To introduce a new method of preauricular fistula resection and discuss its clinical efficacy. METHODS: Clinical data of 40 patients with 40 classical preauricular fistulas in our hospital were collected. The patients comprised of 19 male and 21 female patients aged 3-60 years. The fistula and part of the related cartilage were completely removed by a concealed incision on the inner side of the auricular crus, and the opening of the fistula was retained. The postoperative efficacy was analyzed. RESULTS: The operation time ranged from 15 to 30 minutes (mean, 25 minutes), and the blood loss ranged from 4 to 8 mL (mean, 5 mL). After complete fistula resection, the wound was closed with interrupted sutures. Dressing changes started 2 days after surgery and performed once a day, and the wound sutures were removed 7 days after surgery. All patients were followed up for 6 to 12 months (mean, 8.7 months) after surgery. Except for one patient with mild wound pain after suture removal, no patients developed infection or recurrence. CONCLUSION: Use of a concealed surgical incision for treatment of a classical preauricular fistula has good results. There is no obvious scar on the ear after surgery and the procedure does not affect the facial appearance. It not only completely removes the lesion but also meets the patient's esthetic needs.

Curative effect of modified Parks incision combined with rectus linear tucking on adults with concomitant strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the curative effect of modified Parks incision combined with rectus linear tucking on adults with concomitant strabismus and its influences on postoperative recovery of visual function and ocular aesthetics.METHODS: A total of 160 adults with concomitant strabismus were enrolled as the research subjects between June 2019 and June 2021. They were divided into observation group(modified Parks incision combined with rectus linear tucking, 89 cases)and control group(corneal limbal trapezoid conjunctival flap incision combined with rectus linear tucking, 71 cases)according to different surgical methods. The clinical curative effect and surgical related indexes between the two groups were compared. The changes in scores of corneal fluorescence staining, standard patient of eye dryness(SPEED), visual analogue scale(VAS)and Vancouver scar scale(VSS)before and after surgery in both groups were observed. The occurrence of complications such as poor conjunctival healing and astigmatism was statistically analyzed at 1mo after surgery.RESULTS: The total response rate of surgery in observation group was higher than that in control group, and length of surgical incision was shorter than that in control group(all P&#x003C;0.05). The scores of postoperative corneal fluorescence staining and dry eye in observation group were lower than those in control group, and VAS scores at 1wk after surgery were lower than that in control group(all P&#x003C;0.05). Postoperative divergent fusion range, strabismus angles of short-sighted 33cm and far-sighted 5m in observation group were greater than those in control group. Convergent fusion range was smaller than that in control group, and stereopsis of short-sighted 33cm and far-sighted 5m was lower than that in control group(all P&#x003C;0.05). Postoperative break-up time in observation group was longer than that in control group, lacrimal secretion was more than that in control group, and scores of corneal surface regularity index(SRI)and VSS scores were lower than those in control group(all P&#x003C;0.05). The total incidence of complications in observation group was lower than that in control group(P&#x003C;0.05).CONCLUSION: The modified Parks incision combined with rectus linear tucking can not only improve surgical effect and promote the recovery of visual function and tear film function in adults with concomitant strabismus, but also relieve dry eye and postoperative pain, improve ocular aesthetics and reduce the incidence of postoperative complications.

Effect analysis of the intravitreal Conbercept in the treatment of choroid neovascularization of macular with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of intravitreal conbercept in the treatment of chorionic neovascularization(CNV)of macular macula with high myopia. <p>METHODS: Totally 56 patients with high myopia caused by macular angiogenesis in our hospital were retrospectively selected as the research objects from June 2015 to December 2019. According to the treatment methods, patients were divided into the control group and the observation group. The 28 cases(28 eyes)of patients in the control group were treated with the intravitreous injection of Rayzumab, and 28 cases(28 eyes)of patients in the observation group were treated with intravitreal injection of conbercept. After the last treatment, the patients were followed up for 3mo to record the intraocular pressure, the best corrected visual acuity(BCVA)and the incidence of complications. Optical coherence tomography(OCT)was used to measure the thickness of macular fovea retinal(CMT), and horizontal linear scanning of OCT instrument was used to measure the CNV area.<p>RESULTS:After treatment, the visual acuity of patients in the observation group gradually increased, and the improvement of BCVA was significantly higher than that of the control group at the same time point(<i>P</i><0.05). After 3mo of treatment, it showed that IOP, CNV area and CMT in the observation group were significantly reduced after the combined treatment, and the improvement was better than that in the control group(<i>P</i><0.05). The incidence of complications in the observation group(4%)was significantly lower than that in the control group(18%).<p>CONCLUSION:The treatment of intravitreal conbercept injection for the high myopia CNV was superior to lucentis, which could improve clinical efficacy by increasing BCVA, reducing CMT thickness, improving vision and reducing postoperative complications.

[Efficacy comparison between laparoscopy and open surgery in the treatment of gastric gastrointestinal stromal tumors larger than 2 cm using multicenter propensity score matching method].

Objective: To compare the efficacy between laparoscopy and open surgery for gastric gastrointestinal stromal tumor (GIST) larger than 2 cm. Methods: A multicenter retrospective cohort study was performed. Inclusion criteria: long diameter of primary gastric GIST > 2 cm; undergoing laparoscopy or open surgery; diagnosis confirmed by postoperative pathology without distant metastasis; without preoperative targeted therapy. Clinicopathological data of 857 gastric GIST patients, including 320 in PLA General Hospital, 284 in Shanghai Renji Hospital, 175 in Wuhan Union Hospital and 78 in Tianjin Cancer Hospital, from January 2010 to May 2017 were retrospectively collected. There were 418 males and 439 females, mainly aged between 50 and 70 years old. Among 857 patients, 413 were in the laparoscopy group and 444 in the open group. The nearest neighbor matching of propensity score matching method was conducted with 1:1 matching based on tumor location and size between laparoscopy and open group to obtain samples of covariate equilibrium, and the caliper value was 0.04. The t test, χ(2) test and Wilcoxon rank test were used to compare short-term efficacy, and the Kaplan-Meier curve and log rank test were applied to compare long-term outcomes between the two groups. Results: After propensity score matching, laparoscopy group and open group both enrolled 293 cases. The baseline data, including age, gender, tumor location, tumor long diameter, NIH classification, etc. were not significantly different between the two groups (all P>0.05). Compared with the open group, the laparoscopy group had less intraoperative blood loss [<100 ml: 2.9% (155/293) vs. 36.2% (106/293), Z=-12.857, P<0.001], shorter time to postoperative feeding [(4.0±0.2) days vs. (5.3±0.9) days, t=1.505, P=0.003] and to the removal of drainage tube [(4.8±1.0) days vs. (6.5±1.0) days, t=1.847, P=0.008], and shorter postoperative hospital stay [(8.6±0.3) days vs. (10.5±0.3) days, t=4.235, P<0.001]. Subgroups analysis according to anatomical location: (1) Gastric cardia and pylorus: there were no statistically significant differences in perioperative parameters between the two groups (all P>0.05). (2) Stomach base: feeding time after surgery [(4.0±0.2) days vs. (4.5±0.2) days, t=0.512, P=0.038], drainage tube removal time [(5.1±0.4) days vs. (6.4±0.6) days, t=0.517, P=0.044], postoperative hospital stay [(8.0±0.5) days vs. (11.1±0.9) days, t=0.500, P=0.002] were all significantly shorter in the laparoscopy group as compared to the open group, while the differences in other perioperative parameters were not statistically significant (all P>0.05). (3) Lesser curvature of the stomach: the laparoscopy group had less intraoperative blood loss [<100 ml ratio: 58.1% (43/74) vs. 33.7% (25/74), Z=7.632, P=0.034], shorter gastric tube removal time [(2.7±0.2) days vs. (3.2±0.3) days, t=0.503, P=0.007], earlier postoperative passage of gas [(2.8±0.1) days vs. (3.4±0.2) days, t=0.532, P=0.030], earlier postoperative feeding [(3.6±0.2) days vs. (4.3±0.2) days, t=0.508, P=0.020], shorter drainage tube removal time [(4.2±0.4) days vs. (5.7±0.5) days, t=0.508, P=0.020] and postoperative hospital stay [(8.3±0.6) days vs. (10.7±0.3) days, t=0.502, P=0.006] as compared to the open group. (4) Great curvature of the stomach: the laparoscopy group presented less intraoperative blood loss [<100 ml ratio: 52.7% (39/74) vs. 36.5% (27/74), Z=7.681, P=0.032], earlier gastric tube removal [(2.6±0.2) days vs. (3.6±0.2) days, t=0.501, P=0.001], earlier postoperative passage of gas [(2.7±0.2) days vs. (3.4±0.2) days, t=0.501, P=0.016], earlier postoperative feeding [(3.6±0.2) days vs. (4.7±0.2) days, t=0.500, P=0.001], shorter drainage tube removal time [(4.0±0.5) days to (5.9±0.4) days, t=0.508, P=0.002] and postoperative hospital stay [(7.5±0.3) days to (9.5±0.1) days, t=0.500, P=0.001] than the open group. Subgroup analysis according to tumor size: (1) Tumor long diameter 2.0-5.0 cm: the laparoscopy group had earlier passage of gas [(2.9±0.1) days vs. (3.5±0.1) days, t=0.500, P=0.001], earlier postoperative feeding [(4.5±0.1) days vs. (5.0±0.2) days, t=0.501, P=0.013], shorter drainage tube removal time [(4.8±0.3) days vs. (6.0±0.3) days, t=0.511, P=0.008] and postoperative hospital stay [(8.1±0.4) days to (10.1±0.3) days, t=0.513, P=0.001] than the open group. (2) Tumor long diameter 5.1-10.0 cm: in the laparoscopic group, postoperative feeding time [(4.0±0.2) days vs. (4.7±0.2) days, t=0.506, P=0.015], drainage tube removal time [(4.6±0.4) days vs. (6.4±0.5)) days, t=0.501, P=0.004], postoperative hospital stay [(8.2±0.3) days vs. (10.9±0.6) days, t=0.500, P=0.001] were all shorter than those in the open group. No intraoperative and postoperative complications were observed in each group. The 5-year recurrence-free survival rates of the laparoscopy group and the open group were 95.4% and 91.6%, respectively (P=0.734), and the 5-year overall survival rates were 93.8% and 90.8% (P=0.691), respectively, and the differences were not statistically significant. Conclusions: In experienced medical centers, laparoscopic surgery for gastric GIST larger than 2 cm is safe and feasible, and can achieve comparable efficacy with open surgery. For gastric GISTs which do not locate in the greater curvature and the anterior wall of the stomach, and whose long diameter is ≤5 cm, laparoscopic surgery does not increase the risk of recurrence and metastasis, and can accelerate postoperative recovery.

A retrospective study of Xiaoyan Decoction combined with symptomatic maintenance in treatment of advanced non-small cell lung cancer / 中草药

Objective: To investigate the efficacy of Xiaoyan Decoction in the treatment of non-small cell lung cancer (NSCLC) by retrospective study. Methods: Patients with NSCLC treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 1, 2013 to December 30, 2017 were collected. The patients were divided into two groups: Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group (46) and symptomatic treatment group (50). Analyze the survival of the two groups of patients, compare the Karnofsky scores of the two groups, and analyze the sex, age, smoking history, drinking history, histological grade, chemotherapy regimen, pathological type, TCM syndrome type, vascular invasion, and soft tissue invasion Correlation with patient prognosis. Results: There was a significant difference in median progression-free survival (mPFS) between the two groups (P 0.05).The quality of life of patients in Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group was significantly improved (P < 0.05), among which, lung squamous cell carcinoma, no vascular, no soft tissue invasion, and patients with phlegm heat obstruction of lung syndrome had the best efficacy (P < 0.05). Conclusion: Xiaoyan Decoction combined with symptomatic maintenance therapy can prolong median progression-free survival (mPFS) and improve the quality of life of patients with advanced NSCLC. The best beneficiaries are patients with lung squamous cell carcinoma, phlegm-heat obstructive pulmonary syndrome without vascular or soft tissue invasion.

125I implantation under computed tomography guidance to treat patients with recurrent pelvic tumors: Retrospective analysis of clinical results.

OBJECTIVE: The objective of the study was to evaluate computed tomography (CT)-guided 125I implantation for the treatment of recurrent and malignant pelvic tumors. MATERIALS AND METHODS: Fifteen cases of pelvic malignant tumors were studied. Tumor length/diameter was 4-10 cm (average: 6.8 ± 2.3 cm). In patients with pelvic recurrence or metastasis of malignant tumors, comprehensive treatment, including surgery, chemotherapy, or radiotherapy, was performed alongside CT-guided 125I implantation. The follow-up clinical benefit rate, rate of pain relief, quality of life score, and status of any complications were analyzed. RESULTS: The patients were followed up for 6 months after the operation, and evaluation of lesions revealed complete response (CR) in 3/15 cases, partial response (PR) in 8/15 cases, stable disease in 3/15 cases, and progressive disease in 1/15 cases. The total effective rate (CR + PR) was 73.3% (11/15), and the pain relief rate was 86.6% (13/15). No bleeding, pelvic abscesses, intestinal fistulas, intestinal perforations, or other complications were reported. CONCLUSIONS: When using CT-guided 125I implantation, patients with malignant abdominal tumors undergo a convenient operation, sustain little trauma, and have an improved quality of life.

A clinical study on effectiveness of Ningmitai Capsule combined with Dirithromycin Enteric Tablets in treatment of semen nonliquefaction with positive Ureaplasma urealyticum / 中草药

Objective To investigate the clinical effect of Ningmitai Capsule combined with Dirithromycin Enteric Tablets in the treatment of positive semen nonliquefaction in the culture of Ureaplasma urealyticum (Uu). Methods A total of 120 cases of semen liquefaction patients with positive semen Uu culture were randomly divided into treatment group with 80 cases and control group with 40 cases, which were continuous administrated for two weeks for a period of treatment and observated for two courses of treatment. In the treatment group, four Ningmitai Capsules were taken orally per time, three times per day, and 0.5 g Dirithromycin Enteric Tablets were taken orally per time, once per day, after meals, while the control group only took the Dirithromycin Enteric Tablets orally. Uu negative conversion rate and semen liquefaction time (min) were observed, and adverse reactions were also observed. Results The Uu negative conversion rate in the treatment group and control group after 2 weeks, 4 weeks was 72.5%, 95.0% and 55%, 92.5%, respectively, the negative conversion rate of treatment group was obviously higher than that of control group after 2 weeks treatment (P 0.05). The semen liquefaction time before treatment in the treatment group and control group respectively was (76.19 ± 14.13) min and (77.08 ± 13.34) min, which was (58.64 ± 13.15) min and (67.12 ± 12.52) min two weeks after treatment, (48.64 ± 12.38) min and (56.12 ± 12.86) min 4 weeks after treatment were, semen liquefaction time of the two groups before and after treatment was significant different (P < 0.05), and the treatment group was better than control group (P < 0.01). Conclusion Ningmitai Capsule combined with Dirithromycin Enteric Tablets can partly shorten the Uu negative conversion time, obviously shorten the semen liquefaction time, and has obvious clinical efficacy for Uu positive semen nonliquefaction disease.