BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being...BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.展开更多
BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20...BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20 years,effective treatments are still lacking.Instead,the concept of ADHD seems to have become broader and more heterogeneous.Therefore,the diagnosis and treatment of ADHD remains challenging for clinicians.AIM To investigate the effects of a multimodal integrated intervention for children with ADHD.METHODS Between March 2019 and September 2020,a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility,two of whom revoked their consent.A case-control study was conducted in which the children were equally assigned,using a randomized number table,to either a medication group(methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets)or a multimodal integrated intervention group(medication+parent training+behavior modification+sensory integration therapy+sand tray therapy),with 49 patients in each group.The clinical endpoint was the efficacy of the different intervention modalities.RESULTS The two groups of children with ADHD had comparable patient characteristics(P>0.05).Multimodal integrated intervention resulted in a significantly higher treatment efficacy(91.84%)than medication alone(75.51%)(P<0.05).Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone(P<0.05).The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group(P<0.05).Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone(P<0.05).CONCLUSION Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children.It enhanced their memory and attention with high safety and parental satisfaction,demonstrating good potential for clinical promotion.展开更多
AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent fou...AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.展开更多
Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated...Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.展开更多
This editorial provides a commentary on the recent article.The paper reviews current literature and explores innovative treatment strategies for lower extremity arteriosclerosis obliterans(LEASO)through an integrative...This editorial provides a commentary on the recent article.The paper reviews current literature and explores innovative treatment strategies for lower extremity arteriosclerosis obliterans(LEASO)through an integrative approach.It highlights the effectiveness of combination therapies that merge traditional Chinese medicine(TCM)with Western medical practices,suggesting that such integrative methods may improve patient compliance and outcomes through personalized care.This paper stresses the importance of rigorous clinical trials to evaluate the efficacy and safety of TCM interventions within LEASO treatment protocols,advocating for evidence-based validation of these combined therapies.Our recommendations emphasize accurate diagnosis,appropriate pharmacological in-terventions,the use of advanced surgical and endovascular techniques,and the inclusion of TCM to address underlying dysfunctions.Additionally,continuous monitoring,patient education,and lifestyle modifications are essential to slow disease progression and achieve optimal patient outcomes.The paper concludes by calling for further research to develop standardized treatment protocols that effectively integrate both Western and Chinese medical approaches in managing LEASO.展开更多
Cardiovascular diseases such as chronic limb ischemia, cardiomyopathies and stroke represent the first cause of death. Moreover, type-II diabetes, chronic obstructive pulmonary disease and age-related macular degenera...Cardiovascular diseases such as chronic limb ischemia, cardiomyopathies and stroke represent the first cause of death. Moreover, type-II diabetes, chronic obstructive pulmonary disease and age-related macular degeneration are also progressive pathologies complicated by a chronic inflammation that might be able to maintain progressive chronic oxidative stress. Orthodox medicine has provided excellent drugs which slow down the progression of these diseases but minimally reverse the oxidative stress conditions. Administration of antioxidants is unable to balance the oxidant excess. Today, all the biochemical and molecular mechanisms of ozone therapy have been clarified and it has been demonstrated that ozone therapy can reactivate the fundamental Nrf2 system and be able to restore the innate antioxidant defense mechanisms composed of several highly protective enzymes. This paper proposes to integrate the orthodox treatment with ozone therapy for improving clinical results.展开更多
In recent 20 years, there has been an increasing trend in the incidence of pancreatic cancer both at home and abroad. An estimated 31 860 new cases and 31 270 deaths are expected to occur in the United States in 2004 ...In recent 20 years, there has been an increasing trend in the incidence of pancreatic cancer both at home and abroad. An estimated 31 860 new cases and 31 270 deaths are expected to occur in the United States in 2004 due to this disease, the 4th and 5th leading cause of cancer death for men and women respectively. In China, new cases of pancreatic cancer continue to increase and are 6展开更多
Objective: To improve the effects of treatment of severe acute re spiratory syndrome (SARS) and to explore the clinical significance of integrate d traditional Chinese medicine and western medicine (ICWM) in the treat...Objective: To improve the effects of treatment of severe acute re spiratory syndrome (SARS) and to explore the clinical significance of integrate d traditional Chinese medicine and western medicine (ICWM) in the treatment of S ARS and its influence on the chief indexes in the process of the disease. Methods: The clinical study involving observation of 135 patients of SARS was conducted in the randomized, synchronously controlled and open way. The patients were divided into two groups, 68 in the ICWM group and 67 in the c ontrol group, all of whom were treated with the same basic treatment of western medicine, but to the ICWM group, Chinese drugs for clearing Heat, detoxifying an d removing Dampness were given additionally. The comprehensive effect on relievi ng fever, cell mediated immunity, pulmonary inflammation and secondary infect ion was compared between the two groups. Results: The therapeutic effect in the ICWM group was better than that in the control group in such aspects as steadily lowering body temperature, alleviating general symptoms, accelerating the absorption of pulmonary infiltra tion and easing cellular immunity suppression. Conclusion: The therapeutic effect of ICWM is better in treating SARS than that of western medicine alone.展开更多
Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the ...Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.展开更多
The objective of this integrated literature review was to identify and examine effectiveness of non-pharmacological interventions towards BPSD. Database searches were documented following the PRISMA flow diagram and i...The objective of this integrated literature review was to identify and examine effectiveness of non-pharmacological interventions towards BPSD. Database searches were documented following the PRISMA flow diagram and included papers were judged by the researchers using the SAHTAASS protocol. Coding of the papers was carried out using Polit and Beck matrix for literature review. It was concluded that several non-pharmacological interventions showed a positive influence on BPSD such as stimulating interventions, social and personalized activities and physical exercise. Also, education/training of healthcare professionals and equipment in form of a structured BPSD protocol resulted in decreased BPSD.展开更多
This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and ra...This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and randomly assigned into two groups: group A received (sensory integration therapy program plus specific physiotherapy training) and group B received (specific physiotherapy training program only). Motor coordination test measures (Balancing backward, Hopping, Jumping from side to side and Transferring boxes) to test and follow gross motor coordination, handheld dynamometer to test and follow grip control ability and kinesthesia test to test and follow awareness of joint position and movement. These measurements were taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Data analysis was available on the 30 Down syndrome children participating in the study. The difference between pre- and post-treatment results was more significant in Motor coordination test measures in the study group than the control group. Grip control ability and kinesthesia test demonstrate representative improvement in the study groups (p = 0.0001) while insignificant in the kinesthesia control group and significant in a grip control group. The addition of sensory integration therapy program to specific physiotherapy training is recommended in improving gross motor coordination and grip control abilities in Down syndrome, so this suggested approach may be used as a selective choice for improving posture control and hand functions in Down syndrome children.展开更多
Objective. To observe the therapeutic effect of integrated treatment of peripheral facial paralysis by stages in Qinghai plateau area. Methods: A total of 2 240 cases of peripheral facial paralysis treated with integ...Objective. To observe the therapeutic effect of integrated treatment of peripheral facial paralysis by stages in Qinghai plateau area. Methods: A total of 2 240 cases of peripheral facial paralysis treated with integrated approaches by stages were assigned to treatment group, and other 75 cases treated with acupuncture therapy assigned to control group. In treatment group, patients were treated with 1 ) medication ( Prednisone, Dipazol, etc) and TDP (“special electromagnetic spectrum”) plus ultrashort irradiation in the early stage;2) TDP plus ultrasonic wave irradiation and acupuncture of Yangbai (阳白 GB 14) to Yuyac (鱼腰EX-HN 4, penetration needling), etc in the medium stage; 3) medium-frequency irradiation and electroacupuncture (EA) of muscle motor joints and acupoints (GB-14, etc). Patients of control group were treated with conventional acupuncture therapy (GB-14, etc). Results: After treatment, of the 2 240 patients in treatment group, 2 072 (92.5%) were cured, 120 (5.3%) effective, 33 ( 1.5% ) improved, and 15 (0.7%) failed. The total effective rate was 99.3%. Of the 75 cases in control group, 46 (61.3%) were cured, 16 (21.3%) effective, 9 (12.0%) improved, and 4 (5.4%) ineffective. The total effective rate was 94.6%. The cure rate and the total effective rate of treatment group were significantly higher than those of control group respectively (x^2=29.379, P〈0.01; x^2 =5. 716, P〈0. 025). Conclusion: The therapeutic effect of integrated approaches (medication, acupuncture, electromagnetic + ultrashort wave + ultrasonic wave + medium-frequency wave irradiation) is significantly superior to that of simple acupuncture therapy in treating peripheral facial paralysis.展开更多
Personality Disordered (herein referred to as PD) clients are challenging to statutory mental healthcare programmes. They can be difficult to diagnose: their disorders can be obscured by second-order problems such as ...Personality Disordered (herein referred to as PD) clients are challenging to statutory mental healthcare programmes. They can be difficult to diagnose: their disorders can be obscured by second-order problems such as anxiety and depression, caused by PD cognitive processes. Treatment-as-usual (the predominant model of psychiatric intervention) for PD clients in crisis tends to focus on these second-order presentations, but provide no means of identifying underlying PD. The purpose of this paper is to describe how heuristic methods of diagnosis can be used to reframe the client’s distress in the context of personality disorders (according to DSM-IV criteria), and how subsequent application of integrative therapies can break their cycle of recidivism. Method: Two case studies of treatment-refractory individuals with cyclical patterns of crisis-point service engagement for self-harm or psychotic depression where heuristic/ integrative therapies were used. Results: The use of integrative therapies in the case studies presented resulted in a marked change in recidivism and quality of life for each client, as measured by a significant reduction in presentation of symptoms and hypervigilance. Discussion: By understanding the maladaptive cognitive-behavioural processes of PD clients, they can be modified to reduce the client’s self-defeating behavioural patterns, breaking the cycle of recidivism. However, a new diagnostic strategy must first be formulated that looks at the clients past use of mental health services to detect underlying PD.展开更多
Integrated diagnosis,treatment and whole-course management model of major depressive disorder(MDD)is an integrated drug-psychological-physical comprehensive treatment model based on rapid biological-psychological-soci...Integrated diagnosis,treatment and whole-course management model of major depressive disorder(MDD)is an integrated drug-psychological-physical comprehensive treatment model based on rapid biological-psychological-social evaluation for treating patients with major depressive disorder.This paper comprehensively evaluates the clinical efficacy and biochemical indexes of patients,and carries out symptom evaluation,problem classification,disease diagnosis and etiological analysis of visitors from the three dimensions about physiology,psychology and society.Then,according to the symptoms and causes of different dimensions,this paper formulates personalized drug,psychological and physical therapy programs,and constantly optimizes and adjusts the treatment plan in the treatment process,so as to cure both the symptoms and the root causes,providing a reliable strategy for the treatment of clinical MDD,and establishing a standardized characteristic model for further promotion and application of this technology.At present,the project has been used in the member units of Taihe Medical Group and Shiyan City and its surrounding areas,the market response is good,and will be gradually promoted to the whole country in the later stage.展开更多
Objective:To analyze the therapeutic effects of Integrated Traditional Chinese and Western Medicine on ulcerative colitis (UC) and its effects on coagulation function and inflammatory factors.Methods: 220 cases of pat...Objective:To analyze the therapeutic effects of Integrated Traditional Chinese and Western Medicine on ulcerative colitis (UC) and its effects on coagulation function and inflammatory factors.Methods: 220 cases of patients with UC were selected as the research subjects and randomly divided into the observation group and the control group, 110 cases were included into each group. The patients in the control group were treated with single western medicine, while the patients in the observation group were treated with enema treatment of traditional Chinese Medicine. The clinical therapeutic effects of the two groups were evaluated and compared. The blood coagulation indexes of the activated partial thromboplastin time (APTT), prothrombin time (PT), the plasma fibrinogen (Fib), the D dimer (D-D) of two groups patients who in the treatment were detected and compared. The serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels of the patients in the two groups were measured and compared.Results: The clinical efficiencies of the observation group and the control group were 97% and 75%, the clinical efficiencies and the therapeutic effects of the observation group were better than those in the control group, there were statistically significant differences between the two groups. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the observation group were lower than those in the control group, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the observation group were lower than those in the control group, the difference is powerful and have statistically significant.Conclusion: The application of Integrated Traditional Chinese and Western Medicine in the treatment of UC can improve the therapeutic effect significantly, correct imbalance of the patients' coagulation dissolution function, reduce the degree of inflammatory reaction, which benefits to promote of the patients' rehabilitation, reduce the incidence of complications and improve the prognosis of patients.展开更多
文摘BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.
基金Supported by Ningbo Medical Key Fostering Discipline Child Health Science,No.2022-F26Ningbo Science and Technology Plan Project Public Welfare Plan,No.2019C50099.
文摘BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20 years,effective treatments are still lacking.Instead,the concept of ADHD seems to have become broader and more heterogeneous.Therefore,the diagnosis and treatment of ADHD remains challenging for clinicians.AIM To investigate the effects of a multimodal integrated intervention for children with ADHD.METHODS Between March 2019 and September 2020,a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility,two of whom revoked their consent.A case-control study was conducted in which the children were equally assigned,using a randomized number table,to either a medication group(methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets)or a multimodal integrated intervention group(medication+parent training+behavior modification+sensory integration therapy+sand tray therapy),with 49 patients in each group.The clinical endpoint was the efficacy of the different intervention modalities.RESULTS The two groups of children with ADHD had comparable patient characteristics(P>0.05).Multimodal integrated intervention resulted in a significantly higher treatment efficacy(91.84%)than medication alone(75.51%)(P<0.05).Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone(P<0.05).The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group(P<0.05).Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone(P<0.05).CONCLUSION Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children.It enhanced their memory and attention with high safety and parental satisfaction,demonstrating good potential for clinical promotion.
文摘AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.
文摘Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.
基金Supported by The Scientific Research Project of Guangdong Provincial Bureau of Traditional Chinese Medicine,China,No.2022ZYYJ01The Guangzhou Municipal Science and Technology Bureau's 2024 Basic and Applied Basic Research Topic,China,No.2024A04J4254.
文摘This editorial provides a commentary on the recent article.The paper reviews current literature and explores innovative treatment strategies for lower extremity arteriosclerosis obliterans(LEASO)through an integrative approach.It highlights the effectiveness of combination therapies that merge traditional Chinese medicine(TCM)with Western medical practices,suggesting that such integrative methods may improve patient compliance and outcomes through personalized care.This paper stresses the importance of rigorous clinical trials to evaluate the efficacy and safety of TCM interventions within LEASO treatment protocols,advocating for evidence-based validation of these combined therapies.Our recommendations emphasize accurate diagnosis,appropriate pharmacological in-terventions,the use of advanced surgical and endovascular techniques,and the inclusion of TCM to address underlying dysfunctions.Additionally,continuous monitoring,patient education,and lifestyle modifications are essential to slow disease progression and achieve optimal patient outcomes.The paper concludes by calling for further research to develop standardized treatment protocols that effectively integrate both Western and Chinese medical approaches in managing LEASO.
文摘Cardiovascular diseases such as chronic limb ischemia, cardiomyopathies and stroke represent the first cause of death. Moreover, type-II diabetes, chronic obstructive pulmonary disease and age-related macular degeneration are also progressive pathologies complicated by a chronic inflammation that might be able to maintain progressive chronic oxidative stress. Orthodox medicine has provided excellent drugs which slow down the progression of these diseases but minimally reverse the oxidative stress conditions. Administration of antioxidants is unable to balance the oxidant excess. Today, all the biochemical and molecular mechanisms of ozone therapy have been clarified and it has been demonstrated that ozone therapy can reactivate the fundamental Nrf2 system and be able to restore the innate antioxidant defense mechanisms composed of several highly protective enzymes. This paper proposes to integrate the orthodox treatment with ozone therapy for improving clinical results.
文摘In recent 20 years, there has been an increasing trend in the incidence of pancreatic cancer both at home and abroad. An estimated 31 860 new cases and 31 270 deaths are expected to occur in the United States in 2004 due to this disease, the 4th and 5th leading cause of cancer death for men and women respectively. In China, new cases of pancreatic cancer continue to increase and are 6
文摘Objective: To improve the effects of treatment of severe acute re spiratory syndrome (SARS) and to explore the clinical significance of integrate d traditional Chinese medicine and western medicine (ICWM) in the treatment of S ARS and its influence on the chief indexes in the process of the disease. Methods: The clinical study involving observation of 135 patients of SARS was conducted in the randomized, synchronously controlled and open way. The patients were divided into two groups, 68 in the ICWM group and 67 in the c ontrol group, all of whom were treated with the same basic treatment of western medicine, but to the ICWM group, Chinese drugs for clearing Heat, detoxifying an d removing Dampness were given additionally. The comprehensive effect on relievi ng fever, cell mediated immunity, pulmonary inflammation and secondary infect ion was compared between the two groups. Results: The therapeutic effect in the ICWM group was better than that in the control group in such aspects as steadily lowering body temperature, alleviating general symptoms, accelerating the absorption of pulmonary infiltra tion and easing cellular immunity suppression. Conclusion: The therapeutic effect of ICWM is better in treating SARS than that of western medicine alone.
文摘Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.
文摘The objective of this integrated literature review was to identify and examine effectiveness of non-pharmacological interventions towards BPSD. Database searches were documented following the PRISMA flow diagram and included papers were judged by the researchers using the SAHTAASS protocol. Coding of the papers was carried out using Polit and Beck matrix for literature review. It was concluded that several non-pharmacological interventions showed a positive influence on BPSD such as stimulating interventions, social and personalized activities and physical exercise. Also, education/training of healthcare professionals and equipment in form of a structured BPSD protocol resulted in decreased BPSD.
文摘This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and randomly assigned into two groups: group A received (sensory integration therapy program plus specific physiotherapy training) and group B received (specific physiotherapy training program only). Motor coordination test measures (Balancing backward, Hopping, Jumping from side to side and Transferring boxes) to test and follow gross motor coordination, handheld dynamometer to test and follow grip control ability and kinesthesia test to test and follow awareness of joint position and movement. These measurements were taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Data analysis was available on the 30 Down syndrome children participating in the study. The difference between pre- and post-treatment results was more significant in Motor coordination test measures in the study group than the control group. Grip control ability and kinesthesia test demonstrate representative improvement in the study groups (p = 0.0001) while insignificant in the kinesthesia control group and significant in a grip control group. The addition of sensory integration therapy program to specific physiotherapy training is recommended in improving gross motor coordination and grip control abilities in Down syndrome, so this suggested approach may be used as a selective choice for improving posture control and hand functions in Down syndrome children.
文摘Objective. To observe the therapeutic effect of integrated treatment of peripheral facial paralysis by stages in Qinghai plateau area. Methods: A total of 2 240 cases of peripheral facial paralysis treated with integrated approaches by stages were assigned to treatment group, and other 75 cases treated with acupuncture therapy assigned to control group. In treatment group, patients were treated with 1 ) medication ( Prednisone, Dipazol, etc) and TDP (“special electromagnetic spectrum”) plus ultrashort irradiation in the early stage;2) TDP plus ultrasonic wave irradiation and acupuncture of Yangbai (阳白 GB 14) to Yuyac (鱼腰EX-HN 4, penetration needling), etc in the medium stage; 3) medium-frequency irradiation and electroacupuncture (EA) of muscle motor joints and acupoints (GB-14, etc). Patients of control group were treated with conventional acupuncture therapy (GB-14, etc). Results: After treatment, of the 2 240 patients in treatment group, 2 072 (92.5%) were cured, 120 (5.3%) effective, 33 ( 1.5% ) improved, and 15 (0.7%) failed. The total effective rate was 99.3%. Of the 75 cases in control group, 46 (61.3%) were cured, 16 (21.3%) effective, 9 (12.0%) improved, and 4 (5.4%) ineffective. The total effective rate was 94.6%. The cure rate and the total effective rate of treatment group were significantly higher than those of control group respectively (x^2=29.379, P〈0.01; x^2 =5. 716, P〈0. 025). Conclusion: The therapeutic effect of integrated approaches (medication, acupuncture, electromagnetic + ultrashort wave + ultrasonic wave + medium-frequency wave irradiation) is significantly superior to that of simple acupuncture therapy in treating peripheral facial paralysis.
文摘Personality Disordered (herein referred to as PD) clients are challenging to statutory mental healthcare programmes. They can be difficult to diagnose: their disorders can be obscured by second-order problems such as anxiety and depression, caused by PD cognitive processes. Treatment-as-usual (the predominant model of psychiatric intervention) for PD clients in crisis tends to focus on these second-order presentations, but provide no means of identifying underlying PD. The purpose of this paper is to describe how heuristic methods of diagnosis can be used to reframe the client’s distress in the context of personality disorders (according to DSM-IV criteria), and how subsequent application of integrative therapies can break their cycle of recidivism. Method: Two case studies of treatment-refractory individuals with cyclical patterns of crisis-point service engagement for self-harm or psychotic depression where heuristic/ integrative therapies were used. Results: The use of integrative therapies in the case studies presented resulted in a marked change in recidivism and quality of life for each client, as measured by a significant reduction in presentation of symptoms and hypervigilance. Discussion: By understanding the maladaptive cognitive-behavioural processes of PD clients, they can be modified to reduce the client’s self-defeating behavioural patterns, breaking the cycle of recidivism. However, a new diagnostic strategy must first be formulated that looks at the clients past use of mental health services to detect underlying PD.
基金Supported by Grants from the National Key R&D Program of China (2018YFC1314600)the 2021 Shiyan City Guidance Project (21Y33)
文摘Integrated diagnosis,treatment and whole-course management model of major depressive disorder(MDD)is an integrated drug-psychological-physical comprehensive treatment model based on rapid biological-psychological-social evaluation for treating patients with major depressive disorder.This paper comprehensively evaluates the clinical efficacy and biochemical indexes of patients,and carries out symptom evaluation,problem classification,disease diagnosis and etiological analysis of visitors from the three dimensions about physiology,psychology and society.Then,according to the symptoms and causes of different dimensions,this paper formulates personalized drug,psychological and physical therapy programs,and constantly optimizes and adjusts the treatment plan in the treatment process,so as to cure both the symptoms and the root causes,providing a reliable strategy for the treatment of clinical MDD,and establishing a standardized characteristic model for further promotion and application of this technology.At present,the project has been used in the member units of Taihe Medical Group and Shiyan City and its surrounding areas,the market response is good,and will be gradually promoted to the whole country in the later stage.
基金Projects funded by the National Natural Science Foundation of China.Project,No:81472305.
文摘Objective:To analyze the therapeutic effects of Integrated Traditional Chinese and Western Medicine on ulcerative colitis (UC) and its effects on coagulation function and inflammatory factors.Methods: 220 cases of patients with UC were selected as the research subjects and randomly divided into the observation group and the control group, 110 cases were included into each group. The patients in the control group were treated with single western medicine, while the patients in the observation group were treated with enema treatment of traditional Chinese Medicine. The clinical therapeutic effects of the two groups were evaluated and compared. The blood coagulation indexes of the activated partial thromboplastin time (APTT), prothrombin time (PT), the plasma fibrinogen (Fib), the D dimer (D-D) of two groups patients who in the treatment were detected and compared. The serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels of the patients in the two groups were measured and compared.Results: The clinical efficiencies of the observation group and the control group were 97% and 75%, the clinical efficiencies and the therapeutic effects of the observation group were better than those in the control group, there were statistically significant differences between the two groups. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the observation group were lower than those in the control group, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the observation group were lower than those in the control group, the difference is powerful and have statistically significant.Conclusion: The application of Integrated Traditional Chinese and Western Medicine in the treatment of UC can improve the therapeutic effect significantly, correct imbalance of the patients' coagulation dissolution function, reduce the degree of inflammatory reaction, which benefits to promote of the patients' rehabilitation, reduce the incidence of complications and improve the prognosis of patients.