Therapeutic role of template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract

Lymphadenectomy for urothelial carcinoma of the upper urinary tract has attracted the attention of physicians. The mapping study of lymphatic spread has shown that a relatively wide area should comprise the regional nodes for tumors of the right renal pelvis or the right upper two-thirds of the ureter. A prospective study showed that an anatomical templatebased lymphadenectomy significantly improved patient survival in tumors of the renal pelvis. This benefit was more evident for patients with p T2 stage tumors or higher. The risk of regional node recurrence is significant reduced by template-based lymphadenectomy,which is likely to be associated with improved patient survival. The removal of lymph node micrometastases is assumed to be the reason for therapeutic benefit following lymphadenectomy. The number of resected lymph nodes can be used to assess the quality of lymphadenectomy,but not to determine the extent of lymphadenectomy. The guidelines currently recommend lymphadenectomy for patients with muscle-invasive disease,even though the current recommendation grades are still low. The present limitation of lymphadenectomy is the lack of standardization of the extent of lymphadenectomy and the randomized trials. Further studies are warranted to collect the evidence to support lymphadenectomy.

Blastocystis hominis as a cause of chronic diarrhea in low-resource settings:A systematic review

BACKGROUND Blastocystis hominis(B.hominis),an anaerobic unicellular protist parasite,is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract.Although globally distributed,it is particularly prevalent in developing nations.Examining the symptoms and treatment outcomes of B.hominis infection in low-resource settings holds immense significance,providing healthcare practi-tioners with valuable insights to enhance patient care.AIM To synthesize existing evidence on the symptomatology and treatment outcomes of B.hominis infection in low-resource settings.METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines,a systematic review was conducted.The search spanned electronic databases including PubMed,Scopus,and Google Scholar.After a comprehensive screening process,a thorough examination of the papers,adhering to inclusion and exclusion criteria,and data extraction from eligible studies was conducted.The findings underwent summarization through simple descriptive analysis.RESULTS The search yielded 1200 papers,with 17 meeting inclusion criteria.Chronic diarrhea due to B.hominis infection was reported in only two studies,while abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting emerged as the most commonly documented symptoms.Recovery rates after one week of treatment ranged from 71.8%to 100%,and after two weeks,from 60%to 100%.CONCLUSION In low-resource settings,chronic diarrhea resulting from B.hominis infection is infrequent.Common symptoms include abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting.Post-treatment,clinical outcomes are notably favorable,supporting the recommendation for treatment.Metronidazole is advocated as the first-line agent,with consideration for switching to a second-line option in cases of treatment failure or poor response.

Non-Invasive Treatment to Grade 1 Essential Hypertension by Percutaneous Laser and Electric Pulse to Acupoint with Music:A Randomized Controlled Trial

Objective： To study a non-drug therapy for hypertension disease by combining percutaneous laser and electric pulse stimulation to acupoint with music, and to test the efficiency of the combining treatment to grade 1 essential hypertension. Methods： A total of 174 patients with grade 1 essential hypertension were randomly assigned to 3 groups with a random number table after Chinese medicine（CM） syndrome differentiation： the photoelectric and musical treatment group（Group 1, with a self-developed multi-mode audio frequency pulse photoelectric therapeutic apparatus）, acupuncture group（Group 2）, and oral placebo group（Group 3）, 58 cases per group. The curative effect of each group was evaluated by the changes of blood pressure and CM syndrome integral before and after treatment. Results： Compared with Group 3, there were significant decrease of blood pressure and CM syndrome integral in Group 1 and Group 2（P〈0.01）. Compared with Group 2, Group 1 showed the highest decrease in systolic pressure（P〈0.017）. The total effective rate of anti-hypertension in Group 1（91.38%, 53/58） was significantly higher than that in Group 2（74.13%, 43/58） and Group 3（18.97%, 11/58, P〈0.05 or P〈0.01）; and that in Group 2 was also significantly higher than that in Group 3（P〈0.01）. There were significant difference in the total effective rate of CM syndrome integral in both Group 1（93.10%, 54/58） and Group 2（84.48%, 49/58） as compared with Group 3（17.24%, 10/58, P〈0.01）, while there was no significant difference between Group 1 and Group 2（P〉0.05）. Conclusions： The multi-mode audio frequency pulse photoelectric therapeutic apparatus, combining music, laser and electric pulse stimulation, is clinically useful for grade 1 essential hypertension. This ＂three in one＂ therapy method is non-invasive, easy and simple to handle. It is expected to be popularized as a new alternative treatment.

音乐对抑郁症疗效的影响20例分析

目的 探讨抑郁症病人在临床施于药物治疗的基础上 ,再给以音乐治疗的效果。方法 将 4 0例抑郁症病人 ,随机分为两组 ,每组 2 0例 ,对照组单用阿米替林治疗 ,观察组在用阿米替林治疗的同时 ,再施于音乐治疗 ,用汉密顿抑郁量表(HAMD)总分评价疗效 ,采用 χ2 检验和t检验。结果 两组显效率均在 70 %以上 ,各组内治疗前后的减分率差异均有显著性 (P<0 .0 1) ;两组间比较 ,观察组减分率和治愈率均高于对照组 ,差异有显著性 (P <0 .0 5 )。结论 音乐治疗可以提高抗抑郁药物的疗效 ,缩短疗程 。