Background and Purpose-Inhospital medical complications account for a considerable portion of deaths during the early stage of stroke. However, relatively few studies have examined their long-term effects on mortality...Background and Purpose-Inhospital medical complications account for a considerable portion of deaths during the early stage of stroke. However, relatively few studies have examined their long-term effects on mortality in stroke patients. Methods -We prospectively and consecutively collected data on 579 patients with acute ischemic stroke from November 1998 to February 2001. Mortality was confirmed using national death certificate data from 1999 to 2003. Results -During admission, one or more medical complications requiring intervention developed in 160 of these 579 patients (27.6%). For these 160 subjects, the 30-day, 90-day, 1-year, 2-year, 3-year, and 4-year mortalities were 16.3, 29.4, 46.9, 55. 6, 61.3, and 70.7%, whereas the mortality figures for those without such compli cations (n=419) were 1.4, 3.8, 8.8, 15.0, 19.1, and 22.4 (P < 0.001 with log-ra nk test). To eliminate the short-term effects of these complications and thus r eveal their long-term effects, we investigated differences in mortality versus the presence of inhospital complications at more than 30 days, 90 days, 1 year, 2 years, and 3 years after stroke, respectively. Cox’s proportional hazard regr ession analysis was applied at these times after stroke and showed that all haza rd ratios of medical complications in terms of mortality were statistically larg er than one, regardless of adjusting for effects of potential predictors on mort ality. Conclusions -Our study shows that stroke patient mortality is influenced by inhospital medical complications significantly up to the chronic stage. This finding suggests that the appropriate prevention and management of inhospital complications could improve shortterm and long-term prognoses after stroke.展开更多
Background and aim: Kangaroo mother care (KMC) has become the standard of care for low- risk preterm babies born in developing countries. However, the potential risk of nosocomial transmission of Mycobacterium tubercu...Background and aim: Kangaroo mother care (KMC) has become the standard of care for low- risk preterm babies born in developing countries. However, the potential risk of nosocomial transmission of Mycobacterium tuberculosis within KMC units, particularly in tuberculosis- endemic areas, has not been explored. We report an infant (sentinel case) who was admitted to our paediatric intensive care unit (PICU) with extensive pulmonary tuberculosis. Methods and results: When interviewed, the mother reported no household contact with a tuberculosis source case, but mentioned that she shared a KMC room with someone who had symptoms suspicious of tuberculosis. We found molecular evidence that nosocomial transmission of M. tuberculosis occurred within the KMC unit and conducted a contact investigation of all infants exposed to this infectious source case during her stay in the KMC unit. Conclusion: We present the findings of the contact investigation and discuss the implications of these findings for KMC units, particularly in tuberculosis- endemic areas.展开更多
Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-...Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.展开更多
Objective: To investigate the current status of medical support in military operations other than war (MOOTW) in domestic and overseas. Methods: This paper mainly adopts the descriptive, comparative and induction rese...Objective: To investigate the current status of medical support in military operations other than war (MOOTW) in domestic and overseas. Methods: This paper mainly adopts the descriptive, comparative and induction research methods. The current status of medical support in MOOTW in China, America, Russia, Israel, Canada, had been studied through some official papers, and series of professional books by analysis the precise date in various kinds of emergency event. Results: The contrast shows that there is still a quite huge development in medical support in MOOTW, no matter in China, or in other countries. Conclusion: In order to strengthen the forces, besides building professional rescue teams, it is necessary to take a regular revise of plans, according to missions` needs.展开更多
Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-ma...Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.展开更多
AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin...AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin and clarithromycinfor 1 wk. Then group A took lansoprazole combined with tepreton for 5 wk, group B took lansoprazole and group C took tepreton for 5 wk. Endoscopy and EUS were performed before and 6 wk after medication. RESULTS: There was no significant difference in cumulative healing rate to S stage between the groups (89%, 82%vs83%,P＞0.05). The rate of white scar formation was significantly higher in group A than in groups B and C (67%, 36%, 50%, P＜0.05). The average contraction rates of the width of ulcer crater, length of disrupted muscularis propria layer and hypoechoic area were higher in groupA than in groups B and C (0.792±0.090, 0.660±0.105 vs0.668±0.143, P＜0.05). The hypoechoic area disappeared in four cases of group A, one of group B and two of group C. The percentage of hypoechoic area disappearance was higher in group A than in the other two groups (44%, 9%vs 17%, P＜0.05). Gastric ulcer healing was better ingroup A.CONCLUSION: The combined administration of proton pump inhibitors and mucosal protective agent can improve gastric ulcer healing.展开更多
AIM: The aim of this study was to observe the effect of a Chinese medicine compound Changtong oral liquid (CT) on tissue plasminogen activity (t-PA), plasminogen activator inhibitor (PAI), TGF-β1 and hydroxyproline (...AIM: The aim of this study was to observe the effect of a Chinese medicine compound Changtong oral liquid (CT) on tissue plasminogen activity (t-PA), plasminogen activator inhibitor (PAI), TGF-β1 and hydroxyproline (OHP). METHODS: Two sets of animal experiments were performed in the present study. Forty New Zealand rabbits and 48 Sprague-Dawley (SD) rats were assigned randomly to one of the five groups: sham adhesion, adhesion with saline, adhesion with low dosage of the CT, adhesion with middle dosage of the CT and adhesion with high dosage of the CT. t-PA and PAI activity in plasma, OHP and TGF-β1 expression in adhesion were investigated. Analysis of variance was used to test differences among groups. RESULTS: CT treatment increased plasma t-PA activity in rabbits but decreased TGF-β1 activity in rats. The data were expressed from low to high dose respectively as follows: t-PA, 46.1±8.6 μkat/L, 59.6±10.1 μkat/L, 64.0±11.5 μkat/L; TGF-β1 28±7.23%, 31±3.05%, 30±4.04%. There were significant differences compared with saline-treated animals (t-PA 26.4±5.1 μkat/L, TGF-β1 54±5.51%). OHP content in cecum of rabbits from middle and high but not low dose of CT lowered significantly as compared with saline-treated rabbits, 0.3641±0.1373, 0.3348±0.0321, 0.2757±0.0497 mg/g vs 0.4183±0.0883 mg/g of protein, P>0.05, P<0.05, P<0.05 respectively. The rabbit plasma PAI activity and OHP content in abdominal wall had no difference in all groups. CONCLUSION: CT treatment significantly enhanced t-PA activity in rabbits, but decreased TGF-β1 content in rats, OHP content in cecum of rabbits, and failed to affect the activity of PAI and OHP content in abdominal wall in rabbits, compared with saline group. The result suggests that CT could effectively prevent adhesions without interfering wound healina.展开更多
AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questi...AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients(50%)and only 21 physicians(21%)preferred NOTES(P<0.001).Patients had previously heard of NOTES less frequently(7%vs73%,P<0.001)and had undergone endoscopy more frequently(88%vs 36%,P<0.001)than physicians.Absence of hernia was the most common reason for NOTES preference in physicians(80%vs 44%,P= 0.003),whereas reduced pain was the most common reason in patients(66%vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique(P<0.001)and having an increased risk of infection(P<0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education[odds ratio(OR):2.68,95% confidence interval(CI):1.23-5.83]and prior colonoscopy(OR:2.10,95%CI:1.05-4.19)were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians(P=0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.展开更多
At present,for the treatment of liver cancer is not limited to western medicine chemotherapy.With the development of traditional Chinese medicine(TCM),more patients choose Chinese medicine conservative treatment.TCM h...At present,for the treatment of liver cancer is not limited to western medicine chemotherapy.With the development of traditional Chinese medicine(TCM),more patients choose Chinese medicine conservative treatment.TCM has the theoretical system and treatment system.Tujia medicine,as a branch of TCM,has its own unique treatment methods in the treatment of disease.The author found in the exploration of the diagnosis and treatment of liver cancer,TCM,and Tujia medicine has the effect of different approaches but equally satisfactory results in the treatment of liver cancer,the collation,and research of comparison,in order to provide a reference for the diagnosis and treatment of liver cancer.展开更多
AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and p...AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the fi rst group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangio-pancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the Endoscopic Unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the fi rst group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the fi rst group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied.展开更多
62 patients with chronic colitis were randomly divided into two groups. Acupuncture and moxibustion at acupoints such as Tianshu (St 25), Guanyuan (Ren 4) were applied in the treatment group, and western drugs were ap...62 patients with chronic colitis were randomly divided into two groups. Acupuncture and moxibustion at acupoints such as Tianshu (St 25), Guanyuan (Ren 4) were applied in the treatment group, and western drugs were applied in the control group. The results showed that acupuncture and moxibustion had a marked curative effective with few side effects, and therefore was readily acceptable to the patients.展开更多
文摘Background and Purpose-Inhospital medical complications account for a considerable portion of deaths during the early stage of stroke. However, relatively few studies have examined their long-term effects on mortality in stroke patients. Methods -We prospectively and consecutively collected data on 579 patients with acute ischemic stroke from November 1998 to February 2001. Mortality was confirmed using national death certificate data from 1999 to 2003. Results -During admission, one or more medical complications requiring intervention developed in 160 of these 579 patients (27.6%). For these 160 subjects, the 30-day, 90-day, 1-year, 2-year, 3-year, and 4-year mortalities were 16.3, 29.4, 46.9, 55. 6, 61.3, and 70.7%, whereas the mortality figures for those without such compli cations (n=419) were 1.4, 3.8, 8.8, 15.0, 19.1, and 22.4 (P < 0.001 with log-ra nk test). To eliminate the short-term effects of these complications and thus r eveal their long-term effects, we investigated differences in mortality versus the presence of inhospital complications at more than 30 days, 90 days, 1 year, 2 years, and 3 years after stroke, respectively. Cox’s proportional hazard regr ession analysis was applied at these times after stroke and showed that all haza rd ratios of medical complications in terms of mortality were statistically larg er than one, regardless of adjusting for effects of potential predictors on mort ality. Conclusions -Our study shows that stroke patient mortality is influenced by inhospital medical complications significantly up to the chronic stage. This finding suggests that the appropriate prevention and management of inhospital complications could improve shortterm and long-term prognoses after stroke.
文摘Background and aim: Kangaroo mother care (KMC) has become the standard of care for low- risk preterm babies born in developing countries. However, the potential risk of nosocomial transmission of Mycobacterium tuberculosis within KMC units, particularly in tuberculosis- endemic areas, has not been explored. We report an infant (sentinel case) who was admitted to our paediatric intensive care unit (PICU) with extensive pulmonary tuberculosis. Methods and results: When interviewed, the mother reported no household contact with a tuberculosis source case, but mentioned that she shared a KMC room with someone who had symptoms suspicious of tuberculosis. We found molecular evidence that nosocomial transmission of M. tuberculosis occurred within the KMC unit and conducted a contact investigation of all infants exposed to this infectious source case during her stay in the KMC unit. Conclusion: We present the findings of the contact investigation and discuss the implications of these findings for KMC units, particularly in tuberculosis- endemic areas.
文摘Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.
文摘Objective: To investigate the current status of medical support in military operations other than war (MOOTW) in domestic and overseas. Methods: This paper mainly adopts the descriptive, comparative and induction research methods. The current status of medical support in MOOTW in China, America, Russia, Israel, Canada, had been studied through some official papers, and series of professional books by analysis the precise date in various kinds of emergency event. Results: The contrast shows that there is still a quite huge development in medical support in MOOTW, no matter in China, or in other countries. Conclusion: In order to strengthen the forces, besides building professional rescue teams, it is necessary to take a regular revise of plans, according to missions` needs.
基金Supported by National Natural Science Foundation of China(81400774)PUMC Youth Fund(33320140164 and 3332016128)
文摘Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.
基金Supported by the Grant from the Eisai Human Health Care Company
文摘AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin and clarithromycinfor 1 wk. Then group A took lansoprazole combined with tepreton for 5 wk, group B took lansoprazole and group C took tepreton for 5 wk. Endoscopy and EUS were performed before and 6 wk after medication. RESULTS: There was no significant difference in cumulative healing rate to S stage between the groups (89%, 82%vs83%,P＞0.05). The rate of white scar formation was significantly higher in group A than in groups B and C (67%, 36%, 50%, P＜0.05). The average contraction rates of the width of ulcer crater, length of disrupted muscularis propria layer and hypoechoic area were higher in groupA than in groups B and C (0.792±0.090, 0.660±0.105 vs0.668±0.143, P＜0.05). The hypoechoic area disappeared in four cases of group A, one of group B and two of group C. The percentage of hypoechoic area disappearance was higher in group A than in the other two groups (44%, 9%vs 17%, P＜0.05). Gastric ulcer healing was better ingroup A.CONCLUSION: The combined administration of proton pump inhibitors and mucosal protective agent can improve gastric ulcer healing.
基金Supported by the National New Drug Foundation of China, No.96-901-05-245
文摘AIM: The aim of this study was to observe the effect of a Chinese medicine compound Changtong oral liquid (CT) on tissue plasminogen activity (t-PA), plasminogen activator inhibitor (PAI), TGF-β1 and hydroxyproline (OHP). METHODS: Two sets of animal experiments were performed in the present study. Forty New Zealand rabbits and 48 Sprague-Dawley (SD) rats were assigned randomly to one of the five groups: sham adhesion, adhesion with saline, adhesion with low dosage of the CT, adhesion with middle dosage of the CT and adhesion with high dosage of the CT. t-PA and PAI activity in plasma, OHP and TGF-β1 expression in adhesion were investigated. Analysis of variance was used to test differences among groups. RESULTS: CT treatment increased plasma t-PA activity in rabbits but decreased TGF-β1 activity in rats. The data were expressed from low to high dose respectively as follows: t-PA, 46.1±8.6 μkat/L, 59.6±10.1 μkat/L, 64.0±11.5 μkat/L; TGF-β1 28±7.23%, 31±3.05%, 30±4.04%. There were significant differences compared with saline-treated animals (t-PA 26.4±5.1 μkat/L, TGF-β1 54±5.51%). OHP content in cecum of rabbits from middle and high but not low dose of CT lowered significantly as compared with saline-treated rabbits, 0.3641±0.1373, 0.3348±0.0321, 0.2757±0.0497 mg/g vs 0.4183±0.0883 mg/g of protein, P>0.05, P<0.05, P<0.05 respectively. The rabbit plasma PAI activity and OHP content in abdominal wall had no difference in all groups. CONCLUSION: CT treatment significantly enhanced t-PA activity in rabbits, but decreased TGF-β1 content in rats, OHP content in cecum of rabbits, and failed to affect the activity of PAI and OHP content in abdominal wall in rabbits, compared with saline group. The result suggests that CT could effectively prevent adhesions without interfering wound healina.
基金Supported by Grant NT 11234-3 of the Czech Ministry of Healththe Institutional Research Plan AV0Z10300504
文摘AIM:To investigate perception of natural orifice transluminal endoscopic surgery(NOTES)as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients(50%)and only 21 physicians(21%)preferred NOTES(P<0.001).Patients had previously heard of NOTES less frequently(7%vs73%,P<0.001)and had undergone endoscopy more frequently(88%vs 36%,P<0.001)than physicians.Absence of hernia was the most common reason for NOTES preference in physicians(80%vs 44%,P= 0.003),whereas reduced pain was the most common reason in patients(66%vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique(P<0.001)and having an increased risk of infection(P<0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education[odds ratio(OR):2.68,95% confidence interval(CI):1.23-5.83]and prior colonoscopy(OR:2.10,95%CI:1.05-4.19)were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians(P=0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.
基金National Natural Science Foundation of China Regional Science Fund Project(81460697)Guizhou Provincial Postgraduate Workstation Program(Educational Department)(JYSZ[2014]018)+3 种基金National Natural Science Foundation Regional Science Fund Project(81460691)Guizhou Provincial Science and Technology Department((2016)4032)National Natural Science Foundation of China Regional Science Fund Project(81660833)Guizhou Provincial Department of Education(GZS[2016]08).
文摘At present,for the treatment of liver cancer is not limited to western medicine chemotherapy.With the development of traditional Chinese medicine(TCM),more patients choose Chinese medicine conservative treatment.TCM has the theoretical system and treatment system.Tujia medicine,as a branch of TCM,has its own unique treatment methods in the treatment of disease.The author found in the exploration of the diagnosis and treatment of liver cancer,TCM,and Tujia medicine has the effect of different approaches but equally satisfactory results in the treatment of liver cancer,the collation,and research of comparison,in order to provide a reference for the diagnosis and treatment of liver cancer.
基金Supported by GC Medical Hellas who offered us free cytology brushes
文摘AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the fi rst group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangio-pancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the Endoscopic Unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the fi rst group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the fi rst group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied.
文摘62 patients with chronic colitis were randomly divided into two groups. Acupuncture and moxibustion at acupoints such as Tianshu (St 25), Guanyuan (Ren 4) were applied in the treatment group, and western drugs were applied in the control group. The results showed that acupuncture and moxibustion had a marked curative effective with few side effects, and therefore was readily acceptable to the patients.
