AIM： To evaluate the long-term outcome and surgical indications of hepaticojejunostomy （H J） for the treatment of hepatolithiasis. METHODS- Three hundred and fourteen elective cases with hepatolithiasis but without...AIM： To evaluate the long-term outcome and surgical indications of hepaticojejunostomy （H J） for the treatment of hepatolithiasis. METHODS- Three hundred and fourteen elective cases with hepatolithiasis but without biliary stricture or cystic dilatation treated in the past 10 years were reviewed retrospectively. The patients were divided into HJ group and T tube drainage group according to biliary drainage procedure. Furthermore, four subgroups were subdivided by hepatectomy as a balance factor, group A1： hepatectomy＋HJ; group A2： choledochoctomy＋HJ; group B1： hepatectomy ＋ choledochoctomy T tube drainage; group B2： choledochoctomy ＋ T tube drainage. The stone residual rate, surgical efficacy and long-term outcome were compared among different procedures. RESULTS： There was no surgical mortality among all patients. The total hospital mortality was 1.6%. The overall stone residual rate after surgical clearance was 25.9%. There was no statistical difference between HJ group and T tube drainage group in terms of stone residual rate after surgical clearance, however, after postoperative choledochoscopic lithotripsy, the total stone residual rate of T tube drainage group was significantly lower than that of HJ group （0.5% vs 16.7%, P 〈 0.01）. Hepatectomy ＋ choledochoctomy tube drainage achieved the optimal therapeutic effect, only 8.2% patients suffered from an attack of cholangitis postoperatively, which was significantly lower than that of hepatectomy ＋ HJ （8.2% vs 22.0%, P = 0.034）. The major reason for postoperative cholangitis was stone residual in the HJ group （16/23, 70.0%）, and stone recurrence in the T tube drainage group （34/35, 97.1%）. The operative times were significantly prolonged in those undergoing HJ, and the operative morbidity of HJ was higher than those of T tube drainage. CONCLUSION： The treatment result of HJ for hepatolithiasis is not satisfactory in this retrospective study due to high rate of stone residual and postoperative cholangi- tis. HJ could not drain residual stone effectively. HJ may hinder post-operative choledochoscopic lithotripsy, which is the optimal management for postoperative residual stone. The indications of HJ for hepatolithiasis should be strictly selected.展开更多
To study the therapeutic effects of acupuncture combined with nimodipine for vascular dementia. Methods： Acupuncture was applied at Baihui （GV 20）, Shenshu （BL 23）, Geshu （BL 17）, and the points selected accord...To study the therapeutic effects of acupuncture combined with nimodipine for vascular dementia. Methods： Acupuncture was applied at Baihui （GV 20）, Shenshu （BL 23）, Geshu （BL 17）, and the points selected according to the midnight-noon, ebb-flow eight methods of the intelligent turtle, combined with the drug nimodipine. The treatment was continued for 8 consecutive weeks. Results： Of the 30 cases treated, 6 cases were cured, 21 cases improved, and 3 cases failed, with a total effective rate of 90%. Conclusion： Acupuncture at Baihui （GV 20）, Shenshu （BL 23）, Geshu （BL 17）, and the points selected according to the midnight-noon, ebb-flow eight methods of the intelligent turtle combined with the drug nimodipine can yield definite therapeutic effects for vascular dementia.展开更多
OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therap...OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therapy.METHODS:This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin.All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1,2008,to December 31,2008 were retrospectively followed through one year.The main outcomes were either a recurrence of vascular events,,mortality or both.Risk factors were recorded from medical records.Multivariate regression models were used to analyze predictors.The following independent variables were used:age,gender,hypertension,ischemic heart disease,atrial fibrillation,diabetes mellitus,carotid arterial lesions and history of stroke.RESULTS:Four-hundred and five patients were included.The 1-year mortality rate was 11.11%.23.70% of the patients had a recurrent vascular event,and 30.86% suffered a poor outcome.Multiple logistic regression analysis found that previous stroke,and advanced age were predictors of death within one year,Recurrence of vascular events was associated with carotid arterial lesions,history of diabetes and previous stroke.Long-term poor outcome was predicted by advanced age,history of diabetes,and previous stroke.CONCLUSION:Age,previous stroke,carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year.Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.展开更多
文摘AIM： To evaluate the long-term outcome and surgical indications of hepaticojejunostomy （H J） for the treatment of hepatolithiasis. METHODS- Three hundred and fourteen elective cases with hepatolithiasis but without biliary stricture or cystic dilatation treated in the past 10 years were reviewed retrospectively. The patients were divided into HJ group and T tube drainage group according to biliary drainage procedure. Furthermore, four subgroups were subdivided by hepatectomy as a balance factor, group A1： hepatectomy＋HJ; group A2： choledochoctomy＋HJ; group B1： hepatectomy ＋ choledochoctomy T tube drainage; group B2： choledochoctomy ＋ T tube drainage. The stone residual rate, surgical efficacy and long-term outcome were compared among different procedures. RESULTS： There was no surgical mortality among all patients. The total hospital mortality was 1.6%. The overall stone residual rate after surgical clearance was 25.9%. There was no statistical difference between HJ group and T tube drainage group in terms of stone residual rate after surgical clearance, however, after postoperative choledochoscopic lithotripsy, the total stone residual rate of T tube drainage group was significantly lower than that of HJ group （0.5% vs 16.7%, P 〈 0.01）. Hepatectomy ＋ choledochoctomy tube drainage achieved the optimal therapeutic effect, only 8.2% patients suffered from an attack of cholangitis postoperatively, which was significantly lower than that of hepatectomy ＋ HJ （8.2% vs 22.0%, P = 0.034）. The major reason for postoperative cholangitis was stone residual in the HJ group （16/23, 70.0%）, and stone recurrence in the T tube drainage group （34/35, 97.1%）. The operative times were significantly prolonged in those undergoing HJ, and the operative morbidity of HJ was higher than those of T tube drainage. CONCLUSION： The treatment result of HJ for hepatolithiasis is not satisfactory in this retrospective study due to high rate of stone residual and postoperative cholangi- tis. HJ could not drain residual stone effectively. HJ may hinder post-operative choledochoscopic lithotripsy, which is the optimal management for postoperative residual stone. The indications of HJ for hepatolithiasis should be strictly selected.
文摘To study the therapeutic effects of acupuncture combined with nimodipine for vascular dementia. Methods： Acupuncture was applied at Baihui （GV 20）, Shenshu （BL 23）, Geshu （BL 17）, and the points selected according to the midnight-noon, ebb-flow eight methods of the intelligent turtle, combined with the drug nimodipine. The treatment was continued for 8 consecutive weeks. Results： Of the 30 cases treated, 6 cases were cured, 21 cases improved, and 3 cases failed, with a total effective rate of 90%. Conclusion： Acupuncture at Baihui （GV 20）, Shenshu （BL 23）, Geshu （BL 17）, and the points selected according to the midnight-noon, ebb-flow eight methods of the intelligent turtle combined with the drug nimodipine can yield definite therapeutic effects for vascular dementia.
基金Supported by National Science and Technology Infrastructure Program of China(2006BAI04A02-2)National Basic Research Program of China(2012CB518505)Program of Natural Science Foundation of China(81173416)
文摘OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therapy.METHODS:This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin.All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1,2008,to December 31,2008 were retrospectively followed through one year.The main outcomes were either a recurrence of vascular events,,mortality or both.Risk factors were recorded from medical records.Multivariate regression models were used to analyze predictors.The following independent variables were used:age,gender,hypertension,ischemic heart disease,atrial fibrillation,diabetes mellitus,carotid arterial lesions and history of stroke.RESULTS:Four-hundred and five patients were included.The 1-year mortality rate was 11.11%.23.70% of the patients had a recurrent vascular event,and 30.86% suffered a poor outcome.Multiple logistic regression analysis found that previous stroke,and advanced age were predictors of death within one year,Recurrence of vascular events was associated with carotid arterial lesions,history of diabetes and previous stroke.Long-term poor outcome was predicted by advanced age,history of diabetes,and previous stroke.CONCLUSION:Age,previous stroke,carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year.Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.
