We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.The lesion was large and irregular with three discrete perforations,therefore,we ...We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.The lesion was large and irregular with three discrete perforations,therefore,we decided to close it by placing one clip per perforation,and then connecting all the clips with two endoloops.Finally we chose to use a fibrin glue injection to obtain a complete sealing.Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ.Inspection of the sigma showed complete repair of the perforation.This report underlines how a conservative approach,together with a combination of various endoscopic techniques,can resolve complicated iatrogenic perforations of the colon.展开更多
OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searche...OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searched six English and Chinese electronic databases for randomized clinical trials(RCTs) on integrated traditional and Western medicine for treatment of depression.Two authors extracted data and independently assessed the trial quality.RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference(WMD) with a 95% confidence interval(CI).RESULTS:Seven RCTs with 576 participants were identified for this review.All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias.Meta-analysis showed,compared with Western medicine alone,integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD=-2.39,CI(-2.96,-1.83),Z=8.29,P<0.00001].There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials.CONCLUSIONS:Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD,illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone.However,further large,rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.展开更多
Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point stick...Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point sticking group and an observation group by random number table method,with 30 cases in each group.Patients in the observation group received acupuncture plus auricular point sticking for treatment,while those in the acupuncture group only received acupuncture and those in the auricular point sticking group only received auricular point sticking for treatment.The headache attack frequency and the scores of visual analog scale(VAS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were observed before treatment,after treatment and 3 months after treatment.The clinical efficacy was evaluated at the follow-up of 3 months after treatment.Results:At follow-up,there were significant differences in clinical efficacy among the three groups(P<0.01 or P<0.05),and the clinical efficacy ranking from high to low was the observation group,the acupuncture group and the auricular point sticking group.After treatment and at follow-up,the VAS score,headache attack frequency,SAS and SDS scores in the three groups were significantly lower than those before treatment(all P<0.01).The above four results in the observation group were lower than those in the acupuncture group and the auricular point sticking group at the same time point(all P<0.01);VAS score in the acupuncture group was lower than that in the auricular point sticking group(both P<0.05).At follow-up,the headache frequency in the acupuncture group was lower than that in the auricular point sticking group(P<0.05).Conclusion:Either using acupuncture and auricular point sticking together or separately can reduce the headache degree of TTH patients,reduce the number of headache attacks,and relieve anxiety and depression.The efficacy of acupuncture plus auricular point sticking is most significant.展开更多
文摘We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.The lesion was large and irregular with three discrete perforations,therefore,we decided to close it by placing one clip per perforation,and then connecting all the clips with two endoloops.Finally we chose to use a fibrin glue injection to obtain a complete sealing.Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ.Inspection of the sigma showed complete repair of the perforation.This report underlines how a conservative approach,together with a combination of various endoscopic techniques,can resolve complicated iatrogenic perforations of the colon.
基金supported by the National Natural Science Foundation of China (81072756,30672578)the Chinese National Funds for Distinguished Young Scientists (30825046)+1 种基金the Hi-Tech Research and Development Program of China (2008AA02Z406)the Program for Innovative Research Teams in Beijing University of Chinese Medicine (2011CXTD-07)
文摘OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searched six English and Chinese electronic databases for randomized clinical trials(RCTs) on integrated traditional and Western medicine for treatment of depression.Two authors extracted data and independently assessed the trial quality.RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference(WMD) with a 95% confidence interval(CI).RESULTS:Seven RCTs with 576 participants were identified for this review.All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias.Meta-analysis showed,compared with Western medicine alone,integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD=-2.39,CI(-2.96,-1.83),Z=8.29,P<0.00001].There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials.CONCLUSIONS:Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD,illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone.However,further large,rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.
文摘Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point sticking group and an observation group by random number table method,with 30 cases in each group.Patients in the observation group received acupuncture plus auricular point sticking for treatment,while those in the acupuncture group only received acupuncture and those in the auricular point sticking group only received auricular point sticking for treatment.The headache attack frequency and the scores of visual analog scale(VAS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were observed before treatment,after treatment and 3 months after treatment.The clinical efficacy was evaluated at the follow-up of 3 months after treatment.Results:At follow-up,there were significant differences in clinical efficacy among the three groups(P<0.01 or P<0.05),and the clinical efficacy ranking from high to low was the observation group,the acupuncture group and the auricular point sticking group.After treatment and at follow-up,the VAS score,headache attack frequency,SAS and SDS scores in the three groups were significantly lower than those before treatment(all P<0.01).The above four results in the observation group were lower than those in the acupuncture group and the auricular point sticking group at the same time point(all P<0.01);VAS score in the acupuncture group was lower than that in the auricular point sticking group(both P<0.05).At follow-up,the headache frequency in the acupuncture group was lower than that in the auricular point sticking group(P<0.05).Conclusion:Either using acupuncture and auricular point sticking together or separately can reduce the headache degree of TTH patients,reduce the number of headache attacks,and relieve anxiety and depression.The efficacy of acupuncture plus auricular point sticking is most significant.
