Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

Long-term efficacy of infliximab maintenance therapy for perianal Crohn’s disease

AIM:To assess the long-term efficacy of seton drainage with infliximab maintenance therapy in treatment of stricture for perianal Crohn’s disease(CD). METHODS:Sixty-two patients with perianal CD who required surgical treatment with or without infliximab between September 2000 and April 2010 were identified from our clinic’s database.The activities of the perianal lesions were evaluated using the modified perianal CD activity index(mPDAI)score.The primary endpoint was a clinical response at 12-15 wk after surgery as a shortterm efficacy.Secondary endpoints were recurrence as reflected in the mPDAI score,defined as increased points in every major element.The clinical responses were classified as completely healed(mPDAI=0),partially improved(mPDAI score decreased more than 4 points),and failure or recurrence(mPDAI score increased or decreased less than 3 points). RESULTS:There were 43 males and 19 females,of whom 26 were consecutively treated with infliximab after surgery as maintenance therapy.Complete healing was not seen.Failure was seen in 10/36(27.8%) patients without infliximab and 4/26(15.4%)patients with infliximab(P=0.25).Partial improvement was seen in 26/36(72.2%)patients without infliximab and 22/26(88.5%)patients with infliximab(P=0.25). Short-term improvement was achieved in 48/62(77.4%) patients.Although the mPDAI score improved significantly with surgery regardless of infliximab,it decreased more from baseline in patients with infliximab(50.0%) than in those without infliximab(28.6%),(P=0.003). In the long-term,recurrence rates were low regardless of infliximab in patients without anorectal stricture.In patients with anorectal stricture,cumulative recurrence incidences increased gradually and exceeded 40%at 5 years regardless of infliximab.No efficacy of infliximab treatment was found(P=0.97).Although the cumulative rate of ostomy creation was also low in patients without stricture and high in patients with stricture,no protective efficacy was found with infliximab treatment(P =0.6 without stricture,P=0.22 with stricture). CONCLUSION:Infliximab treatment was demonstrated to have short-term efficacy for perianal lesions.Longterm benefit with infliximab was not proven,at least in patients with anorectal stricture.

Long-term results of an anatomically implanted hip arthroplasty with a short stem prosthesis (MiniHip^(TM))

AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed, bone preserving and anatomical hip arthroplasty with the MiniHip^(TM) system. METHODS In a prospective study, 186 patients underwent hip arthroplasty with a partial neck preserving short stem(MiniHip^(TM), Corin). Elderly patients were not excluded from this study, thus the mean age at the time of surgery was 59.3 years(range 32 to 82 years). Surgery and the follow-up assessments were performed at two Centers. Up until now, the mean follow-up was 112.5 ± 8.2 mo. The Oxford Hip Score(OHS) and the Hip Dysfunction Osteoarthritis and Outcome Score(HOOS) was assessed pre-and each year after surgery. The clinical follow-up was accompanied by standardized a.p. and axial radiological examinations. Periprosthetic lucencies, hypertrophies within the Gruen zones one to fourteen were assessed. A subsidence of the stem was investigated according to Morray and heterotopic ossifications were assessed according to Brooker.RESULTS The OHS and HOOS improved from 18 ± 3.3 to 46 ± 2.0 and from 30 ± 8.3 to 95 ± 4.6 points, P < 0.001 respectively. There were no differences regarding age, etiology, friction pairings, etc.,(P > 0.05). Two stems were revised due to a symptomatic subsidence four and twelve months postoperatively. Thus, the survivorship for aseptic loosening at nine to ten years was 98.66%. Including one stem revision due to a symptomatic exostosis, bursitis and thigh pain as well as one revision because of a septic stem loosening, the overall survival for the stem with revision for any reason was 97.32%. Besides one asymptomatic patient, radiological signs of a proximal stress-shielding, such as bone resorptions within the proximal Gruen zones, were not noticed. Findings suggesting a distal loading, e.g., bony hypertrophies or bone appositions of more than 2 mm, were also not detected. CONCLUSION Regarding these first long-term results on the MiniHip^(TM), the implant performed exceedingly well with a high rate of survivorship for aseptic loosening. Our radiological results within the Gruen zones support the design rationale of the Minihip to provide a reliable metaphyseal anchoring with the expected proximal, more physiological load transfer. This might minimize or exclude a stress shielding which might be associated with thigh pain, proximal bone loss and an increased risk of aseptic loosening. The MiniHip^(TM) is a reliable partial-neck retaining prosthesis with good a clinical long-term outcome in younger as well as elderly patients.

Short-term efficacy of laparoscopy-assisted vs open radical gastrectomy in gastric cancer

AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years who were treated at General Hospital of Lanzhou Military Region were enrolled.Among these,200 patients underwent LARG between October2008 and August 2012(LARG group);and 200 patients underwent ORG between March 2000 and September2008(ORG group).The short-term therapeutic benefits between the two groups were analyzed.RESULTS:The LARG procedure offered significantly better benefits to the patients compared to the ORG procedure,including less intraoperative blood loss(103.1±19.5 mL vs 163.0±32.9 mL,P【0.0001),shorter postoperative hospital stay(6.8±1.2 d vs 9.5±1.6 d,P【0.0001),less frequent occurrence of postoperative complications(6.5%vs 13.5%,P=0.02),shorter time to mobilization(1.0±0.3 vs 3.3±0.4 d,P【0.0001),shorter time to bowel opening(3.3±0.7 d vs 4.5±0.7 d,P【0.0001),and shorter time to normal diet(3.0±0.4 vs d 3.8±0.5 d,P【0.0001).However,LARG required a longer time to complete than the ORG procedure(192.3±20.9 min vs 180.0±26.9 min,P【0.0001).CONCLUSION:Compared to ORG,LARG is safer,more effective,and less invasive for treating gastric cancer,with better short-term efficacy.

The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients: A case control study

Abstract Objective： The aim of the study was to observe the cardiac toxicity caused by different doses of epirubicin in the adjuvant treatment of breast cancer and to evaluate the long-term efficacy. Methods： The 180 cases of breast cancer patients received epirubicin based adjuvant chemotherapy. The patients were randomly assigned to high-dosage group （90 rag/m^2）, medium-dosage group （70 mg/m^2） and low-dosage group （50 rag/m^2）, the primary endpoint was cardiac toxicity. The secondary outcomes were the 5-year overall survival （OS） and 5-year disease-free survival （DFS）. Results： During chemo- therapy, the clinical symptoms such as palpitation, dyspnea and paroxysmal nocturnal dyspnea occurred in 6 patients with the high-dosage group, 4 patients with the medium-dosage group and 3 patients with the low-dosage group. The number of patients who had changed in electrocardiogram （ECG） was 7, 5 and 4 in three groups, respectively. The echocardiographic showed each group had only one case with LVEF 〈 50%, there was no significantly difference （P 〉 0.05）. In the three groups, the 5-year DFS rates were 73.3% （44/60） in high-dose group, 53.3% （32/60） in medium-dose group and 41.6% （25/60） in low dose group. The 5-year OS rates were 85.0% （51/60）, 68.3% （41/60） and 58.3% （35/60） in three groups, respectively. The differences were statistically significant （P 〈 0.05）. Conclusion： The high-dose epirubicin in adjuvant chemotherapy with CEF （cyclophosphamide, epirubicin and fluorouracil） regimen could improve the 5-year OS rate and 5-year DFS rate on patients of breast cancer. The cardiotoxicity was mild-moderate and well tolerated.

Network meta-analysis of long-term efficacy of acupuncture-related therapies and SSRIs in treating post-stroke depression

Objective:To evaluate the effect of existing acupuncture-related therapies on the longterm effects of post-stroke depression(PSD)by using a network meta-analysis with SSRIs as a common reference.Methods:The published randomized controlled clinical trials of acupuncture-related therapies and SSRIs for PSD in PubMed,The Cochrane Library,EMbase,CNKI,CBM,VIP and wan-fang databases were comprehensively searched.The literature retrieval period was from The database establishment to July 31,2020.Cochrane Handbook 5.1.0 was used to assess the risk of bias in included studies.Data analysis is conducted through ADDIS,Review Manager 5.3,and STATA 13.1 software.Results:A total of 3115 patients with PSD were included in 30 RCTs,involving 10 therapeutic methods.Results of network meta-analysis showed that:in terms of total effective rate,body acupuncture+SSRIs was superior to body acupuncture[OR=2.85,95%CI(1.51,5.90)]and SSRIs[OR=5.37,95%CI(3.03,10.33)].In terms of HAMD score,body acupuncture+SSRIs was superior to body acupuncture[MD=1.69,95%CI(0.33,3.06)]and SSRIs[MD=3.87,95%CI(2.68,5.08)].The above ranking predicted that moxibustion+SSRIs was the best.In terms of NIHSS score,body acupuncture[MD=2.15,95%CI(1.10,3.26)]and body acupuncture+SSRIs[MD=1.77,95%CI(0.19,3.37)]were better than SSRIs.Conclusion:Moxibustion combined with SSRIs is the best for the long-term efficacy of acupuncture and moxibustion on PSD.Body acupuncture combined with SSRIs is better than SSRIs alone.The other therapies have their own advantages and disadvantages.Based on the defects of existing studies,this conclusion still needs to be verified by more high-quality RCTs.

Long-Term Efficacy of Parathyroidectomy onHyperparathyroid Bone Disease

This is a retrospective analysis of long-term efficacy of parathyroidectomy on hyperparathyroid bone disease. The clinical manifestations, bone structure, and bone mineral density in 16 patients averaged 5.1 (1. 0-10. 5) years after parathyroidectomy were assessed. The results showed that although the bone disease could be markedly relieved after surgery, yet at terminal point of follow-up, 10/16 cases (62. 5% ) got incomplete recovery of bone disease, the ratio of incomplete recovery in Y1 group with severe bone disease was higher than that of Y2 group with mild bone disease (P <0. 05). The concentrations of serum BGP and morning void urine pyridinoline were within the refer ence ranges of young and middle aged controls. These imply that the osteoblastic and osteoclastic activities had reached a balancing state. The results suggested that hyperparathyroid patients should be operated on as early as possible, and intensively followed up after operation. subsequent therapy should be given to patients with incomplete recovery of bone disease.

Long-term efficacy of microvascular decompression on trigeminal neuralgia and multi-factor research of recurrence

Objective To research the factors that affects the efficacy of 2 826 cases of of trigeminal neuralgia after microvascular decompression during follow-up more than 1 year. Methods The patients with trigeminal meuralgia were followed-up for 1-25 years ( mean 9. 8 years) after microvascular decompression from January 1984 to

Long-term outcomes of focal laser photocoagulation for the treatment of polypoidal choroidal vasculopathy

AIM:To evaluate the long-term effect and safety of focal laser photocoagulation treatment in eyes with polypoidal choroidal vasculopathy(PCV).METHODS:Medical records of 13 eyes of 13 patients with PCV were followed-up for more than 2 y after focal laser photocoagulation treatment.The patients were diagnosed with PCV using indocyanine green angiography,and eyes with other comorbid ocular diseases were excluded.The measurement outcomes of the study were the post-treatment regression and recurrence of polyps,complications,and changes in visual acuities.Paired t-test was performed to compare visual outcome before and after the treatment.RESULTS:The mean age of the 13 patients was 70.2±5.5 y,and the follow-up period was 72.3±31.0(range,25-118)mo.Three eyes had juxtafoveal polyps and 10 eyes had extrafoveal polyps.Of the 13 eyes,9 eyes(69.2%)had regression of polyps 1.7±1.2(range,0.9-4)mo after focal laser photocoagulation.Five eyes(55.6%)showed recurrence of polyps during the follow-up periods,and the recurrence period was 12.8±18.9(range,1.9-48)mo.Mild subretinal hemorrhage occurred in two eyes(15.4%)27 and 72 d after laser treatment,respectively.There were no statistically significant differences in visual acuities at baseline;1,2,3 y post-treatment(all P>0.05);and last follow-up(0.63±0.5,0.73±0.70,0.67±0.57,0.75±0.7,and 0.95±0.8 log MAR,respectively).CONCLUSION:Focal laser photocoagulation is beneficial for early regression of polyps in eyes with PCV and does not result in significant submacular hemorrhage during the long-term follow-up.Furthermore,it can be primarily considered in eyes with PCV with extrafoveal or juxtafoveal polyps to regress risky polyps as well as to maintain visual acuity without serious hemorrhagic complications.

Efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on advanced cervical cancer

Background and Objective: Concurrent chemoradiotherapy for cervical carcinoma develops rapidly and has become a common and standard therapy in recent years. Both the local control rate and survival rate of patients were increased and the risk of death fell by 30%-50%. This study aimed to explore the efficacy of concurrent chemoradiotherapy plus adjuvant chemotherapy on and the treatment compliance of the patients with advanced cervical squamous cell carcinoma. Methods: A total of 156 patients with stage IIa-IIIb cervical squamous cell carcinoma were randomly divided into the concurrent chemoradiotherapy group (experimental group) and radiotherapy group (control group). Intracavity and external beam radiation therapy were administered. At point A, 40-48 Gy were given by 10-12 fractions; at point B, 46-50 Gy were given by 23-25 fractions. In the same time, experimental group was treated by cisplatin (DDP, 40 mg) on day 1, repeated every week. Ten days after radiation therapy, TP regimen was administered as adjuvant chemotherapy. Results: For the experimental and control groups, the objective response rates were 88.61% and 75.32%, 1-year survival rates were 88.57% and 70.77%, 1-year local control rates were 81.43% and 64.62%, 3-year survival rates were 82.14% and 57.69%, and 3-year local control rates were 75.00% and 46.15%, with significant differences (P < 0.05). Quality of life of all patients were significantly improved after treatment (P< 0.05). Conclusion: Concurrent chemoradiotherapy plus adjuvant chemotherapy for advanced cervical cancer can improve short-term and long-term survival and local control rates of patients, improve the quality of life, and the toxicity can be tolerated.

Predictive value of serum levels of transforming growth factor beta 1 for the short-term effects of radiotherapy and chemotherapy in patients with esophageal cancer

Objective To investigate variation in levels of transforming growth factor beta 1(TGF-β1)before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the effects of radiotherapy Methods A total of 140 patients with esophageal squamous carcinoma undergoing radical radiation therapy in the Department of Oncology from March 2015 to December 2017 were enrolled.The patients were divided into the effective(115 cases)and ineffective(25 cases)groups according to World Health Organization(WHO)criteria for the evaluation of solid tumors(2009 RECIST standard).TGF-β1 levels were measured in all patients by using enzyme-linked immunosorbent assay(ELISA).Multiple-factor analysis of the predictive value of the treatment efficacy was performed by Cox regression analysis.Results After radiotherapy,36,79,and 25 cases experienced complete response(CR),partial response(PR),and no response(NR),respectively,with a total effective rate of 82.14%.The TGF-β1 level was significantly lower in the effective group than that in the ineffective group(P<0.05)and covariance analysis revealed significantly reduced TGF-β1 level in esophageal cancer patients following radiotherapy.The multi-factor Cox regression model revealed that the predictive value of TGF-β1 for the effect of radiotherapy was largest,with a hazard ratio[HR]of 1.955(P=0.002),followed by exposure dose,with(HR=1.367;P=0.035).Conclusion Serum TGF-β1 level can serve as a predictor for the short-term effects of radiotherapy in patients with esophageal cancer.

Photosensitivity and a precise combination of size-dependent lambda-cyhalothrin microcapsules synergistically generate better insecticidal efficacy

In this study, lambda-cyhalothrin(LC) loaded polyurea microcapsules(MCs) with different particle sizes were fabricated.All of the MCs showed varying degrees of physical collapse, which was more obvious among those with smaller particle sizes. MCs with particle sizes of 1.38 μm(MC-S), 5.13 μm(MC-M) and 10.05 μm(MC-L) had shell thicknesses of 39.6,50.3 and 150.1 nm, respectively. MCs with smaller particles tended to have significantly faster release profiles, and the MC-S group had much higher bioactivity against Agrotis ipsilon and better foliar affinity on the peanut leaves(indicated by rainfastness) than MC-M and MC-L. All of the MCs exhibited light-enhanced release profiles and had much slower degradation compared with the emulsifiable concentrate(EC) group, among which MC-L had the slowest degradation.To generate MCs with both favorable quick efficacy and long-lasting efficacy, binary mixtures of MC-S, MC-M and MC-L were produced by mixing them in pairs at ratios of 2:1, 1:1 and 1:2. The mixture of MC-S:MC-L at 1:2 showed the best comprehensive efficacy in the peanut foliar spray scenario among the nine tested combinations, and its effective duration was three times longer than that of EC. Overall, the precise combination of MCs with different particle sizes can regulate the efficacy of pesticide control and serve as a strategy for the better utilization of pesticides.

新福菌素注射液治疗低危型妊娠滋养细胞肿瘤的临床效果

目的 观察新福菌素注射液治疗低危型妊娠滋养细胞肿瘤(LRGTN)的临床效果。方法 选取2020年1月—2022年6月江西省妇幼保健院收治的LRGTN患者60例,采用随机数字表法分为新福菌素组与常规组,每组30例。常规组接受“8日疗法”治疗,新福菌素组予新福菌素注射液治疗。比较2组近期疗效、达到完全缓解所用时间,治疗前后血清β-人绒毛膜促性腺激素(β-HCG)水平及不良反应。结果 新福菌素组与常规组治疗总缓解率(96.67%vs.90.00%)比较差异无统计学意义(χ^(2)=0.268,P=0.605);新福菌素组完全缓解时间为(73.10±13.87)d,短于常规组的(88.93±16.47)d(t=4.027,P<0.001);治疗1个疗程后,2组β-HCG水平较治疗前降低,且新福菌素组低于常规组(P均<0.01);新福菌素组与常规组1~2级不良反应发生率中肝损伤(6.67%vs.46.67%)、口腔溃疡(46.67%vs.73.33%)以及3~4级不良反应发生率中骨髓抑制(6.67%vs.26.67%)组间比较差异有统计学意义(P<0.05或P<0.01)。结论 新福菌素相比常规方案治疗LRGTN的临床效果相当,但新福菌素组达到完全缓解所用时间更短,且部分不良反应发生风险更低。

上颌扩弓前牵引治疗青少年唇腭裂继发上颌发育不足的近远期疗效研究

目的:回顾分析上颌扩弓及面框前牵引治疗青少年唇腭裂整复术后继发上颌骨发育不足的近、远期头颅侧位片的变化,了解该治疗的稳定性。方法:收集资料完整行上颌扩弓前牵引治疗并远期观察的唇腭裂患者23例,对治疗前(T0)、治疗后即刻(T1)及远期(T2)的头颅定位侧位片进行头影测量分析比较。结果:治疗后T1期发现∠SNA平均增大1.21°,∠SNB减小1.94°,∠ANB增大3.15°,上颌骨位置及大小均变大。下颌平面角增大,下颌骨升支增大,上下颌前后牙槽高度均变大。上前牙唇倾度改善,软组织表现为上唇突度增加。经远期观察(T2)发现上颌骨相关指标稳定,下颌骨体部在牵引结束后开始明显增大,而升支和下颌前后牙槽高度则表现为T0到T2持续增大。下颌平面角减小,但较T0期仍大。∠ANB虽减小但比T0期仍增大2.05°,上唇软组织突度减小。结论:上颌扩弓前牵引可以通过促进上颌发育和下颌后下旋来改善唇腭裂患者的骨性Ⅲ类关系,长期观察上颌前牵引效果稳定,但下颌骨继续生长和前上旋导致效果有所反弹。

玻璃体腔注射康柏西普治疗糖尿病黄斑水肿的影响因素分析及疗效观察

目的评价和分析糖尿病黄斑水肿(DME)玻璃体腔注射康柏西普后的影响因素及短期疗效观察。方法前瞻性病例研究。收集我院接受玻璃体腔注射康柏西普治疗的DME患者94例(94只眼)为研究对象,时间设定为2022年10月至2023年10月,采集患者年龄、性别、体重指数(BMI)、糖尿病病程、黄斑水肿病程、黄斑水肿分型、注射次数等一般信息;糖化血红蛋白(HbA1c)、总胆固醇、血肌酐水平、低密度脂蛋白、甘油三酯、血尿素氮、血葡萄糖等生化指标;基线视力、基线中央视网膜厚度(CRT)等影像学指标。对比分析患眼玻璃体腔注射康柏西普后短期疗效:视力改善值,以最佳矫正视力(BCVA)提高2行及以上视力定义为达标组,反之为未达标组。运用单因素分析及二元Logistic回归分析DME患者治疗后短期疗效的影响因素,以比值比(OR)及95%可置信区间(CI)表示。并按照水肿形态特征分型分为弥漫性组32例(32只眼)、囊样组和视网膜下液组各31例(31只眼)三组,比较三组患者的短期疗效。结果单因素分析结果可得:年龄、BMI、糖尿病病程、黄斑水肿病程、黄斑水肿分型、血肌酐水平、HbA1c、基线视力与治疗后视力改善值均有统计学意义(均P<0.05)。总胆固醇、基线CRT、低密度脂蛋白、甘油三酯、血尿素氮、血葡萄糖、性别、注射次数均无统计学意义(均P>0.05)。二元Logistic回归分析结果可得:年龄(OR=0.903,95%CI:0.8270.987)、血肌酐水平(OR=0.955,95%CI:0.9130.999)、HbA1c(OR=0.438,95%CI:0.2010.954)、囊样水肿分型(OR=0.013,95%CI:0.0080.564)、视网膜下液分型(OR=0.005,95%CI:0.0580.421)均是治疗后视力未达标的独立危险因素(均P<0.05);基线视力(OR=12.423,95%CI:1.95618.054)是治疗后视力达标的保护因素(P<0.05)。总胆固醇、基线CRT、低密度脂蛋白、甘油三酯、血尿素氮、血葡萄糖等其他指标对治疗后视力改善值均无统计学意义(均P>0.05)。通过对三组患者玻璃体腔注射康柏西普后疗效的比较,与治疗前相比,三组患者经玻璃体腔注射康柏西普治疗后的最佳矫正视力均下降(均P<0.05);弥漫性组患者与囊样组、视网膜下液组相比,治疗后1、3、6个月的最佳矫正视力下降更快,差异均有统计学意义(均P<0.05);囊样组与视网膜下液组治疗后1、3、6个月最佳矫正视力差异无统计学意义(P>0.05)。与治疗前相比,三组患者经玻璃体腔注射康柏西普治疗后的CRT均下降(均P<0.05);弥漫性组患者与囊样组、视网膜下液组相比,治疗后1、3、6个月的CRT下降更快,差异均有统计学意义(均P<0.05);囊样组与视网膜下液组治疗后1个月CRT差异无统计学意义(P>0.05),囊样组与视网膜下液组治疗后3、6个月CRT差异均有统计学意义(均P<0.05)。结论年龄、HbA1c、血肌酐水平、黄斑水肿囊样型及视网膜下液型是玻璃体腔注射康柏西普治疗DME疗效的独立危险因素,基线视力升高是玻璃体腔注射康柏西普治疗DME疗效的独立保护因素;玻璃体腔注射康柏西普治疗不同形态特征分型的DME患者都有效,弥漫性组治疗效果最佳,对于囊样组和视网膜下液组治疗的疗效差异不大。

IL-18评价人工肝治疗HBV相关慢加急性肝衰竭有效性及短期预后效果的研究

目的探讨血清白细胞介素-18(IL-18)评价人工肝治疗乙型肝炎病毒(HBV)相关慢加急性肝衰竭(HBV-ACLF)的有效性及短期预后效果。方法选取2022年1月—11月于我院接受治疗的HBV-ACLF患者151例,所有患者均成功接受人工肝治疗,根据患者90 d内结局分为死亡组(n=63)和生存组(n=88),另选择73例健康受试者作为对照(健康组)。检测患者入院时、治疗后及健康受试者血清IL-18水平,分析IL-18水平对患者预后的评估价值。结果HBV-ACLF患者入院时及治疗后血清IL-18均显著高于健康组,死亡组患者入院时及治疗后血清IL-18均显著高于生存组(P<0.05)。Spearman相关性分析显示IL-18与终末期肝病模型(MELD)呈正相关。多因素Cox回归分析显示,血清IL-18水平是HBV-ACLF患者人工肝治疗后死亡的独立危险因素(P<0.05)。受试者工作曲线(ROC)显示患者入院时、治疗后血清IL-18水平诊断HBV-ACLF患者人工肝治疗后90 d死亡率的曲线下面积分别为0.760、0.739。Kaplan-Meier曲线显示,低IL-18水平患者的生存率高于高IL-18水平患者(P<0.05)。结论血清IL-18可辅助评价HBV-ACLF患者人工肝治疗效果及治疗后短期预后。

ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗前后肿瘤标志物、LMR动态变化及其对近期疗效的影响

目的分析ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗前后肿瘤标志物、淋巴细胞/单核细胞比值(LMR)动态变化及其与放疗效果的关系。方法回顾性分析山西省肿瘤医院2012年7月至2020年7月收治的70例ⅡA/ⅡB期睾丸精原细胞瘤术后患者的临床资料,根据放疗近期疗效情况将患者分为有效组(n=16)和无效组(n=54)。记录并整理患者基线资料、放疗前后肿瘤标志物水平及LMR值,分析肿瘤标志物、LMR与放疗近期疗效的关系。结果肿瘤直径>40 mm、睾丸血管浸润是影响ⅡA/ⅡB期睾丸精原细胞瘤术后患者放疗近期效果的危险因素(P<0.05)。有效组放疗后血清乳酸脱氢酶(LDH)水平低于放疗前,LMR值高于放疗前(P<0.05);无效组放疗前、后血清LDH水平高于有效组,LMR值低于有效组(P<0.05)。两组放疗前、后血清甲胎蛋白(AFP)、人绒毛膜促性腺激素(hCG)水平比较及组内比较,差异均无统计学意义(P>0.05)。放疗前、后血清LDH水平与肿瘤直径、睾丸血管浸润均呈正相关(r>0,P<0.05);放疗前、后LMR值与肿瘤直径、睾丸血管浸润均呈负相关(r<0,P<0.05)。放疗前血清LDH水平、LMR值及联合预测放疗无效的曲线下面积均>0.7,联合预测的价值更高。结论睾丸精原细胞瘤患者术后血清LDH水平、LMR值与放疗近期疗效密切相关。

腹腔镜下低位直肠癌根治术与传统开腹手术的疗效与安全性比较

目的观察腹腔镜下低位直肠癌根治术与常规开腹直肠癌根治术的近期疗效和安全性。方法选取2021年4月~2023年4月收治的80例低位直肠癌患者,采用随机数字表法分为观察组和对照组,各40例。观察组行腹腔镜下低位直肠癌根治术,对照组行常规开腹直肠癌根治术。比较两组围术期指标、环周切缘状态和保肛率、术后恢复情况、血清炎症因子水平及术后并发症发生率。结果两组手术时间、淋巴结清扫数目差异无统计学意义(P>0.05);观察组与对照组术中出血量分别为(90.24±23.34)ml、(148.02±18.67)ml,切口长度分别为(5.17±0.94)cm、(14.75±2.26)cm,观察组术中出血量少于对照组,切口长度短于对照组(P<0.05);两组患者手术后环周切缘阳性率和保肛率差异无统计学意义(P>0.05);观察组与对照组术后肛门首次排气时间分别为(2.07±0.85)d、(2.75±0.91)d,拔除尿管时间分别为(2.21±0.67)d、(3.45±1.22)d,术后首次下床活动时间分别为(4.55±1.17)d、(6.28±1.36)d,术后住院时间分别为(10.69±2.27)d、(12.86±3.61)d,观察组均短于对照组(P<0.05);手术后观察组与对照组血清白细胞介素-6(IL-6)水平分别为(63.09±7.25)ng/L、(69.71±8.43)ng/L,皮质醇(Cor)水平分别为(328.95±41.75)μg/L、(451.37±53.62)μg/L,C反应蛋白(CRP)水平分别为(22.64±7.78)mg/L、(34.51±11.92)mg/L,观察组均低于对照组(P<0.05);观察组与对照组术后并发症发生率分别为5.00%、20.00%,观察组低于对照组(P<0.05)。结论腹腔镜下低位直肠癌根治术与常规开腹手术治疗低位直肠癌在手术时间、淋巴结清扫数目、保肛率等方面效果接近,但腹腔镜下低位直肠癌根治术手术创伤较小,有利于减轻炎症反应、减少术后并发症,有助于术后早期康复。

单侧双通道内镜治疗重度腰椎管狭窄症的近期疗效分析

目的探讨单侧双通道内镜治疗重度腰椎管狭窄症的近期疗效及对患者硬膜囊面积、功能恢复情况的影响。方法前瞻性选取2021年1月至2023年1月衢州市人民医院收治的重度腰椎管狭窄症患者60例为研究对象,采用随机数字表法分为观察组和对照组,各30例。观察组实施单侧双通道内镜技术,对照组实施传统腰椎后路椎板开窗减压术,比较两组患者手术效果、硬膜囊面积变化、功能恢复及并发症发生情况。结果观察组患者总优良率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。与术前比较,术后1个月两组患者硬膜囊面积均增大,且观察组大于对照组,差异均有统计学意义(均P<0.05)。与术前比较,术后3个月两组患者日本骨科协会腰痛评分均升高,Oswestry功能障碍指数均降低,且观察组均上述指标均优于对照组,差异均有统计学意义(均P<0.05)。观察组和对照组并发症发生率分别为10.00%和20.00%,两组比较差异无统计学意义(P>0.05)。结论单侧双通道内镜治疗重度腰椎管狭窄症近期疗效显著,可明显减轻患者术后疼痛程度,改善患者腰椎功能。