Short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function

BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.

Analysis of the Short-Term Curative Effect of Roxadustat in Treating Renal Anemia in Patients with Peritoneal Dialysis

Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.

Control study of short-term curative effect of minimally invasive total hip arthroplasty using metal-on-metal large-diameter femoral head for the elderly patients with femoral neck fractures

Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the 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.

A PRELIMINARY STUDY OF SHORT-TERM EFFICACY OF Nd:YAG LASER PERIPHERAL IRIDOTOMY IN PATIENTS WITH PRIMARY ANGLE CLOSED GLAUCOMA

Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～5.6mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2mm^2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy p...

Clinical implication of naive and memory T cells in locally advanced cervical cancer:A proxy for tumor biology and short-term response prediction

Background:This study was designed to investigate the feasibility of tumor-infiltrating immune cells with different phenotypic characteristics for predicting short-term clinical responses in patients with locally advanced cervical cancer(LACC).Methods:Thirty-four patients who received concurrent chemoradiotherapy and twenty-one patients who merely underwent radiotherapy were enrolled in this study.We retrospectively analyzed the T cell markers(i.e.,CD3,CD4,CD8),memory markers(i.e.,CD45,CCR7),and differentiation markers(i.e.,CD27)in the peripheral blood and tumor tissues of patients with LACC before treatment based on flow cytometry.We also analyzed the relationship of T cell subsets between peripheral blood and tumor tissues,and their correlation with complete response or partial response.Results:The percentage of central memory CD8^(+)TCM(CD8^(+)CD45RA^(−)CD27^(+)CCR7^(+))cells in LACC patients was significantly lower than that of the control group.The percentage of CD8^(+)TN in the peripheral blood of LACC patients was significantly higher than that of tumor tissues.CD8^(+)TEM in the peripheral blood was significantly lower than that of tumor tissues.The percentage of CD8^(+)TN and CD8^(+)TCM in human papillomavirus(HPV)positive samples was significantly higher than that of HPV-negative samples.Similarly,the percentage of CD8^(+)TCM in tumor tissues was significantly higher in cancer tissue samples with lymph nodes compared with those without.Conclusion:A higher proportion of CD4^(+)TCM and a lower proportion of CD8^(+)TN in the tumor microenvironment of LACC may contribute to the therapy response prediction.

俞募配穴针刺治疗肝郁脾虚型抑郁症的临床效果观察

目的:观察俞募配穴针刺治疗肝郁脾虚型抑郁症患者的临床疗效。方法:选取2022年1月至2022年12月福建中医药大学附属第二人民医院收治的肝郁脾虚型抑郁症患者100例作为研究对象,随机分为对照组和观察组,每组50例。对照组给予艾司西酞普兰口服治疗,持续用药1个月;观察组在对照组基础上联合俞募配穴针刺治疗,2 d治疗1次,持续治疗15次。比较2组患者治疗前后主要症状、抑郁程度、生命质量评分、血清5-羟色胺(5-HT)水平、肠道菌群、不良反应、复发率及临床疗效。结果:治疗后,观察组健康调查简表(SF-36)评分、血清5-HT水平、粪便标本乳酸杆菌及双歧杆菌数量高于对照组(均P<0.05),主要症状评分、汉密尔顿抑郁量表(HAMD-24)评分、粪便标本大肠埃希菌及肠球菌数量低于对照组(均P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组治疗后6个月复发率略低于对照组,但差异无统计学意义(P>0.05)。治疗后观察组总有效率高于对照组(P<0.05)。结论:俞募配穴针刺治疗肝郁脾虚型抑郁症患者疗效明确,可有效改善患者症状,减轻抑郁程度,提高生命质量,调节血清5-HT水平及改善肠道菌群分布,安全性高。

经皮微创脊柱后路钉棒系统固定治疗胸腰椎骨折近远期效果观察

目的:观察胸腰椎骨折患者接受经皮微创脊柱后路钉棒系统固定治疗的近远期疗效。方法:选择2018年2月-2022年1月我院70例胸腰椎骨折患者作为研究对象,根据随机数字表法分为对照组和观察组,每组35例。对照组采用常规切开椎弓根内固定治疗,观察组采用经皮微创脊柱后路钉棒系统固定治疗,对比2组各项手术指标、术后恢复情况及并发症发生率。结果:术后观察组患者的手术时间、术中出血量、住院时间、术后引流量、术后负重时间、骨折愈合时间均优于对照组,差异均有统计学意义(P<0.05)。术前2组患者的伤椎后凸Cobb角、伤椎前缘高度比值、伤椎后缘高度比值差异无统计学意义(P>0.05),术后3个月及术后1年伤椎后凸Cobb角均降低,伤椎前缘高度比值、伤椎后缘高度均升高,观察组变化比对照组更明显,差异有统计学意义(P<0.05)。术前2组患者ODI、Harris评分、VAS评分差异无统计学意义(P>0.05)。术后7dVAS评分降低,术后3个月及术后1年ODI评分降低,Harris评分升高,观察组变化比对照组更明显,差异有统计学意义(P<0.05)。观察组术后并发症发生率为5.71%,低于对照组的25.71%,差异有统计学意义(P<0.05)。结论:胸腰椎骨折患者接受经皮微创脊柱后路钉棒系统固定治疗,近期疗效和远期疗效均能得到有效保障,对于促进患者腰椎指标及功能改善、缓解疼痛程度及减少并发症发生率均具有显著效果。

硼替佐米为主化疗方案对初治多发性骨髓瘤患者临床疗效

目的 观察以硼替佐米为主的化疗方案对初治多发性骨髓瘤的治疗效果并分析预后。方法 选取我院收治的初治多发性骨髓瘤患者43例,随机分为观察组和对照组,其中观察组20例,对照组23例。观察组采用以硼替佐米为主的治疗方案,对照组采用传统治疗方案,治疗均为4个标准疗程。比较两组患者治疗前后总反应率、血沉、球蛋白、骨髓浆细胞等指标的变化。结果 化疗4个疗程后,观察组总反应率显著高于对照组(P<0.05),观察组球蛋白、红细胞沉降率、浆细胞比例均显著低于对照组(P均<0.05)。结论 与传统的治疗方案相比,以硼替佐米为主的化疗方案可提高初治多发性骨髓瘤的疗效。

载药微球对比传统化疗栓塞治疗分支门脉癌栓肝癌的临床研究

目的对比不同经导管动脉内化疗栓塞(TACE)方式应用于分支门脉癌栓(PVTT)肝细胞癌(HCC)患者的疗效及安全性。方法回顾性纳入自2019年12月至2022年8月符合纳排标准的122例有分支PVTT的HCC患者,根据不同的TACE方式分为载药微球组(DEB-TACE)和传统TACE组(cTACE)。通过比较两组患者术后并发症、疼痛来评估两者的安全性。比较两组患者术后1个月的肿瘤反应率、术后的无进展生存时间(PFS)和总体生存时间(OS),探究哪一种TACE方式对有分支PVTT的HCC患者疗效更优。结果两组的术后疼痛分级和并发症发生率基本无差异。TACE后1个月,DEB-TACE组的ORR(P=0.033)及DCR(P=0.096)优于cTACE组。DEB-TACE组和c TACE组的中位PFS分别为10.5个月及6.4个月(P=0.003),中位OS为19.3个月及16.8个月(P=0.019)。结论TACE应用于分支PVTT的HCC患者是有效、安全的,DEB-TACE的术后疗效优于c TACE。为提高这部分患者的预后,我们更应该推荐DEBTACE作为初次介入治疗的方式。

Effects of 8-OHdG,H-FABP and CRP on the Development of Ischemic Cardiomyopathy

[Objectives]To analyze the relationship between serum 8-hydroxydeoxyguanosine(8-OHdG),heart fatty acid-binding protein(H-FABP),C-reactive protein(CRP)levels and clinical efficacy and short-term prognosis in patients with ischemic cardiomyopathy.[Methods]The clinical data of 100 patients with ischemic cardiomyopathy from October 2021 to November 2022 were retrospectively analyzed,and the serum levels of 8-OHdG,H-FABP and CRP were compared before and one week after treatment.The patients were followed up for 12 months after discharge,and the incidence of major adverse cardiovascular events(MACE)was counted during the follow-up period.Univariate and multivariate Logistic regression analysis were used to analyze the prognostic factors of patients with ischemic cardiomyopathy in the near future,and the predictive value of serum 8-OHdG,H-FABP and CRP levels for the prognosis of patients was evaluated by ROC curve.[Results]After 1 week of treatment,the serum levels of 8-OHdG,H-FABP and CRP in patients with ischemic cardiomyopathy were significantly lower than those before treatment(P<0.05).During the follow-up period,34 patients developed MACE;the serum levels of 8-OHdG,H-FABP and CRP in the MACE group were higher than those in the non-MACE group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that 8-OHdG,H-FABP and CRP were the risk factors of MACE in patients with ischemic cardiomyopathy(P<0.05).ROC curve analysis showed that the combined prediction of 8-OHdG,H-FABP and CRP for MACE in patients with ischemic cardiomyopathy was higher than that of CRP,H-FABP and 8-OHdG alone(P<0.05).[Conclusions]8-OHdG,H-FABP and CRP are closely related to the clinical efficacy and short-term prognosis of patients with ischemic cardiomyopathy,and the detection of serum 8-OHdG,H-FABP and CRP levels can help to evaluate the clinical efficacy and short-term prognosis of patients with ischemic cardiomyopathy.

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.

补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床研究

目的探究补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床疗效。方法选择河北省石家庄市中医院肛肠科气虚秘型出口梗阻型便秘患者80例作为研究对象,根据随机数字法分为试验组与对照组,两组各40例。对照组予以生物反馈治疗,30 min/次,每周3次;试验组在对照组基础上予补气健脾疏肝法治疗,每日1剂,水煎取汁400 mL,分早晚两次温服。两组均连续治疗4周。观察两组治疗前后的中医临床疗效、证候评分、肛门疼痛情况、生活质量及安全性。结果治疗后,试验组的临床总有效率(97.5%)优于对照组(72.5%)(P<0.05)。治疗后,与治疗前比较,两组排便频率、排便困难、粪便性状、排便时间、肛门堵塞感、排便不尽感的中医证候评分、疼痛数字评定量表(numerical rating scale,NRS)、便秘患者生活质量自评量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分均下降(P<0.05);与对照组比较,试验组各项证候评分、NRS评分、PAC-QOL评分较低(P<0.05)。与对照组相比,试验组不良反应较低(P<0.05)。结论生物反馈联合补气健脾疏肝法治疗出口梗阻型便秘疗效确切,可有效缓解患者的临床症状,减轻患者的肛门疼痛,并提高患者的生活质量。

六藤安脊汤联合柳氮磺吡啶治疗活动期肾虚瘀阻型强直性脊柱炎临床研究

目的:观察六藤安脊汤联合柳氮磺吡啶治疗活动期肾虚瘀阻型强直性脊柱炎(AS)的临床疗效与安全性。方法:选择活动期肾虚瘀阻型AS患者66例,随机分为观察组和对照组各33例。观察组患者口服六藤安脊汤和柳氮磺吡啶,对照组患者口服模拟中药汤(焦糖)和柳氮磺吡啶,两组均治疗12周。比较两组患者主要疗效指标、次要疗效指标、西医AS评估工作组(ASAS)疗效、中医证候疗效及不良反应情况。结果:①治疗后,两组主要疗效指标水平较治疗前均明显改善(P<0.05或P<0.01),且观察组Bath强直性脊柱炎病情活动指数、Bath强直性脊柱炎功能指数、脊柱痛评分、夜间痛评分、患者对病情总体评分、中医证候积分均低于对照组(P<0.01)。②治疗后,两组次要疗效指标中的胸廓活动度、脊柱活动度、Schober试验体征、指地距及红细胞沉降率、C反应蛋白(CRP)水平较治疗前均明显改善(P<0.05或P<0.01),且观察组胸廓活动度、脊柱活动度、Schober试验体征、指地距、CRP水平均优于对照组(P<0.05或P<0.01)。③观察组ASAS疗效和中医证候疗效均优于对照组(P<0.05),且观察组未见不良反应。结论:六藤安脊汤联合柳氮磺吡啶治疗活动期肾虚瘀阻型AS疗效确切,安全性较高。

曲妥珠单抗联合化疗方案治疗乳腺癌的疗效及其作用机制研究

目的评价曲妥珠单抗联合化疗方案治疗乳腺癌(BC)的疗效,并探讨其对患者外周血磷脂酰肌醇-3-激酶(PI3K)/蛋白激酶B(Akt)通路的干预作用。方法选取2019年3月至2021年1月南阳市中心医院乳腺科一病区收治的68例BC患者为研究对象,采用奇偶分组法分为单一组和联合组各34例。单一组患者予以TP方案(紫杉醇+顺铂)化疗,联合组患者予以曲妥珠单抗+TP方案化疗,两组连续治疗3个周期。比较两组患者的临床疗效及治疗前后的血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)]、生化指标[血小板第4因子(PF4)、中期因子(MK)、脂质运载蛋白-2(LCN-2)]水平;比较两组患者治疗前后的外周血PI3K/Akt通路相关蛋白[磷酸化磷脂酰肌醇-3-激酶(p-PI3K)、磷酸化蛋白激酶B(p-AKT)]表达量、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及毒副反应发生率。随访1年后,比较两组患者的生存率。结果联合组患者的治疗总有效率、疾病控制率分别为44.12%、79.41%,明显高于单一组的20.59%、47.06%,差异均有统计学意义(P<0.05);治疗后,联合组患者的血清CEA、CA125、CA153、PF4、MK、LCN-2水平和p-PI3K、p-AKT蛋白表达量明显低于单一组,差异均有统计学意义(P<0.05);治疗后,联合组患者的EORTC QLQ-C30评分为(116.32±9.13)分,明显高于单一组的(101.24±8.46)分,差异有统计学意义(P<0.05);联合组患者的总生存率为93.75%,明显高于单一组的72.41%,差异有统计学意义(P<0.05);两组患者的毒副反应发生率比较差异无统计学意义(P>0.05)。结论曲妥珠单抗联合TP化疗方案可提高BC患者的临床疗效,降低肿瘤标志物和生化指标水平,提高生存率,且具有一定安全性,其可能通过抑制PI3K/Akt通路活化发挥作用。

超声血流参数及血清β2-MG LDH对非霍奇金淋巴瘤的诊断效能及疗效预测效能

目的探讨超声血流参数及血清β2微球蛋白(β2-MG)、乳酸脱氢酶(LDH)对非霍奇金淋巴瘤(NHL)的诊断效能及疗效预测效能。方法选取90例NHL患者设为研究组,90例淋巴结良性肿瘤患者设为对照组,两组患者入院后均给予超声检查,并测定血清β2-MG、LDH水平。比较两组超声血流参数[脉动指数(PI)、阻力指数(RI)]及血清β2-MG、LDH水平,比较不同病理特征、疗效NHL患者上述指标的差异。分析超声血流参数及血清β2-MG、LDH水平与病理特征关联性、对NHL的诊断价值及疗效预测价值。结果研究组患者超声血流参数PI、RI及血清β2-MG、LDH水平均高于对照组(P<0.01);随着肿瘤分化程度增高,PI、RI及血清β2-MG、LDH水平持续降低,随着疾病分期增高、病情加剧,PI、RI及血清β2-MG、LDH水平持续增高(P<0.01)。Pearson相关分析显示,PI、RI及血清β2-MG、LDH水平与肿瘤分化程度呈显著负相关(P<0.01),与疾病分期、病情程度呈显著正相关(P<0.01)。疗效良好者超声血流参数PI、RI及血清β2-MG、LDH水平低于疗效不佳者(P<0.01)。受试者工作特征(ROC)曲线显示,各指标联合诊断的曲线下面积(AUC)为0.901,高于单独诊断,联合诊断敏感度为81.11%、特异度为86.67%;各指标联合预测NHL疗效不佳的AUC为0.892,高于单独预测,联合预测敏感度为80.95%、特异度为85.51%。结论超声血流参数及血清β2-MG、LDH水平均与NHL病理特征有关,联合检测可提高诊断效能,并可有效预测疗效,可指导临床诊治及病情监测。

骨水泥不同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响

目的探讨骨水泥不同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响。方法回顾性分析2019年3月至2022年3月西安国际医学中心医院收治的80例脊柱骨质疏松骨折行单侧PVP手术患者的临床资料,根据X线检查骨水泥分布情况进行分组,其中42例骨水泥分布互相连通的致密型患者纳入观察组,38例骨水泥分布互相分离的弥散型患者纳入对照组。比较两组患者的手术时间、术中骨水泥注入量、骨水泥渗漏率、术后再发骨折发生情况;测量患者手术前后的前缘、后缘椎体高度,计算前、后缘高度比,测量术前、术后3 d局部后凸角(Cobb角)情况;于术前、术后1 d、3个月、12个月采用视觉疼痛评分(VAS)、Oswestry功能障碍量表(ODI)评估两组患者的疼痛及生活质量。结果观察组患者的手术时间为(36.65±8.05)min,明显短于对照组的(40.76±9.16)min,差异有统计学意义(P<0.05);两组患者的透视次数、住院时间、前后缘高度比、术前及术后3 d的Cobb角比较差异均无统计学意义(P>0.05);观察组患者的骨水泥灌注量为(3.34±1.09)mL,骨水泥渗漏6例(14.29%),明显少于对照组的(4.88±1.15)mL和15例(29.47%),差异均有统计学意义(P<0.05);观察组和对照组患者术后再发骨折发生率分别为11.90%、13.16%,差异无统计学意义(P>0.05);两组患者术后VAS评分及ODI评分较术前均降低,且观察组患者术后1 d、3个月的VAS评分明显低于对照组,术后3个月、12个月的ODI评分也明显低于对照组,差异均有统计学意义(P<0.05)。结论骨水泥分布形态是影响PVP手术疗效及预后的重要因素,骨水泥分布互相连通的致密型相较于弥散型效果更优,有助于缩短手术时间,骨水泥渗漏率少,且能缓解术后疼痛,提高生活质量。

不同手术时机治疗对老年股骨颈骨折患者的近远期疗效比较

目的探讨不同手术时机治疗对老年股骨颈骨折患者的近远期疗效。方法选取2015年8月至2020年9月北京市朝阳区双桥医院收治的150例股骨颈骨折患者作为研究对象,根据不同手术时机分为观察组与对照组,每组75例。两组均行全髋关节置换术,观察组在入院后4~6 h进行手术,对照组在入院后1~2 d进行手术。比较两组手术时间、术中出血量和住院时间,两组手术前后不同时间点Harris评分,手术前后血清Dickkopf相关蛋白-1(DKK-1)和血清酸性磷酸酶5b(TPAP5b)水平和术后1、12个月临床疗效。结果观察组手术时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组Harris评分组间、时间、交互比较差异有统计学意义(P<0.05);组内比较:术后1、3、6、12个月,两组Harris评分术后均高于前一时间点,差异有统计学意义(P<0.05)。组间比较:术前、术后12个月,两组Harris评分比较差异无统计学意义;术后1、3、6个月,观察组Harris评分均高于对照组,差异有统计学意义(P<0.05)。术后,两组DKK-1、TPAP5b水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗总有效率术后1个月与术后12个月比较差异无统计学意义;术后1、12个月,观察组治疗总有效率均高于对照组,差异有统计学意义(P<0.05)。结论对老年股骨颈骨折患者越早进行手术,髋关节功能改善越好,缩短手术时间和住院时间、降低出血量,近远期疗效更好。

Short- and long-term results of open vs laparoscopic multisegmental resection and anastomosis for synchronous colorectal cancer located in separate segments

BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate segments.AIM To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate segments.METHODS Patients with SCRC who underwent surgery between January 2010 and December 2021 at the Cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively recruited.In accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,respectively.Furthermore,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,respectively.Multivariate prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with SCRC.CONCLUSION LMRA is safe and feasible for patients with SCRC located in separate segments.Compared to OMRA,the LMRA approach has more advantages related to short-term efficacy.

冠心病心绞痛中西医结合临床疗效评价指标及方法的研究现状和思考

冠心病心绞痛病证结合证候诊断标准正在不断完善,如何评价临床疗效已成为一个亟待解决的问题。笔者筛选出2000-2007年间国内中文核心期刊发表的中、西医冠心病临床研究资料,从症状、体征、实验室指标等不同层面系统分析了冠心病心绞痛常用疗效评价指标和方法,以期为冠心病心绞痛中西医临床疗效评价体系的建立提供思路。