BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration ...BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration can be delayed for several months,leading to concern for distant metastases.To counteract this,a novel treatment approach known as total neoadjuvant therapy(TNT)has gained popularity,in which patients receive both maChT and nCRT prior to resection.We utilized the National Cancer Database to examine temporal trends in TNT usage,and any potential effect on survival.AIM To study the temporal trends in the usage of TNT and evaluate its efficacy compared to neoadjuvant chemoradiation.METHODS We queried the National Cancer Database for patients with locally advanced rectal cancer,Stage II-III,from 2004-2015 treated with nCRT or TNT.TNT was defined as maChT initiated≥90 d prior to nCRT initiation.Overall survival was calculated from the date of diagnosis to the date of last contact or death using Kaplan-Meier curves to present the cumulative probability of survival,with logrank statistics to assess significance.Multivariable cox regression was used to identify predictors of survival and propensity score analysis accounted for bias.RESULTS We identified 9066 eligible patients,with 8812 and 254 patients receiving neoadjuvant chemoradiation followed by maChT and TNT,respectively.Nodal involvement,stage III disease,and treatment in recent years were predictive of TNT use.There was greater use of TNT with more advanced stage,specifically>1 node involved(odds ratio[OR]=2.88,95%confidence interval[CI]:2.11-3.93,P<0.01)and stage III disease(OR=2.88,95%CI:2.11-3.93,P<0.01).From 2010 to 2012 the use of TNT increased(OR=2.41,95%CI:1.27-4.56,P<0.01)with a greater increase from 2013 to 2015(OR=6.62,95%CI:3.57-12.25,P<0.01).Both the TNT and neoadjuvant chemoradiation arms had a similar 5-year survival at 76%and 78%respectively.Multivariable analysis with propensity score demonstrated that increased age,high comorbidity score,higher grade,African American race,and female gender had worse overall survival.CONCLUSION Our data demonstrates a rising trend in TNT use,particularly in patients with worse disease.Patients treated with TNT and nCRT had similar survival.Randomized trials evaluating TNT are underway.展开更多
＂Sinew-bone three-needle therapy＂ was introduced in the paper. The innovation of needle instrument was micro Sinew-bone needles and big Sinew-bone needles; the Innovation of acupuncture techniques were fascia rotati...＂Sinew-bone three-needle therapy＂ was introduced in the paper. The innovation of needle instrument was micro Sinew-bone needles and big Sinew-bone needles; the Innovation of acupuncture techniques were fascia rotating separation, fascia plucked separation, fascia cutting separation, fascia fan separation, flying flicking therapy, and fascia knocking and pricking. The six myofascial power zones i.e three yang hand meridian, three yin hand meridian, three yang foot meridian, three yin foot meridian, conception vessel and governor vessel were put forward. The meridian-sinew flow and move, connecting at the peks of bones where the bones protrude, the sinews connect, movement and stillness harmoniously shift here. Bones have leaks on the sides, there are blood vessels and nerves. Joints peak and protrude, and three points meet. Fascia and muscles meet in a balanced triangle. Meridiansinew knot and form nodes, when soft tissue is damaged there is pain here. Needling manipulation can loose and break this apart, the sinew connection is the key. Treatment method was invented and the location and treatment points using the three needles were summarized.展开更多
Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patie...Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.展开更多
文摘BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration can be delayed for several months,leading to concern for distant metastases.To counteract this,a novel treatment approach known as total neoadjuvant therapy(TNT)has gained popularity,in which patients receive both maChT and nCRT prior to resection.We utilized the National Cancer Database to examine temporal trends in TNT usage,and any potential effect on survival.AIM To study the temporal trends in the usage of TNT and evaluate its efficacy compared to neoadjuvant chemoradiation.METHODS We queried the National Cancer Database for patients with locally advanced rectal cancer,Stage II-III,from 2004-2015 treated with nCRT or TNT.TNT was defined as maChT initiated≥90 d prior to nCRT initiation.Overall survival was calculated from the date of diagnosis to the date of last contact or death using Kaplan-Meier curves to present the cumulative probability of survival,with logrank statistics to assess significance.Multivariable cox regression was used to identify predictors of survival and propensity score analysis accounted for bias.RESULTS We identified 9066 eligible patients,with 8812 and 254 patients receiving neoadjuvant chemoradiation followed by maChT and TNT,respectively.Nodal involvement,stage III disease,and treatment in recent years were predictive of TNT use.There was greater use of TNT with more advanced stage,specifically>1 node involved(odds ratio[OR]=2.88,95%confidence interval[CI]:2.11-3.93,P<0.01)and stage III disease(OR=2.88,95%CI:2.11-3.93,P<0.01).From 2010 to 2012 the use of TNT increased(OR=2.41,95%CI:1.27-4.56,P<0.01)with a greater increase from 2013 to 2015(OR=6.62,95%CI:3.57-12.25,P<0.01).Both the TNT and neoadjuvant chemoradiation arms had a similar 5-year survival at 76%and 78%respectively.Multivariable analysis with propensity score demonstrated that increased age,high comorbidity score,higher grade,African American race,and female gender had worse overall survival.CONCLUSION Our data demonstrates a rising trend in TNT use,particularly in patients with worse disease.Patients treated with TNT and nCRT had similar survival.Randomized trials evaluating TNT are underway.
文摘＂Sinew-bone three-needle therapy＂ was introduced in the paper. The innovation of needle instrument was micro Sinew-bone needles and big Sinew-bone needles; the Innovation of acupuncture techniques were fascia rotating separation, fascia plucked separation, fascia cutting separation, fascia fan separation, flying flicking therapy, and fascia knocking and pricking. The six myofascial power zones i.e three yang hand meridian, three yin hand meridian, three yang foot meridian, three yin foot meridian, conception vessel and governor vessel were put forward. The meridian-sinew flow and move, connecting at the peks of bones where the bones protrude, the sinews connect, movement and stillness harmoniously shift here. Bones have leaks on the sides, there are blood vessels and nerves. Joints peak and protrude, and three points meet. Fascia and muscles meet in a balanced triangle. Meridiansinew knot and form nodes, when soft tissue is damaged there is pain here. Needling manipulation can loose and break this apart, the sinew connection is the key. Treatment method was invented and the location and treatment points using the three needles were summarized.
文摘Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.
