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.

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.

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.

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

经皮脊柱内镜下腰椎间盘切除术后早期和中期不良预后的风险因素

目的观察经皮脊柱内镜下腰椎间盘切除术(Percutaneous endoscopic lumbar discectomy,PELD)治疗腰椎间盘突出症(lumbar disc herniation,LDH)术后早期和中期不良预后的发生情况,并分析其风险因素。方法以该院2018年1月~2021年9月期间开展PELD手术的140例LDH患者作为研究对象,术后6个月和24个月随访时,采用改良MacNab标准评估临床结局,以疗效为“优”+“良”的患者列入预后良好组,以疗效为“可”+“差”的患者列入预后不良组。对两组患者的临床资料、术前相关影像学参数等资料单因素分析,并进一步采用多因素Logistic回归模型进行分析,得出具有独立相关性的影响因素。结果术后6个月时,预后良好者121例,预后不良者19例;多因素Logistic回归分析得出:sROM(OR=1.159,P=0.023)、症状持续时间(OR=1.12795%,P=0.004)、直腿抬高角度(OR=1.103,P=0.039),均是PELD术后6个月预后不良的独立风险因素。术后24个月时,预后良好者115例,预后不良者25例;多因素Logistic回归分析得出:sROM(OR=1.290,P=0.009)、症状持续时间(OR=1.036,P=0.021),均是PELD术后24个月预后不良的独立风险因素,IHI(OR=0.812,P=0.014)则是一项保护因素。结论PELD手术治疗LDH的总体疗效理想,但术后早期和中期仍有少数患者面临预后不良的结局。其中,直腿抬高角度是PELD术后早期预后不良的独立风险因素,IHI是术后中期预后不良的独立保护因素;而sROM、症状持续时间则是术后早期和中期的共同风险因素。

中频超声联合活血止痛膏治疗膝骨关节炎的临床效果

目的探讨中频超声促透联合活血止痛膏治疗膝骨关节炎(KOA)的临床疗效,并对人基质金属蛋白酶抑制因子-1(TIMP-1)及基质金属蛋白抑制酶-3(MMP-3)的影响。方法选取2022年3月至2023年2月来甘肃省第二人民医院骨科门诊及住院部就诊的80例KOA患者,按照随机数表法分为观察组和对照组,每组各40例。其中观察组将活血止痛中药外敷至所选穴位,使用中频超声电导仪照射局部治疗;对照组采用生理盐水制成的凝胶贴片联合中频超声促透治疗。每次30 min,4次/周,共治疗4周。通过视觉模拟评分法(VAS)评分、骨关节炎评分量表(HSS)评分、36条目简明健康量表(SF-36)评价治疗效果,酶联法(ELISA)分析并比较两组患者血清中TIMP-1及MMP-3的含量。结果治疗后,观察组总有效率、膝关节HSS评分、疼痛VAS评分、SF-36评分均明显优于对照组(P<0.05);治疗后,观察组血清中的TIMP-1含量增加,而MMP-3含量降低,结果均明显优于对照组,差异有统计学意义(P<0.05)。结论中频超声促透联合活血止痛膏能够有效改善KOA患者血清中TIMP-1及MMP-3的含量,改善膝关节功能,明显提升患者的生活质量。

调制中频电中药离子导入治疗糖尿病周围神经病变的疗效及对IGF-1的影响

目的评估调制中频电中药离子导入治疗对糖尿病周围神经病变的疗效及胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)的变化。方法选取2021年1—12月十堰市中医医院收治的150例糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者为研究对象,按照治疗方式不同分为对照组(常规治疗)、观察组(常规治疗联合调制中频电中药离子导入治疗),各75例。比较两组多伦多临床评分(Toronto Clinical Scoring System,TCSS)、正中神经及腓总神经的运动神经传导速度(motor conduction velocity,MCV)及感觉神经传导速度(sensory conduction velocity,SCV)、IGF-1、血糖指标(空腹血糖、餐后2 h血糖)水平及治疗总有效率。结果治疗后,观察组TCSS评分、空腹血糖、餐后2 h血糖水平均低于对照组,腓总神经MCV、正中神经MCV、腓总神经SCV及正中神经SCV、IGF-1水平均高于对照组,差异有统计学意义(P均<0.05)。观察组临床治疗总有效率为97.33%(73/75),高于对照组的85.33%(64/75),差异有统计学意义(χ^(2)=6.822,P<0.05)。结论调制中频电中药离子导入对于糖尿病周围神经病变的治疗具有积极作用,可明显缓解患者临床症状,调控血糖水平,提高神经传导速度,上调IGF-1水平。

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.

单髁关节置换治疗前内侧间室膝骨关节炎中期效果观察

目的分析单髁关节置换(unicompartmental knee arthroplasty,UKA)治疗前内侧间室膝骨关节炎的中期效果,探讨手术适应证。方法 回顾性分析2015年10月~2020年3月沧州中西医结合医院因膝关节内侧间室骨性关节炎行膝关节单踝置换术患者83例(84膝),男37例,女46例,年龄44~87岁,体质量指数(BMI)23~33 kg/m^(2)。患者均使用Oxford第3代人工假体,采用微创入路完成UKA手术。术后随访2.1~6.5年,平均3.9年。使用美国膝关节协会评分(KSS)、西安大略和麦克马斯特大学骨关节炎评分(WOMAC)评估患者膝关节功能。测量膝关节活动度(ROM),记录术后并发症发生情况、计算假体生存率。结果 至末次随访,患者膝关节KSS评分和ROM均显著高于术前,WOMAC评分低于术前,差异均有显著统计学意义(P <0.05)。所有患者均未出现假体位置不良、假体松动下沉、假体周围骨溶解及需要行翻修的患者。2例出现衬垫脱位,1例屈膝手法挤压后复位,1例切开复位后更换加厚衬垫。假体生存率为97.59%(2/83)。结论 单髁置换治疗前内侧间室膝骨关节炎中期效果肯定,假体生存率高,阻止了关节炎向其他间室发展。虽然本组肥胖、年轻、合并膝前痛甚至髌股关节退变患者获得了良好效果,但对于手术指征具体如何放宽,还需要进一步进行大样本量对照研究。

全胸腔镜手术治疗早期食管癌的中远期疗效及对患者手术后应激、免疫功能的影响

目的探究全胸腔镜手术治疗早期食管癌的中远期疗效及对患者手术后应激、免疫功能的影响。方法前瞻性选取2017年1月至2019年10月江苏省肿瘤医院胸收治的102例早期食管癌患者为本次研究对象,随机数字表法分为观察组(n=51)及对照组(n=51)。对照组开展传统手术治疗,观察组开展全胸腔镜手术治疗。比较两组的应激反应[C反应蛋白(CRP)、皮质醇、肾上腺素(E)]、免疫功能、炎症反应[白细胞介素(IL)-6、IL-8、IL-10、肿瘤坏死因子α(TNF-α)]、并发症发生率及中远期疗效。结果手术后,观察组CRP、皮质醇、E水平分别为(29.65±3.64)mg/L、(182.65±30.10)μg/L、(56.62±4.25)ng/mL,均低于对照组[(45.56±4.25)mg/L、(196.32±31.25)μg/L、(72.26±4.21)ng/mL],差异均有统计学意义(P<0.05)。手术后,观察组CD4^(+)、CD4^(+)/CD8^(+)水平分别为(32.25±2.11)%、1.10±0.15,均高于对照组[(28.98±2.14)%、0.86±0.11],CD8^(+)水平为(29.22±2.52)%,低于对照组[(33.62±2.58)%],差异均有统计学意义(P<0.05)。手术后,观察组的IL-6、IL-8、IL-10、TNF-α水平分别为(2.72±0.42)pg/mL、(2.25±0.32)pg/mL、(0.68±0.10)pg/mL、(1.30±0.21)ng/mL,均低于对照组[(2.96±0.45)pg/mL、(2.69±0.35)pg/mL、(0.87±0.11)pg/mL、(1.71±0.23)ng/mL],差异均有统计学意义(P<0.05)。观察组的并发症发生率为5.88%,对照组为17.65%,组间比较差异无统计学意义(P>0.05)。手术后18个月,观察组复发率、转移率、病死率分别为5.88%、3.92%、0,对照组分别为3.92%、3.92%、0,手术后36个月,观察组复发率、转移率、病死率分别为13.73%、7.84%、3.92%,对照组分别为7.84%、7.84%、3.92%,组间比较差异无统计学意义(P>0.05)。结论全胸腔镜手术治疗早期食管癌,较传统手术而言,可有效缓解机体应激反应,解除免疫抑制的基础上,稳定免疫功能,缓解炎症反应,且安全性较高,中远期疗效与传统手术无较大差异。

Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

Although transvaginal mesh(TVM)repair is no longer used in some countries,long-term outcomes after TVM surgery are of great importance globally.However,reports with follow-up>10 years are limited.Thus,this study aimed to report outcomes in a prospective cohort with at least 10 years of follow-up.Women with stageⅢ–Ⅳsymptomatic prolapse were approached consecutively from 2008 to 2013 at one tertiary hospital.The main outcome measure was symptomatic failure.Secondary outcomes included anatomic failure,recurrence,patient satisfaction,complications,and reoperation.The Kaplan-Meier curve was used to estimate the cumulative failure rate.Of the 121 patients enrolled in the study,103(85.1%)completed a median follow-up of 11 years.The estimated probability rates of symptomatic and anatomic failure were 17.6%and 8.8%in 11 years,respectively.The estimated incidence of symptomatic failure increased by 8.2%between 5 and 11 years;however,the corresponding rate for anatomic failure was 3.7%.The most common complication was vaginal mesh exposure,and its estimated probability increased from 19.3%to 28.4%from 5 to 11 years,respectively.Office trimming resolved 80.0%of vaginal exposures.These patients did not report decreased overall satisfaction.Patients with vaginal mesh exposure requiring>3 office procedures or mesh removal in the operating room(5.8%by 11 years)had lower satisfaction rates(P<0.01)and were defined as having severe mesh exposure.The rates of postoperative pain,reoperation,and Patient Global Impression of Improvement≥2 were 2.5%,3.3%,and 94.2%,respectively.The results of this study implied that TVM treatment gradually increased the symptomatic failure rate but provided durable anatomical support of the vaginal wall.Vaginal mesh exposure was common in women who were largely not sexually active;however,80%of the cases could be managed in the outpatient clinic,which did not affect patient satisfaction.

八珍汤加减联合阿扎胞苷治疗气血亏虚型中高危骨髓增生异常综合征的疗效分析

目的针对气血亏虚型且已达中高危程度的骨髓增生异常综合征患者展开八珍汤加减联合阿扎胞苷治疗的效果探究。方法随机选取2019年7月—2022年4月日照市中医医院收治的中高危骨髓增生异常综合征且中医辨证属气血亏虚患者50例。根据治疗方式的不同分为观察组与对照组,每组25例。对照组采用阿扎胞苷治疗,观察组采用八珍汤加减联合阿扎胞苷治疗。比较两组患者的临床治疗效果、中医症状积分、外周血细胞计数水平、不良反应发生情况以及生活质量。结果两组患者疗效结果对比,差异无统计学意义(P>0.05)。治疗前,两组中医症状积分对比,差异无统计学意义(P>0.05);治疗后,观察组中医症状积分(17.23±1.12)分低于对照组(19.78±2.23)分,差异有统计学意义(t=5.109,P<0.05)。治疗后,观察组WBC、HGB及PLT水平均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。治疗前,两组生活质量评分对比,差异无统计学意义(P>0.05);治疗后,两组均呈上升趋势,且观察组评分高于对照组,差异有统计学意义(P<0.05)。结论针对中高危骨髓增生异常综合征且中医辨证属气血亏虚患者,应用八珍汤加减联合阿扎胞苷治疗方案干预,能在一定程度上提高临床疗效,有利于提高患者生活质量,减轻不良反应,改善中医症状及相关实验室指标。

Progress in the Study of Vonoprazan Fumarate vs. Proton Pump Inhibitors in the Treatment of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disease, and proton pump inhibitors (PPIs) have been recommended as the first-line treatment for GERD. In recent years, studies on vonoprazan fumarate in the treatment of GERD have attracted widespread attention. In this paper, we review the research progress of vonoprazan fumarate and proton pump inhibitors in the treatment of GERD in recent years, and compare and analyze the efficacy, safety, tolerability, and advantages and disadvantages of long-term application of both. By reviewing the relevant literature, we found that vonoprazan fumarate has similar performance with proton pump inhibitors in terms of efficacy and safety, but has potential advantages in terms of tolerability and long-term application. Therefore, we believe that vonoprazan fumarate may become a new option for GERD treatment, helping clinicians to develop more appropriate treatment plans for patients and providing new ideas and directions for research in related fields.

司库奇尤单抗联合窄谱中波紫外线治疗中重度银屑病疗效与安全性评价

目的:研究司库奇尤单抗联合窄谱中波紫外线(NB-UVB)治疗中重度银屑病的疗效与安全性.方法:选择2020年4月至2022年10月本院收治的92例中重度银屑病患者为研究对象.按随机数字表法将其分为联合组(n=46,采用司库奇尤单抗联合NB-UVB治疗)和对照组(n=46,采用NB-UVB治疗).比较两组临床疗效、治疗期间不良反应及治疗前、治疗8周后银屑病面积与严重性指数(PASI)、皮肤病生命质量指数(DLQ1)、CC趋化因子配体20(CCL20)和CC趋化因子受体6(CCR6)水平、皮肤屏障功能指标.结果:联合组临床总有效率高于对照组,差异有统计学意义(P<0.05);治疗8周后,联合组患者PASI、DLQ1评分及血清CCL20、CCR6水平低于对照组,皮肤屏障功能指标变化幅度高于对照组,差异均有统计学意义(P<0.05);治疗期间联合组不良反应发生率与对照组比较,差异无统计学意义(P>0.05).结论:采用司库奇尤单抗联合NB-UVB治疗中重度银屑病患者有利于提高临床疗效,抑制促炎、趋化因子表达,改善皮肤屏障功能,提高生活质量,且具有一定安全性.

中国结联合内排锚定治疗中大型肩袖损伤的临床疗效

目的探究与分析中国结联合内排锚定治疗中大型肩袖损伤的临床疗效。方法回顾性分析2020年4月—2022年2月郓城县人民医院收治的64例中大型肩袖损伤患者的临床资料,按照不同手术治疗方法分为对照组与观察组,每组32例。对照组采用内外排锚钉(双排锚定)固定治疗,观察组采用中国结联合内排锚定治疗,对比两组治疗效果。结果观察组手术时间、术中出血量、住院时间分别为(104.36±23.09)min、(40.98±6.10)mL、(10.33±1.12)d,与对照组比较,差异无统计学意义(P>0.05)。观察组并发症发生率为3.13%,与对照组比较,差异无统计学意义(P>0.05)。观察组术后视觉模拟评分法(Visual Analogue Scale,VAS)评分、Constant-Murley功能量表评分、美国肩肘外科医师评分系统(the American Shoulder and Elbow Surgeons,ASES)评分、肩关节活动度中前屈上举、外展上举、90°外展位外旋、90°外展位内旋角度分别为(1.25±0.22)分、(80.36±8.11)分、(76.99±4.02)分、(168.41±14.99)°、(165.98±20.02)°、(58.96±12.44)°、(48.69±12.36)°均优于对照组,差异有统计学意义(P<0.05)。结论中国结联合内排锚定治疗中大型肩袖损伤的临床效果突出,经过治疗后患者肩关节疼痛程度以及肩关节功能均得到了有效的改善,肩关节活动度较好,预后综合表现更好。

腹腔镜辅助与开腹胃癌根治术的中期疗效比较

目的探讨腹腔镜辅助胃癌根治术与开腹胃癌根治术的中期疗效。方法比较2005年6月-2011年1月我科同组人员行腹腔镜辅助与开腹胃癌D2根治术,其中腹腔镜辅助胃癌根治术46例（腹腔镜组）,开腹胃癌根治术54例（开腹组）,比较2组胃癌根治术后肿瘤局部复发、远处转移、生存率等中期疗效。结果腹腔镜组与开腹组局部复发率分别为10.9%（5/46）、7.4%（4/54）,无统计学差异（χ^2=0.364,P=0.546）;远处转移率分别为6.5%（3/46）、5.6%（3/54）,差异无显著性意义（χ^2=0.000,P=1.000）。2组生存率无显著性差异（χ^2=1.386,P=0.239）。结论腹腔镜组辅助与开腹胃癌根治术在生存率、术后局部复发和远处转移等中期疗效方面无显著性差异。