ObjectiveTo investigate the effect of fasttrack (FT) and traditional care (TC) on patients with rectal cancer underwent different surgical strategies in perioperative period. MethodsThe clinical data of 285 patients with rectal cancer from January 2009 to January 2010 in this hospital were retrospectively analyzed. These patients underwent high anterior resection (HAR) or lower/super lower anterior resection (LAR) under FT and TC were divided into four groups: FT+HAR (n=39), FT+LAR (n=17), TC+HAR (n=151), and TC+LAR (n=78), and intraoperative conditions and postoperative rehabilitation were analyzed. ResultsThe baselines characteristics of four groups were basically identical (Pgt;0.05). ①The operative time and blood loss of patients in four groups were not statistically significant (Pgt;0.05). ②Anastomotic leakage occurred in three cases, wound infection in 13 cases, and intestinal obstruction in four cases after operation, and the difference was not significant in four groups (Pgt;0.05). ③The time of first defecation and first flatus of four groups were not statistically significant (Pgt;0.05), but there were significant differences in the time with drainage tube, nasogastric tube, and catheter tube, the time of first intake and first ambulation, and length of stay among four groups (Plt;0.05). Compared with TC+HAR and TC+LAR group, the time with drainage tube, nasogastric tube, and catheter tube, and the time of first intake and first ambulation of patients were shorter in FT+HAR and FT+LAR group, and the length of stay of patients in FT+LAR group was shorter than that in TC+HAR group and TC+LAR group (Plt;0.05). ConclusionsFT can promote postoperative rehabilitation of rectal cancer patients underwent different surgical strategies, but which does not demonstrate the superiority of reducing postoperative complications.
ObjectiveTo summarize clinical application progress of stereotactic radiotherapy for primary hepatocellular carcinoma.
MethodsThe literatures about the research progress of the stereotactic radiotherapy for primary hepatocellular carcinoma were reviewed.
ResultsRadiotherapy for hepatocellular carcinoma is importantly based on the radiation biology of the liver and the radiophysics of the liver cancer. Stereotactic precision radiotherapy is an effective and low toxic treatment for early hepatocellular carcinoma, moreover, it alone or in combination with microwave ablation, hepatic artery chemoembolization for unresectable hepatocellular carcinoma is safe and effective method for the treatment.
ConclusionsThe optimal dose model for hepatocellular carcinoma, hepatocellular carcinoma radical dose level are problems that need further exploration, and radiobiology, radiation physics research must be strengthened to explore it, stereotactic precision radiotherapy treatment modalities in the treatment of hepatocellular carcinoma position will become increasingly people attention.
ObjectiveTo evaluate the efficacy of myomectomy via transumbilical laparoendompic single-site surgery (TU-LESS) and traditional multiport laparoscopy.MethodsThe study was conducted at Chengdu Western Hospital from June 2019 to June 2020. Fifty patients underwent TU-LESS myomectomy (TU-LESS group), while another 50 patients underwent traditional multiport laparoscopic myomectmy (multiport laparoscopy group). The conditions of operation, extra analgetic usage, VAS grade, and patients’ satisfaction degree were compared between two groups.ResultsPatients in both groups had similar age, BMI, fibroma volume, operative time, expelling gas day, blood loss, complication rate, and hospitalized costs (P>0.05). Compared with traditional multiport laparoscopy, the TU-LESS group resulted in significantly shorter hospitalization day, lower VAS score of the 1st/3nd/7th days after surgery, less use of analgetic after surgery, and higher satisfaction degree.ConclusionsTU-LESS is safe and feasible for myomectomy, and it is associated with less pain, shorter hospitalization day, and higher satisfaction degree.
Objective To explore the clinical effect of intramuscular injection of methotrexate on hysteroscopic treatment of endogenous cesarean scar pregnancy (CSP). Methods A prospective analysis was conducted on 94 patients diagnosed with endogenous CSP who visited the Department of Gynecology in Liuzhou Workers’ Hospital between January 2013 and January 2018, and they were randomly divided into two groups, the intramuscular injection of methotrexate followed by hysteroscopic surgery group (the methotrexate group, n=39) and the direct hysteroscopic surgery group (the non-methotrexate group, n=55). The operation time, intraoperative blood loss, surgical complications, length of hospital stay, hospitalization expenses, the recovery time of blood human chorionic gonadotropin (HCG) and treatment outcomes of the two groups were compared. The normally distributed data were expressed as mean±standard deviation, and the non-normally distributed data were expressed as median (lower quartile, upper quartile). Results There was no statistically significant difference in age, gestational sac diameter, uterine scar thickness, number of cesarean sections, time from cesarean section to present, time of menopause, or preoperative blood HCG value between the two groups (P>0.05). There was no statistically significant difference in intraoperative blood loss [75 (35, 120) vs. 65 (35, 130) mL, P=0.821], incidence of complications (5.1% vs. 5.5%, P=1.000), postoperative blood HCG recovery time [(5.22±2.17) vs. (4.96±1.81) weeks, P=0.559] or the effective rate of treatment (94.9% vs. 90.9%, P=0.747) between the two groups. The methotrexate group had longer operation time [43 (34, 55) vs. 32 (28, 35) min, P=0.001], longer length of hospital stay [(10.89±1.42) vs. (5.82±1.47) d, P<0.001], and higher hospitalization cost [(8596.46±3336.59) vs. (7058.84±2638.49) yuan, P=0.014]. Conclusion For patients with endogenous CSP, intramuscular injection of methotrexate before hysteroscopic surgery is not necessary, for it has no significant impact on the treatment effect, instead, it may prolong the operation time and length of hospital stay, and increase the hospitalization cost.
ObjectiveTo analyze and compare the clinical efficacy and safety between one-stage operation and staged operation in the treatment of tandem spinal stenosis (TSS).MethodsThe data of 39 patients with TSS were retrospectively analyzed, who were definitely diagnosed and treated surgically between February 2011 and March 2016 in the Affiliated Hospital of Southwest Medical University. According to whether one-stage decompression was performed, the patients were divided into group A (cervical and lumbar vertebral canal decompression procedures were performed in one stage, n=21) and group B (cervical and lumbar spinal canal decompression procedures were performed in two stages with a time interval of 3-6 months, n=18). Both one-stage and staged operations were performed by the same surgical team. The Nurick scores, Japanese Orthopedic Association (JOA) scores of cervical spine and lumbar spine, and Oswestry Disability Index (ODI) before operation and in postoperative follow-up, postoperative JOA improvement rate, and perioperative indicators were recorded and compared.ResultsAll patients completed the operations successfully, and the lengths of follow-up were all longer than 12 months. There was no significant difference in gender, age, body mass index, preoperative duration of symptoms, preoperative Kang grade, preoperative Schizas grade, preoperative underlying diseases, preoperative cervical or lumbar spine JOA score, preoperative ODI, preoperative Nurick score, decompression segment or distribution, or length of follow-up between the two groups (P>0.05). The Nurick score, JOA score of cervical and lumbar spine, and ODI at one year after operation and the last follow-up were significantly improved compared with those before operation. The one-year after operation improvement rates of JOA of cervical and lumbar spine in group A were significantly higher than those in group B [cervical spine: (70.55±9.28)% vs. (55.29±7.82)%, P<0.05; lumbar spine: (69.50±4.95)% vs. (51.58±7.62)%, P<0.05], but there was no significant difference in the improvement rate of JOA between the two groups at the last follow-up (P>0.05). There was no significant difference in Nurick score or ODI between the two groups at one year after operation or the last follow-up (P>0.05). There was no significant difference in the average length of hospital stay between the two groups [(15.67±3.40) vs. (15.72±1.57) d, P>0.05]. The operation time [(293.10±43.83) vs. (244.44±22.29) min] and intraoperative bleeding [(533.33±180.51) vs. (380.56±38.88) mL] in group A were significantly higher than those in group B (P<0.05). The incidence of postoperative complications of group A was higher than that of group B (57.1% vs. 16.7%, P<0.05).ConclusionsCompared with staged surgery, one-stage operation in the treatment of TSS has a significant improvement in neurological function and clinical efficacy in short-term follow-up, but there is no significant difference in long-term follow-up. Staged surgery has the advantages of shorter operation time, less intraoperative blood loss, lower postoperative complication rate, and higher safety.
ObjectiveTo systematically review the efficacy of Chinese medicine injection (CMI) for treating heart failure (HF).MethodsCNKI, WanFang Data, VIP, The Cochrane Library, PubMed, and EMbase databases were electronically searched from inception to January 2021 to identify randomized controlled trials (RCTs) on CMI for treating HF. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Network meta-analysis was then performed by RevMan 5.2 software and Stata 16.0 software.ResultsA total of 47 studies were included involving 4 902 patients and 5 types of CMIs, including Shenmai, Shenfu, Yiqi Fumai (lyophilized), Shengmai, and Danhong injections. The results of network meta-analysis showed that the efficacy of combined CMIs was superior to conventional Western medicine alone. For the main efficacy, Shenmai, Shengmai, and Shenfu injections had significant advantages in improving the total clinical effectiveness. Shengmai, Shenmai, and Yiqi Fumai (lyophilized) injections were significantly more effective for reducing NT pro-BNP levels than other injections. Shenfu and Shengmai injections were significantly more effective for reducing BNP levels than other injections. Shenmai, Danhong and Shengmai injections were significantly more effective for improving the left ventricular ejection fraction than the other injections. These CMIs showed similar advantages for secondary efficacy indicators as for main efficacy indicators.ConclusionsThe combined 5 types of CMIs for treating HF can improve the clinical efficacy when compared with conventional Western medicine treatment. Shenmai injection, Yiqi Fumai injection (lyophilized), and Shengmai injection, which is part of Sheng Mai San, have clear advantages in terms of the overall curative effect or on individual indices.
ObjectiveTo investigate the clinical efficacy of low molecular weight heparin on community-acquired pneumonia (CAP).
MethodsA total of 78 patients with CAP admitted to hospital between January 2013 and March 2015 were randomly assigned into a conventional treatment group and a heparin treatment group. Both groups received anti-infection and symptomatic treatment, and the patients in heparin treatment group additionally received low molecular weight heparin by abdominal subcutaneous injection once daily for a course with seven days. The age, sex and severity of the disease were recorded. White blood cell (WBC) count and the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured on and during admission.
ResultsThe baseline information including age and sex, severity of illness, CRP, ESR and WBC counts on admission and the first treatment day had no difference between two groups (P > 0.05). CRP and ESR on day 3 after treatment and WBC counts on day 7 after treatment in the heparin treatment group were significantly more decreased than those in the conventional treatment group (P < 0.05). For the moderate and severe CAP patients, the level of CRP on day 3 after treatment and WBC counts on day 7 after treatment in the heparin treatment group were significant lower than those in the conventional treatment group (P < 0.05).
ConclusionCombination therapy of low molecular weight heparin may improve the clinical efficacy of CAP.
ObjectiveTo observe the therapeutic effect of the Tizanidine hydroehloride combined with non-steroidal anti-inflammatory drugs (NSAIDs) on fibromyalgia syndrome.
MethodsA total of 166 patients collected from August 2011 to January 2013 were randomly divided into control group and treatment group (with 83 cases in each group), the NSAIDs was used for control group, and for the other group, the Tizanidine hydroehloride combined with NSAIDs was used. The patients in two groups were continuously treated for 2 weeks. And the first and second week after treatment, the psychological evaluation,visual analogue pain, activities of daily living were detected. During the treatment period, the average follow-up duration was 3 months.
ResultsThe clinical efficacy was better after treatment in both of the two groups. The clinical efficacy was more significant in treatment group than that in the control group, and the occurrence of gastrointestinal discomfort were less in the treatment group than that in the control group.
ConclusionTizanidine hydroehloride combined with NSAIDs is effective on fibromyalgia syndrome. And the Tizanidine hydroehloride can protect the gastrointestine from being injured.
Objective To analyze the substitution mechanism of surrogate endpoints for traditional Chinese medicine (TCM) clinical efficacy evaluation of chronic heart failure (CHF). Methods To obtain data from the occurrence of surrogate endpoints and cardiogenic death of patients with CHF in 7 hospitals. The causal relationship between surrogate endpoints and cardiogenic mortality was inferred by the Bayesian network model, and the interaction among surrogate endpoints was analyzed by non-conditional logistic regression model. Results A total of 2 961 patients with CHF were included. The results of Bayesian network causal inference showed that cardiogenic mortality had a causal relationship with the surrogate endpoints including NYHA classification (P=0.46), amino-terminal pro-B-type natriuretic peptide (NT-proBNP) (P=0.24), left ventricular ejaculation fraction (LVEF) (P=0.19), and hemoglobin (HB) (P=0.11); non-conditional logistic regression analysis showed that NYHA classification had interaction with NT-proBNP, LVEF, and HB prior to and after adjusting confounders. Conclusions The substitution capability of surrogate endpoints for TCM clinical efficacy evaluation of CHF for cardiogenic mortality are NYHA classification, NT-proBNP, LVEF, and HB in turn, and there is a multiplicative interaction between the main surrogate endpoint NYHA classification and the secondary surrogate endpoints including NT-proBNP, LVEF, and HB, suggesting that when the two surrogate endpoints with interaction exist at the same time, it can enhance the substitution capability of surrogate endpoints for cardiogenic mortality.
Objectives
To investigate the clinical efficacy of health education intervention on chronic gastritis nursing.
Methods
A total of 142 patients with chronic gastritis in our hospital were recruited from February 2016 to June 2017. All patients were randomly assigned into two groups. The control group received conventional therapy and routine nursing, whereas the case group was offered with extra health education based on control group. Then related disease knowledge, nursing efficiency, nursing satisfaction, and nursing quality were compared.
Results
A total of 71 patients were in the case group, while 71 patients in the control group. Compared with the control group, the case group achieved better related disease knowledge, nursing satisfaction, total nursing efficiency, psychological status, sleep quality, exercise training, and daily diet (all P value<0.05).
Conclusions
Health education intervention not only can enhance disease knowledge of patients with chronic gastritis but also improve nursing quality, clinical effects and nursing satisfaction. Thus, it is worthy of further popularization in clinics.
