ObjectiveTo investigate the curative effects of capecitabine and hessaitin combined with whole brain radiotherapy for treatment the HER2 positive breast cancer with brain metastasis.
MethodsThe clinical data of 60 cases HER2-positive breast cancer patients with brain metastasis in our hospital in January 2004 to January 2012 were retrospectively analyzed.The 32 cases of observe group were treated by using capecitabine and herceptin combined with whole brain radiotherapy, and the 28 cases of control group were treated by using capecitabine and cisplatin combined with whole brain radiotherapy.The disease control rate, toxicity rate, and survival rate were evaluated.
ResultsCompared with the control group, the disease control rate, toxicity rate, and survival rate were all better in observe group (P < 0.05).
ConclusionThe capecitabine and hessaitin combined with whole brain radiotherapy for treating patients with HER 2 positive brest cancer transferred to brain are effect and safe.
Objective To retrospectively analyze the clinical and imaging features of multi-segmental lumbar intervertebral disc protrusion and its treatment with the limited recessive decompression operation. Methods Twenty two patients (14 males and 8 females, aged 49-68 years) were admitted to hospital from March 1999 to March 2004. They suffered from multisegmental lumbar intervertebral disc protrusion that involved L1S1 and were treated with the limited recessive decompression operation. Results The follow-up for 4-21 months showed that 16 of the patients had an excellent outcome, 5 had a good outcome, and 1 had fair outcome. There were nosuch operative complications as nerve root lesions and putamen lesions. Conclusion The limited recessive decompression operation is one of the available good treatments for multi-segmental lumbar intervertebral disc protrusion. It solves problems of herniation and stenosis and maintains stability ofthe spine.
Objective To study some related factors of effect on gluteus muscle contraction and provide the therapeutic basis. Methods The curative effect was assessed in 154 patients who were classified by age, patient’s condition, orthopedic degree in operation and rehabilitation with an average follow-up period of 25 months(ranging from 5 to 36 months).Results The excellent rate of 18-24 years old (25/30) was lower than that of 5 -17 years old(120/124) (Plt;0.05); the excellent rate of slight patients was higher (107/109) than that of serious patients (38/45) (Plt;0.01); the excellent rate from higher orthopedic degree was higher(111/113) than that from lower orthopedic degree(34/41) (Plt;0.01); and the excellent rate of rehabilitation was much higher (107/110) than that of general treatment (38/44) （Plt;0.05）. Conclusion Age, patient’s condition, orthopedic degree in operation and rehabilitation are important factors to affect the curative effect on gluteu muscle contraction.
Objective
The study was performed to compare the efficacy and effect on quality of life of sodium valproate (VPA) sustained-release tablets versus topiramate (TPM) in newly diagnosed adult symptomatic epilepsy.
Methods
This is aprospective, randomized controlled trial on 200 patients newly diagnosed as adult symptomatic epilepsy in Sichuan Province People’s Hospital druing September 2014 to December 2016. The patients were randomly divided into VPA group (n=110) and TPM group (n=90). Then we evaluated the efficacy, retention rate, adverse reactions, and quality of life of the two groups after one year of treatment.
Results
The total effective rate of VPA group was 69.1%, and the rate of no seizures was 38.2%; the total effective rate of TPM was 62.2%, and the rate of no seizures was 42.2%. No statistically significant difference in the effective rate and no seizure rate was found between the two groups. There was no statistical difference in the retention rate between the two groups(69.1% vs. 65.6%, P>0.05) . The incidence of adverse reactions of VPA was significantly lower than that of TPM (9.1%vs. 20%, P<0.05). The quality of life of the two groups was significantly improved from baseline before treatment. VPA group showed significantly better performance than TPM group on mood and cognitive improvement (P<0.05).
Conclusion
① There was no significant difference in efficacy and retention rate between VPA sustained-release tablet and TPM on adult patients with symptomatic epilepsy after one year's treatment; ② The incidence of adverse reactions of TPM group was significantly higher than that of VPA group; ③ VPA sustained-release tablets and TPM can significantly improve the overall quality of life of patients, and VPA sustained-release tablets is significantly better than topiramate on the improvement of emotional and cognitive function.
ObjectivesTo systematically review the differences of operative outcomes between early surgery and delayed surgery in multiple ligament injury of knee joint (MLIK) patients.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were searched to collect cohort studies about operative outcomes of different surgery times in MLIK patients from inception to September 23rd, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 8 cohort studies involving 153 early and 90 delayed operatively treated patients were included. The results of meta-analysis showed that: compared with delayed surgery, early surgery received higher Lysholm score (MD=7.52, 95%CI 2.00 to 13.04, P=0.008) and superior IKDC score rate (OR=2.97, 95%CI 1.51 to 5.84, P=0.002). There were no significant differences in Tegner score (MD=–0.08, 95%CI –1.07 to 0.92, P=0.88) and ROM (MD=4.08, 95%CI –2.38 to 10.55, P=0.22) between two groups. The main adverse reactions of MLIK included neurovascular injury, deep venous thrombosis of lower extremities, common peroneal nerve injury, tourniquet paralysis and limited joint activity. Early surgery had a lower incidence of complications than delayed surgery (7.1% vs. 30%).ConclusionThe current evidence shows that early surgery can receive higher Lysholm score and superior IKDC score rate in treatment of MLIK, and have a lower incidence of complications. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To evaluate the clinical curative effect of early enteral nutrition （EN） in gastric cancer patients after operation and its safety. Methods One hundred and eighty patients with gastric cancer diagnosed and underwent surgical treatment in gastrointestinal surgery center， West China Hospital from February 2011 to December 2011 were studied prospectively， who were randomly divided into EN group （n=91） and parenteral nutrition （PN） group （n=89）. The nutrition state， rehabilitation， hospital stay， cost of nutrition in hospital， and complications were observed. Results ①According to the postoperative serum nutrition index， there were no significant differences in the prealbumin， hemoglobin， and ratio of albumin to globulin in two groups （P＞0.05）， but the albumin level in the EN group was significantlyhigher than that in the PN group （P=0.047）. ②According to the postoperative rehabilitation index， the first ambulation time （P=0.011）， first intake time （P=0.000）， first nasogastric tube away time （P=0.013）， first drainage tube away time （P=0.021）， and first urinary catheter away time （P=0.002） in the EN group were significantly shorter than those in the PN group. The difference of the first anus exhaust time was not statistically significant in two groups （P=0.083）. ③The cost of nutrition in hospital in the EN group was significantly less than that in the PN group （P=0.017）. The postoperative hospital stay and total complication rate were not significant differences in two groups （P＞0.05）. Conclusion Early postoperative EN is effective， economic， practical， which might be superior to PN.
ObjectiveTo compare the keyhole approach and traditional craniotomy in the treatment of basal ganglia region hypertension cerebral hemorrhage postoperative epileptic curative effect comparison keyhole approach and traditional craniotomy in the treatment of basal ganglia region the curative effect of hypertensive cerebral hemorrhage postoperative epilepsy.
MethodsCollected cases of basal ganglia region admitted in department of neurosurgery our hospital from September 2006 to March 2015, 108 cases of hypertensive cerebral hemorrhage patients, randomly divided into two groups:keyhole approach group (58 cases) and conventional surgery group (50 cases).Two groups of patients with perioperative all use the same management scheme, using statistical methods to analyze clinical data of two groups of patients, such as age, sex, blood loss, postoperative epilepsy, drug efficacy and the incidence of adverse drug reactions, etc.
ResultsPostoperative follow-up of 2 years, keyhole approach group 12 cases sufferred postoperative seizure, 1 case of patients with status epilepticus, no death occurred; a total of 10 cases of mono-antiepileptic drug(AEDs) therapy effectively, and 7 cases present adverse drug reactions; Traditional surgical postoperative seizures 22 cases, 9 cases occurred status epilepticus, and five died as a result, only five were effective for single therapy, and 15 cases with adverse drug reactions.Statistical results suggest the incidence of postoperative epilepsy, the incidence of severe epilepsy, prognosis, single drug control and adverse drug reactions between the tuo groups have significant difference (P < 0.05).
ConclusionCompared with traditional craniotomy for removal of hematoma, keyhole approach greatly reduce the incidnce of basal ganglia region hypertension cerebral hemorrhage postoperative complications, severe epilepsy and adverse reaction of AEDs.Therefore, keyhole approach in the treatment of basal ganglia region hypertension cerebral hemorrhage is an admirable way of treatment.
Objective To investigate the treatment and therapeutic efficacy of intra-articular meniscal cysts by arthroscopy. Methods From January 2005 to December 2009, 9 cases of intra-articular meniscal cysts were treated by arthroscopy, including 5 males and 4 females, with an average age of 33.8 years (range, 24-46 years). Six patients suffered in left knees, 3 in right ones. Just 1 case had trauma history, the others had no obvious predisposing causes. The average course of the disease was 24.2 months (range, 4-36 months). The Lysholm score was (74.2 ± 11.6) points. Arthroscopy showed that the locations of cysts were the anterior horn of lateral meniscus in 8 cases and the anterior horn of medial meniscus in 1 case; all being single cyst (of them, 3 being multilocular cyst). Results All incisions healed primarily with no compl ications of infection and joint effusion. All 9 patients were followed up from 3 to 48 months with an average of 12.7 months. Preoperative symptoms disappeared or reduced and the range of motion of the knee returned to normal. TheLysholm score was (95.1 ± 3.4) points after 3 months of operation, showing significant difference (P lt; 0.01) when compared with the socre before operation. According to assessment standard described by Choy, the treatment outcome was excellent in 6 cases, good in 2 cases, and general in 1 case; the excellent and good rate was 88.9%. No recurrence was found during follow-up. Conclusion Arthroscopic surgery shows the advantages to maintain good function of knee for the treatment of meniscal cyst, it is the best choice for intra-articular meniscal cysts because of its mini-trauma, rapid recovery, thorough treatment and less recurrence. Simultaneously, partial or tatol meniscectomy or menicus repairing under arthroscopy is performed.
ObjectiveTo analyze the curative effect and prognosis of drug resistant tuberculosis meningitis (TBM).
MethodsRetrospective analysis was carried out on the clinical data of thirty-two cases of drug resistant tuberculous meningitis patients hospitalized from January 2010 to December 2015. And the prognosis of the patients was evaluated by meliorated Rankin Scale (mRS).
ResultsThirty-one cases (96.9%) were improved in 32 patients with drug resistant TBM, and 1 case (3.1%) was ineffective. After treatment, one patient had hormone-related glaucoma and osteoporosis, and one patient had drug Cushing syndrome. Twenty-seven patients (84.4%) had an mRS score equal to or less than 2 points.
ConclusionDrug resistant TBM is difficult to diagnose in the early stage, and the curative effect is satisfying with active anti-tuberculosis treatment.
Objective To assess the curative effect of percutem transilluminated with negative pressured on the potaried technique on the treatment of venous ulcer in lower extremity. Methods The clinical date of 300 cases involving 300 legs with venous ulcer in lower extremity， who underwent the percutum transilluminated negative pressured potaried technique using TRIVEXTM Ⅱ potaried system or the percutum transfixion surgical treatment from October 2005 to June 2009, were analyzed. Three hundred cases were randomly divided into potaried group and transfixion group. In potaried group, there were 190 cases involving 190 legs treated with TRIVEXTM Ⅱ potaried system. In transfixion group, 110 cases involving 110 legs treated with percutum transfixion. The clinical indexes of skin infection rate and skin necrosis rate, shrinkage rate of wound area and skin depigmentation rate, ulcer healing rate and ulcer recurrence rate were calculated to assess the clinical curative effect on day 5, day 20, day 120 and day 360 after operation respectively. Results The rates of skin infection and skin necrosis were significantly decreased in potaried group compared with transfixion group on day 5 after operation (P＜0.05), the rates of shrinkage of wound area and skin depigmentation were significantly increased in potaried group compared with transfixion group on day 20 (P＜0.05). The ulcer healing rate was not significantly different between the two groups on day 120 (Pgt;0.05). Ulcer recurrence rate was remarkably lower in potaried group than that in transfixion group on day 360 (P＜0.05). Conclusion It can be concluded that percutem transilluminated with negatived pressured on the potaried technique with TRIVEXTM Ⅱ potaried system can efficiently promote the healing of venous ulcer in the lower extremity, and at the same time it has an ascendancy in lessening skin infection and skin reinjury.
