穴位注射结合牵引治疗神经根型颈椎病的疗效观察(英文)

目的:观察穴位注射结合牵引治疗神经根型颈椎病的临床疗效。方法:将 122 例神经根型颈椎病患者随机分为 3 组,观察组 42 例,进行穴位注射结合牵引治疗;穴位注射组 40 例进行穴位注射治疗;牵引组 40 例进行牵引治疗。治疗结束比较三组间疗效差异。结果:观察组总有效率为 92.9%,穴位注射组总有效率为 72.5%,牵引组总有效率为 75.0%,观察组与穴位注射组、牵引组比较均有显著差异(P<0.05),穴位注射组与牵引组比较无显著差异。结论:穴位注射结合牵引治疗神经根型颈椎病的疗效优于单纯穴位注射及单纯牵引治疗。     

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??Objective:To evaluate the clinical merit of contrast??enhanced ultrasound (CEUS) in the diagnosis of Small hepatocellular carcinoma (HCC) in patients with posthepatitic cirrhosis. Methods:Small hepatocellular carcinoma were examined and observed by CEUS between March 2004 and October 2005,using ultrasound contrast agent??Sonovue.Contrast enhanced CT and or MRI were performed in all cases. Results:The accuracy of diagnosing Small HCC by CEUS were 88.2% (60/68),according to the hypo??enhancement in arterial phase,iso??enhancement or hyo??enhancement in portal phase,hypo??enhancement in delayed phase.The accuracy and false positive rate of diagnosing Small HCC by CEUS were 97.1% (66/68) and 2.9%(2/68) according to the hypo??enhancement in delayed phase. Conclusion:CEUS might increase the diagnosis of small HCC.     

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??Value of percutaneous transluminal angioplasty in the treatment of infrapopliteal arterial occlusive diseasesXU Xin,ZHANG Wen??bo,YANG Jue,et al.Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China Corresponding author:FU Wei??guo??E??mail:fu.weiguo@zs??hospital.sh.cn AbstractObjectiveTo investigate the value of endovascular surgery in the treatment of infrapopliteal arterial occlusive diseases.MethodsThe clinical and follow??up data of 86 patients (90 limbs) with infrapopliteal arterial occlusive diseases admitted between February 2006 and May 2008 in the Department of Vascular Surgery of Zhongshan Hospital of Fudan University were analyzed retrospectively.ResultsEighty??six patients (90 limbs) were treated by percutaneous transluminal angioplasty (PTA).Angiographic success on the limb basis was achieved in 82 of 90 treated limbs (defined as the residual stenosis of the treated segment was less than 30%) and the initial technical success rate was 91??1%.Doppler ankle??brachial index (ABI) increased from 0??34±0??16 to 0??85±0??23 (pre vs. post).The 12??month accumulated primary patency rate,24??month accumulated primary patency rate,survival rate and limb salvage rate were 61??2%??49??5%,97??8% and 97??8% respectively.ConclusionPTA is feasible as a primary invasive treatment for infrapopliteal arterial occlusive lesions in patients with chronic critical limb ischemia, yielding acceptable primary clinical success with a low complication rate and resulting in??moderate long??term clinical patency and a high limb salvage rate??     

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??OBJECTIVE To evaluate the cost-utility of terlypressin compared with somatostatin in the treatment of esophageal and gastric variceal bleeding(EGVB) in China. METHODS A discrete event simulation model was created with four transition states:bleeding,no bleeding,rebleeding,and death. Transition probability of the model is derived from Meta analysis of the published literature. Used to calculate the quality of life in transition states health utility value source of literature. Cost data was sourced from (the listing price) of medical institutions. One-way sensitivity analyses were performed.RESULTS In the base case scenario, results showed that terlypressin was more costly and more effective compared with somatostatin, and that incremental cost-utility ratios were 65 478.84 Yuan/QALY. Sensitivity analyses showed that the model was robust, and that all incremental cost-utility ratios were below 110 289.46 Yuan/QALYs,which is far less than three times gross domestic product (GDP) per capita in China. If using the treatment duration in the instructions to calculate drug costs in the sensitivity analysis, treatment with terlypression has lower cost and better effectiveness.CONCLUSION The model indicates that terlypressin is most likely to be cost-effective versus somatostatin.     

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??Clinical research for hepatocellular carcinoma??opportunities and challenges in the age of precision medicine and big data SHEN Feng??CHENG Zhang-jun. Department of Hepatic Surgery??the Eastern Hepatobiliary Surgery Hospital??the Second Military Medical University??Shanghai 200438??China
Corresponding author??SHEN Feng??E-mail??shenfengehbh@
sina.com
Abstract Hepatocellular carcinoma (HCC) is one of the most common malignancy in China. In the age of precision medicine and big data??to improve the treatment and prognosis of HCC??the clinical research must aim to reveal the molecular nature of HCC??characterize drive genes involved in the carcinogenesis of HCC??and achieve precise diagnosis and molecular subtyping of HCC. Further more??the present treatment protocols for HCC should be evaluated fully and staging system as well as clinical practice guideline should be updated to develop new standardized??individualized and comprehensive therapy strategies for HCC patients in China.     

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??Selection and technical points of digestive tract reconstruction after total laparoscopic distal gastrectomy for gastric cancer XU Ze-kuan??XU Hao. Department of General Surgery??the First Affiliated Hospital of Nanjing Medical University??Jiangsu Province Hospital????Nanjing 210029, China
Corresponding author??XU Ze-kuan??E-mail??xuzekuan@njmu.edu.cn
Abstract The distal gastrectomy is the main approach for surgical treatment. In recent years??with the development of laparoscopic technology and improved skills of gastrointestinal surgeons??totally laparoscopic distal gastrectomy has been developed rapidly. And the digestive tract reconstruction is the key procedure for laparoscopic gastrectomy. At present??the most common reconstruction procedures include Billroth I??Billroth II??Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis. All the procedures have their unique features??and no agreement has been established.