Objective To explore the clinical application of the multi-network anatomical lavage on the treatment of chronic osteomyelitis after fracture surgery. Methods A retrospective analysis of 40 patients (41 sites) with chronic osteomyelitis after fracture surgery was performed from June 2006 to December 2008. There were 35 males and 5 females with an average of 42.7 years (range, 16-68). All 40 cases were treated with debridement, closing the cavity, and placing the multi-tube drainage network anatomical catheter lavage system. At the same time, sensitive antibiotics were used for 3 to 4 weeks. Rechecks were scheduled every 3 months after operation, including wound healing, X-ray presentation, ESR and C-reactive protein.Cure criteria depends on the conditions of the inflammation when the lavage treatment was over, and whether it relapsed six months after operation, including wound healing, systemic symptoms, ESR and C-reactive protein. Results Judged by the clinical outcomes when the lavage treatment was over and six months after operation, the effects were categorized into 3 levels, including excellent in 37 cases with primary wound healing, and without relapse six months later;, good in 2 with poor wound healing, the wound healed after a period of treatment without recurrence; poor in one with recurrent sinus infection and a prolonged unhealed wound, after another operation he was healed. 36 cases were treated with bone graft and internal fixation operation, and the fractures were healed after surgery, the fractures were healed directly in 4 cases without bone graft. The patients were followed up for an average of 43.2 months (range, 30-50) after operation, and none relapsed. Conclusion The multi-tube drainage network anatomical method is feasible and effective on the treatment of chronic osteomyelitis after fracture surgery with a high cure rate.

Objective To explore the clinical application value of transcatheter arterial chemoembolization (TACE) combined with CT-guided percutaneous acetic acid injection (PAI) in treatment of huge hepatocellular carcinoma (HCC). Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A underwent routine one course for TACE (three times), and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2-3 weeks after first TACE, and one course included 6-9 times of PAI. Postoperative follow-up was conducted (including AFP, the size of tumor, etc.). One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups (38.10% vs 77.27%). The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.

BACKGROUNDHemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.

METHODSA cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.

RESULTSIn this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.

CONCLUSIONSThe onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.

Adult ; Botulinum Toxins, Type A ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; Hemifacial Spasm ; diagnosis ; drug therapy ; Humans ; Male ; Middle Aged ; Neuromuscular Agents ; therapeutic use

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.