Objective To compare the CLIP score, the JIS score, and the China staging system (CS) in the prediction of survival of patients with resectable hepatocellular carcinoma (HCC). Methods The Clinicopathologic and follow-up data of 224 patients who underwent hepatic resection for HCC from January 2000 to July 2005 were retrospectively studied. The patient distribution and the survival curve of each staging system were used to compare the ability to stratify and to discriminate prognosis. The likelihood ratio, chi-square test and the linear trend chi-square test were used to compare the homogeneity and the monotonicity of the relationship between stage and mortality rate of each staging system. The increase in the -2 log likelihood statistic on removal of any one staging system was in turn used as a means of ranking the individual staging systems according to their importance within the regression model. The statistical package used was SPSS version 16. 0 and Stata SE version 8.0. Results Based on the China staging system, the percentages of patients categorized as Ⅰa, Ⅰ b, Ⅱa,Ⅱb and Ⅲ a were 14. 3%, 17.4%, 21.9%, 31.7% and 14. 7% respectively, showing excellent stratification ability. However, nearly 81. 6% of the patients were classified as a CLIP score of 0-2, which showed poor stratification ability, and only 3. 1 % of the patients were classified as score 0 category of the JIS scoring system. In the follow-up period, the log-rank test and the corresponding Kaplan-Meier survival curves confirmed each staging system to be able to differentiate patient survival in the different stages. Individual pairwise comparisons revealed inconsistencies across the different staging systems. In particular, using the log-rank test, the JIS scoring system and the China staging system showed significant differences in patient survival on all pairwise comparisons. By contrast, the CLIP scoring system failed to differentiate significantly between score 2 and score 3 patients. The JIS scoring system could identify the best prognostic group who would benefit from curative and aggressive treatments, whereas the discriminatory value of the CLIP score was noted in the intermediate- and advanced-phase HCC patients. The China staging system was shown to have the best homogeneity, overall discriminatory capacity and monotonicity of gradient. The change in the -2 log likelihood statistic on removal of any staging system revealed that for this cohort of patients, the appropriate importance in the ranking of the independent contribution of each factor to the regression model was: CS> CLIP>JIS. Conclusion Among three clinical staging systems, the China staging system had the highest prognostic value, with better stratification and higher discriminatory capacity than the CLIP scoring system and the JIS scoring system for this cohort of patients who received partial hepatectomy for HCC. The CLIP scoring system performed better in identifying the worst prognostic patients.

Objective:To observe the clinical efficacy of the rehabilitation technique of "regulating abdomen and dredging collaterals" in the treatment of children with global developmental delay (GDD), and to provide clinical experience and basis for promoting the rehabilitation treatment of GDD.Methods:Eighty-two children with GDD were selected and divided equally into the control and the treatment group according to the random number table method. The control group received conventional rehabilitation treatment, and the treatment group received "regulating abdomen and dredging collaterals" rehabilitation treatment on the basis of the conventional rehabilitation treatment. The duration of treatment for both groups was 5 times a week for 3 months. The developmental quotient (DQ) of the children in both groups was recorded using the Geselll Developmental Scale as an assessment tool to observe the scores of the five functional areas, i.e. gross motor, fine motor, language, adaptive, and personal-social.Results:At the end of the treatment, the DQ values of the children in both groups improved significantly in each energy area (all P<0.05). The treatment group outperformed the control group in terms of total effective rate and gross motor, language, and adaptability (all P<0.05), while the differences between the two groups in fine motor and personal-social energy areas were not statistically significant (all P>0.05). Conclusions:The "regulating abdomen and dredging collaterals" rehabilitation technique is clinically effective in the treatment of GDD, with significant improvement in gross motor, language, and adaptive energy areas.