Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

AIM: To analyze clinical observation and the efficiency of intravitreal conbercept combined with 532-laser on Coats disease in adulthood.METHODS: This was an retrospective analysis.Six eyes from 6 patients(5 males and 1 female) with coats disease diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled.Before the injection, best-corrected visual acuity (BCVA) of early treatment of diabetic retinopathy study (ETDRS), non-contact tonometer, ophthalmoscope, fundus photography, FFA, and OCT were examined.The initial average visual acuity (ETDRS letters) were 51.17±15.15.The initial average central retina thickness (CRT) was 303.30±107.87μm.All affected eyes were treated with intravitreal conbercept 0.05mL (10mg/mL) combined with 532-laser.Patients were followed up for 6 to 12mo, with a mean duration of 7.33±1.26mo.Post-treatment BCVA were compared with baseline using repeat analysis.RESULTS: The mean BCVA showed significant improvement during 1 wk, 1, 3mo post-treatment and the latest follow up (P<0.01).During the latest follow up, the mean BCVA was obviously improved in 3 eyes (50%), improved in 2 eyes (40%), stable in 1 eyes (10%).Likewise, the subretina fluid absorption of different levels.No adverse events such as secondary retinal detachment or endophthalmitis were found during the follow-up.CONCLUSION: Coats disease in adulthood more likely to have lower symptom and have a better response on treatment.Intravitreal conbercept combined with 532-laser significantly improve visual acuity and absorb the subretina fluid.

Lymph node dissection was the key procedure of pancreatic surgery.The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate.However,there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure.It was still a controversial topic considering lymph node dissection.To review the shortcomings of previous randomized controlled trials (RCT),this article combined the experience of new techniques in pancreatic surgery,which are developing rapidly in recent years,and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL).Therefore,the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed,which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice.

BACKGROUND:It is controversial whether anterior approach alone, or combined anterior and posterior approaches were used for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament.
OBJECTIVE:To explore the difference of anterior approach versus combined anterior and posterior approaches for the treatment of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament.
METHODS:A total of 21 cases of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament were included in this study. There were 9 males, aged 56-72 years, and 12 females, aged 58-70 years. We used anterior decompression and titanium mesh bone graft fusion in 11 cases which lesion located between C2-5 vertebra, and ossification excision, combined anterior (titanium mesh plate and screw) and posterior (lateral mass screw) approaches in 10 cases which between C3-7 vertebra. Japanese Orthopaedic Association score system was used to evaluate the results. The excellent and good rate and improvement rate were calculated.
RESULTS AND CONCLUSION:The excellent and good rate was 90%and improvement rate was 82%in 10 cases using combined anterior and posterior approaches. The excellent and good rate was 73%and improvement rate was 73%in 11 cases using anterior treatment alone. Significant differences in the excellent and good rate and improvement rate were detected between the two groups (P<0.05). These suggested that combined anterior and posterior approaches for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament is a better operative procedure.

Objective To investigate the clinical value of PET-CT scans in lymphomatous patients in post-therapy evaluation. Methods 18F-FDG PET-CT imaging were performed in 40 lymphomatous patients whom had been received therapy. Successive PET-CT imaging were performed in 5 cases, and the treatment was evaluated with clinical evaluation. Results Successive PET-CT imaging were performed in 5 cases, in which the tumor was eradicated in 2 cases, improved in 2 cases, and relapsed in 1 case. In 35 patients PET-CT imaging was repeated after treatment, among them 30 cases with complete or partial remission, and PET-CT imaging was positive in 25 cases. PET-CT imaging was still positive in 8 cases with recurrent or remnant tumor. PET-CT imaging changed the therapeutic regime. Conclusion PET-CT imaging can detect the recurrent or remnant tumor sensitively and accurately. There is a significant value for the guidance of clinical therapeutic.

Objective To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all bilialy tree jaundice subsided distinctly. Conclusions The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction ,reduce operation trauma, shorten handling time and possese promising application value.

Objective To evaluate the effect of 3-dimmentional conformal radiotherapy (3-DCRT) for mediastinal metastasis from esophageal carcinoma after surgery.Methods Sixty-three such patients were treated by 3-DCRT. Tumor diameter was: cm 20 patients. Positive supraclavicular lymph node was found in 9 patients. The number of tumor at the upper right, upper left and upper median mediastinum was 27, 27 and 20. All patients received 3-DCRT to the dose of 40?Gy (2?Gy/f, 5f/w), after resetting of portals, the dose was boost to 64～70?Gy by 3?Gy/f, 5f/w. Dose of the patients who had been irradiated was boosted to 50?Gy without further positioning. Results Complete response rate and partial response rate were 43% and 48% one month after the treatment was concluded,with no progression of disease. The 1-, 2- and 3-year survival rates were 75%, 43% and 15%. Conclusions Three-dimmentional conformal radiotherapy, with little side-effects, can markedly improve the local control rate and suvival rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.

Objective:To compare the antihypertensive effects of tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up.Methods:A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group,a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table,with 34 cases in each group.Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively.The blood pressure was recorded by benchtop mercury sphygmomanometer before tuina,immediately after tuina treatment,30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room.The total effective rate was observed.Results:The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P＜0.05).The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P＜0.05).Qiaogong (Extra) group had the highest total effective rate though there was no statistical difference in the total effective rate among the three groups (P＞0.05).Conclusion:Treating primary hypertension due to liver-fire flaming-up with tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively,among which Qiaogong (Extra) has the highest total effective rate.

Objective:To evaluate the correlation between the polysomnographic findings and the degree of obstruction caused by adenoid and tonsillar hypertrophy in children with clinical history of apnea. Method: Retrospectively studied the children who were diagnozed clinically of, obstructive sleep apnea hypopnea syndrome(OSAHS) and underwented polysomnograph and endoscopy. Patients were divided nto OSAHS and non-OSAHS group according to polysomnographic findings. Result: Ninty-four children were involved in the study population, and 63 children of them were male. The mean age of the children at the time of inclusion in the study was 6.7 years. 36 children(38.3%) diagnosed OSAHS clinically had normal polysomnographic findings. No differences were found between children with PSG-documented OSAHS and others. Tonsillar and/or adenoid hypertrophy were not correlated to more severe apnea among enrolled children. Conclusion-There was no significant correlation between polysomnographic and clinical findings in children with OSAHS.

Objective To establish an HPLC method for the determination of lobetyolin in Shengmai Granules. Methods ZORBAX SB-C18(250mm×4.6 mm,5μm) column was used, the mobile phase consisted acetonitrile:0.1% acetic acid (22:78, v/v), the flow rate was 0.8 ml/min, the column temperature was 30℃ and the detecting wavelength was 267 nm. Results The cablibration curve showed good linear relation within a range of 0.082～ 1.640 mg/ml, the average recovery was 98.5% and the RSD was 0.70%.Conclusion The method was simple, repeatable and accurate. It can be applied in quantitative determination of lobetyolin in Shengmai Granules.