1.Characteristics and influencing factors of postoperative weight change in patients with esophageal cancer: A prospective longitudinal study
Chengxiang LI ; Yang YANG ; Tian ZHANG ; Ruonan XIE ; Xin JIANG ; Yingjie LENG ; Zhuomiao NIE ; Guorong WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):267-274
Objective To longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. Methods Patients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. Results A total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. The analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). Conclusion Weight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.
2.The development process, research status, and prospect of physical ablation in the treatment of chronic obstructive pulmonary disease
Xiaoyu ZHOU ; Yirong AN ; Ran JU ; Haoze LENG ; Shiran TAO ; Jiawei TIAN ; Ming' ; e WU ; Haoyang ZHU ; Yi LÜ ; ; Nana ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(04):646-651
Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease around the world, and pharmacotherapy is the foremost treatment method currently. In recent decades, with the rapid development of bronchoscopic interventional therapy, endoscopic physical ablation technology presents a therapeutic effect in treating COPD, with few treatment-related side effects, showing excellent application prospects in treating COPD. Since ablation techniques in this field are emerging technologies with low patient acceptance, they are not widely used in the clinical treatment of COPD. This article reviews the development process of physical ablation techniques. Moreover, their current application status and the prospects in the field of COPD treatment are also summarized and analyzed. We hope to promote the application of physical ablation in the clinical treatment of COPD and provide practical references and a theoretical basis for the clinical treatment of COPD.
3.Acute haemorrhagic conjunctivitis outbreak attributed to coxsackievirus A24 in Ratanakiri, Cambodia, 2023
Kimhour Lay ; Kossama Chukmol ; Guechlaing Chea ; Leng Un ; Kimhong Moch ; Seiha Do ; Lykheang Lou ; Meng Ngy ; Piseth Kong
Western Pacific Surveillance and Response 2026;17(1):42-52
Objective: To determine the causative agent, clinical manifestations and risk factors for infection during a September 2023 outbreak of acute haemorrhagic conjunctivitis (AHC) in Pak Touch village, Ratanakiri province, Cambodia.
Methods: A retrospective case-control study was conducted. Cases were age-matched to controls (1:1), who were randomly selected from the village population. Twenty-one conjunctival samples were analysed using real-time reverse transcription–polymerase chain reaction (RT–PCR). RNA sequencing was additionally performed to identify the causative agent of the outbreak. Logistic regression models were used to identify significant risk factors.
Results: A total of 73 cases and 73 controls were included in the analysis. Cases had a median age of 20 years (range: 1–70, mean and standard deviation: 27.7 ± 20.0), and 46.6% (34/73) were male. The overall attack rate was 12.3% (73 cases/594 residents). Clinical presentations included conjunctival hyperaemia (100%), subconjunctival haemorrhage (82.2%, 60), pain and discharge (64.4%, 47 each), eyelid swelling (57.5%, 42) and tearing (54.8%, 40). RT–PCR identified enterovirus in 52.4% (11/21) of conjunctival swabs, with RNA sequencing confirming the coxsackievirus A24 variant as the causative agent in five swabs. Statistical analysis identified significant risk factors, including physical contact with patients with acute haemorrhagic conjunctivitis (adjusted odds ratio [aOR]: 4.42, 95% confidence interval [CI]: 1.90–10.10), frequent eye rubbing (aOR: 4.56, 95% CI: 2.00–10.37) and poor hand hygiene (aOR: 3.70, 95% CI: 1.64–8.43).
Discussion: The outbreak of acute haemorrhagic conjunctivitis in Pak Touch village was primarily caused by coxsackievirus A24. Significant risk factors included physical contact with infected individuals, frequent eye rubbing and poor hand hygiene. Effective hygiene measures are crucial to prevent the spread of AHC.
4.Mechanism of Yishen Huoxue Tongqiao Formula in Improving Unilateral Vestibular Labyrinth Destruction by Regulating Metabolism-neuroplasticity
Yu TIAN ; Hui LENG ; Rupeng QU ; Xianglong HAO ; Aiping WANG ; Lei SHI ; Zhongyuan QU ; Ye DONG ; Xiande MA ; Yangling HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):54-64
ObjectiveThis study aims to explore the mechanism by which Yishen Huoxue Tongqiao Formula improves metabolism-neuroplasticity and treats unilateral vestibular labyrinth destruction by regulating the metabolic balance of glutamate (Glu)/γ-aminobutyric acid (GABA). Methods48 Sprague-Dawley (SD) adult rats were randomly divided into the sham operation group, model group, Yishen Huoxue Tongqiao Formula groups with low, medium, and high doses (9.20, 18.39, 36.78 g·kg-1), and betahistine group (1.62 mg·kg-1). A unilateral vestibular labyrinth destruction (vestibular dysfunction) model was established by intratympanic injection of chloroform into the right ear, while the control group received intratympanic injection of normal saline. Drugs were administered once daily for seven consecutive days. During the period, behavioral tests were performed to evaluate the behaviors of rats after unilateral vestibular labyrinth destruction. Hematoxylin-eosin (HE) staining and Nissl staining were used to observe the neuronal morphology in the medial vestibular nucleus. Golgi staining was employed to assess the number of dendritic spines of neurons in the medial vestibular nucleus. Ultra-performance liquid chromatography-tandem mass spectrometry (LC-ESI-MS/MS) was utilized to detect Glu/GABA. Immunofluorescence and immunohistochemistry were used to detect the expressions of neuronal nuclei (NeuN), growth-associated protein 43 (GAP-43), and glial fibrillary acidic protein (GFAP). Western blot and real-time fluorescent quantitative polymerase chain reaction (Real-time PCR) were applied to determine the expressions of glutamate-immunoreactive (Glu-IR), GABA, GFAP, postsynaptic density protein 95 (PSD-95), and GAP-43. ResultsCompared with the sham operation group, the model group presented with head deviation, balance disorder, increased tail suspension score, nuclear consolidation of medial vestibular nerve neurons, and decreased Nissl bodies (P<0.01). The number of dendritic spines in neurons and NeuN-positive cells decreased. The content of Glu decreased. The content of GABA increased (Glu/GABA decreased). The expression of GAP-43 was down-regulated, and GFAP was up-regulated (P<0.05, P<0.01). The expressions of Glu-IR, PSD-95, and GAP-43 proteins, as well as Glu-IR mRNA decreased, while the expressions of GABA and GFAP proteins and mRNA increased (P<0.05, P<0.01). Compared with those in the model group, the head deviation, imbalanced behavior, and tail suspension scores in each treatment group decreased, with alleviated neuronal injury and recovered Nissl bodies (P<0.01). The number of dendritic spines of neurons increased, and the number of NeuN-positive cells rebounded. The content of Glu increased, and the content of GABA decreased (Glu/GABA increased). GFAP was down-regulated, and GAP-43 was up-regulated (P<0.05, P<0.01). The expressions of Glu-IR, PMD-95, and GAP-43 proteins, as well as Glu-IR mRNA increased, while the expressions of GABA and GFAP proteins and mRNA decreased. The effect was more significant in the high-dose group (P<0.01). ConclusionThe Yishen Huoxue Tongqiao Formula can alleviate vestibular dysfunction, and its mechanism may be associated with regulating the metabolic balance of Glu/GABA, mitigating neural damage, improving synaptic plasticity (promoting GAP-43 expression and inhibiting GFAP expression), and facilitating vestibular compensation.
5.Meta-analysis of the efficacy and safety total glucosides of paeonia in the treatment of systemic lupus erythematosus
Xiangyan HAO ; Jiahui LENG ; Zhengqi LIU ; Xinchang WANG ; Cong HUANG ; Xiaopeng LI ; Yi LING
China Pharmacy 2026;37(2):232-237
OBJECTIVE To evaluate the efficacy and safety of total glucosides of paeonia (TGP) in the treatment of systemic lupus erythematosus (SLE). METHODS Randomized controlled trial (RCT) about TGP combined with western medicine versus western medicine alone for SLE treatment were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, Wanfang Data, and CBM. The search period spanned from the inception of each database to June 1, 2025. After literature screening, data extraction, and quality assessment of the included studies, Meta-analysis was performed using RevMan 5.4 software. RESULTS Fifteen RCTs, involving 1 318 patients, were included. Meta-analysis results showed that compared with western medicine alone, TGP combined with western medicine significantly improved clinical efficacy [OR=4.96, 95%CI(3.41, 7.23), P<0.000 01], complement 3 [MD=0.18, 95%CI (0.13, 0.23), P<0.000 01] and complement 4[MD=0.08, 般021) 95%CI (0.04, 0.11), P<0.000 01], and reduced the levels of immunoglobulin G (IgG) [MD=-3.10, 95%CI (-3.59,-2.62), P<0.000 01], IgA [MD=-0.68, 95%CI (-0.78, -0.58), P<0.000 01], IgM [MD=-0.43, 95%CI (-0.53,-0.34), P<0.000 01], systemic lupus erythematosus disease activity index (SLEDAI) [MD=-1.59, 95%CI (-2.20, -0.99), P<0.000 01], recurrence rate [OR=0.23, 95%CI (0.13, 0.42), P<0.000 01] and the incidence of adverse drug reactions [OR= 0.54, 95%CI (0.36, 0.82), P=0.004]. CONCLUSIONS TGP therapy can improve clinical efficacy of SLE patients, promote the restoration of immunoglobulins and complements, reduce SLEDAI and recurrence rate and has good safety.
6.Microbiological characterization of Staphylococcus epidermidis with hemolytic phenotype
Guiyun LENG ; Wei CHEN ; Chenghao WANG ; Jie YAO ; Chuanping CHEN ; Wei TANG
Acta Universitatis Medicinalis Anhui 2026;61(1):60-66
ObjectiveTo explore the microbiological characteristics of Staphylococcus epidermidis with hemolytic phenotype (SEHP). MethodsHemolytic phenotype was detected using the three-point inoculation method, involving a total of 5 strains of SEHP and 5 strains of Staphylococcus epidermidis with non-hemolytic phenotype (SENHP) . Bacterial species were identified using the Microflex LT MALDI-TOF mass spectrometer, and a phylogenetic tree was constructed through 16S rRNA sequence alignment. Growth curves were monitored through the microcultivation assay. Biofilm formation ability was assessed by microplate crystal violet staining. Red blood cell toxicity was detected using the microplate method. Antimicrobial susceptibility testing of SEHP and SENHP against commonly used antibiotics was performed using a VITEK 2 GP639 test kit. Antagonistic effects of SEHP and SENHP against Staphylococcus aureus and Corynebacterium striatum were evaluated by the Oxford cup inhibition assay. ResultsCompared with SENHP, SEHP exhibited a marked decrease in growth rate during the late logarithmic phase, accompanied by significant hemolytic toxicity. Additionally, it showed lower resistance rates to levofloxacin and moxifloxacin, and could antagonize Staphylococcus aureus and Corynebacterium striatum. ConclusionThe microbiological characteristics of SEHP differ from those of SENHP in that SEHP demonstrates antagonistic effects against S. aureus and C. striatum.
7.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95%confidence interval(CI)(6.61,12.34),P<0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95%CI(-1.72,0.45),P<0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.
8.Effects of different neuromodulatory stimulation modalities on non-motor symptoms in Parkinson's patients:a network meta-analysis
Xiaoxuan LENG ; Yuxin ZHAO ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(5):1282-1293
OBJECTIVE:It has been confirmed that neuromodulation technology can improve the clinical symptoms of patients with Parkinson's disease,and there are differences in the efficacy of different neuromodulation stimulation methods.Herein,a network meta-analysis was used to evaluate the efficacy of different neuromodulation stimulation modalities in improving non-motor symptoms such as sleep disorders and depression and anxiety in patients with Parkinson's disease,thereby exploring the optimal neuromodulation stimulation regimen.METHODS:The Chinese Biomedical Literature Database,WanFang Database,VIP Database,CNKI Database,Web of Science,PubMed,The Cochrane Library,and EMbase databases were searched for randomized controlled trials on neuromodulation techniques to improve sleep disorders,depression and anxiety in patients with Parkinson's disease.The control group was treated with conventional treatments(drugs,conventional rehabilitation therapy,etc.)or sham stimulation,and the experimental group was supplemented with neuromodulation technology on the basis of the control group.The quality of the included studies was evaluated using the PEDro scale and the deviation risk assessment tool recommended by the Cochrane Collaboration.RevMan 5.4 and Stata 17.0 were used for network meta-analysis of the four outcomes(sleep disorders,anxiety symptoms,depressive symptoms,and quality of life).RESULTS:(1)Twenty-nine randomized controlled trials involving six neuromodulation stimulation modalities were included.These modalities were transcranial direct current stimulation,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,deep brain stimulation of the subthalamic nucleus,deep brain stimulation of the globus pallidus,multi-target deep brain stimulation.(2)The results of network meta-analysis showed that compared with conventional treatment,transcranial direct current stimulation[standardized mean difference(SMD)=-2.57,95%confidence interval(CI)=-4.52 to-0.63,P<0.05)had the best effect in improving sleep disorders in patients with Parkinson's disease.In terms of improving depressive symptoms,deep brain stimulation of the globus pallidus(SMD=-1.00,95%CI=-1.87 to-0.14,P<0.05)had the best effect,followed by low-frequency repetitive transcranial magnetic stimulation(SMD=-0.91,95%CI=-1.60 to-0.23,P<0.05),deep brain stimulation of the subthalamic nucleus(SMD=-0.82,95%CI=-1.56 to-0.08,P<0.05),and high-frequency repetitive transcranial magnetic stimulation(SMD=-0.75,95%CI=-0.97 to-0.53,P<0.05).In terms of improving anxiety symptoms,high-frequency repetitive transcranial magnetic stimulation(SMD=-0.86,95%CI=-1.54 to-0.18,P<0.05)had the best effect.In terms of improving the quality of life,deep brain stimulation of the globus pallidus(SMD=-0.79,95%CI=-1.55 to-0.04,P<0.05)had the best efficacy,followed by high-frequency repetitive transcranial magnetic stimulation(SMD=-0.63,95%CI=-0.90 to-0.36,P<0.05)and transcranial direct current stimulation(SMD=-0.50,95%CI=-0.80 to-0.19,P<0.05).CONCLUSION:Neuromodulation technology has significant efficacy in improving non-motor symptoms in patients with Parkinson's disease.Transcranial direct current stimulation has the best efficacy in improving sleep disorders,deep electrical stimulation of the medial cerebral part of the globus pallidus has the best efficacy in improving depressive symptoms,high-frequency repetitive transcranial magnetic stimulation has the best efficacy in improving anxiety symptoms,and deep electrical stimulation of the globus pallidus has the best efficacy in improving quality of life.
9.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95%confidence interval(CI)(6.61,12.34),P<0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95%CI(-1.72,0.45),P<0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.
10.Effects of different neuromodulatory stimulation modalities on non-motor symptoms in Parkinson's patients:a network meta-analysis
Xiaoxuan LENG ; Yuxin ZHAO ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(5):1282-1293
OBJECTIVE:It has been confirmed that neuromodulation technology can improve the clinical symptoms of patients with Parkinson's disease,and there are differences in the efficacy of different neuromodulation stimulation methods.Herein,a network meta-analysis was used to evaluate the efficacy of different neuromodulation stimulation modalities in improving non-motor symptoms such as sleep disorders and depression and anxiety in patients with Parkinson's disease,thereby exploring the optimal neuromodulation stimulation regimen.METHODS:The Chinese Biomedical Literature Database,WanFang Database,VIP Database,CNKI Database,Web of Science,PubMed,The Cochrane Library,and EMbase databases were searched for randomized controlled trials on neuromodulation techniques to improve sleep disorders,depression and anxiety in patients with Parkinson's disease.The control group was treated with conventional treatments(drugs,conventional rehabilitation therapy,etc.)or sham stimulation,and the experimental group was supplemented with neuromodulation technology on the basis of the control group.The quality of the included studies was evaluated using the PEDro scale and the deviation risk assessment tool recommended by the Cochrane Collaboration.RevMan 5.4 and Stata 17.0 were used for network meta-analysis of the four outcomes(sleep disorders,anxiety symptoms,depressive symptoms,and quality of life).RESULTS:(1)Twenty-nine randomized controlled trials involving six neuromodulation stimulation modalities were included.These modalities were transcranial direct current stimulation,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation,deep brain stimulation of the subthalamic nucleus,deep brain stimulation of the globus pallidus,multi-target deep brain stimulation.(2)The results of network meta-analysis showed that compared with conventional treatment,transcranial direct current stimulation[standardized mean difference(SMD)=-2.57,95%confidence interval(CI)=-4.52 to-0.63,P<0.05)had the best effect in improving sleep disorders in patients with Parkinson's disease.In terms of improving depressive symptoms,deep brain stimulation of the globus pallidus(SMD=-1.00,95%CI=-1.87 to-0.14,P<0.05)had the best effect,followed by low-frequency repetitive transcranial magnetic stimulation(SMD=-0.91,95%CI=-1.60 to-0.23,P<0.05),deep brain stimulation of the subthalamic nucleus(SMD=-0.82,95%CI=-1.56 to-0.08,P<0.05),and high-frequency repetitive transcranial magnetic stimulation(SMD=-0.75,95%CI=-0.97 to-0.53,P<0.05).In terms of improving anxiety symptoms,high-frequency repetitive transcranial magnetic stimulation(SMD=-0.86,95%CI=-1.54 to-0.18,P<0.05)had the best effect.In terms of improving the quality of life,deep brain stimulation of the globus pallidus(SMD=-0.79,95%CI=-1.55 to-0.04,P<0.05)had the best efficacy,followed by high-frequency repetitive transcranial magnetic stimulation(SMD=-0.63,95%CI=-0.90 to-0.36,P<0.05)and transcranial direct current stimulation(SMD=-0.50,95%CI=-0.80 to-0.19,P<0.05).CONCLUSION:Neuromodulation technology has significant efficacy in improving non-motor symptoms in patients with Parkinson's disease.Transcranial direct current stimulation has the best efficacy in improving sleep disorders,deep electrical stimulation of the medial cerebral part of the globus pallidus has the best efficacy in improving depressive symptoms,high-frequency repetitive transcranial magnetic stimulation has the best efficacy in improving anxiety symptoms,and deep electrical stimulation of the globus pallidus has the best efficacy in improving quality of life.


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