This paper introduces Professor WANG Jihong's clinical experience in treating refractory lateral epicondylitis using the Wang's crescent technique of blade needle. Based on the classical theories of Huangdi Neijing (the Yellow Emperor's Inner Classic) such as the "twelve sinew meridians" "short needling" and "shu needling", Professor WANG applies a self-designed blade needle with crescent needling method. This approach forms a distinctive treatment philosophy characterized by "sinew meridians as the foundation, selecting points at the pain site; using chicken-claw needling technique deliverd at both internal and external; integration of heaven, earth, and man, using both short and shu needling; treating tendon injuries and inflammation with the crescent technique of blade needle". It embodies the therapeutic concept of "treating tendons and bones simultaneously, harmonizing yin and yang", and shows unique advantages in the treatment of this condition.
Acupuncture Therapy/methods* ; Humans ; Tennis Elbow/therapy* ; Male ; Middle Aged ; Adult ; Needles ; Female ; Acupuncture Points

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Objective To explore the medium and long term curative effect of laparoscopic treatment of incarcerated indirect inguinal hernia and summarize the experience of laparoscopic treatment and the characteristics of incarcerated indirect inguinal hernia.Methods A retrospective summary was made on clinical data of 170 children with incarcerated hernia who underwent laparoscopic surgery between January 2016 to February 2024,including 109 boys and 61 girls.The patient's age ranged from 11 days to 11 years old,with a median of 8 months and 27 days.There were 88 cases of right incarcerated hernia and 82 cases of left incarcerated hernia.The incarcerating time (from onset to surgery) was 0.5-360 h,with a median time of 24 h.Results The surgical time was 11-191 min (mean,51.9±29.5 min).Conversion to open surgery was required in 20 cases,in which 14 cases were engaged through the inguinal region for reduction of incarcerated organ and removal of necrotic organ,and 6 cases were treated through umbilical incisions (4 cases of intestinal resection and anastomosis and 2 cases of ileal repair).Most of incarcerated organs among them were small intestine (ileum,84 cases),followed by the ovaries and fallopian tubes (53 cases),and ileocecal region (15 cases),as well as the greater momentum (11 cases).During the surgery,148 cases underwent manual reduction through laparoscopic surgery,14 cases underwent open inguinal region reduction,and 8 cases underwent self-reduction.There were 5 cases ( 2.9％) of small intestinal necrosis,3 cases (1.8％) of greater omentum necrosis,2 cases (1.2％) of small intestine perforation,2 cases (1.2％) of small intestine sarcoplasmic layer damage,2 cases (1.2％) of ovarian fallopian tube necrosis,and 1 case of colonic seromuscular layer damage.The intraoperative exploration revealed 109 cases ( 64.1％) of contralateral hidden hernia,7 cases ( 4.1％) of cryptorchidism,7 cases (4.1％) of umbilical hernia,1 case (0.6％) of Meckel' s diverticulum,and 1 case (0.6％) of ovarian cyst.Intestinal incarceration was seen in 106 cases,with 32 cases (30.2％) showing vomiting symptoms before surgery.Among them,all the 7 cases of necrosis or perforation of incarcerated intestinal tract had vomiting,2 out of 3 cases of damage to the seromuscular layer of incarcerated intestinal tract had vomiting,41.2％ cases (7/17) of blue purple incarcerated intestinal tract had vomiting,and 20.3％ cases (16/79) of incarcerated intestinal tract with fair blood supply had vomiting.The hospital stay was 1-11 d ( median,1 d).Follow-up period ranged from 4 months to 8 years and 5 months,with a median of 4 years and 11 months.Among them,51 cases were less than 3 years,38 cases were between 3 and 5 years,and 81 cases were over 5 years.Recurrence was seen in 2 cases (1.2％).One patient (0.6％) suffered from inguinal incision infection,and there were no complications such as intestinal obstruction or iatrogenic cryptorchidism.Conclusions Laparoscopic treatment of incarcerated indirect inguinal hernia has good medium and long term curative effect.During the surgery,it is necessary to consider the difficulty of hernia reduction and the blood supply of incarcerated organ for timely conversion to open surgery.Once a child with incarcerated hernia has vomiting symptoms before surgery,it indicates blood flow of incarcerated intestinal tract is affected,which requires a timely surgical treatment.

Objective To explore the medium and long term curative effect of laparoscopic treatment of incarcerated indirect inguinal hernia and summarize the experience of laparoscopic treatment and the characteristics of incarcerated indirect inguinal hernia.Methods A retrospective summary was made on clinical data of 170 children with incarcerated hernia who underwent laparoscopic surgery between January 2016 to February 2024,including 109 boys and 61 girls.The patient's age ranged from 11 days to 11 years old,with a median of 8 months and 27 days.There were 88 cases of right incarcerated hernia and 82 cases of left incarcerated hernia.The incarcerating time (from onset to surgery) was 0.5-360 h,with a median time of 24 h.Results The surgical time was 11-191 min (mean,51.9±29.5 min).Conversion to open surgery was required in 20 cases,in which 14 cases were engaged through the inguinal region for reduction of incarcerated organ and removal of necrotic organ,and 6 cases were treated through umbilical incisions (4 cases of intestinal resection and anastomosis and 2 cases of ileal repair).Most of incarcerated organs among them were small intestine (ileum,84 cases),followed by the ovaries and fallopian tubes (53 cases),and ileocecal region (15 cases),as well as the greater momentum (11 cases).During the surgery,148 cases underwent manual reduction through laparoscopic surgery,14 cases underwent open inguinal region reduction,and 8 cases underwent self-reduction.There were 5 cases ( 2.9％) of small intestinal necrosis,3 cases (1.8％) of greater omentum necrosis,2 cases (1.2％) of small intestine perforation,2 cases (1.2％) of small intestine sarcoplasmic layer damage,2 cases (1.2％) of ovarian fallopian tube necrosis,and 1 case of colonic seromuscular layer damage.The intraoperative exploration revealed 109 cases ( 64.1％) of contralateral hidden hernia,7 cases ( 4.1％) of cryptorchidism,7 cases (4.1％) of umbilical hernia,1 case (0.6％) of Meckel' s diverticulum,and 1 case (0.6％) of ovarian cyst.Intestinal incarceration was seen in 106 cases,with 32 cases (30.2％) showing vomiting symptoms before surgery.Among them,all the 7 cases of necrosis or perforation of incarcerated intestinal tract had vomiting,2 out of 3 cases of damage to the seromuscular layer of incarcerated intestinal tract had vomiting,41.2％ cases (7/17) of blue purple incarcerated intestinal tract had vomiting,and 20.3％ cases (16/79) of incarcerated intestinal tract with fair blood supply had vomiting.The hospital stay was 1-11 d ( median,1 d).Follow-up period ranged from 4 months to 8 years and 5 months,with a median of 4 years and 11 months.Among them,51 cases were less than 3 years,38 cases were between 3 and 5 years,and 81 cases were over 5 years.Recurrence was seen in 2 cases (1.2％).One patient (0.6％) suffered from inguinal incision infection,and there were no complications such as intestinal obstruction or iatrogenic cryptorchidism.Conclusions Laparoscopic treatment of incarcerated indirect inguinal hernia has good medium and long term curative effect.During the surgery,it is necessary to consider the difficulty of hernia reduction and the blood supply of incarcerated organ for timely conversion to open surgery.Once a child with incarcerated hernia has vomiting symptoms before surgery,it indicates blood flow of incarcerated intestinal tract is affected,which requires a timely surgical treatment.

Liver cancer is one of the most common cancers in China. In recent years, liver cancer tends to be treated with comprehensive therapies, including surgery, ablation, interventional embolization, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and liver transplantation. At present, the low surgical resectionrate is one of the main factors affecting the prognosis of liver cancer patients. Preoperative neoadjuvant therapy or conversion therapy for liver cancer can maximize the rate of surgical resection and improve the prognosis. With the rapid development of radiotherapy and immunotherapy in the comprehensive treatment of liver cancer, it has been gradually confirmed that the unique effects of preoperative radiotherapy and immune therapy for liver cancer can improve the prognosis of the patients. Therefore, this paper reviewed the research progress in the preoperative radiotherapy and immunotherapy for liver cancer by searching relevant literature and reports at home and abroad.

Objective To investigate the correlation between carotid intima-media thickness (CIMT) and left atrial and left ventricular enlargement in patients with acute cerebral infarction. Methods A total of 224 patients with acute cerebral infarction were included. Based on the thickness of CIMT, it was divided into three groups which were normal CIMT group, thickening CIMT group, and carotid plaque (CP) group, with 57, 97, and 70 patients included respectively. Clinical data were collected, and carotid artery color Doppler ultrasound, cardiac color Doppler ultrasound and other examinations were determined to carry out relevant statistical analysis.Results The left anterior-posterior diameter (LAD) , left atrial diameter index (LADI) , left ventricular end-diastolic septal thickness (IVSD) , and left ventricular mass index (LVMI) in the CP group were all higher than those in the normal CIMT group and thickening CIMT group (P < 0.05). The percentage of the left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) took in the thickening CIMT group were both higher than those in the CP group (P < 0.05). Multi-factor logistic regression analysis indicated that there were statistically significant differences in age, homocysteine and left LVMI (P < 0.05). In the Pearson correlation analysis, CIMT and LADI were positively correlated (r= 0.184, P < 0.01) , and there was a positive correlation between CIMT and LVMI (r = 0.236, P < 0.01). Conclusions Left ventricular enlargement is one of the highrisk factors for CIMT abnormalities in patients with acute cerebral infarction. Left atrial and left ventricular enlargement are closely correlated to the severity of CIMT in patients with acute cerebral infarction, indicating that abnormal CIMT in patients with acute cerebral infarction has a certain predictive effect on left atrial and left ventricular enlargement.

Objective: To investigate the clinical value of plasma EBV DNA in monitoring clinical efficacy in the treatment of nasopharyngeal carcinoma (NPC). Methods: Clinical data of 799 patients initially diagnosed with NPC treated with radical intensity-modulated radiotherapy (IMRT) in our hospital from 2016 to 2017 were analyzed retrospectively. Prior to treatment, the correlation between plasma EBV DNA, clinical stage and tumor progression was analyzed. The relationship between EBV DNA and tumor progression was analyzed after radiotherapy and during follow-up. Results: Before IMRT, the level of EBV DNA was positively correlated with both clinical stage and tumor progression (both P<0.001). At 6 to 8 weeks after IMRT, 19(2.3%) patients positive for plasma EBV DNA obtained the worst prognosis and 14 cases had tumor progression. At 6-8 weeks after IMRT, 9 patients were negative for EBV DNA and 3 cases had tumor progression. The tumor progression rate of patients with undetectable plasma EBV DNA at the end of IMRT was only 8.3%(64/772), and the progression-free survival rate significantly differed among three groups (all P<0.05). The sensitivity, specificity and accuracy rates of persistent positive plasma EBV DNA during follow-up were calculated as 77.6%, 100% and 98.1%, respectively. Conclusions The level of plasma EBV DNA in patients with NPC is correlated with tumor bearing and tumor progression prior to IMRT. At 6-8 weeks after IMRT, patients who are persistently positive for EBV DNA obtain the worst prognosis and should be given with appropriate adjuvant therapy. The correlation between persistent positive plasma EBV DNA during follow up and tumor progression yields a high accuracy rate, indicating that plasma EBV DNA is a reliable biomarker for monitoring the clinical efficacy after radical treatment for NPC patients.

PURPOSE: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI)was evaluated regarding its ability to preliminarily predict the short-term treatment response of nasopharyngeal carcinoma (NPC) following intensity-modulated radiation therapy. MATERIALS AND METHODS: IVIM-DWI with 14 b-factors (0-1,000 sec/mm2) was performed with a 3T MR system on 47 consecutive NPCs before, during (end of the 5th, 10th, 15th, 20th, and 25th fractions), and after fractional radiotherapy. IVIM parametrics (D, f, and D*) were calculated and compared to the baseline and xth fraction. Patients were categorized into responders and non-responders after radiotherapy. IVIM parametrics were also compared between subgroups. RESULTS: After fractional radiations, the D (except D5 and D at the end of the 5th fraction) after radiations were larger than the baseline D0 (p < 0.05), and the post-radiation D* (except D*5 and D*10) were smaller than D*0 (p < 0.05). f0 was smaller than f5 and f10 (p < 0.001) but larger than fend (p < 0.05). Furthermore, greater D5, D10, D15, and f10 coupled with smaller f0, D*20, and D*25 were observed in responders than non-responders (all p < 0.01). Responders also presented larger ΔD10, Δf10, ΔD*20, and δD*20 than non-responders (p < 0.05). Receiver operating characteristic curve analysis indicated that the D5, D*20, and f10 could better differentiate responders from non-responders. CONCLUSION: IVIM-DWI could efficiently assess tumor treatment response to fractional radiotherapy and predict the radio-sensitivity for NPCs.
Diffusion* ; Humans ; Radiation Tolerance ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; ROC Curve

Objective     To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods     A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results     There was no statistical difference in drainage time (4.47±1.03 d vs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 ml vs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60 vs. 26/58, P<0.001). Conclusion     The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.