Chronic temporomandibular joint disorders(TMD)patients usually suffer from persistent pain and physical, behavioral, psychological, and social symptoms. Effective control and treatment method are needed to restore their jaw function and manage pain. With the concept of biosupplementation proposed, plasma matrix products have gradually become popular in articular disease treatment and have become one of the core method of regenerative therapy. This paper mainly introduces the application characteristics and action mechanism of injectable platelet-rich plasma fibrin. It analyzes several research reports on the effect of injectable platelet-rich fibrin on pain control, mouth opening improvement and joint morphology restoration in TMD patients. It proposes that differences exist in current clinical trials such as different centrifugation schemes for plasma matrix products, injection times, and disease classification selection, providing a reference for the research and application of injectable platelet-rich fibrin in the treatment of TMD.

Chronic temporomandibular joint disorders(TMD)patients usually suffer from persistent pain and physical, behavioral, psychological, and social symptoms. Effective control and treatment method are needed to restore their jaw function and manage pain. With the concept of biosupplementation proposed, plasma matrix products have gradually become popular in articular disease treatment and have become one of the core method of regenerative therapy. This paper mainly introduces the application characteristics and action mechanism of injectable platelet-rich plasma fibrin. It analyzes several research reports on the effect of injectable platelet-rich fibrin on pain control, mouth opening improvement and joint morphology restoration in TMD patients. It proposes that differences exist in current clinical trials such as different centrifugation schemes for plasma matrix products, injection times, and disease classification selection, providing a reference for the research and application of injectable platelet-rich fibrin in the treatment of TMD.

Oral leukoplakia(OLK)is defined as the white lesions that occur on the oral mucosa which cannot be erased and cannot be clinically or pathologically diagnosed as any other definable diseases.It is a precancerous lesion of the oral muco-sa.Existing treatments for OLK include non-surgical treatments and surgical treatments.However,promising evidence regard-ing the prevention of malignant transformation and recurrence of OLK by non-surgical treatments(such as pharmacotherapy)is needed.Meanwhile,surgical treatments have limited indications and postoperative oral morphology and function impair-ment.Photodynamic therapy(PDT)is a modern non-invasive therapy,which can be used to treat tumors and non-tumor lesions including oral leukoplakia,and has become a new and promising option for the treatment of oral leukoplakia due to its potential of preserving tissue morphology and function.In this paper,photosensitizers and lights of PDT and adjuvant treatment methods for PDT in the treatment of oral leukoplakia were reviewed.

Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.

Strengthening clinical research is an inevitable requirement for expediting the development of the medical and healthcare services, as well as enhancing the capability of the hospitals in China. On the basis of sufficient argumentation of the significance and the internal and external environment of developing clinical research according to structure-conduct-performance analysis model, Henan Cancer Hospital set the aim of transforming from clinical hospital to clinical research hospital. By constructing a high-level phase Ⅰ clinical trials center, establishing the department of clinical research management, promoting the collaborative innovation and cooperation among medical institutions, research institutions, and enterprises, and developing the accessory clinical trial management system, Henan Cancer Hospital has turned abundant patient resources into advantages of clinical research. The quality and quantity of clinical trials have been elevated significantly, which could provide strong impetus for hospital′s discipline construction and high-quality development.

OBJECTIVETo evaluate the efficacy and cosmetic result of suprapubic single incision laparoscopic surgery(SSILS) in the treatment of rectosigmoid cancer.

METHODSClinicopathological data of 16 patients undergoing SSILS and 122 undergoing conventional laparoscopic surgery(CLS) for sigmoid colon and upper rectal cancer in the Nanfang Hospital from August 2011 to July 2012 were retrospectively analyzed. The patients were analyzed with propensity score matching at a ratio of 1 to 2 by logistic regression analysis. The matching covariates included age, gender, body mass index, American Society of Anesthesiologists(ASA) score, tumor location, tumor diameter, pathologic TNM stage, previous abdominal surgery. After matching, 48 patients (16 SSILS and 32 CLS) were enrolled in the study. The SSILS group comprised of 13 (81.3%) males with mean age of (56.4±13.4) years. The CLS group comprised of 23(71.9%) males with mean age of (55.6±13.7) years. Postoperative short-term parameters, oncologic efficacy and cosmetic result were compared between the two groups.

RESULTSThe male gender ratio, age, body mass index, ASA score, tumor location, tumor diameter, tumor differentiation, depth of invasion, lymph node metastasis, TNM stage, previous abdominal surgery were comparable between the two groups. As compared to CLS group, less incision length [(4.8±1.5) cm vs. (6.8±1.2) cm, U=63.000, P=0.000], shorter time to ambulation [(2.6±1.0) days vs. (3.9±1.5) days, U=116.500, P=0.002], shorter hospital stay [(8.4±5.3) days vs.(9.2±3.1) days, U=139.000, P=0.010] and less postopertive pain(Visual Analogue Scale: 4.3±1.4 vs. 5.2±1.1 at day 3, t=2.457, P=0.018; 3.7±1.0 vs. 4.6±1.0 at day 4, t=2.700, P=0.010; 3.3±0.8 vs. 4.0±1.0 at day 5, t=2.466, P=0.017) were observed in SSILS group. The other short-term parameters(blood loss, operative time, insertion of additional port rate, time to flatus, defecation, time to liquid and soft diet, complication morbidity, number of lymph nodes harvested, proximal and distal resection margin) were not significantly different between 2 groups(all P>0.05). The median follow-up time was 41(22-49) months. There was no loco-regional recurrence in 2 groups. Distant metastasis was 18.8% (n=3, all liver metastasis) and 6.3% (n=2, one liver metastasis and one peritoneal metastasis) in SSILS and CLS groups (χ(2)=0.698, P=0.404) respectively. Three-year disease-free survival and 3-year overall survival were 81.3% vs 93.0%(χ(2)=1.355, P=0.244) and 100.0% vs 96.9%(χ(2)=0.500, P=0.480) in SSILS and CLS groups, respectively. Photograph questionnaire investigation showed that the cosmetic score was significantly higher in SSILS group than that in CLS group (8.9±1.1 vs. 7.6±1.1, U=100.500, P=0.000). Of 48 patients of 2 groups, 81.3%(39/48) case preferred SSILS.

CONCLUSIONIn experienced laparoscopic treatment centers, SSILS for rectosigmoid cancer is feasible and safe with quite good oncological efficacy and certain advantages, such as fast recovery, less pain and better cosmetic result.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Disease-Free Survival ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Period ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Sigmoid Neoplasms ; surgery

ObjectiveTo investigate the clinical features of clonorchiasis diagnosed during biliary surgery, and to provide more comprehensive and effective information for the surgical treatment of clonorchiasis. MethodsA retrospective analysis was performed for the clinical data of 15 patients who were diagnosed with clonorchiasis during and after biliary tract surgery in our department from January 2013 to January 2016, and their clinical features were summarized. ResultsAll the 15 patients were male, among whom 5 once ate uncooked freshwater fish and shrimps. Of all patients, 8 underwent laparoscopic bile duct exploration and 7 underwent endoscopic retrograde cholangiopancreatography (ERCP). Adult Clonorchis sinensis was found in intraoperative or postoperative drainage. All the patients achieved clearance of Clonorchis sinensis after regular anthelmintic treatment. ConclusionIf bile duct exploration finds grey-black or bright-red melon seed-like floccules, clonorchiasis should be highly suspected. Intraoperative T-tube drainage is recommended, and if suspected Clonorchis sinensis is found after laparoscopic bile duct exploration and T-tube drainage or after ERCP and nasobiliary drainage, microbiological examination should be performed next. As for the patients with a definite diagnosis of clonorchiasis, they should not eat uncooked freshwater fish or shrimps and should be given regular anthelmintic treatment.

Objective To analyze the retrieval of master and doctorial dissertations entitledsystematic review/meta analysis in domestic universities of traditional Chinese medicine. Methods Master and doctorial dissertations entitledsystematic review/meta analysis in domestic universities of traditional Chinese medicine retrieved from China Dissertation Full-text Database were analyzed using Excel and SPSS 17. 0,respectively. Results Of the 423 master and doctorial dissertations included in this study,71. 9% were retrieved from both Chinese and English databases, 27. 7% were retrieved from Chinese databases,82. 8% were retrieved from two or more Chinese databases,54. 1% were retrieved from two or more English databases. The most frequently retrieved Chinese database was CKNI, followed by VIP, CBM and Wanfang. The most frequently retrieved English database was PubMed, followed by Cochrane Library, EMBASE and OVID. Conclusion The low use of traditional Chinese medicine databases is the main prob-lem in retrieval of master and doctorial dissertations entitledsystematic review/meta analysis in domestic univer-sities of traditional Chinese medicine. No significant difference is found in retrieved doctorial dissertations and mas-ter dissertations between 211and non-211 universities of traditional Chinese medicine.

Objective:To understand the status of two -week prevalence and the influencing factors in rural preschool leftover children of Shandong , so as to provide evidence for putting forward effective health intervention means .Methods:Using the method of stratified -cluster-random sampling and elect 646 cases of preschool lefto-ver children from 2 counties of Shandong .We surveyed with self -made questionnaire .Results:The two-week prevalence of the rural preschool leftover children is high;the influencing factors of the two -week prevalence with the rural preschool leftover children including whether children are only -child, the type of children guardianship , whether children piddle and whether left -behind children can avoid dangerous .Conclusion: The two -week prevalence present situation of rural preschool left -behind children is low , and its problems of health and ethics are clear.Therefore, effective measures should be carried out to improve the health level of rural leftover children .