Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
Interventional radiology (IR) has developed rapidly since its introduction into our country. More and more patients choose this minimally invasive procedure for treatment, but the incidence of infectious complications and potential mortality following IR procedures should not be underestimated. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists and infection control practitioners must possess a thorough understanding of these potential infectious complications and put more emphasis on the quality of care, so as to control the infections and expenses, and maximize the patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, percutaneous transhepatic cholangial drainage, and intravascular stents or grafts. Emphasis is placed on incidence, risk factors, and prevention. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications.
Colorectal cancer is one of the common malignant tumor in the world, and about 57.6% of colorectal cancer surgical cases in our country are rectal cancer patients, which occupies a major proportion. Some patients with rectal cancer may already have emergencies such as intestinal obstruction or limited perforation at the time of consultation, which require immediate relevant treatment measures. Currently, there are multiple surgical and endoscopic treatment strategies available for obstructive and perforated rectal cancer. Surgeons need to perform an accurate and comprehensive assessment of the disease, define the goals of the current treatment, and formulate an appropriate treatment plan based on the patient’s clinical and oncological status in order to optimize the patient’s oncological outcome while minimizing the risk of complications associated with emergency colorectal surgery.
Objective Mucin 1 （MUC1）and Thomsen-Friedenreich related antigens （TFRA）gene play an important role in the occurrence and development of tumor，so we will discuss its research advancements and clinical applications below. Methods Foreign and native related literatures published in recent 10 years were retrieved，and a further exploration on the expression relationship and clinical research progression of MUC1 and TFRA were reviewed. Results MUC1 and TFRA expressed in a high degree of specificity in malignant tumors，and their expressions interacted with each other. Many MUC1 related vaccines had been introduced to clinical in recent years，and some drugs based on TFRA had been put into clinical experiment as gene therapy methods too. Conclusions MUC1 and TFRA may be used as new target antigens of specific immunotherapy for malignant tumor. That they express in high or low level is closely related to tumor biological behavior and prognosis， moreover， they are important to the diagnosis and treatment of cancer.
Objective To analyze the impact of robot assistance on the restoration of limb length and offset distance in total hip arthroplasty (THA). Methods A retrospective analysis was conducted on the clinical data of 316 patients who underwent unilateral primary THA between September 2019 and August 2023. Among them, 117 patients underwent robot-assisted THA (group A), and 199 patients underwent conventional THA (group B). There was no significant difference between the two groups in the gender, age, or side of the hip replacement (P>0.05); but there was a significant difference in the preoperative diagnosis (P<0.05). The leg length discrepancy (LLD) and global offset (GO) dfference were measured on preoperative anteroposterior pelvic X-ray films, and absolute values were used for comparison between groups. Results The operations in both groups were successfully completed. Postoperative imaging measurements showed that the LLD and GO dfference in group A were significantly lower than those in group B (P<0.05). Among them, group A had 32 cases (27.4%), 5 cases (4.3%), and 0 case (0) of LLD>3 mm, >5 mm, and >10 mm, respectively, while group B had 115 cases (57.8%), 75 cases (37.7%), and 22 cases (11.1%), respectively; and the differences in above indicators between groups were significant (P<0.05). Group A had 40 cases (34.2%), 3 cases (2.6%), and 0 case (0) of GO dfference>5 mm, >10 mm, and >20 mm, respectively; group B had 103 cases (51.8%), 54 cases (27.1%), and 7 cases (3.5%), respectively. There was no significant difference in the proportion of patients with GO>20 mm between groups (P>0.05), while there were significant differences in other indicators between groups (P<0.05). Conclusion Compared with traditional THA, robot assisted THA has more advantages in restoration of limb length and offset distance.
Objective To evaluate the effectiveness of unsupported reduction ascending aortoplasty for dilatation of the ascending aorta. Methods Between September 2005 and May 2011, 53 patients with aortic valve disease and dilatation of the ascending aorta underwent aortic valve replacement with unsupported reduction ascending aortoplasty. There were 41males and 12 females, aged 22-75 years (mean, 52 years). The disease duration was 1 month to 14 years. The color Doppler echocardiography showed that the diameter of the ascending aorta before surgery was (45.9 ± 3.3) mm; bicuspid aortic valve and tri-aortic valve were observed in 13 and 40 cases respectively. The heart functions were graded as II level in 19 cases, III level in 33 cases, and IV level in 1 case according to the standard of New York Heart Disease Academy (NYHA). Results After operation, mediastinum errhysis occurred in 1 case, pneumonia in 3 cases, and III degree atrioventricular block in 1 case. There was no related complication of the aortoplasty. All the patients were followed up 3-68 months (mean, 15 months), and had no obvious chest tightness and palpitation. At last follow-up, the NYHA heart functions were graded as I level in 22 cases, II level in 31 cases; the diameter of the ascending aorta was (35.2 ± 4.0) mm, showing significant difference when compared with the preoperative one (P=0.000), but no significant difference when compared with the one at discharge (34.0 ± 2.5) mm (P=0.245). There was significant difference in the diameter of the ascending aorta between last follow-up and preoperation, at discharge in the patients who were followed up more than 60 months (P lt; 0.05); significant difference was found between last followup and preoperation in patients with bicuspid aortic valve (P lt; 0.05), but no significant difference between last follow-up and preoperation (P gt; 0.05) in patients whose diameter of the ascending aorta was more than 50 mm before operation. Conclusion Unsupported reduction ascending aortoplasty has good short- and mid-term results in treating aortic valve disease with mild to moderate dilatation (diameter range, 40-50 mm) of the ascending aorta. Inclusion criteria of the aortoplasty should be strict. Long-term results need further follow-up.
ObjectiveTo explore the clinical value of immunotherapeutic drugs represented by programmed cell death-1 (PD-1) / programmed cell death ligand-1 (PD-L1) blockades for treatment of advanced gastric cancer. MethodThe latest literatures about the clinical studies of PD-1/PD-L1 blockades for the treatment of advanced gastric cancer were retrieved and reviewed. ResultsThe corresponding clinical trials relevant to PD-1/PD-L1 blockades had been conducted in the treatment, biomarkers, and resistance to drugs for advanced gastric cancer. The PD-1/PD-L1 blockades single drug or its in combination with chemical drugs or (and) targeted drugs for the treatment of advanced gastric cancer or gastroesophageal junction cancer had shown a good efficacy in some patients. The patients who benefited from PD-1/PD-L1 blockades might be a population with specific molecular characteristics, but the resistance to drugs during the therapy process affected its therapeutic effect. ConclusionFrom the progress of this review, PD-1/PD-L1 blockades bring benefits to some patients with advanced gastric cancer, but more biomarkers which can predict the therapeutic effect need to be found to optimize the drug regimen, and the resistance to drugs mechanism needs to be further studied.
Objective To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. Methods The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Results Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow’s space can restore the appearance of midface effectively. Conclusion In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.
Objective To review the research progress of injection sites of local infiltration analgesia (LIA) in total knee arthroplasty (TKA). MethodsThe relevant domestic and foreign literature in recent years was extensively reviewed. The neuroanatomy of the knee, and the research progress of the selection and the difference of effectiveness between different injection sites of LIA in clinical studies were summarized. ResultsLarge concentrations of nociceptors are present throughout the various tissues of the knee joint. Patellar tendon, subpatellar fat pad, lateral collateral ligament insertions, iliotibial band insertions, suprapatellar capsule, and posterior capsule were more sensitive to pain. Most current studies support injections into the lateral capsule, collateral ligament, retinaculum, quadriceps tendon, fat pad, and subcutaneous tissue. Whether to inject into the back of the knee and subperiosteum is controversial. ConclusionThe relative difference of knee tissue sensitivity to pain has guiding significance for the selection of LIA injection site after TKA. Although researchers have conducted clinical trials on injection site and technique of LIA in TKA, there are certain limitations. The optimal scheme has not been determined yet, and further studies are needed.