To challenge the 15% enhancement of 5-year survival of cancer for the plan of “Health-China 2030”, we must strive the following measurements to complete the 15% enhancement of 5-year survival of liver cancer: conduct conversion therapy and conversion to resectability for the 70% of unresectable intermediate-to-advanced stage liver cancer so as to prolong survival; try our best to identify and treat the people of HBV and HCV infection, and to screen the risk people so as to reduce the incidence of liver cancer and the proportion for intermediate-to-advanced stage liver cancer; continue to try our best in the full course management of liver cancer under the frame of MDT.
Objective To investigate the effectiveness of personalized treatment based on Hua Xi-knee dislocation and multiple ligament injury (HX-KDMLI) diagnosis and treatment system. Methods A clinical data of 36 patients (36 knees) with KDMLI met the selective criteria between February 2019 and September 2020 was retrospectively analyzed. There were 24 males and 12 females with an average age of 45.7 years (range, 21-62 years). The KDMLI was caused by traffic accident in 15 cases, heavy pound in 8 cases, sports sprain in 7 cases, falling from height in 4 cases, and machine cutting in 2 cases. The interval between injury and operation was 1-9 weeks (mean, 3.6 weeks). All patients were categorized according to HX-KDMLI diagnosis and treatment system. Twenty patients were categorized as acute period and 16 patients as chronic period. Three patients were type HX-Ⅰ-A, 1 type HX-Ⅰ-P, 10 type HX-Ⅲ-L, 13 type HX-Ⅲ-M, 4 type HX-Ⅳ-S, 3 type HX-Ⅴ-F, and 2 type HX-Ⅴ-T. Thirty-five patients were positive in both the anterior drawer test and Lachman test, 31 were positive in the posterior drawer test; 19 patients were positive in varus stress test, 23 were positive in valgus stress test. According to the Internation Knee Documentation Committee (IKDC) grading, there was 1 case of grade A, 5 cases of grade B, 8 cases of grade C, and 2 cases of grade D. Surgical interventions included arthroscopic surgery, open surgery, or arthroscopy combined with open surgery, ligament suture or reconstruction, and internal fixation after anatomical reduction of the fracture. Different rehabilitation protocols were assigned to patients during different postoperative period, according to patient’s individualized classification. ResultsAll incisions healed by first intention with no obvious complications. All patients were followed up 12-19 months (mean, 15 months). At 12 months after operation, all patients retained muscle strength of grade Ⅴ, and range of motion of the knee joint could reach 0° extension and over 120° flexion. Radiographic examination showed no sign of knee instability, healed fractures, ideal joint alignment, good continuity and tension, and clear image of repaired or reconstructed ligaments. The anterior and posterior drawer tests were all negative. Lachman test was degreeⅠpositive in 5 cases, valgus stress test was degreeⅠpositive in 2 cases, varus stress test was degreeⅠpositive in 2 cases; the other patients were all negative. At 12 months after operation, according to the IKDC grading, there were 9 cases of grade A, 19 cases of grade B, 5 cases of grade C, and 3 cases of grade D, showing significant differences when compared with the preoperative ones (Z=–5.328, P=0.000). There were significant differences in the IKDC, Lysholm, and Tegner scores between pre- and post-operation (P<0.05). ConclusionThe promising effectiveness of KDMLI can obtain under the guidance of HX-KDMLI.
Objective To explore the modality of multi-disciplinary team (MDT) applied in surgical treatment of the colorectal cancer. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of colorectal cancer in recent years were collected and reviewed. Results The modality of MDT in surgical treatment of the colorectal cancer is still in the primary stage. Conclusion There are lots of problem of this modality such as construction and collaborative needed more research.
Objective To investigate the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome (PJS) in Chinese cases. Methods The clinical and pathological data of 295 patients with PJS who were treated in Air Force General Hospital from Nov. 1994 to Aug. 2017 were retrospectively analyzed and a multifactor statistical study was carried out on. Results Two hundreds and ninety-five patients with PJS belonged to 7 nationalities and came from 26 provinces and urban areas. 99.0% (292/295) of the patients had black spots on the lip and buccal mucosa, and the median occurrence time was 2 years old (0–33 years). The median age of inital diagnosis and treatment was 15 years old (1–45 years). The median interval time between the occurrence of black spots and abdominal symptoms was about 10 years (0–45 years). PJS hamartoma polyps were found in alimentary canals of 293 patients (99.3%), and 96.9% distributed in the duodenum and small intestine (n=284), 90.4% distributed in the colorectal (n=265), 79.9% distributed in the stomach (n=234). Patients of black spot appearing at age <3 years and (or) initial treatment at age <14 years were classified as early-onset subtype, otherwise they could be included in delayed-onset subtype. Conclusions The clinical features of PJS are prominent and the harm of PJS hamartoma polyps is serious. The black spots on the lip and buccal mucosa can be used as an early warning signal to divide the PJS patients into 2 clinical subtypes, which should be differentiated in clinical therapy and follow-up strategy.
ObjectiveTo explore the clinical treatment measures and etiology analysis of lower urinary tract and penile foreign bodies. MethodsWe retrospectively analyzed the etiology and diagnosis of 48 cases of lower urinary tract and penile foreign body in the Department of Urology of our hospital between 1993 and 2012. ResultsNine bladder foreign bodies were removed successfully by using cystoscopy; nine were removed through suprapubic cystotomy; urethral foreign bodies in 10 patients were successfully taken out by urethrascope; five foreign bodies were extracted by hand and forceps; rubber bands in 2 patients were cut off under local anesthesia; fretsaw was used to cut through the nested rings in 7 patients; dental drill was used to cut nesting materials in 3 patients; and 3 patients underwent penis skin circumcision overturn stripping ring extraction. No complications after urethral foreign body extraction occurred. ConclusionThe lower urinary tract and penile foreign bodies are easy to diagnose, but patients often conceal the etiology, so the natural history collection is very important in the diagnosis, and doctors should take appropriate methods to remove the foreign body after the diagnosis is confirmed.
This paper tried to address how to apply the relative concepts and methods of evidence-based medicine in clinical practice of cardiology, especially in diagnosis and treatment, with an aim to promote the cardiovascular evidence-based medicine in China.