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Objective:To investigate the feasibility and clinical efficacy of laparoscopic radical cholecystectomy(LRC) for gallbladder cancer.Methods:The clinical data of 247 patients with gallbladder cancer who underwent radical resection from Jan 2013 to Dec 2019 at Department of General Surgery, Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine was analyzed retrospectively. After propensity score matching, 54 patients were included in laparoscopic group and 103 in laparotomy group. The clinicopathological characteristics and the short- and long-term outcomes were compared.Results:Compared to the laparotomy group, patients in the laparoscopic group had less intraoperative blood loss [100(50,200)ml vs. 200(100,300) ml, Z=4.105, P<0.001], earlier postoperative oral diet[1.0(1.0,2.0) d vs. 2.0(1.0,4.0) d, Z=4.157, P<0.001]and drainage removal[6.5(4.0,12.5) d vs. 9.0(6.0,16.0) d, Z=2.769, P=0.006], shorter hospital stay[7.0(5.0,9.3) d vs. 9.0(8.0,14.0) d, Z=3.923, P<0.001]. The number of lymph node dissection in laparoscopic group was significantly lesser than that in open group [6(4,9) vs. 8(5,12), Z=2.639, P=0.008]. There were no significant differences between the two groups in postoperative complications, short-term and long-term survival outcomes. Conclusions:Laparoscopic radical surgery for gallbladder cancer is as safe and feasible, and identical survival prognosis as open surgery, and moreover a less traumatic procedure.
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Objective:To explore the effect of International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) framed oral motor therapy combined with acupoint massage intervention on children with cerebral palsy swallowing disorder.Methods:From September 2018 to September 2019, 80 children with cerebral palsy accompanied by dysphagia who were diagnosed and treated in the Department of Neurological Rehabilitation of our hospital were selected as the study subjects, and were divided into the experimental group (40 cases) and the control group (40 cases) by random number table method. A total of 76 patients completed the study. On the basis of routine swallowing training and oral movement intervention, the experimental group was comprehensively evaluated from the aspects of body function and structure, activity and participation, and environmental factors with ICF-CY theory as the framework, and was given oral and facial acupoint massage for 12 weeks. The control group was given conventional swallowing training and oral exercise intervention for 12 weeks. The modified water swallow test was used to evaluate the effect of improving swallowing disorder in two groups of children after 12 weeks of intervention. The improvement of oral motor function in two groups of children after 4 and 12 weeks of intervention was evaluated by using the Grading Criteria for Evaluation of Oral Motor Function.Results:After 12 weeks of intervention, the total effective rate of swallowing disorder improvement in the experimental group and the control group were 89.47% (34/38) and 63.16% (24/38), respectively, and the difference between the two groups was statistically significant ( χ2 value was 7.28, P<0.05). After 4 and 12 weeks of intervention, the functional scores of oral motors in the experimental group were (67.13±2.35) and (82.08±2.33) points, respectively, which were higher than those of the control group at the same time (56.16±2.57) and (65.63±2.54) points, and the differences were statistically significant ( t values were -3.320, -4.433 P<0.05). After 4 and 12 weeks of intervention, the children's functional scores of oral motors in each group were higher than those in each group before intervention. Compared with the group before intervention, t values of the experimental group were -5.377 and -5.376; t values of the control group were -10.715 and -17.486; compared to the group with 4-week intervention, t value of the experimental group was -12.732; t value of the control group was -13.281, all the differences were statistically significant (P<0.05). The results of repeated measures analysis of variance showed that the time effect, grouping effect, and the interaction between time effect and grouping effect of functional scores of oral motors were statistically significant ( F values were 426.780, 9.084, 26.538, P < 0.05). Conclusions:Oral motor therapy combined with acupoint massage based on ICF-CY framework can effectively promotes the recovery and reconstruction of mouth perception and motor function in children with cerebral palsy, significantly improves the children's dysphagia and their ability to actively participate in feeding.
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Objective@#To explore the effect of mouth muscle training game on salivation cerebral palsy children.@*Methods@#Sixty-eight children with cerebral palsy combined with salivation were randomly divided into experimental group and control group, with 34 cases in each group. The control group received routine rehabilitation treatment, while the experimental group performed oral muscle training game on the basis of the control group. Both the two groups were assessed by teacher salivation grading (TDS) and oral motor function assessment grading standards before and 8 weeks after intervention for salivation and oral motor function of cerebral palsy children.@*Results@#After 8 weeks of intervention, there were 30 children with grade III-V salivation turned to grade I-IV in the experimental group, and 21 children with grade III-V salivation turned to grade I-IV in the control group, with the total effective rate of TDS of 88.2%(30/34) and 61.8%(21/34), respectively, and there was statistically difference (χ2= 5.02, P<0.05). The score of oral transport function in the experimental group was 87.68±12.93, which was higher than that of 76.53±10.92 in the control group, and there was statistically differences (t=3.841, P<0.01).@*Conclusions@#Oral muscle training games can stimulate self-exploration and training for oral movement of cerebral palsy children, so as to improve the range, flexibility and strength of the jaw, lip and tongue movement, and promote the self-control of swallowing of saliva, reduce the salivation and improve the quality of life.
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Objective To explore the effect of mouth muscle training game on salivation cerebral palsy children. Methods Sixty-eight children with cerebral palsy combined with salivation were randomly divided into experimental group and control group, with 34 cases in each group. The control group received routine rehabilitation treatment, while the experimental group performed oral muscle training game on the basis of the control group. Both the two groups were assessed by teacher salivation grading (TDS) and oral motor function assessment grading standards before and 8 weeks after intervention for salivation and oral motor function of cerebral palsy children. Results After 8 weeks of intervention, there were 30 children with grade III-V salivation turned to grade I-IV in the experimental group, and 21 children with grade III-V salivation turned to grade I-IV in the control group, with the total effective rate of TDS of 88.2%(30/34) and 61.8%(21/34), respectively, and there was statistically difference (χ2=5.02, P＜0.05). The score of oral transport function in the experimental group was 87.68±12.93, which was higher than that of 76.53±10.92 in the control group, and there was statistically differences (t=3.841, P＜0.01). Conclusions Oral muscle training games can stimulate self-exploration and training for oral movement of cerebral palsy children, so as to improve the range, flexibility and strength of the jaw, lip and tongue movement, and promote the self-control of swallowing of saliva, reduce the salivation and improve the quality of life.
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Objective To estimate the averaged excess relative risk(ERR) in Chinese population based on the radiogenic cancer risk of leukemia in Japanese atomic bomb survivor cohort,and to discuss proper method suitable for risk transfer between populations.Methods Based on BEIR Ⅶ radiogenic cancer model and population transfer model,and the 2009 Chinese leukemia baseline rates given in 2012 Chinese Cancer Registry Annual Report,comparison was made of population incidences in seveal countries to adjust the weighting factors.Results The ERR of three subtypes of leukemia as a whole was obtained,and the weighting factors for risk transfer model was assumed.The additive factor for male was 0.2,and the multiplicative factor was 0.8,while the additive factor for female was 0.15,and the multiplicative factor was 0.85.Conclusions For the risk transfer between populations,weighting factor was adjusted as a whole to obtain the ERR value for estimating the risk to Chinese population.The risk transfer method suitable for Chinese population was obtained by using the incidence rate available for Chinese population to directly transfer radiation-induced leukemia risk to Chinese from Japanese.
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Objective To estimate the excess relative risk coefficients of stomach cancer for Chinese population attributable to ionizing radiation.Methods The excess relative risk and excess absolute risk coefficients of stomach cancer were estimated based on Life Span Study by using risk models developed by BEIR Ⅶ committee (Biological Effect of Ionizing Radiation).Guided by transportation methods from Life Span Study to Americans,we determined that transportation method for Chinese population includes both multiplicative and additive models with a weight of 0.7 and 0.3 respectively,on an arithmetic scale.Besides,curve fitting was used to obtain sex-age-specific stomach cancer baseline incidence based on Chinese cancer annual report.Then,Chinese excess relative risk coefficients of stomach cancer were obtained by substituting excess relative risk,excess absolute risk of Life Span Study and Chinese baseline incidence rate into risk transportation model.Results Excess relative risk coefficients of stomach cancer for Chinese population are 0.26/Sv for male and 0.64/Sv for female,whose exposure age is 30 years old and cancer age is 60 years old.Coefficients increase with decreased exposure age and cancer age.Conclusions Excess relative risk coefficients of stomach cancer for Chinese population are by larger higher than that of Life Span Study,and their sex-age tendency are similar.
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Objective To explore the value of somatosensory cortex evoked potential(CSEP)monitoring in objective evaluation of spinal cord function and integrity as well as prognostication of neural function after surgery.Methods CSEP monitoring was performed before the operation,during surgical procedure and after the operation in 56 spinal cord surgery patients to observe and analyze latency and amplitude of cortical potential.The significant changes were amplitude reduction≥150%or latency prolongation≥10%.Results There were 71.43%(40/56)true negative finding,both latency and amplitude without abnormal changes during the operation and without new neural functional deficit after operation.There was 0.18%(1/56)false negative finding,latency and amplitude without abnormal changes during surgical procedure,but with new neural functional deficit after operation.There were 26.79%(15/56)true positive findings,where latency transient prolongation<10%and amplitude reduction<50%during surgical procedure were observed.After suspending procedure or changing direction during surgical procedure,the waveform restored or improved.Conclusion CSEP monitoring during surgical procedure could reflect the sensitiveness to distracting,ischemia and injury of spinal cord.A timely intervention might improve the CSEP.CSEP could reflect the function and integrity of spinal cord.CSEP possess an important value in preventing spinal cord injury and evaluating the prognosis of neural function.
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Sishencong (Ex-HN 1), Niesanzhen, Shenting (GV 24), Benshen (GB 13), Naohu (GV 17), Naokong (GB 19), Quchi (LI 11), Hegu (LI 4), Biguan (ST 31),Zusanli (ST 36), Zuyunganqu (Foot-Motor-Sensory area),Yundongqu (Motor area), Pinghengqu (Equilibrium area),Shousanli (LI 10), Sanjian (LI 3), Huantiao (GB 30) and Yanglingquan (GB 34) were needled in combination with Vojta and Bobath methods to treat 45 children with cerebral palsy. Results showed that 12 cases got marked effectiveness, 22 cases got effectiveness and 11 cases failed.
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Objective To investigate the value of electroencephalogram(EEG), transcranial Doppler sonography (TCD), somatosensory evoked potentials (SEP) on evaluating brain function in coma patients. Methods The brain function in 72 cases of coma(mild coma 12,moderate coma 17,open eyes coma 4 and severe coma 39 cases) were examined using EEG,SEP ,TCD and scored. Results For the first time of exam, the results of EEG in 25 cases were electrical silence; no blood stream signalthe were found in 28 cases by TCD; the wave of P14 were disappeared in 26 cases by SEP and all of them belonged to severe coma group. For the second time exam, the results of finally EEG in 17 cases were electrical silence. The results of TCD in other 24 cases were surge waves and nail waves spectra eumorphism. Brain function grading: the EEG grade V in 42 cases, grade Ⅳ in 10 cases, grade Ⅲ in 14 cases were affirmed; TCD grade V in 28 cases, grade Ⅳ in 9 cases and SEP grade Ⅲ in 27 cases were affirmed. All the 28 cases of death and the most of 25 cases abandoned treatment for many reasons were belong to severe coma group. Conclusions The more severe of coma, the higher grade of EEG,TCD and SEP, the worse of prognosis. EEG,SEP,TCD testing can provide an objective indicator not only for evaluating brain function of coma patients, but aslo for estimating prognosis.