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Hepatocellular carcinoma (HCC) is characterized by a low resection rate and a high postoperative recurrence rate. Conversion therapy and neoadjuvant therapy are effective stra-tegies to improve the long-term prognosis of patients with HCC. With the clinical application of new technologies and methods and the continuous emergence of new anti-tumor drugs, the conversion therapy and neoadjuvant therapy of HCC have ushered in an unprecedented development. At the same time, they are also facing many new challenges. Based on our own clinical experience and the latest progress in conversion therapy and neoadjuvant therapy of HCC, the authors classify and summarize the selection of treatment strategies and the challenges faced in HCC conversion therapy and neoadjuvant therapy.
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Objective:To investigate the efficacy and safety of comprehensive therapy in the treatment of advanced unresectable hepatocellular carcinoma.Methods:Clinical data of 34 patients with primary liver cancer admitted to Peking Union Medical College Hospital from Nov 2018 to Dec 2020 initially evaluated as unresectable were treated firstly by combined therapy and then underwent reevaluation for further management.Results:A total of 34 patients completed the integrative treatment, and no serious adverse events occurred. Among them, 6 patients were evaluated as partial remission, and underwent successful tumor resection, tumors in 7 patients were stable, and 21 patients suffered from disease progression.Conclusion:After comprehensive therapy, unresectable tumors in some patients could reduce and be rendered resection.
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Objective:To evaluate the efficacy of modified Xiaoji Baozhong granules combined with scraping in the treatment of abdominal obesity with gastric heat and dampness syndrome and its effect on adipocytokines. Method:One hundred and forty-four patients were randomly divided into the control group and the observation group， 72 cases in each group. The lifestyle adjustments were conducted in both groups. The observation group was given a comprehensive traditional Chinese medicine regimen of modified Xiaoji Baozhong granules combined with scraping. The control group was given modified Xiaoji Baozhong granules combined with scraping. The course of treatment was three months. The body mass index （BMI）， body fat percentage （FP）， waist circumference （WC）， waist to hip ratio （WHR）， obesity and abdominal fat thickness of the two groups were compared before and after treatment. The levels of fasting blood glucose （FBG）， insulin resistance index （HOMA-IR）， high density lipoprotein （HDL）， low density lipoprotein （LDL）， triglyceride （TG）， total cholesterol （TC）， adiponectin， leptin， resistin， endolipid and tumor necrosis factor-α （TNF-α） were compared between the two groups before and after treatment. The clinical efficacy and safety were evaluated. Result:After treatment， the BMI， FP， obesity， WC and WHR of the observation group were lower than those of the control group （<italic>P</italic><0.01）. After treatment， the abdominal wall fat thickness and intra-abdominal fat thickness of patients in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The FBG， HOMA-IR， TG， TC and LDL of the observation group were lower than those of the control group （<italic>P</italic><0.01）， while the HDL level was higher than the control group （<italic>P</italic><0.01）. Adiponectin in the observation group was higher than the control group after treatment （<italic>P</italic><0.01）. The leptin， resistin， visfatin and TNF-α were lower than those in the control group （<italic>P</italic><0.01）. The total clinical efficacy rate of patients in the observation group was 88.24% （60/68）， which was better than 73.53% （50/68） in the control group （<italic>χ</italic><sup>2</sup>=4.755， <italic>P</italic><0.05）. Conclusion:In addition to lifestyle adjustments， modified Xiaoji Baozhong granules combined with scraping treatment can reduce the degree of obesity and fat thickness in patients with abdominal obesity， and regulate lipid， carbohydrate metabolism and adipocytokines， with a better clinical efficacy than simple scraping therapy and the safety in practice.
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A 69-year old man presented with high-risk metastatic prostate cancer. After 7 months of androgen deprivation therapy (ADT), he progressed to metastatic castration resistant prostate cancer. We suggested him comprehensive therapy, including Abiraterone, chemo-therapy, radio-therapy, platinum chemo-therapy and Enzalutamide, which proved effective with his long term survival.
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The article examines the influence of the Biologically Active Dietary Supplement (BADS) "Oleopren Hepa" as a hepatoprotective effect in the comprehensive treatment of acute alcoholic hepatitis. During the study, the authors obtained evidence of the effectiveness and functional orientation of the BADS. The materials for the research are the data obtained during the examination and treatment of 60 patients with acute alcoholic hepatitis. All examined patients were divided into 2 groups: 1st group (main), which received dietary supplements; the 2nd group (control) who did not receive this supplement. The average age of patients was 38.7 ± 9.3 years. The study was carried out based on the gastroenterological department of the city clinical hospital. As a result of the use of BADS in the comprehensive therapy of patients with acute alcoholic hepatitis, hepatomegaly was significantly reduced, and a decrease in the levels of total bilirubin, AsAt, AlAT, GGTP and cholesterol was observed. Additional intake of a specialized product enhanced the hepatoprotective effect of the main treatment. According to the tested biochemical parameters, the dynamics were better than in the control group. The use of the BADS, in addition to comprehensive therapy, increases the effectiveness of treatment of acute alcoholic hepatitis.
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Humans , Middle Aged , Dietary Supplements , Hepatoprotector Drugs , Hepatitis, Alcoholic/therapy , Hepatomegaly/therapyABSTRACT
@#AIM: To analyze the therapeutic effects of comprehensive amblyopia therapy in 715 eyes of children.<p>METHODS: Three hundred and nineteen-three cases(715 eyes)of amblyopia were included in this study, who were diagnosed and treated in our hospital from July 2015 to July 2017. The amblyopia treatment file was established, and the therapeutic effect of amblyopia comprehensive therapy was observed. The relationship between age, amblyopia type, amblyopia degree, treatment compliance and fixation were analyzed.<p>RESULTS: Totally 393 children(715 eyes), 520 eyes(72.7%)were basically cured, 117 eyes(16.4%)were progressive, and 78 eyes(10.9%)were ineffective. The total effective rate was 89.1%. The age, amblyopia type, amblyopia degree, fixation and treatment compliance were related with the therapeutic effect of amblyopia respectly.<p>CONCLUSION:The overall treatment effect of amblyopia in children is better. It is closely related to the clinical characteristics included age, amblyopia type, amblyopia degree, fixation and treatment compliance. The treatment effect was poor in children with older age, amblyopia type of aberrant amblyopia, strabismus amblyopia, severe amblyopia, paracentric fixation and poor compliance.
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@#AIM: To research the clinical effects of visual display terminal(VDT)syndrome after local treatment near the eyes in combination with systemic comprehensive treatment.<p>METHODS: Totally 62 patients(124 eyes)with VDT syndrome were randomly divided into a trial group and a control group, 31 cases(62 eyes)in each group. In the control group, artificial tears as eye drops were given. In addition to the above local treatment with artificial tears, the trial group was also treated with the auricular acupressure and tuina at the acupoints near orbits and the whole body. A health education was carried out in both of the two groups. The course of the treatment of the two groups was 2wk. The symptomatic scores, and the amplitude of accommodation, facility of accommodation, accommodative response, near point of convergence and the ratio of accommodative convergence to accommodation(AC/A)based on refractive error correction of all the patients were detected before and after the treatment. The parameters gained before and after the treatment were compared for evaluating efficacy. <p>RESULTS: After treatment, the symptomatic scores and facility of accommodation of the two groups were significantly improved compared with those before treatment(<i>P</i><0.05). Amplitude of accommodation and near point of convergence in the trial group were significantly improved after treatment(<i>P</i><0.05). <p>CONCLUSION: Local treatment near the eyes in combination with systemic comprehensive treatment can effectively improve the accommodative and convergent functions of patients with VDT syndrome, and relieve their symptoms of asthenopia and fatigue.
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In recent years,immunotherapy has become an important part of the treatment for advanced non-small cell lung cancer (NSCLC).Tumor cells can escape from the body's immune system by mediating various immune escape mechanisms,among which programmed death-1/programmed death ligand-1 (PD-1/ PD-L1) mediated immune escape plays an important role.Currently,chemotherapy,radiotherapy and molecular targeted therapy have certain limitations in the treatment of advanced NSCLC.Recent studies have found that the combined application of PD-1/PD-L1 inhibitor and other treatment methods has certain synergistic effect,thus enhances the anti-tumor effect and further prolongs the survival of patients.Immunotherapy brings not only changes in the treatment patterns of NSCLC,but also challenges in the screening of target population and the management of treatment-related adverse reactions.Summarizing the research progress on immune checkpoint inhibitors in the comprehensive treatment of advanced NSCLC can provide reference for the best treatment of NSCLC.
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Esophagogastric junction (EGJ) tumor involves thoracic and celiac cavities due to special lesion location,and its epidemiology and clinical characteristics are different from that of esophageal cancer and gastric cancer.There are many controversies on the etiology,location,staging and surgical treatment of EGJ tumor in the digestive surgery field.Surgical resection is a core method for EGJ tumor,but different surgical procedures are much controverted between thoracic surgery and abdominal surgery.Authors updated the cognition of EGJ tumor and summarized the research progress of surgical treatment through reviewing the recent literatures.
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Acute pancreatitis (AP) is a common clinical acute abdominal disease.To further improve its overall cure rate,severe acute pancreatitis (SAP) should be paid more attention.In early inflammatory reaction period of SAP,comprehensive treatment in ICU should be strengthened,including adequate fluid resuscitation,early viscera function protection,effective nutritional support and dealing with abdominal compartment syndrome.Surgeons should be responsible in the treatment of infection period of SAP,and seize the timing of surgical intervention correctly.Pluralistic debridement model should be set up,which is mainly based on "step-up" strategy and combined with minimally invasive and multi-disciplinary.In addition,late complications of SAP should be prevented and treated with caution when they occur.The whole SAP treatment system should be based on the multi-disciplinary team (MDT),which requires fully cooperation of each department.Moreover,medical unions at different levels should be established to realize prompt network consultation or referral.In this way,case fatality rate of SAP can be reduced and overall cure rate of AP can be improved,thus benefiting the patients to the maximum extent.
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<p><b>OBJECTIVE</b>To observe the effect differences among the comprehensive therapy, acupuncture and oral mecobalamine for senile sensorineural hearing loss.</p><p><b>METHODS</b>A total of 126 senile sensorineural hearing loss patients were randomized into a comprehensive group, an acupuncture group and a western medication group, 42 cases in each group. After removing and discontinuing cases, 40 cases in each group were included in the analysis. Acupuncture, acupoint injection and auricular point pressing were used in the comprehensive group. Acupuncture for 2 courses was at the affected Tinggong (SI 19), Tinghui (GB 2), Yifeng (TE 17), etc, once every other day, 10 times as a course with one week rest between 2 courses, 3 times a week. Acupuncture as the comprehensive group was applied in the acupuncture group. Mecobalamin tablet was prescribed orally for 2 courses in the western medication group, 3 times a day, 0.5 mg a time, 3 weeks as a course, one week at the interval. Pure tone hearing threshold value and tinnitus grading were observed before and after intervention in the three groups. The clinical effects were compared.</p><p><b>RESULTS</b>After treatment, pure tone hearing threshold value and tinnitus grading were better than those before treatment in the three groups (all <0.05), with better results in the comprehensive group than those in the other two groups (all <0.05). The total effective rate of pure tone hearing threshold value was 82.5% (33/40) in the comprehensive group, which was superior to 67.0% (27/40) in the acupuncture group and 62.5% (25/40) in the western medication group (both <0.05). The total effective rate of tinnitus was 83.3% (30/36) in the comprehensive group, which was superior to 69.7% (23/33) in the acupuncture group and 57.1% (20/35) in the western medication group (both <0.05).</p><p><b>CONCLUSION</b>The clinical effects of comprehensive therapy on senile sensorineural hearing loss are superior to those of simple acupuncture and oral administration of mecobalamin in terms of pure tone hearing threshold value and tinnitus grading.</p>
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Depression is a common mood disorder, with a high incidence and prevalence, while the overall diagnosis and treatment rate are low.Even if patients attained the initial clinical cure, there is still a high risk of depression recurrence, of which a great part may turn into self-mutilation or even suicide.Taking antidepressants as the most preferred treatment of moderate and major depression is recommended by almost all clinical treatment guidelines at home and abroad currently.At the same time, the concept of depression treatment is changing gradually from the initial single-mode drug therapy for symptom control to a comprehensive, individualized, quantitative treatment model. Promising psychological treatment, physical therapy and other alternative and complementary treatments are developing quickly.
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Objective:To investigate the clinical efficacy of levodopa combined comprehensive therapy on the children with ametropic amblyopia.Methods:One hundred three patients (180 eyes) with ametropic amblyopia admitted into our hospital from April 2013 to March 2016 were randomly divided into the control group and the study group.Fifty-two patients (90 eyes) in the control group were treated with comprehensive therapy,and fifty-one patients (90 eyes) in study group were treated with levodopa combined comprehensive therapy.After six months of treatment,the treatment efficacy,pattern visual evoked potential (P-VEP),visual sensitivity,and visual function of patients were observed and compared between the two groups,and the adverse reaction were recorded and compared.Results:At six months after treatment,the effective rate of study group was 90.00％,which was significantly higher than that of control group (68.89％,P＜0.05).The wave amplitude ofP-VEP Pl00 of both groups showed a remarkable increase,which was much higher in the study group (P＜0.05);the incubation period in both groups were obviously decreased,while they were markedly lower in the study group (P＜0.05).The visual acuity under 100％,25％,10％ and 5％ of spatial frequency were conspicuously higher than those of control group (P＜0.05).And correction convergence range,and correction separation range in study group were much higher than those of control group,and corrected near stereo vision was markedly lower than that of control group (P＜0.05).Additionally,no significant difference was found in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Levodopa combined comprehensive therapy had a good ability of improving function of visual central neurons,visual acuity and binocular stereo vision functions.
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Objective To observe the clinical efficacy of comprehensive acupuncture therapy in treating tinnitus in elderly neurosensory deafness. Method Eighty elderly neurosensory deafness patients were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by oral administration of Mecobalamin tablets, and the treatment group was intervened by acupuncture plus acupoint injection plus auricular point sticking. The changes of tinnitus intensity after the treatment in the two groups were observed, the clinical efficacies were compared between the two groups, and the correlation between disease duration and therapeutic efficacy was also observed. Result The tinnitus degree was significantly changed after the treatment in both groups (P 3 years in the same groups (P <0.05). Conclusion Comprehensive acupuncture therapy is an effective method in improving tinnitus in elderly neurosensory deafness.
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Objective To evaluate comprehensive therapy in the treatment of keloid effect and the patients' satisfaction.Methods From 2002 to 2015,a total of 523 patients with comprehensive treatment,according to the treatment the patients were divided into group A (surgery combined radiotherapy group) and group B (operation with corticosteroid hormone therapy group),group C (corticosteroids in combination with radiotherapy group),and the therapeutic effect of patients with satisfaction was evaluate.Results Total effective rate of three groups of patients were 85.7％,84.0％,64.9％;the efficiency in group A was higher than that of group B and group C;there was statistically significant difference between group A and C (P＜0.05),but there were no significant difference between the group A and group B (P＞0.05).All the patients were follow up for one years and the adverse reaction in the three groups was slight and happened in the 2 month after cure.And the adverse reaction was all self-cure in the final follow up.Difference was statistically significant between three groups of patients' satisfaction,group B better than in group A and group C;there was no significant difference between group A and group B (P＞0.05);the difference between group B and C group was statistically significant (P＜0.05).Conclusions Three kinds of comprehensive therapy effect are obvious,among which surgical adjuvant radiotherapy effect is best,being worth to recommend for clinical use.
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Depression is a common mood disorder, with a high incidence and prevalence, while the overall diagnosis and treatment rate are low.Even if patients attained the initial clinical cure, there is still a high risk of depression recurrence, of which a great part may turn into self-mutilation or even suicide.Taking antidepressants as the most preferred treatment of moderate and major depression is recommended by almost all clinical treatment guidelines at home and abroad currently.At the same time, the concept of depression treatment is changing gradually from the initial single-mode drug therapy for symptom control to a comprehensive, individualized, quantitative treatment model. Promising psychological treatment, physical therapy and other alternative and complementary treatments are developing quickly.
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OBJECTIVE:To investigate the clinical efficacy of levodopa combined with comprehensive therapy for ametropic amblyopia children and teenagers and its effeets on pattern visual evoked potential(P-VEP)and visual function. METHODS:70 pa-tients(80 eyes)with ametropic amblyopia were randomly divided into observation group(35 cases,40 eyes)and control group(35 cases,38 eyes). Control group received comprehensive therapy as wearing correctional glasses,occlusion therapy and visual stimu-lation training;observation group additionally received levodopa 0.125(d1-3)-0.25 g/time,bid,on the basis of control group for 6 months. Therapeutic efficacy,P-VEP,Visual sensitivity and visual function were compared between two groups,and the occur-rence of ADR was recorded. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of con-trol group(76.32%),with statistical significance(P0.05). CONCLUSIONS:Levodopa combined with comprehensive therapy can improve the function of visual central neurons,and improve visual acuity and binocular stereo vision functions so as to improve therapy efficacy.
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OBJECTIVE:To investigate the prognosis of coronary heart disease complicated with heart failure patients abandon-ing percutaneous coronary intervention (PCI) and receiving drug comprehensive therapy. METHODS:From Dec. 2010 to Jul. 2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group (105 cases) and non-operation group (112 cases). Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography re-checking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovas-cular events were recorded during follow-up period. RESULTS:7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction, heart failure and death in non-operation group was more than operation group,with statistical significance (P<0.05). 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance(P<0.05). The survival time of non-operation group was shorter than that of operation group,with statistical significance(P<0.05). CONCLUSIONS:Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.
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AIM:To explore the effect of comprehensive therapy in the treatment of fungal corneal ulcer and clinical outcome. METHODS:A total of 159 cases 159 eyes fungal corneal ulcer patients took comprehensive therapy of 10 measures, followed up more than 3mo to observe the treatment effect and the final visual acuity in our hospital for treatment. RESULTS: The average hospitalization time of fungal corneal ulcer was(12. 11±5. 13) d. A total of 148 cases of 148 eyes were cured, and the cure rate was 93. 1%;improvement in 8 cases, accounted for 5. 0%; 3 cases were ineffective, accounted for 1. 9%. The final visual acuity of 89 eyes ≥0. 3, accounted for 56. 0%(89/159). The final visual acuity of 136 eyes ≥0. 1, accounting for 85. 5%(136/159), and accounting for 91. 9% in 148 cured patients. CONCLUSION: The comprehensive therapy in the treatment of fungal corneal ulcer has higher cure rate and visual acuity.
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OBJECTIVE: To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. METHODS: By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups: the control group( n = 58) and the treatment group( n = 58). Subjects in the control group were given vitamin B_(12) and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy( infraredtherapy,microwave irradiation therapy),Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. RESULTS: Before treatment,no significant differences( P > 0. 05) were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency( MDL),motor nerve conduction velocity( MCV),sense nerve conduction velocity( SCV) of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators( P < 0. 05),with larger extend of improvement noted in the treatment group than in the control group( P < 0. 05). No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group( P < 0. 05). CONCLUSION: The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.