[Research of TCM synthetic rehabilitation on the recovery of wrist joint after distal radius fractures].

OBJECTIVE: To evaluate efficacy and advantages of the Traditional Chinese Medicine (TCM) synthetic rehabilitation therapy in the treatment of wrist dysfunction after distal radius fractures. METHODS: From May 2014 to October 2015, 72 patients with distal radius fracture meeting standards were treated using central randomization system for clinical research. All the patients were divided into two groups: 36 patients in test group and 36 in control group. Sixty-nine cases were finished treatment and followed up in the end. The test group fell off 1 case, and the control group fell off 2 cases. The test group was given TCM synthetic rehabilitation (manipulative therapy, joint mobilization, soaking-washing with Chinese medicinal herbs, functional exercise), and the control group was given functional exercise as well as soaking-washing with Chinese medicinal herbs, 3 weeks for both. Five evaluation standards were used in this research, which were grip strength, patient-rated wrist evaluation (PRWE), Gartland and Werley wrist score, self-rating anxiety scale(SAS) and the overall curative effect evaluation. Before treatment(baseline), after 3 weeks of treatment and 3 months after fracture were the three points in time when collected the data. RESULTS: After 3 weeks of treatment and 3 months after fracture, the test group had a significantly better results than those of control group in the PRWE, G-W wrist score and the overall curative effect evaluation(P<0.05). In terms of grip strength recovery, after 3 weeks of treatment, the intergroup difference between the test group and the control group were statistically significant relative to the baseline regarding grip strength of ipsilateral wrist by group t-test(P<0.05). However, the test group and the control group had no statistically significant relative to the baseline at 3 months after fracture in grip strength(P<0.05). For the anxiety of patients, compared with the test group and control group at before and after rehabilitation treatment, the anxiety of both test group and control group cases was eased(P<0.05). However, The degree of anxiety relief in test group and control group cases had no difference(P>0.05). CONCLUSIONS: The TCM synthetic rehabilitation therapy has better curative effects on the treatment of functional disability of wrist joints after distal radius fractures than the general therapy of soaking-washing with Chinese medicinal herbs and functional exercise.

Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients with obstructive jaundice.

BACKGROUND: Nonsurgical pathologic diagnosis of malignant bile duct stricture with a high sensitivity and specificity is desirable for therapeutic scheme. Percutaneous transhepatic endobiliary brush cytology in detecting obstructive jaundice is evaluated. METHODS: Fifty-eight consecutive patients with obstructive jaundice underwent percutaneous transhepatic cholangiodrainage (PTCD). During the process, a brush was inserted into the bile duct through the preexisted percutaneous transhepatic 8-F sheath, then exfoliated cells were collected from the bile duct stenosis and sent for cytologic diagnosis. The suspicious results were considered of negative diagnosis. All patients had relevant clinical data and follow-up results (15 months to 3 years). Statistical analysis was performed with the chi-square test and Fisher's exact test of probabilities, and a P value0.05). CONCLUSION: The results of this study indicate that cytological brushing of biliary stricture during PTCD is a useful method to establish a diagnosis of malignant biliary stenosis with a high sensitivity, but the negative predictive value is not satisfied.