Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection.Therefore,we review some prognostic scoring systems and their outcomes.Articles with combinations of two ...Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection.Therefore,we review some prognostic scoring systems and their outcomes.Articles with combinations of two keywords among"metastatic spine tumor"and"prognosis","score","scoring system","predicting",or"life expectancy"were searched for in Pub Med.As a result,236 articles were extracted.Those referring to representative scoring systems about predicting the survival of patients with metastatic spine tumors were used.The significance and limits of these scoring systems,and the future perspectives were described.Tokuhashi score,Tomita score,Baur score,Linden score,Rades score,and Katagiri score were introduced.They are all scoring systems prepared by combining factors that affect prognosis.The primary site of cancer and visceral metastasis were common factors in all of these scoring systems.Other factors selected to influence the prognosis varied.They were useful to roughly predict thesurvival period,such as,"more than one year or not"or"more than six months or not".In particular,they were utilized for decision-making about operative indications and avoidance of excessive medical treatment.Because the function depended on the survival period in the patients with metastatic spine tumor,it was also utilized in assessing functional prognosis.However,no scoring system had more than 90%consistency between the predicted and actual survival periods.Future perspectives should adopt more oncological viewpoints with adjustment of the process of treatment for metastatic spine tumor.展开更多
慢性踝关节外侧不稳在临床十分常见,以反复踝关节扭伤、局部疼痛为主要表现,但手术适应证争议较大。为此,本研究搜索了Pubmed、Web of Science、The Cochrane Library以及中国生物医学文献数据库、维普信息资源系统数据库。对文献进行...慢性踝关节外侧不稳在临床十分常见,以反复踝关节扭伤、局部疼痛为主要表现,但手术适应证争议较大。为此,本研究搜索了Pubmed、Web of Science、The Cochrane Library以及中国生物医学文献数据库、维普信息资源系统数据库。对文献进行全面分析,发现大多数手术医生容易接受的手术适应证为:(1)具有踝关节反复扭伤或者疼痛等不稳症状,保守治疗3~6个月后仍存在症状;(2)通过前抽屉试验或者距骨倾斜试验、或者应力位摄X线片、或者磁共振MRI检查,提示存在踝关节机械性不稳的表现。本文对此现状进行全面综述,为规范化临床治疗提供依据。展开更多
Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing, while little information on surgical treatment has been reported. This study aimed to completely describe and analyze t...Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing, while little information on surgical treatment has been reported. This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA)for CUC in China. Methods Ninety-five consecutive patients, who suffered CUC and had surgical indications, were carefully selected. All patients underwent IPAA. Data on patient characteristics, surgical indications, surgical details, postoperative complications, functional outcome, and quality of life were collected. Results The mean patient age at the time of the operation was 32 years. Twenty-nine (31%) patients underwent an emergency operation, and 66 (69%) underwent elective procedures. Four patients with severe dysplasia underwent operations, but no carcinoma was histologically confirmed. A two-stage operation was performed in 87 (92%) patients, and a hand-sewn technique was applied in 88 (93%) patients. Sixteen patients (17.0%) experienced early complications, and there was a significant difference between the emergency surgery group and the elective group (31.0% vs. 10.6%, respectively; P 〈0.01). Five (5.3%) patients developed pouchitis as a late complication. The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight. According to the Kirwan grading scale, 87 (91.8%) patients showed satisfactory anal continence function. The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P 〈0.01) according to the Cleveland Global Quality of Life index. Conclusions IPAA is an effective and safe surgical procedure for patients with CUC in China. However, some characteristics, such as the low incidence of pouchitis, require further study.展开更多
文摘Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection.Therefore,we review some prognostic scoring systems and their outcomes.Articles with combinations of two keywords among"metastatic spine tumor"and"prognosis","score","scoring system","predicting",or"life expectancy"were searched for in Pub Med.As a result,236 articles were extracted.Those referring to representative scoring systems about predicting the survival of patients with metastatic spine tumors were used.The significance and limits of these scoring systems,and the future perspectives were described.Tokuhashi score,Tomita score,Baur score,Linden score,Rades score,and Katagiri score were introduced.They are all scoring systems prepared by combining factors that affect prognosis.The primary site of cancer and visceral metastasis were common factors in all of these scoring systems.Other factors selected to influence the prognosis varied.They were useful to roughly predict thesurvival period,such as,"more than one year or not"or"more than six months or not".In particular,they were utilized for decision-making about operative indications and avoidance of excessive medical treatment.Because the function depended on the survival period in the patients with metastatic spine tumor,it was also utilized in assessing functional prognosis.However,no scoring system had more than 90%consistency between the predicted and actual survival periods.Future perspectives should adopt more oncological viewpoints with adjustment of the process of treatment for metastatic spine tumor.
文摘慢性踝关节外侧不稳在临床十分常见,以反复踝关节扭伤、局部疼痛为主要表现,但手术适应证争议较大。为此,本研究搜索了Pubmed、Web of Science、The Cochrane Library以及中国生物医学文献数据库、维普信息资源系统数据库。对文献进行全面分析,发现大多数手术医生容易接受的手术适应证为:(1)具有踝关节反复扭伤或者疼痛等不稳症状,保守治疗3~6个月后仍存在症状;(2)通过前抽屉试验或者距骨倾斜试验、或者应力位摄X线片、或者磁共振MRI检查,提示存在踝关节机械性不稳的表现。本文对此现状进行全面综述,为规范化临床治疗提供依据。
文摘Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing, while little information on surgical treatment has been reported. This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA)for CUC in China. Methods Ninety-five consecutive patients, who suffered CUC and had surgical indications, were carefully selected. All patients underwent IPAA. Data on patient characteristics, surgical indications, surgical details, postoperative complications, functional outcome, and quality of life were collected. Results The mean patient age at the time of the operation was 32 years. Twenty-nine (31%) patients underwent an emergency operation, and 66 (69%) underwent elective procedures. Four patients with severe dysplasia underwent operations, but no carcinoma was histologically confirmed. A two-stage operation was performed in 87 (92%) patients, and a hand-sewn technique was applied in 88 (93%) patients. Sixteen patients (17.0%) experienced early complications, and there was a significant difference between the emergency surgery group and the elective group (31.0% vs. 10.6%, respectively; P 〈0.01). Five (5.3%) patients developed pouchitis as a late complication. The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight. According to the Kirwan grading scale, 87 (91.8%) patients showed satisfactory anal continence function. The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P 〈0.01) according to the Cleveland Global Quality of Life index. Conclusions IPAA is an effective and safe surgical procedure for patients with CUC in China. However, some characteristics, such as the low incidence of pouchitis, require further study.