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Objective To discuss the evaluation basis of the clinical rational use of Dahuang Zhechong Capsule and to establish its rationality evaluation criterion to promote the sensible use of Dahuang Zhechong Capsule. Methods The rationality evaluation criterion for Dahuang Zhechong Capsule was formulated by referring to the package insert, treatment guidelines, and other literature. According to the criterion, 270 outpatient prescriptions using Dahuang Zhechong Capsule in Xiyuan Hospital, China Academy of Chinese Medical Sciences were reviewed from January to June 2020. The indication, usage and dosage, drug combination, and repeated administration were analyzed. The pharmaceutical intervention was performed to address the problems found in the prescription reviews, and 328 outpatient prescriptions using Dahuang Zhechong Capsule in October 2020 were reevaluated. Results The irrational use rate of Dahuang Zhechong Capsule from January to June 2020 was 42. 22% (114 cases), including 108 (40%) cases of inappropriate indications, five (1.85%) cases of improper usage and dosage, and one (0.37%) case of inappropriate administration route. However, the pharmaceutical intervention in October 2020 remarkably reduced the irrational use rate of Dahuang Zhechong Capsule (4.27%, 14 cases), all of which were inappropriate indications. Conclusion Dahuang Zhechong Capsule is being used irrationally ； therefore, establishing an evaluation criterion is required. The specific situation of irrational drug use can be identified by prescription review according to its rationality evaluation criterion to manage its clinical use better and promote its rational use. [ABSTRACT FROM AUTHOR]

Copyright of Angle Health Law Review is the property of Angle Publishing Co., Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic hepatitis B (CHB) is a chronic progressive disease caused by hepatitis B virus (HBV), and without timely and effective antiviral therapy, it will eventually develop into liver cirrhosis, liver failure or hepatocellular carcinoma (HCC). Early initiation of antiviral therapy can prevent or delay disease progression and greatly reduce the incidence rates of liver cirrhosis, liver failure, and HCC. Due to the limited efficacy of current antiviral drugs, the indications for antiviral therapy are mainly applicable to patients with positive HBV DNA and persistent ALT abnormality and some special populations with HBV infection. However, some patients who cannot reach the criteria for antiviral therapy may have insidious disease progression, leading to adverse clinical outcomes. Therefore, the guidelines and consensus statements in China and globally are constantly expanding the indications for antiviral therapy for CHB, so as to bring benefits to more patients. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the impact of the change in anti - hepatitis B virus ( HBV) therapy indication on treatment rate and the features of the population requiring treatment. Methods The treatment - nfilve patients with chronic hepatitis B ( CHB ) in the China Registry of Hepatitis B (CR - HepB) database were selected as subjects, and related demographic, virological, hematological, and biochemical data were collected. The Mann - Whitney U test was used for comparison of non - normally distributed continuous data between two groups, and the Kruskal - Wallis H test was used for comparison between multiple groups; the chi - square test or the Fisher ' s exact test was used for comparison of categorical data between groups. Results A total of 3640 treatment - nafve CHB patients were included in this study, among whom 64. 4% were male, 68 . 7% had an age of 30 - 59 years, and 46 . 8% had an indeterminate clinical stage. According to the 2015 and 2019 editions of Guidelines for the prevention and treatment of chronic hepatitis Band the 2022 edition of expert consensus, the number of patients who had the indication for antiviral therapy was 625 ( 17 . 2% ), 1333 ( 36. 6% ), and 2890 ( 79 . 4% ), respectively. The number of patients requiring treatment was increased by 1557 according to the 2022 edition of expert consensus, among whom 1424 ( 91. 5 % ) met the treatment threshold of alanine aminotransferase ( ALT) > 30 U/ L for male patients or ALT > 19 U/ L for female patients. The additional patients requiring treatment according to the 2022 edition of expe rt consensus had significantly higher levels of ALT and HBV DNA and significantly lower scores of APRI and FIB -4 than the additional patients requiring treatment according to the 2019 edition of Guidelines (all P <0. 05). Conclusion The expansion of antiviral therapy indications for CHB may significantly increase the proportion of CHB patients receiving antiviral treatment and help mild CHB patients at the risk of disease progression to receive timely treatment and achieve the improvement in long - term prognosis. [ABSTRACT FROM AUTHOR]

Thyroid cancer is the fastest growing type of tumor globally. Most patients have a long survival period. The management of the disease is similar to that of chronic diseases. Traditional Chinese medicine plays an important role and is of great value in the diagnosis and treatment of thyroid cancer. This paper comprehensively summarizes and analyzes the current situation, research progress and existing problems of TCM diagnosis and treatment of thyroid cancer from the following aspects : TCM diagnosis and treatment indications and characteristic advantages of thyroid cancer, randomized controlled clinical research on the treatment of integrated traditional Chinese and Western medicine after surgery, inheritance and innovation of TCM diagnosis and treatment methods, pattern identification and standardization of diagnosis and treatment. Future research and development directions are thus proposed. It is suggested that the efficacy evaluation should combine "evidence-based research" with "real world study" and "evaluation of symptoms, patterns, quality of life and the relapse risk of thyroid cancer" ; We should form an effective TCM diagnosis and treatment protocol and guidance with distinctive TCM characteristics while integrating the new knowledge of modern medicine; Starting from the clinical questions and unmet clinical needs, we should focus on the key points and expand and deepen the research field, in order to provide reference for improving the TCM diagnosis and treatment level and academic development of thyroid cancer. [ABSTRACT FROM AUTHOR]

Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy.

BACKGROUND: With the improvement of the medical level and people’s higher requirements for the quality of life, the quality and requirements for cartilage repair in the clinic are getting more and more, but traditional repair methods cannot regenerate cartilage with good biological properties. OBJECTIVE: To review the research progress of autologous chondrocyte implantation in recent years, and to analyze its development process, basic science, indications, contraindications, surgical techniques, clinical efficacy and limitations, and look forward to the development trend of this field. METHODS: A computer-based online search of CNKI, PubMed, Web of Science databases, and Google Scholar was performed to retrieve papers published during 1990-2020 with the search terms “autologous chondrocyte implantation, cartilage defect, techniques, clinical effect, indications, contraindications, defect size, treatment after initial failure, return to sports, age, magnetic resonance imaging, limitation” in English and Chinese. The document types include treatise, reviews, case reports, and meta-analysis. A total of over 1 000 papers were retrieved, and 52 of them were included in the final analysis. RESULTS AND CONCLUSION: Autologous chondrocyte transplantation first appeared for the treatment of knee cartilage defects in the late 1980s. The first generation of autologous chondrocyte transplantation used periosteal patches to seal the cultured chondrocytes in the defect. Due to the proliferation of periosteal grafts, second-generation autologous chondrocyte transplantation used collagen membrane patches instead of periosteal patches. The third generation of autologous chondrocyte transplantation used three-dimensional culture technology to improve cell delivery, allowing minimally invasive implantation, which could regenerate normal cartilage structure with accelerating patient recovery. Autologous chondrocyte transplantation was an effective method to treat high tibia or femoral cartilage defects, but it must solve the problems consisting of coronal force line, ligament laxity, and meniscus injury. Because of the graft needing a long time to mature, patients needed a specific rehabilitation plan to return to the sport, which assisted the injured patients in restoring strength and neuromuscular coordination as much as possible before the graft was fully mature. [ABSTRACT FROM AUTHOR]

Decompression is an effective and widely used treatment for jawbone cystic lesions that can, to a great extent, preserve the function and appearance of the jawbone. However, some problems exist with its clinical application, such as the inappropriate determination of indication and the lack of standardized operational guidelines, resulting in treatment ineffectiveness or even failure. This paper aimed to summarize the clinical value of decompression for jawbone cystic lesions in terms of mechanism, scientific evidence, advancement, indications and effective evaluation by reviewing relevant literature and our clinical experience.

Tooth defects due to dental caries, trauma, abrasion, etc., are extremely common and can be treated by di⁃ rect or indirect restoration. Compared with resin directly filling the body, an inlay can better restore the occlusal contact relationship and the adjacent surface contact relationship and has good mechanical properties. In recent years, with the development of ceramic materials and bonding systems and the popularity of chairside CAD/CAM technology, the chair⁃ side CAD/CAM porcelain inlay restoration program has been well received by doctors and patients because of its accura⁃ cy, convenience, aesthetics, hardness and stability, and this program is widely used clinically. This review covers the re⁃ search status of various aspects such as indications and contraindications for chairside CAD/CAM inlay restoration, pre⁃ restoration preparation, tooth preparation, hole type, impression taking and design, porcelain block selection, bonding, polishing, postoperative doctor􀆳s instructions, and common postoperative complications. It is expected to provide a refer⁃ ence for the clinical application of and research on chairside CAD/CAM inlay restoration technology.

Neoadjuvant chemotherapy ( NACT) is a vital part of the systemic treatment to breast cancer. With the formation of consensuses on NACT, controversial perspectives on NACT have been widdy discussed, especially in the fields of indication and therapeutic strategy. To define the indication of NACT, blind obedience to the results of clinical trials is not recommended. Instead, indications of NACT should be strictly controlled based on the targets of the clinical practice. Oriented by the early deoctiveness of NACT, various chemotherapy or local therapeutics for different molecular subtypes of breast cancer should be conducted to the patients with unsatisfied effect. What' s more, the evolvement of precision medicine accelerates the research of drugs mid helps to form in individualized NACT plan. After clarifying the controversial opinions towards NACT in breast cancer, controlling the indication and optimizing the therapeutic strategy will improve the survival of breast cancer patients. [ABSTRACT FROM AUTHOR]

Transcrestal sinus floor augmentation applied for severely atrophic maxilla sinus floor augmentation is fre⁃ quently performed because of posterior maxilla resorption and low bone density. The traditional perspective is that the residual bone height is a main factor influencing the selection of the augmentation technique and the transcrestal tech⁃ nique can only be used when the residual bone height is more than 4⁃5 mm. However, many researchers have used this technique with lower bone heights because of the development of better surgical instruments and clinical skills. Based on the review of the literature in recent years and the author′s understanding of clinical operation, this paper reviews the improvement progress and operation skills of the application of transalveolar ridge top maxillary sinus lift in the se⁃ verely absorbed maxillary posterior tooth area.

Lung transplantation is the ultimate treatment for many kinds of end-stage lung diseases. However, the perioperative management of lung transplantation is complicated with high fatality of patients. Extracorporeal membrane oxygenation (ECMO) is an effective method of extracorporeal respiration and circulation support. ECMO plays an important role in the perioperative support treatment of lung transplantation, which breaks the limitation of contraindications and promotes the development of lung transplantation. In this article, the indications, catheter placement strategies and application of ECMO in the perioperative period of lung transplantation were reviewed. [ABSTRACT FROM AUTHOR]

BACKGROUND: At present, the treatment of rotator cuff injury is still an emphasis and hotspot in orthopedics clinical research. Although the therapies of rotator cuff injury are constantly innovating and improving, there is still a lack of unified standards and understanding, and each treatment has different strengths, weaknesses and indications. OBJECTIVE: To provide more ideas for orthopedic clinicians to treat rotator cuff injury by summarizing the indications of different therapies of rotator cuff injury. METHODS: A computer-based online research of PubMed, Embase, The Cochrane Library and ClinicalKey databases was performed for relevant articles published from 1990 to 2019 with the keywords of “rotator cuff tear, rotator cuff injury, therapeutic, treatment and therapies”. The unrepresentative and over-dated articles and studies that did not meet the inclusion criteria were excluded, and finally 77 eligible articles were included for analysis and summary. RESULTS AND CONCLUSION: (1) The treatments of rotator cuff injury can be divided into conservative treatments and surgical treatments, in which surgical treatments mainly include rotator cuff debridement, superior articular capsule reconstruction, reverse shoulder arthroplasty, and subacromial balloon spacer. In the choice of these treatments, different types of rotator cuff injury have different indications. (2) It is worth noting that massive rotator cuff injury is still a challenge in clinical treatment due to the high surgical failure rate and postoperative retear rate. However, with the rapid development of material science and tissue engineering, the new adjuvant therapy technologies have been gradually applied in clinical practice, and have become the focus in the field of rotator cuff injury. [ABSTRACT FROM AUTHOR]

To further standardize the surgical procedures of combined liver and kidney transplantation, organ transplantation experts of Branch of Organ Transplantation of Chinese Medical Association have formulated the surgical specifications of combined liver and kidney transplantation from the perspectives of indications and contraindications, preoperative examination and preparation of the recipients, surgical standards for donor liver and kidney repair, operational standards for anesthesia, surgical standards for organ implantation, common postoperative complications and treatment, diagnosis and treatment of postoperative rejection, application principles and routine regimes of immunosuppressants and postoperative follow-up in combined liver and kidney transplantation, etc. [ABSTRACT FROM AUTHOR]

Ambulatory ECG(AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and arrhythmia patterns which are not readily obtained from the routine ECG. Prodigious amounts of rhythm information derived from AECG recording system often provide reliable diagnostic references in clinic. This paper introduces the indications of ambulatory monitoring technique in the diagnosis and management of cardiovascular diseases, and evaluates its predictive value on risk stratification against specific clinical context. [ABSTRACT FROM AUTHOR]

As one of the most commonly seen diagnostic tools in clinic, ECG has been applied in more and more fields. It has qualified to become one of the five major routine examinations(blood, urine, stool, imaging, ECG) at present. Especially on some cardiovascular diseases such as chronic ischemic heart disease, acute coronary syndrome, myocarditis, pericarditis, pulmonary embolism and arrhythmia, ECG could make a definite diagnosis. In addition, ECG also plays an important auxiliary role in the diagnosis of hereditary ion channel disease, cardiac structural abnormality, electrolyte disturbances, and so on. Meanwhile, the application of ECG also extends to monitor the curative effect of antiarrhythmic drugs and arrhythmic conditions, make preoperative risk evaluation, and screen the population with high-risk or special occupation. Therefore, to accurately record and analyze ECG is of great concern. With the rapid introduction of digital technology, the performance of digital electrocardiograph has been greatly improved. However, old model has not yet been completely out of the market, which haunts the normalized operation of ECG examination. Routine ECG examination should be performed by ECG related professional and technical personnel. Normalized operation is a prerequisite for acquiring quality qualified ECGs, and also lays a foundation for making correct ECG diagnosis. “Guidelines for the operation of routine ECG examination” is suitable for ECG related professional and technical personnel. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medical air-fluidized bed had its history and present situation in foreign countries and China introduced at first, and its application, possible complications and adverse events were described in detail when used for clinical treatment of extensive burn patients. The future development of medical air-fluidized bed was analyzed, and it's suggested that the bed be improved or replaced to decrease the hidden risks to the patient. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To summarize the technical essentials and experience of calf liposuction to improve the curative effect and reduce the occurrence of complications. Methods From February 2008 to December 2017, calf liposuction was performed in 498 patients. All patients were followed up at 3 months and 1 year after surgery. The postoperative swelling, recovery time, and return to normal walking was investigated. Postoperative efficacy and complications were systematically analyzed. Results The average amount of liposuction of the unilateral calves was (223±56) ml. Three months after operation, the average reduction of calf circumference was (2.1±0.6) cm, time of diminution of swelling was (22.4±7.7) days and return to normal walking was (28.1±10.5) days. Patients' satisfaction rate was 74.4% at 1 year after operation. The postoperative efficacy was not obvious in 24.0% patients, bilateral leg asymmetry occurred in 7.3% patients, and unevenness of surgery regions was present in 3.5% patients. Conclusion Calf liposuction was a safe, minimally invasive, and effective approach to solve fat accumulation in the calves. With accurate selection of indications and attention to the technical points during and after surgery, it was possible to obtain satisfactory surgical results. [ABSTRACT FROM AUTHOR]

Objective: To investigate the indication and treatment of pregnancy complicated with uterine myoma during cesarean section. Methods: Selected 80 cases of patients with uterine myoma who were treated in our hospital from January 2011 to December 2015, divided into two groups according to the treatment, 40 cases in observation group, 40 cases in control group. The observation group was treated with uterine myoma and cesarean section, the control group was treated with simple cesarean section, and 40 cases of normal cesarean section were selected as the routine group. The blood loss, the operation time, intraoperative, before and after the operation of the difference of hemoglobin, postoperative anal exhaust time and hospitalization time: different myoma size, type and number of intraoperative blood loss in the observation group wwere recorded; the neonatal outcome, and maternal postpartum recovery of the three groups were compared. Results: The general condition of the leiomyoma size, type and number in observation group and control group showed no significant difference (P>0.05): the operation time of the observation group was significantly longer than that of the control group and routine group (P<0.05), the amount of bleeding in operation among the three groups, the difference of hemoglobin before and after the operation, the postoperative anal exhaust time and hospitalization time had no significant difference (P>0.05): the bleeding volume of the patients with uterine myoma size < 5 cm was significantly less than that of above 5 cm(P<0.05), and different tumor types and number of intraoperative bleeding had no significant difference(P>0.05): the incidence of apgar scored 7 points, birth weight<2500 g. fetal development retardation and premature of the control group and observation group were significantly higher than those in the conventional group(P<0.05), there was no significant difference between the control group and the observation group (P> 0.05). Conclusions: If the fibroids diameter of pregnancy complicated with uterine myoma is< 5 cm. it can be considered to perform myomectomy, when the diameter > 5 cm. the amount of bleeding during operation ismore and the risk isgreater. cesarean section should not be done at the same time. [ABSTRACT FROM AUTHOR]

Objective To analyze the indications of cesarean section and the main influencing factors of the change of the cesarean section rate in our hospital in recent 5 years. Methods We retrospectively analyzed the clinical data of 18340 cases of pregnant women, 6932 cases of cesarean section from January 2009 to December 2013. Cesarean delivery rate and cesarean section indications of recent changes and influencing factors were analyzed. Results In 2010, 45.76% cesarean delivery rate was the highest in our hospital than that of other years. Various measures were taken to reduce the rate of cesarean delivery, the cesarean delivery rate was reduced year by year form 45.76% to 36.29% in 2013. But indications for the scar uterus changed from 11.7% in 2009 to 20.4% in 2013, placenta previa factors in 2009 accounted for 0.8% of the total rate of cesarean delivery and changed to 1.9% in 2013. And the lack of contractions and dystocia factors in 2009, accounting for 0.2% of the total rate of cesarean section in 2013 to 1.9% increased year by year, social factors such as mother asked cesarean delivery rate of cesarean section rate changed from 23.3% in 2009 to 17.0% in 2013, in 2012, and the mother asked the cesarean section indications had a minimum of 15.7%. Conclusions In recent 5 years, cesarean delivery rate has been reduced year by year, and the indications have changed. Scar uterus, placenta previa, and the lack of contractions during childbirth factors are rising year by year. Measures should be taken to decrease the cesarean delivery rate. [ABSTRACT FROM AUTHOR]

Objectives: To study the indication for therapeutic plasma exchange (TPE) and related complications in children admitted to the pediatric intensive care unit., Methods: A retrospective analysis was performed on the medical records of the children who received TPE in the Pediatric Intensive Care Unit, Hunan Children's Hospital, from March 2015 to March 2021. The indication for TPE and related complications were analyzed and compared with the American Society for Apheresis (ASFA) indication categories., Results: A total of 405 TPE treatment sessions were performed for 196 children, among whom 76 children (38.8%) also received continuous renal replacement therapy and 147 children (75.0%) survived. The children with neurological diseases had the highest survival rate of 93.1% (27/29). The top three indications for TPE were hematologic diseases (61/196, 31.1%), sepsis with multiple organ dysfunction (41/196, 20.9%), and liver diseases (36/196, 18.4%). The children with hematologic diseases received the highest number of 129 TPE treatment sessions. The subjects with ASFA category Ⅲ indications accounted for the highest proportion of 76.5% (150/196), followed by those with ASFA category Ⅰ indications (11.2%, 22/196), ASFA category Ⅱ indications (7.1%, 14/196), and unknown category (5.1%, 10/196), and no ASFA category Ⅳ indications were observed. The incidence rate of TPE complications was 12.3% (50/405), and the most common complications were pipeline coagulation (4.2%, 17/405) and hypotension (3.7%, 15/405). No serious adverse events were observed., Conclusions: TPE can be safely used for the treatment of critically ill children with indications in an experienced pediatric intensive care unit.

Cistanches Herba(CH), a valuable medicinal material which has long been used, originated from Shennong's Classic of Materia Medica. It has a wealth of names, such as Rousongrong, Heisiming, Dijing, and Dayun. The definition on the original plants which are parasitic and distributed in the unique environments in remote areas has been confusing, resulting in the emergence of various counterfeits and substitutes. Moreover, the records on the property, flavor, tropism, and indications of CH are also different. In order to further explore the cultural connotation and medicinal value of CH and further clarify its source and harvesting and processing methods, this study conducted further classical literature research on its name, harvesting and processing, property and flavor, meridian tropism, efficacy and clinical use, and textual research on its source and habitats, providing a reference for research, clinical medication, development and utilization, and industry development of CH.

PURPOSE: To analyze the indications for successful non-extraction correction of dental crowding with Damon appliance. METHODS: 19 patients with non-extraction orthodontic treatment were reviewed. They had Class I skeletal pattern and both arches were treated with Damon 3 or Damon MX appliances. According to the initial diagnosis before treatment (T1), 7 cases needed extraction, but they rejected it. After correction of crowding (T2), they were allotted into either successful group or unsuccessful group. The successful group contained those subjects in whom the Z angle at T2 was no less than 70° or that of T1. Others were allotted into the unsuccessful group. The dental casts and cephalometric radiophotographs were analyzed at T1 and T2. The difference between the two groups was analyzed with SPSS15.0 software package for Student's t test. RESULTS: There were 11 cases in successful group. All the 7 cases rejecting extraction were finally allotted into the unsuccessful group. No significant difference in upper arch perimeter and arch width was detected between the two groups at both T1 and T2. The upper and lower incisors and upper lip showed a more retruded position in successful group at T1, although they showed a similar amount of protrusion from T1 to T2 in both groups. The forward movement of lower lip was 3.4mm in the unsuccessful group, which was significantly larger than that of 1.6mm in successful group (P<0.05). Z angle decreased 10.7° in the unsuccessful group, while no significant change was detected in the successful group. The Holdaway upper lip strain was comparable in two groups, but the successful group showed significantly less soft chin strain than unsuccessful group (P<0.05). CONCLUSIONS: Damon appliance can not rescue extraction cases. Straight soft tissue profile and upright incisor position are prerequisite for non-extraction treatment. And a harmonious chin and lip position is the key leading to the successful non-extraction treatment with Damon appliance. [ABSTRACT FROM AUTHOR]

Objective: To disscuss the changes in indications, surgical opportunity and post-operative management of pediatric tracheotomy. Methods: Retrospective cohort study of pediatric patients undergoing tracheostomy between January 2016 and December 2020 at Children's Hospital of Fudan University. Ninety-five patients were divided into four groups according to their primary indication. Group A: neuromuscular disease（ n =36, 37.9%）, Group B: congenital abnormality（ n =30, 31.6%）, Group C: accidental injury（ n =15, 15.8%）, Group D: tumor（ n =14, 14.7%）. Results: By the comparison between four groups, children in group A had higher incidence of Severe pneumonia（47.2%）, higher usage of mechanical ventilation（97.2%）, longer hospitalization days（=84.9 days） and higher rate of Ventilator dependence（66.7%）; children in group B had higher rate of emergency surgery（4.2%）, lower age（median age 2 months） and lower usage of mechanical ventilation（30.0%）; Mortality of the children in group D was the highest（42.9%）. In the recent five years, we saw a increasing tendency in the proportion of group A（28.6%, 35.0%, 38.5%, 44.4%, 43.5%）, and a decreasing tendency of group B（57.1%, 30.0%, 38.5%, 33.3%, 21.7%）. On discharge, 50.5% of children（48 of 95）spontaneously breathe with the tracheos tomy in situ, 29.5% of children（28 of 95）had ventilator-dependence, tracheostomy decannulation was successful in 6.3% of children （6 of 95） and all-cause mortality was 13.7% （13 of 95）. Conclusion: Most paediatric tracheotomies were performed due to chronic underlying diseases. Pediatric tracheostomy should be considered as a long-term intervention in many children. Earlier tracheotomy can shorten the duration of post-tracheotomy mechanical ventilation in several conditions., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective To evaluate the impact of cervical disc herniation (CDH) combined with mild ossification on the long term range of motion (ROM) after artificial disc replacement (ADR) in CDH patients, and to find out whether it is an indication for cervical ADR. Methods Fifty-four patients who got ADR with the diagnosis of CDH were included. According to the preoperative CT, patients were divided into two groups, CDH with mild ossification (group A, 42 cases) or simple CDH (group B, 12 cases). ROM was compared between two groups by X-ray at preoperation and last follow-up. At last follow-up, axial and sagittal CT was used to identify whether fusion was occurred at the ADR level and whether the mild ossification turned into typical ossification of posterior longitudinal ligament (OPLL). Results The patients of group A were older than those of group B (P<0.05). There were no statistical differences in gender ratio, duration of follow-up, the ROM befor operation and at last follow-up between the two groups (all P>0.05). In group A, 2 patients turned into typical OPLL at the 81-and 96-month follow-up. But the ROM at ADR level of those two patients were maintained which were 6.2° and 15.4°. There were 5 patients whose ROM at ADR level was less the 2° during the follow-up of group A, 4 of them were due to the incorrect indication and the other patient did not have OPLL because the fusion occurred at uncovertebral joint. Conclusion The CDH combined with mild ossification doesn′t affect the ROM at ADR level, so it is an indication for ADR. [ABSTRACT FROM AUTHOR]

To meet the unmet medical needs and better reflect the new clinical evidence of chronic hepatitis B management, Chinese Society of Hepatology developed expert consensus on expanding diagnosis and treatment in China. The recommendations include to expand HBsAg screening in the population and HBV DNA detection by sensitive quantitative real-time PCR (qPCR), decrease the alanine aminotransferase (ALT) threshold for treatment of chronic hepatitis B, and promptly start antiviral therapy in the patients who are at risk of disease progression, and appropriately manage the patients with low level viremia.

Objective: To explore the application value of white light image (WLI), endoscopic ultrasonography (EUS) and magnifying endoscopy with narrow band imaging (ME-NBI) in the endoscopic treatment of early gastric cancer (EGC), and to provide basis for decision-making in clinical diagnosis and treatment., Methods: The clinicopathological data of EGC patients who underwent endoscopic submucosal dissection (ESD) at West China Hospital, Sichuan University between December 2013 and October 2020 were included. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EGC invasive depth were compared between WLI and EUS. The role of ME-NBI in predicting the differentiation types of EGC was analyzed., Results: A total of 280 patients (291 lesions) were enrolled in the study. Among them, 199 patients (207 lesions) received EUS and 160 patients (168 lesions) received ME-NBI. The overall accuracy of WLI in diagnosing the invasive depth of EGC was 87.0%, significantly higher than that of EUS (46.4%, P <0.001). When WLI was combined with EUS, the diagnostic accuracy (87.4%) was not significantly improved. The overall accuracy of determining the differentiation degree of EGC with ME-NBI was 92.3% (155/168), and the accuracy of determining undifferentiated EGC with ME-NBI was significantly lower than that of differentiated EGC (41.2% vs. 98.0%, P <0.001)., Conclusion: In the evaluation of indications for endoscopic treatment of EGC, WLI showed better performance in predicting the invasive depth of EGC, while EUS demonstrated limited value. ME-NBI showed better accuracy for predicting the differentiation degree of most EGC, especially for differentiated EGC., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To analyze the literature of acupuncture and moxibustion for diseases in the recent 5 years, and discuss the spectrum and indications of acupuncture and moxibustion., Methods: The literature on acupuncture and moxibustion for diseases in CNKI, Wanfang and VIP databases from January 1, 2015 to December 31, 2019 was searched, summarized and analyzed, and the disease spectrum was summarized. At the same time, the literature from 2015 to 2019 (group A), 1978 to 2005 (group B), and 1949 to 2005 (group C) was compared, and the indications of acupuncture and moxibustion therapy were summarized., Results: There were 32 011 articles on acupuncture and moxibustion for diseases in the recent 5 years, including 377 kinds of indications. These indications can be mostly classified as neurology (9384), orthopedics and traumatology (7765), gastroenterology (3529) and obstetrics and gynecology (2283). The types of diseases were mostly gastroenterology (52 types), neurology (47 types), ophthalmology and otorhinolaryngology (47 types), and obstetrics and gynecology (42 types). The first-class indications of acupuncture and moxibustion therapy in the recent 5 years were hemiplegia, lumbar disc herniation, cervical spondylosis, knee osteoarthritis, insomnia, constipation and cerebrovascular diseases; the second-class were facial neuritis, shoulder pain and headache; the third-class were dysphagia, dysmenorrhea and depression; the forth-class were asthma, urinary retention, cerebral palsy, hypertension, dementia, side effects of radiotherapy and chemotherapy, infertility, allergic rhinitis, vertigo, shoulder-hand syndrome, diabetic neuropathy, herpes zoster, pain, hiccup, diarrhea, lumbar sprain and sciatica., Conclusion: Although the disease spectrum and indications of acupuncture and moxibustion therapy have changed to some extent in the recent 5 years, neurology and orthopedics and traumatology are still predominant, and the observation objects tend to transition from symptoms to diseases.

Function-preserving gastrectomy (FPG) can be regarded as a concrete embodiment of precise treatment for early gastric cancer. Digestive tract reconstruction plays an important role in FPG. The aims of reconstruction mainly include the preservation of normal digestive tract and digestive function, the reconstruction of pivotal anatomical structure, and the consequent improvement of postoperative quality of life. We establish a new classification of digestive tract reconstruction based on the different role of digestive tract reconstructions in FPG for early gastric cancer, meanwhile we briefly summarize current progress and elucidate surgical indications. We hope that it can provide theoretical reference for surgeons to choose the appropriate procedure of digestive tract reconstruction after FPG.

Neoadjuvant chemotherapy (NACT) is a vital part of the systemic treatment to breast cancer. With the formation of consensuses on NACT, controversial perspectives on NACT have been widely discussed, especially in the fields of indication and therapeutic strategy. To define the indication of NACT, blind obedience to the results of clinical trials is not recommended. Instead, indications of NACT should be strictly controlled based on the targets of the clinical practice. Oriented by the early effectiveness of NACT, various chemotherapy or local therapeutics for different molecular subtypes of breast cancer should be conducted to the patients with unsatisfied effect. What's more, the evolvement of precision medicine accelerates the research of drugs and helps to form an individualized NACT plan. After clarifying the controversial opinions towards NACT in breast cancer, controlling the indication and optimizing the therapeutic strategy will improve the survival of breast cancer patients.

Objective: To review the research progress of indication and treatment of graft in shoulder superior capsular reconstruction (SCR) for rotator cuff tear (RCT)., Methods: The literature related to shoulder SCR in recent years was extensively reviewed, and the anatomy, biomechanics, surgical indications, and treatment of graft in SCR were summarized., Results: Superior capsule plays a role as a functional complex with rotator cuff, ligament, and whole capsule. SCR can effectively restore the superior stability of the shoulder. The indications of SCR include the irreparable massive RCT, massive RCT combined with pseudoparalysis shoulder, medium/large RCT with severe degenerative rotator cuff tissue, and dual-layer RCT. In order to achieve a better healing of tendon-bone in graft and decrease the rate of long-term graft retearing, it is essential to select an appropriate thickness graft, fix the graft in right intensity, and get a better capsular continuity., Conclusion: The technique of SCR advanced to SCR for reinforcement and it is indicated from substantial massive RCT to severe degeneration of rotator cuff tissue. Graft treatment is the key step for a successful SCR.

Auditory brainstem implantation is a hearing restoration technique on the central auditory pathway, which directly stimulates neural tissues of cochlear nucleus by electrode array to produce hearing, so it will not be restricted by abnormalities of the cochlea and cochlear nerve. In the past 30 years since the birth of multi-channel ABI, its indications have expanded from patients with neurofibromatosis type 2 (NF2) to congenital deafness patients with severe inner ear and/or cochlear nerve malformations, and the age of recipients decreases from adults to young children. This article summarizes the principle, indications, surgical techniques, complications and auditory outcomes of ABI.

Objective: To explore the vascular conditions and the necessity of vascular reconstruction in the treatment of chronic ischemic diseases of lower extremities with tibial transverse transport (TTT) from the perspective of vascular surgery., Methods: A clinical data of 59 patients with chronic ischemic disease of lower extremities treated by TTT between February 2014 and July 2019 were analyzed retrospectively. Among them, there were 41 patients with diabetic foot (DF), including Wagner grade 3-4, Texas grade 2-3, and stage B-D lesions; the disease duration ranged from 0.7 to 2.4 years, with an average of 1.5 years, and 5 cases complicated with arteriosclerosis obliteran (ASO). There were 14 patients with ASO (Fontaine stage Ⅳ and Rutherford stage Ⅲ-Ⅳ) with an average disease duration of 10.8 months (range, 1.5-23.4 months). There were 4 patients with thromboangiitis obliteran (TAO) with an average disease duration of 12.3 months (range, 2.1-18.2 months), and the clinical stages were all in the third stage. In 18 patients that ankle brachial index (ABI) of anterior or posterior tibial artery was less than 0.6 before operation, or the blood flow of the three branches of inferior anterior tibial artery did not reach the ankle by imaging examination, vascular reconstruction was performed before TTT (5 cases of DF combined with ASO, 12 of ASO, 1 of TAO). After operation, the effectiveness was evaluated by ulcer wound healing, skin temperature, pain visual analogue scale (VAS) score, ABI, and CT angiography (CTA) examination., Results: The patients with DF were followed up 8-16 months (mean, 12.2 months); the ulcer wounds healed with a healing time of 5.1-9.2 weeks (mean, 6.8 weeks); CTA examination showed that the branches of inferior anterior tibial artery were opened in 5 patients after revascularization; and the tibial osteotomy healed for 5-14 weeks (mean, 8.3 weeks). The patients with ASO were followed up 13-25 months (mean, 16.8 months); the ulcer wounds healed with a healing time of 6.2-9.7 weeks (mean, 7.4 weeks). CTA examination showed that the branches of inferior anterior tibial artery were opened in 12 patients after revascularization; all tibial osteotomy healed, and the healing time was 4.5-14.4 weeks (mean, 10.2 weeks). The patients with TAO were followed up 12-23 months with an average of 12.3 months, and toe/limb amputation was performed after ineffective treatment. The patients were divided into two groups according to whether they were combined with revascularization or not. The ABI, VAS score, and skin temperature in the combined revascularization group significantly improved at 6 months after operation ( P <0.05); while there was no significant difference in ABI at 6 months after operation in the TTT group ( P >0.05), but the skin temperature and VAS scores significantly improved when compared with those before operation ( P <0.05)., Conclusion: The ABI of anterior or posterior tibial artery is more than 0.6, radiological examination shows that at least one of the three branches of inferior anterior tibial artery leads to ankle artery, which is a prerequisite for successful TTT in the treatment of chronic ischemic disease of lower extremities. DF is the indication of TTT. ASO can choose TTT, and TAO should use this technique cautiously.

Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy.
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High tibial osteotomy (HTO) is an effective treatment for knee osteoarthritis. With the application of bi-planer open wedge osteotomy high tibial osteotomy and new angular stable locking plates, HTO has become more accuracy, minimally invasive and standard, achieved satisfactory long-term treatment outcome. The indications of HTO are expanding. We need to comprehensively consider whether the patient has varus deformity, the location and severity of the deformity, the stage of osteoarthritis, age and the demand of activity, as well as individual factors such as weight, gender, bone condition and joint activity, and strive to give the best individualized treatment to osteoarthritis patients in different stages.

The indication of bloodletting therapy was determined based on the multi-dimensional evidence assessment, which could provide guidance for the clinical application of bloodletting therapy. The literature of bloodletting therapy was comprehensively collected by retrieval in CNKI, Wanfang and VIP databases (until February 23, 2019), modern books in Library of Tianjing University of TCM and the Chinese Medical Code (Fifth Edition). The disease spectrum of bloodletting therapy was determined by self-designed questionnaire survey e-mailed to relevant experts. The indication of bloodletting therapy was determined by Delphi expert meeting. As a result, 746 pieces of ancient literature and 32 775 modern literature were included. The indications of bloodletting therapy based on the multi-dimensional evidence assessment include herpes zoster, acne, acute tonsillitis, vascular headache, varicose veins of lower extremities, acute lumbar sprain, early erysipelas, wheat swelling, exogenous fever of children, stroke, which are mainly the syndromes of blood stasis, toxin, excess and heat.

Along with the sharp increase of confirmed cases novel coronavirus infection, more critically ill cases require extracorporeal membrane oxygenation (ECMO) support. Based on the clinical data of novel coronavirus pneumonia (NCP), as well as the dada from previous clinical studies and the recommendations from the Extracorporeal Life Support Organization (ELSO), the committee board of the Chinese Society of Extracorporeal Life Support (CSECLS) made this recommendations to guide clinical ECMO application in the patients with NCP.

Along with the sharp increase of confirmed cases novel coronavirus infection, more critically ill cases require extracorporeal membrane oxygenation (ECMO) support. Based on the clinical data of novel coronavirus pneumonia (NCP), as well as the dada from previous clinical studies and the recommendations from the Extracorporeal Life Support Organization (ELSO), the committee board of the Chinese Society of Extracorporeal Life Support (CSECLS) made this recommendations to guide clinical ECMO application in the patients with NCP.

Large hepatocellular carcinoma (HCC) is one of the most common malignancies and was mistaked as "advanced and unresectable" . Liver resection is still the best curable treatment for HCC.The resection of large HCC is very difficult, which seriously restrict the progress of liver surgery.Our study proved that solitary large HCC (SLHCC) has unique clinicopathological and molecular biological characteristics.No matter how big the tumor size is, it belongs to early stage if there is no vascular invasion.Liver resection should be aggressively recommended for the patients with SLHCC, in which they can obtain good outcome, with 40% 5-year survival rate.We has also defined the borderline resectable hepatocellular carcinoma, and suggested that strictly master and correctly judge the surgical indications, syntheticly evaluate the surgical safety and patient's tolerability for liver resection.After that, with hands of experienced surgeons, liver resection for SLHCC can be safely and reliablely performed.

Objective: To discuss the incidence of complication of treating ectopic gestation by laparoscope. Methdos: Choosed 297 cases of ectopic gestation from Jan. 2013 to Jun. 2015 to analyze their clinic data retrospect and observed their comlication.Results:There were 10 cases happened complication(3.37%), including Subcutaneous emphysema, 4cases of incision in the abdominal wall vascular injury in 2cases, 2cases of pulmonary edema, 2cases Abdominal bleeding. Conclusion: Treating ectopic gestation by laparoscope with high incidence of complication to control operative indication strictly. [ABSTRACT FROM AUTHOR]

There are several trends in contemporary endodontics such as development of minimally invasive biologically based therapies, preservation of dental pulp in a healthy status with sustained vitality, prevention of apical periodontitis and improvement of long-term survival rates of teeth with pulpal disorders. As for the vital pulp therapy, direct pulp capping is a less invasive approach to keep the exposed dental pulp intact, which may improve the long-term treatment outcome employing a minimally invasive biologically strategy. With the recent progress in pulp biology, improvement of treatment modality and development of bioactive dental cements, great advancements have been achieved in direct pulp capping therapy. This review article focuses on the transition of indications, prognostic factors and future perspectives of direct pulp capping therapy, attempting to provide evidence and practical guidance for minimally invasive biologically based therapies of teeth with injured pulp.

The refractive surgery is improved and updated with time. In recent years, the phakic intraocular lens has been continuously modified and innovated in materials and design. With advantages such as less high-order aberrations, reversible lens and good visual quality, it has led to a new trend of refractive surgery, which attract an increasing number of high myopic persons received phakic intraocular lens implantation instead of corneal refractive surgery, particularly to further expand the applying for moderate and low myopia. This article focuses on the rational selection of moderate and low myopia to receive laser correction vision or phakic lens, and elaborates the different characteristics with advantages and disadvantages of corneal refractive surgery and phakic intraocular lens implantation, which suggest to perform the phakic intraocular lens implantation for moderate and low myopia cautiously and standardize surgical indications strictly. It is necessary to continuously strengthen the standardization and safety of laser corneal refractive surgery and phakic intraocular lens implantation in order to improve the visual quality and satisfaction further for myopic patients in clinic. (Chin J Ophthalmol, 2018, 54: 726 - 728) .