简介：Howtodesignclinicaltrialsformedicaldevicesisaproblemplaguingtheindustrytoday.Astherearemanydifferencesinclinicaltrialsofmedicaldevicesanddrugs.Thispaperdescribesthedifferencesofthetwopointsfromtheperspectivsofdefinitionofmedicaldevicesanddrugs,scope,phasing,subjectsanddesignofclinicaltrialsindetails,aimingtohelptherelatedpersonnelmakescientificdecisionswhileconductingclinicaltrialdesignformedicaldevices.

简介：ECAPsarethesummaryofmultipleneurons’spikeswhichcouldberecordedbyabidirectionalstimulation-recordingsystemviathecochlearimplant,withtheartifacteliminationparadigmsofforward-maskingsubtractionparadigmoralternatingpolarityparadigm.ThreekindsofFDAapprovedcochlearimplantssupportECAPtesting.ThisarticleistosummarizetheclinicalapplicationofECAPlest.ECAPtestafterinsertionofelectrodeduringimplantoperationhasbeenwidelyusedduringcochlearimplantsurgery.Inrecentyears.ECAPthresholdsarealsousedtoestimatetheTlevelsandClevelshelpingprogramming.However,correlationbetweenECAPthresholdsandpsychophysicalthresholdsisaffectedbymanyfactors.Sofar,ECAPscannotyetbeagoodindicatorofpost-operativehearingandspeechperformance.

简介：Fermentedfoodshavebeenconsumedforcenturiesacrossmanygeographicallocalesandhavetraditionallybeenconsideredhealthyfoods,partlybecauseofthelivemicrobescontainedinthem.Theconceptof'probiotics'furtherrequiresthatthemicrobesbedefinedandtheirhealtheffectsbedemonstratedthroughhumaninterventionstudiesorothersuitableinvestigationsbeforemarketingwithcorrespondinghealthmessages.Here,wereviewrecommendationsforfermentedfoodsandprobioticsinseveralcountriesoutsidetheEU,focusingonfood-baseddietaryguidelines.Weemphasizerecommendationsonyoghurtandprobioticsmadebyexpertbodies.Wefoundthatdietaryguidelinescommonlyadvocatetheconsumptionofyoghurtorsimilarproducts,butspecificcommentsonprobioticsarerare.Further,wereviewedguidelinesfromclinicalassociations.Ingeneral,theyacknowledgethebeneficialeffectsofprobiotics,butoftensuggesttheneedforfurtherresearch.Thisistruedespitegoodqualityevidencesupportingtheroleofprobioticsforcertainhealtheffects,suchaspreventionofeczemaininfants,managementofsideeffectsfromantibioticsandalleviationoffunctionalbowelsymptoms.Additionalresearchtosupportfuturedietaryrecommendationsshouldfocusondeterminingeffectsize,identifyingrespondersandnon-responders,clarifyingstrain-specificityofeffectsandconfirmingmechanisms.

简介：根据我们的经验，经历割礼的病人主要关于疼痛和阴茎外观被担心。我们进行了未来的使随机化的试用估计一台新可处理的割礼缝术设备(DCSD)的好处。942个病人的一个总数同等地被划分成三个组(常规割礼，商戒指和可处理的缝术设备组)。在DCSD组的病人是有化合物5%lidocaine乳脂的anesthetized，其它与2%lidocaine阴茎块。操作时间，intra起作用的血损失，切口愈合时间，intra起作用、手术后的疼痛，阴茎外观和全面满足度被测量。操作时间和intra起作用的血损失与传统的组相比在商戒指和缝术设备组是显著地更低的(P<；0.001)。Intra起作用的疼痛与另外的二个组相比是在缝术设备组的更少(P<；0.001)；而手术后的疼痛在与另外的二个组相比的传统的组是更高的(P<；0.001)。设备(80.57%)和商戒指(73.57%)组织的在缝术的病人是与常规割礼组相比对阴茎外观满意的更多(20.06%，P<；0.05)。在缝术设备组的病人也比传统的组快显著地愈合了(P<；0.01)。全面满足率在缝术设备组(78.66%)更好与相比常规(47.13%)并且商戒指(50.00%)组(P<；0.05)。DCSD和lidocaine乳脂的联合导致了更短的操作和切口愈合时间，减少了intra起作用、手术后的疼痛并且改进了对化妆外观的耐心的满足。

简介：Objective:Toobservetheclinicalefficacyofacupuncture-moxibustionintreatingAlzheimer’sdisease(AD).Methods:Forty-eighteligibleADpatientswereenrolledtoreceiveacupunctureplusherb-partitionedmoxibustion.Mini-mentalstateexamination(MMSE)wasadoptedforevaluationbeforeandafterintervention,andthetherapeuticefficacywasobserved.Results:Afterintervention,theMMSEscorechangedsignificantly(P<0.01),andthetotaleffectiveratewas83.3%.Conclusion:Acupuncture-moxibustioncansignificantlyimprovethecognitivefunctionofADpatients,beneficialtothegeneralpromotionofthequalityoflife.

简介：Laparoscopicrectalsurgerycontinuestobeachallengingoperationassociatedtoasteeplearningcurve.Roboticsurgicalsystemshavedramaticallychangedminimallyinvasivesurgery.Three-dimensional,magnifiedandstableview,articulatedinstruments,andreductionofphysiologictremorsleadingtosuperiordexterityandergonomics.Therefore,roboticplatformscouldpotentiallyaddresslimitationsoflaparoscopicrectalsurgery.Itwasaimedatreviewingcurrentliteratureonshort-termclinicalandoncological(pathological)outcomesafterroboticrectalcancersurgeryincomparisonwithlaparoscopicsurgery.Asystematicreviewwasperformedfortheperiod2002to2014.Atotalof1776patientswithrectalcancerunderwentminimallyinvasiverobotictreatmentin32studies.Afterroboticandlaparoscopicapproachtooncologicrectalsurgery,respectively,meanoperatingtimevariedfrom192-385min,andfrom158-297min;meanestimatedbloodlosswasbetween33and283mL,andbetween127and300mL;meanlengthofstayvariedfrom4-10d;andfrom6-15d.Conversionafterroboticrectalsurgeryvariedfrom0%to9.4%,andfrom0to22%afterlaparoscopy.Therewasnodifferencebetweenrobotic(0%-41.3%)andlaparoscopic(5.5%-29.3%)surgeryregardingmorbidityandanastomoticcomplications(respectively,0%-13.5%,and0%-11.1%).Regardingimmediateoncologicoutcomes,respectivelyamongroboticandlaparoscopiccases,positivecircumferentialmarginsvariedfrom0%to7.5%,andfrom0%to8.8%;themeannumberofretrievedlymphnodeswasbetween10and20,andbetween11and21;andthemeandistalresectionmarginwasfrom0.8to4.7cm,andfrom1.9to4.5cm.Roboticrectalcancersurgeryisbeingundertakenbyexperiencedsurgeons.However,thequalityoftheassembledevidencedoesnotsupportdefiniteconclusionsaboutmoststudiesvariables.Roboticrectalcancersurgeryisassociatedtoincreasedcostsandoperatingtime.Italsoseemstobeassociatedtoreducedconversionrates.Othershort-termo

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简介：在最近的年里，免疫疗法为前列腺癌症的治疗作为可行、吸引人的策略出现了。当有指向免疫系统的多重方法时，治疗学的癌症疫苗和有免疫力的检查点禁止者在迟了阶段的临床的试用是很成功的。为无征状或最低限度地征兆的变形前列腺癌症的sipuleucel-T的里程碑食物药品管理局赞同与癌症疫苗PSA得信佳和有免疫力的检查点禁止者ipilimumab为进行中的阶段III试用作准备。没有短期的变化，这些基于免疫者的治疗的一个普通特征是改进全面幸存的外观。这类效果看起来由于肿瘤生长率动力学，激活的免疫系统在施加减缓网络肿瘤生长的经常的immunologic压力的调整。新兴的数据建议为癌症疫苗的临床的试用的理想的人口是有更低的肿瘤体积和更少的好攻击的疾病的病人。把免疫疗法与标准治疗相结合的联合策略被显示了扩充有免疫力的反应和临床的利益。

简介：在对待击以后的便秘加专利汉语药观察针灸的临床的功效。

简介：为了加与桑树跳动观察中国草药的忿恨的临床的功效，在治疗脚跟疼痛粘住。

简介：Objective:Toobservetheclinicaleffectofradiofrequencyablation(RFA)combinedwithtranscatheterarterialchemoembolization(TACE)foradvancedhepatocellularcarcinoma(HCC).Methods:Atotalof92casesofadvancedprimarylivercancerunderwentTACEandRFAtreatmentfromJune2005to2011attheDepartmentofHepatobiliarySurgery,theFirstAffiliatedHospitalofBengbuMedicalCollege.Atotalof88caseswithcompleteclinicaltreatmentandfollow-updataweredividedintotwogroups:43patientstreatedwithTACE(TACEgroup)and45patientsthatreceivedTACEcombinedwithRFAtreatment(TACE+RFAgroup).Afterclinicaldataassessment,tumorsizeandsurvivalstatuswerenotsignificantlydifferentbetweenthegroupsasdeterminedbystratifiedanalysis.Results:Beforeandaftersurgery,spiralCTradiographyandcolorcomparisonobservedablationconditions.Thetumornecrosisratesaftertreatment(CR+PR)were67.4%(29/43)and91.1%(41/45)fortheTACEandcombinedtreatmentgroups,respectively,andthedifferencewasstatisticallysignificant(P<0.05).ThequalityoflifewassignificantlyimprovedforpatientsundergoingTACE+RFAcomparedwiththecontrolgroup.SurvivaldurationwasnotsignificantlydifferentinpatientsundergoingTACE+RFAcomparedwiththecontrolgroup.Conclusions:Inthisstudy,theeffectofRFAcombinedwithTACEtreatmentwasbetterthanTACEaloneintreatingadvancedHCC.

简介：Colorectalcancerhepaticmetastasesrepresentthefinalstageofamulti-stepbiologicalprocess.Thisprocessstartswithaseriesofmutationsincolonicepithelialcells,continueswiththeirdetachmentfromthelargeintestine,disseminationthroughthebloodand/orlymphaticcirculation,attachmenttothehepaticsinusoidsandinteractionswiththesinusoidalcells,suchassinusoidalendothelialcells,Kupffercells,stellatecellsandpitcells.Themetastaticsequenceterminateswithcolorectalcancercellinvasion,adaptationandcolonisationofthehepaticparenchyma.Alltheseevents,termedthecolorectalcancerinvasion-metastasiscascade,includemultiplemolecularpathways,intercellularinteractionsandexpressionofaplethoraofchemokinesandgrowthfactors,andadhesionmolecules,suchastheselectins,theintegrinsorthecadherins,aswellasenzymesincludingmatrixmetalloproteinases.Thisreviewaimstopresentrecentadvancesthatprovideinsightsintothesecell-biologicaleventsandemphasizesthosethatmaybeamenabletotherapeutictargeting.

简介：AIM:Toinvestigateandcomparethecytopathologicalandclinicaleffectsofamnioticmembranetransplantation(AMT)andoralmucosalmembranetransplantation(OMMT)insocketcontraction.METHODS:Twelvepatientswhocouldnotbefittedwithocularprosthesisduetosocketcontracturewereincludedinthisstudy.SevenpatientsunderwentAMTand5patientsunderwentOMMT.Thirteenpatientswhohadhealthysocketswereincludedascontrolgroup.Depthofinferiorfornix,degreeofinflammation,extentofthesocketcontractureandsocketvolumeweremeasuredinthepreoperativeperiodandatsixthandtwelfthweekspostoperatively.Impressioncytologyofconjunctivalfornicesandteartransforminggrowthfactorbeta-1(TGFβ1)levelsweredetermined.RESULTS:IntheAMTgroup,socketvolumeandlowerfornixdepthvaluesweresignificantlyhigher(P=0.030andP=0.004respectively)andinflammationlevelsandimpressioncytologystages(P=0.037andP=0.022respectively)weresignificantlylowerinpostoperativeperiodcomparedtopreoperativeperiod.IntheOMMTgroup,nostatisticaldifferenceswerefoundintermsofclinicalparameters,inflammationlevelsandimpressioncytologystagesofpreoperativeversuspostoperativevalues.PreoperativetearTGFβ1levelswerehigherinAMTandOMMTgroupscomparedtothecontrolgroup(25.5ng/mL,26.3ng/mLand21.7ng/mLrespectively).DecreasedtearTGFβ1levelswereobservedinboththeAMTandOMMTgroupspostoperatively(mediandecreasevalue=2.1ng/mLand2.7ng/mLrespectively).CONCLUSION:AMTisassociatedwithpostoperativeimprovementininferiorfornixdepth,socketvolume,inflammationandimpressioncytologylevelsandmaybeamoreproperalternativemethodthanOMMTinthemanagementofsocketcontracture.

简介：BackgroundHospital-acquiredpneumonia(HAP)isthemostcommonandmostseriousnosocomialinfectionforcardiacsurgerypatients,withhighincidenceandfatalityrate1.ItisimportantforcardiacsurgeonstocorrectlyidentifyHAP,assesstheseverity,andthenadjustanti-infectionmethod,whichcanreducethemortalityrate,shortenhospitalizationtime,andreducethewasteofmedicalresources.ThepurposeofthisresearchistoevaluatetheapplicationvalueoflungCTindiagnosisandtreatmentofHAPaftercardiacsurgery.MethodsAretrospectiveanalysiswasconductedforclinicaldataabout76cardiacsurgerypatientswhowerediagnosedwithHAPduringJanuarytoDecember2013.Theclinicaldatamainlyincludedsymptoms,physicalsigns,laboratoryexaminations(suchasroutinebloodtestsandserumprocalcitonin),andlungCTandX-raydata.OurfocusisonthecomparisonbetweenlungCTandX-raydata.ResultsThepositivediagnosticrate,falsenegativerate,andfalsepositiverateoflungCTwere71/76(93.4%),5/76(6.6%),and1/76(1.3%)respectively.ThecoincidencerateofX-rayandCTwas45/76(59.2%),andthefalsenegativerateofX-raywas23/76(30.3%).ConclusionLungCTisbetterthanX-rayindiagnosisofHAPaftercardiacsurgeryandassessmentofseverity,andhasgreatersignificanceforguidingtherationaluseofantibiotics.Therefore,lungCTisworthyofapplicationandpopularization.

简介：Objective:Toassesstheclinicalfeatures,survivalandprognosticfactorsofprimarytesticulardiffuselargeB-celllymphoma(DLBCL).Methods:Aretrospectivestudyof37patientswithprimarytesticularDLBCLwascarriedoutfromNovember2003toMay2012.Theirclinicalfeatures,survivalandprognosticfactorswereanalyzed.Results:Duringamedianfollow-upperiodof39.8months(5.4-93.0months),themedianprogression-freesurvival(PFS)was26.2months(95%CI:0-65months)andthe3-yearoverallsurvival(OS)ratewas78.4%.Withinthewholecohort,thefactorssignificantlyassociatedwithasuperiorPFSwerelimitedstage(stageI/II),lactatedehydrogenase(LDH)≤245U/L,internationalprognosticindex(IPI)≤1,primarytumordiameter<7.5cm,andpatientswhohadcompleteresponse(CR)andreceiveddoxorubicin-containedchemotherapy(P<0.05).Therewasatrendtowardsuperioroutcomeforpatientswhoreceivedcombinedtherapy(surgery/chemotherapy/radiotherapy)(P=0.055).PatientswhohadCR,primarytumordiameter<7.5cmandIPIscore≤1weresignificantlyassociatedwithlongerPFSatmultivariateanalysis.Conclusions:PrimarytesticularDLBCLhadpoorersurvival.CR,primarytumordiameterandIPIwereindependentprognosticfactors.Thecombinedtherapyoforchectomy,doxorubicin-containedchemotherapyandcontralateraltesticularradiotherapy(RT)seemedtoimprovesurvival.

简介：因为输精管切除术的不可避免的复杂并发症，这研究被承担与一个微型外科的方法与没有解剖刀输精管切除术(NSV)相比植入进管腔的一台nonobstructiveintravas设备(IVD)估计男消毒的功效和安全。IVD被分成二种类型：而，IVD-B让一条尾巴使用了修理到管deferens(固定翅膀)IVD--A不做。multicenter未来的使随机化的控制临床的审判在中国被进行。学习由寻求输精管切除术的1459个男志愿者组成随机被分到IVD--一(n=487)，IVD-B(n=485)或NSV(n=487)组并且经历了操作。包括的后续在3rd-6th和12th手术后的月。对这些题目的评价包含了常规物理考试(包括的将军和andrological考试)和精液分析。subjects’；搭挡们也经历了监视因为由月刊的怀孕关于月经会见，如果必要，尿测试。处于怀孕率没有重要差别(0.65%为IVD--一，0为IVD-B并且0.21%为NSV)在三个组之中(P>；0.05)。在12th手术后的月分别地在三个组是零，0.9%和1.7%。在结论，IVD男消毒展出长期的不利事件的低风险并且被发现作为一个男消毒方法有效，类似于NSV技术。IVD男消毒被期望是一个新奇避孕方法。

简介：Prostatecancergene3(PCA3,alsoknownasDD3)isanewbiomarkerthatcouldimprovetheaccuracyofprostatecancerdiagnosis.Itisagreatbiomarkerwithfairlyhighspecificityandsensitivity.Theincidenceofprostatecancerisrisingsteadilyinmostcountries.Thecommonlyusedprostate-specificantigen(PSA)testoncegavepeoplehopeforearlydiagnosisofprostatecancer.However,thelowspecificityofthePSAtesthasresultedinalargenumberofunnecessarybiopsiesandovertreatment.Duringthepastdecade,manynewprostatecancerbiomarkershavebeenfound.Amongthese,PCA3isthemostpromising.Duetoitsgreatperformanceindistinguishingprostatecancerfromotherprostateconditions,PCA3couldlikelybeappliedforearlydiagnosisofprostatecancer,patientfollow-up,prognosisprediction,andtargetedtherapy.Afteryearsofresearch,wehaveobtainedsomeknowledgeaboutthesequenceofPCA3gene.WehavealsodeterminedtherelationshipbetweenPCA3andtheproliferationofprostatecancercellsandlearnedsomeinformationabouthowPCA3affectstumor-relatedgenesandproteins.APCA3scorehasbeencreated,andithasbeenusedinavarietyofstudies.SomeresearchershaveevenappliedPCA3totargetedtherapyandobtainedagoodeffectinvitro.Thisreviewdescribesthecurrentstateofresearch,andexploresthefutureprospectsforPCA3.更多还原

简介：Thefrequenciesofuseof361humanacupointsin74academicjournalsoftraditionalChinesemedicinepublishedbetween1949and2010arearrangedinorderusing‘TraditionalChineseMedicalAcupuncturemoxibustionInformationDatabank’.Thefrequenciesofusearedividedintofivegrades:mostfrequentuse,morefrequentuse,frequentuse,lessfrequentuseandinfrequentuse.Themostfrequentlyusedacupointsandinfrequentlyusedacupointsaresummarizedandanalyzedtohelppointselectionforclinicalacupunctureandselectionofacupunctureresearchprojectsinthefuture.

简介：BackgroundTheclinicalcharacteristicsofstrokepatientstreatedwithdoubleanti-platelettherapy(DAPT)afterpercutaneouscoronaryintervention(PCI)isnotclear.MethodsIntotal,2675patientsunderwentPCIandDAPTinGuangdongGeneralHospital,and68outofthemwerehospitalizedduetosuspectedstroke,ofwhom23werediagnosedashavingstroke.Dataofthe23strokepatientswerecollectedandtraditionalriskfactorsassociatedwithstrokewereanalyzedretrospectively.ResultsThemeanageofthesepatientswas75.6±8.7years,and20(87.0%)weremales.Notably,19patientswerecomplicatedwithhypertension,7withdiabetesmellitus,7withprevioushistoryofstroke,nonewithatrialfibrillation(AF)orpatentforamenovale(PFO).Specifically,22patientswerediagnosedwithischemicstroke,and1patientwithhemorrhagicstroke.ConclusionStrokeinpatientstreatedwithDAPTafterPCIwascorrelatedwithadvancedage,gender,hypertension,diabetesmellitus,strokehistory.Longtermelectrocardiography(ECG)maybeneededforthediagnosisofAF,whiletrans-esophagealechocardiography(TEE)maybeneededforPFO.

简介：Purpose:Wntpathwayscontrolkeybiologicalprocessesthatpotentiallyimpactontumorprogressionandpatientsurvival.Thepresentstudyanalyzedthepolymorphismoflipoprotein-relatedreceptor5(LRP5)(genewithkeyfunctionsinWntsignaling)anditsimpactontheresponsetochemotherapyandsurvivalofpatientswithadvancedgastriccancer(AGC).Methods:Atotalof107consecutivepatientswithAGCtreatedwithfirst-linechemotherapyofEOFregimenwereenrolledinthepresentretrospectivestudy.Theassociationbetweensinglenucleotidepolymorphism(SNP)ofrs3736228inLRP5andtheclinicaloutcomesofthepatientswasstudied.Results:TheCCgenotypeofrs3736228wassignificantlycorrelatedwithahigherdiseasecontrolratewhencomparedtotheCTandTTgenotypes(89.3%and61.8%,respectively,P<0.001).Aunivariatesurvivalanalysisalsoshowedthattheprogressionfreesurvival(PFS)andoverallsurvival(OS)forthepatientswiththeTCandTTgenotypesofrs3736228wereworsethanforthepatientswiththeCCgenotype(PFS:3.3and6.7months,respectively,HR=0.454,P<0.001;OS:8.1monthsand18.8months,respectively,HR=3.056,P<0.001).AmultivariateCoxmodelincorporatesrs3736228andclinicalfeatures,alsoidentifiedrs3736228wassignificantlyassociatedwiththePFSandOS.Conclusions:OurresultsfirstlyhighlighttheimportanceofLRP5geneofWntpathwayinthetreatmentofAGCandidentifypolymorphismofrs3736228asindependentpredictorofdiseasecontrolrate,PFSandOSinAGCpatientstreatedwithfirst-linechemotherapyofEOFregimenintheChineseHanpopulation.