tbuckley/cabot-search huggingface dataset:
阻塞性睡眠呼吸暂停低通气综合征对心脑血管的损害
Authors: 何权瀛
Journal: BMJ (2005)

中国目前已经发表的流行病学调查结果表明,阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种常见多发病.据报道香港地区OSAHS患病率为4.1%[1];张庆等[2]报告河北省承德市OSAHS患病率为4.63%;另有调查报告上海市OSAHS患病率为3.62%[3].如依照4%的患病率估算,目前我国30岁以上人口中OSAHS患者至少有2 000万人.但必须指出,实际患病人数肯定远不止这个数字.因为目前国内外进行OSAHS流行病学调查时通常分两步进行,首先通过问卷了解所调查人群中的中重度打鼾发生率,在此基础上再对中重度打鼾者进行多导睡眠图(PSG)监测以确立诊断.然而众所周知打鼾是人在夜间睡眠过程中发生的,本人通常并不知晓,而且常常否认此种现象,只能靠同床和(或)同室人反映.如果打鼾不很重,或者同床和(或)同室人对此不敏感,则常被忽略.其次还应当特别指出的一点即到目前为止许多人,甚至包括一些医生在内仍旧不认为睡眠打鼾是一种病,是一种可以严重影响全身多脏器功能的临床综合征。
结核病的预防
Authors: 屠德华
Journal: BMJ (2006)

结核病是由结核分枝杆菌引起的经呼吸道传播的慢性传染病,目前预防结核病的关键措施是通过发现传染源并采用直接观察下短程化疗为重点内容的短程督导化疗(directly observed treatment short-cource,DOTS)策略[1],虽能达到控制传染源,避免健康人受结核菌感染,但不能阻止已感染结核菌者的发病.卡介苗接种主要是减少儿童结核特别是儿童结核性脑膜炎和血行播散性结核病的发生,但保护作用有限,难以起到流行病学的作用.针对已感染人群所采用的预防性治疗,主要是阻止和减少感染者结核病的发病,对患者难以发挥作用,因此重点应用在低疫情地区.目前我国所进行的预防手段是采取以控制传染源为重点,综合使用其他措施的策略。
Insulin administration in obese patients with type 2 diabetes mellitus
Authors: Xian Jin
Journal: BMJ (2019)

肥胖和2型糖尿病密切相关，肥胖是2型糖尿病发生的独立危险因素。2型糖尿病合并肥胖患者减重并维持体重困难，血糖达标难度更大。胰岛素治疗导致的体重增加是肥胖糖尿病患者强化血糖控制的主要障碍之一。超重或肥胖2型糖尿病患者应选择增加体重作用小的胰岛素治疗策略，联用至少一种其他降糖药物，减轻因胰岛素剂量过大而引起的体重增加，使胰岛素控制患者血糖的同时，能够改善胰岛素抵抗，减少糖尿病慢性并发症的发生风险。
Early referral to palliative care: Where are we in Brazil?
Authors: Andre Filipe Junqueira Santos, Aurélio Monteiro, Carolina Sarmento Duarte, Carolina Gomes Jacobina Silva, Sarah Ananda Gomes, Clarissa Miranda Vieira
Journal: Journal of Clinical Oncology (2020)

e24118 Background: The American Society of Clinical Oncology (ASCO) recommends that patients with advanced cancer receive dedicated palliative care services concurrently with active treatment within 8 weeks of diagnosis and maintaining follow up for at least 12 weeks. The adherence to these standards in Brazil is unknown. Objective: To evaluate adherence to ASCO recommendations of early referral to a palliative care team at a multicentric outpatient oncological clinic in Brazil using the following indicators: (i) whether patients were enrolled in palliative care services within 8 weeks of diagnosis and (ii) whether patients were followed up for a minimum of 12 weeks. Methods: All palliative care physicians within a network of 15 outpatient oncology clinics (Oncoclinicas Group) prospectively recorded time to care post-diagnosis with advanced cancer by ASCO guidelines and duration of follow up time throughout the 1-year duration of the study. The number of patients enrolled in care within 8 weeks of diagnosis and followed for at least 12 weeks was recorded. An initial goal of adherence was set at 50% for each indicator. Results: Of 1016 patients, we studied 579 data numbers. 26% of patients were referred within 8 weeks of their advanced cancer diagnosis and 23% were followed for 12 weeks or more. Conclusions: These data indicate that even with a recognition of ASCO recommendations for timely palliative care referral, patients in Brazil are often seeing palliative care teams too late. The possible main causes of this late referral in Brazil are: (i) lack of adequate knowledge about the real meaning of palliative care and (ii) a lack of understanding of how a multidisciplinary team acts positively in the patient's experience. We believe that the best way to change this reality is through continuing education about Palliative Care, reinforcing the intention of continuous care: strengthening bonds, facilitating communication, reaching better symptoms control and practicing patient-centered care.
Managing patient complaints in China:a qualitative study in Shanghai
Authors: 蒋伊石, 应晓华, 张倩, Tang Sirui Rae, Kane Sumit, Mukhopadhyay Maitrayee, 钱序, HESVIC团队作者
Journal: BMJ (2018)

目的
检视中国患者投诉处理体系，并识别有效管理的障碍因素。


研究地点
患者投诉处理体系的国家级、上海市级、医院级关键利益相关者。


研究对象
以上海为案例，包括政策制定者、监管者、医院管理者、医务人员、患者和其他利益相关者的35个关键知情人参与。


主要和次要结局
对访谈对象进行半结构式访谈，以了解患者投诉的处理过程及投诉管理过程和结局的影响因素。


结果
中国患者投诉处理体系主要建立于过去10年，其中医院肩负着最大的责任。有效管理患者投诉的障碍因素包括患者不知晓投诉处理体系；医务人员沟通能力不足、医院投诉处理人员影响力弱、投诉处理过程中的信息交流不透明；投诉处理相关规制之间存在冲突、患者的诉求不合理；规制执行不力、投诉管理信息缺失及医院不愿有效管理投诉以改善服务质量。


结论
有效管理患者投诉的障碍因素存在于投诉处理的不同阶段，而医患双方对障碍因素的理解有所不同。信息、流程设计、处理人员、制度安排、统一规制及社会背景因素对有效管理患者投诉至关重要。
The Search for a Uniformly Effective Treatment in Patients With Lupus Miliaris Disseminatus Faciei
Authors: Akanksha Kaushik, Muthu Sendhil Kumaran, Debajyoti Chatterjee, Dipankar De
Journal: JAMA Dermatology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Trial in progress: Neoadjuvant immune checkpoint blockade in resectable malignant pleural mesothelioma.
Authors: Joshua E. Reuss, Boris Sepesi, Christian Diego Rolfo, Marianna Zahurak, Valsamo Anagnostou, Kellie Nicole Smith, Tricia Cottrell, Julie E. Stein, Peter Bela Illei, Janis M. Taube, Gary L. Rosner, Joseph Christopher Murray, Erica C. Nakajima, K Ranh Voong, Russell K. Hales, Stephen Yang, Richard James Battafarano, Joseph Friedberg, Anne S. Tsao, Patrick M. Forde
Journal: Journal of Clinical Oncology (2020)

TPS9078 Background: While the role of surgery in limited-stage (stage I-III) malignant pleural mesothelioma (MPM) is controversial, many centers have adopted an aggressive tri-modality approach incorporating (neo)adjuvant chemotherapy, surgical resection and radiotherapy. Despite this, most patients relapse and die from their disease. Immune checkpoint blockade (ICB) has shown promise in advanced MPM, but the mechanisms of response and resistance remain elusive. Improving the mechanistic understanding of ICB in MPM while concurrently optimizing the treatment strategy for limited-stage MPM are two urgent unmet needs. This multicenter multi-arm phase I/II study seeks to evaluate the safety and feasibility of neoadjuvant ICB in resectable MPM, incorporating novel genomic and immunologic analyses to deliver mechanistic insight into the biology of ICB in MPM. Methods: Patients with surgically resectable stage I-III treatment-naïve epithelioid or biphasic MPM receive neoadjuvant treatment with nivolumab every 2 weeks for 3 doses with or without 1 dose of ipilimumab (arm A: nivolumab monotherapy; arm B: nivolumab + ipilimumab). After macroscopic complete resection, patients receive optional investigator-choice adjuvant chemotherapy +/- radiation. Following this, patients will receive up to 1 year of adjuvant nivolumab. Feasibility and safety are co-primary endpoints of this study with feasibility defined by a delay in surgery of ≤24 days from the preplanned surgical date and safety defined by adverse events according to CTCAE v5.0. Bayesian-designed stopping rules have been implemented for feasibility and safety. Secondary endpoints include assessment of pathologic response and radiographic response using RECIST 1.1 for MPM. Correlative analyses will be performed on tissue specimens obtained pre- and post-ICB, as well as blood obtained pre, during, and post-ICB. Key correlates include multiplex immunofluorescence and longitudinal ctDNA assessment. Whole exome sequencing, T-cell receptor sequencing, and the MANAFEST functional neoantigen assay will be utilized to identify neoantigen-specific T-cell clonotypes and track these clonotypes temporally (during/post ICB) and spatially (across immune compartments). Single-cell RNA sequencing will be used to characterize the functionality of expanded T-cell clonotypes. Accrual to arm B will commence following complete accrual to arm A with a planned total enrollment of 30 patients. This study is open with 1 patient enrolled at the time of submission. Clinical trial information: NCT03918252.
Efficacy of third-line anti-EGFR-based treatment (tx) versus (vs) Regorafenib/TAS-102 (R/T) according to primary tumor site in RAS/BRAF wild-type (wt) metastatic colorectal cancer (mCRC) patients (pts).
Authors: Raffaella Vivolo, Emilio Bria, Ina Valeria Zurlo, Maria Bensi, Emanuela Dell'Aquila, Annunziato Anghelone, Domenico C. Corsi, Giulia Caira, Daniele Santini, Diletta Ingrosso, Alessandra Emiliani, Maria Alessandra Calegari, Fabrizio Citarella, Carmelo Pozzo, Roberta Grande, Michele Basso, Giampaolo Tortora, Lisa Salvatore
Journal: Journal of Clinical Oncology (2020)

4082 Background: Right- (R) and left-sided (L) mCRCs exhibit different clinical and molecular features. Several retrospective analyses showed that the survival benefit of anti-EGFR-based tx is limited to RAS/BRAF wt L-sided mCRC pts, which a larger effect in the first-line setting. Few data are available concerning the anti-EGFR efficacy according to primary tumor site in third line. Methods: Pts affected by RAS/BRAF wt mCRC treated with third-line anti-EGFR-based tx or R/T were retrospectively collected. The objective of the analysis was to compare tx activity and efficacy according to tumor site. Primary endpoint was PFS; secondary endpoints were OS and RR. PFS and OS analyses were performed using Kaplan-Meier method, and survival curves were compared using the log-rank test. RR was evaluated according to RECIST criteria and it was compared in the two groups using Fisher’s exact test. Statistical significance was set at p = 0.05 for a bilateral test. Univariate and multivariate analyses for PFS and OS were performed. Results: A total of 76 RAS/BRAF wt mCRC pts, treated with third-line anti-EGFR-based tx or R/T, were enrolled. Of those, 19 (25%) pts had R-sided tumor (9 pts received anti-EGFR tx and 10 pts received R/T) and 57 (75%) pts had L-sided tumor (30 pts received anti-EGFR tx and 27 pts received R/T). As shown in the table, a significant PFS and OS benefit in favor of anti-EGFR tx vs R/T was observed in L-sided pts, while no difference both in PFS and OS was observed in R-sided pts. RR was significantly higher in L-sided pts treated with anti-EGFR vs R/T, no difference was shown in R-sided pts. At the multivariate analysis, tx regimen was indipendently associated with PFS in L-sided pts, but not in R-sided pts. Conclusions: Our study confirmed the results deriving from the retrospective analysis of the phase III study 20020408. Our results demonstrated a different benefit from third-line anti-EGFR tx according to primary tumor site, confirming the role of L-sided tumor in predicting benefit from third-line anti-EGFR vs R/T, while no difference was observed in R-sided tumors. [Table: see text]
对现行全科医师再培训项目的一些看法
Authors: 曾西军, 贺斌
Journal: BMJ (2007)

随着党和政府对社区卫生服务的重视,社区卫生服务越来越受到人们的关注.然而,社区卫生服务这项工作能不能做好,其中非常重要的一个因素就是要有合格的全科医师,各级政府也注意到了这个问题.为了提高全科医师的整体水平,各个地方都在积极努力地想各种办法,有的甚至拿出很大一部分资金用于全科医师的继续教育.然而,笔者认为目前的全科医师继续教育不尽合理。
Clinical application of small incisions in the treatment of benign thyroid diseases with endoscopic assistance assistance
Authors: Zheng-bin Tu, Wei-xian Huang, Feng Yu
Journal: BMJ (2012)

To explore the clinical application and value of small incisions in the treatment of benign thyroid diseases with endoscopic assistance.A total of 57 cases with thyroid nodules were operated under the assistance of ultrasonic scalpel and endoscope with the lifting-up of special instrument and small neck incisions.However one malignant case was converted iuto open surgery according to frozen sections.The other 56 cases were successfully operated.The mean operative duration was 42 min and postoperative stay 2 -3 days.All incisions achieved primary healing and the length range was 1.5 - 3.5 cm.Except for transient hoarseness in 1 case,there was no such complications as choking,lip paralysis or hemorrhage,etc.All were discharged uneventfully.This surgical approach shall be recommended for its merits of miniinvasiveness,less hemorrhage,fewer complications and wider applications.

Key words: 
Video-assisted surgery; Thyroid tumors
Correlation of baseline molecular and clinical variables with ALK inhibitor efficacy in ALTA-1L.
Authors: D. Ross Camidge, Huifeng Niu, Hye Ryun Kim, James Chih-Hsin Yang, Myung-Ju Ahn, Jacky Yu-Chung Li, Maximilian Hochmair, Angelo Delmonte, Alexander I. Spira, Rosario Garcia Campelo, Fabrice Barlesi, Geoffrey Liu, Marcello Tiseo, Cong Li, Miguel Williams, Hyunjin Shin, Pingkuan Zhang, Sanjay Popat
Journal: Journal of Clinical Oncology (2020)

9517 Background: Efficacy of ALK TKIs in patients (pts) with ALK+ non-small cell lung cancer (NSCLC) varies. We evaluated the impact of EML4-ALK fusion variants and other baseline (BL) molecular and clinical variables on clinical efficacy of brigatinib (BRG) vs crizotinib (CRZ) as first ALK TKI therapy in pts with ALK+ NSCLC in the phase 3 ALTA-1L (NCT02737501) trial. Methods: Plasma samples were collected at screening for molecular genetic analysis of ALK and other genes implicated in NSCLC by next-generation sequencing. Exploratory analyses were performed to identify associations of clinical outcomes with oncogenic alterations including ALK fusion variants and TP53 status. Results: 124 BL samples were collected from 136 BRG-treated pts and 127 from 137 CRZ-treated pts. Pts with plasma samples were representative of the intent-to-treat population. BL ALK fusion detection rate was 52% (65/124) and 54% (68/127) in the BRG and CRZ arms, respectively, of which 83% (54/65) and 93% (63/68) were EML4-ALK fusions. In pts with detectable EML4-ALK fusions, the three predominant EML4-ALK fusion variants (V1, V2, V3) were equally distributed between arms; V1 and V3 were most prevalent (BRG/CRZ: V1, 42%/47%; V3, 42%/33%) but V1 was more frequent than V3 in pts without BL brain metastasis (47% vs 36%) or prior chemotherapy (45% vs 35%). Gender and age did not impact variant type. BRG showed higher ORR and improved mPFS vs CRZ in all variant subgroups; pts with V3 had poorer PFS compared with V1 and V2 regardless of treatment (Table). In pts with V3, BRG showed significantly improved PFS (HR=0.273, 95% CI 0.125, 0.597) and higher ORR (84% vs 67%) vs CRZ. TP53 mutation was detected in 30% (37/124) of pts in BRG arm and 26% (33/127) in CRZ arm. In pts with detectable ALK fusion, TP53 mutation showed poorer PFS in both arms than nonmutant/undetected cases (Table). BRG had better ORR and PFS vs CRZ in pts regardless of TP53 mutation status. Additional analyses of BL variables are ongoing. Conclusions: EML4-ALK fusion variant 3 and TP53 mutation were identified as poor prognosis biomarkers in ALK+ NSCLC. BRG demonstrated better efficacy than CRZ as first-line therapy in pts regardless of EML4-ALK fusion variant and TP53 mutation status. These findings may help define areas of greatest unmet need. Clinical trial information: NCT02737501 . [Table: see text]
Genome-wide methylation analysis in long-term survivors of glioblastoma (GBM).
Authors: Justin Chau, Neha Dhungana, Jordan Kohlmeyer, Michael Petronek, Dawn Quelle, Mariko Sato, Benjamin Darbro, Karra Jones, Varun Monga
Journal: Journal of Clinical Oncology (2020)

2552 Background: Identification of tumor characteristics that may be associated with survival in patients with glioblastoma (GBM) has been largely characterized by IDH mutations and MGMT promoter methylation status. However, these genetic changes and other currently available data are not sufficient to explain the longevity experienced by a subset of long-term survivors (LTS) - patients surviving longer than 3 years past diagnosis. Methods: The study identified GBM patients established and treated at University of Iowa Holden Comprehensive Cancer Center from 2007-2017 whose disease recurred after initial resection. Patients were categorized LTS if they survived &gt; = 3 years beyond initial definitive resection; short-term survivors (STS) if less than 3 years. Pathologic specimens at initial and repeat resection underwent genome wide methylation analysis using the Infinium EPIC microarray system. Data were analyzed to identify genes that exhibited differentially methylated CpG regions. Results: Resection specimens from GBM survivors were compared to those of STS. A total of 29 samples were analyzed and compared (15 LTS and 14 STS samples). Multidimensional scaling plots identified significant differences in genomic constitution between LTS and STS specimens. Granular analysis yielded 89 differentially methylated regions significantly associated with long-term survival (adjusted p &lt; 0.05). PTPRN2 (p = 0.000376), PTPN11 (p = 1.38E-05), and PAX6 (p = 0.000671) were found to exhibit numerous differentially methylated CpG sites between MGMT-methylated vs. unmethylated specimens. Further notable, higher levels of differentially methylated CpG shores and open-seas regions on chromosome 12 were associated with long-term survival (p = 1.89E-08). Conclusions: Our study identified multiple significant epigenetic differences that, functionally or consequentially, may be associated with extended survival in GBM patients. The implication that CpG shores, rather than islands, are associated with long-term survival raises further intriguing questions regarding the depth of epigenetic complexity in this disease. More immediately, the surprising association of multiple protein phosphatases with LTS in our study may hint at the class’ previously unspecified, yet integral, role in delaying disease progression and identify new, novel avenues for therapy.
Diagnosis and treatment of split cord malformations in children
Authors: Chun-quan Cai, Qing-jiang Zhang, Xiao Ma, Ning Sun
Journal: BMJ (2008)

We retrospectively analyzed clinical and imaging data of 26 children with split cord malformations (SCMs). Based on Pang's classification, 14 SCMs were defined as type Ⅰ and 12 as type Ⅱ.Neural function was markedly improved in 20 patients postoperatively. Three of 4 children who did not undergo surgical treatment had neural function deteriorated. Two children lost follow-up. We suggest that Pang's Classification of SCMs may be useful in describing pathological changes and guiding surgical procedure; imaging examine (including MRI, CT and X-ray) would play a significant role in confirmed SCMs diagnosis; and surgical operation should focus on eliminate and prevent spinal cord damnification.

Key words: 
Neural tube defects;  Child
Tumour predisposition and cancer syndromes as models to study gene–environment interactions
Authors: Michele Carbone, Sarah T. Arron, Bruce Beutler, Angela Bononi, Webster Cavenee, James E. Cleaver, Carlo M. Croce, Alan D’Andrea, William D. Foulkes, Giovanni Gaudino, Joanna L. Groden, Elizabeth P. Henske, Ian D. Hickson, Paul M. Hwang, Richard D. Kolodner, Tak W. Mak, David Malkin, Raymond J. Monnat, Flavia Novelli, Harvey I. Pass, John H. Petrini, Laura S. Schmidt, Haining Yang
Journal: Nature reviews. Cancer (2020)
Update concept and pay attention to diagnosis and treatment for hemorrhoids
Authors: 汪建平, 黄美近
Journal: BMJ (2005)

人类早在公元前770年就有了关于痔的文献记载,经历了近三千多年的发展,痔的病因和发病机制仍未完全明确[1].自1975年Thomson 发表在美国外科杂志的文章The nature of hemorrhoids首次提出肛垫和肛垫学说以来[2],近二三十年来越来越多的学者对痔的本质和发病机制进行了深入探讨,逐渐对肛垫有了全新认识,对盆底控便机制有了更深入的了解,直接导致产生了有关痔起源的肛垫下移学说.多年来对痔的研究取得了突破性进展,从解剖学、组织学、病理生理学等方面赋予了痔现代概念,进而提出痔治疗学现代概念。
Treatment of colorectal cancer in Armenia: A retrospective hospital-based study from a developing world.
Authors: Samvel Bardakhchyan, Sergo Mkhitaryan, Davit Zohrabyan, Liana Safaryan, Armen Avagyan, Lilit Harutyunyan, Jemma Arakelyan, Gevorg Tamamyan, Armen Tananyan
Journal: Journal of Clinical Oncology (2020)

e16099 Background: In Armenia colorectal cancer (CRC) is on the third place by incidence. Every year around 700 new cases are diagnosed with 60% diagnosed in 3 rd and 4 th stages. Methods: For this retrospective hospital-based study we have collected data from two main oncology centers in Armenia: National Oncology Center and Muratsan Hospital Complex of Yerevan state medical university. The information about patients with CRC who were treated at these two centers during 01/01/2010 - 07/01/2018 period was collected from the medical records. Results: 602 patients with CRC treated during mentioned period in these two hospitals were involved in final analysis. From them 51.8% were female. Median age at diagnosis was 58. Median follow up time was 37 months (range 3-207). 26.1% had right sided, 30.9% left sided and 43.0% rectum cancer. 8.6% of patients had stage 1, 32.9% stage 2, 38.0% stage 3, 17.6% stage 4 CRC and for 2.7% patients stage was unknown. The median survival was not reached for the entire cohort ( &gt; 37 months). Median survival was &gt; 66.5 months for 1 st , &gt; 48.5 months for 2 nd , &gt; 35 months for 3 rd and 19 months for 4 th stages. Tumor stage, grade and histology were the main independent prognostic factors by univariate and multivariate Cox regression analysis. For stage 2 CRC patients (198) we found significant difference regarding overall survival (OS) (p = 0.024) and disease free survival (DFS) (p = 0.006) for those who received adjuvant chemotherapy after surgery compared to those who didn’t receive adjuvant chemotherapy. For stage 2 and 3 rectum cancer patients, our study failed to show OS (2 nd stage: p = 0.961; 3 rd stage: p = 0.348) or DFS (2 nd stage: p = 0.719; 3 rd stage: p = 0.983) advantage for those who received radiotherapy (RT) compared with those who didn’t receive RT. In our study population 28.3% of stage 4 patients received chemotherapy combined with Bevacizumab while 70% were treated with chemotherapy only. Median OS between these two groups wasn’t significantly different (21 months in Chemo+Bevacizumab group and 18.5 months in chemo only group (p = 0.382)). 3 and 5-year survival rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages 1-2, 62.5% and 48.4% for stage 3, 24.4% and 17% for stage 4 respectively. Conclusions: As seen from our results our survival rates are inferior compared to that of developed world. The reasons for that could be compromise in surgery and RT, poor pathological assessment, unavailability of some molecular markers, poor availability of new targeted drugs and absence of national treatment guidelines.
Micro-traumatic surgical procedure of loose seton and cutting seton in the treatment of high anorectal fistulae of 136 cases
Authors: Chengwei Yu, Yufeng Cui, Jingying Pan, Xiangyu Meng
Journal: BMJ (2014)

To explore the therapeutic effect of micro-traumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistulae. Application of cutting seton (truss rubber bands) implemented the high part of fistulae and loose seton (ligation rubber band but non-fastened) for the low part of fistulae. 133/136 patients undergoing micro-traumatic surgery were cured by one operation, 2 cases had pseudo-healing and there was 1 recurrent case. And the curative rate was 97.8%. The micro-traumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistula has such multiple advantages as small incision, minor trauma, lesser pain, faster healing and a shorter course of treatment. And it may preserve the proper anal function and the integrity of anal skin. And its clinical efficacy is satisfactory.


Key words: 
Loose seton and cutting seton; Surgical procedures, minimally invasive; Rectal fistula