Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
【Abstract】 Objective To investigate the cl inical effect of transplanting by auto-fat granule injection for mastatrophy post suckl ing. Methods From March 2000 to June 2006, 73 patients(146 breasts ) with mastatrophy post suckl ing were treated by transplanting auto-fat granule. The mastatrophy occurred between ages 28 and 52 years with a median of 37 years post suckl ing. The breasts shrank and their elasticity decreased gradually within 2-10 years post suckl ing. The autofat granule was obtained by l iposuction with syringe from patient’s abdomen, waist, buttocks and thighs, etc. After repeated wash and purification, the auto-fat granule was transplanted into the interspace behind the breast by injection. The quantity of auto-fat granule was 50-100 mL in each side of breast per transplantation at 3-6 months intervals, and the whole course of treatment needed 2-6 transplantations. Results The incisions in all cases healed primarily postoperatively. In 73 cases, 65 were followed up from 6 months to 3 years post operation. All patients had a significant improvement in their breast size and shape postoperatively and their breasts were soft and natural in appearance and feel. All of them had more perfect arcuation ofphysique and body with strengthened self-confidence, rel ieved mood and improved qual ity of l ife. However, small indurations were found sporadically in 7 cases (10 breasts) within 2-7 months, and calcifications in 5 cases (8 breasts) within 9-14 months post the first operation. Conclusion The transplantation by auto-fat granule injection for mastatrophy post suckl ing is an effective and practical method. The surgical technique is well worth performing in cl inical practice.
目的:总结分析子宫内膜癌临床特点、治疗方法的疗效及与各预后高危因素之间的关系，以提高临床诊疗水平。方法:回顾性分析我院1998年1月～2005年12月收治住院的子宫内膜癌患者499例的临床病理资料，总结患者的一般情况、临床特点并进行随访，分析内膜癌高危因素对预后的影响。采用寿命表法计算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例风险模型分析预后因素。结果:(1) 手术－病理分期I、Ⅱ、Ⅲ期患者5年生存率分别为94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 单因素分析显示：病理类型、手术－病理分期、组织学分级、肌层浸润深度、淋巴结转移和是否行淋巴结切除术是影响预后的高危因素。（3）多因素分析显示：病理类型、手术－病理分期、组织学分级和肌层浸润深度是影响患者预后的独立危险因素。结论:(1) 对具有高危因素的患者，如特殊病理类型、手术－病理分期期别晚、组织学分级为G3和深肌层浸润，应辅以术后治疗以提高生存率。(2)分期越晚，生存率越低（Plt;0.05）。