Clinical trials

Patients receiving surgery of upper gastrointestinal tract are often elderly, frail, malnourished, with poor functional reserve. They are associated with poor post-operative outcomes. This multimodal treatment is associated with considerable morbidity and decline of patients' functional capacity due to sarcopenia and malnutrition. The poor outcomes can lead to a prolonged delayed recovery, hospital stay, and disability. The post-operative morbidity, especially cardiopulmonary complications, remains substantial. Prehabilitation before surgery can improve the functional capacity of patients to better withstand the stress of surgery. In this perspective, prehabilitation has gained increasing popularity as it consists of various interventions that aim to optimize patient's preoperative condition. The rehabilitation programmes varies considerably. To maximise the benefits that can be accrued in the pre-operative period, prehabilitation programmes should be multimodal, including exercise and nutritional support. Increasing the maximal aerobic capacity by training before surgery, improves patients' functional capacity and should allow patients to better withstand the postoperative stress response. Prehabilitation has been trialled in a range of surgical specialities, including colorectal, breast, hepatobiliary, bariatric, urological, thoracic, and orthopaedic surgery. In major abdominal surgery, multiple studies have indicated that prehabilitation improved preoperative functional capacity and postoperative outcomes. There is a large body of evidence for prehabilitation in patients undergoing intra-abdominal surgery, with studies reporting improvements in pre-operative cardiopulmonary fitness, and reductions in post-operative complications. The data on prehabilitation after surgery for upper gastrointestinal tract are scarce and ambiguous and these studies often lacked a multimodal approach. The evidence of prehabilitation in Taiwan is scarce also. Surgery for upper gastrointestinal tract has a high morbidity and is associated with a prolonged recovery so there is significant potential to improve outcomes in this high-risk population. However, there are few studies of prehabilitation in surgery for upper gastrointestinal tract. Hence, this study aimed to investigate the effect of a multimodal personalised, prehabilitation program on postoperative recovery and morbidity in patients undergoing surgery for upper gastrointestinal tract.

Effects of Antrodia cinnamomea on the hepatoma patients after Transcatheter hepatic artery chemoembolization

This study aims to evaluate the efficacy of two traditional Chinese medicine (TCM) formulas, Danggui Shaoyao San (DSS) and Cuscuta Chinensis (Tu Si Zi), in treating primary dysmenorrhea (PD). Primary dysmenorrhea, a common condition characterized by painful menstrual cramps, affects many women of reproductive age and significantly impacts their quality of life. Conventional treatments, such as NSAIDs and oral contraceptives, often have limited efficacy or side effects, underscoring the need for alternative therapeutic options. In this randomized, double-blind study, participants will be divided into four groups: DSS, Tu Si Zi, a combination of DSS and Tu Si Zi, and a placebo group. The study will measure treatment outcomes using the Visual Analogue Scale (VAS) for pain and the Menstrual Symptom Questionnaire (MSQ), which captures physical and emotional symptoms. Additionally, TCM-based tools like pulse diagnosis and constitution questionnaires will be employed to explore personalized treatment strategies. This research seeks to determine whether these TCM formulas can alleviate pain and improve other menstrual symptoms, potentially providing broader benefits than conventional painkillers. The findings aim to support evidence-based integration of TCM in managing dysmenorrhea and inform clinicians and patients about effective therapeutic choices.

The goal of this clinical trial is to learn if intraoperative music stimulation works to alleviate perioperative pain in surgical patients undergoing general anesthesia. It will also learn about the possible mechanisms by how music affects pain. The main questions it aims to answer are: Does music lower the number of times participants need to use a rescue analgesic? What changes occur in electroencephalogram (EEG) and nociception monitors when participants listen to music? Researchers will compare music to mute or control (hear ambient sounds without earphones) to see if music works to alleviate perioperative pain. Participants will listen music or mute or ambient sounds throughout the operation, and receive routine anesthesia care.