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AIM:To analyze the compliance and curative effect of comprehensive vision training in patients with amblyopia. METHODS:A prospective study was conducted among 200 patients(294 eyes)with amblyopia who were treated in the hospital from July 2018 to August 2019. The patients were divided into a control group(98 patients, 140 eyes, traditional comprehensive vision training)and an experimental group(102 patients, 154 eyes, intelligent multi-dimensional comprehensive vision training)according to the random number table method. Curative effect, compliance, and the correlation between the two groups were observed.RESULTS:The overall response rate and compliance rate in the experimental group(93.5%, 45.1%)were higher than those in the control group(80.0%, 35.7%, all P<0.05). The curative effect was different in patients of different age, with different types and severity of amblyopia, different nature of fixation, and different compliance(all P<0.001). Age and the severity of amblyopia were negatively correlated with the curative effect(r=-0.342, -0.459, P<0.001), while compliance was positively correlated with the curative effect(r=0.378, P<0.001). Patients aged 3-6 had significantly better compliance, followed by those aged 7-10(P<0.05). Age was negatively correlated with treatment compliance(r=-0.398, P<0.001).CONCLUSION:Intelligent multi-dimensional comprehensive vision training can improve the compliance of patients with amblyopia, thereby achieving better curative effect. The curative effect is closely related to age, the type and severity of amblyopia, the nature of fixation and compliance. Compliance is related to age. Clinically, early treatment should be conducted bases on these features.
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Microsurgical longitudinal intussusception vasoepididymostomy (LIVE) has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine (85.5%, 59/69) men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis (>10 000 sperm/ml) in 83.1% (49/59) of men. The natural pregnancy rate was 40.7% (24/59) by the end of the study, with 87.5% (21/24) of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Pregnancy , Young Adult , Azoospermia/surgery , Epididymis/surgery , Follow-Up Studies , Organ Sparing Treatments/methods , Postoperative Complications/epidemiology , Pregnancy Rate , Retrospective Studies , Semen Analysis , Testis/surgery , Treatment Outcome , Urogenital Surgical Procedures/methods , Vas Deferens/surgeryABSTRACT
Microsurgical longitudinal intussusception vasoepididymostomy (LIVE) has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine (85.5%, 59/69) men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis (>10 000 sperm/ml) in 83.1% (49/59) of men. The natural pregnancy rate was 40.7% (24/59) by the end of the study, with 87.5% (21/24) of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.
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Objective To explore the clinical efficacy of endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocyst. Methods 100 patients with pancreatic pseudocyst from March 2014 to March 2015, 80 cases were underwent endoscopic ultrasound-guided transgastric and the other 20 cases were underwent transpapillary drainage. The treatment effect and complications were recorded. Results The success rate was 95.00 %, and cysts completely disappeared in 84.00 % of the patients. Among all the patients there are 10 cases occurred intraoperative bleeding, 3 cases occurred stent clogging or migration and 7 cases occurred infection, the overall incidence of complications was 20.00 %. Conclusion Endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocysts has better clinical curative effect, and can also reduce the occurrence of complications, which is worth popularizing clinically.
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Objective To explore the effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.Methods Data with late-onset bleeding after high frequency electric resection of the colon polyps on colonoscopy were collected from 64 elderly patients using antiplatelet drugs from January 2010 to December 2013.Those 64 elderly patiets using antiplatelet drugs were divided into aspirin,clopidogrel,and aspirin + clopidogrel groups.The clinical situation,blood-coagulation time,bleeding-occurrence time,emergency colonoscopy hemostatic rate of demand,and hemostatic time in hospital were analyzed.Results No statistically significant differences were found in the blood-coagulation time,bleeding-occurrence time,and hemostatic time in hospital among aspirin,clopidogrel,and aspirin + clopidogrel groups.However,the clinical situation,and emergency colonoscopy hemostatic rate of demand in aspirin + clopidogrel group were significantly more serious and higher than those of the aspirin or clopidogrel groups (P ＜ 0.01).Conclusions There are more serious clinical situation and higher emergency colonoscopy hemostatic demand in patients with combined use of antiplatelet drugs relative to the use of single antiplatelet drug.The clinicians should pay attention to the combined use of antiplatelet drugs for late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.
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Objective To investigate the role and action mechanism of chemokine (C-X-C motif)receptor 3 (CXCR3)in hepatic ische-mia-reperfusion injury (IRI).Methods Forty-eight mice were divided into operation group and sham-operation group.The operation group was treated to establish a mouse model of IRI.Liver tissues were obtained at 3,6,12,and 24 h after IRI,with 6 mice at each time point.The expression of chemokine (C-X-C motif)ligand 9-1 1 (CXCL9-1 1 )and their receptor CXCR3 were measured by real-time PCR and Western blot.The effect of CXCR3 was blocked by its specific antagonist C6.Hepatic injury was estimated based on the activity of hepatic transaminase and morphological indices.The distribution of subsets of infiltrating T cells was analyzed by flow cytometry.All data were expressed as mean ±standard deviation.Comparison between groups was made by one-way analysis of variance.Results Compared with the sham-operation group,the operation group had significantly upregulated expression of CXCL9-1 1 and CXCR3 at all time points after IRI (P<0.05).Blocking CXCR3 significantly protected liver function and morphology (P<0.05).Antagonist C6 significantly re-duced Th1 cell infiltration (P<0.01),but significantly increased Treg infiltration (P<0.01).Conclusion CXCR3 is an ideal therapeu-tic target in IRI treatment due to its relationship with immunoregulation.
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Objective To understand the Helicobacter pylori ( Hp) infection eradication rate of standard tri-ple therapy in Guangdong Meizhou and the drug resistance situation for metronidazole ,clarithromycin ,amoxicillin and levofloxacin ,in order to look for the treatment countermeasures in Hp eradication failure .Methods 297 cases of Hp positive patients because of gastrointestinal symptoms to our hospital examined from April 2011 and March 2013,were randomly assigned into three standard triple therapy groups:A ( OCA ) group and B ( OCM ) group and C ( OCL ) group.The Hp eradication rate was analyzed .Patients with primary treatment failure were selected as group D (OBAL),proceed to (PPl+B+A+L)7 d therapy,the Hp eradication rate was analyzed .230 Hp strains were isola-ted and cultured from 297 cases received the first eradication therapy and 87 cases received again eradication therapy . The minimum inhibitory concentration (MIC) of metronidazole,clarithromycin,amoxicillin and levofloxacin were tested by E-test,in order to determine the resistance of these four antibiotics in clinical isolated Hp strains .Results With intention-to-treat(ITT) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.0%(72/100),63.0%(63/100) and 72.2%(70/97),respectively.With per-protocol(PP) analysis,the Hp eradication rates of group A (OCA),group B(OCM) and group C(OCL) were 72.7%(72/99),64.3%(63/98),73.7%(70/95),respectively.The eradication rate among three standard triple therapy groups had no obvi-ous difference (ITT:P=0.278,PP:P=0.288,P>0.05).With ITT analysis,the Hp eradication rate in the quadrup-le therapy group D(OBAL) was 92.0%(80/87).With per-protocol(PP) analysis,the Hp eradication rate in the quadruple therapy group D(OBAL) was 97.6%(80/82),which was higher than that of the three standard triple ther-apy groups(ITT:P=0.000,PP:P=0.000).In 230 clinical isolated Hp strains,the resistant rates of levofloxacin,amoxicillin,clarithromycin and metronidazole were 6.08%(14/230),6.52%(15/230),25.65%(59/230), 70.87%(163/230),respectively.Of those 37 strains were mixed resistance,the mixed resistant rate was 16.09%(37/230).The resistant rate of metronidazole was higher than levofloxacin , amoxicillin and clarithromycin ( P =0.000,P<0.01),the resistant rate of clarithromycin was higher than levofloxacin and amoxicillin (P=0.000),no statistically significant difference between amoxicillin and levofloxacin (P=0.848).Conclusion The Hp resistance is similar to the national average in Guangdong Meizhou ,the eradication rate of standard triple therapy is lower than 80%,contain bismuth agent of quadruple therapy is good rescue therapy .
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Objective To investigate the missing rate of polypus with colonoscopy and correlation factors for missed diagnosis.Methods Data with colorectal polyps collected a second colonoscopy within 180 days after polyps were detected and removed on the initial colonoscopy in 186 patients between July 2009 and June 2013.The following factors were statistically analyzed,including lesionrelated factors (the lesion size,location,shape,number,and pathology),and non-lesion-related factors (intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).Results Polypus missed diagnosis was found in 57 patients out of 186 recruited subjects (30.64％).A total of 76 polypus were missed out of 343 (22.16％) polypus detected by repeated colonoscopy.Flat small polyps were easily missed diagnosis (P ＜ 0.01).Polyps located at sigmoid,cecum and ascending colon,hepatic flexure,and splenic flexure were easily missed diagnosis (P ＜0.05).The rate of missed diagnosis was significantly increased in the condition of the low intestinal cleanliness,short colonoscopy post-set time,non-intravenous anesthesia,and beginner colonoscopy doctors (P ＜ 0.01).Conclusions A markedly missing rate of polyp existed on colonoscopy,and was closely related to the lesion-related factors (the lesion size,location,shape,number,and pathology) and the non-lesion-related factors (the intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).