ABSTRACT
Purpose@#Through meta-analysis, we aimed to assess the efficacy and safety of drug-coated balloons (DCB), compared with drugeluting stents (DES) or uncoated devices, in the treatment of de novo coronary lesions. @*Materials and Methods@#Only randomized controlled trials were included. The primary outcomes were late lumen loss (LLL), target lesion revascularization (TLR), and major adverse cardiac events (MACEs). Subgroup analyses were conducted based on clinical indications, whether DCBs were used with a systematic or bailout stent, and types of DESs. @*Results@#The present meta-analysis demonstrated that DCBs elicit significantly lower incidences of TLR, MACE, and LLL, compared with uncoated devices, and similar incidences, compared with DESs, in the treatment of de novo coronary lesions. Subgroup analysis indicated that DCBs used with a bailout stent achieved lower incidences of binary restenosis and myocardial infarction, compared with uncoated devices, and provided less LLL than DESs. DCBs showed similar rates of TLR and MACE, with significantly less LLL, than DESs in treating de novo small-vessel diseases. The clinical efficacy of DCBs was similar to that of secondgeneration DES. @*Conclusion@#Overall, DCB is favored over bare metal stent alone in treating de novo coronary lesions. DCBs appear to be a promising alternative to DESs in the treatment of de novo coronary lesions.
ABSTRACT
Objective To investigate the application value of Calot triangle hollowing-out maneuver in laparoscopic cholecystectomy (LC) for preventing bile duct injury.Methods The retrospective cross-sectional study was conducted.The clinical data of 537 patients who underwent LC in the Dexing People's Hospital between January 2011 and December 2015 were collected.The tissues in Calot triangle were hollowed out,and cystic ducts were cut off and then gall bladders were resected.Observation indicators:(1) operation situations:anatomy of the Calot triangle and operation time;(2) postoperative recovery situations:postoperative complications and bile duct injury;(3) follow-up situation.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and occurrence of cholangitis up to May 2016.Results (1) Operation situations:of 537 patients with LC,anatomical relation among cystic duct,common hepatic duct and common bile duct (three-duct relation for short) could be seen in 165 patients without dissection,and three-duct relation cannot be seen in other 372 patients.Of 372 patients,16 were operated on with the gallbladder open due to the difficult dissection of Calot triangle,7 were converted to open surgery due to local severe adhesion and unclear structure,1 was converted to open surgery due to intraoperative varices induced bleeding in Calot triangle,and other 348 patients underwent successful LC using Calot triangle hollowing-out maneuver.Operation time was 15-190 minutes,with an average time of 28 minutes.(2) Postoperative situations:2 patients were complicated with biliary colic pain,showing stones in the distal common bile duct via magnetic resonance imaging scans,and then received endoscopic sphincterotomy (EST);3 had subxyphoid puncture hole infection,1 had a small amount of postoperative bleeding due to hepatocirrhosis,3 had pulmonary infection,and they were improved by symptomatic treatment;1 had chylous fistula and were improved through drainage and low fat diet intake for 1 week;2 with mild bile leakage was improved through peritoneal drainage.No bile duct injury was detected.(3) Follow-up situation:348 patients were followed up for 12-18 months,with a median time of 16 months.During the followup,348 patients with follow-up had survival without manifestation of cholangitis.Conclusion Calot triangle hollowing-out maneuver could effectively prevent bile duct injury in LC.
ABSTRACT
As an important acupoints beyond meridians, Huatuo spine points are used extensively. Its localization generally is considered on the back waist where is under the both sides of the spinous processes (0.5 inch) from the first thoracic vertebral to the fifth lumbar. Furthermore, Huatuo spine points include 17 points on the right side and 17 points on the left. Through a large number of clinical observations and literature’s searching, the writer considers that the Huatuo spine points are an integrated, independent region that is combined pass through the Bladder meridian and the Du meridian. Therefore, acupuncture the region may depend on the specific conditions.
ABSTRACT
Acupuncture has a definite curative in treating pain.Pain is a subjective feeling,which is not easy to be measured because of lack of quantifiable index.Besides,because evaluation measures for acupuncture analgesia are not unanimous,it is lack of comparability among the different clinical researches.The author summarized the clinical evaluation measures of acupuncture analgesia which are used in clinical commonly,and considered that the clinical study on acupuncture analgesia should be globally evaluated from the extent of pain,complication symptoms and life quality on the basis of determining the nature and xing quantity of the subjective index.
ABSTRACT
Objective To identify the COL7A1 gene mutation in a family with dy strophic epidermolysis bullosa pruriginosa. Methods PCR and direct DNA sequencin g were employed to determine the mutation sites and mutation types. RT-PCR and cloning sequencing were performed to further identify the pathogeny of this dise ase. Results A splicing mutation was found in 87 exon of COL7A1 gene which resul ted in an in-frame deletion of exon 87. Synthesis of ?1(VII) collagen polypept ides was internally shortened by 23 amino acids. The mutation was not found in n ormal controls. Conclusions The splicing mutation of COL7A1 gene is the underlyi ng cause of and specific rather than common polymorphism for the family with dys trophic epidermolysis bullosa pruriginosa subtype.