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@#Dental anxiety refers to the unique tension, worry and even fear of dental treatment, which may lead to patients refusing to receive treatment and missing the best time for treatment. With the development of bio-psycho-social medical models, psychotherapy has gradually become the optimal treatment for dental anxiety. This article reviewed the etiology, evaluation and psychotherapy of dental anxiety. Research has shown that uncomfortable dental treatment experience is the main cause of dental anxiety, which is commonly assessed using questionnaires in clinical practice. Psychotherapy for dental anxiety is a noninvasive, widely applicable treatment without side effects, mainly including improving the treatment environment and service attitude, behavior therapy, and cognitive therapy, which has been shown to effectively alleviate dental anxiety in patients. However, psychotherapy for dental anxiety is highly demanding for dentists, which hinders its promotion and application. At the same time, the psychotherapeutic mechanism of dental anxiety is not clear and remains to be further elucidated by large-scale and high-quality randomized controlled studies.
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Human leukocyte antigen (HLA) sensitization has been previously considered as a contraindication for kidney transplantation. In the past 30 years, with the development of desensitization therapy strategies and immunosuppressants, more and more highly sensitized patients have been eligible for kidney transplantation. However, highly sensitized patients still face a high incidence of hyperacute rejection and antibody-mediated rejection following kidney transplantation, which restricts the success of kidney transplantation and long-term graft survival. At present, exploring effective desensitization regimen is a hot spot in the research of organ transplantation. In this article, the current desensitization therapy strategies, new preparations for desensitization therapy, and the benefits and risks of desensitization therapy were reviewed, and the current status and future direction of desensitization therapies were investigated, aiming to provide reference for resolving the immune barrier, improving the success rate of kidney transplantation and enhancing the quality of life of highly sensitized recipients.
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Objective To explore the strategies of desensitization treatment for ABO incompatible (ABOi) related living-donor kidney transplantation .Methods A retrospective analysis was performed for 14 recipients undergoing ABOi related living kidney transplantation from July 2015 to December 2018 .The clinical outcomes and expenditures of desensitization treatment before and after optimizing desensitization were compared .Results After desensitization treatment , 14 recipients successfully underwent ABOi-kidney transplantation . Within 2 weeks post-transplantation , blood group antibody rebounded to 1:64 in only 1 recipient .Within 1 week post-transplantation ,the serum creatinine levels decreased to 85-165 μmol/L in 14 recipients .Thirteen patients stabilized after 1 week while another patient had an elevated level of serum creatinine at Day 12 post-operation and renal allograft function recovered after treatment . Two cases of rejection were diagnosed by clinical manifestations and 1 case was confirmed by pathological biopsy . Five cases of programmed renal allograft biopsy indicated critical or suspected acute T-lymphocytic rejection within 1 year .Thirteen cases (92 .6％ ) demonstrated varying degrees of peritubular capillary deposition of C 4d .One case developed BK viral uropathy within 1 year and four patients of pulmonary infections requiring hospitalization were cured after treatment . During an early stage , the incidence of postoperative infection was 57 .14％ and declined to 14 .29％ after optimized desensitization .The expenditure of early desensitization treatment was (27004 .86 ± 10719 .85) yuan and (10612 .29 ± 8143 .05) yuan after optimization .And the expenditure of optimized desensitization was significantly lowered (P<0 .05) . During follow-ups ,renal allograft function of 14 recipients remained decent .And the survival rate of recipient/allograft was 100％ up to the statistical cut-off point .Conclusions Both desensitization strategies may achieve the goal of desensitization for ABOi kidney transplantation and the outcomes are excellent .The expenditure of desensitization treatment is significantly lowered after optimization .
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Objective To evaluate the clinical efficacy and safety of ABO incompatible living kidney transplantation(ABOi-KT). Methods Clinical data of 11 donors and recipients with ABOi-KT were retrospectively analyzed. All the recipients were treated with desensitization before operation. The recovery condition of renal function and blood type antibody titer of the ABOi-KT recipients were monitored after operation. The incidence of complications and clinical prognosis of ABOi-KT recipients were observed. Results The serum creatinine (Scr) of 11 recipients were well recovered after ABOi-KT. No delay in recovery of graft renal function. Among them, 2 recipients experienced a significant increase in the Scr level at postoperative 14 and 45 d respectively, 1 recipient showed criticality cellular rejection after operation and 1 recipient presented with elevated Scr level at postoperative 33 d, accompanied by an increase in blood type antibody titer. The condition became stable after corresponding treatment. The remaining 7 recipients obtained normal graft renal function and postoperative blood type antibody titer did not rebound. During postoperative follow-up until November 2018, no recipient died or graft renal failure occurred. The survival rate of the recipient and graft renal was 100%. Among them, 3 patients suffered from postoperative complications, including pulmonary infection, BK viruria and granulocytopenia, which were cured after symptomatic treatment. Conclusions ABOi-KT is safe, feasible and yields high long-term clinical efficacy, which can increase the source of living donor kidney and relieve the shortage of donor kidney.
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To analyze the impact of sublingual immunotherapy(SLIT)on the quality of life in children with allergic rhinitis.Fifty children with allergic rhinitis who have received sublingual immunotherapy were enrolled in this study.Quality of life was evaluated via measurement of VAS score and rhinoconjunctivitis quality of life questionnaire(RQLQ)before and after treatment.Twenty patients after treatment had complete remission,13 cases were partly alleviated and 17 cases had no response.The total effective rate was 66%.The Multi-VAS scores and Uni-VAS scores in each observation time point(at half a year,one year,two years after treatment)had statistically significant difference compared with that of pre-treatment with SLIT(<0.05).According to RQLQ scores,the quality of life,nasal symptoms,conjunctiva symptoms,non-nasal(ocular)symp-toms,behaviors and emotional responses were greatly improved in each time point compared with that of pretreatment(<0.05).Symptomatic treatment scores in each time point after treatment were significantly different and had a positive correlation with the scores of RQLQ(<0.05).SLIT can improve the nasal allergic symptoms,children's life quality and reduce the use of symptomatic treatment medicines.
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Child , Humans , Administration, Sublingual , Quality of Life , Rhinitis, Allergic , Therapeutics , Sublingual Immunotherapy , Treatment OutcomeABSTRACT
Objective To observe the clinical effect of rhinitis desensitization prescription with nebulization suction in the treatment of allergic rhinitis.Methods 100 patients of allergic rhinitis were randomly divided into control group(50 cases)and study group(50 cases).The control group was given conventional treatment,study group on the basis of conventional therapy was given rhinitis desensitization atomization inhalation.The clinical efficacy was compared between the two groups.Results After 1 course,three course,1 month of treatment,the total effective rates of the study group were 90%,92%,96%,which of the control group were 86%,88%,and 90% respectively,the differences between the two groups were statistically significant (χ2 =3.87,4.10,4.30,all P <0.05).Conclusion Rhinitis desensitization atomization inhalation in the treatment of allergic rhinitis has good curative effect,and it has high clinical application value.
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Objective:To analyze the immune function regulation and clinical effect of dust mite drops desensitization treatment on children with allergic rhinitis.Methods:80 patients with allergic rhinitis and adenoid hypertrophy treated in our department from January 2012 to June 2014 were selected and randomly divided into experimental group and control group.Control group was treated with ebastine and levocabastine treatment, the experimental group was treated with sublingual containing Dermatophagoides Farinae Drops on the basis of control group.The level of IL-2,IL-6,house dust mite specific IgE (sIgE),dust mite IgE (T-IgE),house dust mite specific IgG4 ( sIgE in) ,blood addicted eosinophile cells ( EOS) ,and induced sputum EOS level were compared between the two groups before treatment and after 2 years treatment.Results:The level of IL-2 in the two groups was significantly higher than that before treatment,the level of IL-6 was significantly lower than that before treatment ( P<0.05 ) .After treatment, the level of IL-2 in the experimental group was significantly higher than that in the control group, the level of IL-6 was significantly lower than that in the control group( P<0.05 ).After treatment, the level of sIgE, T-IgE, blood EOS and induced sputum EOS in the two groups were significantly lower than before treatment,the level of sIgG4 were significantly higher than those before treatment (P<0.05).After the treatment,the level of sIgE, T-IgE, blood EOS and induced sputum EOS in experimental group were significantly lower than control group,and the level of sIgG4 was significantly higher than that in control group ( P<0.05).After treatment,the asthma symptom scores and nasal symptom scores of the two groups were significantly lower than before treatment (P<0.05),and those index of experimental group after treatment were significantly lower than control group ( P<0.05 ).Conclusion: Combine the basis of conventional therapy plus with Dermatophagoides Farinae Drops in the treatment of allergic rhinitis and adenoid hypertrophy children can effectively regulate the immune function of the patients,has good clinical efficacy.
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Objective To investigate the desensitization therapy combined with budesonide/symbicort inhalant for treatment of allergic bronchial asthma.Methods 80 patients with allergic asthma randomly divided into observation group and control group,each group of 40 cases.Two groups were given conventional treatment and desensitization therapy,the control group required glucocorticoid,the observation group received budesonide/symbicort inhalant.were evaluated.Results The total effective rate in the observation group was 92.5％ (37/40),the control group was 72.5％(29/40),the difference was statistically significant (P ＜0.05).FEV1.0％ in the two groups after treatment,PET and symptom score were significantly improved after treatment(P ＜0.05).The observation group improved more significantly than that of the control group (P ＜0.05).The incidence of adverse reaction in observation group was 15％(6/40),significantly less than that in the control group 35％ (14/40),the difference was statistically significant (P ＜0.05).Conclusion Desensitization therapy combined with budesonide/symbicort inhalant in asthma symptoms could improve asthma and lung function,which has high safety and worthy of clinical application.
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Las fotodermatosis son un grupo de desórdenes cutáneos causados o agravados por la radiación ultravioleta o la luz visible. Se dividen en cuatro grupos: I, fotodermatosis mediadas inmunológicamente (anteriormente llamadas idiopáticas); II, fotosensibilidad inducida por drogas y químicos; III, desórdenes de la reparación de excisión de nucleótidos del ADN y, IV, dermatosis fotoagravadas. Para llegar al diagnóstico correcto de estas enfermedades es necesario realizar un enfoque clínico adecuado, que esté apoyado en un interrogatorio y examen físico completos, además de exámenes especializados como la fotoprueba y fotoparche. En esta revisión se hace una recopilación de los aspectos epidemiológicos, clínicos, de diagnóstico y tratamiento de las fotodermatosis mediadas inmunológicamente, con mayor énfasis en la terapia de desensibilización con luz ultravioleta (PUVA, UVA, UVB), la cual ha mostrado resultados positivos en estas enfermedades, prefiriéndose la UVB por la mayoría de los autores, a excepción de la urticaria solar, en la cual la PUVA ha demostrado mejores resultados que la UVB a largo plazo. Para esto es fundamental determinar primero la dosis de eritema mínimo (DEM) y la dosis de urticaria mínima en el caso de la urticaria solar. La principal desventaja de la terapia de fotodesensibilización es que sus efectos son temporales y que los pacientes requieren terapia de mantenimiento para lograr un control duradero de la enfermedad, con el riesgo de los efectos carcinogénicos de la luz ultravioleta. Además, hasta el momento hay pocos estudios que evalúen la eficacia y seguridad de la fototerapia de desensibilización y en algunos casos las muestras son muy pequeñas.
Photodermatoses are a group of skin disorders caused or aggravated by ultraviolet radiation or visible light. They are divided in four groups: I, immunologically mediated photodermatoses (previously called idiopathic); II, drug- and chemical- induced photosensitivity; III, defective DNA repair disorders; and IV, photoaggravated dermatoses. To reach the correct diagnosis of these pathologies is necessary to make an appropriate clinical approach supported by a comprehensive interview and physical examination as well as specialized tests like photopatch and phototest. This review is a compilation of the epidemiological, clinical, diagnosis and treatment of immunologically mediated photodermatoses, with greater focus on desensitization therapy with ultraviolet light (PUVA, UVA and UVB), which has shown positive results in this pathologies, being UVB preferred by most authors except in solar urticaria, in which PUVA has displayed better results than UVB in the long term. Firstable, is essential to determine the minimal erythema dose and minimal urticarial dose for solar urticaria. The main disadvantages of photodesensitization therapy is the short therm effects and requirement of maintenance therapy to reach lasting control of disease with the risk of carcinogenesis of UVL. Further, there are few trials that study efficacy and security of desensitization phototherapy and some of these include small sample of patients corroborate this information.
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Humans , Photosensitivity Disorders , Skin Abnormalities , Skin DiseasesABSTRACT
The article aims to introduce a creative desensitization therapy to enrich modem clinic psychological treatment. The imaginary desensitization in the static state of Qigong is one method of the systemic Chinese medicine psychological treatments (SPT). It is suitable for the Chinese cultural background and the psychological characteristics of Chinese people.
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Objective:To eveluate the clinical effects of treating dentine hypersensitivity with three kinds of desensitizer(Prime & Bond NT,GLUMA desensitizer and 75% sodium fluoride glycerin).Methods:324 teeth with dentin hypersensitivity were divided into three groups.Group A:Prime & Bond NT adhesive.Group B:GLUMA desensitizer.Group C:sodium fluoride.Results:Instant,effective rates in group A and group B were significantly higher than that in group C(P0.05).After three months,effective rates in group A was significantly higher than that in group B(P