Clinical efficacy and safety of percutaneous cryoablation combined with percutaneous ethanol injection in elderly patients with hepatocellular carcinoma aged 70 years or older / 临床肝胆病杂志

Objective To investigate the clinical efficacy and safety of percutaneous cryoablation combined with percutaneous ethanol injection (PEI) in elderly patients with early-stage hepatocellular carcinoma aged 70 years or older. Methods A retrospective analysis was performed for the clinical data of 92 elderly patients with hepatocellular carcinoma who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to January 2018, among whom 46 underwent cryoablation alone (CRYO group) and 46 underwent cryoablation combined with PEI (combination therapy group). The two groups were compared in terms of clinical outcome, adverse reactions, and changes in liver function parameters after treatment, and the patients were followed up to observe tumor recurrence and survival. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival curves. The Cox regression analysis was used to identify the independent risk factors for survival and prognosis. Results There was no significant difference in the response rate of initial ablation between the combination therapy group and the CRYO group (89.1% vs 73.9%, P > 0.05). There were no significant differences between the CRYO group and the combination therapy group in overall survival time and tumor-free survival rate after surgery ( P > 0.05), and compared with the CRYO group, the combination therapy group had significantly lower 1-, 2-, and 3-year local tumor progression rates (20%/21%/21% vs 30%/46%/46%, χ 2 =4.187, P 0.05), but 3 patients in the CRYO group experienced serious adverse reactions, while no patients in the combination therapy group experienced such reactions. Conclusion For elderly patients with early-stage hepatocellular carcinoma, cryoablation combined with PEI is safer and more effective than cryoablation alone and can significantly reduce local tumor progression rate.

Inyección intralesional de corticoesteroides como tratamiento conservador del granuloma central de células gigantes: revisión de la literatura / Intralesional corticosteroid injection as a conservative treatment for central giant cell granuloma: a review of the literature

El granuloma central de células gigantes (GCCG) es una lesión benigna intraósea de los maxilares. Tradicionalmente, la cirugía es el tratamiento más utilizado para este tipo de patología, sin embargo, en los últimos años se ha propuesto el uso de inyecciones intra- lesionales de corticoesteroides como alternativa conservadora. El objetivo de este estudio fue realizar una revisión bibliográfica de los casos tratados con corticoesteroides. Para esto, se utilizó la plataforma de PubMed y Google Scholar para buscar artículos publica- dos entre 1994 y el 2020, relacionados al GCCG y su tratamiento con corticoesteroides. Se encontraron 28 artículos y un resumen con 61 pacientes en total; en la mayoría de los casos se utilizaron inyecciones intralesionales semanales de acetonido de triamcinolona con anestésico durante 6 semanas, aunque se reportaron variantes del protocolo. De los 61 casos, 38 tuvieron una resolución completa y en los demás casos fue necesario realizar tratamiento quirúrgico adicional. Con base en lo anterior, parece que el uso de inyecciones intralesionales de triamcinolona tiene un efecto positivo en el tratamiento del GCCG al permitir una resolución completa de la lesión o una disminución en su tamaño, de manera que la cirugía posterior sea más conservadora.

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the jaws. Traditionally, surgery is the most used treatment for this type of pathology, however, in recent years the use of intralesional corticosteroids injections has been proposed as a conservative alternative. The aim of this study is to carry out a bibliographic review of the cases treated with corticosteroids. The author used PubMed and Google Scholar platforms were used to search for articles published between 1994 and 2020, related to CGCG and its treatment with corticosteroids. The results of this research were 28 articles and one abstract were found with 61 patients in total; in most cases, weekly intralesional injections of triamcinolone acetonide with anesthetic were used for 6 weeks, although protocol variants were reported. Of the 61 cases, 38 had complete resolution while the other cases required additional surgical treatment. From this, it seems that the use of intralesional triamcinolone injections have a positive effect in the treatment of CGCG by allowing a complete resolution of the lesion or a decrease in its size, so that subsequent surgery is more conservative.

Vitamina D intralesional em múltiplas verrugas plantares recorrentes - Um estudo cego, prospectivo e controlado por placebo / Intralesional vitamin D in multiple recurrent plantar warts - A single, blind, prospective, placebo-controlled study

Introdução: As verrugas, são proliferações epidérmicas benignas da pele. A maioria dos pacientes procura orientação médica, pois as verrugas são cosmeticamente inaceitáveis e podem ser dolorosas. As verrugas plantares, em particular, são tipicamente refratárias ao tratamento que requer várias sessões. As modalidades terapêuticas disponíveis são limitadas pela alta taxa de recorrência, dor e cicatrizes. Em contraste, as abordagens imunoterapêuticas estimulam o sistema imunológico do hospedeiro, aumentando a imunidade celular para eliminar o vírus. Objetivo: Avaliar a segurança e eficácia da injeção intralesional de vitamina D3 no tratamento de múltiplas verrugas plantares recorrentes. Métodos: Um total de 60 pacientes com verrugas plantares múltiplas recorrentes, foram divididos em dois grupos de 30. No grupo 1, 0,5ml de vitamina D intralesional foi injetado na base da maior verruga e no grupo 2, injetou-se 0,5ml de solução salina normal. As sessões foram repetidas a cada 2 semanas por no máximo 4 sessões e os pacientes foram acompanhados por um período de 12 meses. Resultados: No grupo de estudo, a eliminação completa foi observada em 73,3% (22) e nos controles, 70% dos pacientes não apresentaram resposta. Conclusão: A vitamina D3 intralesional é uma opção de tratamento segura e eficaz em verrugas plantares.

Introduction: Warts or verrucae, caused by the human papillomavirus (HPV), are a benign epidermal proliferation of the skin. Most patients seek medical advice as warts are cosmetically unacceptable and can be painful. Plantar warts, in particular, are typically refractory to treatment requiring multiple treatment sessions. High recurrence rates, pain, and scarring limit the available therapeutic modalities. In contrast, immunotherapeutic approaches stimulate the host immune system by enhancing cellular immunity to eliminate the virus. Objective: To assess the safety and efficacy of intralesional vitamin D3 injection to treat multiple recurrent plantar warts. Methods: 60 patients with multiple recurrent warts were divided into two groups of 30 each. Group 1 received 0.5 ml intralesional vitamin D in the base of the largest wart, and Group 2 received 0.5 ml of normal saline. The sessions were repeated every two weeks for a maximum of four sessions, and patients were followed up for 12 months to detect any recurrences. Results: The study group showed complete clearance in 73.3% (22) individuals, while most controls (70%) showed no response. Conclusion: Intralesional vitamin D3 is a safe and effective treatment option for multiple recurrent plantar warts.

Clinical effectiveness of salvianolic acid B and triamcinolone acetonide in treatment of oral submucous fibrosis / 中华口腔医学杂志

Objective@#To evaluate the clinical effectiveness of salvianolic acid B (SA-B) and triamcinolone acetonide (TA) by means of combined intralesional injection in the treatment of oral submucous fibrosis (OSF).@*Methods@#According to clinical findings and symptoms, TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. Mouth opening degree, color change of the buccal mucosae and numeral increase of the capillary vessels were determined by degree Ⅰ-Ⅳ visual analog scale were evaluated at 12, 24, and 36 months, respectively.@*Results@#One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 1 year, the net gain in mouth opening of the early stage group was (5.5 ± 1.5) mm at 12 months, (8.8 ± 1.6) mm at 24 months and (12.0±1.2) mm at 36 months. The net gain in mouth opening of the middle stage group were (5.3±1.7) mm at 12 months, (10.5±1.5) mm at 24 months and (14.5±2.4) mm at 36 months. The net gain in mouth opening of the advanced stage group were (5.7±1.3) mm at 12 months, (13.7±1.3) mm at 24 months and (15.5±1.5) mm at 36 months. The effective rates of color change of the buccal mucosae and numeral increase of the capillary vessels after treatment for 36 months were 100% in early stage group, 93% (51/55) in middle stage group and 90% (36/40) in advanced stage group.@*Conclusions@#TA and SA-B combined intralesional injection in the treatment of oral submucous fibrosis is effective.

Collagenase Clostridium Histolyticum in the Treatment of Peyronie's Disease: Review of a Minimally Invasive Treatment Option

Peyronie's disease (PD) is an inflammatory disorder characterized by an abnormal collagen deposition in the tunica albuginea of the penis, leading to fibrous and non-compliant plaques that can impede normal erection. Although pharmacological treatments are available, only intralesional injection therapy and surgical reconstruction have demonstrated tangible clinical efficacy in the management of this condition. Intralesional injection of collagenase clostridium histolyticum (CCH) has come to the forefront of minimally invasive treatment of PD. In this review, the authors provide an update on the safety, efficacy, and indications for CCH. The efficacy of CCH will be assessed on the basis of improvement in the severity of penile fibrosis, curvature, and pain. Numerous well-designed clinical trials and post-approval studies involving more than 1,500 patients have consistently demonstrated the efficacy and tolerability of CCH in the treatment of PD. CCH significantly decreases penile curvature and plaque consistency, as well as improves quality of life. Post-approval studies continue to demonstrate the efficacy of CCH despite broader inclusion criteria for treatment, such as the case with acute phase disease and atypical plaque deformities (i.e., ventral plaques, hourglass narrowing). CCH continues to be the gold standard for non-surgical management of stable phase PD, in the absence of strong evidence supporting oral therapy agents and ongoing evaluation of extracorporeal shockwave therapy. However, recent studies are beginning to provide precedent for the use of CCH in the management of acute phase and atypical PD.

Nonsurgical Interventions for Peyronie's Disease: Update as of 2016

Peyronie's disease (PD) is a debilitating condition of the penis that leads to significant pain, erectile dysfunction, and emotional distress in men. PD is likely underreported due to lack of knowledge of the disease and the absence of well-established available treatments. Surgical treatment can lead to sustained improvements, but is often associated with penile shortening and places the patient at risk for perioperative morbidity. Nonsurgical management has been studied for several years as an alternative to surgery for men with PD. Currently, much of the data on nonsurgical management is conflicting, with only one treatment that has been recently approved by the US Food and Drug Administration. Significant effort has been devoted to advancing non-surgical treatments for PD that can be implemented outside of the operating room. This review aims to describe the research behind current nonsurgical therapies for PD and to highlight the recent advances that have been made within the last three years.

Recent Developments in the Use of Intralesional Injections Keloid Treatment

Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.

The effects of intra-tumoral injection of ethanol on nude mice with implanted pancreatic cancer / 中华胰腺病杂志

Objective To study the efficacy of intra-tumoral injection of different concentrations of ethanol for nude mice with implanted pancreatic cancer and provide evidence for choosing appropriate concentration of ethanol for clinical treatment of pancreatic cancer.Methods A subcutaneous xenograft mouse model of human pancreatic cancer SW1990 was established.Forty-eight nude mice with similar tumor size were randomly divided into 20％,40％,60％,80％,95％ ethanol injection groups and saline injection group.The longest (a) and the shortest diameters (b) of tumor of nude mice were measured.Tumor volume (TV),relative tumor volume (RTV) and the relative rate of tumor proliferation (T/C％) were calculated.Eight days later the nude mice were sacrificed.The tumor tissue was harvested for pathologic examinations.Results RTV in 20％ ethanol injection group was similar that of saline injection group (P =0.212).RTV in 40％,60％,80％ and 95％ ethanol injection groups were significantly lower than that in saline injection group (P ＜ 0.01).RTV was less than 1 and T/C％ was less than 30％ in 60％,80％ and 95％ ethanol injection groups.The values of RTV and T/C％ decreased with the increase of ethanol concentration.RTV in 80％ and 95％ ethanol injection groups were significantly lower than that of 60％ ethanol injection group (P =0.003 and P =0.009).RTV was similar in 80％ and 95％ ethanol injection groups (P =0.819).The pathologic examinations showed no tumor necrosis in saline injection group,while small amounts of necrosis in implanted pancreatic cancer was observed in 20％ and 40％ ethanol injection groups,while a large area of coagulation necrosis could be found in 60％,80％ and 95％ ethanol injection groups.Conclusions Intra-tumoral injection of 80％ ethanol is feasible therapy method for nude mice with human pancreatic cancer xenografts.

Intralesional Steroid Injection to Prevent Stricture after Near-Circumferential Endosopic Submucosal Dissection for Superficial Esophageal Cancer

Stricture frequently occurs after endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma with near- or whole-circumferential mucosal defects, and post-ESD stricture is difficult to treat and usually requires multiple sessions of endoscopic balloon dilatation. Intralesional steroid injection has previously been used to prevent stricture; however, there have been few experiences with this method after near- or whole-circumferential ESD. We present a case of a single session of intralesional steroid injection performed immediately after near-circumferential ESD to prevent post-ESD stricture. After a follow-up period of 6 months, the patient showed good outcome without dysphagia.

Effect of dexamethasone on conversion of subclinical hypothyroidism caused hy Hashimoto's thyroiditis / 中国基层医药

Objective To evaluate the effect of oral levothyroxine plus intrathyroidal injection of dexamethasone on conversion of subclinical hypothroidism caused by Hashimoto's thyroiditis.Methods 80 subjects with Hashimoto thyroiditis were randomly divided into 2 groups.Subjects in levothyroxine group(40 cases) were treated with oral levothyroxine sodium,subjects in dexamethasone group(40 cases) were treated with oral levothyroxine plus intrathyroidal injection of dexamethasone.Serum free triiodothyronine(FT_3),free thyroxine(FT_4),sentient thyrotropin(sTSH) and other parameters were evaluated before treatment and after treatment in patients with Hashimoto's thyroiditis.Results The content of FT_3,FT_4 after treatment were obviously higher than that before treatment(t=2.123,P

Treatment of auricle pseudocyst by injecting triamcinolone acetonide in cavity:a report of 105 cases / 中国基层医药

Objective To explore a better medication by analyzing retrospectively 179 cases with confirmed auricle pseudocyst.Methods A comparative study was carried out for the clinical effects of injecting triamcinolone acetonide in cavity with that of washing the cyst using dexamethasone and fixing it with gypsum.Results There was significant difference between the two groups(P

Clinical Study on Intra-Amiotic Administration of Pulmonary Surfactant for Neonatal Respiratory Distress Syndrome Prophylaxis / 中华围产医学杂志

ObjectiveTo discuss the effects and security o f intra-anmiotic administration of pulmonary surfactant for neonatal respiratory distress syndrome prophylaxis.MethodsForty-five cases of pr eterm delivery with immature fetal lungs were divided into two groups. Fifteen w omen of the study group were administered one dose of pulmonary surfactant into the amniotic cavity and delivered in several hours. Nothing was injected into th e amniotic cavity of the 30 women in the control group. The proportion of NRDS, mortality and the time in hospital were analyzed to make clear whether there wer e any differences between the two groups.ResulstsThere was n o difference between the two groups for neonatal Apgar score. Foam test demonstr ated that the proportion of lung maturity of the neonates was:56.3%(9/16)in the study group, 13.3%(4/30)in the control group,(P

Long- term evaluation of intracystic corticosteroid injection in the treatment of simple bone cysts / 中华骨科杂志

Objective To evaluate the long- term results of intracystic corticosteroid injection for the treatment of simple bone cysts. Methods Seventy- six children with simple bone cysts treated by intracystic injection of corticosteroid from 1985 to 1995 were followed- up for an average of 8.2 years（ 5－ 13 years） . Forty- one of the cysts were situated at the proximal end of the humerus, 20 at the proximal end of the femur and 15 at other sites. The mean injection times were 4.2(2－ 13 times). Results Forty- two(55.3％ ) cysts were healed up completely, 16(21.1％ ) basically healed up, 9(11.8％ ) healed up partially and 9(11.8％ ) failures. Satisfactory and effective rate was 76.4％ and 88.2％ respectively. Conclusion Intracystic corticosteroid injection appears to be the initial choice of treatment for simple bone cysts, because it is an effective, and non－ invasive method which can be carried out easily.

CT-guided percutaneous ethanol injection in treatment of metastatic adrenal tumors / 第二军医大学学报

Objective:To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty-one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT-guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Radiofrequency ablation in the treatment of small liver cancer / 中国普通外科杂志

Objective To investigate the effect of radiofrequency ablation(RFA) in the treatment of small liver cancer.Methods In recent 6 years,130 patients with primary or secondary liver cancer(≤5cm in diameter)were treated by RFA,among which 86 cases were primary,and 44 cases were secondary liver cancer.Among the 130 cases,18 received RFA plus TAEC,and 20 had RFA combined with PEI.Results Overall 1-and 3-year survival rate was 91.3% and 77.7% respectively.Complications occurred in 7 cases,including biliary fistula,intestinal fistula,and slight burn of skin.There was no death in this series.Conclusions RFA is an effective and safe therapeutic approach for small liver cancer ≤5cm in diameter.Its effect may be similar to that of surgical resection.