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Purpose: To evaluate the effect of extralesional triamcinolone acetonide (TA) injection in the treatment of small chalazion (diameter ? 5 mm). Methods: Prospective interventional clinal study that included patients diagnosed as chalazion of small size not responding to conservative management for at least 2 weeks. All patients were treated with extralesional TA injection (4 mg). Successful resolution of a chalazion was defined as a decrease in size to 1 mm or smaller. Results: Thirty?eight patients were included in the study. The resolution was achieved in 33 (87%) patients. Nineteen (50%) patients had complete resolution after the first injection, and 13 (34.2%) patients had complete resolution after the second injection. Chalazion near the lower punctum needed more times of injections than those elsewhere (P = 0.02). Conclusions: Extralesional TA injection is effective in the treatment of both primary and recurred small chalazia. It is a simple and cost?saving procedure and can be considered an alternative first?line treatment for small chalazion.
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Abstract Objective The aim of study was to demonstrate that transcutaneous intralesional injection of Triamcinolone Acetonide (TA) under fibrolaryngoscopy could be an option for persistent granulation after Transoral Laser Microsurgery (TLM) in glottic cancer patients. Methods We recruited 32 patients, who had conservative treatment but failed. 20 patients accepted TA injection monthly until the granulation disappeared or did not shrink further. 12 patients chose to closely monitor. Results For the 20 patients, 17 (85.0%) patients' granulations completely disappeared. 3 (15.0%) patients' granulations had reduced 80%. For the 12 patients, 3 (25.0%) patients' granulations disappeared but 9 (75%) patients' granulations did not have an obvious change. Recurrence was not observed. Conclusion Our experience showed that transcutaneous intralesional TA injection for persistent granulation after TLM through cricothyroid membrane is an efficient, security, harmless and low recurrence method. Especially suitable for huge granulation which blocks the glottis and recur after a second operation.
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AIM: To compare the efficacy and safety of intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide in the treatment of wet age-related macular degeneration(ARMD)with poor response to anti-vascular endothelial growth factor drugs.METHODS: Retrospective cohort study. From June 2018 to May 2020, a total of 60 patients(60 eyes)with refractory ARMD who had poor response to the treatment of anti VEGF drug ranibizumab were randomly divided into the control group of aflibercept and the observation group of triamcinolone acetonide combined with aflibercept, with 30 patients(30 eyes)in each group. Once a month, the patients in the two groups received intravitreal injection of aflibercept alone or intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide for three consecutive times. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure were reviewed before injection and 1, 3 and 6mo after the third injection.RESULTS: The BCVA and CMT of the two groups were significantly improved 1, 3 and 6mo after the injection of the drug(P<0.05). The mean intraocular pressure in the combined group was higher at 1mo after treatment than before, but it still within the normal range. There was a significant difference in intraocular pressure between the two groups(17.50±4.60 vs. 18.30±3.73mmHg, P<0.05).CONCLUSION: Triamcinolone acetonide injection under the posterior fascia of the eyeball combined with intravitreal injection of aflibercept in the treatment of wet ARMD can effectively reduce macular edema and improve vision, which is more safe and reliable.
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【Objective】 To evaluate the efficacy and safety of 450 nm semiconductor blue laser combined with triamcinolone acetonide injection in the treatment of bladder neck contracture (BNC). 【Methods】 A 61-year-old male patient with BNC and urethral stricture was treated with 450 nm semiconductor blue laser vaporization combined with triamcinolone acetonide injection. The surgery was performed with a small-caliber laser resectoscope of F22. The follow-up results 3 months after surgery were reported. 【Results】 The operation was successful, the operation time was 30 minutes, and the patient was discharged the next day after operation. Follow-up 3 months after operation showed the maximum urinary flow rate (Qmax) was 22.1 mL/s, the International Prostate Symptom Score (IPSS) was 2, the Quality of Life Scale (QoL) was 0, and no recurrence was observed. 【Conclusion】 It is safe and feasible to use 450 nm semiconductor blue laser combined with triamcinolone acetonide injection to treat bladder neck contracture through a small-caliber laser resectoscope of F22, especially for patients with urethral stricture. The short-term efficacy is satisfactory.
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【Objective】 To analyze the efficacy and safety of intralesional triamcinolone acetonide in the treatment of mass granulomatous mastitis (GLM). 【Methods】 Retrospective analysis was made on 67 patients with GLM who were treated in Xijing Hospital from July 2021 to May 2022 and met the inclusion criteria. Among them, 31 patients were treated with local injection of triamcinolone acetonide, while 36 ones were treated with oral methylprednisolone. All the included patients underwent surgical treatment after their condition met the surgical criteria, and the follow-up period lasted for up to six months after surgery. The two groups were compared in improvement of symptoms and signs, treatment time, clinical effectiveness and safety, and recurrence rate. 【Results】 The effective rate of triamcinolone acetonide group and methylprednisolone group was 100%, but the clinical cure rate was significantly higher in triamcinolone acetonide group than in methylprednisolone group in stratified analysis (P<0.05). The improvement time of symptoms and signs in triamcinolone acetonide group was significantly shorter than that in methylprednisolone group (P<0.05). The incidence of side effects in triamcinolone acetonide group was also significantly reduced compared to methylprednisolone group (P<0.05). Follow-up for half a year showed no recurrence in both groups. 【Conclusion】 Compared with the traditional oral methylprednisolone group, local injection of triamcinolone acetonide in the treatment of mass granulomatous mastitis can rapidly relieve clinical symptoms and signs, shorten treatment time, and has higher efficiency and fewer side effects. Local injection of hormone combined with surgery is effective in treating mass granulomatous mastitis with low recurrence rate.
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Objective To conduct in vitro transdermal test on triamcinolone acetonide spray solution, and investigate the effects of ethanol and propylene glycol alone or in combination on the in vitro transdermal function of triamcinolone acetonide spray solution. Methods Rabbit abdominal skin was selected, and the in vitro penetration test of triamcinolone acetonide spray solution was carried out by Franz diffusion cell method, and the content of triamcinolone acetonide was determined by HPLC. The rate of transdermal absorption was compared. Results The transdermal absorption rate of the combined use of ethanol and propylene glycol was significantly higher than that of the single use (P<0.05), and the order of promoting the penetration of triamcinolone acetonide spray solution when ethanol and propylene glycol were combined by 10% ethanol + 25% propylene glycol >10% ethanol + 20% propylene glycol >15% ethanol + 25% propylene glycol >15% ethanol + 20% propylene glycol. Conclusion The combination of 10% ethanol and 25% propylene glycol could optimize the transdermal function of triamcinolone acetonide spray solution.
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Diabetic macular edema (DME) is the most threatening complication of diabetic retinopathy that affects visual function, which is characterized by intractability and recurrent attacks. Currently, the clinical routine treatments for DME mainly include intravitreal injection, grid laser photocoagulation in the macular area, subthreshold micropulse laser, periocular corticosteroid injection, and vitrectomy. Although conventional treatments are effective for some patients, persistent, refractory, and recurrent DME remains a clinical challenge that needs to be urgently addressed. In recent years, clinical studies have found that certain combination therapies are superior to monotherapy, which can not only restore the anatomical structure of the macular area and effectively reduce macular edema but also improve visual function to some extent while reducing the number of treatments and the overall cost. This makes up for the shortcomings of single treatment modalities and is highly anticipated in the clinical setting. However, the application of combination therapy in clinical practice is relatively short, and its safety and long-term effectiveness need further exploration. Currently, new drugs, new formulations, and new therapeutic targets are still under research and development to address different mechanisms of DME occurrence and development, such as anti-vascular endothelial growth factor agents designed to anchor repetitive sequence proteins with stronger inhibition of vascular leakage, multiple growth factor inhibitors, anti-inflammatory agents, and stem cell therapy. With the continuous improvement of the combination application of existing drugs and treatments and the development of new drugs and treatment technologies, personalized treatment for DME will become possible.
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Objective:To investigate the clinical efficacy of triamcinolone acetonide peribulbar injection combined with vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment (RRD-CD).Methods:This study was a retrospective case series study. Nineteen cases (19 eyes) with RRD-CD who had undergone pars plana vitrectomy at the Dalian No.3 People′s Hospital were analyzed. All the cases received 20 mg triamcinolone acetonide peribulbar injection within 3 to 7 days before surgery. The severity of patient′s uveitis was assessed before and after peribulbar injection of triamcinolone acetonide. Best corrected visual acuity (BCVA) and intra ocular pressure (IOP) before and after surgery, the area of retinal detachment, the rate of retinal reattachment, the rate of recurrent retinal detachment and surgical complications were analyzed. Patients′ blood pressure and blood glucose levels were also monitored.Results:19 patients were followed up for (13.1±1.5)months. The severity of uveitis reduced to different extents compared with preoperative condition. The IOP was (8.73±3.38)mmHg before injection and (10.95±2.46)mmHg after injection, and the difference was statistically significant ( t=-7.571, P=0.027). The choroid detachment range was 4-12(9.37±2.69)sites before injection, and 0-11(4.63±4.10)sites after injection, and the difference was statistically significant ( Z=-3.834, P=0.001). Compared with the preoperative results, the BCVA increased in 12 patients, unchanged in 5 cases and decreased in 2 cases. In the final follow-up of 18 patients with retinal reattachment, 17 eyes underwent a single operation, 2 eyes had recurrent retinal detachment, and 1 eye had retinal reattachment after a second operation. There were no significant difference in blood glucose and blood pressure before and after injection (all P>0.05). There were no other complications besides temporarily elevated IOP and cataract. Conclusions:Vitrectomy combined with triamcinolone acetonide peribulbar injection is effective and safe for patients with RRD-CD.
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Purpose: To study the safety and efficacy of pre?operative suprachoroidal triamcinolone acetonide (SCTA) for achieving reduction/resolution of serous choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD). Methods: This was a prospective, noncomparative, interventional pilot study. All consecutive patients presenting with RD and coexisting CD underwent transconjunctival injection of SCTA before proceeding with vitrectomy/scleral buckle surgery. Sequential ultrasound B scans were performed for assessing the change in height of the CD. Results: The mean age of the cohort was 53.8 � 10.8 years (range: 39� years). The CD was present in a median of 3 quadrants; the cumulative mean CD height was 5.59 mm (range: 2.02�42 mm). Following SCTA, a successful response (>50% reduction) was seen in five eyes by day 3 and in two eyes by day 5. Three eyes failed to respond to SCTA and required surgical drainage before proceeding with vitrectomy. No intraprocedural injection?related complications were noted. A transient rise in the intraocular pressure (30 mmHg) was seen in one eye following vitrectomy and was managed successfully with topical antiglaucoma medications. Conclusion: Suprachoroidal administration of triamcinolone appears to be a safe and effective technique to achieve CD resolution in eyes with RRD.
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Oral lichen planus (OLP) is a common chronic inflammatory oral mucosa disease, which is closely related to immune deficiency. Triamcinolone acetonide is considered to be the drug of choice for treatment of OLP due to its anti-inflammatory, anti-allergic and immunosuppressive effects. However, long-term application of triamcinolone acetonide can produce a variety of adverse reactions, and it prone to rebound after discontinuation, which greatly hinders the clinical diagnosis and treatment of OLP. This article reviews the adverse reactions of triamcinolone acetonide in the treatment of OLP and its coping strategies in order to provide some reference for the clinical treatment of OLP.
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Objective:To evaluate the efficacy of combination therapy of intravitreal conbercept (IVC) with posterior sub-Tenon injection of triamcinolone acetonide (PSTA) in treating macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO).Methods:A nonrandomized controlled study was conducted.Fifty-nine patients (59 eyes) diagnosed with macular edema secondary to non-ischemic BRVO were enrolled in Heping Hospital Affiliated to Changzhi Medical College from October 2016 to November 2019.The subjects were divided into IVC group (28 eyes) and combination therapy of IVC with PSTA group (IVC+ PSTA group for short) (31 eyes). IVC group received IVC 0.5 mg and IVC+ PSTA group received IVC 0.5 mg combined with PSTA 40 mg as the initial therapy, then a pro re nata (PRN) IVC administration was adopted for the two groups.The mean best corrected visual acuity (BCVA) converted to the logarithm of the minimum angle of resolution unit, central macular thickness (CMT) and intraocular pressure (IOP) before and 1, 3, 6 months after injection were measured and compared.The number of repeated IVC injections and relevant complications were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Heping Hospital Affiliated to Changzhi Medical College (No.20160R9). Written informed consent was obtained from each subject prior to any medical examination.Results:There was a statistically significant difference in BCVA between the two groups among different time points ( Fgroup=0.464, P=0.498; Ftime=25.454, P<0.001). Compared with before injection, the BCVA of both groups was significantly improved at each time point after injection (all at P<0.001). There was a statistically significant difference in CMT between the two groups among different time points ( Fgroup=6.208, P=0.016; Ftime=155.505, P<0.001). The CMT of both groups at each time point after injection was significantly smaller than that before injection, and the CMT in IVC+ PSTA group at 1 and 3 months after injection was smaller than that in IVC group (all at P<0.05). There was a statistically significant overall difference in IOP between the two groups ( Fgroup=9.994, P=0.006; Ftime=2.679, P=0.056). At 1 and 3 months after injection, the IOP in IVC+ PSTA group was higher than that in IVC group, showing statistically significant differences (both at P<0.01). There were 4 eyes with an IOP higher than 21 mmHg (1 mmHg=0.133 kPa) in IVC+ PSTA group.Within the 6-month follow-up, the mean number of repeated IVC injections of IVC group was 1.25±0.93, which was higher than 0.61±0.72 of IVC+ PSTA group, and the difference was statistically significant ( P=0.039). No other ocular complication was observed in both groups. Conclusions:Combination therapy of IVC with PSTA is effective in improving the BCVA and macular edema of patients with macular edema secondary to non-ischemic BRVO.A single PSTA injection can enhance the effect of conbercept in reliving macular edema in early months and reduce the number of repeated conbercept injections in the short term.
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Objective:The aim of this study was to observe the clinical effects of myopic foveoschisis (MF) via triamcinolone (TA) assisted fovea-sparing internal limiting membrane peeling (FSILMP).Methods:This study was prospective research, including 41 cases (44 eyes) of patients diagnosed with MF in Changsha Aier Eye Hospital from November 2018 to June 2020. All patients underwent combined TA assisted FSILMP and 25 G pars plana vitrectomy (PPV). The posterior vitreous cortex, epiretinal membrane and internal limiting membrane (ILM) in the macular area were labeled by TA particles. The corrected visual acuity, central retinal thickness (CRT), post-operative healing of myopic foveoschisis and the incidence of macular hole were observed. Facilitating statistics, in this study, decimal visual acuity was converted to logMAR visual acuity through the formula logMAR=lg(1/decimal visual acuity).Results:Three cases underwent binocular surgery and 38 cases underwent monocular surgery. The average age of the patients was (56.16±11.00)years old ranging from 30-73 year olds; the average axial length of the patients was (30.50±1.96)mm which was ranging from 26.19-34.52 mm. The corrected visual acuity was 0.1-3(1.65±0.67) and the CRT was 126-1 100(473.47±195.96)mm. The patients were followed up for 1-31(13.89±8.32)months. A total of 38 cases (41 eyes) were followed up and 3 cases were lost. Reduction of MF in 41 eyes: 5 eyes (12.2%) were not healed, 12 eyes (29.3%) were improved, 8 eyes (19.5%) were near healed and 16 eyes (39.0%) were healed. The incidence of macular hole was 4.9% (2 eyes). The postoperative corrected visual acuity was 1.00±0.62, which was significantly higher than the preoperative corrected visual acuity [(1.65±0.67), t=8.23, P<0.01]. The postoperative CRT was (295.88±167.55)μm, which was significantly lower than that before operation (473.47±195.96)μm( t=7.82, P<0.01). Conclusions:TA can better mark the vitreous cortex, epiretinal membrane and inner limiting membrane of high myopia MF, and avoid the retinal toxicity caused by repeated indocyanine green (ICG) staining. At the same time, the effect of TA assisted FSILMP is no less than that of ICG assisted FSILMP in postoperative visual acuity recovery, CRT and the incidence of postoperative macular hole.
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Objective:To observe the clinical efficacy of intra-articular injection with Triamcinolone acetonide on the treatment of juvenile idiopathic arthritis (JIA).Methods:The clinical data of 26 children diagnosed with JIA undergoing the intra-articular injection of Triamcinolone acetonide for the joints with obvious swelling and pain at the Children′s Hospital Affiliated to Capital Institute of Pediatrics from October 2018 to December 2019 who were retrospectively analyzed.Erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) were tested before and after the application of Triamcinolone acetonide.Detailed clinical manifestations were recorded.The nonparametric Kruskal- Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at diffe-rent treatment times. Results:Among the 26 children, 8 were boys and 18 were girls.After the intra-articular injection of Triamcinolone acetonide, 9 cases (34.62%) achieved complete remission, 15 cases(57.69%) achieved partial remission, and 2 cases (7.69%) were not responsive to the intra-articular injection.The overall therapeutic efficacy was 92.31%.Compared with pre-treatment period, from 4 weeks after treatment, assessment of disease activity by the physicians and parents of the children was significantly improved after 4-week treatment, and the number of active joints, ESR and CRP and the Juvenile Arthritis Disease Activity Score with 27 joints (JADAS 27) gradually decreased, and the differences were statistically significant (all P<0.05). No adverse drug reactions were seen during the treatment and follow-up period. Conclusions:Intra-articular injection of Triamcinolone acetonide is effective in contro-lling joint symptoms of JIA with less adverse events.
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OBJECTIVES@#Steroidal anti-inflammatory drugs have certain side effects in the treatment of hypertrophic scar, and the scar recurrence is easy after withdrawal of steroid anti-inflammatory drugs. Finding reliable alternative drugs is an effective means to improve this defect. Aspirin, a traditional non-steroidal anti-inflammatory drug, is safe for topical use and has anti-inflammatory effects similar to those of steroidal anti-inflammatory drugs, which may have similar effects on the treatment of hypertrophic scar. This study aims to investigate the inhibitory effect of aspirin on the proliferation of hypertrophic scar in rabbit ears and the underlying mechanism.@*METHODS@#The rabbit ear hypertrophic scar models were prepared. The rabbits were randomly divided into a normal skin group (group A), a blank control group (group B), a 0.9% NaCl group (group C), a 0.2% aspirin group (group D), a 0.5% aspirin group (group E), a 2% aspirin group (group F), and a triamcinolone acetonide group (group G). Macroscopic observation of hyperplasia was performed 8 weeks after local injection of the scar, followed by collecting the scar tissue samples for HE staining, Masson staining, and immunohistochemistry, respectively to assess the proliferation of fibroblasts and collagen fibers, and calculate the hypertrophic index, microvessel density, and immunohistochemical score.@*RESULTS@#All rabbit ear hypertrophic scar models were successfully constructed. In groups B and C, the hypertrophic scar edge was irregular, with reddish protruding epidermis, significant contracture and hard touch. In group D, E, and F, with the increase of aspirin administration concentration, the scar became thinner and gradually flat, the proliferation of fibrocytes and collagen fibers was weakened, and the hypertrophic index was gradually decreased (P<0.05). Immunohistochemistry showed that the expression of β-catenin was decreased in the group D, E and F in turn, and the immunohistochemical score was gradually decreased (P<0.05). There was no significant difference in hypertrophic index, microvessel density, and immunohistochemical score (all P>0.05).@*CONCLUSIONS@#Local injection of aspirin can reduce the generation of hypertrophic scar in a dose-dependent manner within a certain concentration range; aspirin inhibits the growth of hypertrophic scar in rabbit ears by inhibiting Wnt/β-catenin signal pathway; 2% aspirin and 40 mg/mL triamcinolone acetonide have similar curative efficacy on hypertrophic scar.
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Animals , Rabbits , Anti-Inflammatory Agents/therapeutic use , Aspirin/therapeutic use , Cicatrix, Hypertrophic/pathology , Collagen , Signal Transduction , Triamcinolone Acetonide/therapeutic use , beta Catenin/metabolismABSTRACT
@#AIM: To investigate the effect of triamcinolone acetonide(TA), artesunate(ART), and luteolin(LU)on the prevention and treatment of traumatic proliferative vitreoretinopathy(TPVR). <p>METHODS: Forty-eight cyanotic blue rabbits were selected to prepare TPVR animal models by making a penetrating eye injury and intravitreal injection of 0.3mL platelet-rich plasma, and were randomly divided into four groups(<i>n</i>=12), in which the vitreous cavity of the control group was injected with 0.1mL saline; The vitreous cavity of the TA group was injected with 0.1mL(1mg/mL)triamcinolone acetonide; The vitreous cavity of the ART group was injected with 0.1mL(20μg/mL)artesunate; 0.1mL(10μg/mL)luteolin was injected into the vitreous cavity of the LU group. The vitreous and retinal proliferation were observed by fundus photography and ocular ultrasound at 1, 2, 3 and 4wk postoperatively. The expression levels of α-SMA and VIM protein in the vitreous fluid of each group of rabbit eyes were detected by Western Blot at 28d postoperatively, and the retinal tissue structure of each group was observed by retinal HE staining. <p>RESULTS: At 28d postoperatively, the TPVR grading of rabbit eyes in the TA, ART and LU groups were significantly lower than that in the control group(<i>P</i><0.05), and the TPVR grading of rabbit eyes in the TA group was significantly lower than that in the ART and LU groups(<i>P</i><0.05). The expression levels of α-SMA and VIM proteins in the vitreous fluid of the rabbit eyes in the TA, ART and LU groups were significantly lower than those in the control group at 28d after surgery(<i>P</i><0.01). The results of HE staining showed that the arrangement of retinal layers in rabbit eyesin the control group were disordered, severely distorted or locally broken, the structure of each layer were unclear, the anterior membrane was obviously thickened, and the retina was obviously detached; The arrangement of retinal layersin rabbit eyes in the LU group were slightly distorted, inflammatory exudation was visible in front of the retina, and the retina was superficially detached; The structure of retina in rabbit eyes in the ART group were clear, with mild edema and superficial detachment; The structure of retinal layers in rabbit eyes in the TA group were clear, the arrangement was still neat, the retinal folds were locally visible, and there was no retinal detachment.<p>CONCLUSION: Intravitreal injection of triamcinolone acetonide, artesunate and luteolin were all effective in preventing and treating traumatic TPVR, among which triamcinolone acetonide has the most obvious effect.
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Objective:To investigate the efficacy and safety of bladder neck resection combined with multipoint injection of triamcinolone acetonide in the treatment of bladder neck contractures (BNC) after transurethral resection prostate (TURP).Methods:The data of 25 patients with BNC after TUPR who underwent transurethral surgery in West China Hospital of Sichuan University from July 2019 to November 2021 were retrospectively analyzed, and the patients were divided into 2 groups according to the treatment method. There were 15 cases in the steroid injection group, with an average age of (67.5±8.8) years, 1 case of diabetes, and 2 cases of hypertension. And the average postoperative time after TURP was (21.9±29.1) months, the preoperative International Prostate Symptom Score (IPSS) was (30.0±3.5) points, quality of life (QOL) score was (5.7±0.5) points. There were 10 cases in the non-steroid injection group, with an average age of (65.2±10.5) years, 1 case of diabetes, and 2 cases of hypertension. And the average postoperative time of TURP was (29.3±33.5) months, and the preoperative IPSS was (30.4±2.6) points, QOL score was (5.8±0.4) points. There was no significant difference between the two groups ( P>0.05). In the steroid injection group, bladder neck resection combined with multipoint injection of triamcinolone acetonide was performed. The patients were in the lithotomy position, and a scope was placed through the urethra into the distal end of the narrow urethra under direct vision for observation, and a supersmooth guide wire was placed. The narrow section is then incised at 6 o'clock. After replacing the resectoscope, the urethral stricture scar was excised until the normal tissue of the bladder neck was exposed. Hemostasis by electrocoagulation resulted in no active bleeding from the urethra after resection. After the bladder injection needle was inserted, 80 mg (12 ml) of triamcinolone acetonide injection was injected in 6 equally spaced needles at the direction of the bladder neck from 3 to 9 o'clock. A supersmooth guide wire was placed, and a three-channel silicone urinary catheter was indwelled along the guide wire. The non-steroid injection group underwent simple bladder neck resection. Re-examination of urethroscopy at 3 and 6 months after operation showed that the patient had obvious dysuria and the microscopic examination showed that the recurrence of bladder neck stenosis was defined as the recurrence of stenosis. The efficacy, complications, and recurrence-free survival rates of the two groups were compared. Predictors of postoperative BNC recurrence were analyzed. Results:The operations in both groups were successfully completed. The operation time of the steroid injection group and the non-steroid injection group were (36.0±17.8) min and (48.5±57.9) min respectively ( P=0.438), and the intraoperative blood loss was (1.9±3.0) ml and (12.0±31.1) ml ( P=0.221)respectively. The length of hospital stay was (5.8±1.2) d and (4.4±2.5) d, respectively ( P=0.070). There was 1 case of transient hematuria and 1 case of epididymitis in the steroid injection group, and 1 case of transient hematuria and 1 case of transient dysuria in the non-steroid injection group ( P>0.05), all of which were relieved after symptomatic treatment. The IPSS of steroid injection group and non-steroid injection group were (11.0±5.6) points and (12.4±3.9) points at 3 months after operation, and (10.1±4.9) points and (14.7±7.7) points at 6 months after operation, respectively. QOL at 3 months after operation was (1.7±1.2) points and (2.1±1.5) points, respectively, and at 6 months after operation, it was (1.5±1.3) points and (3.0±2.0) points, respectively. There was statistical significance ( P<0.05). There were 1 case and 2 cases of recurrence in the steroid injection group and non-steroid injection group at 3 months after operation ( P=0.543), and 1 case and 5 cases at 6 months after operation ( P=0.023). The difference in survival curve between the two groups was statistically significant ( P=0.013). Combined steroid therapy ( OR=14.000, 95% CI1.299-150.889, P=0.030), time after scar resection ( OR=1.138, 95% CI1.017-1.273, P=0.025), postoperative IPSS( OR=1.302, 95% CI1.018-1.666, P=0.036), postoperative QOL score ( OR=4.280, 95% CI1.523-12.030, P=0.006) were the predictors of stenosis recurrence 6 months after surgery. Conclusion:Bladder neck scar resection combined with steroid injection could be safe and effective in the treatment of BNC after TURP, and local steroid injection may help reduce the recurrence rate of postoperative stenosis.
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Objective:To determine the clinical effect of sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser for hypertrophic scar. Methods:A total of 80 hypertrophic scar patients, including 45 male and 35 female, in our clinic were randomly divided into test ( n=40) and control ( n=40) groups from March 2019 to May 2020. Patients aged from 18-42 years with average age 28.1. Patients in test groups were treated with triamcinolone acetonide and lattice CO 2laser sequentially. After final treatments, third-party blind evaluation, Vancouver scar scale, visual analog scale and dermatology life quality index were performed. Results:Test group acquired more satisfied result in third-party blind evaluation (82.5% vs. 52.5%, χ2=8.216, P<0.05). Vancouver scar scale, visual analog scale and dermatology life quality index were not significantly different before treatment for both groups while test group acquired better improvement after treatment ( P<0.05). Conclusions:Sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser is effective for hypertrophic scar and worths wide application in the clinic.
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Objective:To investigate the efficacy of triamcinolone acetonide injection behind the eyeball in the treatment of Purtscher disease and its effects on vision, inflammatory factors, nitric oxide (NO) and endothelin-1 (ET-1) of aqueous fluid.Methods:A total of 64 patients with Purtscher disease admitted to First People′s Hospital of Lanzhou City from January 2016 to January 2020 were selected and divided into two groups by random number table, with 32 cases in each group. The control group was given conventional treatment, and the observation group was injected with triamcinolone acetonide behind the eyeball on this basis. The total effective rate after 6 weeks of treatment, the best corrected visual acuity and hemodynamic indicators peak flow velocity (V max), end-diastolic flow velocity (V min), resistance index (RI) of ophthalmic artery and central retinal artery during systole, aqueous humor inflammatory factors tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-2, IL-6, NO, ET-1, and adverse reactions after 3 and 6 weeks of treatment were compared between the two groups. Results:After 6 weeks of treatment, the total effective rate in the observation group was higher than that in the control group: 96.9% (31/32) vs. 75.0% (24/32), and the difference was statistically significant ( χ2 = 4.655, P<0.05). After 3, 6 weeks of treatment, the best corrected visual acuity in the observation group was higher than that in the control group: 0.44 ± 0.13 vs. 0.35 ± 0.12, 0.88 ± 0.16 vs. 0.62 ± 0.15, and the difference was statistically significant ( P<0.05). After 3, 6 weeks of treatment, the V max and V min of the ophthalmic artery and central retinal artery in the observation group were higher than those in the control group: after 3 weeks of treatment: (29.42 ± 0.93) cm/s vs. (28.65 ± 0.90) cm/s, (8.04 ± 1.08) cm/s vs. (6.95 ± 1.12) cm/s, (8.42 ± 1.21) cm/s vs. (8.39 ± 1.19) cm/s, (4.05 ± 0.61) cm/s vs.(3.58 ± 0.57) cm/s; after 6 weeks of treatment: (31.72 ± 1.03) cm/s vs. (29.58 ± 0.95) cm/s, (9.81 ± 1.06) cm/s vs. (7.78 ± 1.15) cm/s, (12.01 ± 1.23) cm/s vs. (10.82 ± 1.07) cm/s, (4.65 ± 0.47) cm/s vs. (4.02 ± 0.36) cm/s; the RI of the ophthalmic artery and central retinal artery in the observation group were lower than those in the control group: after 3 weeks of treatment: 0.76 ± 0.06 vs. 0.80 ± 0.05, 0.70 ± 0.03 vs. 0.76 ± 0.04; after 6 weeks of treatment: 0.71 ± 0.05 vs.0.75 ± 0.04, 0.68 ± 0.04 vs.0.72 ± 0.03, and the differences were statistically significant ( P<0.05). After 3 and 6 weeks of treatment, the levels of TNF-α, IL-1β, IL-2, IL-6 of aqueous fluid in the observation group werelower than those in the control group: after 3 weeks of treatment: (2.61 ± 0.38) μg/L vs.(4.75 ± 0.41) μg/L, (3.45 ± 0.28) μg/L vs.(6.28 ± 1.05) μg/L, (6.28 ± 0.34) μg/L vs. (9.45 ± 1.14)μg/L, (9.82 ± 1.66) ng/L vs. (12.45 ± 2.31) ng/L; after 6 weeks of treatment: (0.98 ± 0.23) μg/L vs. (1.44 ± 0.27) μg/L, (1.11 ± 0.36) μg/L vs. (1.69 ± 0.38) μg/L, (3.68 ± 1.02) μg/L vs. (5.73 ± 1.15) μg/L, (4.11 ± 1.19) ng/L vs. (7.38 ± 1.06) ng/L, and the differences were statistically significant ( P<0.05). After 3, 6 weeks of treatment, the levels of NO in the observation group washigher than that in the control group: (56.49 ± 9.17) μmol/L vs. (50.22 ± 8.68) μmol/L, (60.18 ± 8.27) μmol/L vs. (53.24 ± 7.96) μmol/L; the levels of ET-1 waslower than that in the control group: (60.77 ± 9.61) ng/L vs. (65.02 ± 10.85) ng/L, (56.59 ± 7.22) ng/L vs. (61.18 ± 6.76) ng/L, and the differences were statistically significant ( P<0.05). The incidence of adverse reactions in the two groups had no statistical significance ( P>0.05). Conclusions:The injection of triamcinolone acetonide behind the eyeball to treat Purtscher disease can improve ocular hemodynamics, inhibit inflammation, improve vascular endothelial function and improve visual acuity. It has significant curative effect and certain safety.
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@#Oral submucous fibrosis (OSF) is a chronic disease that produces scars, tissue fibrosis, and precancerous lesions. Epidemiological studies have shown that chewing betel nut is the most significant risk factor for OSF. Many studies have also indicated that habits such as chewing and smoking tobacco and drinking alcohol increase the risk of OSF, which is widely recognized as an oral precancerous lesion or a potentially malignant oral disorder. Pathological characteristics include chronic inflammation, excessive collagen deposition in the connective tissues below the oral mucous epithelium and local inflammation in the lamina propria or deep connective tissues. OSF patients have a 7%~30% chance of developing oral cancer. Submucosal local injection of triamcinolone and tanshinone was mainly used for the treatment of oral submucosal fibrosis. This treatment improves mouth opening and alleviates the burning sensation in OSF, and the treatment efficacy was as high as 93%. The article will discuss the occurrence, development, diagnosis and treatment of oral submucous fibrosis for clinical management by the medical community.
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@#Oral submucous fibrosis is a chronic, occult and progressive potentially malignant disease that seriously affects the oral function and quality of life of patients. The oral burning sensation and limitation of mouth opening are the main reasons for patients to see a doctor. At present, the main treatment for oral submucosal fibrosis is still drug therapy. To provide ideas and references for the clinical treatment of oral submucosal fibrosis, this article reviews the mechanism, therapeutic effect and characteristics of common Chinese and Western medicine in the treatment of oral submucosal fibrosis. The results of the literature review show that salvia miltiorrhiza, aloe, lycopene, curcumin and other traditional Chinese medicine and Western medicine are effective in the treatment of oral submucosal fibrosis; in addition, Taohong Siwu Decoction combined with Western medicine and other combinations of traditional Chinese and Western medicine are effective and reduce side effects, and clinicians can choose appropriate drugs according to the patient’s main symptoms and general condition. In the future, researchers can study more combinations of traditional Chinese and Western medicine to treat oral submucosal fibrosis.