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RESUMEN: Introducción: Con el fin de prevenir la progresión de la caries interproximal no cavitada en dientes temporales, se ha generalizado el uso de estrategias mínimamente invasivas como la aplicación de sellantes, barniz de flúor o la resina infiltrante, ya sea combinadas o como monoterapia. Pese a lo anterior, hay incertidumbre con relación al efecto de la infiltración de resina en combinación con el barniz de flúor en dientes temporales. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metaanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Se identificaron nueve revisiones sistemáticas que en conjunto incluyeron tres estudios primarios que corresponden a ensayos clínicos aleatorizados. Se concluye que la infiltración de resina probablemente reduce el riesgo de la progresión de la caries interproximal no cavitada en dientes temporales. No se encontraron estudios que evaluaran los eventos adversos. Palabras claves: caries, infiltración de resina, caries interproximal, barniz de flúor, tratamiento mínimamente invasivo, Epistemonikos, GRADE.
ABSTRACT: Introduction: Minimally invasive techniques are widely used in non-cavitated interproximal caries treatment in primary dentition. Sealants, fluoride varnish, or resin infiltration can be applied in conjunction or as monotherapy. There is uncertainty regarding the effect of resin infiltration in conjunction with fluoride varnish in primary dentition. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified 9 systematic reviews including three studies overall, of which all were randomized trials. We conclude that resin infiltration plus fluoride varnish probably decreases the risk of progression of non-cavitated interproximal caries in primary dentition. No studies were found that looked at adverse effects.
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Humans , Resins, Synthetic , Dental Caries , DentitionABSTRACT
@#AIM: To observe the clinical effects of 23G micro-invasive vitrectomy combined with intravitreal injection of ranibizumab in the treatment of proliferative diabetic retinopathy(PDR).<p>METHODS: A retrospective review was performed on 78 patients with PDR who were seen between January 2016 and January 2020. Those treated with 23G micro-invasive vitrectomy alone were included in the surgery group(<i>n</i>=35, 41 eyes), while those treated with 23G micro-invasive vitrectomy and preoperative intravitreal injection of ranibizumab were included in the combined group(<i>n</i>=43, 48 eyes). The operation time, intraoperative blood loss, frequency of electric coagulation hemostasis during surgery, intraocular tamponade, occurrence of retinal tear, changes in the best corrected visual acuity(BCVA), intraocular pressure, central macular thickness(CMT)and fluorescein leakage area of retinal neovascularization before treatment, at 1d and 3mo were compared between the 2 groups. Aqueous humor samples were collected before treatment and at 1wk to determine changes in vascular endothelial growth factor(VEGF)-A, human stromal cell-derived factor-1(SDF-1)and pigment epithelial-derived factor(PEDF)levels. The incidence of surgical complications within 3mo of follow-up was counted.<p>RESULTS: Operation time for the combined group was shorter than that for the surgery group, the frequency of electric coagulation hemostasis, the number of eyes filled with silica-gel and the total number of intraoperative bleeding eyes were lower and smaller than those in the surgery group(<i>P</i><0.05). At 1d and 3mo, the improvement of BCVA was better in the combined group than in the surgery group(<i>P</i><0.05), CMT and retinal neovascularization leakage area were smaller than the surgery group(<i>P</i><0.05), but no significant difference was found in intraocular pressure between the 2 groups(<i>P</i>>0.05). At 1wk, VEGF-A, SDF-1 and PEDF decreased in both groups(<i>P</i><0.001), lower in the combined group than in the surgery group(<i>P</i><0.001). The incidences of iatrogenic tear and vitreous re-hemorrhage were lower in the combined group than in the surgery group(<i>P</i><0.05). There was no significant difference in the incidence of the other complications between the 2 groups(<i>P</i>>0.05).<p>CONCLUSION: 23G micro-invasive vitrectomy combined with intravitreal injection of ranibizumab is superior to 23G micro-invasive vitrectomy alone in the treatment of PDR since the combined treatment can reduce surgical difficulty, shorten the operation time, reduce intraoperative blood loss and instrument operation, promote postoperative recovery of visual acuity, inhibit retinal neovascularization, and reduce the risks of iatrogenic injury, with fewer complications. Also, it is safer and more effective.
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@#The Micro-invasive glaucoma surgery(MIGS)group of operations has been developed in the recent years to reduce some of complications of most standard glaucoma procedures such as trabculectomy. In order to increase the surgical effect, a new group of surgical manners has emerged that seeks to decrease IOP with lower associated rates of complications. The MIGS of the latest technique and devices are presented by three manners of reducing IOP: aqueous reduction surgery(Endoscopic Cyclophotocoagulation, Ultrasound Cyclo-Plasty); external filtering surgery(Implantation of EX-PRESS miniature glaucoma device, CANALOPLASTY); internal filtering surgery(Trabecular microbypass stent, Ab Interno Trabeculectomy). The article will summarize clinically relevant information of the glaucoma treatment and to describe indications, advantages and disadvantages of the MIGS.
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Objective@#To investigate the clinical effect of modified three minimally invasive blepharoplasty of double-fixation method.@*Methods@#From April 2015 to December 2016, 82 patients were included, all received minimally invasive blepharoplasty. Three 3 mm-long small incision (at medial, middle and lateral) were designed, then part of the orbicularis oculi muscle and pretarsal fat were removed. Pretarsal fascia was then sutured with orbicularis oculi muscle and skin with two-layer-suture to form double eyelid respectively.@*Results@#With up to 18 months follow-up, all patients had short period of detumescence within 7-12 days, high satisfaction rate with long lasting and natural double eyelid shape were achieved, no obvious scarring was noted.@*Conclusions@#Modified three minimally invasive blepharoplasty of double-fixation method has presented the merits of accurate presentation, natural shape, quicker recovery and less trauma, which makes it worthy of clinical presentation.
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Pancreatic duct stone is a sequel of chronic pancreatitis and may be found in the main ducts,side branches or parenchyma.These stones obstruct the pancreatic ducts and produce ductal hypertension,which leads to pain,the cardinal feature of CP.Surgical operation has been the preferred treatment of pancreatic duct stones in many domestic and external pancreatic medical centers.Lithotomy by longitudinal pancreatic duct incision and Roux-en-Y anastomosis of pancreatic duct to jejunum is the main and effective surgical procedure,while micro-surgery was also rational for the treatment of pancreatic duct stones.However,further studies with a larger sample size and longer follow-up duration are needed to improve the surgical technique and verify our initial results.
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<p><b>OBJECTIVE</b>To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma (CVA).</p><p><b>METHODS</b>A total of 240 patients were randomly assigned into an observation group and a control group, 120 cases in each one. Considering of cases dropping, 101 patients in the observation group and 105 cases in the control group were included. Montelukast sodium chewable tablets were applied before sleep for 3 months in the control group, 5 mg a time, once a day. Based on the treatment as the control group, micro-invasive embedding was used for 3 months in the observation group, twice in the first month and once in the other two months. The acupoints were Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1), and Zusanli (ST 36). Follow-up was conducted 9 months after treatment in the two groups. The cough score, serum immunoglobulin (IgE, IgG, IgA), platelet activating factor (PAF) were observed before and after treatment. The indices were compared before and after treatment and at follow-up, including pulmonary function indices[peak expiratory flow rate (PEF), forced expiratory volume at the 1st second (FEV1)], and small airway function indices[forced expiratory flow rate with remaining 25% vital capacity (MEF25%), forced expiratory flow rate with remaining 50% vital capacity (MEF50%), forced expiratory flow rate with remaining 75% vital capacity (MEF75%) and mid expiratory flow rate (MEF25%-75%)]. Also, the total effects were evaluated.</p><p><b>RESULTS</b>①The total effective rate in the observation group was 93.1% (94/101), which was better than 87.6% (92/105) in the control group (<0.05). The cough disappearance time of the cured children in the observation group was (10.38±2.64) d, and it was shorter than (10.72 ±2.60) d of those in the control group (<0.05). After treatment, the cough score apparently decreased compared with those before treatment in the two groups (both<0.05), with better result in the observation group (<0.05). At follow-up, the recurrence frequency of the observation group was (1.43±1.20), and it was less than (1.91±1.71) in the control group (<0.05). ②The levels of serum IgA and IgG after treatment in the two groups increased, and those of serum IgE and PAF decreased, compared with those before treatment. There was statistically significance except IgG in the control group before and after treatment (all<0.05), with better Results in the observation group after treatment (all<0.05). ③ Compared with those before treatment, all the pulmonary function indices were improved obviously after treatment and at follow-up in the two groups (all<0.05), without statistically significance between the two groups (both>0.05). ④ There was no statistically significance before and after treatment on small airway function indices in the two groups (all>0.05). The indices at follow-up increased compared with those before treatment in the two groups (all<0.05), with better Results in the observation group (all<0.05).</p><p><b>CONCLUSIONS</b>Micro-invasive embedding combined with montelukast sodium achieved de-finite effect for children CVA, which can improve the body's immune and microcirculation. The effect is better than that of simple montelukast sodium on improving small airway function, etc.</p>
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@#Glaucoma is the second major causes of blindness after cataract. The conventional trabeculectomy and shunt implantation is still the most common surgical procedure in treatment of glaucoma. However, the limitations of the treatments are the security and failure rate. Micro-invasive glaucoma surgery(MIGS)is an emerging category which shares the following five characteristics compared with traditional glaucoma surgery:(1)an interno microincision,(2)micro-invasion,(3)definite curative effect,(4)high safety, and(5)rapid recovery. moreover, it can also reduce the use of glaucoma medication after operation. This kind of surgery can be conducted in three different space, such as Schlemm canal, the suprachoroidal space, and the subconjunctival space. This article reviews briefly the new techniques of micro-invasive glaucoma surgery.
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Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.
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Objective To explore the effect of the application of cervical loop electric knife (LEEP) in the patients with cervical micro invasive cancer.Methods Clinical data of 66 patients with minimal invasive carcinoma diagnosed by LEEP cone resection in our hospital from June 2013 to June were retrospectively analyzed. Preoperative and postoperative patients with LEEP were compared with 66 patients who underwent biopsy with biopsy, the diagnosis of micro invasive carcinoma was compared with LEEP cone resection.Results The results of colposcopy biopsy were detected in 2 cases of LSIL, 60 cases of HSIL and 1 cases of AIS, 3 cases were diagnosed as cervical microinvasive carcinoma or suspicious cervical microinvasive carcinoma, the sensitivity was 4.54%, the misdiagnosis rate was 95.46%; LEEP conization were detected in 1 cases of LSIL, 44 cases of HSIL and 1 cases of AIS, 20 cases negative margin. There was no significant difference in the thickness and area of the resected tissue between the three groups (P > 0.05). The depth of the resected tissue was significantly higher than that in the HSIL and AIS group, the HSIL and AIS groups were significantly higher than the LSIL group, the difference was statistically significant (P 0.05). Cut edge positive group, positive margin group and interstitial fiber positive margin group of patients with postoperative residual disease rates were 25.00%, 15.38% and 23.80%, the difference was not statistically significant (P > 0.05).Conclusion The rate of missed diagnosis of small invasive cervical cancer is higher, and the diagnosis rate can be improved by the combination of LEEP and cone resection.
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Refractory glaucoma is one of the main blinding diseases in ophthalmology.Glaucoma drainage device implantation has become one of the main methods of refractory glaucoma.It has been widely used in clinic because of its advantages of safety,effectiveness and less complications.After a large number of clinical applications and innovative development of minimally invasive glaucoma surgery,glaucoma drainage device implantation shows its good treatment prospects.In this paper,the structural features of glaucoma external drainage device (Molteno,Schocket,Baerveldt,Human aqueous drainage,Krupin,Ahmed,Joseph,Whites,Optimed drainage device) and microin vasive glaucoma surgery (MIGS) (Ex-PRESS drainage device,Xen Gel Stent,CyPass Micro-Stent,Ab interno trabeculectomy trabectome,Hydrus Schlemm canal scaffold,iStent trabecular micro-bypass stent,SOLX Gold Shunt) were summarized.The drainage device implantations for glaucoma in the role of the refractory glaucoma were reviewed.
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[Objective]To compare the immediate therapeutic effects of the treatment of gluteal muscle constracture(GMC)with arthroscopic release of contractured tissue and conventional surgery.To investigate the indications of arthroscopic surgery.[Method]Ninty-six limbs of 48 patients with traditional surgery and 84 limbs of 42 patients with arthroscopic surgery were analyzed in terms of operation time,length of the incision,postoperative pain,complications,the time of exercise,postoperative hospital stay and one-year recurrence rate.[Result]Arthroscopic surgery group had smaller incisions,earlier exercise,less postoperative pain and shorter hospital stay than conventional surgery group,but the two groups showed no significant difference in operative time,complications,effects of operation and one-year recurrence rate.[Conclusion]Arthroscopic release of contracture tissue is a safe,effective,economical and cosmetic way to treat the gluteal muscle contracture.This method is worthy of wide promotion.
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Objective To develop a new portable micro-invasive blood glucose detector.Methods With a high-performance MCU C8051F060 as the core,the system is composed of SPR biosensor,step-motor,vacuum pump and a lattice-style liquid crystal module.With multi-task RTOS,RTX51-TINY,the system realizes blood measurement.Results Microinvasive and real-time acquisition and detection for the body's blood glucose can be fulfilled.Conclusion This detector has the characteristics of small size,high-speed and accurate detection,so it has a nice application foreground.
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Objective To investigate the skills and effects of TriVex system and to discuss its indications and complications in the treatment of varicose vein in lower limbs.Methods The TriVex system operation was underwent in 106 lower limbs with varicose vein.Sixteen of them showed thrombophlebitis while 38 of them showed chronic ulcer and pigmentation.The lower limbs with perforating vein were treated with subfascial endoscopic perforator vein surgery(SEPS) and limbs with deep insufficient vein valve underwent endoscopic valve repair.Results The therapeutic effect of TriVex system was satisfactory and none of them had soft tissue infection.Hematoma occurred in 12 lower limbs(11.2%).Pigmentation and skin petechia disappeared in 3 weeks after operation.Chronic ulcer healed and ankle pigment reduced in 38 limbs.Hematoma,petechia and numbness were the common complications in the patients with varicose vein in lower limbs.Conclusion It was effective,cosmetic and micro invasive to use the TriVex system in the treatment of thrombophlebitis and varicose vein with chronic ulcer.Adept operation skill can minimize the postoperative complications but the long-term effects of this new technique still needed follow-up studies.