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【Objective】 To explore the rational management of contralateral patent processus vaginalis (CPPV) in laparoscopic high ligation of processus vaginalis. 【Methods】 A total of 300 children with unilateral oblique inguinal hernia/hydrocele who received laparoscopic high ligation of processus vaginalis in Baoding Children’s Hospital during Jun.2018 and Jun.2022 were selected and divided into two groups by random number table method, with 150 in either group. In the control group, 53 cases of CPPV were found intraoperatively, which were treated simultaneously. In the study group, 58 cases of CPPV were detected, among which 11 met the indications of high ligation and received simultaneous surgical treatment. The incidence of recurrence was compared between the two groups. 【Results】 After 1 year of follow-up, the recurrence rate was 8.62% in the study group and 1.88% in the control group (P>0.05). The detection rate of CPPV was 23.02% in children with unilateral inguinal hernia, significantly lower than that in children with unilateral hydrocele (49.07%, P<0.001). The detection rate of CPPV was 42.71% in children with left patent processus vaginalis and 32.95% in children with right patent processus vaginalis (P=0.19). The detection rate of CPPV was 62.93% in the age group of 1-2 years, significantly higher than that in other age groups (P<0.001). 【Conclusion】 The incidence of CPPV conversion into oblique inguinal hernia or hydrocele is low. Only children who meet the indications can be treated at the same time during surgery.
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Objective:To evaluate the safety and efficacy of radiofrequency ablation guided by CT hepatic arteriography (CTHA) in the treatment of multiple nodular liver metastases of colorectal cancer.Methods:Clinical data of 32 patients with liver metastasis of colorectal cancer who underwent femoral arterial catheterization and percutaneous radiofrequency ablation guided by CT hepatic arteriography (CTHA) at the Affiliated Cancer Hospital of Zhengzhou University from March 2020 to September 2021 were retrospectively analyzed, including 21 males and 11 females, aged (53.2±9.9) years old. Before ablation, the angiography catheter were placed in the common or proper hepatic artery under the digital subtraction angiography (DSA). The patients were then transferred to a CT operating room. Under general anesthesia, contrast agent was injected into the indwelling angiography catheter and percutaneous radiofrequency ablation guided by CTHA was performed. The presentation of lesions, the dosage of contrast agent and complications during ablation were analyzed, and the treatment outcome was followed up outpatient or inpatient review.Results:All 32 patients uneventfully underwent DSA-guided angiography catheter placement, and CTHA-guided radiofrequency ablation was successfully performed in 97 lesions, with a technical success rate of 100% (97/97). The difference between CT values at the lesion enhancement site and peri-tumor hepatic parenchyma were greater than 25 HU. The total amount of contrast agent used during the procedure was 63.9±14.7 ml. All ablation-related complications were graded as A or B according to the Society of Interventional Radiology classification system. The complete ablation rate assessed by CTHA after the ablation was 100% (97/97). The rate of lesion necrosis was 100% evaluated by MRI one month after ablation. All patients were followed up and no recurrence was observed in 97 ablated lesions by the end of follow-up period.Conclusion:Radiofrequency ablation guided by CTHA is safe and feasible for the treatment of multiple nodular liver metastases of colorectal cancer, which could reduce the local recurrence of lesions after ablation.
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Objective:To investigate the clinical efficacy of five-element music therapy in the treatment of bipolar disorder.Methods:Eighty patients with bipolar disorder admitted to Shandong Mental Health Center from January 2018 to December 2019 were included in this study. They were randomly divided into a study group and a control group ( n = 40/group). The control group was treated with conventional drug treatment. The study group was treated with five-element music therapy based on conventional drug treatment. Before, during and after treatment, mania and depression were evaluated. Symptom self-evaluation scale and the Traditional Chinese Medicine Five State Emotion Questionnaire were completed to evaluate the curative effect. Patients were followed up by telephone call. Recurrence at 3, 6 and 12 months was recorded. Results:Before treatment, there were no significant differences in the scores of the Bech-Rafaelsen Mania Rating Scale (BRMs), Hamilton Depression Rating Scale (HAMD), Traditional Chinese Medicine Five State Emotion Questionnaire, Symptom Checklist-90 (SCL-90) between the two groups (all P > 0.05). During and after treatment, BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire, and SCL-90 scores were significantly decreased in each group compared with before treatment [Control group: BRMs score during and after treatment: (11.52 ± 1.57) points, (9.43 ± 1.05) points; HAMD score during and after treatment: (16.75 ± 3.05) points, (13.61 ± 2.51) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary (67.25 ± 5.7) points, (56.38 ± 4.97) points, physical symptoms (29.52 ± 3.94) points, (24.19 ± 3.05) points, SCL-90 score: (100.52 ± 10.26) points, (68.85 ± 7.33) points. Study group: BRMs score during and after treatment: (9.33 ± 1.09) points, (7.85 ± 0.82) points; HAMD score: (13.74 ± 2.54) points, (10.17 ± 1.97) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary: (58.19 ± 5.06) points, (46.85 ± 4.06) points, physical symptoms (25.14 ± 3.54) points, (20.11 ± 2.57) points; SCL-90 scores: (90.85 ± 8.97) points, (56.87 ± 5.81) points]. During and after treatment, scores of BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire and SCL-90 in the study group were significantly lower than those in the control group ( t = 3.77, 7.01, 4.48, 6.99, 8.78, 4.89, 6.05, 4.19, 7.57, all P < 0.05). Total response rate in the study group was significantly higher than that in the control group (90.0% vs. 72.5%, χ2 = 4.02, P < 0.05). At 3, 6 and 12 months after treatment, recurrence rate in the study group was 2.5%, 15.0% and 30.0%, respectively, which were significantly lower than 17.5%, 35.0%, and 52.5% in the control group ( χ2 = 5.00, 4.26, 4.17, all P < 0.05). Conclusion:Five-element music therapy for the treatment of bipolar disorder can markedly alleviate depression and mania, restore patient's emotional state, improve clinical efficacy, and decrease recurrence rate.
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Objective:To analyze the application of video nystagmography in the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) so as to provide evidence for clinical diagnosis.Methods:A total of 120 patients with suspected BPPV who received treatment in Yueqing People's Hospital from January to July 2020 were included in this study. There were anterior ( n = 24), posterior ( n = 80) and horizontal semicircular canal ( n = 16) BPPV according to the disease type. The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography and naked eyes were determined. Therapeutic effects of video nystagmography on three types of BPPV were compared. Results:The diagnostic rates of anterior, posterior and horizontal semicircular canal BPPV were 91.68%, 92.50% and 93.75%, respectively, and the difference was not statistically significant ( χ2 = 0.06, P > 0.05). The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography were 91.68%, 92.50% and 93.75% respectively, which were significantly higher than those by naked eyes (58.34%, 78.75%, 56.25%, χ2 = 7.11, 6.14, 3.86, all P < 0.05). After 1 week of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 62.50%, 66.25%, 68.75%, respectively. After 3 months of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 95.83%, 96.25% and 100.00%, respectively. There were no significant differences between anterior, posterior and horizontal semicircular canal BPPV after 1 week and 3 months of treatment ( χ2 = 0.18, 0.64, P > 0.05). At 3 months after surgery, the recurrence rates of anterior, posterior and horizontal semicircular canal BPPV were 4.16%, 5.00% and 6.25%, respectively, and the difference was not statistically significant ( χ2 = 0.08, P > 0.05). Conclusion:Video nystagmography is highly effective in the diagnosis and treatment of BPPV. It can accurately judge the occurrence of nystagmus in BPPV and increase the detection rate, which is worthy of clinical application.
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Objective:To investigate the efficacy of mosapride versus domperidone in the treatment of functional dyspepsia and its effects on gastric motility indexes and gastrointestinal hormone levels. Methods:Ninety-four patients with functional dyspepsia who received treatment in Huzhou Linghu People's Hospital between May 2019 and May 2021 were included in this study. They were randomly assigned to undergo treatment with either domperidone (control group, n = 47) or mosapride (study group, n = 47). Efficacy was compared between the two groups. Results:Total response rate in the study group was significantly higher than that in the control group ( χ2 = 5.04, P = 0.025). After medication, motilin, plasma leptin and corticotropin-releasing hormone in the study group were (184.22 ± 25.36) μg/mL, (18.57 ± 2.44) μg/L, (7.21 ± 1.14) pg/mL, respectively, which were superior to those in the control group [(111.25 ± 21.00) μg/mL, (15.41 ± 2.28) μg/L, (9.02 ± 1.32) μg/mL, t = 15.19, 6.48, 16.23, P < 0.001, < 0.001, < 0.001]. After medication, cholecystokinin, somatostatin, vasoactive intestinal peptide and gastrin levels in the study group were (45.36 ± 5.12) ng/L, (5.48 ± 1.25) ng/L, (86.35 ± 12.11) pg/mL, and (105.24 ± 12.05) ng/L, respectively, which were significantly superior to those in the control group [(50.21 ± 6.18) ng/L, (7.01 ± 0.98) ng/L, (98.75 ± 14.18) pg/mL and (97.35 ± 11.48) ng/L, t = 4.14, 6.60, 4.55, 3.25, P < 0.001, < 0.001, < 0.001, < 0.002]. The recurrence rate in the study group was significantly lower than that in the control group (2.13% vs. 27.66%, χ2 = 4.66, P = 0.031). The incidence of adverse reactions in the study group was significantly lower than that in the control group (14.89% vs. 34.04%, χ2 = 10.80; P = 0.001). Conclusion:Mosapride has a better therapeutic effect on functional dyspepsia, exhibits a greater effect on improving gastric motility indexes and gastrointestinal hormone levels, and leads to a lower incidence of recurred functional dyspepsia than domperidone. Therefore, mosapride for treatment of functional dyspepsia deserves clinical promotion.
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Objective:To compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).Methods:A cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.Results:All of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference ( P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group ( χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups ( χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group ( χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group ( χ2=4.255, P=0.039). Conclusions:Compared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.
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OBJECTIVE@#To compare the clinical therapeutic effect and the impacts on recurrence rate on chronic spontaneous urticaria (CSU) between the combined treatment of bloodletting therapy and auricular point sticking on the base of xuanfu theory and the oral solution of levocetirizine hydrochloride.@*METHODS@#A total of 86 patients with CSU were randomized into an observation group (43 cases, 1 case dropped off) and a control group (43 cases, 3 cases dropped off). In the observation group, bloodletting therapy at Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17) and Pishu (BL 20) was combined with auricular point sticking at lung (CO14), kidney (CO10), shenmen (TF4) and heart (CO15), etc. This combined treatment was given once every two days. In the control group, the oral solution of levocetirizine hydrochloride was prescribed, 10 mL each time, once daily. The treatment lasted for 4 weeks in the two groups. Before and after treatment, urticaria activity score 7 (UAS7), the score of dermatology life quality index (DLQI) and the levels of serum immune globulin E (IgE), interleukin 4 (IL-4) and interferon γ (IFN-γ) were compared in the patients between the two groups. The clinical therapeutic effect was evaluated in patients of the two groups and the recurrence rate was followed up 4, 8 and 12 weeks after treatment separately.@*RESULTS@#After treatment, the scores of UAS7 and DLQI, as well as the levels of serum IgE and IL-4 were all reduced as compared with those before treatment in the two groups (P<0.05), and the level of serum IFN-γ was increased (P<0.05). The total effective rate was 83.3% (35/42) in the observation group and was 85.0% (34/40) in the control group. There was no statistical significance for the difference in the clinical therapeutic effect between the two groups (P>0.05). Eight and 12 weeks after treatment, the recurrence rates were 21.1% (4/19) and 26.3% (5/19) in the observation group, lower than 55.0% (11/20) and 65.0% (13/20) in the control group, respectively (P<0.05).@*CONCLUSION@#The combined therapy of bloodletting and auricular point sticking on the base of xuanfu theory relieves the clinical symptoms, regulates the levels of serum IgE, IL-4 and IFN-γ and improves the quality of life in the patients with CSU. The clinical therapeutic effect of this combined treatment is similar to the oral solution of levocetirizine hydrochloride. But, the recurrence rate of the combined treatment of bloodletting and auricular point sticking is lower and its long-term curative effect is better.
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Humans , Acupuncture Points , Acupuncture Therapy , Acupuncture, Ear , Bloodletting , Chronic Urticaria , Quality of Life , Treatment OutcomeABSTRACT
ObjectiveTo systematically review the efficacy of intervention by WeChat on medication compliance， psychotic symptom and recurrence rate of schizophrenic patients in community. MethodsDatabases including PubMed， the Cochrane Library， CBM， CNKI， Wanfang Data and VIP were searched electronically from January 1， 2011 to November 1， 2020 to collect randomized controlled trials （RCTs） about the effects of WeChat intervention on community schizophrenic patients. After two reviewers independently screened literature， extracted data and assessed the risk of bias of included studies， the meta-analysis was performed with Stata 12.0 software. ResultsA total of 381 articles were retrieved and finally 10 RCTs were included， including 1 251 patients with WeChat intervention group 641 cases and routine health education group 610 cases. Meta-analysis showed that compared with the conventional health education group， the WeChat intervention group had higher medication compliance （OR=3.05，95% CI：1.98~4.69，P<0.01）， lower PANSS score （SMD=-1.05，95% CI：-1.46~-0.64，P<0.01） and relapse rate （OR=0.34，95% CI：0.24~0.48，P<0.01）. ConclusionThe interactive intervention based on WeChat platform can effectively improve the medication compliance of patients with schizophrenia in the community， help to reduce the severity of psychotic symptoms and the recurrence rate.
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Objective:To investigate the clinical efficacy of compound Huangdai tablets combined with all-trans retinoic acid in the treatment of acute promyelocytic leukemia. Methods:A total of 120 patients with acute promyelocytic leukemia who received treatment in the First People's Hospital of Huzhou, China between February 2013 and February 2015 were included in this study. They were randomly assigned to receive either all-trans retinoic acid, mercaptopurine and methotrexate in combination (control group, n = 60) or all-trans retinoic acid combined with compound Huangdai tablets (study group, n = 60). The time to hemoglobin rebounding, the time to platelet count rebounding, and the time to first complete remission were recorded. The recurrence and death of patients during 5 years of follow up were recorded. Adverse drug reactions during the treatment period were recorded. Results:The time to hemoglobin rebounding, the time to platelet count rebounding, and the time to first complete remission in the study group were (19.56 ± 2.61) days, (20.42 ± 2.73) days, (1.74 ± 0.45) months, respectively, which were significantly shorter than those in the control group [(28.42 ± 3.85) days, (30.63 ± 4.02) days, (3.31 ± 0.69) months, t = 10.328, 9.746, 8.521, P < 0.001]. The 1-year and 5-year recurrence rate in the study group were 11.37% and 21.67% respectively, which were significantly lower than those in the control group [28.33%, 41.67%, χ2 = 5.208, 5.546, P = 0.022, 0.019]. 5-year mortality rate in the study group was significantly lower than that in the control group [8.33% vs. 25.00%, χ2 = 6.000, P = 0.014]. There was no significant difference in adverse drug reaction between study and control group [28.33% vs. 26.67%, χ2 = 0.042, P = 0.838]. Conclusion:Compound Huangdai tablets combined with all-trans retinoic acid can effectively shorten the remission time of acute promyelocytic leukemia, reduces the disease recurrence rate and mortality rate, and is highly safe.
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Objective@#To compare the efficacy of laparoscopic choledochoscopic cholelithotripsy and laparoscopic cholecystectomy in the treatment of cholecystolithiasis.@*Methods@#A retrospective study was conducted in 81 cases of cholecystolithiasis who admitted to the People's Hospital of Yuci District from March 2013 to March 2018.The patients were divided into control group (n=38, laparoscopic cholecystectomy) and study group (n=43, laparoscopic choledochoscope choledocholithotomy) according to the different surgical method.The perioperative indicators, liver function indicators, recurrence rate and complications were compared between the two groups.@*Results@#The operation time, hospital stay, recovery time of gastrointestinal function, recovery time of diet after operation and intraoperative bleeding volume in the study group were (43.59±4.59)min, (7.24±1.17)d, (15.51±2.09)d, (2.88±0.42)d, (15.07±1.32)mL, respectively, which were better than those in the control group [(55.23±5.47)min, (9.12±1.32)d, (26.48±3.48)d, (3.53±0.58)d, (24.65±1.48)mL] (t=10.411, 6.796, 17.426, 5.823, 6.864, all P=0.000). The levels of total bilirubin (TBIL), alanine transferase (ALT), aspartate aminotransferase (AST) and total protein (TP) at 1 day after operation in the study group were (24.39±2.21)μmol/L, (29.09±4.68)U/L, (29.02±4.41)U/L, (21.95±2.52)g/L, respectively, which were lower than those in the control group [(28.43±2.31)μmol/L, (34.39±4.28)U/L, (35.31±3.08)U/L, (25.28±2.42)g/L] (t=8.038, 5.293, 7.348, 6.046, all P=0.000). TBIL, ALT, ALT, AST, AST, TP levels at 3 days after surgery in the study group were (20.32±2.24)μmol/L, (24.61±4.26)U/L, (23.68±4.79)U/L, (18.94±2.89)g/L, respectively, which were lower than those in the control group [(24.45±2.02)μmol/L, (29.81±3.32)U/L, (27.94±4.50)U/L, (21.41±2.87)g/L] (t=8.669, 6.609, 4.109, 3.851; all P=0.000). The recurrence rates of the control group and the study group were 5.26% (2/38) and 6.98% (3/43), respectively, there was no statistically significant difference between the two groups (χ2=0.102, P=0.749). The incidence of complications in the study group was 4.65% (2/43), which was lower than 21.05% (8/38) in the control group, the difference was statistically significant (χ2=5.015, P=0.025).@*Conclusion@#Compared with laparoscopic cholecystectomy, laparoscopic assisted choledochoscopic choledocholithotomy has better curative effect, it can reduce the damage to liver function, with low incidence of complications, and it has high clinical value.
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Objective@#To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.@*Methods@#From January 2012 to January 2018, 90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair, while the observation group was treated with partial rectal resection with anal stapler.The operative effect, incidence of postoperative complications, recurrence rate, degree of pain after operation, length of hospital stay and cost of treatment were compared between the two groups.@*Results@#The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1/45), which was lower than that in the control group [17.8%(8/45)] (χ2=4.444, P=0.035). The recurrence rate in the observation group was 0(0/45), which was lower than that in the control group [13.3%(6/45)] (χ2=4.464, P=0.035). The hospitalization time in the observation group was shorter than that in the control group[(7.01±2.06)d vs.(11.31±2.42)d]. Compared with the control group, the treatment cost of the observation group was higher[(0.836±0.164)×104CNY vs.(0.605±0.136)×104CNY], and the post-operative pain score was lower[(4.24±1.33) vs.(6.45±1.17)](t=9.076, 7.273, 8.369, all P<0.001).@*Conclusion@#Transanal stapler partial rectal resection is effective in the treatment of rectocele, with less complications, lower recurrence rate and less pain after operation, but the cost of treatment is higher.
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@#AIM:Comparison of curative effect of different surgical methods on children with meibomian cyst.<p>METHODS: Totally 150 children who needed meibomian gland cyst surgery were selected and divided into traditional group and cauterization group. The traditional group used traditional surgical excision and the cauterization group took cysts to remove povidone-iodinated cotton tablets. The average operation time, the probability of hematoma, cure rate, recurrence rate and family satisfaction. <p>RESULTS:There was no significant difference in general data of children in traditional group and cautery group(<i>P</i>>0.05). The average operation time of the traditional group and the cautery group were(14.5±2.58)min and(12.29±1.53)min(<i>P</i><0.05); the probability of hematoma was 21.3% and 9.3%, and the cautery group had less compared with the traditional group(<i>P</i><0.05); The total effective rates of the cautery group and the traditional group were 97.3% and 89.3% respectively(<i>P</i>>0.05), there were fewer children in the cautery group(<i>P</i>>0.05); the satisfaction of the family members of the children in the cauterization group was 97.3%, better than the traditional group 86.7%(χ2=4.832, <i>P</i><0.05).<p>CONCLUSION:The use of cyst curettage plus povidone-iodine cotton tablets for cauterization can reduce the operation time and hematoma rate of meibomian gland cysts, and the curative effect is high. It is worthy of clinical application.
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Objective To investigate the clinical efficacy of pretreatment regimen containing idarubicin (IDA) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for high-risk refractory leukemia. Methods A total of 116 patients with high-risk refractory leukemia who received allo-HSCT treated with 7 types of IDA-containing pretreatment regimes were enrolled in this study. The implantation rate of 116 recipients was summed up. The 2-year overall survival (OS), 2-year disease free survival (DFS), cumulative recurrence rate, recurrent mortality, transplantation related mortality (TRM), cumulative incidence of acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) were statistically analyzed by Kaplan-Meier survival curve. Results All 116 recipients successfully implanted. The median follow-up time was 28 (7-70) months. Among them, 64 recipients survived, the 2-year OS was 55.2%, 2-year DFS was 51.7%, 2-year recurrent mortality was 23.3% and 2-year TRM was 18.1%. Among 116 recipients, 72 cases suffered from aGVHD. The 2-year cumulative incidence rate of aGVHD was 62.1% including 20 cases of grade Ⅲ-Ⅳ aGVHD, the 2-year cumulative incidence rate was 17.2%. Among 116 recipients, 59 cases presented with cGVHD. The 2-year cumulative incidence rate was 55.4%, of which the 2-year cumulative incidence rate of extensive cGVHD was 14.7%. Among 116 recipients, 30 cases recurred with a 2-year cumulative recurrence rate of 25.9%. Conclusions IDA-containingpretreatment regime has high safety and effectiveness, and can be used as an effective pretreatment regime for transplantation preprocessing in patients with high-risk refractory leukemia.
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Objective To investigate the clinical effect of transanal stapler partial rectal resection for rectocele.Methods From January 2012 to January 2018,90 patients with rectocele treated in Changzhi Traditional Chinese Medicine Hospital were divided into control group (45 cases) and observation group (45 cases) according to the operation method.The control group was treated with closed transrectal repair ,while the observation group was treated with partial rectal resection with anal stapler.The operative effect ,incidence of postoperative complications , recurrence rate,degree of pain after operation ,length of hospital stay and cost of treatment were compared between the two groups.Results The total effective rate of the two groups was 100.0%.The incidence of complications in the observation group was 2.2%(1／45),which was lower than that in the control group [17.8%(8／45)] (χ2 ＝4.444, P＝0.035).The recurrence rate in the observation group was 0(0／45),which was lower than that in the control group [13.3%(6／45)] (χ2 ＝4.464,P＝0.035).The hospitalization time in the observation group was shorter than that in the control group[(7.01 ±2.06)d vs.(11.31 ±2.42)d].Compared with the control group ,the treatment cost of the observation group was higher[(0.836 ±0.164)×104CNY vs.(0.605 ±0.136)×104CNY],and the post-operative pain score was lower [(4.24 ±1.33) vs.(6.45 ±1.17)] ( t＝9.076,7.273,8.369,all P＜0.001).Conclusion Transanal stapler partial rectal resection is effective in the treatment of rectocele , with less complications, lower recurrence rate and less pain after operation ,but the cost of treatment is higher.
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@#AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y.<p>METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients(142 males and 122 females)with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24a. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12 and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated.<p>RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. 5 eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo.<p>CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.
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BACKGROUND: Herpes zoster (HZ) is generally thought to occur once in a lifetime and recurrence is considered to be limited to immunocompromised individuals. Although HZ recurrence rates seem to be increasing, there have been few studies exploring these rates in the general population. We investigated the recurrence rate and associated risk factors in the general population. METHODS: We used the population-based samples of the National Health Insurance Service database to identify cases of initial HZ episodes from January 1, 2002 to December 31, 2013. We also followed up on these cases through December 31, 2013 to identify recurrence. RESULTS: Overall, the incidence rate of HZ is 5.1 per 1,000 person years and the recurrence rate is 12.0 per 1,000 person years. There were 2,100 recurrent cases out of 39,441 initial episodes with 4.4 years of the mean follow-up period. We identified significant risk factors for recurrence such as old age (51–70 years) (hazard ratio [HR], 1.447; 95% confidence interval [CI], 1.311–1.598), women (1.476; 1.345–1.619), zoster-related pain (ZRP) longer than 30 days (cases of ZRP lasting 31–90 days [1.200; 1.042–1.383], and ZRP lasting longer than 90 days [2.293; 1.990–2.643]). Concurrent hematologic malignancies (2.864; 1.929–4.251), autoimmune diseases (1.466; 1.252–1.715), dyslipidemia (1.390; 1.263–1.530), and hypertension (1.222; 1.107–1.350) were also significant risk factors. CONCLUSION: Our results suggest that the recurrence of HZ is much more common than generally expected, and that the associated risk factors can play an important role in predicting recurrence.
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Female , Humans , Autoimmune Diseases , Cohort Studies , Dyslipidemias , Epidemiology , Follow-Up Studies , Hematologic Neoplasms , Herpes Zoster , Hypertension , Incidence , National Health Programs , Recurrence , Risk FactorsABSTRACT
Objective: To compare the perioperative and recent curative effects of laparoscopic radical resection of low rectal rectal carcinoma by natural orifice specimen extraction surgery (NOSES) with two-step procedure to turn rectum out from the abdominal cavity and traditional one-step procedure to turn rectum out from abdominal cavity. Methods: The clinical data of 63 patients who were treated by laparoscopic radical resection of low rectal rectal carcmoma by NOSES were analyzed retrospectively. A total of 39 patients were treated with the method of two-step procedure to turn rectum out from the abdominal cavity (two-step procedure group) and 24 patients were treated with the traditional one-step procedure to turn rectum out from the abdominal cavity (traditional one-step procedure group). Results: The maximum tumor diameters, the successful rates, tumor fragmentation rates, operation time, intraperative bleeding loss, postoperative exhaust time, anastomotic leakage rates after operation, and the shortterm-follow-up results of the patients in two groups were recovered The specimens of 39 patients in two-step procedure group were successfully pulled out from the anus, the anastomosis was finishehed after resection, and the NOSES of low rectal carcinoma was successfully completed, while 3 cases were failed of 24 cases in traditional onestep procedure group, the successful rate was decreased (P=0. 024). After the specimen were pulled out from the anus, the fragmentation rate of the patients in two-step procedure group was lower than that in traditional one-step procedure group (P=0. 004). The operation time of the patients in two-step procedure group was less than that in traditional one-step procedure group (t=4. 266, P<0. 01). There were no significant differences in the maximum diameters of tumor (t= - 0.406, P=0. 686), intraoperative bleeding loss (t=1.799, P=0. 075), postoperative exhaust time (t=- 0.144, P= 0.886), postoperative anastomotic leakage rate (P= 1.000) of the patients between two groups. During 3 to 24 months of follow-up, there were no significant differences in the recurrence rate (P = 0. 140) and metastatic rate of carcinoma (P = 0. 36) of the patients between two groups. Conclusion: Two-step procedure to turn rectum out from the abdominal cavity can reduce the pressure on the tumor during turning the rectum out, which can save the operation time and get good short-term curative effect during the radical resection of low rectal carcinoma by NOSES.
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Objective@#To observe the efficacy and safety of 308 nm excimer light combined with compound triamcinolone acetoniazole cream in the treatment of chronic hand eczema.@*Methods@#From February 2016 to August 2017, 62 patients with chronic hand eczema admitted to the First People's Hospital of Taicang were divided into two groups using random digital tables, with 31 cases in each group.The treatment group was given 308nm excimer light combined with compound triamcinolone acetoniazole cream.The control group was treated only with compound triamcinolone acetoniazole cream.The effect after 4 and 8 weeks of treatment were determined in both two groups.@*Results@#After 4 and 8 weeks of treatment, the effective rates in the treatment group were 35.48% and 87.10%, respectively, which in the control group were 29.03% and 61.29%, respectively.After 8 weeks of treatment, the difference between the treatment group and the control group was statistically significant(χ2=5.39, P<0.05).@*Conclusion@#308 nm excimer light combined with triamcinolone acetoniazole cream in the treatment of chronic hand eczema has good clinical effect and less adverse reactions, and the recurrence rate is low.
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Radical hysterectomy(RH)with bilateral pelvic lymph node dissection is recommended as the standard treatment for early-stage cervical cancer(FIGO stageⅠB1 or ⅡA1 disease).Minimally invasive surgery(MIS)has been adopted as an optimal treatment for early cervical cancer since 20th century for its advantages in perioperative outcomes and comparable oncological outcomes.Not until 2018 were two articles from MD Anderson Center published in The New England Journal of Medicine reversed the situation.Their results suggested that patients who underwent MIS for RH had higher recurrence rates and worse overall survival compared to patients that underwent open surgery.Since then,controversy about open surgery and MIS has continued.This article will discuss the current controversy and stragegies of laparoscopic surgery for cervical cancer.
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Objective To observe the efficacy and safety of 308 nm excimer light combined with compound triamcinolone acetoniazole cream in the treatment of chronic hand eczema.Methods From February 2016 to August 2017,62 patients with chronic hand eczema admitted to the First People＇s Hospital of Taicang were divided into two groups using random digital tables,with 31 cases in each group.The treatment group was given 308nm excimer light combined with compound triamcinolone acetoniazole cream. The control group was treated only with compound triamcinolone acetoniazole cream.The effect after 4 and 8 weeks of treatment were determined in both two groups. Results After 4 and 8 weeks of treatment,the effective rates in the treatment group were 35.48% and 87.10%, respectively,which in the control group were 29.03% and 61.29%, respectively. After 8 weeks of treatment, the difference between the treatment group and the control group was statistically significant ( χ2 =5.39, P ＜0.05 ). Conclusion 308 nm excimer light combined with triamcinolone acetoniazole cream in the treatment of chronic hand eczema has good clinical effect and less adverse reactions,and the recurrence rate is low.