Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen t...Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy （HBOT） to reduce the keloid recurrence rate after surgical excision and radiotherapy. Methods： （1） A total of 240 patients were randomly divided into two groups. Patients in the HBOT group （O group） received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy （K group）. （2） Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin （H＆E） staining was used to observe keloid morphology. Certain inflammatory factors （interleukin-6 （IL-6）, hypoxia-inducible factor-1α （HIF-1α）, tumor necrosis factor-α （TNF-α）, nuclear factor KB （NF-κB）, and vascular endothelial growth factor （VEGF）） were measured using immunohistochemical staining. Results： （1） The recurrence rate of the O group （5.97%） was significantly lower than that of the K group （14.15%）, P〈0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group （P〈0.05）. （2） Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. Conclusions： Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Treatment options available for breast cancer are Surgery [Breast conservation surgery (BCS) or Modified radical mastectomy (...<strong>Background:</strong><span style="font-family:Verdana;"> Treatment options available for breast cancer are Surgery [Breast conservation surgery (BCS) or Modified radical mastectomy (MRM)];Radiation treatment [Conventional radiation treatment or CRT and Hypofractionated radiation treatment or HRT] and Chemotherapy. In the postmastectomy or post lumpectomy setting, radiotherapy (RT) improves loco-regional control. CRT for breast include</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> 50</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 25 fractions (2</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy per fraction) and HRT include</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> 42.5</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 16 fractions (2.7</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy per fraction) or extreme hypofractionation like 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 5 fraction</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;">. Alpha/beta value for breast is less, so HRT is ideal for breast. So, there will be good loco-regional control, without increased normal tissue damage. This study aims to identify recurrence rate and toxicity in breast cancer patients treated using conventional and hypofractionated postmastectomy radiotherapy among Indian population. </span><b><span style="font-family:Verdana;">Primary objective: </span></b><span style="font-family:Verdana;">To assess recurrence rate of disease in breast cancer patients treated using hypofractionated postmastectomy radiation and to compare it with breast cancer patients treated using conventional postmastectomy radiation. </span><b><span style="font-family:Verdana;">Secondary objective:</span></b><span style="font-family:Verdana;"> To assess the toxicity in hypofractionation and conventional fractionation arm. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This is a prospective observational study conducted in Department of Radiation Oncology from December 2017 to June 2019. Radically treated breast cancer patients who received radiation treatment either conventional or hypofractionated as one of the treatment modalities were included in the study. Data were collected using a structured proforma, history and physical examination, master file of the patients, lab results and the imaging reports, written informed consent form, ECOG performance status scale (Eastern Cooperative Oncology Group), RTOG (</span></span><span style="font-family:Verdana;">Radiation Therapy Oncology Group) </span><span style="font-family:""><span style="font-family:Verdana;">Acute Radiation Morbidity Scoring Schema. Patients were monitored for 18 months to identify recurrence rate and toxicity in each arm. </span><b><span style="font-family:Verdana;">Results and discussion:</span></b><span style="font-family:Verdana;"> A total of 241 patients were enrolled into this study, among them 175 patients (73%) were given hypofractionation radiotherapy and 66 patients (27%) were given conventional radiotherapy. </span></span><span style="font-family:Verdana;">In hypofractionation arm, recurrence was found in 14 patients (8%), of which, 3 were local recurrences [chest wall] and 11 were systemic recurrences, while in conventional arm, recurrence was found in 4 patients (6%) and all of them were systemic recurrences. </span><span style="font-family:Verdana;">Recurrence rate in hypofractionation arm was 8% and in conventional arm was 6.10%.</span><span style="font-family:""><span style="font-family:Verdana;"> The Kaplan Meier curve shows no significant difference between the two arms with p value = 0.76. Acute toxicities assessed were dermatitis, esophagitis and pneumonitis. Among acute dermatitis, 4 patients had grade 3 and 2 patients had grade 4 in hypofractionation arm, while in conventional arm, 7 patients had grade 3 and 1 patient had grade 4. Grade 1 and 2 together versus grade 3 and 4 acute dermatitis showed a statistically significant difference between the two arms, with more acute toxicity in the conventional arm. Among acute esophagitis, 1 patient had grade 3 and no patients had grade 4 in hypofractionation arm;while in conventional arm, no grade 3 and grade 4 acute esophagitis were found. Among acute pneumonitis, 2 patients had grade 3 and 1 patient had grade 4 in hypofractionation arm, while in conventional arm, 1 patient had grade 3 and no patients with grade 4 were found. Grade 2 and grade 3 acute lung toxicities were found in patients with central lung distance more than 1.5 cm. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was found that the recurrence rate of hypofractionation radiotherapy was comparable to conventional fractionation radiotherapy. With respect to acute dermatitis, grade 1 and grade 2 were significantly more in conventional than hypofractionation arm. Hypofractionated radiotherapy is an equally effective option to conventional radiotherapy and should be encouraged, especially for developing countries like India where the resource is limited, and the incidence of tumour is high.</span></span>展开更多
Objective: to explore the application of health education in nursing care of children with pneumonia and its effect on reducing recurrence rate. Methods: 80 cases of children with pneumonia were randomly divided into ...Objective: to explore the application of health education in nursing care of children with pneumonia and its effect on reducing recurrence rate. Methods: 80 cases of children with pneumonia were randomly divided into two groups, 40 cases of basic nursing in the control group and 40 cases of basic nursing combined with health education in the observation group. The results were compared. Results: the observation group had higher nursing compliance and lower relapse rate of pneumonia (P < 0.05). Conclusion: health education can improve the nursing compliance of children and reduce the recurrence rate of pneumonia.展开更多
Pressure fluctuations signals of a lab-scale fiuidized bed （15 cm inner diameter and 2 m height） at different superficial gas velocities were measured. Recurrence plot （RP） and recurrence rate （RR）, and the simp...Pressure fluctuations signals of a lab-scale fiuidized bed （15 cm inner diameter and 2 m height） at different superficial gas velocities were measured. Recurrence plot （RP） and recurrence rate （RR）, and the simplest variable of recurrence quantification analysis （RQA） were used to analyze the pressure signals. Different patterns observed in RP reflect different dynamic behavior of the system under study. It was also found that the variance of RR （a2R） Could reveal the peak dominant frequencies （PDF） of different dynamic systems： completely periodic, completely stochastic, Lorenz system, and fluidized bed. The results were compared with power spectral density. Additionally, the diagram of σ^2RR provides a new technique for prediction of transition velocity from bubbling to turbulent fluidization regime.展开更多
BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recur...BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.展开更多
BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures...BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures,they are largely ineffective for fibrotic and mixed strictures,often necessitating surgical intervention.However,surgery carries considerable risks,including bleeding,infection,anastomotic leaks,and postoperative restricture formation.Endoscopic treatment,particularly endoscopic stricturotomy,offers a minimally invasive alternative that bridges the gap between medication and surgery.AIM To investigate the safety and efficacy of stricturotomy under single-balloon enteroscopy in stricturing CD.METHODS Patients diagnosed with stricturing CD at The First People's Hospital of Changzhou from June 2020 to April 2024 were enrolled and underwent endoscopic stricturotomy(ES).Relevant clinical data of patients were collected retrospectively.Outcomes included success rate,remission time,complications,and follow-up interventions.This observational study was followed up postoperatively to observe patient remission and recurrence rates.RESULTS Seventeen endoscopic strictures were created in 11 patients,achieving a 100%immediate success rate without any serious complications.During the follow-up period,stricture recurrence was observed in two patients,resulting in an endoscopic reintervention rate of 18.2%.Additionally,two patients required subsequent surgical intervention,with a surgical treatment rate of 18.2%.One patient experienced bowel obstruction 18 months post-ES and was successfully managed with conservative treatment without surgical intervention.The remission duration after the initial ES treatment was 10.1±8.2 months,with a median remission time of 10 months.CONCLUSION ES is a safe and effective treatment for CD-related strictures and warrants further clinical promotion and application.展开更多
Acute myocardial infarction(AMI)is a leading cause of death and disability worldwide and consists of two distinct cardiac pathologies:ST-elevation myocardial infarction(STEMI)and non-ST-elevation myocardial infarction...Acute myocardial infarction(AMI)is a leading cause of death and disability worldwide and consists of two distinct cardiac pathologies:ST-elevation myocardial infarction(STEMI)and non-ST-elevation myocardial infarction(NSTEMI).[1]In China,AMI is widely recognized as a predominant cause of mortality in both urban and rural demographics,based on the 2022 Report on Cardiovascular Health and Diseases in China;moreover,its mortality rate has been reported to be rising,with a recurrence rate of 2.5%within one year.展开更多
AIM:To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 fema...AIM:To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 females with a mean age of 54.8±14.1y)who demonstrated at least one inferior recurrence of RRD were included in this retrospective study.All patients were categorized as having received either circular scleral buckling(SB),pars plana vitrectomy(PPV),a combination of SB and PPV(SB+PPV),PPV with retinotomy(PPV+RT),or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade(PPV+RT+pPFCL).All cases were followed up until successful retinal reattachment or third recurrence.The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and bestcorrected visual acuity(BCVA).RESULTS:After the treatment of the first recurrence,the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV(P=0.0012),PPV+RT(P=0.028),or PPV+RT+pPFCL(P=0.047)group.There was no statistically significant difference between PPV+SB,PPV+RT,and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence(42 eyes).However,there was a statistically significant(P=0.016)trend towards a decrease of recurrence rate after PPV+RT+pPFCL.There was no statistically significant improvement of BCVA in either study group(P>0.05)after both first and second recurrence surgery.The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence.CONCLUSION:Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV.RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes,however,without functional improvement.展开更多
BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different tre...BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.展开更多
Purpose: During the last decade laparoscopic approach to perforated peptic ulcer has gained wide acceptance over the traditional open repair on the basis of being an equally efficient and less invasive technique. Meth...Purpose: During the last decade laparoscopic approach to perforated peptic ulcer has gained wide acceptance over the traditional open repair on the basis of being an equally efficient and less invasive technique. Methods: 198 patients with perforated duodenal or prepyloric ulcer that were surgically treated from 2003 to 2014 were included in this study. 140 were operated within 2 - 6 hours from the onset of symptoms, 55 within 6 - 24 hours, and 3 patients after 24 hours. Results: Laparoscopic simple closure with Graham patch was performed in 179 patients. In 19 patients with known chronic ulcer resistant to pharmacologic therapy, who were operated within 6 hours from the onset of symptoms, laparoscopic Taylor procedure was undertaken. Conversion to open repair was necessitated in four patients. The operating time was 40 - 100 min for the Graham patch repair and 120 - 155 min for the Taylor procedure. During follow-up, 48% of patients from the “Graham patch” group and no one from the “definitive procedure” group had recurrent ulcer. Conclusions: Laparoscopic treatment of perforated peptic ulcer is technically feasible and safe when performed by experienced surgeons. In certain cases more definitive procedures may achieve better long-term results.展开更多
Objective： The choice between total gastrectomy （TG） and subtotal gastrectomy （STG） for early adenocarcinoma of the lower third of the stomach is still a matter of debate and controversy amongst surgeons. The aim...Objective： The choice between total gastrectomy （TG） and subtotal gastrectomy （STG） for early adenocarcinoma of the lower third of the stomach is still a matter of debate and controversy amongst surgeons. The aim of this study was to compare the surgical outcomes, quality of life （QoL）, and local recurrence rates as well as other results of curative resection of early distal adenocarcinoma of the stomach using TG or STG performed in Iran. Methods： Hospital records of 66 patients with early distal adenocarcinoma of stomach that underwent even total or subtotal gastrectomy with perigastric （D2） lymphadenectomy between October 2001 and February 2006 in Taleghani Hospital, Iran were reviewed retrospectively. Demographic data as well as clinicopathological factors including number of involved lymph nodes, tumor grading, depth of invation, tumor size, and tumor type were recorded. Post-operative outcomes including mortality and morbidity, tumor recurrence and quality of life were assessed. Univariate analyses using Fisher＇s exact test, the Student t-test, and the Pearson χ^2 test were used. Results： Local recurrence of tumor was found in 8 （23%） TG group patients and in 19 （61%） patients of STG group, the Pearson χ^2 test showed a significant higher recurrence rate in STG （P value=0.002, Relative Risk=2.68, Confidence Interval： 1.37-5.24）.The mean time interval between gastrectomy and tumor recurrence was not different between TG and STG. （19.75±5.1 vs. 18.0±7.8 respectively; P value=0.507） Tumor size 〉5 cm （P value=0.004）, diffuse type （P value=0.034）, poor differentiation （P value=0.000） and serosal invasion （P value=0.012） were found to be significantly related to tumor recurrence in patients undergone gastrectomy. In none of the QoL measures a significant difference was found between TG and STG Conclusion： Our results show that subtotal and total gastrectomy methods with perigastric lymphadenectomy have a similar postoperative complication rate and surgical outcomes as well as patient＇s QoL but STG was associated to a more than twofold increase in local recurrence risk.展开更多
Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the cli...Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 30% SA peeling and IEG in the treatment of moderate-to-severe acne vulgaris. Methods: Patients with moderate-to-severe acne vulgaris were randomized into 3 groups of 30 persons each, and treated with SA peel, or IEG, or SA combine with IEG (SA + IEG group). Evaluation of acne was done by effective rate and individual lesion counts. And the adverse effects and recurrence were recorded. Results: The SA + IEG group was better in clinical efficacy and treating noninflammatory and inflammatory lesions than that of single treatment group (P 0.05). Conclusion: 30% SA combined with IEG had a significant effect in the treatment of moderate-to-severe acne lesions.展开更多
Objective: To realize the effect and clinical value of implementing oral metronidazole + miconazole nitrate in patients with recurrent vaginosis. Methods: This study was analyzed retrospectively, and the time period w...Objective: To realize the effect and clinical value of implementing oral metronidazole + miconazole nitrate in patients with recurrent vaginosis. Methods: This study was analyzed retrospectively, and the time period was controlled from April 2020 to August 2021.200 consecutive patients with recurrent candida vaginitis in our hospital were admitted and randomized, and 100 consecutive patients were included in each group. The control group was given metronidazole treatment, and the observation group used miconazole nitrate based on the control group. The disease recurrence rate, incidence of adverse reactions, time to clinical symptom improvement, clinical efficacy, Candida clearance rate, and vaginal health status were observed and compared. Results: The clinical efficacy of the observed group was 97.00%, the incidence of adverse reactions was only 3.00%, 88.00% and 11.00% of the control groups, respectively, and P 0.05. In the observation group treated with combination therapy, the patients had a short improvement time of clinical symptoms, a good vaginal health status, and a high vaginal cleanliness, with P 0.05. Patients in the post-treatment observation group had higher Candida clearance and lower disease recurrence rate, and the data were P 0.05 compared to the control group. Conclusion: Oral metronidazole plus miconazole nitrate in treating recurrent candida vaginitis can shorten the clinical symptoms, improve the vaginal health and improve the clinical effect.展开更多
BACKGROUND： Hepatocellular carcinoma（HCC） recurrence remains a key issue after liver transplantation. This study aimed to determine a subgroup of HCC patients within the Milan criteria who could achieve a theoretic...BACKGROUND： Hepatocellular carcinoma（HCC） recurrence remains a key issue after liver transplantation. This study aimed to determine a subgroup of HCC patients within the Milan criteria who could achieve a theoretical goal of zero recurrence rates after liver transplantation.METHODS： Between 1999 and 2009, 179 patients who received liver transplantation for HCC within the Milan criteria were retrospectively included. Analysis of the factors associated with HCC recurrence was performed to determine the subgroup of patients at the lowest risk of recurrence.RESULTS： Seventy-two percent of the patients received a bridging therapy, including 54 liver resections. Eleven（6.1%） patients recurred within a delay of 19±22 months and ultimately died. Factors associated with recurrence were serum alpha-fetoprotein level 〉400 ng/m L, satellite nodules, poor differentiation, microvascular invasion and cholangiocarcinoma component. Recurrence rates decreased from 6.1% to 3.1% in patients without any of these factors.CONCLUSIONS： Among HCC patients within the Milan criteria, selecting patients with factors based on histology would allow tending towards zero recurrence, and prior histological assessment by liver biopsy or resection may be essential to rule out poorly differentiated tumors, microvascular invasion,and cholangiocarcinoma component.展开更多
Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analy...Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.展开更多
BACKGROUND Rhinophyma,a late-stage subtype of rosacea,is characterized by excessive sebaceous glands and connective tissue proliferation.Patients may experience respiratory disturbances and psychological distress that...BACKGROUND Rhinophyma,a late-stage subtype of rosacea,is characterized by excessive sebaceous glands and connective tissue proliferation.Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves.Surgery is the treatment of choice for rhinophyma.However,excessive bleeding,scarring,pigmentation,and high recurrence rates frequently characterize current surgical methods.AIM To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher.METHODS This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea.The Global Flushing Severity Score(GFSS),Clinician Erythema Assessment(CEA),Rhinophyma Severity Index(RHISI),Glasgow Benefit Inventory(GBI),and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years,with the recurrence rate calculated at 5 years postoperatively.In addition,the levels of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the serum of patients before and after surgery were detected by ELISA.RESULTS The GFSS,CEA,and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively(P<0.001 for both periods).Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction.A small number of patients(7/28,25%)reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment.The expression of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the patient's serum was significantly reduced after surgery of five-blade scratcher.CONCLUSION The five-blade scratcher treatment demonstrates notable advantages,including simplicity,safety,efficacy,and cost-effectiveness,coupled with reduced bleeding,minimized scarring,lower recurrence rates,reduced the level of pro-inflammatory factors and improved patient satisfaction.Consequently,this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma.展开更多
Approximately 7%of the polyps resected endoscopically have an adenocarcinoma focus,with no previous endoscopic evidence of malignancy.This raises the question of whether endoscopic resection has been curative.Furtherm...Approximately 7%of the polyps resected endoscopically have an adenocarcinoma focus,with no previous endoscopic evidence of malignancy.This raises the question of whether endoscopic resection has been curative.Furthermore,there is no consensus on what the endoscopic and histological criteria for good prognosis are,the appropriate follow-up strategy and what are the long-term results.The aim of the retrospective study by Fábián et al was to evaluate the occurrence of local relapse or distant metastasis in those tumors that were resected endoscopically compared to those that underwent oncologic surgery.They concluded that,regardless of the treatment strategy chosen,there was a higher recurrence rate than described in the literature and that adherence to follow-up was poor.The management approach for an endoscopically benign polyp histologically confirmed as adenocarcinoma depends on the presence of any of the previously described poor prognostic histological factors.If none of these factors are present and the polyp has been completely resected en bloc(R0),active surveillance is considered appropriate as endoscopic resection is deemed curative.These results highlight,once again,the need for further multicentric clinical practice studies to obtain more evidence for the purpose of establishing appropriate treatment and follow-up strategies.展开更多
Pterygium is a benign lesion usually growing from the nasal side of the conjunctiva onto the cornea.Most cases of pterygium does not cause problem or requires specific treatment.The exact cause of pterygium is not cle...Pterygium is a benign lesion usually growing from the nasal side of the conjunctiva onto the cornea.Most cases of pterygium does not cause problem or requires specific treatment.The exact cause of pterygium is not clear yet,but some factors are pointed as causes,being the most important the long-term ultraviolet ray exposure.Pterygium surgery is usually considered when there are symptoms that do not respond to conservative treatment.Recurrence is the main complication of the surgery,and much has been done to avoid it.Mitomycin C（MMC） has been used as a fibroblast proliferation inhibitor during the surgery to reduce the chance of recurrence of the pterygium.This review describes the use of MMC as an adjunctive,the optimal dosage,the duration of administration of MMC and possible complications,when used during,after and before the surgery.Most studies suggest that increased exposure（dose or duration） of MMC is associated with a lower recurrence,but with higher risks of complications.展开更多
Oral hairy leukoplakia(OHL) is a disease associated with Epstein-Barr virus and human immunodeficiency virus infections. OHL is usually an asymptomatic lesion, but in some cases treatment is recommended to reestablish...Oral hairy leukoplakia(OHL) is a disease associated with Epstein-Barr virus and human immunodeficiency virus infections. OHL is usually an asymptomatic lesion, but in some cases treatment is recommended to reestablish the normal characteristics of the tongue, to eliminate pathogenic microorganisms, to improve patient comfort and for cosmetic reasons. Proposed treatments for this condition include surgery, systemic antiviral treatment and topical management. Topical treatment is an inexpensive and safe therapy that is easy to apply, noninvasive, free of systemic adverse effects and effective over a long period of time. The aim of this study was to present a review of the literature for topical therapy for OHL. Gentian violet, retinoids, podophyllin, acyclovir and podophyllin associated with topical antiviral drugs were used to treat OHL. Reports with this focus are limited, and since 2010, no new studies have been published that discuss the efficacy of topical treatments for OHL. Podophyllin with acyclovircream was found to be effective, causing regression of lesions with no recurrences. Additional searches are necessary to provide clinical evidence of topical man agement effectiveness.展开更多
基金Project supported by the National Natural Science Foundation of China(No.81471885)the Beijing Natural Science Foundation(No.7172172),China
文摘Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy （HBOT） to reduce the keloid recurrence rate after surgical excision and radiotherapy. Methods： （1） A total of 240 patients were randomly divided into two groups. Patients in the HBOT group （O group） received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy （K group）. （2） Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin （H＆E） staining was used to observe keloid morphology. Certain inflammatory factors （interleukin-6 （IL-6）, hypoxia-inducible factor-1α （HIF-1α）, tumor necrosis factor-α （TNF-α）, nuclear factor KB （NF-κB）, and vascular endothelial growth factor （VEGF）） were measured using immunohistochemical staining. Results： （1） The recurrence rate of the O group （5.97%） was significantly lower than that of the K group （14.15%）, P〈0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group （P〈0.05）. （2） Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. Conclusions： Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Treatment options available for breast cancer are Surgery [Breast conservation surgery (BCS) or Modified radical mastectomy (MRM)];Radiation treatment [Conventional radiation treatment or CRT and Hypofractionated radiation treatment or HRT] and Chemotherapy. In the postmastectomy or post lumpectomy setting, radiotherapy (RT) improves loco-regional control. CRT for breast include</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> 50</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 25 fractions (2</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy per fraction) and HRT include</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> 42.5</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 16 fractions (2.7</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy per fraction) or extreme hypofractionation like 26</span><span style="font-family:""> </span><span style="font-family:Verdana;">Gy in 5 fraction</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;">. Alpha/beta value for breast is less, so HRT is ideal for breast. So, there will be good loco-regional control, without increased normal tissue damage. This study aims to identify recurrence rate and toxicity in breast cancer patients treated using conventional and hypofractionated postmastectomy radiotherapy among Indian population. </span><b><span style="font-family:Verdana;">Primary objective: </span></b><span style="font-family:Verdana;">To assess recurrence rate of disease in breast cancer patients treated using hypofractionated postmastectomy radiation and to compare it with breast cancer patients treated using conventional postmastectomy radiation. </span><b><span style="font-family:Verdana;">Secondary objective:</span></b><span style="font-family:Verdana;"> To assess the toxicity in hypofractionation and conventional fractionation arm. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This is a prospective observational study conducted in Department of Radiation Oncology from December 2017 to June 2019. Radically treated breast cancer patients who received radiation treatment either conventional or hypofractionated as one of the treatment modalities were included in the study. Data were collected using a structured proforma, history and physical examination, master file of the patients, lab results and the imaging reports, written informed consent form, ECOG performance status scale (Eastern Cooperative Oncology Group), RTOG (</span></span><span style="font-family:Verdana;">Radiation Therapy Oncology Group) </span><span style="font-family:""><span style="font-family:Verdana;">Acute Radiation Morbidity Scoring Schema. Patients were monitored for 18 months to identify recurrence rate and toxicity in each arm. </span><b><span style="font-family:Verdana;">Results and discussion:</span></b><span style="font-family:Verdana;"> A total of 241 patients were enrolled into this study, among them 175 patients (73%) were given hypofractionation radiotherapy and 66 patients (27%) were given conventional radiotherapy. </span></span><span style="font-family:Verdana;">In hypofractionation arm, recurrence was found in 14 patients (8%), of which, 3 were local recurrences [chest wall] and 11 were systemic recurrences, while in conventional arm, recurrence was found in 4 patients (6%) and all of them were systemic recurrences. </span><span style="font-family:Verdana;">Recurrence rate in hypofractionation arm was 8% and in conventional arm was 6.10%.</span><span style="font-family:""><span style="font-family:Verdana;"> The Kaplan Meier curve shows no significant difference between the two arms with p value = 0.76. Acute toxicities assessed were dermatitis, esophagitis and pneumonitis. Among acute dermatitis, 4 patients had grade 3 and 2 patients had grade 4 in hypofractionation arm, while in conventional arm, 7 patients had grade 3 and 1 patient had grade 4. Grade 1 and 2 together versus grade 3 and 4 acute dermatitis showed a statistically significant difference between the two arms, with more acute toxicity in the conventional arm. Among acute esophagitis, 1 patient had grade 3 and no patients had grade 4 in hypofractionation arm;while in conventional arm, no grade 3 and grade 4 acute esophagitis were found. Among acute pneumonitis, 2 patients had grade 3 and 1 patient had grade 4 in hypofractionation arm, while in conventional arm, 1 patient had grade 3 and no patients with grade 4 were found. Grade 2 and grade 3 acute lung toxicities were found in patients with central lung distance more than 1.5 cm. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was found that the recurrence rate of hypofractionation radiotherapy was comparable to conventional fractionation radiotherapy. With respect to acute dermatitis, grade 1 and grade 2 were significantly more in conventional than hypofractionation arm. Hypofractionated radiotherapy is an equally effective option to conventional radiotherapy and should be encouraged, especially for developing countries like India where the resource is limited, and the incidence of tumour is high.</span></span>
文摘Objective: to explore the application of health education in nursing care of children with pneumonia and its effect on reducing recurrence rate. Methods: 80 cases of children with pneumonia were randomly divided into two groups, 40 cases of basic nursing in the control group and 40 cases of basic nursing combined with health education in the observation group. The results were compared. Results: the observation group had higher nursing compliance and lower relapse rate of pneumonia (P < 0.05). Conclusion: health education can improve the nursing compliance of children and reduce the recurrence rate of pneumonia.
基金Supports from the Iran National Science Foundation(INSF) in lran(No.91001766)
文摘Pressure fluctuations signals of a lab-scale fiuidized bed （15 cm inner diameter and 2 m height） at different superficial gas velocities were measured. Recurrence plot （RP） and recurrence rate （RR）, and the simplest variable of recurrence quantification analysis （RQA） were used to analyze the pressure signals. Different patterns observed in RP reflect different dynamic behavior of the system under study. It was also found that the variance of RR （a2R） Could reveal the peak dominant frequencies （PDF） of different dynamic systems： completely periodic, completely stochastic, Lorenz system, and fluidized bed. The results were compared with power spectral density. Additionally, the diagram of σ^2RR provides a new technique for prediction of transition velocity from bubbling to turbulent fluidization regime.
基金Supported by The Zhenjiang City Key Research and Development Plan Social Development,China,No.SH2023047.
文摘BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.
文摘BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures,they are largely ineffective for fibrotic and mixed strictures,often necessitating surgical intervention.However,surgery carries considerable risks,including bleeding,infection,anastomotic leaks,and postoperative restricture formation.Endoscopic treatment,particularly endoscopic stricturotomy,offers a minimally invasive alternative that bridges the gap between medication and surgery.AIM To investigate the safety and efficacy of stricturotomy under single-balloon enteroscopy in stricturing CD.METHODS Patients diagnosed with stricturing CD at The First People's Hospital of Changzhou from June 2020 to April 2024 were enrolled and underwent endoscopic stricturotomy(ES).Relevant clinical data of patients were collected retrospectively.Outcomes included success rate,remission time,complications,and follow-up interventions.This observational study was followed up postoperatively to observe patient remission and recurrence rates.RESULTS Seventeen endoscopic strictures were created in 11 patients,achieving a 100%immediate success rate without any serious complications.During the follow-up period,stricture recurrence was observed in two patients,resulting in an endoscopic reintervention rate of 18.2%.Additionally,two patients required subsequent surgical intervention,with a surgical treatment rate of 18.2%.One patient experienced bowel obstruction 18 months post-ES and was successfully managed with conservative treatment without surgical intervention.The remission duration after the initial ES treatment was 10.1±8.2 months,with a median remission time of 10 months.CONCLUSION ES is a safe and effective treatment for CD-related strictures and warrants further clinical promotion and application.
基金supported by the Natural Science Foundation of Shandong Province(ZR2021QH096,ZR2020MH024)the National Natural Science Foundation of China(82300354,882070345)+2 种基金the Academic Promotion Program of Shandong First Medical University(2019QL012)the Shandong Taishan Scholarship(to SHY)fund of Tianjin Zhongxin Pharmaceutical Group Co.,Ltd。
文摘Acute myocardial infarction(AMI)is a leading cause of death and disability worldwide and consists of two distinct cardiac pathologies:ST-elevation myocardial infarction(STEMI)and non-ST-elevation myocardial infarction(NSTEMI).[1]In China,AMI is widely recognized as a predominant cause of mortality in both urban and rural demographics,based on the 2022 Report on Cardiovascular Health and Diseases in China;moreover,its mortality rate has been reported to be rising,with a recurrence rate of 2.5%within one year.
文摘AIM:To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment(RRD)depending on the surgical approach.METHODS:Eighty-one eyes of 81 patients(47 males and 34 females with a mean age of 54.8±14.1y)who demonstrated at least one inferior recurrence of RRD were included in this retrospective study.All patients were categorized as having received either circular scleral buckling(SB),pars plana vitrectomy(PPV),a combination of SB and PPV(SB+PPV),PPV with retinotomy(PPV+RT),or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade(PPV+RT+pPFCL).All cases were followed up until successful retinal reattachment or third recurrence.The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and bestcorrected visual acuity(BCVA).RESULTS:After the treatment of the first recurrence,the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV(P=0.0012),PPV+RT(P=0.028),or PPV+RT+pPFCL(P=0.047)group.There was no statistically significant difference between PPV+SB,PPV+RT,and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence(42 eyes).However,there was a statistically significant(P=0.016)trend towards a decrease of recurrence rate after PPV+RT+pPFCL.There was no statistically significant improvement of BCVA in either study group(P>0.05)after both first and second recurrence surgery.The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence.CONCLUSION:Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV.RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes,however,without functional improvement.
文摘BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.
文摘Purpose: During the last decade laparoscopic approach to perforated peptic ulcer has gained wide acceptance over the traditional open repair on the basis of being an equally efficient and less invasive technique. Methods: 198 patients with perforated duodenal or prepyloric ulcer that were surgically treated from 2003 to 2014 were included in this study. 140 were operated within 2 - 6 hours from the onset of symptoms, 55 within 6 - 24 hours, and 3 patients after 24 hours. Results: Laparoscopic simple closure with Graham patch was performed in 179 patients. In 19 patients with known chronic ulcer resistant to pharmacologic therapy, who were operated within 6 hours from the onset of symptoms, laparoscopic Taylor procedure was undertaken. Conversion to open repair was necessitated in four patients. The operating time was 40 - 100 min for the Graham patch repair and 120 - 155 min for the Taylor procedure. During follow-up, 48% of patients from the “Graham patch” group and no one from the “definitive procedure” group had recurrent ulcer. Conclusions: Laparoscopic treatment of perforated peptic ulcer is technically feasible and safe when performed by experienced surgeons. In certain cases more definitive procedures may achieve better long-term results.
文摘Objective： The choice between total gastrectomy （TG） and subtotal gastrectomy （STG） for early adenocarcinoma of the lower third of the stomach is still a matter of debate and controversy amongst surgeons. The aim of this study was to compare the surgical outcomes, quality of life （QoL）, and local recurrence rates as well as other results of curative resection of early distal adenocarcinoma of the stomach using TG or STG performed in Iran. Methods： Hospital records of 66 patients with early distal adenocarcinoma of stomach that underwent even total or subtotal gastrectomy with perigastric （D2） lymphadenectomy between October 2001 and February 2006 in Taleghani Hospital, Iran were reviewed retrospectively. Demographic data as well as clinicopathological factors including number of involved lymph nodes, tumor grading, depth of invation, tumor size, and tumor type were recorded. Post-operative outcomes including mortality and morbidity, tumor recurrence and quality of life were assessed. Univariate analyses using Fisher＇s exact test, the Student t-test, and the Pearson χ^2 test were used. Results： Local recurrence of tumor was found in 8 （23%） TG group patients and in 19 （61%） patients of STG group, the Pearson χ^2 test showed a significant higher recurrence rate in STG （P value=0.002, Relative Risk=2.68, Confidence Interval： 1.37-5.24）.The mean time interval between gastrectomy and tumor recurrence was not different between TG and STG. （19.75±5.1 vs. 18.0±7.8 respectively; P value=0.507） Tumor size 〉5 cm （P value=0.004）, diffuse type （P value=0.034）, poor differentiation （P value=0.000） and serosal invasion （P value=0.012） were found to be significantly related to tumor recurrence in patients undergone gastrectomy. In none of the QoL measures a significant difference was found between TG and STG Conclusion： Our results show that subtotal and total gastrectomy methods with perigastric lymphadenectomy have a similar postoperative complication rate and surgical outcomes as well as patient＇s QoL but STG was associated to a more than twofold increase in local recurrence risk.
文摘Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 30% SA peeling and IEG in the treatment of moderate-to-severe acne vulgaris. Methods: Patients with moderate-to-severe acne vulgaris were randomized into 3 groups of 30 persons each, and treated with SA peel, or IEG, or SA combine with IEG (SA + IEG group). Evaluation of acne was done by effective rate and individual lesion counts. And the adverse effects and recurrence were recorded. Results: The SA + IEG group was better in clinical efficacy and treating noninflammatory and inflammatory lesions than that of single treatment group (P 0.05). Conclusion: 30% SA combined with IEG had a significant effect in the treatment of moderate-to-severe acne lesions.
文摘Objective: To realize the effect and clinical value of implementing oral metronidazole + miconazole nitrate in patients with recurrent vaginosis. Methods: This study was analyzed retrospectively, and the time period was controlled from April 2020 to August 2021.200 consecutive patients with recurrent candida vaginitis in our hospital were admitted and randomized, and 100 consecutive patients were included in each group. The control group was given metronidazole treatment, and the observation group used miconazole nitrate based on the control group. The disease recurrence rate, incidence of adverse reactions, time to clinical symptom improvement, clinical efficacy, Candida clearance rate, and vaginal health status were observed and compared. Results: The clinical efficacy of the observed group was 97.00%, the incidence of adverse reactions was only 3.00%, 88.00% and 11.00% of the control groups, respectively, and P 0.05. In the observation group treated with combination therapy, the patients had a short improvement time of clinical symptoms, a good vaginal health status, and a high vaginal cleanliness, with P 0.05. Patients in the post-treatment observation group had higher Candida clearance and lower disease recurrence rate, and the data were P 0.05 compared to the control group. Conclusion: Oral metronidazole plus miconazole nitrate in treating recurrent candida vaginitis can shorten the clinical symptoms, improve the vaginal health and improve the clinical effect.
文摘BACKGROUND： Hepatocellular carcinoma（HCC） recurrence remains a key issue after liver transplantation. This study aimed to determine a subgroup of HCC patients within the Milan criteria who could achieve a theoretical goal of zero recurrence rates after liver transplantation.METHODS： Between 1999 and 2009, 179 patients who received liver transplantation for HCC within the Milan criteria were retrospectively included. Analysis of the factors associated with HCC recurrence was performed to determine the subgroup of patients at the lowest risk of recurrence.RESULTS： Seventy-two percent of the patients received a bridging therapy, including 54 liver resections. Eleven（6.1%） patients recurred within a delay of 19±22 months and ultimately died. Factors associated with recurrence were serum alpha-fetoprotein level 〉400 ng/m L, satellite nodules, poor differentiation, microvascular invasion and cholangiocarcinoma component. Recurrence rates decreased from 6.1% to 3.1% in patients without any of these factors.CONCLUSIONS： Among HCC patients within the Milan criteria, selecting patients with factors based on histology would allow tending towards zero recurrence, and prior histological assessment by liver biopsy or resection may be essential to rule out poorly differentiated tumors, microvascular invasion,and cholangiocarcinoma component.
文摘Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.
基金Shanghai Science and Technology Commission,No.21ZR1464000.
文摘BACKGROUND Rhinophyma,a late-stage subtype of rosacea,is characterized by excessive sebaceous glands and connective tissue proliferation.Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves.Surgery is the treatment of choice for rhinophyma.However,excessive bleeding,scarring,pigmentation,and high recurrence rates frequently characterize current surgical methods.AIM To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher.METHODS This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea.The Global Flushing Severity Score(GFSS),Clinician Erythema Assessment(CEA),Rhinophyma Severity Index(RHISI),Glasgow Benefit Inventory(GBI),and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years,with the recurrence rate calculated at 5 years postoperatively.In addition,the levels of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the serum of patients before and after surgery were detected by ELISA.RESULTS The GFSS,CEA,and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively(P<0.001 for both periods).Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction.A small number of patients(7/28,25%)reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment.The expression of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the patient's serum was significantly reduced after surgery of five-blade scratcher.CONCLUSION The five-blade scratcher treatment demonstrates notable advantages,including simplicity,safety,efficacy,and cost-effectiveness,coupled with reduced bleeding,minimized scarring,lower recurrence rates,reduced the level of pro-inflammatory factors and improved patient satisfaction.Consequently,this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma.
文摘Approximately 7%of the polyps resected endoscopically have an adenocarcinoma focus,with no previous endoscopic evidence of malignancy.This raises the question of whether endoscopic resection has been curative.Furthermore,there is no consensus on what the endoscopic and histological criteria for good prognosis are,the appropriate follow-up strategy and what are the long-term results.The aim of the retrospective study by Fábián et al was to evaluate the occurrence of local relapse or distant metastasis in those tumors that were resected endoscopically compared to those that underwent oncologic surgery.They concluded that,regardless of the treatment strategy chosen,there was a higher recurrence rate than described in the literature and that adherence to follow-up was poor.The management approach for an endoscopically benign polyp histologically confirmed as adenocarcinoma depends on the presence of any of the previously described poor prognostic histological factors.If none of these factors are present and the polyp has been completely resected en bloc(R0),active surveillance is considered appropriate as endoscopic resection is deemed curative.These results highlight,once again,the need for further multicentric clinical practice studies to obtain more evidence for the purpose of establishing appropriate treatment and follow-up strategies.
文摘Pterygium is a benign lesion usually growing from the nasal side of the conjunctiva onto the cornea.Most cases of pterygium does not cause problem or requires specific treatment.The exact cause of pterygium is not clear yet,but some factors are pointed as causes,being the most important the long-term ultraviolet ray exposure.Pterygium surgery is usually considered when there are symptoms that do not respond to conservative treatment.Recurrence is the main complication of the surgery,and much has been done to avoid it.Mitomycin C（MMC） has been used as a fibroblast proliferation inhibitor during the surgery to reduce the chance of recurrence of the pterygium.This review describes the use of MMC as an adjunctive,the optimal dosage,the duration of administration of MMC and possible complications,when used during,after and before the surgery.Most studies suggest that increased exposure（dose or duration） of MMC is associated with a lower recurrence,but with higher risks of complications.
基金National Council for Scientific and Technological Development(CNPq)Office of the Dean of Research of Universidade Federal de Minas Gerais(PRPq,#01/2014).
文摘Oral hairy leukoplakia(OHL) is a disease associated with Epstein-Barr virus and human immunodeficiency virus infections. OHL is usually an asymptomatic lesion, but in some cases treatment is recommended to reestablish the normal characteristics of the tongue, to eliminate pathogenic microorganisms, to improve patient comfort and for cosmetic reasons. Proposed treatments for this condition include surgery, systemic antiviral treatment and topical management. Topical treatment is an inexpensive and safe therapy that is easy to apply, noninvasive, free of systemic adverse effects and effective over a long period of time. The aim of this study was to present a review of the literature for topical therapy for OHL. Gentian violet, retinoids, podophyllin, acyclovir and podophyllin associated with topical antiviral drugs were used to treat OHL. Reports with this focus are limited, and since 2010, no new studies have been published that discuss the efficacy of topical treatments for OHL. Podophyllin with acyclovircream was found to be effective, causing regression of lesions with no recurrences. Additional searches are necessary to provide clinical evidence of topical man agement effectiveness.
