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In recent years, with the application and exploration of fluorescence imaging technology in pancreatic surgery, it has brought new changes and new hope for the intraoperative treatment of pancreatic diseases. Intraoperative fluorescence imaging with indocyanine green (ICG) as probe is increasingly applied in identify neoplasms, real-time margin assessment, tissue perfusion, lymph node detection, anastomotic leakage and so on, which provides a new means for intraoperative decision-making. This article reviewed the progress in the application of ICG fluorescence imaging in pancreatic surgery.
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Objective To evaluate the efficacy and safety of ilaprazole sodium for injection in the treatment of peptic ulcer bleeding.Methods It was designed as a multi-center,stratified randomized,double-blind,positive drug parallel controlled and non-inferiority study.From October 2014 to April 2015,at 40 hospitals,patients with peptic ulcer hemorrhage confirmed by gastroendoscopy were enrolled and divided into the ilaprazde sodium group (10 mg ilaprazole sodium for injection every 24 h,the first dose doubled) and the positive control group (40 mg of omeprazole sodium for injection every 12 h).The course of both treatment was 72 h.The hemostasis rate of overall group at 72 h,the clinical rebleeding rate at four to seven days,the blood transfusion rate,the incidence of switching to other treatments and the incidence of adverse reactions were compared between the two groups.A chi-square test or Fisher's exact probability method were performed for statistical analysis.Results A total of 533 patients with peptic ulcer bleeding were enrolled,355 patients in the ilaprazole sodium group and 178 patients in the positive control group.The hemostasis rates of ilaprazole sodium group and positive control group at 72 h were 97.69 ％ (339/347) and 97.14 ％ (170/175),respectively,and the difference was not statistically significant (P＞0.05).There were no rebleeding patients in both groups at four to seven days.The blood transfusion rates of ilaprazole sodium group and positive control group were 5.07 ％ (18/355) and 3.37 ％ (6/178).The incidence of switching to other treatments was 0.56％ (2/355) and 0.56％ (1/178),respectively,and the differences were not statistically significant (both P＞ 0.05).The incidence of adverse reactions in the ilaprazole sodium group was 3.94％ (14/355),which was lower than that of positive control group (8.43％,15/178).And the difference was statistically significant (Fisher's exact probability method,P=0.042).Conclusions The efficacy of ilaprazole sodium for injection in the treatment of peptic ulcer bleeding is similar to that of omeprazole sodium for injection.Moreover,the smaller the dose,the lower the frequency of administration and the better the safety.
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<p><b>BACKGROUND</b>Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients.</p><p><b>METHODS</b>This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups.</p><p><b>RESULTS</b>All of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P < 0.05). There were significant differences in BCVA between the two groups at the 12-month follow-up (χ(2) = 9.86, P = 0.020). Cox proportional hazards regression showed NVG as a risk factor for surgical failure (RR = 15.08, P = 0.033). Postoperative complications were similar between the two groups.</p><p><b>CONCLUSIONS</b>AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Glaucoma , General Surgery , Glaucoma Drainage Implants , Glaucoma, Neovascular , General Surgery , Proportional Hazards Models , Prospective StudiesABSTRACT
Objective To observe the effect of two different periodontal therapies on serum levels of C-reactive protein (CRP) and tumor necrosis factor-alpha(TNF-α)in elderly patients with coronary heart disease.Methods Totally 42 elderly patients with severe periodontitis were randomized into two groups:periodontal initial therapy and periodontal flap surgery group.The percentage of bleeding on probing (BOP),probing depth (PD) and serum levels of CRP and TNF-α were recorded at baseline and 12 weeks after treatment.Results The percentage of BOP,PD and serum levels of CRP and TNF-α in all patients were significantly reduced at 12 weeks after treatment as compared with baseline (all P＜0.05).Serum levels of CRP and TNF-α were lower in periodontal flap surgery than in periodontal initial therapy at 12 weeks after treatment [(3.4±9.1) μg/L vs.(2.6 ±7.9)μg/L,(4.4±1.8)mg/L vs.(3.5±2.1)mg/L,both P＜0.05].Conclusions Compared with periodontal initial therapy,periodontal flap surgery maybe better to reduce the levels of serum inflammatory markers.
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Objective To observe the clinical effectiveness of calcium sodium phosphosilicate desensitizer for the treatment of root-dentin hypersensitivity.Methods This was a randomized,single-blind,placebo controlled pilot study.135 subjects,a total of 215 teeth with a confirmed diagnosis of root-dentin hypersensitivity were randomly divided into three groups:group 1 (patients treated with 100％ calcium sodium phosphosilicate powder with 7％ calcium sodium phosphosilicate toothpaste),group 2 (patients treated with a placebo powder with 7 ％ calcium sodium phosphosilicate toothpaste),group 3 (patients treated with a placebo powder vith 0.11％ NaF toothpaste).Two standard test stimuli,cool air and cold water,were applied to sensitive root surfaces.Subjects recorded the intensity of sensitivity in response to each stimulus on a visual analogue scale (VAS) at baseline,immediately after powder application and after 2,4 and 6 weeks of twice-daily product use.Results The VAS values stimulated by cool air immediately,and 2,4 and 6 weeks after the treatment were [[(4.87±1.98),(3.85±1.09),(2.03±1.16),(0.59±0.51),respectivly] in Group 1; [(6.35±1.84),(4.83±0.75),(3.17±1.12),(1.45±0.91),respectively] in Group 2; [(6.83±0.78),(6.73±1.54),(5.441.58),(4.18±0.98),respectively] in Group 3.The VAS values stimulated by cold water immediately,and after 2,4 and 6 of treatment were [(6.43±1.01),(4.95±1.21),(3.06±0.86),(1.38±0.92),respectively] in Group 1; [(7.72±0.56),(5.65±0.69),(3.81±0.41),(2.17±0.58),respectively] inGroup2; [(8.380.89),(8.17±1.02),(7.99±0.74),(6.46±0.77),respectively] in Group 3.Compared with before treatment,there were significant differences in VAS values stimulated by the two tests at all time points in Group 1,and after 2,4 and 6 weeks of treatment in Group 2 (all P ＜0.05).Group 3 had significant differences in VAS values stimulated by cool air after 4 and 6 weeks of treatment,and had a significant difference in VAS values stimulated by cold water after 6 weeks of treatment (all P＜0.05).There were significant differences between group 1 and group 2 in the hypersensitivity reduction over baseline by two stimuli at all time point.Conclusions The 7％ calcium sodium phosphosilicate toothpaste shows a good performance in relieving the root dentin hypersensitivity.Moreover,the 100％ calcium sodium phosphosilicate powder can enhance the effectiveness of the 7％ calcium sodium phosphosilicate toothpaste.
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To investigate the neuronal migration and synthesis of peptidic neurotransmitters in vitro, neuromuscular co-cultures of nodose ganglia and cardiac muscle cells of Wistar rats were established. The living cells of co-cultures were observed with an inverted contrast microscope at different culture age. At 72 h and 96 h of culture age, the neuromuscular co-cultures were examined by Holmes' reduced silver staining technique for observing the neuronal migration. Immunohistochemical staining method was used for investigating the synthesis of peptidic neurotransmitters- substance P (SP) and calcitonin gene-related peptide (CGRP). The neuronal morphorlogical maturation in neuromuscular co-cultures seems at 72 h of culture age in terms of the observation of living cells and Holmes' reduced silver staining technique. SP- and CGRP-immunoreactive neurons were observed in neuromuscular co-cultures at 96 h of culture age but not 72 h. The results indicate that the neuronal morphological maturation can not represent the maturation of neurotransmitter synthesis. The synthesis of neurotransmitters is not maturated in the neuromuscular co-cultures until 96 h of the culture age.
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Objective To study the clinical features of senile salivary gland neoplasms. Methods A total of 104 cases of senile (beyond 60 years old) salivary gland tumors treated in the past 15 years were analysed. Results Among the 104 cases of senile salivary gland tumors, benigns(85.6%) was more than malignants; males(76.0%) was more than females, the ratio of M∶F was about 1.5∶1. Seventy-two cases(69.2%) were from the parotid gland, 19 (18.3%) from the submandibular gland, 6 (5.8%) from the sublingual gland, 7 cases(6.7%) from the minor salivary gland. Warthin tumor (34 cases) accounted for 32.7%(34/104) of all senile salivary gland tumors, and 47.2%(34/72) of senile parotid gland tumors, 54.8%(34/62) of benign parotid gland tumors. Conclusions The senile salivary gland tumor were mainly benign tumor; Warthim tumor is the most commonly seen and the parotid gland is the most frequently targeted organ. The incidence in males is higher than in females, patients at 60-70 years old (76.0%) are the main victims. Regional excision of parotid gland (resection of tumor together with its surrounding glands) was efficient for surgical treatment in the elderly.