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1.
Surg Endosc ; 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32052148

RESUMO

BACKGROUND: Laparoscopic partial splenectomy (LPS) for splenic benign space-occupying lesions has been reported by many researchers; however, few studies have described methods to control intraoperative bleeding. Trustworthy experience in LPS with a satisfactory intraoperative hemorrhage control technique is therefore necessary. The current study aims to present our experience in LPS with temporary occlusion of the trunk of the splenic artery for controlling intraoperative bleeding with a large sample of 51 cases and to evaluate the safety, feasibility, and reproducibility of this technique. METHODS: Fifty-one patients from August 2014 to April 2019 who underwent LPS in our institution were retrospectively analyzed. Surgical techniques were described in detail. RESULTS: All patients had successfully undergone LPS with temporary occlusion of the trunk of the splenic artery. Conversions to open surgery, hand-assisted laparoscopic splenectomies, or blood transfusions were not needed. The operative time was 94.75 ± 18.91 min, the estimated blood loss was 71.13 ± 53.87 ml, and the volume of resected spleen was 34.75 ± 12.19%. The range of postoperative stays was 4-14 days. One female patient (2%, 1/51) suffered from postoperative complications. No perioperative mortality, incision infections, postoperative pancreatic fistulas (POPFs), splenic infarctions, or portal/splenic vein thromboembolic events occurred. CONCLUSION: LPS is an effective spleen-preserving surgery. Although there are many other bleeding control methods, temporarily occluding the trunk of the splenic artery was found to be a safe, feasible, and reproducible technique in LPS. The outcomes of this technique and the efficacy of splenic parenchyma preservation are acceptable.

3.
BMC Musculoskelet Disord ; 20(1): 596, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31830981

RESUMO

BACKGROUND: Sport participants are at increased risk of joint pain and osteoarthritis. A better understanding of factors associated with joint pain and osteoarthritis in this population could inform the development of strategies to optimise their long-term joint health. The purpose of the study was to describe the prevalence of joint pain and osteoarthritis in former cricketers, and determine whether playing position, playing standard (i.e. elite or recreational standard) and length-of-play are associated with region-specific joint pain. METHODS: The data were from the Cricket Health and Wellbeing Study (CHWS), a cohort of 2294 current and former cricketers (played ≥1 season) in England and Wales. For this study, eligible individuals had to be aged ≥30 years and be a former cricket participant. Joint pain was defined as region-specific (hip/knee/ankle/shoulder/hand/back) pain on most days of the last month. Osteoarthritis was defined as joint-specific doctor-diagnosed osteoarthritis. Logistic regression was used to calculate unadjusted and adjusted (for history of joint injury resulting in > 4 weeks of reduced activity +/- age) odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS: 846 individuals from the CHWS were former cricketers aged ≥30 years (3% female, aged median 62(IQR 54-69) years, 62% played cricket recreationally, median 33(IQR 21-41) cricket seasons). One-in-two (48%) reported joint pain and 38% had been diagnosed with osteoarthritis. Joint pain and OA were most common in the knee (23% pain, 22% osteoarthritis), followed by the back (14% pain, 10% osteoarthritis) and hand (12% pain, 6% osteoarthritis). After adjusting for injury, bowlers had greater odds of shoulder pain (OR (95% CI) 3.1(1.3, 7.4)) and back pain (3.6(1.8, 7.4)), and all-rounders had greater odds of knee (1.7(1.0, 2.7)) and back pain (2.1(1.0, 4.2)), compared to batters. Former elite cricketers had greater odds of hand pain (1.6(1.0, 2.5)) than former recreational cricketers. Playing standard was not related to pain at other sites, and length-of-play was not associated with joint pain in former cricketers. CONCLUSIONS: Every second former cricketer experienced joint pain on most days of the last month, and more than one in three had been diagnosed with osteoarthritis. Compared with batters, bowlers had higher odds of shoulder and back pain and all-rounders had higher odds of back and knee pain. Elite cricket participation was only related to higher odds of hand pain compared with recreational cricket participation.

4.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 429-432, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631613

RESUMO

Objective: To evaluate the clinical predictive ability of POSSUM and P-POSSUM scoring system in laparoscopic pancreatoduodenectomy (LPD). Methods: There were 132 consecutive LPD performed in West China Hospital of Sichuan University from February 2014 to July 2017. The clinical data were retrospective collected, including 12 preoperative physiological variables, 6 operative severity variables, and complications and mortality The postoperative expected mortality and morbidity were calculated by POSSUM and P-POSSUM score, and compared with measured morbidity and mortality. The clinical predictive ability of POSSUM and P-POSSUM system was evaluated by the receiver operating characteristic (ROC) curve and hierarchical analysis. Results: The area under ROC curve ( AUC) was 0.83. The preoperative physiological score (PS) and POSSUM score of the patients with complications were higher, and the difference was statistically significant ( P<0.01). For the prediction of complications after LPD, the expected value was the most accurate to the measured value when POSSUM score was >0.4-0.6. POSSUM scoring system had no significant difference in predicting the incidence of complications for benign and malignant lesions ( P>0.05), with a higher predictive value for malignant tumors. It was valuable in predicting the incidence of complications in male and female, and there was no significant difference in expected value between the sexes. Expected morbidity rate by POSSUM scoring system was 36.6% and measured morbidity rate was 33.3%. The expected and measured morbidities had no significantly differences. The expected mortality was 7.0% and measured mortality rate was 1.5%. The expected and measured mortality had no significantly differences. Expected mortality by P-POSSUM system was 1.6%, the expected and measured mortality had no significantly differences. Conclusion: POSSUM and P-POSSUM scoring system had high value for predicting LPD postoperative morbidity and mortality of LPD patients.


Assuntos
Laparoscopia/efeitos adversos , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , China , Feminino , Humanos , Masculino , Morbidade , Mortalidade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença
5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 339-342, 2019 Jun 05.
Artigo em Chinês | MEDLINE | ID: mdl-31544423

RESUMO

OBJECTIVE: To evaluate the effect of integrated schistosomiasis control measures in Honghu City during the period from 2008 through 2018. METHODS: The data pertaining to schistosomiasis control measures and the endemic situation of schistosomiasis in Honghu City were collected from 2008 to 2018, and the effect of integrated schistosomiasis control measures implemented was evaluated. RESULTS: The resources from agriculture, water resources, forestry, land, education and communication sectors were integrated to implement the integrated schistosomiasis control strategy with the focus on the control of source of Schistosoma japonicum infection in Honghu City from 2008 to 2018. The prevalence of S. japonicum infection reduced from 3.03% in 2008 to 0 in 2018 in humans in the city, and no acute infection was detected since 2009. In addition, the prevalence of S. japonicum infection in cattle reduced from 2.85% in 2008 to 0 in 2018, and no snail infection was found since 2012. Transmission control of schistosomiasis was achieved in the city in 2013, and transmission interruption was achieved in 2018. CONCLUSIONS: The integrated schistosomiasis control measures achieve remarkable effects in Honghu City; however, there is still a risk of schistosomiasis transmission.


Assuntos
Doenças dos Bovinos , Serviços Preventivos de Saúde/normas , Esquistossomose , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/prevenção & controle , China/epidemiologia , Água Doce/parasitologia , Humanos , Prevalência , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose Japônica , Caramujos/parasitologia
6.
BMC Cardiovasc Disord ; 19(1): 210, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492095

RESUMO

BACKGROUND: The purpose of this study was to analyze cardiopulmonary fitness in Phase I cardiac rehabilitation on the prognosis of patients with ST-Elevation Myocardial Infarction (STEMI) after percutaneous coronary intervention (PCI). METHODS: The study enrolled a total of 499 STEMI patients treated with PCI between January 2015 and December 2015. Patients were assigned to individualized exercise prescriptions (IEP) group and non-individualized exercise prescriptions (NIEP) group according to whether they accept or refuse individualized exercise prescriptions. We compared the incidence of major cardiovascular events between the two groups. IEP group were further divided into two subgroups based on prognosis status, namely good prognosis (GP) group and poor prognosis (PP) group. Key cardio-pulmonary exercise testing (CPX) variables that may affect the prognosis of patients were identified through comparison of the cardio-respiratory fitness (CRF). RESULTS: There is no significant difference in the incidence of cardio-genetic death, re-hospitalization, heart failure, stroke, or atrial fibrillation between the IEP and the NIEP group. But the incidence of total major adverse cardiac events (MACE) was significantly lower in the IEP group than in the NIEP group (P = 0.039). The oxygen consumption (VO2) at ventilation threshold (VT), minute CO2 ventilation (E-VCO2), margin of minute ventilation carbon dioxide production (△CO2), rest partial pressure of end-tidal carbon dioxide(R-PETCO2), exercise partial pressure of end-tidal carbon dioxide(E-PETCO2) and margin of partial pressure of end-tidal carbon dioxide(△PETCO2) were significantly higher in the GP subgroup than in the PP subgroup; and the slope for minute ventilation/carbon dioxide production (VE/VCO2) was significantly lower in GP subgroup than in PP subgroup (P = 0.010). The VO2 at VT, VE/VCO2 slope, E-VCO2, △CO2, R-PETCO2, E-PETCO2 and margin of partial pressure of end-tidal carbon dioxide CO2 (△PETCO2) were predictive of adverse events. The VO2 at VT was an independent risk factor for cardiovascular disease prognosis. CONCLUSIONS: Individualized exercise prescription of Phase I cardiac rehabilitation reduced the incidence of cardiovascular events in patients with STEMI after PCI. VO2 at VT is an independent risk factor for cardiovascular disease prognosis, and could be used as an important evaluating indicator for Phase I cardiac rehabilitation.

7.
Surg Laparosc Endosc Percutan Tech ; 29(5): 378-382, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31107854

RESUMO

PURPOSES: To present preliminary perioperative and long-term outcomes in elderly patients compared with younger patients who underwent laparoscopic pancreaticoduodenectomy (LPD). MATERIALS AND METHODS: A total of 199 patients who underwent LPD were included in this study. The primary data relating to these patients were collected and analyzed in our center from October 2010 to 2017. RESULTS: The intraoperative and postoperative information, including the rate and severity of short-term complications, pathologic outcomes, and other surgical outcomes, showed no significant differences between the 2 groups. Furthermore, the median overall survival for 2 malignant diseases of the young patients was not significantly better than the elderly. CONCLUSIONS: Our data suggest that patient age showed little influence on postoperative morbidity, mortality, and long-term survival in pancreatic adenocarcinoma and periampullary adenocarcinoma following LPD, whereas studies with larger sample sizes and longer follow-up are necessary before definitive conclusions can be made.

8.
Opt Lett ; 44(7): 1778-1780, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30933145

RESUMO

A diode-pumped alkali laser has gained rapid development in recent years. In this study, we take the advantages of high-gain cross section and low upper energy lifetime of an alkali laser to propose, to the best of our knowledge, a novel type of time-domain-modulated alkali vapor amplifier. By using the amplifier, we experimentally demonstrate the power scaling of a modulated seed laser. The study should offer a new methodology to construct a practice high-power and high-modulated laser source for long-distance light detection and ranging systems in the future.

9.
Medicine (Baltimore) ; 98(13): e14957, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30921196

RESUMO

Patients who undergo several in-vitro fertilization (IVF) treatment cycles and fail to conceive present a frustrating problem to the clinician. When 1 cycle of IVF treatment fails, should we offer the couples to choose additional cycle of IVF instead of evaluation of the potential peritoneal factor? In cases of otherwise unexplained infertility, the investigation cannot be considered to be complete until laparoscopy has been performed. The aim of the study is to investigate the fertility outcome of laparoscopic treatment in infertile women with repeated IVF failures.This is a retrospective case-control study conducted in a tertiary care, academic teaching hospital from January 2012 to December 2015. Patients recruited in this study were classified into 2 groups. Study group (n = 45) were offered laparoscopy for evaluation of infertility, control group (n = 45) elected to proceed to IVF without laparoscopy. Diagnostic laparoscopy and subsequent excision of suspected endometriotic lesions, lysis of adhesion and treatment of tubal pathology were performed when indicated.Forty-four (97.8%) patients in study had pelvic pathologies and the treatment was performed at the same time. Twenty-four patients in study group conceived including 16 patients conceived spontaneously and 14 patients conceived with additional IVF following laparoscopy management. There was a significant difference in the ongoing pregnancy rates between patients conceived through IVF in study group and control group (41.9% vs 19.6%, P < .05).Laparoscopy in women with normal hysterosalpingography but recurrent IVF failures can detect unrecognized pelvic pathologies. Laparoscopy evaluation prior to additional cycle of IVF seems to improve the subsequent pregnancy rate.


Assuntos
Fertilização In Vitro/estatística & dados numéricos , Infertilidade Feminina/cirurgia , Laparoscopia/estatística & dados numéricos , Taxa de Gravidez , Centros Médicos Acadêmicos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Histerossalpingografia , Infertilidade Feminina/diagnóstico por imagem , Laparoscopia/métodos , Gravidez , Estudos Retrospectivos
10.
Inorg Chem ; 58(4): 2856-2864, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30730708

RESUMO

In this work, three Cu metal-organic framework samples with tunable rhombic, squama, and trucated bipyramid morphologies have been synthesized at 0, 25, and 60 °C, respectively, and further employed as precursors to initially prepare Cu@C composites by the calcination-thermolysis procedure. Then Cu@C composites have been etched with HCl and subsequently activated with KOH to obtain activated porous carbon (APC-0, -25, and -60). Interestingly, APC-25 presents a loose multilevel morphology of cabbage and possesses the largest specific surface area (1880.4 m2 g-1) and pore volume (0.81 cm3 g-1) among these APC materials. Consequently, APC-25 also exhibits the highest specific capacitance of 196 F g-1 at 0.5 A g-1, and the corresponding symmetric supercapacitor cell (SSC) achieves a remarkable energy density of 11.8 Wh kg-1 at a power density of 350 W kg-1. Furthermore, APC-25 shows excellent cycling stability, and the loss of capacitance is only 7.7% even after 10000 cycles at 1 A g-1. Significantly, five light-emitting diodes can be lit by six SSCs, which proves that APC-25 can be used in energy storage devices.

11.
Food Chem ; 283: 530-538, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-30722909

RESUMO

In this study, a novel core-shell structured Fe3O4@TA@P(NVP-co-NIPAM) magnetic microsphere has been successfully developed for polyphenol extraction employing tannic acid (TA) directed copolymerization. The TA directing strategy guided copolymerization preferentially on the surface of the magnetic core and facilitated formation of the shell for coating the magnetic core. It was unveiled that the amount of TA, the ratio of the two monomers, and the amount of surfactant were critical for the preparation of the magnetic microspheres. The identity and proportion of the shell were analyzed by FT-IR and TGA. Magnetic hysteresis loop measurement confirmed the superparamagnetic nature and no loss of magnetization after coating. The prepared magnetic microspheres demonstrated outstanding absorption ability to typical polyphenols. Kinetic studies suggested that the adsorption behavior followed Langmuir absorption model. The developed magnetic microspheres should be useful for biological studies. The TA directing strategy would be valuable for synthesis of core-shell structured particles.


Assuntos
Fracionamento Químico/métodos , Microesferas , Polifenóis/isolamento & purificação , Taninos/química , Acrilamidas/química , Adsorção , Fracionamento Químico/instrumentação , Compostos Férricos/química , Ligações de Hidrogênio , Cinética , Magnetismo , Nanopartículas de Magnetita/química , Polimerização , Pirrolidinonas/química , Espectroscopia de Infravermelho com Transformada de Fourier , Termogravimetria
12.
J Sci Food Agric ; 99(8): 3785-3791, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30637749

RESUMO

BACKGROUND: Methylated derivatives of catechins have received great attention for health beneficial effects, especially antiallergic activity. However, the scarce natural abundance of methylated catechins limits further bioactive studies. The objective of this work was to investigate regiospecific methylation of the hydroxyls of (+)-catechin through a stepwise differentiation strategy based on electronic difference between the hydroxyl groups. RESULTS: Selective methylation of the hydroxyls on different rings was realized by employing Meerwein salt as the methylation reagent. Preferential acylation of the phenolic hydroxyls on A and B rings allowed selective exposure of the aliphatic hydroxyl on C ring to methylation. The vicinal phenolic hydroxyls on B ring were preferentially methylated under mild basic condition due to the acidic properties. Methylation of the phenolic hydroxyls on A ring was achieved by sequential protection and deprotection operations. Finally, antioxidant activities of all the individual methylated (+)-catechins were explored by 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assay. CONCLUSION: Regiospecific methylation of the phenolic and aliphatic hydroxyls was systematically achieved under mild conditions. Preparation of all the individual methylated (+)-catechins was accomplished with a greener methylation reagent: nonvolatile Meerwein salt. This work laid a solid foundation for preparation of diverse O-methylated catechins for bioactivity studies. © 2019 Society of Chemical Industry.


Assuntos
Catequina/química , Acilação , Radical Hidroxila , Isomerismo , Metilação , Fenóis/química
13.
Appl Opt ; 57(32): 9562-9570, 2018 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-30461736

RESUMO

Diode-pumped alkali vapor lasers (DPALs) have been rapidly developed because of their excellent performances. However, there have been few reports about DPALs with multiple wavelengths until now. The effects of the output features on the waist size and position of both Rb and Cs pump beams were first theoretically investigated using a kinetic model for an end-pumped dual-wavelength Rb-Cs laser. Then, a continuous-wave (CW) laser was experimentally constructed. Finally, the hybrid CW-modulated output with two wavelengths was also successfully obtained for the first time in development of alkali lasers. The results might be helpful in applications for laser communication and ranging/radar in the future.

14.
Ann Transl Med ; 6(11): 211, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30023374

RESUMO

Annular pancreas is in adults is a rare congenital anomaly which incidence varied from 0.005% to 0.015%. Although 33% of the cases are symptomatic, the symptoms are most commonly associated with gastric outlet obstruction. Here we presented an adult diagnosed with annular pancreas treated by laparoscopic Roux-en-Y side to side duodenojejunostomy.

15.
Ann Transl Med ; 6(11): 215, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30023378

RESUMO

With the development and ubiquitous use of minimally invasive surgery, the advanced laparoscopic skills such as suture is essential for performing gastrointestinal procedures. However, the steep learning curve and lack of standardized training make most residents underprepared for laparoscopic suture. Moreover, the current simulation-based training is inadequate for trainees to master these advanced skills. Thus, there is a need for laparoscopic suture training modeled with cognitive knowledge, approachable techniques and standardized steps. Here, we present a suture training curriculum with video demonstration. In this study, we developed a suture training curriculum, which are divided into two categories depending on its difficulty and application. Basic techniques are designed for novice to master the basic suture skills, and it also shortens the learning curve of advanced suture techniques. Advanced techniques focused on the application of suture in specific circumstances. Also, it could prepare residents for more complex procedures. In order to increase the efficacy of suture training, we recommend a learning method similar to Peyton's four-step approach, personalized video feedback and spaced learning in our curricula. This article demonstrates the various laparoscopic techniques and their applications from simple to complex, with a view to help residents in training. Also, the training curricula and recommendations will further help residents to improve efficiently. Thus, we recommend to incorporate the curricula into suture training courses and surgical programs.

16.
Opt Express ; 26(7): 8503-8514, 2018 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-29715816

RESUMO

Diode-pumped alkali lasers (DPALs) have drawn much attention since they were proposed in 2001. The narrow-linewidth DPAL can be potentially applied in the fields of coherent communication, laser radar, and atomic spectroscopy. In this study, we propose a novel protocol to narrow the width of one kind of DPAL, diode-pumped rubidium vapor laser (DPRVL), by use of an injection locking technique. A kinetic model is first set up for an injection-locked DPRVL with the end-pumped configuration. The laser tunable duration is also analyzed for a continuous wave (CW) injection-locked DPRVL system. Then, the influences of the pump power, power of a master laser, and reflectance of an output coupler on the output performance are theoretically analyzed. The study should be useful for design of a narrow-linewidth DPAL with the relatively high output.

17.
Medicine (Baltimore) ; 97(17): e0551, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29703038

RESUMO

RATIONALE: Dedifferentiated endometrioid adenocarcinoma (DEAC) consisted of a combination of undifferentiated and differentiated carcinoma is more aggressive than other conventional endometrioid adenocarcinomas. PATIENT CONCERNS: A 33-year-old woman with atypical vaginal bleeding was refereed to our hospital. She had an endometrial biopsy in a local clinic which showed differentiated endometrioid carcinoma with trophoblastic components. High levels of ß-Human chorionic gonadotropin (ß-hCG) and alfa-fetoprotein (AFP) were detected in the patient's serum. INTERVENTIONS: The patient underwent total hysterectomy with bilateral salpingo-oophorectomy, total omentectomy and systemic pelvic lymphadenectomy in our center. DIAGNOSIS: Pathological investigation indicated that the tumor had well differentiated and undifferentiated adenocarcinoma as well as trophoblastic components. OUTCOMES: Serum ß-hCG and AFP dropped significantly after operation. But three weeks later, the patient had developed pulmonary metastases and elevation of serum ß-hCG. She died of the disease five months after surgery. LESSONS: DEAC with trophoblastic differentiation seems to follow an aggressive course with early metastasis and poor clinical prognosis. However, due to small number of cases, further studies are necessary.


Assuntos
Carcinoma Endometrioide/sangue , Carcinoma Endometrioide/patologia , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/patologia , Neoplasias Trofoblásticas/sangue , Neoplasias Trofoblásticas/patologia , alfa-Fetoproteínas/análise , Adulto , Desdiferenciação Celular , Evolução Fatal , Feminino , Humanos
18.
Arch Gynecol Obstet ; 297(5): 1169-1173, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29445925

RESUMO

OBJECTIVE: The study was carried out to clarify the IVF outcome after laparoscopic neosalpingostomy for infertile patients affected by hydrosalpinx stage III. MATERIALS AND METHODS: From January 2010 to June 2015, 91 subjects of hydrosalpinx stage III were treated in out center by laparoscopic surgery before IVF cycle. 43 underwent neosalpingostomy (group 1) and the remaining 48 underwent salpingestomy (group 2). We compared these patients and their IVF outcomes after two different surgical techniques. RESULTS: There were no significant differences between the two groups, except a higher number of patients with bilaterial hydrosalpinges was noted in the neosalpingostomy group (79.1% vs. 56.3%, respectively). 25 patients with neosalpingostomy and 29 with salpingectomy achieved pregnancy by IVF. The ongoing pregnancy rate per cycle in group 1 and group 2 was 51.1 and 47.2%, respectively. Two cases of ampullary ectopic pregnancies were noted in group 1 and one case of right tube interstitial pregnancy in group 2. No significant difference was observed in live birth rate between the groups (48.9% vs. 45.3%, respectively). CONCLUSIONS: The outcomes of IVF after neosalpingostomy were matchable with salpingectomy. For patients desire to preserve fallopian tubes, we recommend laparoscopic neosalpingostomy as an alternative choice to manage moderate hydrosalpinx before IVF.


Assuntos
Tubas Uterinas/cirurgia , Fertilização In Vitro , Laparoscopia/métodos , Salpingectomia , Salpingite/cirurgia , Salpingostomia , Adulto , Coeficiente de Natalidade , Doenças das Tubas Uterinas/cirurgia , Feminino , Humanos , Infertilidade Feminina/cirurgia , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Gravidez Ectópica/cirurgia , Salpingite/complicações
19.
J Dent ; 70: 110-117, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29371043

RESUMO

OBJECTIVES: The implant abutments, which had their own colour, might cause the discoloration of peri-implant mucosa. We aimed to appraise trails comparing the discoloration of peri-implant soft tissue around zirconia and titanium or golden abutments, the tints of which were vastly different. DATA: We included randomized controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies with patients rehabilitated with zirconia, titanium or golden implant abutments, quantitatively comparing the discoloration of peri-implant soft tissue according to CIE-Lab colour scale. SOURCES: A systematic search was conducted in PubMed, EMBASE, CDSR, and CENTRAL databases without any restriction on September 23, 2017. "Grey" literatures were also searched. A manual search was carried out as well. STUDY SELECTION: Of 584 articles initially retrieved, eight were eligible for inclusion. After data extraction, meta-analyses with mean differences (MDs) and their 95% confidence intervals (CIs) were employed. Moreover, the risk of bias within or across studies was assessed by Cochrane Collaboration's tool for assessing risk, the Newcastle-Ottawa scale, funnel plots, or Egger's test. RESULTS: Four RCTs and four cohort studies were included. Soft-tissue discoloration around zirconia abutments was significantly less likely compared to that around titanium abutments (MD = -1.84; 95% CI = -3.62 to -0.07; P = 0.04 < 0.05) or golden abutments (MD = -0.90; 95% CI = -1.60 to -0.20; P = 0.01 < 0.05). CONCLUSIONS: Zirconia abutments with white tint compared to grey titanium or golden abutments seem to restore a more appropriate colour match between peri-implant mucosa and natural teeth. CLINICAL SIGNIFICANCE: Based on the present evidence, the "nature-like" zirconia abutments should be applied more often in the clinic. PROSPERO REGISTRATION NUMBER: CRD42017075930.


Assuntos
Cor , Dente Suporte/efeitos adversos , Implantes Dentários/efeitos adversos , Gengiva/patologia , Zircônio/efeitos adversos , Bases de Dados Factuais , Implantação Dentária Endo-Óssea , Materiais Dentários/efeitos adversos , Planejamento de Prótese Dentária , Estética Dentária , Ligas de Ouro/efeitos adversos , Humanos , Titânio/efeitos adversos
20.
Surg Laparosc Endosc Percutan Tech ; 28(1): 56-61, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29334528

RESUMO

BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD), a surgical option for nonpancreatic periampullary adenocarcinoma (NPPA), is a complex procedure that has become increasing popular. However, there is no consensus as to whether this technique should be performed routinely. Our aim was to evaluate the outcomes of LPD compared with open pancreaticoduodenectomy (OPD). MATERIALS AND METHODS: From October 2010 to September 2015, 58 LPDs were performed to treat NPPA and were compared with 58 OPDs, which can theoretically be carried out by laparoscopic approach. Patients were also matched based on their demographic data and pathologic diagnosis. Demographic information, intraoperative and postoperative data, pathologic data, and follow-up evaluation data were collected at our center. RESULTS: All patients had a median follow-up of 34 months (range, 8 to 60 mo). Overall median survival during the study between the groups was not different (P=0.760). No significant differences between the 2 groups were found in terms of patient demographics, short-term complications, pathologic outcomes, or tumor-node-metastasis stage. With regard to operative time, the LPD group was slightly longer than the OPD group (P<0.001). There were significant differences between groups in the time to the first passage of flatus and the time to oral intake (P<0.001). However, no differences were seen in blood loss, length of intensive care unit stay, node positive, or R0 resection between the laparoscopic and open groups. CONCLUSIONS: This study found that LPD is a feasible, safe, and effective method for the treatment of NPPA compared with OPD and may be a preferred method for surgeons to choose.


Assuntos
Adenocarcinoma/cirurgia , Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Laparoscopia/métodos , Pancreaticoduodenectomia/métodos , Adenocarcinoma/patologia , Adulto , Idoso , Ampola Hepatopancreática/patologia , China , Estudos de Coortes , Neoplasias do Ducto Colédoco/patologia , Feminino , Hospitais Universitários , Humanos , Estimativa de Kaplan-Meier , Laparotomia/métodos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Duração da Cirurgia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
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