scholarly journals Invaginated Duct to Mucosa Pancreaticojejunostomy Reduced Pstoperative Pancreatic Leakage: A Matched Case-Controlled Study

2020 ◽  
Author(s):  
Guo-Liang Yao ◽  
Meng-Jiao AN ◽  
YongGang Fan
Keyword(s):  
Pancreatic Duct ◽  
Statistical Significance ◽  
Operation Time ◽  
Controlled Study ◽  
Biliary Leakage ◽  
Related Data ◽  
Pancreatic Leakage ◽  
Pancreatic Texture ◽  
The Difference ◽  
Group Sex

Abstract Background Postoperative pancreatic leakage was also the obstacle of pancreaticoduodenectomy (PD) which always followed the failure of pancreaticojejunostomy. Dozens of pancreaticojejunostomy had been reported. None showed superiority over others. To assess the potential advantages of invaginated duct to mucosa pancreaticojejunostomy (invaginated D-M PJ), we introduced this study.Methods Retrospectively analyzed the related data from the patients who had their pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital to Henan University of Science and Technology during January 2017 to August 2019. According to the different procedure of pancreaticojejunostomy, the patients divided into custom D-M group and invaginated D-M group. Sex, age, pancreatic duct size and pancreatic texture were matched. Pancreatic leakage and other complications were compared. SPSS 16.0 was employed for analysis.Results 48 pairs of patients were involved. Both groups had almost the same baseline characterisitics, such as Sex (P=1.000), Age (P=0.897), ASA (P=0.575), BMI (P=0.873), pancreatic duct size (P=0.932), pancreatic texture (P=1.000) and tumor origin (P=0.686). No statistical difference was observed relation to operation outcomes, such as operation time (P=0.632), pancreaticojejunostomy time (P=0.748), blood loss (P=0.617) and number of required transfusion (P=0.523). Pancreatic leakage was significantly declined for invaginated D-M group (P=0.005). The difference of other complications, such as, bleeding (P=0.617), biliary leakage (P=0.646), pneumonia (P=0.594) and thrombosis (P=0.714), didn’t reach statistical significance. Postoperative hospitalization was almost the same for both groups (P=0.764).Conclusions Invaginated D-M PJ could reduce pancreatic leakage followed PD. Invaginated D-M PJ should be a choice for the patients who had PD.

scholarly journals Invaginated Duct to Mucosa Pancreaticojejunostomy Reduced Postoperative Pancreatic Leakage: A Matched Case-controlled Study

2020 ◽  
Author(s):  
Guo-Liang Yao ◽  
Meng-Jiao An ◽  
Yong-Gang Fan
Keyword(s):  
Pancreatic Duct ◽  
Statistical Significance ◽  
Operation Time ◽  
Controlled Study ◽  
Biliary Leakage ◽  
Related Data ◽  
Pancreatic Leakage ◽  
Pancreatic Texture ◽  
The Difference ◽  
Group Sex

Abstract Background Postoperative pancreatic leakage was also the obstacle of pancreaticoduodenectomy (PD) which always followed the failure of pancreaticojejunostomy. Dozens of pancreaticojejunostomy had been reported. None showed superiority over others. To assess the potential advantages of invaginated duct to mucosa pancreaticojejunostomy (invaginated D-M PJ), we introduced this study.Methods Retrospectively analyzed the related data from the patients who had their pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital to Henan University of Science and Technology during January 2017 to August 2019. According to the different procedure of pancreaticojejunostomy, the patients divided into custom D-M group and invaginated D-M group. Sex, age, pancreatic duct size and pancreatic texture were matched. Pancreatic leakage and other complications were compared. SPSS 16.0 was employed for analysis.Results 48 pairs of patients were involved. Both groups had almost the same baseline characterisitics, such as Sex (P=1.000), Age (P=0.897), ASA (P=0.575), BMI (P=0.873), pancreatic duct size (P=0.932), pancreatic texture (P=1.000) and tumor origin (P=0.686). No statistical difference was observed relation to operation outcomes, such as operation time (P=0.632), pancreaticojejunostomy time (P=0.748), blood loss (P=0.617) and number of required transfusion (P=0.523). Pancreatic leakage was significantly declined for invaginated D-M group (P=0.005). The difference of other complications, such as, bleeding (P=0.617), biliary leakage (P=0.646), pneumonia (P=0.594) and thrombosis (P=0.714), didn’t reach statistical significance. Postoperative hospitalization was almost the same for both groups (P=0.764).Conclusions Invaginated D-M PJ could reduce pancreatic leakage followed PD. Invaginated D-M PJ should be a choice for the patients who had PD.

Clinical Study of Qingpeng Ointment Treatment of Shoulder-Hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period

2020 ◽  
Vol 23 ◽  
Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Hemorrhage ◽  
Clinical Medicine ◽  
External Rotation ◽  
Statistical Significance ◽  
Hand Function ◽  
Tibetan Medicine ◽  
Controlled Study ◽  
Control Group ◽  
The Difference

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS． Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P＜0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.

scholarly journals Development and Application of One Separation-Free Safety Tube on the Disposable Infusion Needle

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Weifen Lu ◽  
Qianli Pan ◽  
Yinxin Zhou ◽  
Wenyu Chen ◽  
Hongyan Zhang ◽  
...  
Keyword(s):  
Exposure Time ◽  
Statistical Significance ◽  
Intervention Group ◽  
Operation Time ◽  
Control Group ◽  
Needle Stick ◽  
Significant Difference ◽  
New Type ◽  
Needle Stick Injuries ◽  
The Difference

Objective. To develop a new type infusion set and apply it to the clinic, as well as explore its effectiveness in the prevention from needle stick injuries. Methods. A total of 200 inpatients who were in need of intravenous infusion with a disposable infusion needle were included and randomly divided into two groups: intervention group and control group. Disposable infusion needles with a separation-free safety tube were used in the intervention group, whereas conventional ones were used in the control group. Then, effects of the two types of infusion sets were observed and compared. Results. As for the operation time for infusion, it was (82.19±1.80) seconds in the intervention group and (83.02±1.83) seconds in the control group, with the difference statistically significant (P<0.05). Besides, the exposure time of the needles after infusion in the intervention group was (3.36±0.17) seconds while (18.85±1.18) seconds in the control group; the difference between which was statistically significant (P<0.05). In terms of the time for needle disposal, (18.60±0.84) seconds was required in the intervention group, while for the control group, it took (18.85±1.18) seconds, and the difference between two groups was of statistical significance as well (P<0.05). Nevertheless, there was no statistically significant difference in the accidental slip rate of the needles as that turned out 0% in both groups (P>0.05). It was worth noting that the block rate of the disposed needles in the intervention group was 100%. Conclusion. The separation-free safety tube on the disposable infusion needle could instantly block the sharp needle after infusion, which reduces the needle exposure time and lowers the risk of needle stick injuries. In the meantime, the safety tube is convenient to use, and its application can shorten the time for infusion and needle disposal, consequently improving the working efficiency of nurses. As the new type safety tube has above advantages and would not raise the risk of needle slippage, it is worthy of clinical promotion.

scholarly journals The Individualized Selection of Pancreaticoenteric Anastomosis in Pancreaticoduodenectomy

2020 ◽  
Author(s):  
Ke-Min Jin ◽  
Wei Liu ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Operation Time ◽  
Postoperative Management ◽  
Postoperative Pancreatic Fistula ◽  
Drainage Fluid ◽  
Soft Pancreas ◽  
Pancreatic Texture ◽  
The Impact

Abstract Background: The mortality following pancreaticoduodenectomy has markedly decreased but remains an important challenge for the complexity of operation and technical skills involved. The present study aimed to clarify the impact of individualized pancreaticoenteric anastomosis and management to postoperative pancreatic fistula.Methods: Data from 529 consecutive pancreaticoduodenectomies were retrospectively analysed from the Hepatobiliary and Pancreatic Surgery Unit I, Peking Cancer Hospital. The pancreaticoenteric anastomosis was determined based on the pancreatic texture and diameter of the main pancreatic duct. The amylase value of the drainage fluid was dynamically monitored postoperatively on days 3, 5 and 7. A low speed intermittent irrigation was performed in selected patients. Intraoperative and postoperative results were collected and compared between the pancreaticogastrostomy (PG) group and pancreaticojejunostomy (PJ) group.Results: From 2010 to 2019, 529 consecutive patients underwent pancreaticoduodenectomy. Pancreaticogastrostomy was performed in 364 patients; pancreaticojejunostomy was performed in 150 patients respectively. The clinically relevant pancreatic fistula (CR-POPF) was 9.8% and mortality was zero. The soft pancreas, diameter of main pancreatic duct≤3mm, BMI≥25, operation time>330min and pancreaticogastrostomy was correlated with postoperative pancreatic fistula significantly. The CR-POPF of PJ was significantly higher than that of PG in soft pancreas patients; the operation time of PJ was shorter than that of PG significantly in hard pancreas patients. Intraoperative blood loss and operation time of PG was less than that of PJ significantly in normal pancreatic duct patients (p<0.05).Conclusions: Individualized pancreaticoenteric anastomosis should be determined based on the pancreatic texture and pancreatic duct diameter. The appropriate anastomosis and postoperative management could prevent mortality.

scholarly journals PSYLLIUM HUSK TO INCREASE HDL-CHOLESTEROL

2010 ◽  
Vol 17 (04) ◽  
pp. 711-714
Author(s):  
SAMINA KARIM ◽  
SHAH MURAD ◽  
MANZOOR AHMED UNAR ◽  
Ghazi Mahmood ◽  
Moosa Khan ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Hdl Cholesterol ◽  
T Test ◽  
Controlled Study ◽  
Control Group ◽  
Medical Sciences ◽  
Psyllium Husk ◽  
Metallic Taste ◽  
The Difference ◽  
Basic Medical

Objectives: To examine the effects of Psyllium husk on HDL-Cholesterol. Design: Single blind placebo controlled study. Place and Duration of Study: Study was conducted at department of Pharmacology and therapeutics at Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January 2006 to July 2006. Patient and Methods: Forty hyperlipidemic patients were included, among which 20 patients were on placebo as control group, and 20 were on Psyllium husk, 3 gram daily, in divided doses for the period of three months. Patients with peptic ulcer, renal disease, hepatic disease, hypothyroidism, diabetes mellitus, and alcoholism were excluded from the study. HDL- Cholesterol was determined by using kit Cat. # 303210040 by Eli Tech Diagnostic, France. Data were expressedas the mean ± SD and “t” test was applied to determine statistical significance as the difference. A probability value of <0.05 was the limit of significance. Results: Two patients were dropped from the study due to low compliance of metallic taste of psyllium husk. Psyllium husk has increased HDL-Cholesterol, in 90 days of treatment, from 34.61±1.85 to 36.77±1.96 (mg/dl), which was highly significant statistically whenpaired “t” test was applied for results. Percentage change was +6.24. Conclusions: It is concluded from this study that Psyllium husk decreases the risk of CHD by increasing HDL-Cholesterol.

scholarly journals Prolonged-release fampridine as adjunct therapy to active enabled motor training in multiple sclerosis patients: a pilot, double-blind, placebo-controlled study

2015 ◽  
Vol 42 (S1) ◽  
pp. S32-S33
Author(s):  
FH Jacques ◽  
A Schembri ◽  
A Nativ ◽  
C Paquette ◽  
P Kalinowski
Keyword(s):  
Statistical Significance ◽  
Treated Group ◽  
Controlled Study ◽  
Motor Training ◽  
Prolonged Release ◽  
Double Blind ◽  
Sit To Stand ◽  
Percent Improvement ◽  
The Difference ◽  
Multiple Sclerosis Patients

Objectives: To investigate if MS subjects treated with PRF 10mg BID will show a greater benefit from active enabled motor training compared with placebo. Methods: Single center, phase 4, pilot, placebo-controlled, double-blind 18 weeks study. Fifteen patients were randomized to receive PRF 10 mg BID and fifteen to received placebo BID. All patients participated in active enabled motor training of 3 sessions of 1 hour/week for 6 weeks. Patients were evaluated at -4, 0, 6 and 14 weeks using the timed 8 meters walk (8 MW), the 6 minute walk (6 MW) and the timed sit to stand (STS). Results: The PRF treated group achieved a higher mean percent improvement from baseline in all tasks at both 6 and 14 week time points. The difference reached statistical significance (mean difference of 14.29, p=0.046) for the 8MW at the 14 week time point. A higher incidence of responders (>20% improvement from baseline) was seen in the PRF treated group at 6 weeks on the 8MW (odds ratio [OR] of 2.31) and the 6MW (OR of 1.63), and at 14 weeks on the 8MW and the STS (OR of 2.0). Conclusions: PRF in MS patients appears to enhance the benefit of active enabled motor training and to better sustain it over the following 8 weeks.

Laparoscopic assisted pancreaticoduodenectomy vs. totally laparoscopic pancreaticoduodenectomy for malignant tumor: a retrospectively controlled study

2020 ◽  
Author(s):  
Guo-Liang Yao ◽  
Jing-Ming Zhai
Keyword(s):  
Malignant Tumor ◽  
Statistical Difference ◽  
Operation Time ◽  
Visual Analogue Score ◽  
Controlled Study ◽  
Open Approach ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Biliary Leakage ◽  
Laparoscopic Assisted ◽  
Totally Laparoscopic

Abstract Background Laparoscopic pancreaticoduodenectomy was now accepted worldwide with potential advantages over open pacreaticoduodenectomy. The defect was time wasting with the prone of increased postoperative complications. To assess the potential superiority and feasibility of laparoscopic assisted pancreaticoduodenectomy (LAPD) comparing to totally laparoscopic pancreaticoduodenectomy (TLPD), we introduce this study.Methods Retrospectively analyzed the relation data from the patients who had laparoscopic pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital of Henan University of Science and Technology during January 2015 to July 2019. Complications and operation time were compared. SPSS 16.0 was employed for analysis.Results Both groups had almost the same baseline characteristics, such as Sex (P=0.880), Age (P=0.861), ASA (P=0.559), BMI (P=0.854), pancreatic duct size (P=0.623), pancreatic texture (P=0.573) and tumor origin (P=0.878). LAPD was association to shorter operation time (231.6±43.7 min VS. 305.4±55.3 min; P=0.047), pancreaticojejunostomy time (13.8±4.2 min VS. 41.6±9.4 min; P=0.007), gastrojejunostomy time (10.9±3.0 min VS. 24.8±6.5 min; P=0.014) and jejunojejunostomy time (7.8±2.4 min VS. 23.4±5.8 min; P=0.005). No statistical difference was observed relation to resection time (P=0.864), cholangiojejunostomy time (P=0.897), blood loss (P=0.723), number of required transfusion (P=0.809), and incision length (P=0.183). Both groups had comparable conversion to open approach (P=0.402). LAPD had comparable complications to TLPD, such as pancreatic leakage (P=0.328), biliary leakage (P=0.673), bleeding (P=0.889), pneumonia (P=0.809) and thrombosis (P=0.443) and incision infection (P=0.889). No statistical difference was observed relation to visual analogue score at 1 day postoperatively (P=0.913) and hospitalization (P=0.137).Conclusions Laparoscopic assisted pancreaticoduodenectomy with open pancreaticojejunostomy should be a choice for certain surgeons with less operation time.

The Advantages of DiLEP Operation in the Treatment of BPH Patients and the Observation of Postoperative Urinary Control Effect

2021 ◽  
Vol 7 (5) ◽  
pp. 3155-3160
Author(s):  
Chao Wang ◽  
Lijun Yang ◽  
Haili Li ◽  
Zhi Qu
Keyword(s):  
Surgical Complication ◽  
Statistical Significance ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Control Effect ◽  
Early Recovery ◽  
Postoperative Rehabilitation ◽  
The Difference ◽  
Urinary Control

Objective: To evaluate the efficacy of Semiconductor laser trefoil enucleation of the prostate (DiLEP) in the treatment of patients with benign prostatic hyperplasia (BPH). Methods: 120 BPH patients scheduled for prostate surgery in our hospital were randomly divided into two groups: study group (DiLEP treatment) and control group (transurethral plasma bipolar resection of the prostate treatment), with 60 cases in each one. Surgical process indicators, postoperative rehabilitation indicators, Qmax before and after surgery, post-void residual volume (PVR), international prostate symptom score (IPSS), hemoglobin (Hb), urinary control and surgical complications for two groups were compared. Results: The operation time, intraoperative blood loss, bladder irrigation time, urinary catheter indwelling time and hospital stay in the study group were lower than those in the control group (P<0.05). The weight of resected tissue in the study group was higher than that in the control group (P <0.05). The difference in Qmax, PVR, IPSS scores and Hb between the study group and the control group before operation and one month after operation had no statistical significance (P>0.05). The Qmax and Hb scores in the study group were higher than those in the control group (P<0.05), while the PVR and IPSS scores were lower than those in the control group (P<0.05); five days and two weeks after operation, the urinary control rates in the study group were all higher than that in the control group (P<0.05); one month after operation, the difference in the urinary control rates between the two groups had no statistical significance (P>0.05); the difference in the surgical complication rate between the study group and the control group had no stastiscal significance (P>0.05). Conclusion: DiLEP is beneficial for early recovery of urodynamics in patients with BPH, with less trauma and faster recovery of urinary control after surgery.

COMPARATIVE EVALUATION OF MULTIPARAMETRIC ENDORECTAL ULTRASOUND AND ENHANCED IMAGING COLONOSCOPY IN THE DIAGNOSIS OF EARLY COLORECTAL CANCER

2020 ◽  
Vol 19 (3) ◽  
pp. 49-64
Author(s):  
E. M. Bogdanova ◽  
Yu. L. Trubacheva ◽  
O. M. Yugai ◽  
S. V. Chernyshov ◽  
E. G. Rybakov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Statistical Significance ◽  
Muscle Layer ◽  
Endorectal Ultrasound ◽  
Diagnostic Methods ◽  
Early Colorectal Cancer ◽  
Morphological Examination ◽  
Optical Magnification ◽  
The Difference ◽  
Enhanced Imaging

AIM: to compare multiparametric endorectal ultrasound (ERUS) and enhanced imaging colonoscopy in the diagnosis of early colorectal cancer.PATIENTS AND METHODS: the study included 78 patients with epithelial rectal tumor. All the patients underwent multiparametric ERUS and colonoscopy with examination by narrow beam imaging (NBI) at optical magnification. All the patients were operated.RESULTS: a morphological examination removed specimens revealed adenomas in 48 cases, in 19 specimens – adenocarcinomas in situ and T1, and in 11 specimens – adenocarcinomas with invasion of the muscle layer or deeper. When calculating the accuracy indicators of diagnostic methods for groups of patients with adenoma, Tis-T1 adenocarcinoma, and T2-T3 adenocarcinoma, the difference in the sensitivity and specificity of the methods in none of the presented groups did not reach the level of statistical significance (p>0.05).ROC analysis showed that ultrasound has a prognostic value comparable to colonoscopy. The area difference was 0.013 (p=0.85).CONCLUSION: endoscopy and ultrasound have similar value in the diagnosis of malignant transformation of rectal adenomas.

scholarly journals Busulfan plus melphalan versus melphalan alone conditioning regimen after bortezomib based triplet induction chemotherapy for patients with newly diagnosed multiple myeloma

2021 ◽  
Vol 12 ◽  
pp. 204062072110129
Author(s):  
Songyi Park ◽  
Dong-Yeop Shin ◽  
Junshik Hong ◽  
Inho Kim ◽  
Youngil Koh ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Induction Chemotherapy ◽  
Statistical Significance ◽  
Conditioning Regimen ◽  
Progression Free Survival ◽  
High Dose ◽  
Newly Diagnosed ◽  
Cell Engraftment ◽  
The Difference ◽  
High Dose Melphalan

Background: High dose melphalan (HDMEL) is considered the standard conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients. Recent studies showed superiority of busulfan plus melphalan (BUMEL) compared to HDMEL as a conditioning regimen. We compared the efficacy of HDMEL and BUMEL in newly diagnosed Asian MM patients, who are often underrepresented. Methods: This is a single-center, retrospective study including MM patients who underwent ASCT after bortezomib-thalidomide-dexamethasone (VTD) triplet induction chemotherapy between January 2015 and August 2019. Result: In the end, 79 patients in the HDMEL group were compared to 31 patients in the BUMEL group. There were no differences between the two groups with regards to sex, age at ASCT, risk group, and stage. The HDMEL group showed better response to pre-transplant VTD compared to BUMEL, but after ASCT the BUMEL group showed better overall response. In terms of progression-free survival (PFS), although BUMEL showed trends towards better PFS regardless of pre-transplant status and age, the difference did not reach statistical significance. The BUMEL group more often experienced mucositis related to chemotherapy, but there was no difference between the two groups with regards to hospitalization days, cell engraftment, and infection rates. Conclusion: BUMEL conditioning deserves attention as the alternative option to HDMEL for newly diagnosed MM patients, even in the era of triplet induction chemotherapy. Specifically, patients achieving very good partial response (VGPR) or better response with triplet induction chemotherapy might benefit the most from BUMEL conditioning. Tailored conditioning regimen, based on patient’s response to induction chemotherapy and co-morbidities, can lead to better treatment outcomes.

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