ObjectiveTo investigate the effect of indocyanogen green retention rate (ICGR) measurement and Child-Pugh classification of liver function in the preoperative evaluation of hepatic functional reservation. MethodsThe level of ICGR at 15 min (ICGR15) and the percentage of liver fibrosis in 103 patients with liver cancer were measured before hepatectomy, and the Child-Pugh classification of liver function was evaluated before and after the operations, and their connections were analyzed. ResultsAs the rise of Child-Pugh classification of liver function, the percentage of liver fibrosis increased gradually, there were significant differences between any two Child-Pugh classification (Plt;0.05). There was a linear correlation between the ICGR15 and the liver fibrosis percentage (rs=0.960, Plt;0.05). The value of preoperative ICGR15 in patients with postoperative Child-Pugh classification from grade A to grade B or grade B to grade C was gnificantly higher than that in patients with stabilization of Child-Pugh classification before and after operations (Plt;0.05). ConclusionICGR15 combined with Child-Pugh classification can improve the accuracy for the evaluation of preoperative hepatic functional reservation.
Objective To investigate the value of retention rate of indocyanine green at fifteen minutes (ICGR15) during hemihepatectomy for evaluation of residual liver reserve function in patients with primary liver carcinoma. Methods During hemihepatectomy, ICGR15 was tested in 44 patients after the hepatic artery and portal vein of resected side were ligated. Child-Pugh score, Child-Pugh classification, and MELD score before operation were tested. After operation, the liver function condition was estimated. Results The incidence of liver dysfunction was significantly lower in ICGR15lt;10% group (17.9%, 5/28) than that in 10%~15% group (75.0%, 12/16), Plt;0.05. There was no significant difference of Child-Pugh score among normal liver function group, mild insufficiency of liver function group, and severe insufficiency of liver function group （Pgt;0.05）. ICGR15 and MELD score in normal liver function group were statistical lower than those in mild insufficiency of liver function group and severe insufficiency of liver function group (Plt;0.05). ICGR15 was significantly lower in Child-Pugh A group than that in Child-Pugh B group (Plt;0.05). Conclusion Intraoperative residual liver ICGR15 may be more precisely compared with Child-Pugh score in evaluation liver reserve function for the patients with primary liver carcinoma and can help to guide liver resection.
ObjectiveTo evaluate the treatment retention rate of five new types of antiepileptic drugs:lamotrigine (LTG), topiramate (TPM), oxcarbazepine (OXC), levetiracetam (LEV) and gabapentin (GBP) and their tolerability. MethodsA total of 216 patients diagnosed as epilepsy by receiving the long-term video electroencephalography monitoring between October 2012 and October 2014 were randomized into five drug treatment groups (LTG, n=57; TPM, n=42; OXC, n=49; LEV, n=47; GBP, n=21) and received corresponding dose of drug therapy. The seizure frequency, adverse events and number of patients giving up therapy were collected and recorded via phone or interview every 4 weeks. Every follow-up retention rate of every drug group equals current patient number continuing therapy/initial patient number of this drug group×100%. When the trial ended, Kaplan-Meier curve and Cox proportional risk model were applied for statistical analysis. ResultsThe trial lasted for 106 weeks. The final retention rate of LTG was the highest (85.9%), and GBP was the lowest (14.3%). Most patients could continue the therapy until the end of the trial after 24 weeks. The leading causes of discontinuing therapy included:no efficacy, rash, sedation and aggressive behavior. ConclusionThe retention rate of new types of antiepileptic drugs is associated with these elements:drug efficacy, adverse events, individual tolerability of drug, drug accessibility and the patients' individual preference of drug administration.
ObjectiveTo investigate the long-term retention rate of Oxcabazepine (OXC) in Chinese young children with symptomatic epilepsy and to evaluate the withdrawal causes of OXC. MethodsClinical features of 89 cases (male/female:48/41) from January.2009 to June.2015 were collected. Patients with symptomatic epilepsy who received mono-or adjunctive therapy with OXC. The initial dose was 10mg/kg/d twice a daily, 3~4weeks to increased to the target dose. OXC doses ranged between 12~53 mg/(kg·d) (mean dose:34.0±8.59 mg/(kg·d). An investigator recorded the antiepileptic drugs, seizure frequency, electroencephalogram and side effects for 3, 6, 12, 24 and 36months during follow-up. ResultsA total of 89 patients were enrolled in this investigation. patients with 50% reduction in seizure frequency in 6, 12, 24 and 36 months were 56.5%, 55.3%, 44.7%, 24.7%, and with seizure-free were 36.5%, 34.1%, 29.4%, 16.5%. In this research, 16(18.0%) patients experienced at least one side effect. The most common side effects observed were drowsiness 8 (42.1%), rash 3 (15.8%), and most were mild in severity. The retention rate of OXC in 3, 6, 12, 24, and 36months were 95.5%, 87.6%, 75.3%, 56.2%, 25.8%, respectively. The predominant causes of withdrawal were lack of efficacy 36(54.5%), end point 10(15.2%), adverse effects 8(12.1%), seizure-free 5(7.6%), follow-up loss 3(4.5%). COX analysis reveals that the age of onset was associated with treatment failure. ConclusionOur study demonstrates that OXC is safe and well tolerated in infants and very young children with symptomatic epilepsy, but the long-term retention rate is low. Whereas, for the purpose of better retention rate and therapeutic benefits, we should treat discretely depending on the complicated etiology and clinical features.
ObjectiveTo systematically review the implant survival and postoperative aesthetics of immediate versus delayed implant treatment in the anterior maxilla regions.MethodsWe searched databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI and WanFang Data from inception to April 2017, to collect randomized controlled trials (RCTs) and cohort studies on immediate implant and delayed implant in the anterior teeth areas. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 4 RCTs and 12 retrospective cohort studies involving 1 316 implants were finally included. The results of meta-analysis showed that: there was no significant difference between two groups in retention rate (RCT: RR=0.99, 95%CI 0.97 to 1.02, P=0.70; retrospective cohort study: RR=0.99, 95%CI 0.96 to 1.02, P=0.54), the implant stability of permanent restoration for 4 months (MD=0.82, 95%CI –0.11 to 1.76, P=0.08), alveolar bone resorption of long-term permanent crown restoration (12 months: RCT: MD=0.06, 95%CI –0.35 to 0.47, P=0.79; retrospective cohort study: MD=–0.27, 95%CI –0.57 to 0.03, P=0.07; 24 months: retrospective cohort study MD=–0.09, 95%CI –0.18 to 0.00, P=0.05), respectively. The immediate implant group was superior to the control group in alveolar bone resorption of short-term permanent crown restoration (3 months: MD=–0.08, 95%CI –0.13 to –0.04, P=0.000 1; 6 months: MD=–0.23, 95%CI –0.38 to –0.07, P=0.004). The PES score in the immediate implant group was higher than that in the delayed implant group(MD=1.12, 95%CI 0.11 to 2.13, P=0.03).ConclusionsCurrent evidence shows that both immediate and delayed implant procedures have similar outcomes in terms of implant retention, long-term stability and long-term alveolar bone resorption of the implants in the anterior maxilla regions, but the former procedure possesses better short-term reduction of alveolar bone absorption and postoperative gingival aesthetics. Furthermore, due to the limited quality and quantity of the included studies, more large-scale and high-quality studies are needed to verify the above conclusions.
ObjectiveTo explore the impact on the retention and effective rate of the mode of continuous guidance with wechat group in children with infantile spasms (IS) treated by ketogenic diet (KD).MethodsThe clinical data of 40 children who received KD treatment in Jiangxi Children’s Hospital from January 2017 to June 2019 were retrospectively analyzed, including 23 males and 17 females, the average age was (19.90±13.10) months and the average course was (9.95±7.61) months. They were randomly divided into control group (20 cases) and observation group (wechat group continuity Guidance Group, 20 cases), and followed up one year to compare the retention rate and efficacy.ResultsThere was no statistical difference between the general data of the observation group and the control group (P>0.05). After 9 and 12 months of KD treatment, the retention and effective rate of the observation group was significantly higher than the control group (P<0.05). And the seizure-free rate was higher than the control group (35% vs. 10%, 35% vs. 15%).ConclusionThis model of continuous guidance with wechat group can increase the KD retention rate of IS children, And increase the effective rate.