Relief Of Clinical Symptoms Research Articles

P0606 The efficacy of upadacitinib in Intestinal Behçet’s Disease refractory to anti-TNF-α therapy in a retrospective study

Abstract Background Behçet’s syndrome is a chronic, systemic vasculitis that affects multiple organs, with intestinal involvement referred to as intestinal Behçet’s disease. The understanding of effective treatments for this condition remains limited. Anti-tumor necrosis factor-α (TNF-α) therapy is recommended for moderate to severe or refractory cases. However, managing patients unresponsive to anti-TNF-α therapy presents a significant clinical challenge. Upadacitinib, a Janus kinase (JAK) inhibitor, has not previously been studied in this context. This study aims to evaluate the efficacy of upadacitinib in patients with anti-TNF-refractory intestinal Behçet’s disease. Methods We retrospectively included patients with refractory intestinal Behçet’s disease treated with upadacitinib at the First Affiliated Hospital of Zhejiang University School of Medicine. Data collected included clinical manifestations, medication history, physical examination findings, laboratory results, and endoscopic evaluations before and after treatment. Results Six patients with intestinal Behçet’s disease were included, five of whom were female, with an average age of 35.5±11.0 years. All patients presented with recurrent oral ulcers and abdominal symptoms, accompanied by endoscopic evidence of ileocecal ulcers. They had previously failed treatment with corticosteroids, immunosuppressants, and at least one anti-TNF-α biologic agent. Following 6.1±2.1 months of upadacitinib treatment, all patients showed clinical symptom improvement or relief. Compared to baseline, hemoglobin levels increased (107.2±11.3 vs. 127.5±7.9, P=0.030), serum albumin levels improved (39.2±4.0 vs. 47.2±1.4, P=0.009), C-reactive protein levels decreased (39.9±37.4 vs. 3.0±3.4, P=0.048), and Endoscopic performance improved (P=0.026). No serious adverse events were reported in either of the 6 patients during follow-up. Conclusion Upadacitinib appears to be a promising therapeutic option for patients with intestinal Behçet’s disease refractory to anti-TNF-α therapy.

Comparison of crossed and parallel rod configurations used in posterior occipitocervical and atlantoaxial fixations: a retrospective cohort study

BackgroundThis study is aimed to compare the differences in clinical outcomes between the crossed rod configuration and the parallel rod configuration applied in posterior occipitocervical and atlantoaxial fixations, and to assess the clinical applicability of crossed rods.MethodsFrom January 2015 to December 2021, 21 patients with craniocervical junction disorders were treated surgically with the crossed rod technique (CR group). Meanwhile, 27 corresponding patients treated with the conventional parallel rod technique were included as control (PR group). Clinical data, internal fixation type, neurological status, clinical symptoms relief, image parameter, complications and bone fusion conditions were retrospectively analyzed and evaluated.ResultsNo statistically significant differences were found in baseline characteristics, fixation type and postoperative complications between the two groups. Although the postoperative ADI was significantly reduced in both groups, the ADI was significantly greater in the CR group than that in the PR group after surgery and at the final follow-up (P < 0.05). All patients achieved bone fusion at 1-year postoperative follow-up except for one case in the PR group. However, patients in the CR group had a significantly higher fusion rate than those in the PR group at 3 months postoperatively (P < 0.05).ConclusionsThe application of a crossed rod configuration in posterior occipitocervical and atlantoaxial fixations provides good clinical applicability. Although this technique has a relatively weaker reduction force, it has greater fixation stability and a higher rate of early bone fusion. This technique could be an easy and viable alternative to the current parallel rod configuration for upper cervical surgery.

Evaluation of the efficacy and safety of Chinese medicine Cang-Er-Zi-San in the treatment of allergic rhinitis in children: A meta-analysis and systematic review.

More and more studies have shown that Chinese medicine can effectively and safely treat allergic rhinitis (AR) in children. This meta-analysis aims to compare the efficacy and safety differences between conventional therapy and the Chinese herbal medicine Cang-Er-Zi-San (CEZS) from an evidence-based perspective, and guide the clinical treatment of pediatric AR. This study aims to compare the effects of intervention with traditional Chinese medicine formula CEZS on the clinical symptoms of pediatric AR, determine the effectiveness and safety of CEZS in treating pediatric AR, and obtain high-quality clinical evidence. Research method: based on the preferred reporting item (PRISMA) statement of systematic review and meta-analysis, inclusion and exclusion criteria were established. Retrieve 7 mainstream medical databases to obtain randomized controlled trials (RCTs) of traditional Chinese medicine CEZS for the treatment of pediatric AR. Include RCTs that meet research requirements. Then extract the data information and evaluate the quality using the Cochrane bias risk assessment tool. Meta-analysis was conducted using RevMan software on the effective rate, clinical symptom relief time, recurrence rate, and adverse event indicators. Calculate relative risk (RR) and 95% confidence interval (95% CI), test heterogeneity identify its source, evaluate publication bias through funnel plots. 15 RCTs and 1361 patients were included. The results of meta-analysis showed that the efficacy of Chinese herbal compound CEZS in the treatment of children with AR was significantly superior to other therapies. Effective rate (RR = 1.21; 95% CI = 1.15, 1.26) The difference was statistically significant, and the symptom relief time, Recurrence rate, adverse event, the time of symptom relief in the treatment group were all better than those in the control group. It is suggested that CEZS therapy is more suitable for the clinical treatment of children with AR. CEZS has a definite therapeutic effect on children with AR and is an effective method for treating it. However, due to biased results and limited research, a large number of high-quality studies are needed to validate the effectiveness of CEZS and provide new treatments for clinical reference.

Using high-intensity phototechnology as a method of treating mild to severe diffuse alopecia

Purpose of the study. Publications on the use of laser technologies are isolated and additional studies on representative samples and with an assessment of the stability of the effects of laser therapy are needed to confirm their effectiveness. The aim of the study was the scientific substantiation and development of a combined method including fractional laser therapy, intravenous blood irradiation and minoxidil for the treatment of patients with diffuse telogen effluvium. Material and methods: To study the effectiveness of laser technologies, 4 treatment regimens were analyzed. A total of 177 patients with an established diagnosis of diffuse telogen effluvium were observed. The work used the DIQOL index (dermatological index of quality of life), which is a universal tool for assessing quality of life indicators in various skin diseases. Results: The data obtained show that the relief of clinical symptoms in diffuse alopecia improves the psycho-emotional state and increases the quality of life of patients, which is confirmed by the improvement in the dynamics of the DIQOL index in all study groups: in the group using erbium and neodymium lasers, the dynamics were 27.2 % / 41.2 %, in the group where transcutaneous laser irradiation of blood was used — 20 % / 29.4 %, in the control group 9.1 % / 23.5 %. The best result was obtained in the combination therapy group, where the dynamics were 45.4 % and 52.9 %, with a mild and severe degree, respectively.

A possible alternative to antibacterial therapy in the treatment of acute rhinosinusitis

High incidence of acute rhinosinusitis in a population remains one of the topical issues in practical otolaryngology. Statistical data show an increasing trend towards transition of acute rhinosinusitis in patients into chronic rhinosinusitis. According to literary sources, the emergence of bacterial resistance to antibiotics is as a rule the major reason of protracted course of the disease. Unreasonable antibiotics prescription, irrational use and uncontrolled intake result in the rapid development of antibiotic resistance. In this context, the use of herbal medicines having not only antibacterial, but also mucolytic, fungicidal, antioxidant effects in the complex therapy is a modern solution for disease management. Respero Myrtol, a standardized myrtol-based medicine, has taken its rightful place in the therapy. This article is aimed to investigate the possibilities of the effective use of medicine containing standardized myrtol as its main ingredient in the treatment of acute rhinosinusitis (based on the review of literature). Research materials included scientific articles on aspects of acute rhinosinusitis in otorhinolaryngology practice that were published in domestic specialized periodicals of eLIBRARY and scientific databases Scopus, Web of Science, Medline from 2014 to 2024. The published literature was analysed using the cause-and-effect technique. A clinical example was dis-cussed. With regard to the analysis of scientific literature, a brief overview of the epidemiology, etiology, predisposing factors for the development, diagnosis and treatment of acute rhinosinusitis was provided. The article addresses relevant socio-economic issues related to acute rhinosinusitis, the problem of antibiotic resistance. The issues of improving acute rhinosinusitis treatments using a standardized myrtol medicine in complex therapy as an alternative to antibiotic therapy were brought to attention. As a result, the authors concluded that the use of Respero Myrtol contributes to the rapid relief of clinical symptoms of acute rhinosinusitis, improves the patient’s quality of life, and can be advised as an alternative to antibiotic therapy in uncomplicated course of the disease.

Efficacy of Clarithromycin Combined with Fluticasone Propionate on Nasal Function, Nasal Mucociliary Transport Function, and Serum Inflammatory Markers in Chronic Rhinosinusitis Patients After Functional Endoscopic Sinus Surgery.

Objective: This study aims to assess the efficacy of clarithromycin (CAM) combined with fluticasone propionate (FP) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS), focusing on nasal function, nasal mucociliary transport (MCT) function, and serum inflammatory markers. Methods: The control group (n = 48) was treated with FESS alone, while the study group (n = 48) was treated with FESS plus CAM combined with FP. The clinical effects, symptom scores, nasal function, nasal MCT function, serum inflammatory marker levels, and the occurrence of adverse reactions were compared. Results: The total efficacy rate of the study group (95.83%) was significantly higher than that of the control group (83.33%). After treatment, the study group showed lower symptom scores for nasal congestion, runny nose, sneezing and dizziness, and headache compared to those in the control group. The study group also had lower nasal airway resistance, shorter distance from the minimal cross-sectional area to the nostril, and lower T&T olfactory scores. In contrast, their nasal cavity volume and minimal cross-sectional area were higher than those of the control group. Additionally, the nasal mucociliary clearance and MCT rates were higher in the study group. Serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin were significantly lower in the study group compared to the control group (all P < .05). Conclusion: The use of CAM combined with FP in patients after FESS for CRS is effective, leading to the relief of clinical symptoms, improvement of nasal function, enhancement of MCT function, and reduction of inflammatory response, without increasing the incidence of adverse reactions.

Tegoprazan-Amoxicillin Dual Therapy for Helicobacter pylori Eradication: A Prospective, Randomized, Multicenter Study in Fujian, China.

Few studies have investigated the efficacy and safety of tegoprazan-amoxicillin (TA) dual therapy for Helicobacter pylori eradication. We aim to evaluate the effectiveness and safety of different dosages of TA dual therapy for H. pylori eradication. This prospective, randomized, open-label, multicenter study was conducted at four centers in Fujian, China. H. pylori-infective patients were randomized 1:1:1 to receive one of the following treatments: bismuth quadruple therapy (BQT, esomeprazole 20 mg twice daily + potassium bismuth citrate 240 mg twice daily + amoxicillin 1 g twice daily + clarithromycin 500 mg twice daily), tegoprazan-amoxicillin dual therapies (TA-qd, tegoprazan 50 mg once daily + amoxicillin 1 g thrice daily; TA-bid, tegoprazan 50 mg twice daily + amoxicillin 1 g thrice daily) for 14 days. The primary outcome was noninferiority in eradication rates of the different TA groups compared to the BQT group. Secondary outcomes encompassed an assessment of adverse reactions and clinical symptom relief. Additionally, exploratory outcomes were focused on the shifts in gut microbiota and a cost-effectiveness analysis. A total of 321 patients were enrolled. The eradication rates in the BQT group, TA-qd group, and TA-bid group were 85.05% (91/107), 85.98% (92/107), and 85.98% (92/107) in the intention-to-treat analysis (ITT) (BQT vs. TA-qd, 95% CI -8.50% to 10.36%, noninferiority p = 0.012; BQT vs. TA-bid, 95% CI -8.50% to 10.36%, noninferiority p = 0.012); 91.00% (91/100), 91.09% (92/101), and 92.93% (92/99) in the modified intention-to-treat analysis (mITT) (BQT vs. TA-qd, 95% CI -7.81% to 7.98%, noninferiority p = 0.006; BQT vs. TA-bid, 95% CI -5.62% to 9.48%, noninferiority p < 0.001); 90.81% (89/98), 91.00% (91/100), and 93.81% (91/97) in the per-protocol analysis (PP) (BQT vs. TA-qd, 95% CI -7.83% to 8.19%, noninferiority p = 0.006; BQT vs. TA-bid, 95% CI 4.46% to 10.46%, noninferiority p < 0.001). The incidence of adverse reactions in the TA-qd and TA-bid groups was significantly lower than in the BQT group (13.33%, 14.56%, and 27.18%, respectively; p = 0.017). The complete remissions of clinical symptoms for BQT, TA-qd, and TA-bid were 36.89%, 65.71%, and 68.93%, respectively, had significant differences (p < 0.001). Two weeks of TA therapy altered gut microbiota diversity and composition, but that recovered 4 weeks after discontinuation. The cost-effectiveness ratios (CERs) for BQT, TA-qd, and TA-bid were 1.85 CNY, 2.08 CNY, and 3.69 CNY, respectively. Both TA dual therapies provided satisfactory eradication rates of > 90% for eradicating H. pylori, fewer adverse reactions, and greater clinical symptom relief compared to BQT, with a mild, reversible impact on gut microbiota. In addition, the TA dual therapy with low doses of tegoprazan showed better cost-effectiveness. Chinese Clinical Trial Register and registration No.: ChiCTR2300071997.

Changes of CD8+CD28- Tregs and Gamma-Delta-T-cells in a Neonate with Intrauterine Cytomegalovirus Infection: A Case Report

BackgroundCongenital cytomegalovirus (cCMV) infection can lead to a range of adverse outcomes. The majority of cCMV neonates with clinical symptoms are infected postnatally; however, established cases of intrauterine infection are uncommon, resulting in a paucity of reports on clinical findings and lymphocytes expression in CMV-infected neonates.Case presentationWe followed a neonate with cCMV infection from the onset of hospitalization to several months of follow-up. This infant was intrauterine CMV-positive in the amniotic fluid of the mother at 21 weeks’ gestation and received intravenous ganciclovir infusion and sequential oral valganciclovir after birth. The typical clinical signs manifested in the nervous system, liver, and peripheral blood and were documented during the hospitalizaion period and up to the follow-up visit. Flow cytometry was employed to examine the expression of T cells, their subsets, and the associated cytokines in peripheral blood samples at various time points. The flow data for the cCMV neonate were compared with those of the controls at each time point. Following treatment, clinical symptoms improved and the infant became CMV negative. However, developmental delays occurred later in life. The proportion of CD8+CD28− Tregs in the peripheral blood of the neonate with congenital CMV infection was higher than that in the controls at the three time points. The expression levels of perforin and granzyme B secreted by γδ T cells (Vδ1 and Vδ2 T cells), increased during the course of hospitalization until follow-up and were higher than those in the controls at the three time points.ConclusionsDespite the alleviation of clinical symptoms, developmental delay in later life remains inevitable in this intrauterine cCMV neonate. CD8+CD28− Tregs and Vδ1 and Vδ2 T cells secreting perforin and granzyme B may be involved in congenital CMV infection, although this hypothesis requires validation in a larger study. This report may contribute to our understanding of the effect of current treatment and the immune status of intrauterine cCMV-infected neonates.

CICARE communication model and hierarchical responsibility nursing coordination in the application research of elderly patients with chronic heart failure.

The aim of this study was to evaluate the efficacy of implementing the CICARE communication model and hierarchical responsibility nursing coordination in managing chronic heart failure among elderly patients. From June 2021 to June 2023, 120 elderly patients diagnosed with chronic heart failure were admitted to our hospital. They were divided into 2 groups according to different treatment methods: the regular group and the observation group. Both groups of patients received nursing interventions for 3 months. Before and after the intervention, we assessed the levels of cardiac function indicators (left ventricular end-diastolic diameter, left ventricular ejection fraction, and B-type natriuretic peptide levels) and exercise tolerance (6-minute walk test) in both groups of patients. The time to clinical symptom relief, self-efficacy, and quality of life scores were compared between the 2 groups of patients. Before the intervention, there were no significant differences in cardiac function indicators between the 2 groups (P > .05). However, after the intervention, both groups exhibited improvements in left ventricular end-diastolic diameter and B-type natriuretic peptide levels, with the observation group demonstrating greater reductions compared to the control group. Furthermore, both groups showed increased left ventricular ejection fraction levels, with the observation group experiencing a significantly higher improvement. Although exercise tolerance did not differ significantly between the groups before the intervention, post-intervention analysis revealed a greater increase in 6-minute walk test distance in the observation group compared to the control group (P < .05). The time to relief of breathlessness and edema did not significantly differ between the groups (P > .05). Similarly, there were no significant differences in self-efficacy and quality of life scores between the groups before the intervention (P > .05); however, post-intervention analysis showed higher self-efficacy scores in the observation group. Application of the CICARE communication model and hierarchical responsibility nursing coordination in elderly patients with chronic heart failure can effectively improve the patients' cardiac function levels and significantly enhance their exercise tolerance, self-efficacy, and quality of life.

Current Diagnostic and Therapeutic Challenges in Superficial Venous Thrombosis.

Superficial venous thrombosis (SVT) is a fairly common disorder, characterized by the formation of thrombi inside superficial veins, with or without an associated inflammatory reaction. Its evolution is frequently self-limited. However, serious complications may change this clinical course with extension to deep vein thrombosis (DVT) and pulmonary embolism (PE). SVT shares similar risk factors with DVT and is frequently associated with the presence of varicose veins. However, the occurrence of non-varicose veins could conceal risk factors such as malignancies, thrombophilia, or Buerger's disease. While the clinical diagnosis is generally straightforward, additional diagnostic evaluations are often necessary. Duplex ultrasound (DUS) is an invaluable tool that provides the location of SVT, the proximity to the sapheno-femoral junction, and the clot length, all of which influence the decision for optimal management. The treatment of SVT should be symptomatic, pathogenic (limiting the extension of thrombosis), and prognostic (to prevent complications). There are several guidelines that provide recommendations, and despite the need for more consensus and for further studies, the treatment of SVT should be mainly medical, including anticoagulation in specific clinical situations and symptom relief, with invasive treatment in a minority of cases. Initiation, intensity, and length of anticoagulant treatment should be based on the eventual risk of progression to DVT or PE, which can be high, intermediate, or low, based on the location of SVT and the clot length. Our review summarizes the evaluation and proper management of SVT and highlights the importance of a shared decision within the heart team regarding this condition in order to prevent further complications.

Ablation strategy for idiopathic outflow tract premature ventricular complexes: rationale and design of the ABOUT-PVC study, a prospective multicenter study

BackgroundAn idiopathic outflow tract premature ventricular complex (OT-PVC) is a common arrhythmia, and the accuracy of site of origin prediction using the 12-lead electrocardiogram (ECG) algorithm is not high. There are no studies about a systematic strategy that can provide practical help to electrophysiologists in OT-PVC mapping and ablation. This study aims to evaluate the efficacy and safety of the proposed ablation protocol and establish an optimal catheter ablation strategy by simultaneously investigating and synthesizing various indicators observed during the mapping procedure.Methods and designThis study (ABOUT-PVC) was designed as a prospective multicenter study to enroll 210 patients from 11 tertiary university hospitals over an estimated 27 months. Patients with idiopathic OT-PVC requiring catheter ablation will receive the procedure through a proposed ablation strategy and will be followed up for at least 12 months. The primary outcome is the acute procedural success rate. The secondary outcomes are clinical success rate, procedure time, complication rate, symptom relief, and changes in echocardiographic parameters.ConclusionsThe ABOUT-PVC study was designed to investigate the efficacy and safety of the proposed ablation strategy and establish an optimal catheter ablation strategy. We expect this study to overcome the limitations of the ECG prediction algorithms and provide a practical guide to electrophysiologists, increasing the procedure’s success rate and reducing complications and procedure time.

Curative Effect of Helicobacter Pylori Radical Treatment on Gastric Cancer Patients with Helicobacter Pylori Infection

To explore the role and value of radical treatment of Helicobacter pylori in patients with gastric cancer complicated with Helicobacter pylori infection. Methods: From January 2022 to January 2023, 152 patients with gastric cancer complicated with Helicobacter pylori infection who were treated in our hospital were included in this study by random number table method. According to whether each patient received radical treatment based on Helicobacter pylori infection while receiving chemotherapy treatment, they were divided into the control group of single chemotherapy treatment and the observation group of combined radical treatment of Helicobacter pylori. The difference of treatment indexes between the two groups was analyzed. Results: The effective rate of treatment in the observation group was 88.16%, the total adverse reaction rate was 39.47%, and the treatment satisfaction rate was 93.42%; The effective rate of treatment in the control group was 78.95%, the total adverse reaction rate was 68.42%, and the treatment satisfaction rate was 82.89%. The difference was statistically significant (P&lt;0.05). Conclusion: For patients with gastric cancer complicated with Helicobacter pylori infection, while receiving chemotherapy for gastric cancer, radical treatment for Helicobacter pylori can significantly improve the effective rate of clinical symptom relief of disease treatment, reduce the incidence of adverse reactions during various treatments, and improve the overall satisfaction of patients and their families with treatment.

Modified Atlantoaxial Arthrodesis Technique for Atlantoaxial Instability via Intraarticular Autografting Using Structural Iliac Bone: Technical Nuances and Case Series

ObjectiveThe present study described a modified technique of atlantoaxial arthrodesis in patients with atlantoaxial instability (AAI) along with the postoperative clinical and radiological results. MethodsFive patients underwent this method for their AAI concurrent with C1 arch hypoplasia and/or the development of odontoid pannus causing myelopathy. After thorough exposure of the posterior surface of the C1-2 complex, the bilateral C2 nerve roots were sectioned to allow for easier access to the C1/2 facet joints. To prepare a suitable grafting bed, the C1/2 facet capsule was opened, then the articular cartilaginous and synovial tissues were thoroughly removed. After being properly fashioned to match the gap between the C1/2 facet joint spaces, the structural bone grafts from the iliac crest were directly inserted into the facet joint spaces. To alleviate cord compression caused by concomitant odontoid pannus and/or hypoplastic C1 arch, C1 laminectomy was necessitated in all cases. Subsequently, posterior screw-rod instrumental fixation was conducted. ResultsAll five patients underwent this procedure successfully. Clinical and radiological follow-up data of all patients indicated favorable relief of clinical symptoms and early rigid C1-2 stability. The sequelae of C2 nerve resection were not remarkable. No other neural or vascular damage associated with this technique was observed. ConclusionModified atlantoaxial arthrodesis via intraarticular autografting using the structural iliac bone combined with posterior instrumentation appears to be an efficient alternative treatment method for AAI patients with concurrent pathologies, even when the C1-2 posterior arches are unavailable for the grafting bed.

An Ayurvedic methodology for managing PCOD - A Case Report

Polycystic ovarian disease (PCOD) is a heterogenous endocrine disorder characterized by ovarian cysts, anovulation, and hormonal fluctuations, impacting women’s health in various ways. PCOD has transformed into a lifestyle disorder due to sedentary habits, excessive consumption of fast food, and an unhealthy lifestyle. Predisposing risk factors such as genetics, neuroendocrine factors, lifestyle and environmental influences, as well as obesity, play significant roles in the development of PCOD. In Ayurveda, PCOD cannot be correlated to any one particular disease; it can be related to certain diseases like Vandhya, Nasthartava, Aratava Kshaya, Pushpaghni Jataharini, etc. and must be controlled according to the Dosha Dushya vitiation. In this present case study, a 21 year old female patient came with symptoms of scanty menses, acne over face and weight gain in the OPD of Kayachikitsa. The USG report reveals PCOD changes in both ovaries as both ovaries are bulky in size right ovary, vol = 18cc and left ovary, vol = 13.2cc with multiple peripherally arranged follicles with central echogenic stroma. The result was determined based on the relief of clinical symptoms and the findings from the ultrasound report. Therefore, in this case study, drugs such as Dashmool Kwath, Narikanti, Cystogrit diamond etc. was given which have Lekhaniya properties results into reducing the size of ovary and effectively alleviate Kapha Dosha and Ama, facilitating the treatment of Sroto-Dusti and removing obstructions caused by Apana Vayu, ultimately enhancing menstrual flow.

Minimally invasive versus open ileal ureter with ileocystoplasty: comparative outcomes and 5-year experience

PurposeTo present the experience of ileal ureter with ileocystoplasty (IUC), and compare the outcomes of IUC in minimally invasive procedures to open procedures.Patients and methodsFrom December 2017 to April 2023, twenty patients underwent IUC in open or minimally invasive (including laparoscopic and robotic) procedures. The baseline characteristics, perioperative data and follow-up outcomes were collected. Success was defined as relief of clinical symptoms, stable postoperative serum creatine and absence of radiographic obstruction. The perioperative and follow-up outcomes of open procedures and minimally invasive procedures were compared.ResultsThe etiology included pelvic irradiation (14/20), urinary tuberculosis (3/20) and surgical injury (3/20). Bilateral ureter strictures were repaired in 15 cases. The surgeries conducted consisted of open procedures in 9 patients and minimally invasive procedures in 11 patients. Compared to open procedures, minimally invasive surgeries had less median estimated blood loss (EBL) (100 ml vs. 300 min, p = 0.010) and shorter postoperative hospitalization (27 d vs. 13 d, p = 0.004). Two patients in the open group experienced grade 3 complications (sigmoid fistula and acute cholecystitis in one patient, and pulmonary embolism in another patient). Over a median follow-up period of 20.1 months, the median bladder functional capacity was 300 ml, with a 100% success rate of IUC.ConclusionIUC is feasible in both open and minimally invasive procedures, with acceptable complications and a high success rate. Minimally invasive procedures can have less EBL and shorter postoperative hospitalization than open procedure. However, prospective studies with larger groups and longer follow-up are needed.

(230) A NEW TECHNIQUE OF MODIFIED PROSTATE W-POINT MASSAGE

Abstract Introduction Palpation and fluid extraction of the prostate are necessary means for the clinical diagnosis of prostate diseases. Objective To introduce a new modified technique of Prostate W-point Massage(PWM) and explore its effectiveness in the diagnosis and treatment of prostate diseases. Methods A total of 200 patients with prostatic inflammation and hyperplasia were randomly divided into experimental group and control group. The patients in the control group were treated with traditional prostate massage method, the patients in the experimental group were massaged with the modified Prostate W-point Massage method (the massage path was similar to the letter W), to analyze the effectiveness of two massage techniques on the success rate of prostatic fluid extraction and the therapeutic effect of prostatic diseases. Results There was no significant difference between the two groups before massage (P &amp;gt; 0.05). The success rate of prostate massage fluid extraction in the experimental group was higher than that in the control group (p &amp;lt; 0.05), and the effective rate of clinical symptom relief in the experimental group was higher than that in the control group (p &amp;lt; 0.05). Conclusions 1. The application of the PWM technique in patients with prostate diseases is effective, which not only increases the success rate of fluid extraction, but also helps to relieve the clinical symptoms of various prostate diseases. 2. At the same time, PWM can promote erection and sexual pleasure. After the prostate disease was cured, most of them asked to continue massage. Disclosure No.

Upadacitinib Reduces Crohn’s Disease Symptoms Within the First Week of Induction Therapy

Upadacitinib (UPA), an oral Janus kinase inhibitor, is approved to treat moderately to severely active Crohn's disease (CD). As symptomatic response is an important initial treatment goal for patients, we evaluated the rapidity of symptomatic improvement in patients with CD receiving UPA 45 mg once daily (UPA45) induction therapy. This post hoc analysis included pooled data from 2 phase 3, multicenter, double-blind 12-week induction trials (U-EXCEL and U-EXCEED) and 1 maintenance trial (U-ENDURE). Daily diary data for the first 15 days of UPA45 or placebo (PBO) treatment were used to analyze improvement in very soft/liquid stool frequency (SF) and abdominal pain score (APS). Clinical outcomes were evaluated at every study visit. Overall, 1021 patients (n = 674 UPA45; n = 347 PBO) were analyzed. UPA45 demonstrated greater efficacy vs PBO for SF <3 and APS ≤1, providing rapid relief by day 5 or 6, regardless of prior biologic exposure. Mean changes in SF and APS were greater with UPA45 beginning at week 2 (-2.0 and -0.5, respectively; P < .001) and were maintained through week 12 (-3.0 and -1.0, respectively; P < .001) vs PBO. First achievement of daily SF/APS clinical remission occurred earlier with UPA45 (median 13 days) vs PBO (median 32 days), and patients treated with UPA45 showed improved rates of SF/APS clinical remission (21.1% UPA45 vs 8.9% PBO) and clinical response (58.8% UPA45 vs 37.9% PBO) starting at week 2 (both P ≤ .01). UPA45 provided rapid relief of clinical symptoms within the first week of treatment in patients with CD. NCT03345849, NCT03345836, and NCT03345823.

Licorice extract inhibits porcine epidemic diarrhea virus in vitro and in vivo.

Porcine epidemic diarrhea virus (PEDV) causes severe diarrhea and even death in piglets, resulting in significant economic losses to the pig industry. Because of the ongoing mutation of PEDV, there might be variations between the vaccine strain and the prevailing strain, causing the vaccine to not offer full protection against different PEDV variant strains. Therefore, it is necessary to develop anti-PEDV drugs to compensate for vaccines. This study confirmed the anti-PEDV effect of licorice extract (Le) in vitro and in vivo. Le inhibited PEDV replication in a dose-dependent manner in vitro. By exploring the effect of Le on the life cycle of PEDV, we found that Le inhibited the attachment, internalization, and replication stages of the virus. In vivo, all five piglets in the PEDV-infected group died within 72 h. In comparison, the Le-treated group had a survival rate of 80 % at the same time, with significant relief of clinical symptoms, pathological damage, and viral loads in the jejunum and ileum. Our results suggested that Le can exert anti-PEDV effects in vitro and in vivo. Le is effective and inexpensive; therefore it has the potential to be developed as a new anti-PEDV drug.

Efficacy and safety of Lianhua Qingwen granule in the treatment of non-influenza viral pneumonia: a randomized, double-blind, placebo-controlled, multicenter clinical study.

To observe the effectiveness and safety of Lianhua Qingwen granule in the treatment of non-influenza viral pneumonia. This study was a multicenter, randomized, double-blind, placebo-controlled trial. Subjects who met the inclusion and exclusion criteria and were clinically diagnosed with viral pneumonia (negative for influenza virus) were randomly divided into the Lianhua Qingwen granule trial group and placebo control group. Patients in the trial group was given Lianhua Qingwen granule, 2 bags at a time, 3 times a day, and the controls were given placebo, with a treatment course of 7 days. Patients' clinical symptoms and signs, and treatment-associated adverse events were observed. Subjects should be included in the full analysis set (FAS) as long as they were all given the medication and had an effectiveness test performed after randomization. Subjects should be included in the Per Protocol Set (PPS),a subset of the total analysis set, which should contain those with strong compliance, no protocol violations, and complete baseline values for the primary indicators. A total of 169 subjects were enrolled in 12 subcenters, including 151 (76 in the trial group and 75 in the control group) in the FAS and 140 (68 in the trial group and 72 in the control group) in the PPS. After 7 days of treatment, the clinical symptom relief rates were 82.98% (FAS) and 87.12% (PPS) in the trial group, and 75.11% (FAS) and 76.02% (PPS) in the control group, respectively. The clinical symptom relief rates in the trial group were significantly higher than those in the control group (p < 0.001). Significant improvements in single symptoms of cough and expectoration in the trial group were observed compared with the control group (p < 0.05). There were no statistical differences in fever, sputum color change, chest pain, muscle pain, dyspnea, chills, and thirst between the two groups (p > 0.05). There were no significant differences in body weight, vital signs, blood routine, urine routine, stool routine, and blood biochemical indicators (CK, AST, ALT, Cr, and Bun) between the two groups before and after treatment (p > 0.05). During treatment, there were no significant differences in the incidence of adverse events and serious adverse events between the two groups (p > 0.05). Lianhua Qingwen granules improved the clinical symptoms of patients with non-influenza virus pneumonia, especially ameliorating cough and expectoration. Lianhua Qingwen granules were associated with good safety.

Surgical versus non-surgical treatment for carpal tunnel syndrome.

Surgical versus non-surgical treatment for carpal tunnel syndrome.