Evaluation Of Clinical Effects Research Articles

Comparative study on the curative effect of laparoscopic nephron sparing surgery and renal functions under selective segmental renal artery clamping and main renal artery clamping.

Objective:To discuss the clinical effect and safety evaluation of laparoscopic nephron sparing surgery (LNSS) under selective segmental renal artery clamping (SSRAC) and main renal artery clamping (MRAC).Methods:Eighty-four patients with T1 localized renal tumors who were admitted and treated from October 2017 to October 2018 were retrospectively analyzed, and they were classified into the S group (42 patients) and M group (42 patients). The patients in the S group received LNSS under SSRAC, while the patients in the M group received LNSS under MRAC. The duration of the operation, amount of intraoperative blood loss, intraoperative warm ischemia time, duration of postoperative hospital stay and positive rate of incisal edge; the serum creatinine and blood urea nitrogen values before and after the operation; and the occurrence rates of intraoperative and postoperative complications were compared.Results:All operations were completed smoothly. No patients had a positive incisal edge, and no patients were converted to MRAC during the operation. The duration of the operation and the amount of intraoperative blood loss increased in the S group compared with the M group. The differences were statistically significant (P <0.05). The differences in the intraoperative warm ischemia time, postoperative drainage and duration of postoperative hospital stay in both groups had no statistical significance (P >0.05). The differences in serum creatinine (SCr) and blood urea nitrogen (BUN) in both groups before the operation had no statistical significance (P >0.05). The SCr and BUN levels significantly increased 1 d and 1 m after the operation. The SCr and BUN levels 1 d and 1 m after the operation were significantly lower in the S group than in the M group, and the differences were statistically significant (P <0.05). The differences in the occurrence rates of intraoperative and postoperative complications in both groups had no statistical significance (P >0.05).Conclusion:SSRAC is a new renal artery clamping technology, and its curative effect on LNSS patients is significant. In addition, SSRAC has high safety and little influence on renal functions.

Comparative evaluation of sedative and clinical effects of dexmedetomidine and xylazine in dromedary calves (Camelus dromedarius)

ObjectiveTo compare the sedative and clinical effects of intravenous (IV) administration of dexmedetomidine and xylazine in dromedary calves. Study designExperimental, crossover, randomized, blinded study. AnimalsA total of seven healthy male dromedary calves aged 14 ± 2 weeks and weighing 95 ± 5.5 kg. MethodsCalves were assigned three IV treatments: treatment XYL, xylazine (0.2 mg kg−1); treatment DEX, dexmedetomidine (5 μg kg−1); and control treatment, normal saline (0.01 mL kg−1). Sedation scores, heart rate (HR), respiratory rate (fR), rectal temperature (RT) and ruminal motility were recorded before (baseline) and after drug administration. Sedation signs were scored using a 4-point scale. One-way anova and Mann–Whitney U tests were used for data analysis. ResultsCalves in treatments XYL and DEX were sedated at 5–60 minutes. Sedation had waned in XYL calves, but not DEX calves, at 60 minutes (p = 0.037). Sedation was not present in calves of any treatment at 90 minutes. HR decreased from baseline in XYL and DEX at 5–90 minutes after drug administration and was lower in DEX than XYL at 5 minutes (p = 0.017). HR was lower in DEX (p = 0.001) and XYL (p = 0.013) than in control treatment at 90 minutes. fR decreased from baseline in XYL and DEX at 5–60 minutes after drug administration and was lower in DEX than XYL at 5 minutes (p = 0.013). RT was unchanged in any treatment over 120 minutes. Ruminal motility was decreased in XYL at 5, 90 and 120 minutes and absent at 10–60 minutes. Motility was decreased in DEX at 5, 10 and 120 minutes and was absent at 15–90 minutes. Conclusion and clinical relevanceThe duration of sedation from dexmedetomidine (5 μg kg–1) and xylazine (0.2 mg kg–1) was similar in dromedary calves.

Dendritic Cells Therapy with Cytokine-Induced Killer Cells and Activated Cytotoxic T Cells Attenuated Th2 Bias Immune Response

ABSTRACT The aim of this study The purpose of this study is to investigate whether the DC cells combined with CIK cells (DC/CIK) and DC activated cytotoxic T cells (DC-ACT) treatment can promote antitumor response and change the immune indicators by targeting the heterogeneous tumor cell populations at a system level. Methods In this study, 112 patients with cancer were assigned to the DC/CIK treatment and 116 patients received the DC-ACT therapy. We detected the lymphocyte subsets and other immune indicators pre- and post-treatment to evaluate the changes of patient’s immunity and compare the differences in immune status between two adoptive cellular immunotherapies. Results DC/CIK therapy elevated the percentage of CD3+ HLA-DR+ T cells, NK cells and several serological cytokines such as IL-2, IL-6 after cell infusion (p < .05). DC-ACT therapy could increase the total CD3 + T cells, CD8 + T cells, CD3+ HLA-DR+ cells and IL-12 cytokines after cell infusion (p < .05). The levels of IL-4/IFN-γ, IL-4/IL-12 and IL-6/IL-12 were reduced significantly in the DC-ACT group compared with DC/CIK group. These observations suggested that DC-ACT therapy has more dominance to induce Th1 cytokine response instead of skewing toward the Th2 cytokine profile based on the immunomodulatory properties. Conclusions These results indicated that DC, CIK, and DC-ACT cells exert anti-tumor activity through the different pathways. Thus, this work may provide valuable insights into the clinical curative effect evaluation of immunocyte therapy and the design of combined immunotherapeutic strategies for malignant tumors.

Clinical Curative Effect Evaluation Study of Treatment of Oral Deferiprone Tablets in Aceruloplasminaemia Patients

Clinical Curative Effect Evaluation Study of Treatment of Oral Deferiprone Tablets in Aceruloplasminaemia Patients

Improved biodegradable magnesium alloys through advanced solidification processing

The potential of using external fields to reduce the cost of emerging magnesium alloys used for the manufacture of medical implant devices while maintaining biocompatibility and mechanical performance is explored. Zirconium (Zr) is often added to high performance magnesium alloys as a grain refiner which is expensive, and there is uncertainty about whether or not Zr is harmful to the biocompatibility of the alloy. This is a significant barrier to the adoption of alloys that contain Zr because of the need to undertake cytotoxicity and haemocompatibility testing, as well as evaluation of long-term clinical effects. An alternative approach is to investigate methods to minimise or eliminate the need for Zr addition. External fields applied during solidification of the alloy provide an opportunity to produce a refined microstructure without the addition of Mg–Zr master alloy presenting a distinct advantage both from biodegradation and biocompatibility perspectives. Preliminary work evaluates the effect of ultrasonic treatment on microstructure and mechanical properties of Mg–Zn–Ca alloys with and without Zr and then compares their in-vivo corrosion performance to that of WE43. A framework for future research is proposed along with opportunities for the development of lower cost alloys with at least equal biocompatibility, mechanical and corrosion performance.

High-resolution colonic manometry and its clinical application in patients with colonic dysmotility: A review.

The detailed process and mechanism of colonic motility are still unclear, and colonic motility disorders are associated with numerous clinical diseases. Colonic manometry is considered to the most direct means of evaluating colonic peristalsis. Colonic manometry has been studied for more than 30 years; however, the long duration of the examination, high risk of catheterization, huge amount of real-time data, strict catheter sterilization, and high cost of disposable equipment restrict its wide application in clinical practice. Recently, high-resolution colonic manometry (HRCM) has rapidly developed into a major technique for obtaining more effective information involved in the physiology and/or pathophysiology of colonic contractile activity in colonic dysmotility patients. This review focuses on colonic motility, manometry, operation, and motor patterns, and the clinical application of HRCM. Furthermore, the limitations, future directions, and potential usefulness of HRCM in the evaluation of clinical treatment effects are also discussed.

Clinical evaluation of Nasya Karma and Vatagajankusha Rasa effect in the management of Pakshaghata

Vata Vyadhi is considered one among the Ashta Maha Gada as told by Acharya’s. Out of all Nanatmaja Vata Vyadhis, the disease Pakshaghata is considered superior among the other Vataja disorders. In modern era, the Lakshana’s of Pakshaghata is closely resembles the disease Hemiplegia. In Hemiplegia, symptoms appears due to the Ischemia of Brain tissue which is an end result of improper blood supply to the brain either due to thrombus, embolism or may be due to rupture of any cerebral blood vessels. Acharya Bhela, has considered Pakshaghata as one among the Asthi Majjagata Roga’s. Acharya Sushruta also states that, the Mastulunga Majja is nothing but it is Majjadhara Kala. So, here an attempt has been made to evaluate the efficacy of Brimhana Nasya along with Shamanoushadi’s for the management of Pakashaghata.

Observation of curative effect on lumbar facet joint syndrome by palace bonesetting therapeutic combined with lumbar medial branch nerve block

Objective To observe the clinical effect of palace bone-setting Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi fixation in the treatment of acute ankle sprain. Methods A total of 60 patients with acute ankle sprain were collected and randomly divided into observation group and control group according to the random number table method, with 30 cases in each group. The observation group was treated with Palace Bone-setting Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi for fixation. The control group was treated with external application of diclofenac diethylamine emulsion and fixation of elastic bandage. Two groups were treated for 14 days. The patients pain disappeared time and the swelling subsided, the VAS scale for assessment of ankle pain observed. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-after scoring system was used to assess the Ankle function, evaluation of clinical curative effect. Results The pain disappear time (9.7 ± 1.6 d vs. 13.4 ± 3.5 d, t=5.638), regression and time (3.5 ± 1.3 d vs. 6.7 ± 1.1 d, t=10.292) in the observation group were significantly earlier than those in the control group (P<0.01). After treatment, VAS score (1.9 ± 1.1 vs. 3.3 ± 1.3, t=4.503) of the observation group significantly lower than that of the control group (P<0.01); AOFAS score (93.6 ± 3.9 vs. 84.2 ± 5.1, t=8.019) significantly higher than the control group (P<0.01). Total effective rate in the observation group was 96.7% (29/30), and the control group was 80.0% (24/30), which the difference was statistically significant (χ2=4.043, P=0.044). Conclusions The Palace Bone-setting Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi fixation has definite curative effect on acute ankle sprain, relieve pain, swelling and promote the ankle function. Key words: Ankle joint; Sprains and strains; Dieda-Wanying cream; Yuan Shu Zhi Pai Zi; Palace bonesetting; Comparative effectiveness research

Clinical Significance of Plasma Apolipoprotein-AII Isoforms as a Marker of Pancreatic Exocrine Disorder for Patients with Pancreatic Adenocarcinoma Undergoing Chemoradiotherapy, Paying Attention to Pancreatic Morphological Changes.

Background Circulating apolipoprotein-AII (apoAII-) ATQ/AT is a potential useful biomarker for early stage pancreatic ductal adenocarcinoma (PDAC), but its clinical significance in PDAC patients remains uncertain. The aim of the current study was to assess the usefulness of apoAII-ATQ/AT as a surrogate for the effect of chemoradiotherapy (CRT) and its association with pancreatic exocrine disorder, paying attention to morphological changes of the pancreas. Methods In the 264 PDAC patients who were enrolled in our CRT protocol, the following parameters were measured at specified time points before and after CRT: serum levels of albumin, total cholesterol, and amylase as indices of pancreatic exocrine function, serum levels of CA19-9, and the pancreatic morphology including tumor size (TS), main pancreatic duct diameter (MPDD), and pancreatic parenchymal volume excluding tumor volume (PPV) by using computed tomography (CT) images. Plasma apoAII-ATQ/AT levels were simultaneously measured with enzyme-linked immunosorbent assay in 4 healthy volunteers and the 44 PDAC patients before and after CRT. Plasma apoAII-ATQ/AT levels after CRT were analyzed according to small/large-MPDD and small/large-PPV groups based on their median values after CRT. Plasma samples after CRT were measured after incubation with human pancreatic juice (PJ) to examine the relevance between apoAII isoforms and circulating pancreatic enzymes. Results The serum levels of albumin, amylase, CA19-9, TS, MPDD, and PPV after CRT were significantly lower than those before CRT (median, before vs. after: 3.9 g/dl, 74 U/l, 180.2 U/ml, 58.1 mm, 4.0 mm, and 34.8 ml vs. 3.8, 59, 43.5, 55.6, 3.6, and 25.2). ApoAII-ATQ/AT levels (median, μg/ml) of PDAC patients before CRT were significantly lower than those in healthy volunteers: 32.9 vs. 61.2, and unexpectedly those after CRT significantly decreased: 14.7. The reduction rate of apoAII-ATQ/AT was not correlated with those of CA19-9 and TS, indicating that apoAII-ATQ/AT is not a tumor-specific marker. On the other hand, the patient group with large MPDD and small PV exhibited higher apoAII-ATQ levels than those with small MPDD and large PPV. The incubation of plasma samples after CRT with PJ did not alter apoAII-ATQ/AT and apoAII-AT levels but significantly decreased apoAII-ATQ levels, suggesting that circulating pancreatic enzymes markedly influenced apoAII-ATQ levels. Conclusions ApoAII-ATQ/AT levels are not useful for evaluation of clinical effect of CRT for PDAC, but apoAII isoforms are very useful to assess pancreatic exocrine disorder because pancreatic atrophy and insufficient secretion of circulating pancreatic enzymes are considered likely to influence apoAII-ATQ levels.

Evaluation of Clinical Profile and Effect of Cervical Spinal Cord Injuries with or Without Bony Injuries

Evaluation of Clinical Profile and Effect of Cervical Spinal Cord Injuries with or Without Bony Injuries

Comprehensive analysis of the effect of null zone shifting surgery treatment on patients with infantile nystagmus syndrome

Objective: To characterize the postoperative change of eyes related parameters of patients with infantile nystagmus syndrome(INS), so as to provide a reference for the clinical evaluation of postoperative effect and the rational arrangement of patients' follow-up time after operation. Methods: A retrospective study. Clinical and follow-up data of 17 patients diagnosed with INS at Department of Ophthalmology in Xinhua Hospital, School of Medicine, Shanghai Jiaotong University from June 2014 to December 2016 were collected. All patients with abnormal head posture (AHP) underwent null zone shift surgery. The operative methods were Parks 5-6-7-8, Anderson, Kestenbum 5-5-6-4,null zone shift combined with strabismus correction and vertical null zone transposition. Ophthalmological examination and eye movement were recorded, including best corrected binocular visual acuity (BCBVA), position of the null zone, expanded nystagmus acuity function (NAFX) and foveation time. Single factor repeated analysis of variance, independent sample t test and rank sum test were used for statistical analysis. Results: Among the 17 children, 6 were females and 11 were males. The age at surgery of the patients was 5-11 years.The follow-up time was (14.8±6.0) months. Preoperative BCBVA was 0.382±0.147 (corrected posture), 0.300±0.056 (AHP); foveation time was (0.594±0.011)s;position of null zone was 23.570°±0.118°. The BCBVA at three months after operation was 0.318±0.044 (corrected posture), 0.260±0.045 (AHP); foveation time was (0.950±0.146)s; position of null zone was 5.360°±1.107°. The BCBVA at six months after operation was 0.264±0.039 (corrected posture), 0.230±0.037 (AHP);foveation time was (1.496±0.233) s; position of null zone was 6.070°±1.303°. The BCBVA at twelve months after operation was 0.309±0.039 (corrected posture), 0.250±0.045 (AHP);foveation time was (1.455±0.201) s; position of null zone was 9.290°±8.520°. There was statistical difference between the data of pre-operation and post-operation(all P<0.05). Change of null zone position was identified in six patients after six months.The preoperative NAFX of patients with presence of change of null zone positon was 0.308±0.063 (the primary position), 0.393±0.210 (null zone); BCBVA was 0.450±0.043 (corrected posture), 0.417±0.031 (AHP); foveation time was 0.122 (0.080-1.014)s. The postoperative NAFX of those patients was 0.430±0.090(the primary position), 0.471±0.140 (null zone); foveation time was 0.438(0.170-1.450) s. The data above were lower than that of patients with no regression of null zone[0.523±0.142,0.601±0.110,0.200±0.063,0.250±0.076,0.725(0.230-1.440)s,0.610±0.160,0.680±0.120,0.975(0.380-2.000)s]. The difference was statistically significant(all P<0.05). Conclusions: Null zone shifting surgery is an effective approach for treating INS. Reduction in the null zone position can be observed in some patients at 6 months after operation, which was related to NAFX, BCBVA and foveation time. It is recommended to extend the follow-up time to at least 6 months after the operation. (Chin J Ophthalmol, 2019, 55:13-19).

One-year Clinical Evaluation of Retention Ability and Anticaries Effect of a Glass Ionomer-based and a Resin-based Fissure Sealant on Permanent First Molars: An In Vivo Study.

ABSTRACTAimTo evaluate and compare the retention ability, anticaries effect and marginal discoloration when sealed with a glass ionomer-based sealant (Fusion i-seal) and a resin-based fissure sealant (Helioseal-F) on permanent first molars.Materials and methodsCaries free, fully erupted permanent first molars of 50 children between 6 years and 8 years were sealed with pit and fissure sealants under rubber dam isolation. Glass ionomer-based sealant was applied on a permanent first molar and the contralateral molar with resin-based sealant. The sealants were evaluated at regular intervals for a period of 1 year. Statistical analysis was done by Chi-square test.ResultsHigher retention rates were noted for resin-based sealant (88%) compared to glass ionomer-based sealant (78%). None of the teeth sealed with resin sealant developed caries whereas 2% of teeth sealed with glass ionomer sealant developed caries. Marginal discoloration was not noted in teeth sealed with glass ionomer sealant whereas slight marginal discoloration was noted for 6% of teeth sealed with resin sealant.ConclusionClinically a difference was noted in the retention rate, anticaries effect and marginal discoloration whereas statistically no significant difference was noted for the two sealants after 1 year.Clinical significancePit and fissure sealants are highly effective and economical in preventing occlusal caries in young permanent tooth with low failure rate.How to cite this articleMathew SR, Narayanan RK, Vadekkepurayil K, et al. One-year Clinical Evaluation of Retention Ability and Anticaries Effect of a Glass Ionomer-based and a Resin-based Fissure Sealant on Permanent First Molars: An In Vivo Study. Int J Clin Pediatr Dent 2019;12(6):553–559.

A Clinical Evaluation of Effect of Positional Change of Mini Implant on Intrusion of Maxillary Incisors - A Randomized Clinical Trial

Introduction: A true maxillary intrusion is always a challenge for orthodontists. There are number of methods of incisor intrusion. Mini Implant assisted incisor intrusion is gaining popularity in recent years. We conducted this research to evaluate and compare the effect of different implant positioning on amount and rate of intrusion, axial and labiolingual inclination of incisors, amount of external apical root resorption of incisors.&#x0D; Materials &amp; Method: A prospective, double-blind, randomized clinical study was designed consisting of 30 adult or-thodontic patients, aged 25 and above. The subjects were divided into two groups (Group A-15 patients where mini-implant was placed between two maxillary central incisors below ANS, Group B -15 patients where mini- implant was placed distal to maxillary lateral incisor). Amount of intrusion and change in axial inclination was measured on OPG, labiolingual inclination was measured on Lateral cephalogram, IOPA was taken to observe EARR. The intragroup comparison of pre treatment and post treatment changes were done using Wil-coxon signed rank test, where as the intergroup comparison between Group A and Group B were compared using Mann Whitney U test.&#x0D; Result: Statistically significant 3D changes of both central and lateral incisors were seen when continuous intrusion forces were applied from implant placed distal to lateral incisors. Whereas true intrusion with minimal (non significant) axial and labiolingual inclination changes were seen with forces applied through implant placed in the midline. 80 grams of light continuous forces brought about rapid tooth movement with no side effects such as tissue irritation and EARR.&#x0D; Conclusion: Mini implant placed below ANS leads to true en-mass intrusion of four maxillary incisors while intrusion carried out with implant placed distal to lateral incisors bilaterally have 3D changes on all four maxillary incisors.

Evaluation of Clinical and Histologic Effects of High-Dose Radiosurgery on Rat Dorsal Root Ganglion

Stereotactic radiosurgery (SRS) is an effective technique to create lesions of the trigeminal nerve to treat refractory trigeminal neuralgia. In the lumbar spine, the dorsal root ganglion (DRG) contains the body of the sensory neurons responsible for pain sensitivity. Neuromodulation of the DRG might therefore improve chronic peripheral pain. This study was performed to determine the feasibility, clinical, and histologic effects of delivering high-dose SRS targeted to the lumbar DRG in a rat model. Four Sprague Dawley male rats underwent 80 Gy maximum-dose single-fraction SRS to the left L5 and L6 DRG using the Leksell Gamma Knife Icon (Elekta, Atlanta, Georgia, USA). The right L5 and L6 DRGs served as controls. The animals were evaluated for motor and sensory deficits every 2 weeks and were sacrificed at 3 and 6 months after SRS. Common histologic techniques were used to assess for fibrosis and demyelination at the target levels. No detectable motor or sensory deficits were seen in any animal. Histologic changes including fibrosis and loss of myelin were noted to the left L5 and L6 DRGs, but not the right side control DRGs. Fibrotic changes within the vertebral body were also evident on the treated sides of the vertebral bodies. We were able to detect a demyelinating response from SRS delivered to the DRG in rats. Because such changes mimic those seen after trigeminal SRS in experimental animals, we hypothesize that radiosurgery may be a potential option in chronic spinal radicular pain amenable to neuromodulation.

Analysis of therapeutic efficacy and treatment model of interventional treatment in hepatic hemangiomas with poor blood supply

Objective To analyze the efficacy and complications of interventional treatment in hepatic hemangiomas with poor blood supply, and to explore the mode of treatment. Methods From May 2013 to October 2016, at Tianjin Third Central Hospital, 82 patients with hepatic hemangiomas with poor blood supply were enrolled and divided into intervention group, puncture group and combination group. Conventional hepatic artery intubation was performed in intervention group, using a microcatheter to superselect to hemangioma and injecting pingyangmycin-lipiodol emulsion into the tumor of hemangioma. Patients of puncture group underwent the ultrasound-guided percutaneous liver puncture, and the pingyangmycin-lipiodol emulsion was injected into the tumor. The patients of combination group first received intervention treatment, and the pingyangmycin-lipiodol emulsion were injected again into the tumor area lacking of iodized oil deposition through percutaneous transhepatic puncture. After treatment, the complications and clinical efficacy of patients in three groups were evaluated and the reasons of patients lost to follow-up were analyzed. The analysis of variance, Chi-square test and Fisher′s exact test were performed for statistical analysis. For patients lost to follow up, intention-to-treat (ITT) analysis and per protocol (PP) analysis were used. Results Among 82 patients with hepatic hemangiomas with poor blood supply, there were 27 in intervention group, 24 in puncture group and 31 in combination group. Seven patients developed serious complications such as liver failure. At three months after the treatment, the overall efficacy of combination group (20.9%, 9/31) was higher than that of intervention group (7.4%, 2/27) and puncture group (4.2%, 1/24), and the differences were statistically significant (χ2=6.296, P=0.014; χ2=5.622, P=0.031). At six months after the treatment, the overall efficacy of combination group (ITT analysis 70.3%, 26/37; PP analysis 71.0%, 22/31) was still higher than that of intervention group (40.9%, 9/22) and puncture group (7/18), and the differences were statistically significant (ITT analysis χ2=4.929 and 4.969, PP analysis χ2=4.789 and 4.851; all P<0.05). At twelve months after the treatment, a total of 41 patients of three group were lost. Among them, the patients with ineffective treatment by clinical effect evaluation accounted for 63.4% (26/41), which was higher than those with significantly effective treatment (12.2%, 5/41) and those with effective treatment (24.4%, 10/41), and the differences were statistically significant (χ2=22.873 and 12.676, both P<0.01). Conclusions The efficacy of the interventional treatment alone for hepatic hemangiomas with poor blood supply is poor and the complications should be considered when selecting the appropriate treatment methods. Key words: Liver hemangioma; Poor blood supply type; Treatment model; Analysis of therapeutic effect; Psychological factor

Evaluation of Clinical Effects and Tolerability of Cefepime in Hospital Settings in Bangladesh

Background: Cefepime a parenteral fourth generation cephalosporin is active against many Gram-positive and Gram-negative organisms. The study aimed to evaluate the effectiveness and tolerability of cefepime when used alone or in combination with other antibiotics for the treatment of infections in hospital settings in Bangladesh.&#x0D; Methods: This multi-centric, prospective observational study enrolled eligible males and females &gt;18 years who had been prescribe cefepime as a part of treatment strategy regardless of the purpose of hospitalization. No therapeutic intervention was implied rather treatment strategy and dosage of cefepime was on individual physician’s discretion as per routine clinical practice. Percentage of patients who would have clinical success in terms of cure, improvement or failure was evaluated during the end of cefepime therapy. Patient’s overall tolerability to cefepime therapy as excellent, good, satisfactory and poor was considered for safety assessment. The outcome analysis was done in patients’ available follow-up at the end of therapy.&#x0D; Results: A total of 1000 patients were enrolled in this study between March 2013 and September 2014 in different hospital settings of Internal Medicine, Coronary Care Unit, Orthopedic, Intensive Care Unit, Surgery and Nephrology (51.6%, 17.8%, 15.2%, 11.6%, 2.2% &amp; 1.6%). The mean (±SD) age of patients was 50.1 (±14.7) years (range 18-100) and 64.3% were males. Bacteriology or culture sensitivity report was available with 67 patients at baseline and most common microorganisms were E coli (35.8%), Pseudomonas sp. (20.8%), Klebsiella sp. (16.4%), Staphylococcus sp. (11.9%) and Streptococcus sp. (7.4%) and others (7.4). Cefepime was used as medical or surgical prophylaxis in 52.2% of the patients. In 47.8% of patients cefepime was prescribed for treatment of infections including lower respiratory tract infections, trauma / fracture related wound infections, urinary tract infections, treatment of gangrene and septicaemia (39.7%, 31.8%, 10.9%, 9.2% &amp; 8.4%). The dose of cefepime was 500 mg to 2 gm twice or thrice daily with the mean (±SD) duration of 6.1 (±2.1) days (range 2-14). 55 patients were lost to follow-up at the end of therapy and 25 died due to congestive heart failure, renal or hepatic failure and multiple organ failure. On physicians end of therapy overall clinical outcome evaluation, 70.7% of the patients were cured, 24.9% improved and 4.4% had no improvement or worsening in the sign and symptoms. Overall tolerability of cefepime was good in 56.6 %, excellent in 28.7%, satisfactory in 9.8% and poor in 4.9% of patients. No non-serious adverse event was reported in this study. Nonetheless, the 25 death cases would be considered as serious adverse events.&#x0D; Conclusion: Cefepime therapy in different indications was effective in hospitalized patients for cure (67.5 %) or improvement (26.9 %) of sign and symptoms. It was also well tolerated in 85.3% of patients as assessed by the treating physicians&#x0D; J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 17-24

A3464 The clinical effect and contrast evaluation of office blood pressure,ambulatory blood pressure mornitoring on treatment of Yinxu-Yangkang type of primary hypertensives by TCM of Tianma Gouteng Yin

Objectives: To observe the clinical curative effect and contrast evaluation of office blood pressure,ambulatory blood pressure monitoring on treatment of Yinxu-Yangkang type of primary hypertensives by TCM of Tianma Gouteng Yin. Methods: Total of 106 cases of Yinxu-Yangkang type of primary hypertension patients diagnosed by CBP and ABPM were randomly selected to take Tianma gouten Yin with 150 ml (tid) for 4 weeks, Then, the clinical curative effect, changes in CBP and 24 hours ABP were compared. Results: The clinical symptoms of patients were improved significantly and side effects were less; The DBP reducing at night was not significant difference (p > 0.05);All of blood pressure variability, nocturnal blood pressure drop rate and heart rate were not significant difference before and after treatment (p > 0.05); ***All of 24-hour average blood pressure, daytime and nighttime (only SBP) mean blood pressure,daytime and nighttime (only SBP) blood pressure load values had significant difference (p < 0.01 or p < 0.05) before and after treatment (p < 0.01 or p < 0.05);The office blood pressure is higher than the mean ambulatory blood pressure after treatment. Conclusion: It had better improving efficacy of clinical symptoms and tolerability, and less side effects in treatment of hypertension patients byTianma gouten Yin; The reasons and possiblities of lower antihypertension effect for DBP in nighttime of Tianma gouten Yin on ambulatory blood pressure may be follows:The evidence of dose-effect relation of evidence-based medicine is still short of; blood drug concentration is not easy to keep constant in nighttime;or the bioavailability is differences obviously. To explore some new taking ways of traditional Chinese medicine in treatment of hypertension are necessary.

Clinical effect and safety of pulsed radiofrequency treatment for pudendal neuralgia: a prospective, randomized controlled clinical trial.

Pudendal neuralgia is an intractable pain related to the pudendal nerve. The clinical effect and safety evaluation of pudendal neuralgia were investigated by pulse radiofrequency (PRF) treatment of pudendal nerve. Eighty patients who were diagnosed with pudendal neuralgia were randomly divided into PRF group (PRF and pudendal nerve block [NB]) and NB group. After surgery, the patients were followed up to evaluate the visual analog scale (VAS) score and the Patient Health Questionnaire score on the postoperative day and at 2 weeks, 1 and 3 months. Meanwhile, the patients' efficacy assessment and the usage of pain medication were also recorded for 3 months during follow-up. All the surgical complications were recorded. A total of 77 patients were followed up, 38 in the PRF group and 39 in the NB group. On the postoperative day, the VAS scores was significantly decreased in both groups than before (P<0.01), whereas there was no statistical difference within the two groups (P>0.05). However, the VAS score of PRF group was significantly lower than that of NB group in 2 weeks, 1 and 3 months after surgery, respectively (P<0.01). In the meanwhile, the Patient Health Questionnaire score of PRF group was also significantly lower than that of NB group (P<0.01) in 3 months after the operation. The clinical effective rate of PRF group was 92.1% in 3 months after surgery, while this rate was only 35.9% in the NB group. The postoperative analgesic usage of PRF group was superior to that of NB group (P<0.01). No severe adverse events were observed in either group. Compared with the single NB treatment, pudendal nerve PRF combined with NB therapy could provide more long-lasting relief from pain symptoms of pudendal neuralgia and improve the depression symptoms in patients.

Effects of minimally invasive plate-screw internal fixation in the treatment of posterior pelvic ring fracture.

Effects of minimally invasive plate-screw internal fixation and sacroiliac joint screw fixation in the treatment of posterior pelvic ring fracture were compared. Continuous selection of 20 cases of unstable pelvic posterior ring fractures, according to indications of operation, were divided into a group of 13 cases of plate-screw internal fixation and a group of 7 cases of sacroiliac joint screw fixation, and the operation effect and complications were compared. The comparisons of operation time, amount of radiation exposure, intraoperative blood loss, length of incision, partial load and full load time, and complications between two groups were carried out, and there were no statistically significant differences (P>0.05). The evaluation of clinical effects (based on the Majeed pelvic functional scoring criteria) and the evaluation of anatomic effects (based on Matta and Tornetta scoring criteria) between the two groups were compared, there was no statistically significant difference (P>0.05). Minimally invasive plate-screw internal fixation and sacroiliac joint screw fixation in the treatment of the posterior pelvic instability fracture both have indications and their therapeutic effects are equally matched.

Clinical application and effect evaluation of gastric catheter guide device with apparent vision difficulty

Objective To explore the method of gastric tube placement in patients with severe visual difficulties. Methods A total of 100 patients with difficult gastric tube placement were selected as the observation group, and retrospectively analyzed 100 patients with difficult gastric tube placement were selected as the control group.The two groups of patients were placed into the gastric tube using different methods.The patients in the observation group were given homemade guide device under open vision, and the patients in the control group were given direct intubation under larygoscope.By comparing the success rate of disposable catheterization, catheterization time, incidence of adverse reactions, changes in hemodynamics, and family members' satisfaction with catheterization in the two groups of patients, the reasonable catheterization method of difficult gastric catheterization in critically ill patients was discussed. Results The success rate of one-time catheterization in the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was lower than that of the control group, and the catheterization time was less than that of the control group. Conclusion The success rate of home-made catheterization is high, which can shorten the time of catheterization, reduce the incidence of complications and adverse reactions.It is suitable for difficult gastric tube placement. Key words: Insertion of gastric tube; Difficult gastric tube placement; Homemade guide laryngoscope; Laryngoscopy bright; Tongue falling