Recurrence Rate Of Lesions Research Articles

A Review of Linear Lichen Planus Case Reports.

Lichen linear planus is a rare variant of lichen planus that appears as pruritic, polygonal, purple papules in a blaschkoid distribution. This review critically assesses all reported cases of linear lichen planus (LLP) for proposed etiology, clinical and histologic traits, treatment options, and recurrence. A PubMed search from inception through March 2023, followed by article screening and full-text review, identified 51 unique cases of LLP. Data from each case including the sex of the patient, anatomic distribution of lesions, biopsy results, proposed etiology, treatment, and recurrence were recorded. LLP did not show a significant gender or age predilection, most frequently presented unilaterally with pruritus, and involved numerous anatomic regions. Various triggers including metal implants, vaccinations, infections, malignancy, and pregnancy were identified. The most common histopathologic descriptions included band-like lymphocytic or lichenoid infiltrate, basal liquefactive, vacuolar degeneration, hypergranulosis, hyperkeratosis, civatte or colloid bodies, melanin incontinence, and orthokeratosis. Treatment options, duration of treatment, and recurrence rate of LLP lesions were variable. Although LLP is rare, dermatologists should be aware of this presentation and appropriate diagnostic and treatment options because swift diagnosis can reduce patient morbidity.

Efficacy of interventions for cutaneous squamous cell carcinoma insitu (Bowen's disease): A systematic review and meta-analysis of proportions.

Cutaneous squamous cell carcinoma insitu (Bowen's disease) is a precancerous condition confined to the epidermis of the skin. Despite the critical need for effective interventions to halt its progression, there remains a notable shortage of comprehensive data comparing the efficacy of various therapeutic approaches. This systematic review and meta-analysis endeavour to compare the different efficacies of interventions by investigating and synthesizing data from numerous trials. A pre-defined protocol was registered in PROSPERO (CRD42021242224, registration date: 16 April 2021). Systematic searches in Medline, Embase and Central, along with manual trial register searches, identified studies reporting lesion clearance rates (LCR), participant clearance rates (PCR) or recurrence rates (date of last search: 12 June 2024). Quality assessment followed guidelines from the National Heart, Lung, and Blood Institute (NHLBI). After the study arms were categorized into treatment groups and groups of study quality, the proportions were pooled using the generalized linear mixed model (GLMM) as meta-analytical method. A comprehensive inclusion of 71 studies facilitated an evaluation of 3783 lesions for LCR, 1225 patients for PCR, 4073 lesions for lesion recurrence rates (LRR) and 740 patients for participant recurrence rates (PRR). Surgery demonstrated the highest LCR and PCR (0.97, 95% confidence interval (CI): 0.90-0.99) and the lowest LRR (0.04, 95% CI: 0.02-0.07). This study provides a thorough overview of reported efficacy outcomes for practice-relevant interventions for Bowen's disease. Surgery outperformed other treatments for Bowen's disease. For the other intervention groups, it was not possible to show clear differences in effectiveness: LCR, PCR, LRR and PRR showed various treatment rankings, and the comparability was restricted by different numbers of studies between treatment groups and outcome measures, methodical and clinical heterogeneity. Further high-quality studies are needed to investigate practice-relevant interventions for Bowen's disease.

Presurgical Mapping With Ultra-high Frequency Ultrasound of Hidradenitis Suppurativa Lesions Treated With Wide Local Excision and Secondary Intention Healing.

Hidradenitis suppurativa (HS) is a challenging chronic inflammatory condition often requiring surgical intervention, such as wide local excision. Preoperative mapping with ultra-high frequency ultrasound (UHFUS) enables detailed assessment of lesion extension, particularly identifying tunnels and fistulas, facilitating surgical planning. This study aimed to analyze recurrence rates of HS lesions previously mapped with UHFUS and treated with wide excision and secondary intention healing. A retrospective single-center study enrolled 40 patients with HS undergoing wide excision surgery after UHFUS mapping. Patients were assessed weekly until complete healing and then every 3 months, evaluating clinical and sonographic signs of relapse and pain using the visual analogue scale. Results showed a population predominantly composed of women (65%) with a mean age of 39 years and a medium HS-Hurley score of 2.5. Over a 22-month follow-up, only 10% experienced clinical relapse, achieving an 90% total remission rate. Pain scores decreased significantly from Week 0 to Week 4. The study highlights the clinical challenge of HS management, particularly regarding surgical planning and lesion margin definition. The remission rate observed in this study suggests the effectiveness of UHFUS-guided surgical approaches. Future studies should extend observation periods to further validate these findings.

Effective treatment of actinic keratosis on the hands with red light photodynamic therapy using BF-200 ALA

BackgroundAcral actinic keratosis (AK) lesions are considered difficult to treat, and published data for photodynamic therapy (PDT) on these lesions is limited. Thus, we evaluated sustained efficacy, safety, and satisfaction after PDT for AK on the hands. MethodsWe analysed subgroup data for treatment on the hands from a randomised, double-blind, intra-individual phase III study. All participants previously underwent up to two field-directed red light PDTs with 10 % 5-aminolevulinic acid nanoemulsion gel (BF-200 ALA). Assessments included pain during PDT, clearance and recurrence rates, and satisfaction. Results24 participants treated on the hands were included; 21 participants were analysed. Complete clearance rates with BF-200 ALA were 90.9 % (lesion-based) and 76.2 % (per participant's side), both markedly higher than with vehicle. The lesion recurrence rate with BF-200 ALA was 29.0 %. Adverse events reflected the mode of action. Mean pain intensities were 4.8 ± 3.8 (BF-200 ALA) and 0.8 ± 2.1 (vehicle) on an 11-point numeric rating scale. Most participants (81.0 %) rated their satisfaction with BF-200 ALA as very good or good. ConclusionThis subgroup analysis indicates that PDT with BF-200 ALA provides a suitable treatment for AK lesions on the hands.

Advances in thoracic consolidation radiotherapy after first-line immunotherapy combined with chemotherapy for extensive stage small cell lung cancer

Small cell lung cancer (SCLC) accounts for about 13%~17% of primary bronchial lung cancer. Due to its rapid growth rate, aggressive behavior, early metastasis and poor prognosis, about 70% of patients were diagnosed with extensive-stage (ES) disease. Although most ES-SCLC patients are sensitive to initial chemotherapy, local recurrence and distant metastasis develop in the short term. Immunotherapy has brought the dawn to overcome it. At present, immune checkpoint inhibitor combined with chemotherapy has become an important strategy as first-line therapy for ES-SCLC. Nevertheless, patients are still at a high risk of chest lesion recurrence after initial systemic therapy. Whether the addition of thoracic consolidation radiotherapy (TRT) can reduce chest lesion recurrence rate remains to be determined. In this review, we summarized the latest research progress in the mode of first-line chemotherapy combined with immunotherapy followed by TRT in ES-SCLC, aiming to provide reference for clinical practice.

Pregnancy outcomes in infertile patients with endometrial hyperplasia with or without atypia undergoing in vitro fertilization: the early-follicular long protocol is superior to midluteal long protocol.

Although in vitro fertilization (IVF) in infertile patients with endometrial hyperplasia is common after drug treatment, the pregnancy outcomes are often unsatisfactory. Till date, no studies have reported the outcome of patients with endometrial hyperplasia treated using early-follicular long (EL) protocol and midluteal long (ML) protocol. To evaluate the pregnancy outcomes and disease prognosis of patients with endometrial hyperplasia with or without atypia undergoing IVF treatment with EL protocol or ML protocol. This was a retrospective study in university-affiliated reproductive medical center. A total of 138 patients with endometrial hyperplasia undergoing IVF treatment were included to compare the pregnancy outcomes and disease prognosis between EL and ML protocols. We further matched 276 patients with normal endometrium to compare the pregnancy outcomes between patients with endometrial hyperplasia and patients with normal endometrium under different controlled ovarian stimulation (COS) protocol. In patients with endometrial hyperplasia, the clinical pregnancy rate (CPR) and live birth rate (LBR) were significantly higher in EL protocol than in ML protocol (61.8% vs. 43.5%, P=0.032; 50.0% vs. 30.6%, P= 0.022). In the ML protocol, patients with endometrial hyperplasia had significantly lower CPR and LBR than those with normal endometrium (43.5% vs. 59.7%, P=0.037; 30.6% vs. 49.2%, P=0.016). While in the EL protocol, they achieved similar CPR and LBR as patients with normal endometrium (61.8% vs. 69.7%, P=0.232; 50.0% vs. 59.9%, P=0.156). In patients with endometrial hyperplasia, COS protocol was an independent factor affecting clinical pregnancy (adjusted odds ratio [OR] 2.479; 95% confidence interval [CI] 1.154-5.327) and live birth (adjusted OR 2.730; 95% CI 1.249-5.966). After 1-10 years of follow-up, no significant difference was found in the recurrence rate of endometrial lesions between both treatment groups. For patients with endometrial hyperplasia undergoing IVF treatment, the EL protocol is superior to ML protocol, and in the EL protocol, they can achieve similar pregnancy outcomes as patients with normal endometrium.

Management & surveillance of rectal neuroendocrine tumours: a single-centre retrospective analysis.

Rectal neuroendocrine tumours (rNETs) are rare but are increasing in incidence. Current management and surveillance recommendations are based on low-grade evidence. Follow-up practices are often inconsistent and costly. This retrospective study analyses a single-centre's experience with rNETs to assess incidence, management practices, outcomes, and guideline adherence. This is a single-centre retrospective study from Queensland Australia, spanning from 2012 to 2023. Twenty-eight rNET cases met inclusion criteria. Examined parameters included incidence, management, outcomes and adherence to European Neuroendocrine Tumour Society (ENETS) guidelines. R1 resection rate was analysed for associations with resection technique and lesion recognition and recurrence rate was assessed in all patients. This study shows an increasing incidence of rNETs during the study period, reflecting a global trend. R1 resection rate at initial endoscopy was 75%. There was a general lack of advanced endoscopic techniques utilized and poor lesion recognition, however a statistically significant correlation was not established between these factors and an R1 result (P < 0.05). Most patients with an R1 result had subsequent re-resection to render the result R0, however five patients (33%) underwent surveillance with no reports of recurrence on follow-up. Overall, follow-up practices in our cohort were inconsistent and did not adhere to guidelines. rNETs are increasing in incidence, emphasizing the need for standardized management and surveillance. Further training is required for rNET recognition and advanced endoscopic resection techniques. Further research is required to assess long-term outcomes in surveilled R1 cases, understand optimal endoscopic resection techniques and further develop local surveillance guidelines.

Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients

BackgroundTopical photodynamic therapy (PDT) has demonstrated encouraging results in the treatment of oral leukoplakia (OLK). However, data on the clinical efficacy of PDT in Chinese patients with OLK are still limited.MethodsFifty patients diagnosed with OLK were enrolled, including patients with various dysplastic tissues. All patients received topical PDT with 5-aminolevulinic acid (5-ALA) as a photosensitizer. Clinical efficacy was evaluated 4 weeks after treatment. Follow-up was performed every 3 months during the first year and every 6 months during the second year.ResultsThe overall response rate was 68% (34/50): 12% (n = 6) complete and 56% (n = 28) partial responses. Aneuploidy was reduced in the patients with dysplastic lesions. Oral pain and local ulcers developed in 52% of the patients (n = 26). Patients with a long history of OLK including hyperplasia and dysplastic lesions, as well as those with non-homogenous lesions, were more likely to develop pain and ulcer. During follow-up, the recurrence rate of hyperplasia and dysplastic lesions was 32% (n = 16) and the malignant transformation rate of dysplastic lesions was 4% (n = 2). Lesions on the buccal mucosa were associated with recurrence (P = 0.044; OR: 0.108, 95% CI: 0.013–0.915).ConclusionTopical 5-ALA-mediated PDT is an effective treatment for OLK, particularly for homogenous leukoplakia, with few side effects. The buccal mucosa may be a protective factor that can reduce recurrence.

Recurrence and Carcinogenetic Rates of Colorectal Polyps.

to determin the recurrence rate of benign recto-colonic polyps in a 5-year interval, and compare the development rate of intrapolypoid carcinomatous lesions in polypectomized versus nonpolypectomized subjects. a group of 77 patients diagnosed with recto-colonic polypoid lesions during the period 2014-2019 underwent colonoscopy at the time of study initiation and then annually during a five-year interval. Results: The recurrence rate of polyps increased annually from 5 to 12.5%; the highest rate was noted in the last two years. The five-year cumulative risk of neoplastic lesions was 73% in patients without polypectomy and 20% among those with endoscopic resection (p 0.05). Comparing the recurrence rate of benign lesions (60%) in patients without neoplastic findings with the recurrence rate of adenomas in patients with benign lesions (40%), a higher risk of recurrence was found in the first category, and seemed to be influenced by the personal history of pre-existing adenomatous lesions. an increased risk of colorectal polyps recurrence was reported during five year follow up; moreover, during the first three years an increased risk of malignant transformation was observed among cases in which endoscopic resection was not feasible when compared to those in which complete excision was feasible.

A study on the correlation between the prognosis of HPV infection and lesion recurrence after cervical conization.

Persistent human papillomavirus infection is an important factor in the development of cervical cancer, which is usually a long process evolving from the development of squamous intraepithelial lesions (SIL), also referred to as cervical intraepithelial neoplasia (CIN). Local treatment of advanced squamous intraepithelial lesions, also regarded as High-Grade Squamous Intraepithelial Lesion, may be effective in preventing cancer. To promptly identify high-risk patients with a tendency to recurrence. We retrospectively analyzed the clinical data of 300 patients with high-grade squamous intraepithelial lesions of the cervix admitted to the Second Affiliated Hospital of Dalian Medical University from 2019 to 2020 to investigate the relationship between recurrence of cervical lesions and postoperative regression of HPV infection, as well as other related risk factors. We found that the HPV-negative rates were 81.81, 85.71, and 90.91% at 6, 12, and 24 months, respectively, and the average lesion recurrence rate was 8.16%, with a median time to recurrence of 14 months in patients undergoing CKC for HSIL. The risk of cervical squamous intraepithelial lesions was highest in patients with HPV16. Patients over 61 years of age had the lowest postoperative HPV-negative rate. The conversion rate was significantly lower in patients with multiple HPV genotypes than in those with single HPV infection (p < 0.05). The probability of recurrence was higher in patients with the same HPV infection genotype before and after surgery than in patients with different infection genotypes before and after surgery (p < 0.05). Combined with the literature review, we believe that patients aged ≥50 years, with ≥3 pregnancies and births, a history of smoking, and consistent genotypes of preoperative and postoperative HPV infection in cervical conization have more HPV re-infection or persistent infection, and that these factors may be high-risk factors for lesion recurrence. For patients with possible potential high-risk factors, we need to carry out individualized follow-up and focused management, take timely and effective management measures, optimize the treatment plan, reduce the recurrence rate, prevent HSIL and cervical cancer, improve the quality of patient's survival, and improve the prognosis.

P-338 Preliminary results of the DINE Study (Dienogest vs. Norethindrone Acetate in Endometriosis Treatment)

Abstract Study question How do the two-progestin type NETA and dienogest affect on pain and recurrence in patients with endometriosis? Summary answer NETA and dienogest are progestin derivatives that have similar effects on pain and recurrence in treating endometriosis and canbe safely preferred for treatment. What is known already Although surgical treatment significantly improves pain symptoms in endometriosis, it may be associated with significant urinary, intestinal and vascular complications; In addition, postoperative pain and recurrence rates of endometriotic lesions are high. Medical treatment gains importance, and progestins are mainly used in treatment. NETA is one of the most researched progestins for the treatment. It has a good safety profile and efficacy in curing endometriosis-related pain, making NETA a viable medical option among first-line treatments. Study design, size, duration The study was designed as a single-center, prospective, randomized study. Patients were randomly assigned to one of the two treatment protocols, with the single digit 'NETA' and double 'dienogest' according to the last digit of their protocol number. Patient recruitment started in February 2022. The patients were evaluated at 6-month visits for one year. Participants/materials, setting, methods Seventy patients aged 18-40 years were included. Patients with contraindicated progestins and pelvic inflammatory disease were excluded from the study. Demographic data, medical and surgical treatment histories were recorded. Patients were evaluated with detailed physical examination, ultrasound, and laboratory tests. They were questioned because of their chronic pain symptoms, they were asked to give a score between 1 and 10 with the numerical scoring system and recorded. They were re-evaluated at 6 and 12 months. Main results and the role of chance 40 dienogest and 30 NETA patients were included in the study. There were eight patients (one headache, one orthostatic hypotension, five metrorrhagia, one pregnancy request) in the NETA group and 11 patients (1 headache, one decreased sexual desire, one surgery, eight metrorrhagia) in the dienogest group. In the final analysis, 48 patients were included in the study. There was no significant difference between the two groups regarding initial laboratory, ultrasonographic and demographic parameters. (p &amp;gt; 0.5) There was no significant difference between the two groups in dropout rates at six months. (p = 0.65) Dysmenorrhea, dyspareunia, dyschezia, and chronic pelvic pain scores were similar both at the beginning of treatment and at the 6th-month follow-up, and no significant difference was observed in both group. (p &amp;gt; 0.5) Significant improvement was observed in all scores in both groups.(p &amp;lt; 0.001) In the 6th month, the most common side effects in the dienogest group were emotional lability (26%), and metrorrhagia (15%), while the NETA group were metrorrhagia (40%) and weight gain (20%). No significant effect was observed on the lipid profile and bone mineral density at the 6th-month control. Limitations, reasons for caution Our study is the first study in the literature to compare NETA and dienogest in the medical treatment of endometriosis. The strongest aspect is that it is a randomized control study. The small number of study population and the high dropout rates are the limitations. Wider implications of the findings NETA and dienogest are two progestin derivatives that are effective on pain and recurrence in the medical treatment of endometriosis and can be safely preferred for treatment. An analysis of our long-term data and further studies are needed to evaluate which progestin preparation is more effective and safe in treatment. Trial registration number NCT05476172

Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study

This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.

Effectiveness of 730 nm Picosecond Laser for the Treatment of Freckles and Solar Lentigines: A Retrospective Analysis

Background. Freckles and solar lentigines are epidermal pigmentation disorders that affect the face and impact the quality of life of affected individuals. Aims. We aimed to observe and evaluate the clinical effectiveness of a 730 nm picosecond laser for the treatment of freckles and solar lentigines. Methods. We retrospectively collected patient information on freckles and solar lentigines and observed and evaluated the clinical outcome of a 730 nm picosecond laser. These included lesion clearance and recurrence rates, adverse reactions, and patient satisfaction. Results. Fifty cases of freckles and solar lentigines reported between January 1, 2022, and July 1, 2022, were included. All patients received two 730 nm picosecond laser treatments. The lesion clearance rates after one and two treatments were 53.1% and 78.4%, respectively, and the rates after one and six months of treatment were 78.7% and 78.4%, respectively. 90% of the patients reported ≥95% clearance of lesions after six months via a questionnaire survey. Among the patients, 86.0% were satisfied with their treatment. Postinflammatory hyperpigmentation occurred in two patients, both of whom had Fitzpatrick skin type IV. There was no recurrence of lesions. Conclusions. The 730 nm picosecond laser treatment for freckles and solar lentigines has the advantages of a high clearance rate, low recurrence rate, and high patient satisfaction. This trial is registered with ChiCTR2200058573.

Патология верхушки пирамиды височной кости

The review of papers, focused on studying various neoplasms, diagnosis, selection of surgical approach, complications, and recurrence rates of the petrous apex lesions, that have been published in 2008–2022, is provided. Effusion, mucocele, cholesterol granuloma, cholesteatoma are the most common benign lesions of the petrous apex. Such surgical approaches as translabyrinthine, transcochlear, endoscopic endonasal approach and the middle cranial fossa approach are most often used during treatment. The middle cranial fossa approach, infracochlear approach and endoscopic transnasal approach are recommended for patients with preserved hearing. In case of disseminated lesions, when the carotid artery and the jugular bulb should be additionally controlled, transcochlear and translabyrinthine surgical corridors could be used.

Abstract No. 94 Utility of CT-guided coil localization of lung nodules before thoracoscopic surgical resection: a single institution review

To evaluate the utility of pneumothorax creation and chest tube insertion before CT-guided coil localization of non-palpable lung nodules prior to robotic or video-assisted thoracoscopic surgery (RATS or VATS) in terms of the rate of technical success, conversion to completion lobectomy and recurrence rate for malignant lesions

Effectiveness of photodynamic therapy with 5-aminolevulinic acid for Bowenoid papulosis: A retrospective study with long-term follow-up

BackgroundBowenoid papulosis (BP) is a rare infectious skin disease that occurs in sexually active young people. BP is associated with human papillomavirus (HPV)16 and 18 infections, spreads through sexual contact, and tends to become cancerous. Currently, there are different BP treatment methods, and few reports on the efficacy of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) (ALA-PDT).We compared the differences in the clearance and recurrence rates of BP between the ALA-PDT group and other groups, and explored methods to improve clinical effects and reduce lesion recurrence by combining clinical retrospective data. MethodsWe enrolled patients who were diagnosed with bowel papulosis" between January 1, 2009, and December 31, 2020. Patient information, such as ID number, hospitalization number, admission time, name, age, gender, telephone number, admission record, discharge record, outpatient medical history, HPV type analysis, histopathological examination, and treatment plan were recorded. Outcomes were obtained and recorded through outpatient visits, telephone, and online follow-ups from patients who had reached the treatment endpoint. We compared and evaluated the differences in lesion clearance rate, lesion recurrence rate, and patient satisfaction between the ALA-PDT group and other groups using statistical analysis. ResultsThe lesion clearance rate of the ALA-PDT group was significantly higher than that of the control group, the lesion recurrence rate was lower than that of the control group, and patient satisfaction was higher than that of the control group. The lesion clearance rate of the ALA-PDT group was higher than that of the microwave and radiofrequency groups, the lesion recurrence rate of the ALA-PDT group was significantly lower than that of the microwave and radiofrequency groups, and patient satisfaction was significantly higher than that of the microwave and radiofrequency groups. In the lesions of patients with BP, in addition to HPV16 and HPV18 types, other types were also detected, and most of them were mixed types of HPV infection. Age, sex, and duration of disease were not risk factors that affected BP recurrence. ConclusionsALA-PDT for BP has the advantages of high lesion clearance rate, low lesion recurrence rate, and high patient satisfaction. ALA-PDT is worthy of recommendation as a preferred treatment plan for the treatment of BP.

Research Progress in Delayed Bleeding after Endoscopic Submucosal Dissection of Early-Stage Gastrointestinal Cancer

Endoscopic submucosal dissection (ESD) has been widely used in the clinical treatment of early-stage and precancerous lesions of the digestive tract. Compared with traditional open surgery, the procedure has a number of advantages, including low postprocedural recurrence rate, the location and scope of lesions not posing much restrictions on the procedure, and quick patients recovery afterwards. The procedure has hence become one of the minimally-invasive procedures commonly performed with gastrointestinal endoscope. However, due to the influence of various factors, complications such as intraoperative and postoperative bleeding, perforation, electrocoagulation syndrome and lumen stenosis may occur. Delayed postoperative bleeding, in particular, may induce cardiovascular and other related diseases due to the insidious nature of its onset, resulting in serious consequences. It is critically important for the further development of ESD that we should acquire thorough understanding and mastery of the relevant influencing factors and preventive measures of delayed bleeding after ESD of early-stage gastrointestinal cancer. We herein summarized and discussed the latest research findings in the preventative and treatment measures.

Assessment of sinecatechins 10% ointment used as proactive sequential therapy in recurrence rate of genital warts lesions after cryotherapy. The PACT-II Trial (postablation immunomodulator treatment of condylomata with sinecatechins): a prospective assessor-blinded, multicenter, pilot trial.

Cryotherapy is commonly used as ablative treatment of external genital warts (EGW). However, after cryotherapy recurrence of lesions affects on average 45% (42-70%) of subjects in the 6 months after the treatment. Sinecatechins 10% are an effective topical treatment of EGW. A low recurrence rate (<6%) was observed in pivotal phase 3 trials conducted with this product. Topical sinecatechins have demonstrated to significantly reduce the recurrence rate of EGW in subjects treated with laser therapy (The PACT-I trial). So far, no prospective data are available regarding the efficacy of sinecathechins as immunomodulator sequential therapy after cryotherapy in EGW subjects. The purpose of this study was to assess the rate of recurrence lesions after the use of topical sinecatechins 10%, as sequential proactive immunomodulation treatment after cryotherapy in subjects with EGW (The PACT-II Trial: the postablation immunomodulator treatment of condylomata with sinecatechins trial) (Trial Registration number: ISRCTN44037479). In a prospective, assessor-blinded, multicenter trial a total of 55 subjects with a diagnosis of multiple EGW (36 men and 19 women, mean age 47±10 years) and a mean lesion number of 9±7, after their informed consent, were enrolled in the study. All subjects were treated with cryotherapy (an average of 2 sessions). After the ablative treatment, all subjects were instructed to apply sinecatechin 10% ointment 3 times daily for 4 consecutive months. The primary study endpoint was the evaluation (assessor-blinded) of recurrent lesions after 6 months (2 month of follow-up after the conclusion of topical treatment). The secondary study endpoints were the appearance of new EGW lesions (lesions affecting area not treated by cryotherapy) and the local tolerability. At baseline, the mean number of EGW lesions were 9±7. After cryotherapy, the mean lesions number were reduced to 1.6±1.8. At month 4, EGW mean lesion number were 0.2±0.4 (P=0.0001 vs. after cryotherapy). At month 6, recurrence of lesions was detected in 10 subjects (18%; 95% CI: 9-30%) with an average of 1.4 lesions. Of these recurrent lesions, 6 occurred in completely healed lesions site after cryotherapy and 8 in partially healed ones. New lesions (outside the cryotherapy treated area) were observed in 10 subjects. The product was very well tolerated. No serious side effects were reported. Three subjects reported moderate skin irritation on the application site. The PACT-II Trial has shown that the recurrence rate of EGW lesions after successful cryotherapy using sinecatechins as immunomodulator sequential therapy is lower in comparison with the percentage documented in the literature without sequential therapy (20 vs. 45%). These results are in line with already published data evaluating the role of sinecatechins after laser therapy (PACT-I trial). Future comparative, double-blind controlled trials assessing the efficacy of different proactive strategies are warranted.

Long-term outcomes of photodynamic therapy for a positive resection margin after conization for cervical intraepithelial neoplasia grade 3

BackgroundPositive resection margins after conization or loop electrosurgical excision procedure (conization/LEEP) are associated with increased risks of recurrence or residual cervical intraepithelial neoplasia (CIN). Herein, we investigated the long-term outcomes of photodynamic therapy (PDT) for incomplete excision of CIN3. MethodsWe retrospectively reviewed the medical charts of 73 patients treated with PDT between 2000 and 2011. Patients who underwent conization/LEEP before PDT within 6 months were included. The primary outcomes were the complete response (CR) rate after 1 year and human papillomavirus (HPV) eradication rate at 6 months after PDT. ResultsA total of 34 patients with positive resection margins were finally enrolled. The median patient age was 33 years. Carcinoma in situ was diagnosed in 25 patients and CIN3 in 7 patients. The CR rate was 97.1% after 1 year. Except for one case of a persistent disease, there was no recurrence or newly developed disease during the median follow-up of 84 months (range, 12–224 months). The HPV eradication rate of PDT following conization/LEEP after 6 months was 96.9% (31/32). Photosensitivity was identified in five patients and cervical stenosis in one patient. ConclusionsIn conclusion, PDT could be an effective therapeutic option for patients with a positive resection margin after conization/LEEP for CIN3. It could reduce the residual or recurrence rate of CIN lesions with tolerable adverse events.

Efficacy and action mechanism of ZHU Lian inhibition type Ⅰacupuncture for acne with spleen-stomach dampness-heat

To observe the efficacy of ZHU Lian inhibition type Ⅰ acupuncture for acne with spleen-stomach dampness-heat, and to explore its possible action mechanism. A total of 82 patients of acne with spleen-stomach dampness-heat were randomly divided into an observation group and a control group, 41 cases in each group. The patients in the control group were treated with danshentong capsules (1 g, 3 times per day) and 0.1% adapalene gel smear (once every night) for 4 weeks. The patients in the observation group were treated with ZHU Lian inhibition type Ⅰ acupuncture at Hegu (LI 4), Neiting (ST 44), Quchi (LI 11), Yangbai (GB 14), Sibai (ST 2), Qihai (CV 6), Xuehai (SP 10), Yinlingquan (SP 9) and skin lesions, once every other day, 7 times as a course of treatment, totaling for 2 courses of treatment. The skin lesion score of the global acne grading system (GAGS) and quality of life-acne (Qol-Acne) score as well as the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared between the two groups before and after treatment; the clinical efficacy were compared between the two groups, and the recurrence rate was evaluated 4 weeks after treatment. After treatment, the skin lesion scores of GAGS in the two groups were reduced (P<0.05), and the score in the observation group was lower than that in the control group (P<0.05). After treatment, the Qol-Acne scores were increased in the two groups (P<0.05), and the score in the observation group was higher than that in the control group (P<0.05). The serum levels of TNF-αand IL-6 in the two groups were reduced after treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate was 95.1% (39/41) in the observation group, which was higher than 82.9% (34/41) in the control group (P<0.05). Four weeks after treatment, the recurrence rate of acne lesions was 10.3% (4/39) in the observation group, which was lower than 32.4% (11/34) in the control group (P<0.05). ZHU Lian inhibition type Ⅰ acupuncture is effective for acne with spleen-stomach dampness-heat, and the recurrence rate is low. Its mechanism may be related to the reduction of serum inflammatory factor TNF-α and IL-6.