【摘要】 目的 觀察光子嫩膚合并左旋維生素C導入治療面部黃褐斑的臨床療效。 方法 2008年3月-2009年5月，105例黃褐斑患者隨機分為兩組，治療組53例，用光子嫩膚治療2個療程后用左旋維生素C導入，1次/周，持續2個月；對照組52例，單純使用光子嫩膚治療后進行防曬、護膚治療2個月。 結果 治療組有40例黃褐斑消失，13例色斑明顯減淡；對照組有12例黃褐斑消失，26例色斑明顯減淡，11例色斑減淡，3例無效。兩組療效比較，差異有統計學意義（Plt;0.05）。 結論 光子嫩膚合并左旋維生素C導入治療面部黃褐斑安全、方便、療效好，患者易于接受。【Abstract】 Objective To observe the clinical efficacy of the treatment of facial melasma by intense pulsed light (IPL) photorejuvenation combined with vitamin C. Methods From March 2008 to May 2009, 105 patients with facial melasma were randomly divided into two groups. In the treatment group, there were 53 patients who were treated with vitamin C after IPL photorejuvenation once a week for two months. For the 52 patients in the control group, sunscreen and skin care treatment were carried out after IPL treatment for two months. Results In the treatment group, 40 patients’ melasma disappeared and 13 patients’ melasma dodged obviously. In the control group, 12 patients’ melasma disappeared and pigmentation existed more or less in 40 patients. Conclusion Treatment for facial melasma by IPL photorejuvenation combined with vitamin C is safe, convenient, and have good effect, which can be easily accepted by the patients.
Objective To evaluate effectiveness and safety of electronic choledochoscopy in treatment of intrahepatic bile duct stones. Methods From July 2013 to February 2016, 280 patients with intrahepatic bile duct stones in the Department of General Surgery of the Affiliated Hospital of Shandong Academy of Medical Sciences were selected as the research objects. All the patients were randomly divided into a choledochoscopy treatment group and a conventional treatment group by envelope principle method. There were 140 patients in each group. The safety and short- and long-term effectiveness were compared in these two groups. This study was approved by the ethics committee of the hospital. Results ① The age, gender, body mass index, course of disease, and location of stone had no significant differences in these two groups (P>0.05). ② The operations and the net stones were successfully completed in all the patients. The operative time was shorter, the blood loss was less, the incision length was smaller, the postoperative anal exhaust time was earlier, and the hospitalization time was shorter in the choledochoscopy treatment group as compared with the conventional treatment group (P<0.05). ③ The total postoperative complication rate on day 14 in the choledochoscopy treatment group was 2.9% (4/140), which was significantly lower than that in the conventional treatment group (11.4%, 16/140, P<0.05). ④ The curative excellent and good rates was 97.9% and 85.0% in the choledochoscopy treatment group and conventional treatment group respectively, which was a significant difference in these two groups (P<0.05). ⑤ The postoperative serum ALT and AST values on month 6 in the choledochoscopy treatment group were significantly lower than those in the conventional treatment group (P<0.05). Conclusion Electronic choledochoscopy in treatment of intrahepatic bile duct stones could promote rehabilitation of patient, reduce incidence of postoperative complications, and it is conducive to promoting recovery of liver function and improving follow-up effect.
Objective To summarize the application of double valve ring enlargement combined with mitral Chimney technique (Chimney Commando) in the secondary valve replacement and to analyze the efficacy in the near and medium term. Methods Patients who underwent the secondary aortic valve and mitral valve (double valve) replacement by Chimney Commando in Wuhan Asia Heart Hospital from 2019 to 2022 were included, and their clinical data were retrospectively collected to analyze the safety and feasibility of this procedure in secondary valve replacement of small aortic root patients. Results A total of 49 patients (44 females and 5 males) were included. The body surface area was 1.64±0.17 m2. The time from the first operation was 13.10±5.90 years. Except for 4 patients whose first operation was valvuloplasty, the remaining 45 patients were all patients after valve replacement, 41 patients of double valves replacement, including 39 patients with mechanical valve and 2 patients with biological valve. The majority of the aortic valves were St.Jude regent 19 mm or St.Jude regent 21 mm, accounting for 30.61% and 34.69%, respectively. The mitral valves were predominantly St.Jude 25 mm mechanical valves, making up 65.31%. All patients underwent Chimney Commando double valve ring enlargement, and the mean time of aortic occlusion was 154.00±45.40 min. The mean size of the aortic valve was 23.90±1.40 mm and that of the mitral valve was 28.20±1.20 mm, and the transvalvular pressure difference across the aortic valve was 20.16±5.76 mm Hg at 6 months postoperatively. There was one death during hospitalization due to multi-organ failure. The follow-up time ranged from 1 to 24 months with a median time of 8 months. Two patients were implanted with permanent pacemakers during the follow-up period and 1 patient died due to massive stroke and malignant arrhythmia. Conclusion Chimney Commando is safe and effective in patients with secondary double valve replacement, and the postoperative prosthetic valves have good hemodynamics, and can achieve good clinical results in the near and medium term.