Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injectio...Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.展开更多
AIM: To evaluate the effect of different approaches in the treatment of achalasia in China. METHODS: We performed a systematic review and meta-analysis of Chinese literature by searching the Chinese Biomedical Databas...AIM: To evaluate the effect of different approaches in the treatment of achalasia in China. METHODS: We performed a systematic review and meta-analysis of Chinese literature by searching the Chinese Biomedical Database and Chinese scientific Journals database (up to March 2008). All cohort studies (controlled or uncontrolled) in which the patients were observed for more than a year were reviewed in detail. Dichotomous outcomes were reported as relative risks (RR) with 95% confidence interval (CI) for controlled trials. The efficacy in uncontrolled trials was assessed by a pooled estimate of response rate with individual studies weighted in proportion to the sample size. RESULTS: Seven controlled trials compared the effect of botulinum toxin injection (BoTx) with pneumatic dilation (PD). PD was superior to BoTx [65.2% vs 45.3%; RR 1.47 (95% CI 1.23-1.77), P < 0.0001], and had a lower clinical relapse rate (BoTx 30.2% vs PD 10%, RR 0.32 (0.16-0.65), P = 0.001). Heller myotomy (HM) had superior remission rate compared to PD [HM 94.0% vs PD 64.1%, RR 1.48 (1.15-1.99), P = 0.002]. In uncontrolled trials, the effectiveness of PD was 86.6% (23.9%) vs 94.8% (10.6%) for HM. The main complications of PD were perforation and gastroesophageal reflux disease. CONCLUSION: HM is the most effective long-term treatment for patients with achalasia in China. In the future, controlled clinical trials on the treatment of achalasia should focus on comparing laparoscopic myotomy with or without antireflux procedure,including different partial and total fundoplication techniques.展开更多
Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an...Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an elevated LES pressure, leading to an altered passage of bolus through the esophago-gastric junction. A definitive cure for achalasia is currently unavailable. Palliative treatment options provide only food and liquid bolus intake and relief of symptoms. Endoscopic therapy for achalasia aims to disrupt or weaken the lower esophageal sphincter. Intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides superior results than botulinum toxin injection and a similar mediumterm efficacy almost comparable to that attained after surgery. Per oral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and further objective and long-term follow up. This article will review different endoscopic treatments in achalasia, and summarize the short-term and long-term outcomes.展开更多
文摘Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.
文摘AIM: To evaluate the effect of different approaches in the treatment of achalasia in China. METHODS: We performed a systematic review and meta-analysis of Chinese literature by searching the Chinese Biomedical Database and Chinese scientific Journals database (up to March 2008). All cohort studies (controlled or uncontrolled) in which the patients were observed for more than a year were reviewed in detail. Dichotomous outcomes were reported as relative risks (RR) with 95% confidence interval (CI) for controlled trials. The efficacy in uncontrolled trials was assessed by a pooled estimate of response rate with individual studies weighted in proportion to the sample size. RESULTS: Seven controlled trials compared the effect of botulinum toxin injection (BoTx) with pneumatic dilation (PD). PD was superior to BoTx [65.2% vs 45.3%; RR 1.47 (95% CI 1.23-1.77), P < 0.0001], and had a lower clinical relapse rate (BoTx 30.2% vs PD 10%, RR 0.32 (0.16-0.65), P = 0.001). Heller myotomy (HM) had superior remission rate compared to PD [HM 94.0% vs PD 64.1%, RR 1.48 (1.15-1.99), P = 0.002]. In uncontrolled trials, the effectiveness of PD was 86.6% (23.9%) vs 94.8% (10.6%) for HM. The main complications of PD were perforation and gastroesophageal reflux disease. CONCLUSION: HM is the most effective long-term treatment for patients with achalasia in China. In the future, controlled clinical trials on the treatment of achalasia should focus on comparing laparoscopic myotomy with or without antireflux procedure,including different partial and total fundoplication techniques.
文摘Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an elevated LES pressure, leading to an altered passage of bolus through the esophago-gastric junction. A definitive cure for achalasia is currently unavailable. Palliative treatment options provide only food and liquid bolus intake and relief of symptoms. Endoscopic therapy for achalasia aims to disrupt or weaken the lower esophageal sphincter. Intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides superior results than botulinum toxin injection and a similar mediumterm efficacy almost comparable to that attained after surgery. Per oral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and further objective and long-term follow up. This article will review different endoscopic treatments in achalasia, and summarize the short-term and long-term outcomes.
