Objective In order to solve the problem of the decreased portal inflow, decreased metabolic function and dangerous varicosity in portal hypertension, a pulsation-type portal pump was prepared and used in the treatmen...Objective In order to solve the problem of the decreased portal inflow, decreased metabolic function and dangerous varicosity in portal hypertension, a pulsation-type portal pump was prepared and used in the treatment experiment of canine model for portal hypertension, which was made by thread embolization in the portal vein. Methods Tow threads which were injected into the two branches of the portal vein would lead to portal hypertension after 2 weeks. A pulsation-type portal pump was made of a silica rubber balloon and a T-shaped silica rubber tube. At the 2 tips of the T-shaped tube, two valves allowed the blood to flow in one direction. Two plates on both side of the balloon made the balloon pulsate constantly. One plate made of stainless steel was fixed on one side of the balloon while the other made of a piece of strong magnetic steel were fixed on the other side. The power was supplied by a low frequency alternating magnetic field that was placed outside the abdomen. The T-shaped tip of the pump was then placed into the portal vein at the point above the major collateral branches. The blood pressure and flow of the portal system and the liver metabolic functions were measured. Results After pump working, the portal blood pressure above the pump increased from ( 2.969±0.412)kPa to (4.802±0.696)kPa, whereas the portal pressure below the pump decreased from ( 3.077± 0.301)kPa to ( 1.764± 0.421)kPa,and the blood inflow of the liver increased from ( 0.270± 0.028)L·min -1 to (0.396±0.025) L·min -1. The pressure of the splenic vein decreased from ( 3.548± 0.392)kPa to ( 2.009± 0.333)kPa and the pressure of the gastric fundal vein decreased from ( 3.459± 0.323)kPa to ( 1.891± 0.461)kPa. The ICGK increased from ( 0.092± 0.009) to ( 0.151± 0.013) while the ICGR 15 decreased from 19.03± 8.50 to 9.04± 2.50.Conclusion The pulsation-type portal pump significantly increased the blood inflow and the metabolic function of the liver, and decreased the blood pressure of the portal system. The design of the pump structure and the power supply were reasonable and skillful. More research work is needed to make the pump to be placed safer and longer.展开更多
BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in ord...BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODS Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD.Clinical prospective or retrospective studies had to explore the impact of medical treatment(s)on the clinical presentation of suspected or confirmed LPRD.The criteria for considering studies for the review were based on the population,intervention,comparison,and outcome framework.RESULTS The search identified 1355 relevant papers,of which 76 studies met the inclusion criteria,accounting for 6457 patients.A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring(MII-pH).The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk.The most used PPIs were omeprazole,esomeprazole,rabeprazole,lansoprazole and pantoprazole with a success rate ranging from 18%to 87%.Other composite treatments have been prescribed including PPIs,alginate,prokinetics,and H2 Receptor antagonists.CONCLUSION Regarding the development of MII-pH and the identification of LPRD subtypes(acid,nonacid,mixed),future studies are needed to improve the LPRD treatment considering all subtypes of reflux.展开更多
The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has bee...The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.展开更多
文摘Objective In order to solve the problem of the decreased portal inflow, decreased metabolic function and dangerous varicosity in portal hypertension, a pulsation-type portal pump was prepared and used in the treatment experiment of canine model for portal hypertension, which was made by thread embolization in the portal vein. Methods Tow threads which were injected into the two branches of the portal vein would lead to portal hypertension after 2 weeks. A pulsation-type portal pump was made of a silica rubber balloon and a T-shaped silica rubber tube. At the 2 tips of the T-shaped tube, two valves allowed the blood to flow in one direction. Two plates on both side of the balloon made the balloon pulsate constantly. One plate made of stainless steel was fixed on one side of the balloon while the other made of a piece of strong magnetic steel were fixed on the other side. The power was supplied by a low frequency alternating magnetic field that was placed outside the abdomen. The T-shaped tip of the pump was then placed into the portal vein at the point above the major collateral branches. The blood pressure and flow of the portal system and the liver metabolic functions were measured. Results After pump working, the portal blood pressure above the pump increased from ( 2.969±0.412)kPa to (4.802±0.696)kPa, whereas the portal pressure below the pump decreased from ( 3.077± 0.301)kPa to ( 1.764± 0.421)kPa,and the blood inflow of the liver increased from ( 0.270± 0.028)L·min -1 to (0.396±0.025) L·min -1. The pressure of the splenic vein decreased from ( 3.548± 0.392)kPa to ( 2.009± 0.333)kPa and the pressure of the gastric fundal vein decreased from ( 3.459± 0.323)kPa to ( 1.891± 0.461)kPa. The ICGK increased from ( 0.092± 0.009) to ( 0.151± 0.013) while the ICGR 15 decreased from 19.03± 8.50 to 9.04± 2.50.Conclusion The pulsation-type portal pump significantly increased the blood inflow and the metabolic function of the liver, and decreased the blood pressure of the portal system. The design of the pump structure and the power supply were reasonable and skillful. More research work is needed to make the pump to be placed safer and longer.
文摘BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODS Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD.Clinical prospective or retrospective studies had to explore the impact of medical treatment(s)on the clinical presentation of suspected or confirmed LPRD.The criteria for considering studies for the review were based on the population,intervention,comparison,and outcome framework.RESULTS The search identified 1355 relevant papers,of which 76 studies met the inclusion criteria,accounting for 6457 patients.A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring(MII-pH).The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk.The most used PPIs were omeprazole,esomeprazole,rabeprazole,lansoprazole and pantoprazole with a success rate ranging from 18%to 87%.Other composite treatments have been prescribed including PPIs,alginate,prokinetics,and H2 Receptor antagonists.CONCLUSION Regarding the development of MII-pH and the identification of LPRD subtypes(acid,nonacid,mixed),future studies are needed to improve the LPRD treatment considering all subtypes of reflux.
文摘The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.
