Improvement of clinical parameters in patients with gastroesophageal reflux disease after radiofrequency energy delivery

AIM:To evaluate the efficacy of Stretta procedure with gastroesophageal reflux disease(GERD)based on symptom control,medication changes and oesophagitis grade.METHODS:Ninety patients with a history of GERD underwent Stretta procedure from June 2007 to March 2010.All patients with GERD diagnosed by the pres-ence of endoscopically evidenced oesophagitis or abnormal esophageal pH testing.We evaluated GERD-health-related quality of life,satisfaction,medication use and endoscopy at baseline,6,12 mo after treatment.Complications of the procedure were analyzed.RESULTS:We found that patients experienced significant changes in symptoms of GERD after Stretta proce-dure.The onset of GERD symptom relief was less than 2 mo(70.0%)or 2 to 6 mo(16.7%).The mean GERD-HRQL score was 25.6(baseline),7.3(6 mo,P<0.01),and 8.1(12 mo,P<0.01).The mean heartburn scorewas 3.3(baseline),and 1.2(12 mo,P<0.05).The percentage of patients with satisfactory GERD control improved from 31.1%at baseline to 86.7%after treat-ment,and patient satisfaction improved from 1.4 at baseline to 4.0 at 12 mo(P<0.01).Medication usage decreased significantly from 100%of patients on pro-ton pump inhibitors therapy at baseline to 76.7%of patients showing elimination of medications or only as needed use of antacids/H2-RA at 12 mo.An improvement in endoscopic grade of oesophagitis was seen in 33 of the 41 patients.All patients had either no erosions or only mild erosive disease(grade A)at 6 mo.CONCLUSION:The experience with Stretta procedure confirms that it is well tolerated,safe,effective and durable in the treatment of GERD.The Stretta procedure provides the drug-refractory patients with a new mini-mally invasive method.

Clinical and laboratory features of COVID-19 patients infected with SARS-CoV-2 variant B.1.1.7 versus those infected with other SARS-CoV-2 strains:A retrospective observational study

Objective:To investigate the clinical symptoms of coronavirus disease 2019(COVID-19)patients with and without B.1.1.7 mutation.Methods:This retrospective observational study included COVID-19 patients who were divided into two groups,the mutation and the non-mutation group.Demographics characteristics,clinical characteristics,laboratory parameters,and mortality rates were recorded and compared between the two groups.Results:A total of 196 patients were included in the study.The relationship between the mutant virus status and sex,age,comorbidity,survival status,and disease severity was not significant(P>0.05).No significant differences were found in duration of hospitalization between the mutation and the non-mutation group(P>0.05).However,there was a statistically significant difference between patients with and without mutant viruses in hemoglobin,mean platelet volume,procalcitonin,low density lipoprotein,iron-binding capacity,potassium,calcium,C-reactive protein,folate,creatine kinase myocardial band,D-dimer,and international normalized ratio(P<0.05).Conclusions:No significant difference is found in mortality rate,disease severity or duration of hospitalization between the patients with and without variant B.1.1.7.Careful monitoring of COVID-19 patients is required for all variants.

Clinical relevance of distolingual roots and periodontal status in mandibular first molars: a cross-sectional study employing CBCT analysis

Objectives:Distolingual root of the permanent mandibular first molar(PMFM-DLR)has been frequently reported,which may complicate the treatment of periodontitis.This study aimed to assess the morphological features of PMFM-DLR and investigate the correlation between the morphological features of PMFM-DLR and periodontal status in patients with Eastern Chinese ethnic background.Materials and methods:A total of 836 cone beam computed tomography(CBCT)images with 1497 mandibular first molars were analyzed to observe the prevalence of PMFM-DLR at the patients and tooth levels in Eastern China.Among them,complete periodontal charts were available for 69 Chinese patients with 103 teeth.Correlation and regression analyses were used to evaluate the correlation between the morphological features of DLR,bone loss,and periodontal clinical parameters,including clinical attachment loss(CAL),probing pocket depth(PPD),gingival recession(GR),and furcation involvement(FI).Results:The patient-level prevalence and tooth-level prevalence of DLR in mandibular first molars were 29.4%and 26.3%,respectively.Multiple linear regression analysis suggested that bone loss at the lingual site and CAL were negatively affected by the angle of separation between distolingual and mesial roots in the transverse section,while they were significantly influenced by age and the angle of separation between distobuccal and mesial roots in the coronal section.Conclusions:The prevalence of PMFM-DLR in Eastern China was relatively high in our cohort.The morphological features of DLR were correlated with the periodontal status of mandibular first molars.This study provides critical information on the morphological features of DLR for improved diagnosis and treatment options of mandibular molars with DLR.

Factors determining delay in relaparotomy for anastomotic leakage after colorectal resection

AIM： To analyze the time interval （‘delay＇） between the first occurrence of clinical parameters associated with anastomotic leakage alter colorectal resection and subsequent relaparotomy. METHODS： In 36 out of 289 consecutive patients with colorectal anastomosis, leakage was confirmed at relaparotomy. The medical records of these patients were retrospectively analysed and type and time of appearance of clinical parameters suggestive of anastomotic leakage were recorded. These parameters included heart rate, body temperature, local or generalized peritoneal reaction, leucocytosis, ileus and delayed gastric emptying. Factors influencing delay of relaparotomy and consequences of delayed recognition and treatment were determined. RESULTS： First documentation of at least one of the predefined parameters for anastomotic leakage was alter a median interval of 4 ± 1.7 d alter the operation. The median number of days between first parameter（s） associated with leakage and relaparotomy was 3.5 ± 5.7 d. The time interval between the first signs of leakage and relaparotomy was significantly longer when a weekend was included （4.2 d vs 2.4 d, P = 0.021） or radiological evaluation proved to be false-negative （8.1 d vs 3.5 d, P = 0.007）. No significant association between delay and number of additional relaparotomies, hospital stay or mortality could be demonstrated.CONCLUSION： An intervening weekend and negative diagnostic imaging reports may contribute to a delay in diagnosis and relaparotomy for anastomotic leakage. That delay was more than two days in two-thirds of the patients.

Pharmacokinetics of Aminoglycosides

The Pharmacokinetics informations of aminoglycosides, their monograph and clinical Pharmacokinetics parameters are reported in this review. The Aminoglycosides are highly polarity and in reserve for serious infections caused by aerobic gram negative bacteria and some gram positive bacteria but their toxicity are major limitations in clinical use.

Therapeutic Efficacy of Quinapyramine Sulphate with Freund＇s Complete Adjuvant in Wistar Rats Infected with Trypanosoma Congolense

Therapeutic efficacy of QS （quinapyramine sulphate） and FCA （Freund＇s complete adjuvant） combination was studied. The aim of the study was to evaluate therapeutic efficacy of QS using FCA in Trypanosorna congolense infection. GrouPs treated with QS and FCA had parasite disappeared in peripheral circulation 2 days pi, relapse was observed one week later. Effect of treatment on rectal temperature shows no significance （p 〈 0.05）, normalization of rectal temperature occurred in QS and FCA treated groups （34.1℃） than untreated （42.8 ℃）, QS （37.4 ℃） and FCA （35.92 ℃） treated groups. Mean body weight was significant （p 〈 0.001） in QS and FCA, QS, and FCA groups. Packed cell volume and hemoglobin concentration for untreated groups were lower, but increased in QS, FCA, QS and FCA treated groups, indicating anemia amelioration. White blood cell counted in untreated, QS and FCA treated groups showed no significance （p 〈 0.05）, however, there was leukocytosis due to lymphocytosis in QS and FCA treated group （6.79 × 10^3/μl） compared with untreated and other groups. There was comparative decrease in serum liver enzymes in QS and FCA treated group than other groups. Therefore, QS at lower recommended dose with FCA may enhance efficacy of QS in trypanosomiasis.