3.Stratified treatment and management of adenomyosis.
Journal of Zhejiang University. Medical sciences 2019;48(2):123-129
In recent years, surgical and non-surgical excision and drug therapy have replaced hysterectomy as the main therapeutic modalities for adenomyosis. It is suggested that the precise clinical diagnosis should be based on the reconstruction of digitized three-dimensional model with original image data of adenomyosis. Patients' age and clinical manifestations should also be considered, and the patients should be stratified according to reproductive requirements, so as to determine the best treatment. In view of the infiltration and diffuse growth of adenomyosis lesions in the myometrium of the uterus, it is suggested that long-term drug management should be adopted after surgical or non-surgical lesion resection.Gonadotropin releasing hormone agonists, levonorgestrel-releasing intrauterine system, dienogest and short-acting oral contraceptives should be recommended to consolidate the curative effect in order to delay the progress of the disease and prevent recurrence.
Adenomyosis
;
diagnostic imaging
;
prevention & control
;
therapy
;
Female
;
Humans
;
Recurrence
4.Clinical analysis of different periods of liver transplantation at an organ transplantation centre.
Ting-bo LIANG ; Shu-sen ZHENG ; Wei-lin WANG ; Dong-sheng HUANG ; Yan SHEN ; Min ZHANG
Chinese Journal of Surgery 2003;41(1):6-9
OBJECTIVETo summarize our clinical experience in liver transplantation while considering the background in this field in China.
METHODSNinety-five patients who had received liver transplantation from April 1993 to March 2002 were analyzed retrospectively. Three periods were defined objectively as period I (1993 - 1997), II (1999) and III (2000 - 2002). Operative techniques, recipients, original diseases, complications and survival rates were compared among the three periods.
RESULTSMalignant liver lesions were the main cause for liver transplantation in period I and II. The ratio of number of malignant disease to total recipients decreased gradually from period I to III (100%, 53% and 35%, respectively). The 1-year survival rate in patients with benign liver disease was 85% and the total operative mortality was 5% in period III. The incidence of hepatitis B virus reactivation or reinfection was 24% twelve months after liver transplantation. Vascular complication decreased but biliary complications did not and remained a major long-standing problem. No veno-venous bypass technique was used in period III, and its advantages were obvious when comparing with those with veno-venous bypass in period I and II.
CONCLUSIONSStrict selection of recipients, fine operative technique, familiarity with various complications and correct therapeutic methods, prophylaxis of recurrence of hepatitis B and hepatocellular carcinoma are necessary to improve long-term results of liver transplantation in China.
Adult ; Female ; Hepatitis B ; prevention & control ; Humans ; Liver Transplantation ; mortality ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Recurrence ; Retrospective Studies
5.Revision endoscopic sinus surgery and combined therapy for recurrent sinusitis.
Liwei ZHU ; Hanqing ZHANG ; Jiongjiong HU ; Liyun YING ; Yingjun SHAN ; Zhenghua ZHU ; Changqing ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2009;23(11):488-490
OBJECTIVE:
To investigate the efficacy of revision endoscopic sinus surgery and combined therapy on recurrent sinusitis and polyps.
METHOD:
Revision endoscopic sinus surgery was performed in 72 patients, of which endoscopic nasal lateral wall dissection was used in 3 cases, the endoscopic frontal sinus surgery (Draf I-II) was used in 16 cases, and all patients received combined therapy including peri-operation conservative management and nasal endoscopy examination during the follow-up period.
RESULT:
All patients were followed up for more than one year. Of 72 patients, 52 patients were successfully cured, 10 patients showed improvement, but there was no change in other 13 patients. The total efficacy rate was 91.67% (66/72). No serious complication occurred.
CONCLUSION
The treatment efficacy can be greatly improved by enough preoperative preparation, fine operation, combined pre-operation conservative therapy and postoperative follow-up.
Adult
;
Aged
;
Endoscopy
;
Female
;
Humans
;
Male
;
Middle Aged
;
Nasal Polyps
;
prevention & control
;
surgery
;
Recurrence
;
Sinusitis
;
prevention & control
;
surgery
;
Young Adult