Local methylcobalamin injection was not only efficacious in relieving pain, but also appears to be tolerable and a potential choice of treatment for subacute herpetic neuralgia.

Twenty-hertz TENS improved incontinence symptoms and promoted activities of daily living better than 75-Hz TENS. These results will aid future research regarding TENS parameters.

Background Minimally invasive McKeown esophagectomy is an important surgical approach for esophageal cancer. Anastomotic leak is one of its common and serious complications. We assumed that the preoperative risk factors and postoperative indicators would predict or detect anastomotic leak. Methods Between December 2016 and July 2017, patients underwent minimally invasive McKeown esophagectomy were identified and their preoperative variables and postoperative test indicators were recorded. Fisher’s exact test, 2-tailed unpaired t test, nonparametric test and logistic regression were used to compare these datum between patients with or without anastomotic leak (AL). Receiver Operator Characteristic (ROC) curve was used to identify the best cut-off value of drainage amylase concentration for distinguishing anastomotic leak. Results In all the 96 patients included, 12 patients were diagnosed as anastomotic leak by the esophagram. No differences in preoperative variables were observed between patients with and without AL. Patients in AL group appeared to have a lower prealbumin concentration in AL group on POD (postoperative day) 4( P = 0.05), POD 5( P = 0.04), POD 6 ( P = 0.06). Prealbumin concentration cutoff value of 128 g/L on postoperative day 5 is 100.00% sensitive and 50.00% specific for predicting esophageal leaks. Drain amylases levels were higher in patients with anastomotic leak than those without anastomotic leak on POD 3( P = 0.03), POD 4( P = 0.01), POD 5( P < 0.001), POD 6( P < 0.001). The drain amylase cutoff value of 85 IU/L on postoperative day 4 was 75.00% sensitive and 84.00% specific for detecting esophageal leaks; the cutoff value of 65 IU/L on postoperative day 5 was 91.67% sensitive and 80.77% specific. The cutoff of 55/L on POD 6 is 100% sensitive and 86.96% specific. Conclusion Drainage amylase concentration on postoperative days may help to discover anastomotic leak in early stage after minimally invasive McKeown esophagectomy. Prealbumin concentration below 128 g/L on POD 5 might be potential risk factor for anastomotic leak.

Background: Cardiovascular outcomes in clinical trials with type 2 diabetes mellitus (T2DM) patients have shown that glucagon-like peptide-1 receptor agonist can have a beneficial effect on the kidney. This trial aimed to assess the effects of exenatide on renal outcomes in patients with T2DM and diabetic kidney disease (DKD). Methods: We performed a randomized parallel study encompassing 4 general hospitals. T2DM patients with an estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 and macroalbuminuria, defined as 24-h urinary albumin excretion rate (UAER) >0.3 g/24 h were randomized 1:1 to receive exenatide twice daily plus insulin glargine (intervention group) or insulin lispro plus glargine (control group) for 24 weeks. The primary outcome was the UAER percentage change from the baseline after 24 weeks of intervention. The rates of hypoglycemia, adverse events (AEs), and change in eGFR during the follow-up were measured as safety outcomes. Results: Between March 2016 and April 2019, 92 patients were randomized and took at least 1 dose of the study drug. The mean age of the participants was 56 years. At baseline, the median UAER was 1,512.0 mg/24 h and mean eGFR was 70.4 mL/min/1.73 m2. After 24 weeks of treatment, the UAER percentage change was significantly lower in the intervention group than in the control group (p = 0.0255). Moreover, the body weight declined by 1.3 kg in the intervention group (the difference between the 2 groups was 2.7 kg, p = 0.0001). Compared to the control group, a lower frequency of hypoglycemia and more gastrointestinal AEs were observed in the intervention group. Conclusion: Exenatide plus insulin glargine treatment for 24 weeks resulted in a reduction of albuminuria in T2DM patients with DKD.

Objective. This study explored the 10-year efficacy, safety, and prognostic factors of low-dose collagenase chemonucleolysis (CCNL) combined with radiofrequency (RF) in the treatment of lumbar disc herniation (LDH). Methods. The data of 167 LDH patients were collected. Modified MacNab criteria, Numerical Rating Scale (NRS), and Japanese Orthopedic Association (JOA) scores were, respectively, used to evaluate patients’ excellent and good rates, pain degree, and nerve function. The preoperative and 10-year postoperative patients’ pain, numbness, and muscle weakness were compared. Patients’ complications in perioperative period, recurrent/reappeared LDH, and reoperations were recorded. Finally, the independent risk factors affecting the long-time efficacy were assessed. Results. A total of 126 patients were included. The patients’ excellent and good rates were 86.51%–92.86% with no significant difference P > 0.05 . Postoperative NRS and JOA scores significantly improved P < 0.01 , most obvious within 6 months postoperatively. At 10 years postoperatively, 65.08%, 83.95%, and 93.02% of patients’ pain, numbness, and muscle weakness were completely relieved P < 0.05 . Perioperative complications occurred in three patients with the rate of 2.38%. Recurrent/reappeared LDH patients were 11 with the ratio of 8.73%; nine of them underwent reoperations with the rate of 7.14%. And patients’ probability of fair and poor efficacy at 10 years postoperatively with the course of disease >12 months and the responsibility disc ≥2 were, respectively, 6.005 and 4.227 times that of patients with the course of disease ≤12 months and the responsibility disc = 1 P < 0.05 . Conclusion. The combined treatment is effective and safe in the long term. A course of disease >12 months and responsibility disc ≥2 independently reduce efficacy, and a course of disease >12 months has a more significant impact.

Positive expression of both factors in a biopsy sample requires wider excision to ensure negative margins.

TENS in combination with local cobalamin injection has a significant analgesic effect.

Objective: This study aims to investigate whether there was a collaborative weight-loss effect or other metabolic benefits between low-carbohydrate (LCD) and calorie restriction (CR) on overweight/obese subjects from South China. Methods: We enrolled 290 overweight/overweight adults with similar dietary habits from 13 hospitals in different areas of South China. Participants were randomly assigned into four diets for 12-week intervention, including normal diet, low-carbohydrate diet, calorie-restricted diet and calorie-restricted combined with low-carbohydrate diet. Covariance in quasi-factorial design was used to calculate the major effect as well as collaborative effect between low-carbohydrate and calorie restriction. Results: A total of 259 participants completed the study for 12-week intervention. Participants in CR+LCD group lost weight by 7.99±3.57 kg, which was most significantly among 4 groups (P&lt;0.001). Similarly, the results of body composition analysis showed that the visceral fat area and body fat rate was improved after intervention, especially in the CR+LCD group (P&lt;0.001). Besides, fatty liver also alleviated substantially compared with control group (p=0.018). In addition, Significant effect of different diet intervention was shown on changes of triglycerides (P &lt;0.001), which decreased by 0.73±1.26 mmol/L in the CR+LCD group. Furthermore, the results of covariance analysis showed no collaborative effects between calorie restriction and low carbohydrates (F=0.004, P=0.950). Conclusions: Although our study indicated that low carbohydrate combined with calorie restricted diet have more significant effect on weight loss, it’s the first time to prove that no collaborative weight-loss effect of low carbohydrate diet and calorie restriction, which may possibly due to the carbohydrate based dietary habits in South China. (Registration number, ChiCTR1800015156). Disclosure J. Sun: None. N. Xu: None. N. Lin: None. P. Wu: None. K. Yuan: None. S. An: None. Z. Zhang: None. Y. Ruan: None. Y. Zhang: None. G. Xu: None. W. Ma: None. Z. Lu: None. X. Chen: None. Q. Huang: None. X. Zhang: None. Y. Li: None. S. Li: None. G. Deng: None. Y. Liang: None. L. Liu: None. H. Chen: None.