Objective To summarize the available clinical research evidence for the treatment of hepatorenal syndrome (HRS). Methods Using the basic methods and principles of evidence-based medicine, we searched and evaluated clinical studies involving the treatment of HRS. Results We found that plasma expansion, vasoconstrictor, transjugular intrahepatic portosystemic shunts (TIPS) and liver transplantation were effective interventions for patients with HRS. Conclusion HRS is a common complication of end-stage liver diseases and the prognosis for patients with HRS is extremely poor. However, due to the small number of clinical trials, small sample sizes and low methodological quality, the strength of the current evidence is limited. Rigorously-designed, randomized, multi-center, large-scale trials on HRS are required.
Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
Objective Vibration response imaging(VRI) is a new lung sound imaging technology.It provides quantitative lung data（QLD） of vibration in respiratory system.The study is to explore the value of QLD in diagnosis of obstructive lung diseases.Methods The QLD of 61 chronic obstructive pulmonary disease（COPD） patients，58 asthma patients and 64 healthy volunteers were reviewed.The QLD were transferred to abnormity and variation by a formulation and were analyzed.Results The mean QLD of healthy volunteers were 8.4，14.5，22.0，11.1，18.5，25.5 with mean abnormity as 10.0 and mean variation as 2.0.The mean QLD of the COPD patients were 11.6，16.7，21.9，12.6，17.2，20.1 with mean abnormity as 47.1 and mean variation as 10.9.The mean QLD of the asthma patients were 12.8，17.2，19.9，13.3，17.5，19.3 with mean abnormity as 58.1 and mean variation as 12.2.The abnormity and variation of the patients were different from those of volunteers（Plt;0.05）.When abnormity≥20.0 or variation≥5.0 was define as threshold value，the specificity was 87.5%.The diagnosis sensitivity for COPD is 82.0% and sensitivity for asthma is 82.8%.Conclusion COPD and asthma patients can be detected by quantitative lung data from vibration response imaging.
Objective To summarize the available clinical research evidence on gliquidone for treating diabetes mellitus. Methods The clinical research on gliquidone for diabetes mellitus was systematically searched and appraised. Result Six randomized controlled trials and eleven controlled clinical trials were identified. The methodological quality of most papers about gliquidone for diabetes mellitus was poor. Currently, clinically patient-related endpoints as outcome measures and health economic analyses are lacking in this field. Conclusions Based on the available evidence, gliquidone appears specifically applicable to elderly diabetic patients with kidney diseases. More methodologically sound and patient-related endpoints and economic analyses based on clinical research are required.
Objective To summarize the available clinical evidence on the treatment of non-proliferative diabetic retinopathy (NPDR). Methods Based on the basic methods and principles of evidence-based medicine, we searched and evaluated the NPDR-related evidence from the Cochrane Library(Issue 3,2007), PubMed (1966 to June 2007) and CBM(1979 to June 2007) Results We finally identified 1 systematic review and 20 randomized controlled trials. Clinical evidence showed that critical glycemic control and blood pressure control were essential in the treatment of NPDR, which might delay the progression of retinopathy. The effectiveness of other therapeutic measures needed to be further investigated. Conclusion NPDR is the early stage of diabetic retinopathy (DR). Relevant systematic reviews and high-quality randomized controlled trials have confirmed the effectiveness of critical control of blood glucose and blood pressure for NPDR. The effectiveness of other therapeutic measures needs to be confirmed by systematic reviews of high quality and rigorously designed randomized, multi-center and large-scale trials.
Objective Based on the methodology of evidence-based medicine, we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidence of type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer fromspontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.
Objective Neuron purification is essential to procedure of various nerve cell experimental research, however, at present there is few reports on the effect of various factors on neural axons during purification. To find out a simple method of neuron purification, and to investigate the influence factors of corresponding purification culture in dorsal root gangl ion (DRG) tissue culture on β3-tubul in positive axon. Methods The DRGs were obtained from the 3 days neonatal SD rat microscopically and were made into cell suspension. Then, the amount of attached DRG neurons and non neuronal cells in poly-D-lysine (PDL) group, PDL/Laminin (PDL/LN) group and collagen-I (Col I) group was observed from 10 to 100 minutes. Then, the extension and arborization of β3-tubul in positive axons were observed after 72 hours completely randomised DRG tissue culture for the research of the influences among culture substrates (PDL, PDL/LN, and Col I), FBS (0, 5%, and 10%), 5 fluorouracil (5-Fu, 0, 20, and 40 μmol/L), and cytrarabine (Ara-C, 0, 10, and 20 μmol/L). Results Adherent cells were observed instantly after inoculation by inverted phase contrast microscope and inverted fluoresence microscope; after cell suspension was removed, adherent growth of DRGn cells and non-DRGn cells were still seen. In PDL group, the amount of NSE negative cells was significantly higher than that of NSE positive cells at 10 and 30 minutes (P lt; 0.05); the amount of NSE positive cells was significantly higher than that of NSE negative cells at 80, 90 and 100 minutes (P lt; 0.05). In PDL/LN gruop, there was no significant difference (P gt; 0.05) in the amount of NSE negative cells and NSE positive cells at 10, 20, 30, 40, and 50 minutes; the amount of NSE positive cells was significantly higher (P lt; 0.05) than that of NSE negative cells at 60, 70, 80, 90, 100 minutes. In Col I group, the amount of NSE negative cells was higher than that of NSE positive cells at 10-40 minutes, but showing no significant difference (P gt; 0.05); the amount of NSE positive cells was significantly higher (P lt; 0.05) than that of NSE negative cells at 70-100 minutes. At 72 hours after DRG tissue culture, the best result of β3-tubul in positive axon extension and arborization was obtained when the substrate level was PDL/LN, and the average length of PDL/LN level was significantly larger than that of other two substrates (P lt; 0.05). The highest number of β3-tubul in positive axon distal end was obtained at 5% concentration level of FBS (P lt; 0.05), but showing no significant differences in β3-tubul in positive axon length among three levels (P gt; 0.05). Both the most of β3-tubul in positive axon distal ends and the longest β3-tubul in positive axon average length were obtained at 0 μmol/L concentration level of 5-Fu, showing significant differences between 0 μmol/L level and 20, 40 μmol/L levels (P lt; 0.05). A similar result of β3-tubul in positive axon distal end was got at the 0 μmol/L level and 10 μmol/L level of Ara-C, which was significantly higher than that of 20 μmol/L level (Plt; 0.05). Conclusion? A purified DRG neuron suspension for neuron culture could be obtained via PDL differential attachment for 30 minutes. When DRG neuron culture, neuron special medium, PDL/LN substrate and 10 μmol/L Ara-C are recommended in β3-tubul in positive axon research.
目的：探讨3D网塞在腹股沟疝修补术中的应用。方法：随机选取30例腹股沟疝患者用3D网塞行无张力疝修补术。结果：本组平均手术时间35 min，平均术中出血15 mL。术后8~24 h下地活动，均未给镇痛药，无手术死亡、无切口感染、阴囊血肿等并发症，患者局部舒适性好，异物感不明显，随访5~10个月，无一例复发。结论：使用3D网塞作为充填式疝修补材料具有手术创伤小、恢复快，患者局部舒适性好，复发率低等优点。
Objective To explore the interventions for traumatic floating knee. Method We retrospectively analyzed the data of 32 patients with traumatic floating knee. The following-up time is 6 to 22 months with average time of 11 months. Result All the followed-up patients got bone union. One patient was with plate revealed, 2 patientss were infectious, 2 patients were with lock pin broken. According to Floating Knee Damage Limb Function Evaluation Scale produced by Karlstrom, 21 patients were excellent, 6 were good, 4 were fair and one was poor, and the excellent and good rate was 84.3%. Conclusion Operation for traumatic floating can recover the alignment and stability of lower limber, recover knee function and reduce complication.
ObjectiveTo investigate the effect of jejunostomy combined with Ivor-Lewis or McKeown operation on the treatment of middle and lower esophageal cancer.MethodsThe clinical data of 127 patients with middle and lower esophageal cancer admitted to our hospital from June 2018 to October 2019 were retrospectively analyzed, including 89 males and 38 females, aged 62.82±8.65 years. The patients were divided into an Ivor-Lewis group (IL group, 72 patients) and a McKeown group (MK group, 55 patients) according to surgical methods. Patients in the IL group received jejunostomy combined with Ivor-Lewis operation, and patients in the MK group received jejunostomy combined with McKeown operation. The operation time, postoperative bedside electrical impedance tomography (EIT) parameters, postoperative inflammatory factor levels, postoperative complications and rehabilitation of the two groups were compared.ResultsThe operation time (262.65±49.78 min vs. 303.04±60.13 min), postoperative eating time (10.54±2.22 d vs. 11.47±2.49 d) and postoperative hospital stay (14.78±2.47 d vs.15.72±2.36 d) in the IL group were significantly shorter than those in the MK group (P<0.05). The blood loss (156.13±52.43 mL vs. 158.87±48.47 mL) and the number of lymph node dissection (29.47±8.88 vs. 30.17±9.80) in the IL group were less than those in the MK group, but the differences were not statistically significant (P>0.05). The repeated measurement analysis of variance showed that the time point could significantly affect tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-8 levels (Ftime point=520.543, 272.379, 147.688, all P<0.05), but the surgical methods and the interactive effect of time point and surgical methods did not affect the levels of TNF-α, IL-6 and IL-8 (P>0.05). Postoperative bedside EIT image parameters were statistically different on the postoperative 1 d, 3 d, 5 d and 7 d between the two groups (P<0.05). Compared with the MK group, the incidences of recurrent laryngeal nerve injury, arrhythmia, pulmonary infection and atelectasis, anastomotic leakage, gastric wall necrosis and stump fistula, secondary thoracotomy and abdominal hemostasis, and intestinal obstruction were lower, but the differences were not statistically different (P>0.05). The recurrence rate of patients in the IL group within 6 months was lower than that in the MK group, but the difference was not statistically significant (8.33% vs. 9.09%, P>0.05).ConclusionJejunostomy combined with Ivor-Lewis or McKeown surgery have equivalent effects on patients with middle and lower esophageal cancer.