To analyze the effectiveness of anterior cruciate l igament (ACL) reconstruction with preserving the remnant ACL by allograft l igament. Methods Between January and July in 2008, 97 patients underwent ACL reconstruction with the allograft l igament. On the basis of the ACL’s condition, patients were divided into 2 groups. In the trial group (patients having remnant ACL, n=38), there were 27 males and 11 females with an average age of 24.3 years (range, 16-43 years); of them, 8 cases compl icated by menicus injury and 13 cases by Outbridge I degree cartilage injury; the time from injuryto operation was 3-20 weeks (mean, 8.6 weeks). In the control group (patients having no remnant ACL, n=59), there were 35 males and 24 females with an average age of 27.8 years (range, 18-48 years); of them, 16 cases compl icated by menicus injury and 23 cases by Outbridge I degree cartilage injury; the time from injury to operation was 4-44 weeks (mean, 12.7 weeks). All injuries were caused by sports in 2 groups. All patients had positive anterior drawer test and positive Lackman test. Before operation and 3, 8, 9, 15 months after operation, the function of the knee joint was evaluated by the International Knee Documentation Committee (IKDC) scale and Lysholm score. KT-2000 arthrometer was used to evaluate knee laxity. Results All incisions healed primarily, and no intraarticular infection occurred. Thirty-seven cases and 57 cases were followed up 15 months in the trial group and the control group, respectively. Knee instabil ity disappeared; the patients showed negative anterior drawer test and negative Lackman test. By the evaluation of KT-2000, the joint sl ippage of 2 groups were less than 2 mm at 3 and 6 months after operation, but it was more than 2 mm in 2 cases of the trial group and in 3 cases of the control group at 9 months after operation; and it was no change in the trial group and 2.5-4.0 mm (mean, 3.4 mm) in the control group at 15 months after operation. Both the IKDC scale and Lysholm score were higher in the trial group than in the control group 3 months after operation, but the differences were not significant (P gt; 0.05). Both the IKDC scale and Lysholm score were
In recent years, with the development of positive psychology, resilience has gradually become a research hotspot and has been applied to the study of mental illness. This paper introduced the concepts, theoretical models and measurement tools of resilience, reviewed the level of resilience of patients with bipolar disorder and its related influencing factors, and further research were suggested based on existing problems. It is expected to provide scientific basis for formulating systematic, efficient and personalized interventions for patients with bipolar disorder.
Objective To summarize the current status and progress of treatment for ductal carcinoma in situ （DCIS）. Methods The related literatures on actuality and advancement of treatment for DCIS were searched and reviewed. Results As the increase of incidence， the treatment options for DCIS continued to evolve. Surgical treatment options included mastectomy and breast-conserving surgery. Postoperative radiation therapy in combination with breast-conserving surgery was considered to be the standard for the decrease of local recurrence. The role of endocrine therapy was also being evaluated currently. Conclusions Breast-conserving surgery and combined therapy have became the main methods for treatment of DCIS. Further studies are necessary to determine which subset of patients with DCIS require only surgery alone without adjuvant therapy. Minimally invasive treatment will be a developing direction of DCIS.
This is the seventh paper in the evidence-based medicine glossary series. In this paper, We mainlyintroduced five terms related to meta-analysis——prospective meta-analysis, individual patient data meta-analysis,cumulative meta-analysis, multiple-treatments meta-analysis and meta regression.We also gave some examples to helpreaders better understand and use them.
ObjectiveTo explore the effect of early enteral nutrition (EEN) on immune status of patients in intenseive care unit (ICU). MethodsA prospective control study was conducted from July 2011 to December 2012, and 80 patients after trauma and surgery were admitted to ICU. The Patients were divided into EEN group and normal enteral nutrition (NEN) group randomly. Enteral nutrition in EEN group began within 24 hours after admitted to ICU, while within 48 hours in NEN group. ResultsIn 80 patients, 78(37 in EEN group and 41 in NEN group) completed the end point. The baseline in two groups was consistent (P>0.05). The indicators of lymphocyte, IgA, IgG, IgM and CD4+, CD8+, natural kill cell and pre-albumin values in EEN group were higher than those in NEN group (P<0.05). The incidence of diarrhea (8.1%, 26.8%) and infection of wound (2.7%, 17.1%) in EEN were less than those in NEN group. The hospitalization duration in ICU in EEN group[(7.94±3.72) days] was also shorter than that in NEN group[(10.62±3.14) days]. ConclusionEarly enteral nutrition improves immune function and nutrition status in ICU patients; it also protects gut barrier function and reduces the ICU hospitalization duration.
ObjectiveTo summarize the progress and clinical application of portal vein embolization (PVE). MethodsDomestic and international publications about the PVE were retrieved and reviewed. ResultsPVE could effectively increase the perioperative security when selected at the appropriate time during liver resection surgery. However, there were some disputes on the best choice of the PVE in material, the use of dosage, and the clinical operation method. ConclusionsPVE as a method to induce liver to compensation, has a prominent role in increasing liver subtotal security, and improving the survival rate of patients. But it needs to be researched further to improve technique to promote future liver remnant hyperplasia compensatory faster and better.
Objective The baseline, clinical characteristics, and risk factors were analyzed in the stroke registry program of the Xinjiang Production Constraction Corp’s Hospital aimed to aid the clinical management and stroke prevention. Method A single center prospective method based on Lausanne Stroke Registry was used in this study. Patients generally, past history, living conditions, onset to treatment time, the stroke scale were collected with 1 year follow up. The investigators of follow up were single blinded. Result Eight hundred and ten ischemic stroke patients were included, of which 478 (59.01%) were male, 332 (40.99%) were female. The average age of these patients was 66.50±10.66 years. One year loss rate of follow up was 4.64%. Seven hundred and sixty-nine patients were diagnosis as acute cerebral infarction, 41 patients were TIA. The median time from onset to treatment was 15 hours. Lacunar infarction was the most common type with 334 (43.43%) patients. The average score of the National Institutes of Heath Stroke Scale was 5.55±7.24. The incidence of carotid artery plaque was 82.2%. Conclution Xinjiang region has its own characteristics of stroke with a higher carotid artery plaque rate and thrombolytic therapy ratio. Good stroke registration system could standardize the clinical behavior and promote the continuous improvement of medical quality.
Objectives To investigate the correlation between blood total cholesterol (TC) and prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) and to provide references for clinical treatment and prognosis assessment. Methods We included 232 ISSNHL patients with total deafness in Wenzhou Central Hospital from June 2015 to March 2017 using a prospective cohort design. Recording information including age, gender, hypertension, diabetes mellitus, vertigo, level of blood total cholesterol (TC), level of triglyceride (TG), level of low-density lipoprotein (LDL-C) and LDL/HDL ratio (LDL-C/HDL-C) were collected. Correlation between the prognosis of ISSNHL and blood total cholesterol were analyzed by univariable and multivariable logistic regression analysis. Results The clinical effective rate of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L was higher than that of patients with TC lower than 5.2 mmol/L (univariable: RR=6.49, 95%CI 3.16 to 13.30, P<0.001; multivariable-adjusted covariates: RR=6.15, 95%CI 2.66 to 14.3,P<0.001) with significant difference. No significant difference was found between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (univariable: RR=1.02, 95%CI 0.52 to 2.00,P=0.960; multivariable-adjusted covariates: RR=1.61, 95%CI 0.55 to 4.73, P=0.386). Gender-specific analysis showed for both male and female groups, the effective rates of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L were significantly higher than those of patients with TC lower than 5.2 mmol/L. There was no significant difference between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (P>0.05) in either male group or female group. Conclusion The current study suggests that patients with levels of TC ranging from 5.2 mmol/L to 6.2 mmol/L predicts the best prognosis.
ObjectiveTo do a brief introduction and prospects for simultaneous pancreas and kidney transplanta-tion from aspects of recipient screening, choice of operative method, prognosis, quality of life, and complications. MethodDomestic and international literatures were collected to summary the effect, prognosis, and the latest progress of simultaneous pancreas and kidney transplantation in the treatment of diabetes. ResultsAs a kind of mature treatment of diabetic with end-stage renal disease, simultaneous pancreas and kidney transplantation had been carried out in most transplantation centers around the world, it had the definite therapeutic effect and controllable side effects, the life quality of posttransplantation patients would be improved notably. However, the screen of transplantation patient, the selection of transplantation operation, and the postoperative immunosuppressive protocols had not yet been reached a consensus. ConclusionsSimultaneous pancreas and kidney transplantation is the most effective treatment for type 1 diabetes patients with end-stage renal disease, it provides a more feasible and more physiological way for the secretion of insulin. Although the patient has to undergo a major operation and take some risk, simultaneous pancreas and kidney transplantation still improves the patient's survival rate and the quality of life, and reduces the incidence of complications related to diabetes. Based on the above reasons, simultaneous pancreas and kidney transplantation should be a preferred treatment for all eligible patients.
Risk ratio (RR) and hazard ratio (HR) are two common effect measures in prospective studies. When describing the magnitude of clinical effects in the original study and meta-analysis, they cannot be used interchangeably. Selecting an appropriate measures and interpreting them correctly is critical in clinical research. In this study, we summarized similarities and differences between risk and hazard, compared differences between RR and HR in estimation methods and clinical interpretation. The magnitude of RR and HR estimated from the same studies were compared, and two feasible formulas converting between RR and HR were presented for meta-analysis.