The biological pacemaker has become a new strategy in the treatment of severe bradycardias, in which a kind of ideal pacemaker cells is a pivotal factor. Here we reviewed the progress in the differentiation of bone-marrow mesenchymal stem cells and adipose-derived stem cells into pacemaker-like cells by means of gene transfer, chemical molecules, co-culture with other cells and specific culture media, and we also analyzed the potential issues to be solved when they are used as seeding cells of biological pacemaker.
ObjectiveTo systematically review the accuracy of serum ferritin (SF) for detecting breast cancer. MethodsWe electronically and comprehensively searched databases including CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 5, 2013) up to April 2013, for diagnostic tests about using SF for detecting breast cancer. Four reviewers independently screened literature according to the exclusion and inclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using Meta-Disc 1.4 software and funnel plots were drawn using Stata 12.0 software. ResultsA total of 19 studies were finally included involving 2 977 patients. The results of meta-analysis showed that:Sen, Spe, +LR, -LR, DOR were 0.51 (95%CI 0.48 to 0.53), 0.91 (95%CI 0.89 to 0.92), 5.32 (95%CI 3.72 to 7.60), 0.45 (95%CI 0.35 to 0.57), and 13.22 (95%CI 7.22 to 24.18); SROC area under the curve (AUC) was 0.920 5 and Q* was 0.853 9. Besides, when cut off value was 101-150 μg/L, Sen, Spe, AUC and Q* were the largest, and the best cut-off value was probably 150 μg/L. ConclusionSF has relatively high Sen and Spe in the diagnosis of breast cancer which could not be used as specific index. Heterogeneities exist among the research results, which are possibly associated with researchers, severity of disease, instrument types, sources of reagents, and cut off values. Due to limited quality and quantity of the included studies, the above conclusion should be treated with caution, and in clinic, combing other tumour markers with SF is recommended in detecting breast cancer to augment accuracy.
Objective To explore the effect of total glucosides of Cistanche deserticola on oxidative stress and cognitive function in rats with intermittent hypoxia. Methods Adult male Wistar rats (n=72) were randomly divided into three groups: a blank control group, a 5% intermittent hypoxia group (IH group) and a total glucosides of Cistanche deserticola intervention group (TGs intervention group). The 5% intermittent hypoxia rat model was simulated by using the self-made cabin of intermittent hypoxia. The rats in the IH group and the TGs intervention group were given 5% intermittent hypoxia respectively, and the rats in the TGs intervention group were treated with total glucosides of Cistanche deserticola simultaneously. Learning and memory function was tested by Morris water maze in three groups at the 2nd, 4th, 6th and 8th week respectively. The expressions of superoxide dismutase (SOD) and malondialdehyde (MDA) in hippocampus were detected by test kit. Results Compared with the blank control group, the escape latency time of the rats in the IH group and the TGs intervention group was significantly prolonged at the 2nd, 4th, 6th and 8th week respectively (P<0.05). The time to cross the target quadrant in the IH group and the TGs intervention group was gradually shortened at the 2nd, 4th, 6th and 8th week respectively (P<0.05). Compared with the IH group, the escape latency gradually shortened at the 2nd, 4th, 6th and 8th week in the TGs intervention group (P<0.05), while the time to cross the target quadrant was gradually prolonged at the 2nd, 4th, 6th and 8th week (P<0.05). The expressions of MDA in hippocampal tissue in the IH group and the TGs intervention group increased at the 2nd, 4th, 6th and 8th week (P<0.05), which were significantly higher than those in the blank control group; and the expressions of SOD at the 2nd, 4th, 6th, and 8th week were all lower than those in the blank control group(P<0.05). Compared with the IH group, the expression of MDA protein in hippocampal tissue in the TGs intervention group decreased at the 2nd, 4th, 6th and 8th week, while the expression of SOD protein at the 2nd, 4th, 6th and 8th week increased, and the differences were statistically significant (P<0.05). Conclusion The total glycosides of Cistanche deserticola can improve the learning and memory function of intermittent hypoxia rats by inhibiting oxidative stress.
ObjectivesTo evaluate the reporting status of conflict of interest and economic evidence in Chinese clinical practice guidelines published in 2017 and to provide implications for the guideline development in China.MethodsCNKI, WanFang Data and Google Scholar were electronically searched to collect clinical practice guidelines published in 2017 from January 1st to December 31st, 2017. Two authors independently screened literature, extracted information of interest, such as conflict of interest disclosure and economic evidences, then, the analysis was performed by using the Microsoft Excel 20013 software.ResultsA total of 53 guidelines were included; in which, 14 (26.42%) disclosed conflict of interest, 10 (18.87%) stated sources of funding, and 6 (11.32%) mentioned economics evidence.ConclusionIn China, inadequate attention is addressed to the conflict of interest disclosure and economics evidence during the development of clinical practice guidelines. We propose the inclusion of conflict of interest and economics evidence disclosure in clinical practice guidelines, which will improve their objectivity, independence, and transparency.
Objectives To establish the quality criteria for clinical nursing practice guidelines in China. Methods Two focus groups’ interviews for 26 clinical nursing experts and methodological experts from China were adopted to build the quality criteria for clinical nursing practice guidelines. Results The quality criteria for clinical nursing practice guidelines in China covered 5 domains and 15 items, which included scientificity/rigor, effectiveness/safety, economy, availability/feasibility, and conflict of interest. All items were from 0 to 5 scale and weighted 0.5 to 2 based on their contributions to the quality of guidelines. Conclusions The quality criteria for clinical nursing practice guidelines adopt the same framework with the quality criteria of guidelines in medical field and also integrate features of nursing. It provides the quality standard for Chinese clinical nursing practice guidelines.
ObjectiveTo explore the risk factors of lymph node metastasis in patients with colorectal cancer, and construct a risk prediction model to provide reference for clinical diagnosis and treatment.MethodsThe clinicopathological data of 416 patients with colorectal cancer who underwent radical resection of colorectal cancer in the Department of Gastrointestinal Surgery of the Second Affiliated Hospital of Nanchang University from May 2018 to December 2019 were retrospectively analyzed. The correlation between lymph node metastasis and preoperative inflammatory markers, clinicopathological factors and tumor markers were analyzed. Logistic regression was used to analyze the risk factors of lymph node metastasis, and R language was used to construct nomogram model for evaluating the risk of colorectal cancer lymph node metastasis before surgery, and drew a calibration curve and compared with actual observations. The Bootstrap method was used for internal verification, and the consistency index (C-index) was calculated to evaluate the accuracy of the model.ResultsThe results of univariate analysis showed that factors such as sex, age, tumor location, smoking history, hypertension and diabetes history were not significantly related to lymph node metastasis (all P>0.05). The factors related to lymph node metastasis were tumor size, T staging, tumor differentiation level, fibrinogen, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), fibrinogen/albumin ratio (FAR), fibrinogen/prealbumin ratio (FpAR), CEA, and CA199 (all P<0.05). The results of logistic regression analysis showed the FpAR [OR=3.630, 95%CI (2.208, 5.968), P<0.001], CA199 [OR=2.058, 95%CI (1.221, 3.470), P=0.007], CEA [OR=2.335, 95%CI (1.372, 3.975), P=0.002], NLR [OR=2.532, 95%CI (1.491, 4.301), P=0.001], and T staging were independent risk factors for lymph node metastasis. The above independent risk factors were enrolled to construct regression equation and nomogram model, the area under the ROC curve of this equation was 0.803, and the sensitivity and specificity were 75.2% and 73.5%, respectively. The consistency index (C-index) of the nomogram prediction model in this study was 0.803, and the calibration curve showed that the result of predicting lymph node metastasis was highly consistent with actual observations.ConclusionsFpAR>0.018, NLR>3.631, CEA>4.620 U/mL, CA199>21.720 U/mL and T staging are independent risk factors for lymph node metastasis. The nomogram can accurately predict the risk of lymph node metastasis in patients with colorectal cancer before surgery, and provide certain assistance in the formulation of clinical diagnosis and treatment plans.
Objective To explore the key contents of nosocomial infection prevention and control training for medical staff in secondary and above hospitals, so as to provide scientific basis for training in the future. Methods The medical workers who participated in the training of nosocomial infection prevention and control in secondary and above hospitals of 6 prefecture-level cities in Jiangxi province in December 2020 were selected. The same questionnaire was used to test the participants before and after training, and the changes of scores before and after training were compared. Results A total of 73 medical workers were included. After training, the total scores of the questionnaire (14.13±1.95 vs. 11.27±2.76; t=11.053, P<0.001), scores of manual hygiene specifications knowledge unit (4.63±0.65 vs. 4.02±1.37; t=4.215, P<0.001), scores of hospital isolation technical specifications knowledge unit (4.28±1.05 vs. 3.47±1.29; t=4.895, P<0.001), scores of airborne disease hospital infection prevention and control norms knowledge unit (5.21±0.96 vs. 3.76±1.04; t=10.419, P<0.001) and the overall accuracy of the questionnaire (83.00% vs. 66.32%) were higher than those before training. Conclusions After the training, the accuracies of different topics are improved, but there is still room for improvement in each knowledge unit. More effective training strategies should be considered.
ObjectivesTo investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.MethodsWe conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.ResultsA total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.ConclusionsThis study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.