Objective To systematically evaluate the effectiveness of N-acetylcysteine (NAC) combined with low-dose glucocorticoid for patients with idiopathic pulmonary fibrosis (IPF). Methods Such databases as The Cochrane Library (Issue 12, 2012), EMbase (January 1974 to July 2012), PubMed (January 1966 to July 2012), CHEST (January 1995 to July 2012), CNKI (January 1994 to July 2012), CBM (January 1978 to July 2012), VIP (January 1989 to July 2012) and WanFang Data (January 1995 to July 2012) were searched to collect the randomized controlled trials (RCTs) about NAC combined with low-dose glucocorticoid versus glucocorticoid alone for IPF patients. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then the meta-analysis was performed using RevMan 5.1 software. Results A total of seven RCTs including 264 IPF patients were included. The results of meta-analysis demonstrated that, compared with the glucocorticoid used alone, a) NAC combined with low-dose glucocorticoid could significantly improve PaO2 (SMD=0.82 mmHg, 95%CI 0.30 to 1.35, P=0.002) and DLco (SMD=0.59 mmHg, 95%CI 0.16 to 1.03, P=0.008) with a significant difference. b) NAC combined with low-dose glucocorticoid could significantly improve all clinical symptoms (RR=1.56, 95%CI 1.26 to 1.92, Plt;0.000 1). Conclusion NAC combined with low-dose glucocorticoid for IPF patients can significantly improve PaO2, DLco, and the clinical symptoms such as cough, difficulty breathing after activities, cyanosis, and Velcro rales. Due to the quantity and quality limitation of included studies, this conclusion still needs to be further proved by more high quality and double blind RCTs.
目的 观察乌司他丁对多发伤患者的治疗作用和对肝、肾功能的保护作用。方法 46例多发伤患者随机分为治疗组（23例）和对照组（23例）。治疗组从入院第1天开始，每天静脉点滴乌司他丁10万单位+生理盐水100 ml，每8 h 1次，连续用药6 d，观察患者的临床指标判断疗效，并在入院时以及术后第1、3、5、7天检测谷丙转氨酶（ALT）、谷草转氨酶（AST）、血尿素氮（BUN）、血肌酐（Scr）、血浆肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）、白细胞介素-6（IL-6）以及白细胞介素-8（IL-8）含量的变化。结果 多发伤患者治疗组平均住院时间及平均住ICU时间均低于对照组，差异有显著性意义（P＜0.05）； 治疗组术后血浆ALT、AST、BUN及Scr浓度均明显低于对照组（P＜0.05）； 治疗组术后血浆TNF-α水平逐渐降低，对照组维持在较高水平； IL-2、IL-6及IL-8水平低于对照组（P＜0.05）。结论 乌司他丁对多发伤有治疗作用，并能减轻机体的全身炎症反应程度，有保护和改善肝、肾功能的作用。
Objective To employ spinal virtual surgery system (SVSS) for preoperative planning of thoracolumbar pedicle screw fixation, and to establ ish the measurement method for pedicle screw-related parameters. Methods Eight thoracicand lumbar spine specimens (T11-L3) were selected. First of all, SVSS was used for the preoperative planning of pedicle screw and the parameters of both sides of pedicle were measured in every vertebral segment, including angle of axial view (Aa), angle of sagittal view (As), x-direction entrance (XE), total pedicle length of axial view (TLa), total pedicle length of sagittal view (TLs), pedicle height (PH), pedicle width (PW), and pedicle spongy width (PSW). Then the corresponding parameters of the right and left pedicle screws of the specimens were measured actually. Finally, its accuracy was verified by comparing the data by virtual measurement and actual measurement. Results There was no significant difference in the parameters of virtual measurement (Aa, As, TLa, TLs, XE, PW, PSW, and PH) and actual measurement (Aa, As, TLa, XE, PW, PSW, and PH) between the right and left sides (P gt; 0.05). Except XE of the L3 vertebral segment and PSW of T11 and T12 vertebral segments (P lt; 0.05), the differences in other parameters of other segments were not significant (P gt; 0.05). Conclusion After statistical analysis and comparison, the feasibil ity of preoperative planning of thoracolumbar pedicle screw fixation and the accuracy of the measurement of the SVSS is verified.
Objective To investigate inpatient disease constitution in Traditional Chinese Medicine (TCM) Hospital of Xinjiang Uygur Autonomous Region from 2008 to 2010, in order to provide baseline data for medicine allocation of hospitals in western China and development of TCM hospitals. Methods A questionnaire combined with a subject interview was carried out, and the case records of inpatients from 2008 to 2010 were collected. The diseases in discharge records were classified according to International Classification of Diseases (ICD-10) based on the first diagnosis. Data including general information of the inpatients, discharge diagnosis etc. were rearranged and analyzed by Excel software. Results a) The top four systematic diseases seen commonly from 2008 to 2010 were as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases were hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. Respiratory system diseases ranked the third in 2009 and 2010 from the fourth in 2008, and circulatory system diseases had ranked the first during the past three years; b) The following diseases as hypertension, bronchial emphysema and other chronic obstructive pulmonary diseases, diabetes, fractures, airway (bronchus, lung) cancer, and viral hepatitis were commonly seen in males rather than in females. By contrast, intervertebral disc disease, gallstone disease and cholecystitis, and anemia were commonly seen in females; and c) Hypertension was commonly seen in the aged above 60 years old; intervertebral disc disease mainly focused on the patients at the age of 15 to 59; and bronchial emphysema and other chronic obstructive pulmonary diseases, airway (bronchus, lung) cancer involved in the patients who were mostly over 60 years old. Conclusion a) The top four systematic diseases seen commonly from 2008to 2010 are as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases are hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. So these diseases should be taken into well consideration when making development plans by hospital and complementing essential drugs list by local development; b) Chronic diseases become the main disease for troubling Xinjiang population; and c) Male and female are susceptible to different diseases which should be rationally avoided in order to prevent the induced occurrence.
目的 研究脑电双频指数（BIS）在小儿麻醉中的应用，为BIS在小儿临床麻醉上的广泛应用及提高小儿麻醉的安全性提供依据。 方法 2011年1月－3月拟行腹部外科手术的患儿60例，男39例，女21例；年龄1～4岁，美国麻醉医师协会分级Ⅰ～Ⅱ级，随机分为两组，每组各30例。S组：七氟醚、瑞芬太尼和维库溴铵维持麻醉；P组：丙泊酚、瑞芬太尼和维库溴铵维持麻醉。采用BIS监测麻醉深度，将BIS控制在50 ± 5，记录麻醉诱导前到手术探查期间不同时点的血流动力学参数及苏醒、拔管时间。 结果 手术过程中P组血压及心率明显低于麻醉前水平（P＜0.05）。S组苏醒迅速、完全，苏醒时间与P组比较差异有统计学意义（P＜0.05）。S组的血流动力学稳定性优于P组，苏醒时间、拔管时间相对较短。麻醉诱导前两组的BIS值均为97 ± 1，意识消失时的BIS值为71 ± 2。BIS值为50 ± 5时，结果显示手术过程中（T4、T5、T6、T7）两组的心率、血压都很平稳。 结论 BIS作为小儿麻醉镇静深度的监测指标有临床意义。
ObjectiveThis study aimed to compare the effects of aerobic training, resistance training, and aerobic training combined with resistance training on blood lipid levels for patients with hypertension using network meta-analysis. MethodsWe searched the CNKI, VIP, WanFang Data, PubMed, Web of Science, The Cochrane Library, and EMbase databases to collect randomized controlled trials (RCTs) on the effects of exercise on blood lipid levels among patients with hypertension from inception to September 16th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Stata 15.1 software and RevMan 5.0 software were then used to perform network meta-analysis. ResultsA total of 29 RCTs involving 2 519 patients were included. Compared with the control group, aerobic training (MD=−0.47, 95%CI −0.62 to −0.319, P<0.001), resistance training (MD=−0.37, 95%CI −0.63 to −0.11, P<0.05), and aerobic training combined with resistance training (MD=−0.61, 95%CI 0.88 to −0.34, P=0.005) reduced total cholesterol levels; aerobic training (MD=0.14, 95%CI 0.08 to 0.20, P<0.001), resistance training (MD=0.10, 95%CI 0.02 to 0.19, P<0.05), and aerobic training combined with resistance training (MD=0.12, 95%CI 0.02 to 0.23, P=0.038) increased high-density lipoproteins; aerobic training (MD=−0.32, 95%CI −0.48 to −0.15, P=0.001), resistance training (MD=−0.19, 95%CI −0.48 to −0.01, P<0.05), and aerobic training combined with resistance training (MD=−0.40, 95%CI −0.70 to −0.11, P<0.05) reduced low-density lipoproteins. The SUCRA probability sorting results showed that aerobic training had the most significant effect on the improvement of systolic blood pressure and diastolic blood pressure; aerobic exercise combined with resistance training had the largest effect on total cholesterol, triglycerides, low-density lipoproteins, and high-density lipoproteins. ConclusionsAerobic training combined with resistance training is the most effective exercise method to improve blood lipid levels for patients with hypertension. Due to the limited quantity and quality of the included studies, the above conclusions are needed to be verified by more high-quality studies.