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find Author "李雨" 5 results
  • Lamivudine plus Adefovir Combination Therapy versus Entecavir Monotherapy for Lamivudine-resistant Chronic Hepatitis B: A Meta-analysis

    ObjectiveTo systematically review the efficacy of lamivudine (LAM) plus adefovir (ADV) versus entecavir (ETV) monotherapy for LAM-resistant chronic hepatitis B patients. MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 12, 2013), CBM, CNKI, VIP, WanFang Data from their inception to December 2013, to collect randomized controlled trials (RCTs) or cohort studies of LAM+ADV versus ETV for LAM-resistant chronic hepatitis B. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 13 RCTs and 5 cohort studies involving 1 336 patients were included. The results of meta-analyses of RCTs showed that:there were no significant differences between the LAM+ADV group and the ETV group in the negative rates of serum HBV-DNA (RR=1.00, 95%CI 0.91 to 1.10, P=0.94), HBeAg (RR=0.90, 95%CI 0.70 to 1.17, P=0.43), serum ALT recovery rate (RR=0.97, 95%CI 0.90 to 1.05, P=0.45) and serum HBeAg conversion rate (RR=0.71, 95%CI 0.40 to 1.24, P=0.22) at the 48th week. The results of meta-analyses of cohort studies showed that:there were no significant differences between the two groups in the negative rates of serum HBV-DNA (RR=1.37, 95% CI 0.91 to 2.06, P=0.13) and serum ALT recovery rate (RR=0.99, 95%CI 0.87 to 1.12, P=0.87), but the ETV group had higher serum HBeAg conversion rate (RR=0.24, 95% CI 0.07 to 0.79, P=0.02). ConclusionCurrent evidence shows that the efficacy of LAM+ADV is similar to ETV at the 48th week for LAM-resistant chronic hepatitis B patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

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  • Related Research on Mechanical Property of Valve Membrane in Transcatheter Bioprosthesis Valve Based on the Chemical Modification and Cutting Technology

    The aim of this research is to investigate the preparation method of valve membrane in transcatheter bioprosthetic valve, and to study the effect of chemical modification and cutting technology to tensile property and suture force property of valve membrane. We carried out a series of processes to perform the tests, such as firstly to test the crosslinking degree of valve membrane using ninhydrin method, then to test the tensile property and suture force property by using Instron's biomechanical testing equipment, and then to observe the collagen fiber orientation in valve membrane using Instron's biomechanical testing equipment and using field emission scanning electron microscopy. The study indicated that after the chemical modification, the crosslinking degree, tensile strength and suture force strength increasing rate of valve membrane were 93.78%±3.2%, (8.24±0.79) MPa, 102%, respectively. The valve membrane had a better biomechanical property and would be expected to become valve membrane in transcatheter bioprosthesis valve.

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  • 地市级医院建立日间手术中心的探索与实践

    日间手术起步于欧美,近 20 年在我国得到迅速的开展,特别是发达地区的教学医院,相继成立了专门的日间手术中心。通过对国内已开展的日间手术中心的实地考察与研究,德阳市人民医院经过长达 2 年的准备,于 2016 年 6 月 1 日成立了日间手术中心。该文从我国日间手术的发展现状出发,对德阳市人民医院成立日间手术中心的实践过程进行回顾性总结,包括前期择期手术预入院,与市医疗保险管理局联合完成结算报销系统改造和择期手术患者就诊流程改造的回顾,日间手术中心成立过程中遇到相关问题的探索,并对支撑日间手术中心发展密切相关的医疗保险、绩效问题进行研究。

    Release date:2017-04-19 10:17 Export PDF Favorites Scan
  • Effect of Tension Suture on Healing Quality of Incision after Abdominal Surgery: A Meta-Analysis

    ObjectiveTo investigate the effect of tension suture on healing quality of incision after abdominal surgery, and to provide a theoretical basis for reducing post-operative wound complications. MethodLiteratures on the tension suture in the application of abdominal incision were searched from January 2005 to January 2015, and then a Meta-analysis was carried out based on the data obtained from CBM, CNKI, and WanFang database. ResultsEight articles involving 2 001 patients with abdominal surgery, including 1 044 cases in tension suture group, and 957 cases in the conventional suture group, were incorporated. The Meta analysis results showed that, the technique of tension suture could reduce the incidence of post-operative wound infection (OR=0.40, 95% CI: 0.28-0.57, P<0.05), fat liquefaction (OR=0.51, 95% CI: 0.37-0.69, P<0.05), incisional hernia (OR=0.11, 95% CI: 0.04-0.34, P<0.05), wound dehiscence (OR=0.13, 95% CI: 0.07-0.25, P<0.05), and second stage surgery (OR=0.16, 95% CI: 0.09-0.30, P<0.05). But, it would also augment the risk of post-operative skin incision necrosis (OR=15.14, 95% CI: 2.79-82.08, P<0.05). On the other hand, the method of tension suture had no effect on the subcutaneous hemorrhage in the incision area (OR=0.58, 95% CI: 0.30-1.13, P>0.05). ConclusionsCompared with conventional suture, tension suture can reduce the hazard of wound infection, fat liquefaction, incisional hernia, wound dehiscence, and reoperation after abdominal surgery. In contrast, it can also increase the risk of post-operative skin incision necrosis.

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  • Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision

    ObjectiveTo research the effect of different surgical sutures on abdominal surgical incision healing quality, and provide a novel theory basis for promoting the healing of incision of abdominal wall. MethodsTotally 341 patients who underwent laparotomy were collected from general surgery of Affiliated Hospital of North Sichuan Medical College, and they were randomly divided into three groups: the including polydioxanoneⅡ(PDSⅡ) suture group, abdominal wall incision except the skin was successively sutured with PDSⅡsuture; the Vicryl group, abdominal wall incision except the skin was successively suture with antibacterial Vicryl; and the common silk thread group, abdominal wall incision was performed layering intermittent silk suture. ResultsIn terms of suture time, the PDSⅡsuture group [(11.23±1.62) min〕was significantly lower than the Vicryl group [(14.04±1.20) min〕, P < 0.05, and also both were significantly lower than the ordinary silk thread group [(21.95±1.95) min〕, P < 0.05. In respect of rejection reaction, incision infection and incision split, the PDSⅡsuture group and the Vicryl group were significantly lower than the ordinary silk thread group (P < 0.05), but compared the PDSⅡsuture group with the Vicryl group, the differences were not statistically significant (P > 0.05). Regarding post operation hospitalization duration, fat liquefaction and effusion, compared the differences between the three groups were not statistically significant (P > 0.05). ConclusionFull fascia is successively suture with PDSⅡsutures and antibacterial Vicryl suture that can significantly shorten the suture time, reduce the incidence of rejection incision, wound infection and wound dehiscence and promote the postoperative recovery of the patients.

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