ObjectiveTo systematically review the methodological quality of evidence-based guidelines on non-pharmacology management of behavioral and psychological symptoms of dementia, so as to provide references for taking caring for the dementia with behavioral and psychological symptoms. MethodsGuidelines concerning non-pharmacology treatment of behavioral and psychological symptoms were searched from websites of guideline development, websites of medical association and literature databases from inception to May 31st 2016. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences and similarities between recommendations of included guidelines were compared. ResultsA total of 544 literatures were identified and 6 of them were included. All the included guidelines were from abroad. The average scores of guidelines in six domains of AGREE Ⅱ were:scope and purpose 88.89%, stakeholder involvement 65.74%, rigor of development 63.72%, clarity of presentations 86.11%, applicability 50.69%, and independence 37.50%. The overall qualities of the included guidelines were grade B. The recommendations of the included guidelines were almost consistent. Recommended non-pharmacology management of behavioral and psychological symptoms of dementia included leisure and recreation activity, reminiscence therapy, behavioral therapy, training of caregivers, physical environment modification, animal-assisted therapy, massage, physical activity and patient-centered approach. ConclusionThe overall quality of included guidelines is relatively high. More efforts are needed to improve the applicability and independence of guidelines. There is still no local guideline concerning non-pharmacology recommendations on behavioral and psychological symptoms of dementia in China. It is suggested to develop guideline that is suitable for Chinese condition as soon as possible.
On January 7, 2022, the University of Maryland Medical Center reported that the world’s first gene-edited pig heart was successfully transplanted into a 57-year-old man with end-stage heart disease, causing a global attention. The first gene-edited pig heart transplanted into a human successfully survived for 59 d without showing early signs of rejection, creating a history of xenotransplantation and marking a key step forward the clinical development of xenotransplantation. This article focuses on the role of gene editing in alleviating immune rejection, summarizes the case of xenotransplantation at the Maryland Medical Center, and outlines the current status of xenotransplantation and the unresolved issues of xenotransplantation. It is expected that xenotransplantation can successfully enter the clinic in the near future.
目的 观察AQUACEL-Ag®亲水性纤维敷料对肛周脓肿患者术后创面愈合的作用。方法 将49例肛周脓肿术后患者按随机数字表法随机分为试验组（25例）和对照组（24例），分别予AQUACEL-Ag®亲水性纤维敷料换药（1 次/3d）和无菌凡士林纱布换药（1次/d），并观察2组患者的换药时创面疼痛程度、创面愈合时间、创面换药次数、创面愈合率及换药时创面分泌物培养结果。结果 试验组在创面疼痛、愈合时间、创面换药次数及换药时分泌物培养转阴时间方面均优于对照组（P＜0.05）；动态监测创面愈合率：第3d时2组间比较差异无统计学意义（P＞0.05），第9、15、21d时试验组创面愈合率明显高于对照组（P＜0.05）。结论 从本组有限的数据看，AQUACEL-Ag®亲水性纤维敷料对肛周脓肿患者术后创面愈合有重要作用。
Objective To explore predictive value of radiological indexes for hemorrhage in patients with portal hypertension. Methods The clinical data and radiological data of patients with portal hypertension accompanied with hepatitis B from June 2008 to June 2014 in the Nanjing Drum Tower Hospital were analyzed retrospectively. Patients with hepatocellular carcinoma, portal vein thrombosis, or portal hypertension due to other causes, such as autoimmune hepatitis, pancreatitis, or hematological diseases were excluded. Results Ninety-eight patients were studied and subsequently divided into a hemorrhage group (n=57) and a non-hemorrhage group (n=41). There were no statistical differences in the clinical indexes such as the age, prothrombin time, serum albumin, serum creatinine, serum sodium, white blood cell count, and blood platelet count (P>0.05). However, the differences were statistically significant in the serum total bilirubin, hemoglobin, and liver function with theP values of 0.023, 0.000, and 0.039, respectively. For the radiological indexes, the hemorrhage was correlated with the diameter of posterior gastric vein (P=0.028 3) or grading of esophageal varices (P=0.022 1). Logistic procedure was used to construct the model with stepwise selection and finally the diameter of inferior mesenteric vein, diameter of posterior gastric vein, grading of esophageal varices, and diameter of short gastric vein were enrolled into this model. These indexes were scored, the risk of bleeding increased with increasing the points. Then the model was validated with 26 patients with portal hypertension from July 2014 to December 2014, the area under the receiver operating characteristic curve was 0.884 9 by this radiological model. Conclusions A radiological scoring model is constructed including diameter of inferior mesenteric vein, grading of esophageal varices, diameter of posterior gastric vein, and diameter of short gastric vein, which might predict risk of hemorrhage in patients with portal hypertension. However, further protective study of large sample is needed to validate this model.