ObjectiveTo systematically review the efficacy and safety of simvastatin and its different doses in the adjunct therapy of chronic obstructive pulmonary disease (COPD).MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on adjunct therapy of simvastatin in patients with COPD from inception to May 15th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; then, meta-analysis was performed by using Stata 14.0 software.ResultsA total of 22 RCTs involving 2 377 patients were included. The results of meta-analysis showed that treatment with 20 mg simvastatin could improve FEV1%pred, FEV1/FVC, and reduce inflammatory indexes such as CRP, hs-CRP, IL-8 and TNF-α, while 40 mg failed to improve. Simvastatin could reduce COPD score (CAT), but failed to increase the 6-minute walking distance or alleviate acute exacerbation.ConclusionsCurrent evidence shows that treatment with 20 mg simvastatin can improve pulmonary function, reduce inflammatory index and optimize CAT score in COPD patients, but it cannot increase the 6-minute walking distance and reduce the number of acute exacerbations of COPD. Due to the limited quantity and quality of included studies, the above conclusions are needed to be verified by more high-quality studies.
This study was an interpretation study based on the standard of AGREEⅡ. It analyzed methodological perspective of the International Evidence-Based Recommendations for Focused Cardiac Ultrasound determined by the International Conference on Focused Cardiac UltraSound (IC-FoCUS).
Objective To explore the components of passive movement resistance in the wrist flexor in subjects after stroke, and investigate the correlations between these components and clinical scales such as Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA). Methods From March to August 2017, a cross-sectional study was performed in 15 stroke survivors in the Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University. MAS and FMA were assessed by an experienced physical therapist. Components of passive movement resistance in the flexors of wrist and finger were recorded by NeuroFlexor (Aggro MedTech AB, Solna, Sweden), then the average resisting force in one second ensued the passive stretch at 5°/s was took as peak resisting force (PRF). The PRF between paretic side and non-paretic side was compared. Spearman’s rank correlation was used to test the relation between the components and clinical scales. Results The PRF of the paretic side during the slow passive stretch (5°/s) was significantly higher than that of the non-paretic side [(10.49±1.65) vs. (8.98±1.11) N, P<0.05]. Correlations between MAS and the components/PRF were insignificant (P>0.05). FMA had a significant correlation with neural component of the paretic side (rs=–0.645, P=0.009). Conclusions The higher PRF of slow passive stretch in the paretic side may be attributed to the higher muscle stiffness. Neural component of the paretic wrist is correlated with FMA. These findings could be applied in clinical evaluation of functional performance of the wrist muscle of stroke survivors.
ObjectiveTo explore the clinical efficacy and application significance of continuous irrigation and drainage for intestinal fistula combined with abdominal infection.MethodsClinical data of 62 patients with intestinafistula combined with abdominal infection admitted by Department of General Surgery of The 940th Hospital of The People’s Liberation Army Joint Service Support Force from March 2012 to March 2017 were retrospectively analyzed. All patients were treated with continuous abdominal flushing and drainage after emergency surgery. The duration of peritoneal flushing, antibiotic use, blood picture recovery, fistula healing, and total hospitalization were summarized.ResultsAll 62 patients were treated successfully without death or septic shock. Among them, 49 cases of intestinal fistula were treated with continuous abdominal flushing and drainage, and 13 cases of intestinal fistula were treated by continuous flushing and drainage of the abdominal cavity. There were 6 cases of abdominal abscess, 5 cases of incision infection, 5 cases of pleural effusion, and 2 cases of pulmonary infection after surgery. The continuous abdominal cavity washing time was (45±21) d, antibiotic use time was (14±7) d, blood image recovery time was (16±8) d, the healing time of fistula was (47±24) d, total length of hospital stay was (56±27) d.ConclusionsFor intestinal fistula combined with abdominal cavity infection, peritoneal continuous flushing and drainage is related with curative effect, high cure rate, fewer complications, simple washing equipment, simple technology, lower cost, and convenient nursing, which can create a good condition for the complexity or refractory patients with intestinal fistula, and has a high clinical application significance.
Using the AGREE Ⅱ standard, this paper interpretated from methodological perspective of the Korean Guidelines for Appropriate use of cardiac CT which was made by Korean Society of Radiology and the Korean Society of Cardiology.