Objective To investigate the protective effects of ulinastatin on acute lung injury ( ALI)induced by seawater drowning in rats. Methods Thirty male SD rats were randomly divided into three groups, ie. a control group, a model group, and an ulinastatin treatment group. The rats in the model group and the ulinastatin treatment group received intratracheal artificial seawater ( 4 mL/kg) instillation. Then the ulinastatin treatment group received ulinastatin ( 100 000 U/kg) injection after infusion of seawater while the model group received an injection of same amount of saline. The rats were sacrificed at 4 hours after instillation. The pathological changes of lung were evaluated by hematoxylin-eosin stain under light microscope. Lung wet/dry weight ratios were measured to assess the level of pulmonary edema.Concentrations of tumor necrosis factor ( TNF) -α, interleukin ( IL) -1β, IL-6, and IL-10 in bronchoalveolar lavage fluid ( BALF) were detected by enzyme-linked immunosorbent assay ( ELISA) . The myeloperoxidase activity in lung tissue homogenates were measured by colorimetric method. Results Ulinastatin treatmentsignificantly relieved the decline of PaO2 and lung pathological changes, inhibited myeloperoxidase activity,and reduced lung wet/dry weight ratios. Ulinastatin also inhibited the release of TNF-α, IL-1β, and IL-6,whereas increased the expression of IL-10 simultaneously. Conclusion Ulinastatin attenuates seawater induced ALI, which may be related to its inhibitory effects on inflammation reaction through regulating cytokine secretion.
ObjectivesTo evaluate the effects of physical exercises on the vision of students in China.MethodsTrials of the effects of physical exercises on students' vision were retrieved in databases of CNKI, WanFang Data, VIP, Web of Science, EBSCO, PubMed and The Cochrane Library from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was carried out with RevMan 5.3 and Stata 13.0 software.ResultsA total of 8 studies including 681 students in the experimental group and 679 in the control group were included. The results of meta-analysis showed that physical exercises were beneficial to improving students' vision (SMD=1.02, 95%CI 0.90 to 1.13, P<0.000 01). The results of subgroup analysis showed that physical exercises in the elementary school students group (SMD=1.361, 95%CI 0.873 to 1.850, P<0.000 01), long period (>24 weeks) (SMD=1.502, 95%CI 0.984 to 2.019, P<0.000 01), medium frequency (3 times/week) (SMD=1.631, 95%CI 1.022 to 2.240, P<0.000 01), and short time (<90 min) (SMD=1.410, 95%CI 0.758 to 2.062, P<0.000 01) had superior results.ConclusionsPhysical exercises have beneficial effects on improving vision. Limited by quantity and quality of subjects, the above conclusions requires verification by more high-quality studies.
Objective To analyze the factors influencing day surgery developing towards same-day surgery, and provide a reference for the promotion of same-day surgery. Methods A questionnaire on influencing factors of same-day surgery was prepared based on structural equation modeling (SEM), including 6 dimensions and 23 items. From January to October 2021, at the Day Surgery Center of West China Hospital, Sichuan University, the random sampling method was used to select the research subjects for a questionnaire survey, and SEM was used to analyze the factors impacting the iterative development of day surgery to same-day surgery service model. Results A total of 200 questionnaires were distributed, and 192 valid questionnaires were recovered, with an effective recovery rate of 96.0%. The Cronbach’s α coefficient of the questionnaire was 0.857, and the Cronbach’s α coefficient of each dimension was from 0.832 to 0.934. The KMO test value was 0.822, and the result of Bartlett sphericity test was χ2=4568.330, P<0.001. The model fit indexes met the standard requirements well. The result of SEM revealed that the standard path coefficients of “the hospital’s preliminary preparation for day surgery developing towards same-day surgery” impacting “the guarantee system related to surgical quality and safety”, “the guarantee system related to surgical quality and safety” impacting “the public’s awareness of day surgery developing towards same-day surgery”, “the guarantee system related to surgical quality and safety” impacting “the ‘hospital-community’ integrated collaboration network”, “the public’s awareness of day surgery developing towards same-day surgery” impacting “the ‘hospital-community’ integrated collaboration network”, and “the ‘hospital-community’ integrated collaboration network” impacting “the iterative upgrade of day surgery” were all larger than 0.5, indicating strong influences between these factors, but the absolute value of standard path coefficient of the “hospital’s development brought by the transform of day surgery to same-day surgery” impacting “the guarantee system related to surgical quality and safety” was smaller than 0.3. Conclusion The hospital’s preliminary preparation, the guarantee system related to surgical quality and safety, the development of the “hospital-community” integrated collaboration network, and the public’s awareness are the probable factors influencing the iterative development of day surgery to same-day surgery.
The International Society on Thrombosis and Hemostasis (ISTH) recently released the first ISTH guideline for antithrombotic treatment of COVID-19, which provides recommendations on anticoagulant and antiplatelet agents for patients with COVID-19 in different clinical settings. The target audience includes clinicians in internal medicine, intensive care, infectious diseases, hematology, vascular medicine, residents, family physicians, and other health care providers providing inpatient or outpatient care to COVID-19 patients. This article interprets the important parts of ISTH guideline.
ObjectivesTo analyze the metrological characteristics of hypertension-related clinical trials registered on Chinese Clinical Trial Registry (ChiCTR), and discuss the characteristics and developmental trends of hypertension clinical trials registration in China.MethodsChiCTR were searched to collect hypertension-related clinical trials from inception to March 25th, 2018. The characteristics of registered trials were analyzed.ResultsA total of 135 registered trials were included, in which the trials from Beijing, Guangdong, Jiangsu, Chongqing and Shanghai accounted for 55.5%. 115 trials were pre-registered. The top three funding sources were from finance (32, 23.7%), self-financing (25, 18.5%) and hospital (20, 14.8%), respectively. Of all 79 randomized controlled trials, 55 were blank/missing in the entry of blinding method.ConclusionsThe number of hypertension-related clinical trials in ChiCTR tends to increase, however there are large regional disparities and incomplete, non-standardiazed information in the registration of clinical trials. The relevant departments should increase the publicity on the registration of clinical trials, raise the awareness of registration, and promote the development and registration of high quality clinical trials.
The vigorous development of day surgery is crucial to alleviating the contradiction between supply and demand of medical and health care and improving the efficiency of medical and health resources in China. The current path dependence, policy inertia, and lack of coordination in the development of day surgery have brought a more severe test to the healthy and orderly development of day surgery in China, and the vulnerability in the development of day surgery has also emerged gradually. By examining the positive and negative experiences and lessons learned in the current development of day surgery, from the perspective of “structure-resource-information- society” subsystems, and based on the identification of key competencies in the collaborative development system for day surgery, this article indicates that the day surgery resilience is a composite system composed of spatial resilience, digital resilience, resource oriented resilience, institutional resilience and management resilience, and analyzes the implementation path of day surgery collaborative development system, providing a theoretical basis for the healthy and orderly development of day surgery in China.
Objective To investigate the effectiveness of anterior cruciate ligament (ACL) reconstruction for single bundle rupture using hamstring autograft with preservation of the left bundle. Methods Between March 2005 and May 2009, 20 patientswith ACL single bundle rupture were treated using hamstring autograft with preservation of the left bundle. There were 15 males and 5 females with an average age of 25.5 years (range, 16-43 years). Injury was caused by sports in all the patients. The locations were the left knee in 12 cases and the right knee in 8 cases, including 11 cases of antero-medial bundle rupture and 9 cases of postero-lateral bundle rupture. Ten patients had positive results of anterior drawer test, 8 patients had positive result of Lachman test, and 2 patients had positive results of both tests. The Lysholm score was 67.0 ± 6.2 and International Knee Documentation Committee (IKDC) score was 69.0 ± 7.5. The time from injury to surgery was 1 week to 12 months (mean, 2.8 months). Results All the patients had healing of incision by first intention. Twenty patients were followed up 18.5 months on average (range, 12-36 months). The range of motion of all the knees was more than 130° at last follow-up. The results of both the anterior drawer test and Lachman test were negative in 17patients. The result of anterior drawer test was weakly positive and the result of Lachman test was negative in 2 patients. The result of Lachman test was weakly positive and the result of the anterior drawer test was negative in 1 patient. The Lysholm score and the IKDC score were 91.0 ± 3.7 and 92.0 ± 4.9 at last follow-up, showing significant differences when compared with the preoperative ones (P lt; 0.05). Conclusion ACL reconstruction using hamstring autograft with preservation of the left bundle has satisfactory effects and can partially preserve the proprioceptive sense of the knee, which is beneficial for improving the stability of the knee.
ObjectiveTo analyse the hundred top-cited articles in obstructive sleep apnea hypopnea syndrome (OSAHS), and summarize the development trend of OSAHS research.MethodsWe searched the Web of Science core collection for all published articles on OSAHS or sleep disorders from January 1st, 1992 to May 23th, 2018. The hundred top-cited articles with the most frequent citation were selected. The publication time, country of origin, journal, institution, professional field of corresponding author, funding type, publication type, etc. were analyzed.ResultsThe hundred top-cited articles were published between 1992 and 2013, with 300～5 980 citations and a total of 65 719 citations. The main types of articles were clinical studies (73 articles), reviews (20 articles), guidelines (4 articles) and basic research (3 articles). Fourteen authors published more than one first-author paper, and fifteen authors published more than one articles as corresponding authors. These authors were distributed across 22 subject areas. The most cited country was the United States (60 articles), and the most cited institution was the University of Wisconsin (10 articles). The hundred top-cited articles were published in 31 journals, most of which were cited less than 1 000 times, and a few articles were cited more than 2 000 times.ConclusionsOSAHS has attracted much attention in respiratory medicine, neurology, epidemiology and other fields, and many articles about clinical research types of OSAHS have been cited. In addition, most of the highly cited articles in the OSAHS field come from the developed countries; our country needs to devote more resources to OSAHS research.
ObjectiveTo report an improved classification system of Kümmell’s disease and its clinical application.MethodsBased on CT and MRI, an improved classification system of Kümmell’s disease was proposed in terms of the integrity of sagittal endplate, the integrity of posterior wall of vertebral body, and the degree of vertebral compression. Between January 2011 and March 2018, the improved classification system was used to evaluate and guide the treatment of 78 patients with Kümmell’s disease. There were 13 males and 65 females. The mean age was 69.1 years (range, 54-85 years). The mean disease duration was 4.0 months (range, 1-8 months). The mean T value of bone mineral density was −3.66 (range, −3.86- −3.34).The fractures located at thoracic vertebrae in 47 cases and lumbar vertebrae in 31 cases. According to the modified classification system of Kümmell’s disease, there were 11 cases of type A1, 13 cases of type A2, 2 cases of type A3, 10 cases of type B1, 18 cases of type B2, 4 cases of type B3, 4 cases of type C1, 5 cases of type C2, and 11 cases of type C3. According to the classification results, the patients of types A and B were treated with percutaneous kyphoplasty (PKP), while the patients of type C were treated with PKP or intra- vertebral fixation according to the degree of vertebral reduction. Visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to evaluate clinical efficacy. The heights of the anterior, middle, and posterior edges of the vertebrae and the Cobb angle were measured to evaluate the reduction of the injured vertebrae and the improvement of kyphosis deformity. The complications were recorded.ResultsThe statistical analysis showed that the improved classification system has good consistency. All patients were followed up 12-36 months (mean, 24.3 months). The heights of anterior, middle, and posterior edges of the vertebrae, Cobb angle, VAS score, and ODI of all types of patients at last follow-up showed significant differences when compared with those before operation (P<0.05). After operation, 4 patients of type A2 had different degree of vertebral height loss; 2 patients of type B2, 3 patients of type C1, and 2 patients of type C2 developed asymptomatic bone cement leakage during PKP; 2 patients of type B3 and 3 patients of type C2 underwent percutaneous internal fixation and vertebral augmentation due to bone cement loosening.ConclusionThe modified classification system of Kümmell’s disease can be used to guide treatment of Kümmell’s disease, but the number of clinical application cases is limited, and further application and observation are needed.
The promotion of day surgery has improved the procedure of the traditional inpatient surgery and put forward higher professional requirements for medical quality managers. Therefore, medical institutions need the matching norm of medical documents recording and management. The Medical Affairs Department and Day Surgery Center of West China Hospital of Sichuan University keep exploring and practicing new norm which should be conform with the diagnosis and treatment characteristics of the daytime operation mode to insure medical treatment quality and simplify the writing work of medical documents. This new recording norm of West China Hospital of Sichuan University for day surgery should not only meet the basic requirement of the medical record writing, but also stipulate the content detail and add more assessment rules for records grading. Moreover, the new norm could actively explore the management mode of medical record quality for day surgery. For example, by arranging the medical record quality monitors and arousing the working enthusiasm of clinical department and day surgery center through the (hospital and clinical departments) two-level management mode, the medical record writing process could be normalized, and the quality of medical records could also be well guaranteed.