ObjectiveTo systematically review the clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth.MethodsThe Cochrane Library (Issue 12, 2016), PubMed, EMbase, WanFang Data, CBM and CNKI databases were searched for randomized controlled trials (RCTs) about indirect and direct resin composite restorations in permanent posterior teeth from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsNine RCTs involving 671 patients and 1 012 teeth (544 in indirect restorations group and 468 in direct restorations group) were included. The results of meta-analysis indicated that: there was no significant difference in the overall failure rate between direct and indirect resin composite restorations (RR=0.91, 95%CI 0.52 to 1.58, P=0.73). In further analysing the reasons of failure, there were no significant differences between both groups on fractured restorations (RR=1.71, 95%CI 0.76 to 3.84, P=0.19) and fractured remaining cusp (RR=1.27, 95%CI 0.62 to 2.59, P=0.52). In addition, the secondary caries in the direct composite restorations group was higher than that in the indirect group (RR=0.33, 95%CI 0.13 to 0.85, P=0.02). Subgroup analysis according to molars and premolars restored indicated that there was no statistical difference in the restorations failure rate between two groups.ConclusionThe clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth are equivalent. Due to the limitation of quality and quantity of the included RCTs, the above conclusions are needed to be verified by more high quality and large sample RCTs.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.
Objective To systematically analyze and compare the casualties’ medical evacuation (ME) in Wenchuan and Yushu earthquakes, so as to provide useful references for earthquake casualties’ ME in the future. Methods The data about casualties’ ME in Wenchuan and Yushu earthquakes were collected from the field research, work statement of the Ministry of Health, official websites, and literatures. And the descriptive analysis was then performed. Results From Wenchuan to Yushu, the principle of ME tended to be “early evacuation, all evacuation”; the evacuation level was gradually simplified, the casualties were evacuated directly from the disaster area to the rear hospital through highway and railway, or air evacuation became the major method of ME; triage became less prominent, while specialist treatment was strived as early as possible. Conclusion The early establishment of appropriate evacuation principles, building of a simplified evacuation system, ensuring adequate medical transport capacity, and scientific assessment of treatment capacity at all levels are the main issues of effective and safe ME after earthquakes that require to be solved urgently.
目的 分析主动脉夹层的临床及病理特点。 方法 回顾性分析1998年1月－2011年10月26例主动脉夹层致死的临床及法医尸检病理资料，对其发病、死亡经过、诊断、死因进行总结。 结果 26例主动脉夹层平均发病年龄为39.2岁，男女比例为3.3︰1；26例中6例无临床诊断，17例误诊，3例疑似诊断。26例主动脉夹层中，夹层破裂致心包填塞死亡20例，夹层破裂致失血性休克死亡5例，主动脉夹层未破裂1例系心衰致死；26例按DeBakey分类标准9例为Ⅰ型，14例为Ⅱ型，3例为Ⅲ型。 结论 临床应警惕主动脉夹层的特殊临床表现并采取必要的辅助检查，有助于主动脉夹层的诊治和减少医疗纠纷的发生。
Objective To explore the feasibility and safety of laparoscopic cyst resection and Roux-en-Y hepatojejunostomy in treatment for adult congenital cholangiectasis and to compare the therapeutic effects of laparoscopic procedure with conventional open procedure. Methods The clinical data of 33 adult patients with congenital cholangiectasis from May 2008 to September 2011 in the department of general surgery of Shengjing Hospital of China Medical University were retrospectively analyzed. Fourteen patients received laparoscopic procedure （laparoscopic group），whereas the other 19 patients received conventional open procedure （conventional group）. Results All the operations were carried out successfully through laparoscopic procedure. The mean time of operation in the laparoscopic group was significantly longer than that in the conventional group （195min versus 130min，P＜0.01）. The average intraoperative blood loss in the laparoscopic group was significantly less than that in the conventional group （80ml versus 270ml，P＜0.01）. In contrast，the mean time of bowel peristalsis recovery and postoperative hospital stay in the laparoscopic group were significantly shorter than those in the conventional group （time of bowel motion recovery：76h versus 104 h，P＜0.01；hospital stay：6.1 d versus 9.6 d，P＜0.01）. There were no differences in the early complications between two groups （P＞0.05）. Conclusions Totally laparoscopic treatment for congenital cholangiectasis in adult is feasible and safe. It is worth to be generally applied because of its minimal invasion and fast postoperative recovery.
Objective To evaluate the effects of delicacy management applied in branch health management sub-center. Methods From July 2013 to December 2015, integrated delicacy management was applied throughout the whole process of the preparation for the establishment and the running of the branch health management sub-center. The strengths and weaknesses of the management, the management of the details and the control of the emphasis were analyzed. And the medical visits and incomes after the application of delicacy management were also analyzed. Results From July 2013 to December 2015, the monthly average medical visits were 1 870.17±609.93, 2 842.50±1 247.60 and 3 717.92±1 257.98, while the monthly average incomes were (2 136.0±585.1) thousand yuan, (3 620.5±1 559.9) thousand yuan and (4 921.1±1 837.2) thousand yuan, which increased significantly. Conclusion The application of delicacy management in the branch health management sub-center could ensure the quality of service, promote the steady growth of performance, and improve the understanding of the surrounding population of health management, thus we can improve the economic and social benefits of the health management sub-center.
Objective To investigate the effect of aerobic combined with resistance training on exercise capacity and quality of life in patients with severe or very severe chronic obstructive pulmonary disease (COPD). Methods Thirty patients with severe or very severe COPD were randomly divided into the control group (n=15) and the exercise group (n=15) from January 2011 to January 2013. The control group was given health education and routine drug treatment. The exercise group was given muscle relaxation and 6-week aerobic combined resistance exercise training on the basis of the control group. Pulmonary function, 6-minute walk test (6MWT), 30-second sit-to-stand (30-STS), 30-second arm curl test (30-ACT), Medical Research Council Dyspnea Scale (MRC), COPD Assessment Test (CAT), Beck Anxiety and Depression Scale were performed before and after intervention in both groups. Results After intervention, compared with those in the control group, the 6MWT, 30-STS and 30-ACT in the exercise group increased significantly [(518.44±84.62) vs. (412.93±82.53) m, (24.53±3.98) vs. (16.87±3.91) times, (26.07±3.41) vs. (17.93±3.39) times, P<0.05], while the CAT score, Beck anxiety and depression scores decreased significantly (4.87±3.68vs. 26.10±10.18, 2.47±1.81 vs. 11.50±4.89, 2.27±2.49 vs. 12.20±6.35, P<0.05), and MRC score also decreased significantly [1.0 (1.0, 2.0)vs. 2.0 (2.0, 4.0), P<0.05]. There was no statistical difference in pulmonary function between the two groups before or after intervention (P>0.05). Conclusion Exercise-based pulmonary rehabilitation can significantly improve the treatment outcomes in Chinese patients with severe or very severe COPD.
Objective To compare the effectiveness of three teaching modes, namely traditional teaching, online teaching, and online and offline blended teaching, in the teaching of the clinical nutrition elective course, and to evaluate the advantages of the online and offline blended teaching mode. Methods A total of 316 students taking the clinical nutrition elective course at Sichuan University in one of the three semesters, Fall 2019-2020, Spring 2019-2020, and Fall 2020-2021, were enrolled as the study population. In the offline group, 69 students used the traditional teaching mode; in the online group, 133 students used the online teaching mode through Chaoxing Xuexitong application; in the online and offline blended teaching group, 144 students used the traditional teaching mode combined with the online teaching. The final exam results and questionnaire satisfaction of the three groups were analyzed and compared. The exam results were presented as median (lower quartile, upper quartile). Results The exam results of the online group [males: 88.0 (85.0, 93.0); females: 91.0 (86.0, 94.0)] and the online and offline blended group [males: 90.0 (83.0, 94.0); females: 91.0 (87.5, 95.0)] were significantly higher than those of the offline group [males: 83.0 (77.0, 89.0); females: 77.5 (67.0, 87.0)] (P<0.001). Compared to the offline teaching mode and online teaching mode, the female students’ satisfaction with the online and offline teaching mode was better (P<0.01). Conclusion The online and offline blended teaching mode can significantly improve students’ performance and learning motivation, and provide a basis for promoting the reform of the clinical nutrition elective course.
【Abstract】 Objective To reconstruct three different kinds of tympanic membrane in vitro by tissue engineeringtechnique, and to examine their histological structures and mechanical properties. Methods The skin and dura of pig(weight 30 kg) were processed with high satuated sal ine and enzymes to make extracellular matrix. Meanwhile, fibroblasts(1×106 /mL,0.2 mL) were seeded on the surface of these two scaffolds and collagen. The composite tissues were cultured in vitro for 1 week and examined in histological structure and mechanical properties. Results Fibroblasts cultured were spindle–shaped and could grow and attach to these scaffolds with a arrangement of sarciniform and parallel. The reconstructed tissue of ECM and collagen appeared to integrate well and had better bio-compatibil ity. The mean thickness of the collagen, the skin and the dura (all covered with fibroblasts) were 9.4, 10.0 and 10.4 μm respectively. The tension of the collagen was (1.417±0.030) N/mm2, of the acellular dermal matrix was (24.500±2.040) N/mm2(being close to the tension of normal tympanic membrane, 26.700 N/ mm2),of the acellular dura was (53.300±2.600) N/mm2. Conclusion The results suggest that the tension and the thinkness of acellular dermal matrix is similar to the normal tympanic membrane of guinea pig, it is an ideal material for tympanoplasty.