ObjectiveTo systematically review the clinical effectiveness and safety of middle and low-dose gamma globulin for severe idiopathic thrombocytopenic purpurar (ITP). MethodsDatabases such as The Cochrane Library (Issue 2, 2013), PubMed, EMbase, CBM, CNKI and WanFang Data were searched to collect randomized controlled trials (RCTs) involving the effectiveness and safety of middle and low-dose gamma globulin for severe ITP from the date of their establishment to July 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsEleven RCTs involving 548 patients were included. The trial group (n=272) were treated with middle and low dose of gamma globulin, while the control group (n=276) were treated with high dose of gamma globulin. The results of meta-analyses showed that there were no significant differences between the two groups in the total effective rate (RR=0.95, 95%CI 0.87 to 1.04, P=0.30), overall response rate (RR=0.97, 95%CI 0.85 to 1.10, P=0.60) and excellence rate (RR=0.94, 95%CI 0.78 to 1.14, P=0.54). The outcomes of time effect such as the time of platelet starting to rise and haemostasis time between the two groups was similar without significant differences. However, the control group was superior to the trial group in the peak time of platelet. The results of meta-analysis for platelet count of different periods showed that no significant differences were found in platelet count of 3, 7, and 14 days after starting the treatment, so do the peak of platelet count. No severe side effects were reported by both groups. ConclusionMiddle and low-dose gamma globulin could achieve the similar effect with the high-dose gamma globulin in the treatment of ITP. However, more high-quality, large-scale, RCTs are required to validate these results.
ObjectiveTo study the analgesia and rehabilitation effect of femoral nerve block after anterior cruciate ligament reconstruction (ACLR). MethodsDuring June to September 2014, 62 patients who were scheduled to undergo ACLR were randomly divided into two groups:femoral nerve block group (n=31) and control group (n=31). All the patients were given celecoxib 200 mg (twice per day) three days before surgery. Patients in the femoral nerve block group were given a single-injection femoral nerve block (SFNB) half an hour before surgery (ropivacaine 0.75%, 30 mL), Both of the two groups underwent ice therapy after surgery. The visual analogue scale (VAS) scores, knee joint range of motion, the muscle strength of quadriceps femoris, the side effects, complications and infection rate were recorded after the operation. ResultsThe VAS scores were significantly lower in the femoral nerve block group within 2 hours to 7 days after surgery (P<0.05), and the use of morphine was less than the control group in all the time points with statistical significance (P<0.05). The muscle strength of quadriceps femoris was significantly weaker in the femoral nerve block group than the control group in the first 12 hours (P<0.05). The side effects and infection rate between the two group had no significant difference (P>0.05). ConclusionThe femoral nerve block in anterior cruciate ligament reconstruction before surgery has a good effect on postoperative analgesia and rehabilitation, which is worth popularizing and applying.
ObjectiveTo explore the impact of the preoperative nutritional status on quality of life of colorectal cancer patients. MethodsIn this study, patients diagnosed definitely as colorectal cancer were enrolled from September 2012 to December 2012 in this hospital.NRS-2002 was used to assess the preoperative nutritional status, and QLQ-C30 was used to assess the quality of life. ResultsForty-four patients were enrolled in this study and divided into two groups based on NRS-2002 preoperative nutritional status evaluation scores:mild nutritional risk group had 27 patients who got 1 point, and moderate-severe nutritional risk group had 17 patients who got 2 point or over it.Patients in moderate-severe nutritional risk group were significantly older than the mild nutritional risk group (P=0.001), but there were no statistical differences between the two groups in gender (P=0.718), TNM stage (P=0.302), differentiation degree (P=0.564), preoperative medical complications (P=0.070), postoperative complications[NS (not significant)], and stoma (P=0.786).There were no statistical differences between the two groups in quality of life, too (P > 0.05). ConclusionsThis study don't get the conclusion that there is any relationship between nutritional status and quality of life of the colorectal cancer patients.And maybe it is effected by the too small sample size and single time of accessing.Therefore, the further research by expanding sample size, using more kinds of assessment tools, and selecting different time to explore the impact of the preoperative nutritional status on quality of life of colorectal cancer patients are necessary.