ObjectiveTo analyze and compare the clinical and pathological characteristics of patients with porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC), so as to provide a reference for reducing misdiagnosis and missed diagnosis. MethodsThe patients who underwent liver biopsy in the Department of Infectious Diseases in the First Hospital of Lanzhou University from January 2008 to December 2022 were retrospectively collected. The clinical, biochemical, imaging, and liver biopsy pathological data of the patients with PSVD and LC were compared. ResultsA total of 45 patients with PSVD and 48 patients with LC were included. The males to females ratio in the patients with PSVD and LC was 25∶20 and 21∶27, respectively, and the average age of the patients with PSVD was younger than that of the patients with LC (P<0.001). The patients with PSVD had overall better liver function, although the proportion of the patients with the Child-Pugh class B in the two groups was all higher, the proportion of patients with the Child-Pugh class B and the end stage liver disease model score ≥10 points in the patients with PSVD was lower (nearly three times) than those in the patients with LC (P<0.05). The initial diagnosis rate of the patients with PSVD was lower than that of the patients with the LC (6.7% vs. 95.8%, χ2=74.0786, P<0.001). The imaging findings of the patients with PSVD as compared with LC showed that the proportion of the portal hypertension was higher (33.3% vs. 39.6%) in both, but the flow velocity of the portal vein was faster (P=0.039), and the extrahepatic bile duct diameter was smaller (P=0.001). The main specific manifestations of liver biopsy histopathology in the patients with PSVD were the portal occlusion [19 (42.2%)], nodular regenerative hyperplasia [1 (2.2%)], and incomplete septal cirrhosis or fibrosis [14 (31.1%)], as well as the non-specific manifestation was the fine bile duct reaction [8 (17.8%)]. And the proportion of the patients with the liver tissue inflammatory activity grading (G) and liver fibrosis staging (S) ＞G2S2 in the patients with PSVD was lower as compared with the patients with LC [12 (26.7%) vs. 48 (100%), χ2=54.560, P<0.001]. ConclusionThe diagnosis of PSVD and LC should “seek common ground while reserving differences”, and it is necessary that a routine examination in combination with imaging manifestation and liver pathology, and should focus on a liver vascular abnormality so as to reduce a rate of misdiagnosis.
ObjectiveTo systematically evaluate the influencing factors of disaster resilience for medical rescue workers. MethodsPubMed, Cochrane Library, Web of Science, CINAHL, APA PsycInfo, EMbase, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the influencing factors of disaster resilience for medical rescue workers from inception to November 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 36 studies involving 7 974 medical rescue workers were included. The meta-analysis results showed that personal influencing factors, including active coping, rescue confidence, disaster preparedness, knowledge attainment, physical health, and exercise were positively correlated with the disaster resilience of healthcare workers. However, depression, anxiety, stress, and a history of mental illness were negatively related to the disaster resilience of medical rescue workers. Environmental and background factors, including social support, relief supplies, disaster training, economic condition, rescue experience, length of service, and technical title, were positively correlated with the disaster resilience of medical rescue workers. ConclusionCurrent evidence shows that the disaster resilience of medical rescue workers is affected by a variety of personal factors and environmental/background factors. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To systematically review the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) and sorafenib (SORF) separately or combined in the treatment of advanced hepatocellular carcinoma (HCC). MethodsWe searched the PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases for studies on HAIC and SORA separately or in combination in the treatment of advanced HCC from inception to November 1, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 21 studies involving 2 501 patients were included. The results of meta-analysis showed that the overall survival (OS) (HR=0.46, 95% CI 0.25 to 0.87, P=0.02), objective response rate (ORR) (OR=4.00, 95%CI 2.74 to 5.85, P<0.000 01) and disease control rate (DCR) (OR=2.20, 95%CI 1.30 to 3.75, P=0.004) were higher in the HAIC group than the SORF group, while the incidence of adverse reactions was not increased. However, HAIC combined with SORF showed no significant difference in OS, ORR, DCR or progression-free survival (PFS) compared with SORF alone. Moreover, combined treatment increased the adverse reactions of blood system. Conclusion The current study suggests that HAIC can improve OS, ORR and DCR in patients with advanced HCC; however, there is no additional benefit when combining SORF with HAIC. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsA total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. ConclusionCurrent evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.