目的:观察前列地尔治疗失代偿期肝硬化的疗效。方法:对2007年2月到2008年2月入院的失代偿期肝硬化期肝硬化患者，按入院次序，查阅随机数字表分为治疗组和对照组，均给予支持、保肝、利尿治疗，治疗组加输前列地尔100 μg+5%葡萄糖液250 mL，每日1次，疗程2周。以治疗前后ALT，AST，前白蛋白，24小时尿量，腹围，B超下腹水深度为观察指标。结果:治疗2周后，治疗组与对照组比较，AST，ALT，腹围及腹水深度显著下降，而前白蛋白及24小时尿量显著升高。结论:前列地尔治疗失代偿期肝硬化疗效显著，副作用少。值得临床推广应用。
ObjectiveTo probe plasma calcitonin gene related peptide (CGRP) levels during thrombolytic therapy in patients with iliofemoral venous thrombosis in order to investigate its regularity of the alteration and its clinical significance.MethodsFifty patients with acute iliofemoral venous thrombosis and 30 patients with chronic iliofemoral venous thrombosis were given urokinase and prostaglandin E1 from veins for 15 days. The CGRP levels were determined by radioimmunoassay before treatment and on the 6th hour, 1st day, 3rd day, 7th day, 14th day, 30th day after treatment.ResultsThe plasma CGRP levels were increased in patients with acute iliofemoral venous thrombosis compared with the contrast ones. The CGRP levels in serious group was lower than those in mild group. However, the CGRP levels of 30 chronic patients and 12 patients who received the second course of thrombolysis as on effective were not different from those of contrast ones. The plasma CGRP levels were increased at the 6th hour,reached the peak at the 3th day and returned to normal at the 14th day after thrombolytic therapy in acute group which just consistent with the therapeutic effectiveness.ConclusionIt is helpful to judge whether the thrombolytic therapy is effective and the illness has come to chronic stage according to the levels of plasma CGRP in patients with iliofemoral venous thrombosis.
Abstract: Objective To investigate the effects of haemopoietic stem cell mobilization on vein graft patency and intimal hyperplasia of anastomosis. Methods Twentyfour New Zealand rabbits were randomly divided into experimental group and control group, 12 rabbits in each group. A double side of carotid arteryvein transplantation model was made in each rabbit. One side of vein graft was digested by 0.25% trypsin for complete endothelial denudation before transplantation. Recombinant human granulocyte colonystimulating factor was given by subcutaneous injection 24 hours after operation, once per day in successive 10 days in experimental group, saline was given in the same way in control group. Bone marrow stem cells mobilization was observed after operation, including karyote counts and mononuclear cell proportion in peripheral blood. The patency rate of vein grafts and the degree of anastomosis intimal hyperplasia were observed too. Results The karyote counts (t=8.406,P=0.000)and mononuclear cell proportion(t=31.267,P=0.000) in peripheral blood of experimental group increased significantly 5 days after operation than those in control group. The vein grafts with intact endothelium had higher patency rate in both groups. In the vein grafts with complete endothelial denudation, the patency rate were obviously lower, but it was higher in experimental group than those in control group (67% vs. 30%). In the end of experiment, the pulsatility index of the vein grafts anastomosis with complete endothelial denudation was lower in experimental group than that in control group(t=2.958,P=0.009). Pathological examination showed that various degrees of intimal hyperplasia in all anastomoses of vein grafts were observed 4 weeks after operation. The degree of anastomosis intimal hyperplasia was more severe in vein grafts with complete endothelial denudation. Compared with control group, re-endothelization occurred completely in vein grafts with complete endothelial denudation of experimental group and the degree of anastomosis intimal hyperplasia was relatively lower (Plt;0.05). Conclusion Haemopoietic stem cell mobilization can provide protective effects on vein grafts by accelerating reendothelization which might increase vein grafts patency rate in the near future after operation and reduce anastomosis restenosis caused by intimal hyperplasia.
Although the evidence from randomized controlled trials (RCTs) is regarded as a golden standard, it often fails to be applied in clinical practice for lack of generalizability. Evidence from either RCTs or non-RCTs is mutually complementary and referred. Different designs are suitable for different stages and can resolve different issues. During evaluation of an intervention, the proper research design should be selected in accordance with the objective, feasibility, and merits and limitations of different design modes.
Acute kidney injury (AKI) is a complication with high morbidity and mortality after cardiac surgery. In order to predict the incidence of AKI after cardiac surgery, many risk prediction models have been established worldwide. We made a detailed introduction to the composing features, clinical application and predictive capability of 14 commonly used models. Among the 14 risk prediction models, age, congestive heart failure, hypertension, left ventricular ejection fraction, diabetes, cardiac valve surgery, coronary artery bypass grafting (CABG) combined with cardiac valve surgery, emergency surgery, preoperative creatinine, preoperative estimated glomerular filtration rate (eGFR), preoperative New York Heart Association (NYHA) score>Ⅱ, previous cardiac surgery, cadiopulmonary bypass (CPB) time and low cardiac output syndrome (LCOS) are included in many risks prediction models (>3 times). In comparison to Mehta and SRI models, Cleveland risk prediction model shows the best discrimination for the prediction of renal replacement therapy (RRT)-AKI and AKI in the European. However, in Chinese population, the predictive ability of the above three risk prediction models for RRT-AKI and AKI is poor.
ObjectiveTo systematically evaluate the efficacy and safety of probiotics for prevention of ventilator-associated pneumonia (VAP).MethodsThe Web of Science, Pubmed, OVID, Cochrane Library, CNKI, EMbase, Sciencedirect, Chinese biomedical database, and Wanfang database before August 2017 were searched, and the relevant data resources were also searched by hand to collect randomized controlled trials (RCTs) of probiotics for prevention of VAP. The quality of the included studies was evaluated using a modified version of the Jadad scale. Meta-analysis was performed with RevMan 5.3 software.ResultsA total of 16 RCTs were included. The use of probiotics can reduce the incidence of VAP [RR=0.71, 95%CI (0.62, 0.80), P<0.000 01], ICU days [MD=–3.28, 95%CI (–6.15, –0.41), P=0.03] and total duration of antibiotics [MD=–2.47, 95%CI (–4.89, –0.04), P=0.05], but can not reduce the mortality of ICU [RR=0.99, 95%CI (0.74, 1.32), P=0.94], hospital mortality [RR=0.77, 95%CI (0.58, 1.01), P=0.06], 28-day mortality [RR=1.01, 95%CI (0.69, 1.47), P=0.97], 90-day mortality [RR=1.00, 95%CI (0.72, 1.37), P=0.99], hospital stays [MD=–0.68, 95%CI (–3.88, 2.52), P=0.68], duration of mechanical ventilation [MD=–2.17, 95%CI (–4.78, 0.44), P=0.10], or the incidence of diarrhea [RR=0.96, 95%CI (0.80, 1.14), P=0.62]. No serious adverse events were reported in all included RCTs.ConclusionsThe use of probiotics can reduce the incidence of VAP, but it has no effect on the mortality, hospital stay, duration of mechanical ventilation or the incidence of diarrhea. However, considering the heterogeneity of research designs, we need more rigorous, large sample randomized controlled studies to increase the strength of evidence.
ObjectivesTo systematically review the efficacy of hypothermia intervention on adult severe craniocerebral injury.MethodsCNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Web of Science and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of hypothermia intervention on severe craniocerebral injury from the establishment of the database to July 2nd, 2020.Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 25 RCTs involving 2 949 patients were included. The results of meta-analysis showed that the mortality of hypothermia intervention group was lower than that of normal body temperature group (RR=0.72, 95%CI 0.58 to 0.89, P=0.003), and the prognosis of hypothermia intervention group was better than that of normal body temperature group (RR=1.29, 95%CI 1.15 to 1.46, P<0.000 1).ConclusionsCurrent evidence shows that the hypothermia intervention has a lower mortality rate and a higher prognosis rate in the treatment of adult severe brain injury. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
China is one of the countries in the world with the highest rate of esophageal cancer. Early detection, accurate diagnosis, and treatment of esophageal cancer are critical for improving patients’ prognosis and survival. Machine learning technology has become widely used in cancer, which is benefited from the accumulation of medical images and advancement of artificial intelligence technology. Therefore, the learning model, image type, data type and application efficiency of current machine learning technology in esophageal cancer are summarized in this review. The major challenges are identified, and solutions are proposed in medical image machine learning for esophageal cancer. Machine learning's potential future directions in esophageal cancer diagnosis and treatment are discussed, with a focus on the possibility of establishing a link between medical images and molecular mechanisms. The general rules of machine learning application in the medical field are summarized and forecasted on this foundation. By drawing on the advanced achievements of machine learning in other cancers and focusing on interdisciplinary cooperation, esophageal cancer research will be effectively promoted.
Children’s neurological diseases are complex. Common clinical diseases include autism spectrum disorder, cerebral palsy, attention deficit/hyperactivity disorder, etc. The rehabilitation methods in China mainly start with children’s language and cognition. Animal-assisted intervention is a kind of psychosocial intervention, including animal assisted therapy, animal assisted education or animal assisted activities under specific conditions. With its popularity in the world, this field is rapidly approaching a paradigm shift and can be used as a new supplementary and alternative treatment for children’s neurological diseases. By analyzing the literature on animal-assisted intervention and research on children’s neurological diseases, this paper summarizes the application methods and effects of various types of animals in clinical practice, aiming to provide new intervention methods with scientific theoretical basis for the rehabilitation of children with neurological diseases in China and promote the further development of rehabilitation in China.
Objective To explore the intervention effect of music therapy on children with autism spectrum disorder. Methods The China National Knowledge Infrastructure, Wanfang, Chongqing VIP, PubMed, Embase, Cochrane Library were searched by computer to comprehensively collect randomized controlled trials on the intervention effect of music therapy on children with autism spectrum disorder. The search period was from the establishment of the database to December 31, 2022. RevMan 5.4 software was used for meta-analysis. Results Finally, 20 articles were included, including 913 cases in the music therapy group and 811 cases in the control group, with a total sample size of 1724 cases. The meta-analysis results showed that the overall treatment effect [standardized mean difference (SMD)=−0.95, 95% confidence interval (CI) (−1.12, −0.78)], the treatment effect of language [SMD=−0.71, 95%CI (−0.84, −0.57)], behavior [SMD=−0.65, 95%CI (−0.78, −0.52)], social interaction [SMD=−0.52, 95%CI (−0.63, −0.40)], cognition [SMD=1.37, 95%CI (1.00, 1.74)] and sensory perception [SMD=−0.89, 95%CI (−1.03, −0.74)] of the music therapy group were better than those of the control group (P<0.05). Conclusion The existing data show that music therapy applied to children with autism spectrum disorder can effectively improve their language, behavior, social interaction, cognition, and sensory perception, thereby having a positive impact on the overall treatment effect of children. However, due to the limitations of the number and quality of included studies, more high-quality studies are needed to verify.