In the present investigation, we studied four methods of blind source separation/independent component analysis (BSS/ICA), AMUSE, SOBI, JADE, and FastICA. We did the feature extraction of electroencephalogram (EEG) signals of brain computer interface (BCI) for classifying spontaneous mental activities, which contained four mental tasks including imagination of left hand, right hand, foot and tongue movement. Different methods of extract physiological components were studied and achieved good performance. Then, three combined methods of SOBI and FastICA for extraction of EEG features of motor imagery were proposed. The results showed that combining of SOBI and ICA could not only reduce various artifacts and noise but also localize useful source and improve accuracy of BCI. It would improve further study of physiological mechanisms of motor imagery.
ObjectiveTo systematically review transfusion of red blood cells with different duration for patients' prognosis so as to provide evidence for the reasonable blood use in clinic. MethodsDatabases including The Cochrane Library (Issue 3, 2013), PubMed, Ovid, EMbase, WanFang Data and CNKI were electrically searched to collect studies published from 2002 to 2013, and relevant periodicals and references of the included studies were also manually retrieved. According to the inclusion and exclusion criteria, related studies were screened, data were extracted, and the quality of included studies was evaluated by two reviewers independently. Then meta-analysis was conducted using RevMan 5.0 software. ResultsA total of 10 studies (including 4 case-control studies and 6 cohort studies) were included, involving 15 187 patients. The results of meta-analysis revealed that, transfusion of fresh red cells (≤10-18 days) was superior to that of old ones ( > 14-28 days) in decreasing the short-term mortality (OR=0.69, 95%CI 0.58 to 0.82, P < 0.000 1) and the incidence of hospital infection (OR=0.67, 95%CI 0.55 to 0.81, P < 0.000 1), and in decreasing the incidences of post-operation kidney failure (OR=0.52 95%CI 0.37 to 0.73, P=0.000 2) and prolonged ventilatory support ( > 72 h) (OR=0.54 95%CI 0.45 to 0.66, P < 0.000 01) for patients with cardiac surgery, all with significant differences. ConclusionTransfusion of fresh red cells (≤10-18 days) is superior to that of old ones ( > 14-28 days) in decreasing the short-term mortality and the incidence of hospital infection, and in decreasing the incidences of post-operation kidney failure and prolonged ventilatory support ( > 72 h) for patients with cardiac surgery, which improve prognosis. Due to the limited quality and quantity of the included studies, the aforementioned conclusion needs to be verified by conducting more high quality studies.
ObjectiveTo systematically evaluate the benefits and harms of intraoperative positive end-expiratory pressure (PEEP) to all adult patients suffered surgery, especially on the postoperative mortality and pulmonary outcomes. MethodsWe electronically searched PubMed, EMbase, The Cochrane library (Issue 3, 2012), CBM, CNKI from inception to January 2013, for randomized controlled trials (RCTs) about PEEP for the prevention of pulmonary complications. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 8 RCTs involving 336 patients were finally included. The results of meta-analysis showed that there was no difference between two groups in mortality (OR=0.95, 95%CI 0.13 to 6.92, P=0.96). However, the PEEP group had a higher PaO2/FiO2 the first day after surgery (MD=22.98, 95%CI 4.40 to 41.55, P=0.02), while there was no difference 2-3 days after surgery (MD=12.59, 95%CI-6.78 to 31.96, P=0.31). Meanwhile, postoperative atelectasis was less in the PEEP group (OR=0.27, 95%CI 0.08 to 0.9, P=0.03). ConclusionChoosing PEEP mode during general anaesthesia may improve postoperative oxygenation index in the first day after surgery, and reduce pulmonary complications, which has a protective effect on patients pulmonary function. However, it has no marked influence on the prognosis. Because of the limited quality and sampling size of the induced studies, this conclusion still needs to be further proved by more large-scale, multicenter and perspective RCTs.
ObjectiveTo systematically review the effectiveness of non-depolarizing neuromuscular blockers for the prevention of succinylcholine-induced myalgia in clinical practice. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2, 2014), WanFang Data, CBM and CNKI were searched to collect the randomized controlled trails (RCTs) about non-depolarizing neuromuscular blockers for the prevention of succinylcholine-induced myalgia from inception to March 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 11 RCTs involving 666 patients were included. The results of meta-analysis showed that:the pre-treatment of non-depolarizing neuromuscular blockers prevented succinylcholine-induced myalgia at 24 h after surgery (RR=0.46, 95%CI 0.39 to 0.55, P<0.000 01); however, the effectiveness of non-depolarizing neuromuscular blockers for prevention of succinylcholine-induced myalgia at 48 h after surgery was still unclear. ConclusionCurrent studies suggests that both rocuronium and atracurium are effective for the prevention of succinylcholine-induced myalgia. However, due to limited quantity and quality of the included studies, more high-quality studies are needed to verify the abovementioned conclusion.
ObjectiveTo systematically evaluate the efficacy of different interventions in preventing rocuroniuminduced injection pain or withdrawal movements, so as to provide references for preventing adverse reactions induced by rocuronium injection in clinical practice. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 3, 2014), CBM, and CNKI databases to collect randomized controlled trials (RCTs) about the prevention of rocuronium-induced injection pain or withdrawal movements from inception to March 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2.8 software. ResultsA total of 43 RCTs involving 6 034 patients were include. The results of meta-analysis showed that compared with the placebo/blank group, lidocaine pretreatment with venous occlusion (RR=0.37, 95%CI 0.29 to 0.48, P<0.000 01), opioid drug pretreatment with venous occlusion (RR=0.77, 95%CI 0.68 to 0.87, P<0.000 1), lidocaine pretreatment with venous injection (RR=0.51, 95%CI 0.44 to 0.59, P<0.000 01), opioid drug pretreatment with venous injection (OR=0.03, 95%CI 0.02 to 0.05, P<0.000 01), ketamine pretreatment with venous injection (RR=0.36, 95%CI 0.23 to 0.54, P<0.000 01), mixing sodium bicarbonate (NaHCO3) with rocuronium (OR=0.02, 95%CI 0.01 to 0.04, P<0.000 01) and local heating (RR=0.74, 95%CI 0.63 to 0.88, P=0.000 6) were all effective in decreasing the incidence of rocuronium-induced injection pain or withdrawal movements. ConclusionThe intravenous injection of opioid drugs was effective in preventing rocuronium-induced injection pain or withdrawal movements, while local heating needs further research. Due to the limited quantity and quality of the induced studies, the above conclusion still needs to be verified by more high quality studies.
ObjectiveTo systematically evaluate the effect of leucocyte-depleted blood cardioplegia on myocardial protection in adult patients underwent cardiac surgery with extracorporeal circulation. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 2, 2015), CBM, VIP, WanFang Data and CNKI databases from inception to March 1st 2015, to collect randomized controlled trials (RCTs) about leucocyte-depleted blood cardioplegia for adult patients underwent cardiac surgery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted by using RevMan 5.3 software. ResultsA total of 17 RCTs including 637 patients were included. The results of meta-analysis showed that: Compared with the control group, the leucocyte-depleted blood cardioplegia could significantly reduce the level of postoperative CK-MB peak value (SMD=-0.75, 95%CI -1.12 to -0.39, P<0.0001), the utilization of inotropic drugs after operation (OR=0.51, 95%CI 0.29 to 0.92, P=0.02), and perioperative incidence of arrhythmia (OR=0.51, 95%CI 0.31 to 0.84, P=0.009). However, no significant differences were found in the incidence of perioperative myocardial infarction (OR=1.0, 95%CI 0.20 to 5.13, P=1.00), peri-operative mortality (peto-OR=0.51, 95%CI 0.05 to 4.94, P=0.56) and ICU stay (SMD=-0.06, 95%CI -0.32 to 0.21, P=0.68) between the two groups. ConclusionCurrent evidence shows, leucocyte-depleted blood cardioplegia could effectively reduce the myocardial injury in adult patients underwent cardiac surgery with extracorporeal circulation, but in reducing perioperative severe complications and mortality, improving the long-term prognosis in patients, the protective effect of leucocyte-depleted blood cardioplegia is yet to be evaluated. In addition, due to the limitation of quality and quantity of included studies, the above conclusion still need to be verified by conducting larger sample, high quality, multi-central RCTs.
ObjectiveTo systematically review the effect of perioperative supplemental oxygen administration on surgical site infection (SSI) in patients underwent abdominal surgery with general anesthesia. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2,2015), CBM, VIP, WanFang Data and CNKI were searched to collect randomized controlled trials (RCTs) about perioperative supplemental oxygen administration versus normal FiO2 in patients underwent abdominal surgery with general anesthesia from inception to March, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 13 RCTs involving 3 532 patients were included. The results of meta-analysis indicated that: the incidence of SSI in the perioperative supplemental oxygen administration group was lower than that in the control group (OR=0.68, 95%CI 0.47 to 0.99, P=0.04). There were no significiant differences between both groups in incidence of atelectasis, incidence of infection requiring reoperation and 30-day mortality after surgery (all P values >0.05). ConclusionPerioperative supplemental oxygen administration could further decrease the risk of SSI in patients underwent abdominal surgery with general anesthesia, and does not increase the risk of other adverse events. Due to the limitations of quality of included studies, more high quality studies are needed to verify the above conclusions.
ObjectiveTo assess the accuracy of European System for Cardiac Operative Risk Evaluation (EuroSCORE) model in predicting the in-hospital mortality of Uyghur patients and Han nationality patients undergoing heart valve surgery. MethodsClinical data of 361 consecutive patients who underwent heart valve surgery at our center from September 2012 to December 2013 were collected, including 209 Uyghur patients and 152 Han nationality patients. According to the score for additive and logistic EuroSCORE models, the patients were divided into 3 subgroups including a low risk subgroup, a moderate risk subgroup, and a high risk subgroup. The actual and predicted mortality of each risk subgroup were studied and compared. Calibration of the EuroSCORE model was assessed by the test of goodness of fit, discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve. ResultsThe actual mortality was 8.03% for overall patients, 6.70% for Uyghur patients,and 9.87% for Han nationality patients. The predicted mortality by additive EuroSCORE and logistic EuroSCORE for Uyghur patients were 4.03% and 3.37%,for Han nationality patients were 4.43% and 3.77%, significantly lower than actual mortality (P<0.01). The area under the ROC curve of additive EuroSCORE and logistic EuroSCORE for overall patients were 0.606 and 0.598, for Han nationality patients were 0.574 and 0.553,and for Uyghur patients were 0.609 and 0.610. ConclusionThe additive and logistic EuroSCORE are unable to predict the in-hospital mortality accurately for Uyghur and Han nationality patients undergoing heart valve surgery. Clinical use of these model should be considered cautiously.
ObjectiveTo systematically review the effectiveness and safety of anatomic landmarks positioning method (ALM) and real-time two-dimensional ultrasound (RTUS) guidance in the internal jugular vein cannulation. MethodsWe searched PubMed, EMbase, Web of Knowledge, CBM, WanFang Data and CNKI for randomized controlled trials (RCTs) concerning the effectiveness and safety of ALM and RTUS in the internal jugular vein catheterization up to May 1st, 2014. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assess methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 10 RCTs involving 1 973 cases were included in the metaanalysis. The results of meta-analysis showed that, compared with the ALM method, the RTUS method reduced puncture failure rate (OR=0.08, 95%CI 0.05 to 0.15, P<0.000 01). For safety, compared with the ALM method, the RTUS method was significantly lower in arterial injury rate (peto-OR=0.22, 95%CI 0.14 to 0.37, P<0.000 01), and the incidence of pneumothorax (peto-OR=0.13, 95%CI 0.04 to 0.40, P=0.000 3). ConclusionCompared to the ALM method, the RTUS method has characteristics such as causing fewer traumas, and having higher success rate and fewer complications. Due to limited quantity and quality of the included studies, the above conclusion still needs to be verified by conducting more studies.
ObjectiveTo systematically evaluate the analgesic efficacy of local infiltration analgesia versus femoral nerve block for total knee arthroplasty. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 4, 2016), WanFang Data, CBM, and CNKI were searched to collect randomized controlled trials (RCTs) about the analgesic efficacy of local infiltration analgesia versus femoral nerve block for total knee arthroplasty from inception to April 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. The meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 13 RCTs involving 1 001 patients were included. The results of meta-analysis showed that: There were no significant differences in pain scores at rest (SMD=0.02, 95%CI -0.23 to 0.27, P=0.86), morphine consumption on movement (MD=-1.85, 95%CI -4.67 to 0.97, P=0.20), incidence of post-operative nausea and vomiting (RD=0.02, 95%CI -0.03 to 0.08, P=0.41) and incidence of post-operative knee infection (RD=0.01, 95%CI -0.02 to 0.03, P=0.60) between the two groups, but he local infiltration analgesia group had lower length of stay than the femoral nerve block group with statistical difference (SMD=-0.24, 95%CI -0.41 to -0.07, P=0.005). ConclusionLocal infiltration analgesia provides similar postoperative analgesia after total knee arthroplasty to femoral nerve block. However, due to the limited quantity of the included studies, the above conclusion still need to be verified by more high quality studies.