目的：观察前房冲洗术联合尿激酶治疗严重外伤性前房积血的临床疗效。方法：选择近3年来我科收治的严重外伤性前房积血患者57例(56眼)，随机分为Ａ组29例(29)眼)、Ｂ组28例(28眼)，Ａ组采用先前房注入尿激酶再行前房冲洗的方法，Ｂ组行单纯前房冲洗术。观察术中及术后并发症；术后视力、眼压情况。结果：Ａ组术中干净清除血凝块29眼(100％)，术中出血5眼(17.24％)，无虹膜损伤，术后第一天矫正视力≥0.5有24眼，眼压≥21 mm Hg者4眼(13.79％)；Ｂ组术中仍有少量血凝块4眼(14.29％)，术中出血4眼(14.29％)，虹膜损伤1眼(3.57％)，术后第一天矫正视力≥0.5有16眼，眼压≥21 mm Hg者8眼(28.57％)。Ｂ组术后仍有少量血凝块者加用药物治疗后吸收，两组病例中高眼压均加用药物控制正常，一周时视力无明显差异(P＞0.05)。结论：前房冲洗术前先使用尿激酶治疗严重外伤性前房积血是一种操作更安全，更有效的手术方法。
Lung cancer is an epithelial cancer arising from the bronchial surface epithelium or bronchial mucous glands. Non-small lung cancer constitutes about 75%-80% of all lung cancer. At the time of diagnosis, a lot of people have got stage Ⅲb non-small lung cancer which is unresectalbe. Both chemotherapy and radiotherapy are widely used in unresectable stage Ⅲ non-small lung cancer. The regimes of chemotherapy or radiotherapy are varied too. Systematic reviews and randomized controlled trials have provide much convincing evidence for us to choose and utilize the most appropriate treatment.
Tissue engineering technology and stem cell research based on tissue engineering have made great progresses in overcoming the problems of tissue and organ damage, functional loss and surgical complications. Traditional method is to use biological substitute materials to repair tissues, while tissue engineering technology focuses on combining seed cells with biological materials to form biological tissues with the same structure and function as its own to repair tissue defects. The advantage is that such tissue engineering organs and tissues can solve the problem that the donor material is limited, and effectively reduce complications. The purpose of tissue engineering is to find suitable seed cells and biomaterials which can replace the biological function of original tissue and build suitable microenvironment in vivo. This paper mainly describes current technologies of tissue engineering in various fields of urology, and discusses the future trend of tissue engineering technology in the treatment of complex urinary diseases. The results of this study show that although there are relatively few clinical trials, the good results of the existing studies on animal models reveal a bright future of tissue engineering technology for the treatment of various urinary diseases.
Objective To compare vein graft patency after endoscopic great saphenous vein harvesting (EVH) and conventional open saphenous veinharvesting (OVH) in coronary artery bypass grafting (CABG), and to identify risk factors for vein graft stenosis. Methods The great saphenous vein was harvested using an EVH method in 60 patients, 34 males and 26 females, who underwent CABG in the General Hospital of PLA between May 2006 and May 2009. The mean patient age was 66.6±9.2 years in the EVH group.The OVH group had 60 patients (40 males and 20 females with a mean age of 65.7±10.6 years), chosen to match the clinical characteristics of the EVH group. 64multislice computed tomography (64MSCT) was used to evaluate vein graft patency at six months and two years postoperatively. We also collected and analyzeddata on possible risk factors for vein graft stenosis. Results The harvesting time was longer in the EVH group than in the OVH group (52.5±13.3 minutes vs. 36.1±18.0 minutes, t=2.13, P＜0.05). The EVH group requireda greater number of repairs to veins than did the OVH group (2.2±13 vs. 0.9±0.6,t=2.60, P＜0.05). There were no statistically significant differences invein length, number of vein grafts, or vein graft flow between the two groups. There was also no significant difference in vein graft patency between the EVH and OVH groups at six months postoperatively (96.2% vs. 94.5%) or at two years postoperatively (90.2% vs. 91.5%). The average of vein graft blood flow was a riskfactor for vein graft stenosis(t=2.61, P=001). Conclusion The EVH vein graft had a good patency rate at six months and two years after the surgery.
Objective To evaluate the correlation between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS). Methods Total 666 elderly male patients admitted to West China Hospital for routine physical examination in May, 2010 were included in this study. The related laboratory tests of BPH and MS were taken. The correlation among BPH, lower urinary tract Symptoms (LUTS), prostate volume (PV), MS and its component diseases were analyzed. Results Hypertension was an important risk factor for BPH (OR=1.309, 95%CI 1.033 to 1.661), low HDL-C hyperlipidemia was a risk factor for IPSS scored over 7 points (OR=1.573, 95%CI 0.330 to 0.997), and the score of PV was positively correlated to obesity, hypertension, low HDL-C hyperlipidemia and MS (all Plt;0.05). Conclusion For the patient with BPH, MS and its component diseases mainly exert their effects on PV changes rather than LUTS.
Objectives To assess the efficacy and safety of statins for adult osteoporosis. Methods We electronically searched The Cochrane Library (Issue 4, 2007), MEDLINE (1990 to November 2007), EMBASE (1990 to November 2007), Current Controlled Trials, The National Research Register, CBM (1990 to November 2007), VIP (1990 to November 2007) and CNKI (1990 to November 2007). We also handsearched some related journals and identified randomized controlled trials of statins versus placebo in adults with osteoporosis. Results Two randomized controlled trials were included. We didn’t perform meta-analysis due to heterogeneity. No significant differences were observed in the changes of bone density at the lumbar spine and total hip from baseline between statins and placebo. However, a significant increase in bone density was found in response to simvastatin at the forearm. Biochemical markers of bone metabolism changes from baseline did not differ significantly between statins and placebo groups. Conclusions The evidence currently available does not support the use of statins in the treatment of osteoporosis. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of statins in the treatment of osteoporosis.
Objective To access the efficacy and safety of different doses of metoprolol for patients with chronic heart failure. Methods We searched databases such as MEDLINE, EMbase, The Cochrane Library, CBM and CMCC. The search was conducted in March 2006. Randomised controlled trials, systematic reviews, and current guidelines of chronic heart failure were reviewed. The efficacy and safety of the high-dose (≥100 mg/d) and low-dose metoprolol (lt;100 mg/d) were compared. Results Only one small-scale, short-term randomised trial met our inclusion criteria. This found that metoprolol 100 mg/d was more effective than 25 mg/d and 50 mg/d. A sub-group analysis of MERIT-HF recommended individualized titration for drug administration. Most guidelines suggested that the administration of metoprolol CR/XL for chronic left ventricular systolic dysfunction should be performed by titrating up to 200 mg/d or the maximum tolerance dose. Patients receiving 100 mg/d might have more adverse events than those receiving a lower dose than this. However, in the long-term, it’s the benefits of high-dose treatment outweighed its risks. Race-related differences in tolerance or dose-related adverse effects were not found. Conclusion We couldn’t determine an optimal dose based on the existing evidence, but a target dose of metoprolol CR/XL 200 mg/d is safe and effective. We are unable to draw any conclusions about the relationship between dose and adverse effects.
Rheumatoid arthritis is a chronic inflammatory disorder. It is characterized by a chronic polyarthritis that primarily affects the peripheral joints and related periarticular tissues. To a patient with rheumatoid arthritis, we searched the evidence and indentified the best available therapy for him: ① Ibuprofen was used to relieve pain. ② Methopterin ivgtt qw and oral methopterin after the discharge for 12 months. ③ Oral omeprazole 20 mg/d to prevent peptic ulcear. ④ Administration with fish oil and physical exercises after discharge were recommended.
ObjectiveTo observe the effect of Baduanjin on the motor function and balance function in patients within 6 months after stroke.Methods Between July 2018 and March 2019, a total of 40 stroke patients were randomly divided into the Baduanjin group and the control group. Twenty patients in the Baduanjin group received the treatment of Baduanjin training and conventional rehabilitation, while the other 20 patients in the control group were treated with conventional rehabilitation only. The duration of the treatment was 3 weeks; then the motor function, balance ability and the ability of daily life in the two groups were assessed by the Fugl-Meyer Assessment (FMA), the 6-minute Walking Test (6MWT), the Berg Balance Scale (BBS), the balance tester and the Barthel Index (BI) respectively before and after treatment.ResultsAfter the 3-week treatment, the motor function, balance ability and the ability of daily life assessed by FMA, 6MWT, BBS, the balance tester, and BI were improved significantly in both groups (P<0.05). The post-treatment scores of FMA, BI, BBS and 6MWT distance in the Baduanjin group were more than those in the control group [72.25±20.91 vs. 57.90±20.25, 89.75±12.08 vs. 77.75±15.68, 53.25±5.74 vs. 47.80±9.77, (251.03±79.43) vs. (186.92±100.09) m; P<0.05]. In the sit-to-stand balance test, compared with those in the control group, the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in standing stance in the Baduanjin group reduced significantly [(235.86±76.08) vs. (303.60±123.01) cm, (11.67±3.37) vs. (15.76±7.05) cm/s, (2.53±0.99) vs. (3.40±1.28) cm/cm2; P<0.05], and the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in sitting stance in the Baduanjin group also reduced significantly [(246.59±98.79) vs. (334.05±155.87) cm, (7.69±2.29) vs. (11.13±6.41) cm/s, (4.10±1.38) vs. (6.25±4.21) cm/cm2; P<0.05].ConclusionConventional rehabilitation with or without Baduanjin can improve the motor function, balance function and the ability of daily life in patients after stroke, but the effect of rehabilitation with Baduanjin is better than conventional rehabilitation.
ObjectiveTo identify differences in blood routine indicators between lung cancer patients and healthy controls, and between different subgroups of lung cancer patients, so as to improve the early detection of lung cancer prognosis, and provide a basis for risk stratification and prognostic judgment for patients with lung cancer.MethodsThis study enrolled 1 227 patients pathologically diagnosed with lung cancer from December 2008 to December 2013 and 2 454 healthy controls 1∶2 matched by sex and age. The blood routine data of lung cancer patients were collected when they were first diagnosed with lung cancer. Gender and age stratified analysis of blood routine indicators between lung cancer patients and controls were conducted. Comparisons of blood routine indicators among lung cancer patients with different pathological types, stages, and prognosis were performed, followed by Cox regression survival analysis. Normally distributed quantitative variables were presented as mean ± standard deviation and non-normally distributed quantitative variables as medium (lower quartile, upper quartile).ResultsCompared to healthy controls, the counts of platelet [(206.84±80.47) vs. (175.27±55.74)×109/L], white blood cells [(7.04±2.29) vs. (6.08±1.40)×109/L], neutrophil [(4.90±2.08) vs. (3.61±1.07)×109/L], monocyte [0.42 (0.30, 0.54) vs. 0.33 (0.26, 0.42)×109/L], and eosinophil [0.14 (0.07, 0.24) vs. 0.12 (0.07, 0.19)×109/L], as the well as neutrophil-lymphocytes ratio (3.91±2.82 vs. 2.03±0.89) and platelet-lymphocyte ratio (160.35±96.06 vs. 96.93±38.02) in lung cancer patients increased significantly, while the counts of red blood cells [(4.41±0.58) vs. (4.85±0.51)×1012/L] and lymphocyte [(1.49±0.60) vs. (1.93±0.59)×109/L] in lung cancer patients decreased, and the differences were statistically significant (P<0.05). The counts of platelet, red blood cells, white blood cells, neutrophil, and monocyte differed among patients with different pathological types, tumor stages, and prognosis (P<0.05). Neutrophil-lymphocytes ratio and platelet-lymphocyte ratio were higher in squamous cell carcinoma patients than those in other pathological patients, higher in advanced lung cancer patients than those in early stage patients, and higher in dead lung cancer patients than those in survival patients (P<0.05). Neutrophil-lymphocyte ratio was an independent factor affecting the prognosis of lung cancer [hazard ratio=1.077, 95% confidence interval (1.051, 1.103), P<0.001].ConclusionsThe inflammatory index of blood routine indicators are higher in lung cancer patients than those in healthy controls, which indicates that lung cancer is closely related to chronic inflammation. There are significant differences in blood routine inflammation index among lung cancer patients with different pathological types, stages, and prognosis, which reflects the heterogeneity and complexity of lung cancer. Neutrophil-lymphocytes ratio inverse correlates with the prognosis of lung cancer.