We reviewed the research progress of anesthesia management in hepatic echinococcosis surgery in recent years, including the key technologies, practical experience, and research progress of anesthesia management in hepatic echinococcosis surgery, so as to guide clinical practice. Firstly, in the selection of anesthesia, the general anesthesia combined with epidural block or regional nerve block is recommended to improve surgical safety and patients’ comfort. At the same time, the importance of intraoperative continuous monitoring, including key indicators such as hemodynamics and respiratory function, is emphasized, and transesophageal echocardiography and brain function monitoring techniques are introduced to optimize anesthesia management. Finally, the concept of enhanced recovery after surgery is promoted, and measures such as preoperative optimization, intraoperative heat preservation, refined fluid management, and postoperative analgesic management are implemented to promote the rapid recovery of patients. At the same time, some challenges and unsolved problems in the current research also are pointed out, such as complex case evaluation, complications prevention, and teamwork, etc., which need to be further studied in the future to optimize the anesthesia strategy.
ObjectivesTo systematically review the teaching efficacy of cardiac ultrasound simulation.MethodsCNKI, VIP, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on cardiac ultrasound simulation from inception to March 7th, 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 7 RCTs involving 300 trainees were included. The results of meta-analysis showed that: compared with traditional teaching method, trainees who received cardiac ultrasound simulation obtained higher cardiac ultrasonic structure image recognition score (SMD=1.38, 95%CI 0.81 to 1.94, P<0.000 01), higher ultrasonic image quality score (SMD=2.08, 95%CI 1.71 to 2.44, P<0.000 01), and shorter time required to obtain the correct ultrasound image (SMD=−1.19, 95%CI −1.55 to −0.83, P<0.000 01).ConclusionsThe current evidence shows that trainees who received cardiac ultrasound simulation have superior teaching effect immediately after the training compared with those who received traditional teaching method. However, further high-quality researches are needed to confirm whether there is a difference between the two training methods in long-term teaching effect.
Objective To explore the effect of preoperative hypothyroidism on postoperative cognition dysfunction (POCD) in elderly patients after on-pump cardiac surgery. Methods Patients who were no younger than 50 years and scheduled to have on-pump cardiac surgeries were selected in West China Hospital from March 2016 to December 2017. Based on hormone levels, patients were divided into two groups: a hypo group (hypothyroidism group, thyroid stimulating hormone (TSH) >4.2 mU/L or free triiodothyronine 3 (FT3) <3.60 pmol/L or FT4 <12.0 pmol/L) and an eu group (euthyroidism group, normal TSH, FT3 and FT4). The mini-mental state examination (MMSE) test and a battery of neuropsychological tests were used by a fixed researcher to assess cognitive function on 1 day before operation and 7 days after operation. Primer outcome was the incidence of POCD. Secondary outcomes were the incidence of cognitive degradation, scores or time cost in every aspect of cognitive function. Results No matter cognitive function was assessed by MMSE or a battery of neuropsychological tests, the incidence of POCD in the hypo group was higher than that of the eu group. The statistical significance existed when using MMSE (55.56% vs. 26.67%, P=0.014) but was absent when using a battery of neuropsychological tests (55.56% vs. 44.44%, P=0.361). The incidence of cognitive deterioration in the hypo group was higher than that in the eu group in verbal fluency test (48.15% vs. 20.00%, P=0.012). The cognitive deterioration incidence between the hypo group and the eu group was not statistically different in the other aspects of cognitive function. There was no statistical difference about scores or time cost between the hypo group and the eu group in all the aspects of cognitive function before surgery. After surgery, the scores between the hypo group and the eu group was statistically different in verbal fluency test (26.26±6.55 vs. 30.23±8.00, P=0.023) while was not statistically significant in other aspects of cognitive function. Conclusion The incidence of POCD is high in the elderly patients complicated with hypothyroidism after on-pump cardiac surgery and words reserve, fluency, and classification of cognitive function are significantly impacted by hypothyroidism over than other domains, which indicates hypothyroidism may have close relationship with POCD in this kind of patients.
ObjectivesTo analyze and track the hotspots and frontiers of the field of frailty by analyzing the related research published by SCI-journals in recent decade.MethodsData of publications from 2010 to 2019 were retrieved from the Web of Science Core Collection database. CiteSpace was used to analyze the hotspots and frontiers of frailty research from high-impact countries/regions, institutions, authors, high-frequency keywords and burst terms.ResultsA total of 12 768 publications were identified. The United States was the leading country for publications. Research hotspots focused on adverse health outcomes associated with frailty, interventions, and frailty in elderly patients and females. Besides, frailty assessment and screening, cohort study, meta-analysis and cognitive impairment were the frontier fields.ConclusionsAdverse health outcomes associated with frailty, interventions, and frailty in elderly patients and females are the hotspots and frontiers of frailty research.
Evidence mapping is a new type of comprehensive evidence research method that systematically collects, evaluates, and synthesizes existing evidence to clarify research status and gaps, thereby promoting scientific research and decision-making. After nearly 20 years of development, the methodology of evidence mapping has been continuously improved, and has gained wide attention and recognition from the international community. China has paid much attention to evidence mapping at an early stage, but there are relatively few theoretical and practical researches, and the concept definition is inconsistent. This paper introduces the methodology of evidence mapping production and reporting for researchers to use for reference, with a view to further promoting the research and development of evidence mapping in China.
ObjectiveTo systematically investigate the registration status, methodology and reporting quality of the systematic review protocols for animal experiment registered on PROSPERO platform.MethodsSystematic review protocols of animal experiments registered on PROSPERO platform were searched up to December 31st, 2019. Two reviewers independently screened literature, extracted data, and performed a descriptive analysis of the methodological quality and reporting characteristics of the included studies.ResultsA total of 351 protocols from 50 countries were included, involving 22 diseases. The intervention measures were primarily "pharmaceutical chemicals". Only approximately 1/3 of the studies reported the search strategy from at least one database, approximately half of the studies were prepared to report heterogeneity analysis and publication bias, and only approximately 1/3 of the studies were prepared to report sensitivity analysis.ConclusionsThe quantity of systematic reviews of animal experiments registered on the PROSPERO platform is increasing annually, however, there are still some limitations in the methodology and reporting quality.
ObjectiveTo systematically review the dose-response relationship between body mass index (BMI) and all-cause mortality in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data, and CBM databases were electronically searched to collect cohort studies on the association of BMI and mortality in frail adults from inception to November 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; Stata 15.0 software was then used to analyze the dose-response analysis of BMI and mortality by restricted cubic spline function and generalized least squares method.ResultsA total of 4 cohort studies involving 12 861 frail adults were included. Meta-analysis results showed that compared with normal BMI, the frail elderly who were overweight (HR=0.80, 95%CI 0.74 to 0.88, P<0.001) and obese (HR=0.89, 95%CI 0.79 to 1.00, P=0.047) had lower all-cause mortality. The results of dose-response meta-analysis showed that there was a non-linear relationship between BMI and all-cause mortality in the elderly with frailty (P value for nonlinearity was 0.035), for which the elderly with frailty had a BMI nadir of 27.5-31.9 kg/m2. For linear trends, and when BMI was less than 27.5 kg/m2, the risk of all-cause death was reduced by 4% for every 1 kg/m2 increase in BMI (RR=0.96, 95%CI 0.90 to 1.03, P=0.320), when BMI was greater than 27.5 kg/m2, the risk of all-cause death increased by 4% for every 1 kg/m2 increase in BMI (RR=1.04, 95%CI 1.03 to 1.05, P<0.001).ConclusionsThere is a paradox of obesity and a significant nonlinear relationship between BMI and all-cause mortality in the frailty elderly, with the lowest all-cause mortality in the frailty elderly at BMI 27.5-31.9 kg/m2. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
ObjectiveTo explore modified methods and outcomes of collection of donor blood from donation after citizen death (DCD). MethodThe clinicopathologic data of 26 DCD donors underwent phase Ⅰ clinical trials and 6 patients who received donor blood by modified collection technique from May 2020 to November 2021 in the West China Hospital of Sichuan University were collected retrospectively. ResultsCompared with the data of 26 DCD donors at phase Ⅰ clinical trials, after the modified collection technique, the blood collection volume, the concentrated red blood cells following filtration, centrifugation, and the amount of concentrated red blood cell/kg body mass were more (P<0.05). In addition, compared with the components of stored red blood cell suspension, the pH value, sodium and chloride ions concentrations of the red blood cell suspension obtained after modified collection technique were higher (P<0.05), the potassium ion concentration was <1 mmol/L, and the lactic acid concentration of none of blood was >15 mmol/L. ConclusionThe adoption of the modified collection technique increases the amount of donor red blood collected, and its biochemical and electrolyte indicators are more in line with physiological requirements than those of stored blood.