This paper is aimed to introduce the definition and application of Population Impact Measures (PIMs). The PIMs use Number Need to Treat (NNT) for reference and generalize the variables of clinical research to interest population, which then can be used to measure the effectiveness of interventions and the harmfulness of risk factors, so as to provide evidence for making public health policy. Of the PIMs, the variables used for measuring the effectiveness of interventions include Disease Impact Number (DIN), Population Impact Number (PIN) and Number of Events Prevented in your Population (NEPP); The variables used for measuring the harmfulness of risk factors include Exposure Impact Number (EIN), Exposed Cases Impact Number (ECIN), Population Impact Number (PIN), Case Impact Number (CIN) and Population Impact Number of Eliminating a Risk factor (PIN-ER-t).
Objective To investigate the effects of transforming growth factor beta (TGF-β) on airway remodeling in obese asthmatic mice and intervention effects of pirfenidone. Methods Seventy-five C57BL/6J mice were randomly divided into five groups, namely a blank control group (group A), an obese group (group B), an obese asthmatic group (group C), a budesonide treatment group (group D) and a pirfenidone treatment group (group E). The mice in the B, C, D, and E groups were fed with high fat diets, then the mice in the C, D, and E groups were sensitized and challenged with ovalbumin (OVA) to establish the model of chronic obese asthma. The mice in group A were fed with normal diets, sensitized and challenged with normal saline. The mice in group D were treated with budesonide (0.5 mg/ml), and the mice in group E were treated with pirfenidone (300 mg/kg). After 4 weeks of treatment, the total number of white cells as well as the percentage of leukocytes, eosinophils, neutrophils and macrophage in bronchoalveolar lavage fluid (BALF) were counted. ELISA and Western blot were used to evaluate the expression of TGF-β. The pathological changes of mice were observed under light microscope by HE and periodic acid-Schiff staining. Meanwhile the remodeling indices were measured including total bronchial wall area (WAt), smooth muscle area (WAm), and bronchial basement membrane perimeter (Pbm). Results The levels of leukocyte and eosinophils in BALF, expression of TGF-β, WAt/Pbm and WAm/Pbm in group C were higher than those in group A, B, D, and E (allP<0.05). The levels of eosinophils in BALF, WAt/Pbm in group E were lower than those in group D (allP<0.05). The level of TGF-β decreased in a sequence of group C>D>E>B>A (allP<0.05). The expression of TGF-β was in a positive correlation with eosinophil percentage in BALF (r=0.79,P<0.01). Conclusions The expression of TGF-β in the airway of obese asthmatic mice is closely related to airway inflammation, airway hyper-secretion and airway remodeling. Pirfenidone can effectively inhibit the expression of TGF-β and improve airway remodeling.
In recent years, domestic and foreign scholars have carried out extensive research on the prognostic factors of gastric cancer. Among them, non-specific inflammatory markers and nutritional indicators are the most concentrated in gastric cancer. C-reactive protein, as an acute phase protein, has been widely used to diagnose acute and chronic inflammation throughout the body. Prealbumin is a sensitive indicator of nutrition with a shorter half-life, which can quickly reflect the nutritional status of the body. At present, C-reactive protein and prealbumin as sensitive indicators of inflammation and nutrition, have shown certain predictive value in terms of postoperative complications and prognosis of gastric cancer. This article reviews the use of C-reactive protein, prealbumin and their ratios in predicting postoperative complications and prognosis of gastric cancer, aiming to provide a reference for the diagnosis and treatment of patients after gastric cancer.
Objective To reflect the correlation between social support and mental health of the aged through the Pearson correlation coefficient. Methods Databases including PubMed, SpringerLink, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI were searched from inception to October, 2011 to collect literature on the correlation between social support and mental health of the aged. The studies were screened according to the inclusion and exclusion criteria. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.0 software. Results Of the 2 396 identified studies, 4 studies were included. The results showed that 4 studies were not high in the overall quality. The total score of social support of the elderly and its three dimensions were related to mental health. Among 9 factors associated with mental health, somatization, depression and anxiety were weakly correlated to the objective support while the others were extremely weakly correlated. Anxiety and phobic anxiety were weakly correlated to the subjective support while the others were extremely weakly correlated. Phobic anxiety was weakly correlated to the utilizing degree while the others were extremely weakly correlated. Somatization, anxiety and phobic anxiety were weakly correlated to the total score of social support while the others were extremely weakly correlated. Conclusion Social support probably improves mental health of the aged to some extent.
Objective?To evaluate Mental Imagery on rehabilitation of functions in patients with stroke. Methods?Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMbase, PEDro (www.pedro.org.au), OpenSIGLE, National Technical Information Service (NTIS), CNKI, VIP, Wanfang Data, and CBM were searched for the Randomized controlled trials (RCTs) of Mental Imagery on rehabilitation of functions in patients with stroke from the date of establishment of the databases to October 2010. The bibliographies of the included studies were searched, too. Three independent researchers evaluated the included studies using GRADE. The extracted data were analyzed by RevMan 5.0.25 and GRAEDprofiler 3.2.2. Results?A total 16 trials were discovered. Meta-analyses showed that at the end of 4th, 6th, and 8th, compared with conventional rehabilitation, the mental practice increased the score measured by FMA (WMD=7.81, 95%CI 1.96 to 13.65; WMD=13.89, 95%CI 4.53 to 23.25; and WMD=9.45, 95%CI 3.67 to 15.23, respectively) and ARAT (WMD=5.70, 95%CI 3.17 to 8.22, P=0.30). The 4 outcomes were all of low quality in the GRADE system. Conclusion?The current evidence shows mental practice could improve the upper limb function in patients after stroke, and the side effects of mental practice are not found in meta-analyses. Compared with other rehabilitative therapies, it is simper, of lower input costs, and of low operating costs. The clinicians should recommend it. Due to the limitations of the included studies, more large-sample, high-quality RCTs are required.
Objective To assess the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CTX) in the induction treatment for lupus nephritis (LN). Methods Such databases as MEDLINE, EMBASE, SCIE, The Cochrane Library, the Cochrane Controlled Trials Register, CBM, and CNKI were searched from their establishment date to August of 2010 to retrieve the randomized controlled trials (RCTs) about MMF versus CTX for LN. The methodology quality of included studies was evaluated. The efficacy indexes i.e. the clinical total remission (TR), complete remission (CR), partial remission (PR), pathological activity index, the chronicity index and complete induction therapy rate (CIR), and the safety indexes i.e. the rate of patient intolerance-to-drug, the incidence of infection, leukopenia and diarrhea, were abstracted. Finally the Meta-analyses were conducted by using Cochrane Collaboration’s RevMan 4.2. Results Eight RCTs involving 773 patients met the inclusive criteria. The results of meta-analyses showed that the total remission rate (OR=1.49, 95%CI 1.10 to 2.02) and complete remission rate (OR=1.67, 95%CI 1.08 to 2.57) were significantly higher in the MMF group than the CTX group. There was no significant difference in the rate of partial remission, the complete induction rate, the rate of patient intolerance-to-drug, the incidence of infection and leukopenia. However, the incidence of diarrhea was higher in the MMF group (OR=2.99, 95%CI 1.87 to 4.78). The results of meta-analyses for type IV LN were the same. Conclusion MMF is superior to CTX in the induction therapy to Lupus Nephritis (type III, IV, V), but the incidence of diarrhea is higher.
目的 总结前交通动脉瘤栓塞治疗的经验。 方法 2008年1月－2011年8月，23例前交通动脉瘤患者均在全身麻醉下行动脉瘤内栓塞治疗。其中4例在导丝或导管保护动脉瘤颈情况下行栓塞治疗；1例术中导丝刺破动脉瘤，继续快速填塞至动脉瘤完全栓塞；1例栓塞后弹簧圈突入载瘤动脉，行A1-A2段支架后置入。 结果 23例患者手术技术成功率100%。术后即刻造影，动脉瘤完全栓塞11例，＞90%栓塞8例，＜90%栓塞4例。支架后置入患者术后出现脑梗死，经治疗1个月后康复出院。所有患者临床随访6～24个月，未见再出血。16例患者行全脑血管数字减影血管成像复查，动脉瘤未见复发，其中3例＞90%栓塞、2例＜90%栓塞患者动脉瘤完全闭塞。 结论 弹簧圈栓塞治疗前交通动脉瘤是一种安全、有效的治疗方式。但其技术难度相对较大，需要细致操作。
ObjectiveTo compare the effectiveness of anterior subcutaneous pelvic internal fixator (INFIX) and plate internal fixation in treatment of unstable anterior pelvic ring fractures.MethodsThe clinical data of 48 patients with unstable anterior pelvic ring fractures who met the selection criteria between June 2014 and December 2019 were retrospectively analyzed. Among them, 21 cases were treated with INFIX (INFIX group), and 27 cases were treated with plate (plate group). There was no significant difference in gender, age, body mass index, cause of injury, time from injury to operation, Injury Severity Score (ISS), and fracture type between the two groups (P>0.05). The operation time, intraoperative blood loss, fracture healing time, partial weight-bearing time, and complete weight-bearing time were recorded and compared between the two groups. Matta standard was used to evaluate the quality of fracture reduction, and Majeed score system was used to evaluate the functional recovery of pelvic fracture after operation.ResultsThe patients in both groups were followed up for an average of 12.5 months (range, 6-16 months). The operation time and intraoperative blood loss in INFIX group were significantly lower than those in plate group (t=−11.965, P=0.000; t=−20.105, P=0.000). There was no significant difference in the quality of fracture reduction, fracture healing time, partial weight-bearing time, and complete weight-bearing time between the two groups (P>0.05). At 14 weeks after operation, there was no significant difference in the scores of pain, working, standing and walking, and total scores between INFIX group and plate group (P>0.05), but there were significant differences in sitting and sexual intercourse scores (t=−4.250, P=0.003; t=−6.135, P=0.006). The incidences of lateral femoral cutaneous nerve injury, femoral nerve injury, and heterotopic ossification were significantly higher in INFIX group than in plate group (P<0.05), while the incidence of incision infection was lower in INFIX group than in plate group (P<0.05).ConclusionCompared with the plate internal fixation, the INFIX internal fixation can obtain the similar effectiveness for the unstable anterior pelvic ring fracture and has the advantages of shorter operation time, less blood loss, and lower risk of infection.
Brain-computer interface (BCI) is a revolutionary human-computer interaction technology, which includes both BCI that can output instructions directly from the brain to external devices or machines without relying on the peripheral nerve and muscle system, and BCI that bypasses the peripheral nerve and muscle system and inputs electrical, magnetic, acoustic and optical stimuli or neural feedback directly to the brain from external devices or machines. With the development of BCI technology, it has potential application not only in medical field, but also in non-medical fields, such as education, military, finance, entertainment, smart home and so on. At present, there is little literature on the relevant application of BCI technology, the current situation of BCI industrialization at home and abroad and its commercial value. Therefore, this paper expounds and discusses the above contents, which are expected to provide valuable information for the public and organizations, BCI researchers, BCI industry translators and salespeople, and improve the cognitive level of BCI technology, further promote the application and industrial transformation of BCI technology and enhance the commercial value of BCI, so as to serve mankind better.
Implantable brain-computer interfaces (BCIs) have potentially important clinical applications due to the high spatial resolution and signal-to-noise ratio of electrodes that are closer to or implanted in the cerebral cortex. However, the surgery and electrodes of implantable BCIs carry safety risks of brain tissue damage, and their medical applications face ethical challenges, with little literature to date systematically considering ethical norms for the medical applications of implantable BCIs. In order to promote the clinical translation of this type of BCI, we considered the ethics of practice for the medical application of implantable BCIs, including: reducing the risk of brain tissue damage from implantable BCI surgery and electrodes, providing patients with customized and personalized implantable BCI treatments, ensuring multidisciplinary collaboration in the clinical application of implantable BCIs, and the responsible use of implantable BCIs, among others. It is expected that this article will provide thoughts and references for the research and development of ethics of the medical application of implantable BCI.