With the popularization of digestive endoscopy in children, colonoscopy has been widely used. As the basis of digestive endoscopy, bowel preparation directly affects the diagnosis and treatment results of colonoscopy. Compared with adults, the functioning of important organs of children is immature, and their ability of cognition, communication and tolerance are weak. Their structure of the digestive tract is also significantly different in different ages. However, there have been no existing evidence-based guidelines on bowel preparation for digestive endoscopy of Chinese children. Therefore, it is important to develop evidence-based guidelines for bowel preparation combined with the clinical practice in China. In order to provide guidance and decision-making basis for Chinese pediatricians, we collaborated with multidisciplinary experts, based on existing evidence, adopted the grading of recommendations assessment, development and evaluation (GRADE) approach, followed the Reporting Items for Practice Guidelines in Healthcare (RIGHT) to develop this guideline for bowel preparation related to the diagnosis and treatment of children's digestive endoscopy.
Day surgery dates back to 1909, when it was first performed by British paediatricians. Anesthesia management for day surgery requires quick onset, early recovery, rapid recovery, and few perioperative adverse reactions. Ensuring the medical safety of patients is the primary condition for the gradual implementation of day surgery. With the continuous development of medical level, the applicable field of day surgery has gradually expanded, and new concepts and progress have also emerged in anesthesia management. This article summarizes the relevant research at home and abroad, and reviews the new progress of anesthesia for day surgery from three aspects: preparation before anesthesia, selection of anesthesia methods, and recovery after anesthesia, in order to provide a reference for anesthesia management of day surgery.
ObjectiveTo analyze the effect of microecological preparation on digestive tract complications and nutritional status after esophageal cancer surgery.MethodsA total of 146 patients with esophageal cancer admitted to the Department of Thoracic Surgery, Renmin Hospital of Wuhan University from October 2017 to June 2019 were selected. There were 91 males and 55 females, aged 65 (61.9±8.2) years. They were randomly divided into two groups (an observation group and a control group, n=73 in each group) according to whether microecological preparation was given when they could take food one week after the surgery. Nutritional status and the incidence of gastrointestinal complications including anorexia, acid reflux, nausea, vomiting and diarrhea (≥3 times per day) in the first month after operation were compared between the two groups.ResultsThe incidence of anorexia, nausea, diarrhea (≥3 times per day), anastomotic fistula and stenosis in the observation group was lower and the index of nutritional status was higher than those in the control group within one month after the operation (all P<0.05). There was no statistically significant difference in acid reflux, vomiting, lung infection and incision infection between the two groups (all P>0.05).ConclusionMicroecological preparation can regulate gastrointestinal microecological balance, improve nutritional status, reduce the incidence of gastrointestinal complications and accelerate the postoperative rehabilitation.
Objective To analyze the effectiveness and effect on pregnant outcome about living preparation of lactobacillus versus metronidazole in the treatment of bacterial vaginosis in pregnancy. Methods We searched PubMed, The Cochrane Library, VIP, CNKI, Wangfang, CBM, FMJS, and FEBMT to identify randomized controlled trials (RCT) of living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy. The quality of the included trials was assessed. RevMan 5.0.24 software was used for meta-analysis. Results Eight trials involving 1 687 patients were included. The results of meta-analysis showed: no significant difference was found in the effectiveness between the two groups (RR=1.04, 95%CI 1.00 to 1.08, P=0.08); living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate compared with metronidazole (RR=0.16, 95%CI 0.06 to 0.43, P=0.0004; RR=0.56, 95%CI 0.33 to 0.94, P=0.03); no significant differences were found in premature rupture of membrane, puerperal infection, infant of low-birth weight, infant infection, and infant jaundice between the two groups. Conclusion The effectiveness about living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy is similar, but living preparation of lactobacillus has lower recurrence rate and lower premature delivery rate, the others of effect on pregnant outcome are similar.
Objective To observe the effect of Fufang XueShuanTong (FXST) on prevention for retinal microangiopathy of diabetic rats. Methods Take the normal male Wistar rats as normal control group; take the streptozotocin (STZ) Wistar rats as diabetic model group. And then the diabetic model group was divided into two groups: diabetic control group (without other treatment) and FXST treatment group (with FXST at dose 900 mg/kg, by the way of given medicine from esophagus to stomach, 1 time/day, experimental period was 20 weeks). When all the animals had been raised for 20 weeks, not only retinal digesting preparations were used, the endothelium/pericyte ratio (E/P ratio) and micro-vascular changes were observed by microscope, vascular relative area were measured by image system，but also the thickness of capillary basement membrane, the ultrastructural changes of endothelium and pericyte were observed by transmission electron microscope. Results On the 20th week, retinal digesting preparations showed that acellular capillaries, irregular vessel nets, segmental expansion, segmental stricture even occlusion, pericyte number decreased obviously, E/P ratio increased, vascular relative area increased and ghosts of pericytes etc in diabetic control group. Compared to diabetic control group, the retinal changes of FXST treatment group was lighter, the E/P ratio and vascular relative area were closer to normal control group. Transmission electron microscopy results showed that thickness of basement membrane was increased in DM group, vascular changes was light in FXST treated group. Conclusions FXST can prevent the changes of micrangium in diabetic rats effectively. （Chin J Ocul Fundus Dis，2008，24：272-275）
Based on the principle of manual preparation of sclerosing foam with Tessari method, using the analysis of user requirements and combining it with theory of mechanics, we designed an automatic equipment. The device could be used to replace the manual operation, and could overcome the shortcomings of manual sclerosing foam preparation, such as the difficulty in controlling of pushing speed and stroke and poor reproducibility. This automatic device has the functions of adjustable pushing speed, pushing frequency, pushing stroke and is suitable for a variety of different types of syringes. It can not only provide quantitative parameters for the study of foam properties, but also be used for the standardization of clinical sclerosing foam. The experimental study on "the effect of pushing speed on the stability of foam" was carried out with using the device, and the experimental results were quite satisfactory.
Objective To explore the effects of early enteral nutrition therapy combined with micro-ecologicalpreparation on early intestinal function recovery in patients with severe acute pancreatitis (SAP). Methods The clinical data of 48 patients with SAP treated from January 2012 to January 2015 were retrospectively analyzed. Out of the 48 cases, 23 were treated with early enteral nutrition therapy (the control group), and 25 were treated with early enteral nutrition therapy combined with micro-ecologicalpreparation (the observation group). The counts of white blood cells (WBC), the levels of blood amylase, serum lipase, lactic dehydrogenase (LDH), and the scores of gastrointestinal function 1 day before treatment and on the 7th and 14th day of treatment were observed. The incidences of complications, case fatality rates, and lengths of hospital stay were recorded. Results One day before treatment, the differences in the counts of WBC, the levels of blood amylase, lipase, and LDH between the two groups were not statistically significant (P>0.05). On the 7th day of treatment, the counts of WBC, the levels of blood amylase, lipase, and LDH in the two groups decreased in varying degrees, and the decreasing in the observation group was more obvious (P<0.05). On the 14th day of treatment, the levels of blood amylase in the two groups were almost normal, and the difference between the two groups was not statistically significant (P>0.05); the levels of lipase, LDH and the counts of WBC in the observation group were lower than those in the control group (P<0.05). One day before treatment, the difference in the scores of gastrointestinal function between the control group (1.34±0.76) and the observation group (1.46±0.62) was not statistically significant (P>0.05); on the 7th and 14th day of treatment, the scores of gastrointestinal function in the observation group (0.37±0.18, 0.29±0.06) were lower than those in the control group (0.63±0.32, 0.47±0.08), and the differences were statistically significant (P<0.05). There were significant differences between the two groups in terms of the incidence of total complications and length of hospital stay (P<0.05), while the difference in the case fatality rate between the two groups was not statistically significant (P>0.05). Conclusion Early enteral nutrition combined with micro-ecological preparation is benefit to the intestinal function recovery in patients with SAP.
Objective We searched and reviewed medical evidence to find the guide of bowel preparation we should choose before large bowel preparation. Method Firstly, we put forward clinical questions. Secondly, we searched medical evidence from PubMed, MEDLINE, EMbase, Cochrane Library, Science and ACP in recent 10 years. And then we reviewed the results. Results We finally identified 17 literatures including 2 system reviews, 6 meta-analyses and 9 randomized control trials which included 4 multicentre randomized clinical trials. Most of literature suggested that there was no evidence showing the benefit of mechanical bowel preparation (MBP). No MBP before large bowel surgery would not increase rate of anastomotic leakage. On the contrary, MBP may increase the percentage of anastomotic leakage and wound infection. Considering the research with the clinical situation, we produced a new method of simplified MBP to treat the patient. It reached the predictive effect. Conclusion No evidence of systematic review and meta-analysis supports the benefit of BMP. The new simplified bowel preparation before surgery in West China Hospital was worthy to test.
Objective To study the current clinical application and advancement of microbioecological preparation. Methods Literatures about microbioecological preparation published in China and abroad were collected and reviewed. Results The microbioecological preparation has been widely used at present. It is used to rebuild a balanced microbial population in human body, particularly in intestinal, to promote the stability of internal environment, control dysbacteriosis and to treat a variety of gastrointestinal diseases associated with ectopic microbial population. Conclusion Although microbioecological preparation has been widely used in clinical settings, its effect yet should be further supported and evaluated both by large sample research in randomized double-blind control trails and evidence-based medicine.
ObjectiveTo observe the effectiveness and safety of pseudomonas aeruginosa preparation in treating refractory seroma after breast cancer surgery.MethodsA total of 76 patients with refractory seroma after breast cancer surgery who underwent surgery from October 2018 to August 2019 in our hospital were selected. The subjects were randomly divided into two groups. The patients in the control group (n=36) adopted negative pressure drainage connected with indwelling needle in the lower position of the seroma chamber; on the basis, patients in the experimental group (n=400) were injected with pseudomonas aeruginosa preparation into the seroma chamber. The drainage time, total drainage volume, recurrence rate, and incidence of complications of the two groups were compared.ResultsThere were 4 cases in the experimental group and 3 cases in the control group were lost followed-up, so only 69 cases enrolled in data analysis. The drainage time, total drainage volume, and the recurrence rate of the experimental group were all shorter or less than those of the control group (P<0.05). But there was no significant difference in the incidence of complications between the experimental group and the control group (P>0.05), such as fever, inflamed skin, and infection of incision.ConclusionPseudomonas aeruginosa preparation is an effective treatment for refractory seroma after breast cancer surgery, which can shorten the drainage time and promote wound healing.