ObjectiveTo investigate the status of research and development methods of Cochrane overviews. MethodsThe Cochrane Library and PubMed were searched up to March 2014 to identify Cochrane overviews. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed and analyzed search strategy, quality assessment method, data analysis, and study results. ResultsA total of 18 Cochrane overviews were included. Among them, 4 (22.2%) overviews included formal statistical indirect comparison; 8 (44.4%) included only results from direct comparison; 6 (33.4%) only systematically analyzed current studies without data pooling; 12 (66.7%) only searched The Cochrane Library, while 6 (33.3%) expanded search to other databases; 14 (77.8%) applied the AMSTAR tool to assess methodological quality of included literature; 12 (66.7%) applied the GRADE system to assess the quality of evidence; and 9 (50%) yielded new outcomes. ConclusionCurrently, the development and reporting standards of Cochrane overviews are still immature. Investigators should choose proper methods based on research objectives when developing Cochrane overviews.
ObjectiveTo investigate the distribution and antibiotic resistance of pathogens isolated from children with primary nephrotic syndrome (PNS) complicated with urinary tract infection (UTI), so as to provide references for reasonable use of anti-infective agents in clinical practice. MethodsA total of 218 eligible patients who hospitalized in our department between January 2009 and December 2012 were included, and the data of distribution and antibiotic resistance of pathogens were analyzed retrospectively. ResultsIn this cohort, asymptomatic UTI in children with PNS accounted for 75.7% (165/218). And a total of 249 pathogenic strains were isolated and cultivated. The main pathogens of those subjects were G- bacilli, accounting for 64.3% (160/249), and 63.8% (102/160) of G- bacilli was Escherichia coli (E.coli); G+ cocci accounted for 31.7% (79/249), and 59.5% (47/79) of them was Enterococci faecalis; and fungi accounted for only 4.0%. Drug-susceptibility testing suggested that E.coli had a high resistance rate to hydroxyl ampicillin, cefazolin and ceftriaxone (>50%), but had lower resistance rate to cefoperazone/sulbactam and imipenem (<10%). Enterococci faecalis had a high resistance rate to rifampicin (74.6%), but had low resistance to vancomycin and linezolid (<10%). ConclusionAsymptomatic UTI is common in children with PNS. E.coli is the major pathogen and the proportion of enterococcus infection is also not low, and these pathogens have a high antibiotic resistance and most of them are multi-resistant.
ObjectiveTo systematically review the effects of Liujunzi decoction on improving the quality of life (QOL) of patients with advanced primary liver cancer. MethodsDatabases including MEDLINE, EMbase, SCI, The Cochrane Library (Issue 2, 2014), CBM, CNKI, VIP and WanFang Data were searched electronically from inception to July 2014 to collect randomized controlled trials (RCTs) about Liujunzi Decoction for advanced primary liver cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 458 patients were included. The results of meta-analysis showed that the Liujunzi decoction group had significantly higher stability of QOL (RR=0.76, 95%CI 0.64 to 0.91, P=0.002), Karnofsky Performance Score (KPS) (MD=4.47, 95%CI 2.74 to 6.21, P<0.00001) and effective rate of TCM syndrome (RR=0.73, 95%CI 0.62 to 0.86, P=0.0001) than those of the control group. ConclusionCurrent evidence shows that Liujunzi decoction could improve the QOL and KPS, and relieve TCM syndromes of patients with advanced primary liver cancer, especially for those with spleen deficiency-syndrome. Due to the limited quantity and quality of the included studies, the above conclusion still needs to be verified by carrying out more high-quality RCTs.
ObjectiveTo explore the related factors for the influences and outcomes of mothers and infants, and further provide a basic reference for reducing maternal and prenatal mortality caused by central placenta previa, through the analysis of its clinical characteristics. MethodsWe retrospectively analyzed the clinical data of 89 patients with central placenta previa treated from January to August 2012. ResultsThere were 89 patients with central placenta previa, and the average age of these patients was (29.6±11.4) years, and the average number of pregnancy among the patients was 3.17. Nine patients had scar uterus; 8 had pernicious placenta previa (9%); 34 had prenatal anemia symptoms; 44 had prenatal vaginal bleeding with the bleeding volume ranged from 2 to 500 mL; 40 were treated before delivery. The average gestational age was 36 weeks ±4.2 days, and 28 of them were readmitted. The intraoperative bleeding in such patients as had placenta located in the anterior wall, placenta adhesion or implantation, history of uterine cavity operation or multipara was more than other patients. The postpartum hemorrhage of patients with the gestational age of 36 weeks or more was more than that of patients with the gestational age shorter than 36 weeks. The incidence of fetal distress in patients with the gestational age of 36 weeks or more is lower and the neonatal 1-minute Apgar score was higher than that in patients with the gestational age shorter than 36 weeks (P<0.05). ConclusionThe treatment of central type of placenta previa should be more active to prolong the gestational week. Patients with placenta adhesion or implantation, caesarean, multipara and placenta in the anterior wall are susceptible to intraoperative bleeding during the termination of pregnancy. Termination of pregnancy in these patients with central placenta previa should be carried out by cesarean section when gestation is more than 36 weeks to reduce postpartum hemorrhage and complications.
ObjectiveTo evaluate the effectiveness of the screw-based intermaxillary traction combined with occlusal splint in the treatment of pediatric mandibular condylar fracture. MethodsBetween June 2005 and December 2013, 35 pediatric patients with 49 mandibular condylar fractures were treated, and the clinical data were retrospectively reviewed. There were 25 boys and 10 girls, aged 3-13 years (mean, 7.3 years). The injury causes included falling (18 cases), traffic accident (14 cases), and violence (3 cases). The time between injury and treatment was 2-30 days (mean, 6.8 days). Restricted mouth opening was observed, and the maximal mouth opening was (22.74±7.22) mm except 3 patients who were too young to measure. Condylar fractures were located at the left (12 cases), at the right (9 cases), at bilateral (14 cases) based on the sites; and fractures were classified as intra-capsular (35 fractures), neck (10 fractures), and subcondylar (4 fractures) based on the fracture line. Four self-drilling titanium screws were inserted into the alveolar bone of both maxilla and mandible. After screw inserting, an occlusal splint with a fulcrum was used on the affected side and elastic band was put to perform anterior intermaxillary traction. After 1 month, the screws and splint were removed. Follow-up examinations were carried out on schedule. ResultsAll the patients were followed up from 6 months to 8 years and 10 months (median, 71 months). No screw-related complication occurred in the others except one case of screw loosening. The postoperative maximal mouth opening was (38.82±2.02)mm. Mild joint noise was found in 4 cases and opening deviation occurred in 6 cases. Radiographic results demonstrated complete condyle remodeling was achieved in 24 cases (32 fractures), and moderate remodeling in 11 cases (17 fractures) at last follow-up. ConclusionThe screw-based intermaxillary traction combined with occlusal splint might be an effective method for pediatric mandibular condylar fracture. The screw-related complications may be avoided by careful preoperative investigations.
ObjectiveTo explore the effect and mechanisms of bone marrow mesenchymal stem cells (BMSCs) on healing quality of acetic acid-induced gastric ulcer. MethodsForty-eight clean grade male Wistar rats were used to establish the model of gastric ulcer with acetic acid and were randomly divided into 3 groups after 3 days of modeling, 16 rats each group. After the abdominal cavity was open and stomach was pulled out, no treatment was given in group A, 150 μL phosphate buffered saline (PBS) and 150 μL BMSCs at passage 4+PBS (1×108 cells/100 μL) were injected into the gastric wall surrounding the ulcer at 5 different points in groups B and C respectively. After 10 days, the ulcer area was measured, the mucosal thickness and the number of dilated glands were tested in the regenerative mucosa by histological method. And the expression of vascular endothelial growth factor (VEGF) was detected at ulcerative margin by immunohistochemical method. ResultsThe ulcer area in group C was significantly smaller than that of groups A and B (P<0.01), but no significant difference was found between groups A and B (P>0.05). HE staining showed that group C had thicker regenerative gastric mucosa, less dilated glands, and more regular mucosal structure than groups A and B, showing significant differences in regenerative gastric mucosa thickness and dilated glands number (P<0.01), but no significant difference between groups A and B (P>0.05). Immunohistochemical staining showed that the positive expression of VEGF in the ulcer margin mucosa of group C was significantly higher than that of groups A and B. The integral absorbance (IA) value of VEGF expression in group C was significantly higher than that in groups A and B (P<0.01), but no significant difference between groups A and B (P>0.05). ConclusionBMSCs can accelerate ulcer healing by the secretion of VEGF, and improve the quality of ulcer healing.
ObjectiveTo investigate the influence of ISOBAR TTL dynamic internal fixation system on degeneration of adjacent intervertebral disc by MRI measurement of lumbar nucleus pulposus volume in treating lumbar degenerative disease after operation. MethodsBetween March 2010 and October 2011, 34 patients with lumbar intervertebral disc herniation (23 cases of paracentral type and 11 cases of lateral type) underwent operation with ISOBAR TTL dynamic internal fixation system for fixation of single segment, and the clinical data were analyzed retrospectively. There were 20 males and 14 females, aged 39-62 years (mean, 47.5 years). The disease duration was 6-18 months (mean, 14 months). Involved segments included L4, 5 in 21 cases and L5, S1 in 13 cases. The X-ray films and MRI images were taken at 6, 12, 18, 24, 36, and 48 months after surgery. Based on X-ray films, the height of intervertebral space was measured using angle bisectrix method. The nucleus pulposus volume was measured based on the MRI scan. The postoperative change of nucleus pulposus volume and intervertebral disc height were used to evaluate the influence of ISOBAR TTL system on degeneration of adjacent intervertebral disc nucleus pulposus. ResultsThirty patients were followed up 48 months. The height of intervertebral space showed no significant difference between at pre-and post-operation (P>0.05). The nucleus pulposus volume increased after operation, showing no significant difference at 6, 12, and 18 months when compared with preoperative value (P>0.05), but significant difference was found at 24, 36, and 48 months when compared with preoperative value (P < 0.05). The height of nucleus pulposus increased after operation but the width was decreased; the values showed no significant difference at 6, 12, and 18 months when compared with preoperative ones, but showed significant difference at 24, 36, and 48 months when compared with preoperative ones (P < 0.05). The diameter of nucleus pulposus at 18, 24, 36, and 48 months after operation was significantly langer than that at preoperation (P < 0.05). ConclusionISOBAR TTL dynamic internal fixation system can prevent or delay the degeneration of intervertebral discs.
ObjectiveTo investigate the effect ofγ-ray irradiation on echinococcus protoscoleces before abdominal cavity implantation in mice. MethodsEchinococcus protoscoleces were cultured in vitro, and then divided into 5 groups, four groups receivedγ-ray irradiation with 10 Gy, 20 Gy, 40 Gy, and 80 Gy, respectively. The remaining control group was not irradiated. The protoscoleces were then implanted into the abdominal cavity of mice. Four months later, the incidence of echinococcosis was measured by detection of echinococcus antibody in the blood and then abdominal laparotomy was performed to isolate intraabdominal cysts, and the weight and structure of the echinococcus generated from the protoscoleces were measured and observed. ResultsAfter implantation of irradiated echinococcus protoscoleces in mice, the incidence of echinococcosis was 100% in the control group, 80.0% in the 10 Gy group, 33.3% in the 20 Gy group, 33.3% in the 40 Gy group, and 26.7% in the 80 Gy group. The echinococci had lower weight in the irradiated groups with 10 Gy (35.80 mg), with 20 Gy (0.00 mg), with 40 Gy (0.00 mg), and with 80 Gy (0.00 mg) as compared with the control group (157.80 mg). The echinococcus generated from the protoscoleces appeared calcification. Conclusionsγ-ray irradiation could inhibit the formation of echinococcus granulosus generated from protoscoleces, damage the structure of echinococcus generated from the protoscoleces. Irradiation might prevent echinococcosis recurrence after surgical removal of hydatid cysts.
Objective To investigate application values and techniques of robot-assisted extended thymectomy for the treatment of typeⅠmyasthenia gravis （MG） using Da Vinci S system. Methods We retrospectively analyzed clinical data of 3 patients with MG who underwent robot-assisted extended thymectomy in General Hospital of Shenyang Military Command from March 2012 to September 2012. All the patients were ocular MG （typeⅠ） including 2 men （33 years and 66 years old respectively） and 1 woman （21 years old）. Surgical outcomes were analyzed. Results All the 3 patients successfully received robot-assisted extended thymectomy without accessorial incisions. None of the patients required converting to open sternotomy or postoperative reexploration for bleeding. Intraoperative blood loss was 5-10 ml．Overall operation time was95-138 minutes, and thymoma dissection time was 26-80 minutes. No myasthenic crisis or other major postoperative complic-ation occurred. Postoperative chest drainage duration was 3-9 days and postoperative hospital stay was 10-15 days. Two patientswere followed up for 6-12 months after discharge without MG recurrence. Conclusion Robot-assisted extended thymectomy is safe and feasible for the treatment of typeⅠMG with satisfactory results．
ObjectiveTo explore the influence of different radiation doses of 125Ⅰseed on human poorly differentiated gastric cancer cells (BGC823). MethodsSixty four male nude mice of BLAB nu/nu inoculated with human poorly differentiated gastric cancer cells (BGC823) were took as animal models. When tumors of nude mice grew to 0.7-1.2 cm, the nude mice were randomly divided into blank control group, low dose group, middle dose group, and high dose group (n=16). The tumors of nude mice in blank control group were implanted with blank seed, but tumors of nude mice in low dose group, middle dose group, and high dose group were implanted with 125Ⅰseed (the radiation doses of 3 groups were 1.48×10-7 Bq, 2.22×10-7 Bq, and 2.96×10-7 Bq respectively). Four nude mice of 4 groups were randomly collected to measure the tumor volume and weight before implantation, and on 7, 14, 21, and 28 days after implantation, but apoptosis rates and expression levels of cyclinE mRNA were measured on 14 days and 28 days after implantation, by using flow cytometer and semi quantitative RT-PCR method respectively. Results①Except for the blank control group, the tumor volume and weight decreased over time in low dose group, middle dose group, and high dose group. The tumor volume and weight in blank control group were higher than those of other 3 groups on 7, 14, 21, and 28 days after implantation (P < 0.05);in addition, on 28 days after implantation, tumor volume and weight in low dose group were lower than those of middle dose group and high dose group (P < 0.05).②On 14 days and 28 days after implantation, the apoptosis rates of blank control group were lower than those of other 3 groups (P < 0.05), but expression levels of cyclinE mRNA were all higher than those of other 3 groups (P < 0.05). In addition, on 28 days after implantation, apoptosis rate of low dose group was higher than both of middle dose group and high dose group (P < 0.05), but expression level of cyclinE mRNA was lower (P < 0.05). Compared with 14 days in the same group, except for the blank control group (P > 0.05), the apoptosis rates in other 3 groups on 28 days were higher (P < 0.05), with the lower expression levels of cyclinE mRNA (P < 0.05). Conclusions125Ⅰseed in organizational implantation can effectively inhibit the expression of cyclinE mRNA and the growth of human poorly differentiated gastric cancer tissue. Compared with doses of 2.22×10-7 Bq and 2.96×10-7 Bq of 125Ⅰ, low dose (1.48×10-7 Bq) contributes to the apoptosis of human poorly differentiated gastric cancer cells (BGC823).