ObjectiveTo analyze and explore the thyroid defunctionalization method for preoperative preparation of hyperthyroidism patients in endoscopic thyroid surgery. MethodsThe clinical data of 45 cases of hyperthyroidism treated with endoscopic surgery in this hospital from June 2009 to June 2014 were analyzed retrospectively. These patients were divided into study group (n=20) and control group (n=25) according to the preoperative preparation method, the study group was prepared with thyroid defunctionalization method, the control group was prepared with antithyroid drugs and iodine. The intraoperative blood loss, conversion to open surgery, and postoperative complications were compared in these two groups. ResultsThe intraoperative blood loss and the operation time of the study group were significantly less than those of the control group﹝intraoperative blood loss: (120.32±50.26) mL versus (200.63±60.95) mL, P < 0.05; operation time: (120.43±40.56) min versus (180.76±50.92) min, P < 0.05﹞. There was no case of conversion to open surgery in the study group, there were three cases of conversion to open surgery in the control group. The incidence of postoperative complications of the study group was significantly lower than that of the control group﹝10% (2/20) versus 24% (6/25), P < 0.05﹞. ConclusionThyroid defunctionalization method is more suitable as compared with the traditional method for the preoperative preparation of hyperthyroidism in endoscopic thyroid surgery.
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.
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.
ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. 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 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
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 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.
Colonoscopy examination is the gold standard for diagnosis and treatment of colon diseases and screening for early cancer. Good quality of bowel preparation, which is also called intestinal cleanliness, is the prerequisite for full visualization of colonic mucosal lesions and their details. In clinic, more intestinal cleansing agents, such as polyethylene glycol and magneium suifate, have bad taste and high dosage, which can not be tolerated by some patients and affect the effect of bowel preparation. The use of oral adjuvant, add adjuvant to intestinal cleansing agents, new low-volume or very low-volume polyethylene glycol-ascorbic acid preparation methods, can reduce the incidence of adverse reactions, such as nausea and vomiting in patients, improve their tolerance, satisfaction and so on. This article reviews the methods of improving the taste and reducing the adverse reactions of intestinal cleansing agents at home and abroad to offer references for clinical practice.
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.