小气道病变曾经是全球呼吸界研究的热点，许多肺功能测定方法和指标被用于小气道功能的诊断，其后热度骤减，最近又引起一些学者的重视。
Lung cancer is a malignant tumor with the highest incidence and mortality in China. Early diagnosis and early treatment is the key to improve the survival and prognosis of patients with lung cancer. In recent years, many studies have focused on biomarkers of lung cancer. Emerging biomarkers tests have shown some potential in lung cancer screening. Combining biomarkers, imaging omics and artificial intelligence to establish a comprehensive model for lung cancer screening and prediction may be the development direction for improving lung cancer screening in the future. This paper summarizes the application of biomarkers in lung cancer screening, introduces the emerging biomarkers and new technologies, and discusses the application prospects of biomarkers in lung cancer screening, in order to providea theoretical basis for improving screening, early diagnosis and early treatment of lung cancer.
Objective To evaluate the diagnostic accuracy of Wilson score for predicating difficult intubation. Methods Such databases as PubMed, EMbase, CNKI, WanFang Data and VIP were searched to collect the studies about Wilson score for predicating difficult intubation published from inception to January 2013. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality by QUADAS. The analysis was conducted by using Meta-Disc 1.4 software, and the random effect model was chosen to calculate the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the 95%CI. The summary receiver operating characteristic (SROC) curve was drawn and the area under the curve (AUC) was calculated in order to comprehensively assess the total diagnostic accuracy of Wilson score for predicating difficult intubation. Results A total of 9 studies involving 6 506 subjects were included. The results of meta-analysis showed that: the pooled sensitivity was 0.57 (95%CI 0.53 to 0.62), specificity was 0.89 (95%CI 0.88 to 0.90), positive likelihood ratio was 6.11 (95%CI 4.63 to 8.07), negative likelihood ratio was 0.52 (95%CI 0.41 to 0.66), diagnostic odds ratio was 12.76 (95%CI 8.60 to 18.93), and the AUC of SROC was 0.84. Conclusion Wilson score plays a role in predicating difficult intubation, while some other clinical indicators also need to be taken into consideration in its application.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
摘要:目的：观察厄贝沙坦治疗非杓型高血压患者降压效果及其杓型血压昼夜节律恢复情况,并观察治疗后血浆醛固酮水平的影响。方法:对杓型和非杓型两组原发性高血压患者分别给予150300 mg/d,观察降压效果及对血压昼夜节律的影响,并监测用药前后血浆醛固酮水平的变化。结果:所有高血压患者应用厄贝沙坦治疗前后收缩压及舒张压均有不同程度的下降,非杓型组夜间收缩压及舒张压的下降值与杓型相比有统计学差异,出现了明显的昼夜节律,血浆醛固酮水平出现了明显差异。结论:厄贝沙坦对非杓型高血压患者有良好的降压作用,并能恢复非杓型高血压患者的昼夜节律,向杓型血压变化。Abstract: Objective: To investigate the effect of blood pressure control and circadian variability of dipper blood pressure induced by irbesartan in patients with nondipper essential hypertension and to observe levels of aldosterone.after treatment.Methods:The patients were divided into dipper and nondipper groups. All patients were treated with irbesartan (150300 mg/d). The variability of circadian blood pressure were observed, and the levels of plasma aldosterone were monitored before and after treatment Results: After the treatment with irbesartan, the blood pressure in all patients were evidently reduced. The night blood pressure of the patient with nondipper essential hypertension had more significant improvement . The circadian variability was appeared. The levels of aldosterone had a significant difference between day and night. Conclusion:Irbesartan has significant effects for the patients with nondipper essential hypertension. It can induce a circadian variability and recover the dipper blood pressure from nondipper blood pressure.
Objective To observe the feature of post-operative hyperglycemia after coronary artery bypass grafting(CABG) surgery in department of intensive care unit（ICU） patients.Methods Patients who had CABG surgery in Zhongshan Hospital from January 2005 to December 2005 were enrolled.Data were collected including the history of diabetes，pre-operative and post-operative blood glucose(BG) levels，and the time that post-operative hyperglycemia and peak BG occurred.The patients were divided into diabetic and non-diabetic groups according to the diabetic history.The data were compared and analyzed between the two groups.Results 200 patients were enrolled in this study.The incidence of post-operative hyperglycemia was 77%，and about 99.4% occurred in the first 24 hours admitted to ICU，which was independent on diabetic history (χ2=2.58，P=0.108)，but was related to the BG level above 6.1 mmol/L (χ2=12.31，P=0.000).In 80% of the patients，peak BG occurred in the first 24 hours admitted to ICU，which was significantly earlier in the non-diabetic group compared with the diabetic group (8.5 h vs 18.5 h，P=0.02 ).In the patients who had post-operative hyperglycemia，the median time of the BG peak is 10 hours，and 75.3% of the BG peak occurred in the first 24 hours admitted to ICU.Conclusion There is a high incidence of post-operative hyperglycemia in post-CABG patients which always occur within 24 hours after operation and relate to pre-operative high BG.
Objectives To assess the efficacy and safety of cytidine diphosphate choline for patients with acute stroke. Methods Such databases as PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, VIP Database and Chinese Medical Association Journals were searched from the establishment to September of 2010, and the references of the included literatures were also searched to collect randomized controlled trials (RCTs) of cytidine diphosphate choline for patients with acute stroke. The data were extracted by two reviewers independently in accordance with the inclusion criteria. The quality of included trials was evaluated according to the Jadad scale standard. RevMan5.0 software was used for data analyses. Results Thirteen RCTs involving 2837 patients were included. The results of meta-analyses showed that, there was no significant difference in the mortality or the rate of dependency at the end of follow-up (OR=0.94, 95%CI 0.66 to 1.36, P=0.75) between the cytidine diphosphate choline group and the placebo group. But the total effective rate of the cytidine diphosphate choline group was higher than that of the placebo group with a significant difference (OR=1.72, 95%CI 1.41 to 2.10, Plt;0.000 01). Five trials reported the incidence of adverse reaction of cytidine diphosphate choline treatment which showed the adverse reaction was mild; no severe adverse events (SAEs) were reported and the clinical application was safe. Conclusion The cytidine diphosphate choline is effective and safe for acute stroke. However, it is invalid to reduce the mortality and the rate of dependency at the end of three months’ follow-up.
Objective To study the special traits of primiparae’s compliance with labor analgesia, so as to offer individualized analgesia solutions during spontaneous labor. Methods The uniparous primiparae with cephalic presentation between gestational weeks 38 and 40 were divided into two groups based on their educational background (college education or above, and high school education or below), each group with 20 cases. The demographical statistics of the two groups including their State-Trait Anxiety Inventory (STAI) grading, PCA results, and delivery situation were recorded and analyzed. Results Differences in age, height, and weight were not statisticallysignificant (Pgt;0.05); differences in T-AI were not statistically significant (Pgt;0.05); differences in S-AI were statistically significant (Plt;0.05); differences in anxiety and numbers of adding anesthetics were not statistically significant (Pgt;0.05); differences in failure to tolerate labor pains and requiring caesarean section were statistically significant (Plt;0.05). Conclusion Primiparae with higher educational degree tend to have higher S-AI grading and perform poorly in compliance with labor analgesia.
Objective To summarize the experience of preparation and administration of medical materials for the daytime-sickroom during the treatment of patients who were injured during Wenchuan earthquake in order to supply management experience for future emergency situations. Methods Data concerning the preparation and administration of medical materials and medical treatment for the daytime-sickroom were collected systematically. Results The high level of activity and order during the rescue provided quality care to patients injured in the earthquake. All 224 patients were treated effectively from May 12-29.Conclusion The daytime-sickroom acts as a combination sickroom, which allowed flexibility. The daytime-sickroom can manage medical materials and succesfully insure the treatement of patients when emergent events happen.