ObjectiveTo investigate the effects of nursing interventions on reducing the hospital infection rates in children with extremely low birth weight. MethodsA total of 158 children with extremely low birth weight were treated in our hospital from January 2012 to June 2013. Based on the routine care, we took a series of other nursing interventions, such as strengthening environmental management, strict materials management and disinfection, active prevention of ventilator-associated pneumonia and catheter-related bloodstream infections, close monitoring of a series of isolated neonatal care interventions, to reduce the nosocomial infections in these children. ResultsThe hospital infection rate of this group of children was 9.49%, and the rate of infection cases was 10.76%. The infection sites included blood system, respiratory tract, digestive tract, mouth and eye. The patients were improved or cured after anti-infection and symptomatic treatment and caring measures. ConclusionScientific nursing interventions can reduce the incidence of nosocomial infection in children with extremely low birth weight.
The incidence of chronic kidney disease is increasing worldwide, which greatly increases the risk of end-stage renal disease. It is particularly important to find out the risk factors for the development and progression of chronic kidney disease. Whether gender is a risk factor for the progression of kidney disease remains controversial with inconsistent results in human cohort studies with diabetic or non-diabetic kidney disease. In most of the studies, women seem to exhibit certain gender advantages. Sex hormones, renal hemodynamics and lifestyle differences may play an important role. The underlying mechanism of gender affecting the progression of kidney disease deserves further exploration. This article reviews the gender differences and possible mechanisms in diabetic and non-diabetic chronic kidney disease, in order to provide reference for future research.
ObjectiveTo summarize the epidemiology of nonalcoholic fatty liver disease (NAFLD) and the epidemiological and economic burdens of NAFLD, so as to provide a reference for hospital management decision-making. MethodThe domestic and foreign guidelines relevant to NAFLD and the literatures relevant to epidemiological investigation and disease burden researches were summarized and its research progress was reviewed. ResultsThe global prevalence of NAFLD was increasing over years. The incidence, mortality, and disability adjusted life years of liver cirrhosis and liver cancer caused by NAFLD had increased year by year. The patients relevant to NAFLD of inpatients and outpatients had increased obviously, and the overall medical expenses had also shown a rising trend. The possible reasons were health care awareness, new drug research, population aging, and excessive medical consumption. In addition, children and adolescents with NAFLD had a obviously increased risk of liver or extrahepatic diseases. ConclusionsBy understanding the epidemiological trend of NAFLD, it is a certain understanding of the disease burden of NAFLD and the related factors affecting the increase of its treatment cost. It is believed that it is necessary to further pay attention to and strengthen the genetic characteristics, pathogenesis, drug research and development, and early diagnosis of cirrhosis and liver cancer relevant to NAFLD in the future. At the same time, the NAFLD group of children and adolescents should not be ignored.
Anti-vascular endothelial growth factor (VEGF) drugs have been widely used in clinic by inhibiting angiogenesis to treat ocular diseases such as malignant tumors and diabetic retinopathy. However, recent studies have shown that intravitreal injection of anti-VEGF drugs may have significant systemic absorption, leading to a series of renal damages such as worsening hypertension, proteinuria, new glomerular disease, and thrombotic microangiopathy. This article reviews the renal toxicity of intravitreal injection of anti-VEGF drugs in the treatment of diabetic retinopathy and other ocular diseases, aiming to provide recommendations for clinicians.
Objective To introduce the evidence-based evaluation on off-label uses at home and abroad, so as to investigate a systematic method of evidence-based evaluation on off-label uses. Methods In combination with the domestic and international research literature, a systematic method of evidence-based evaluation on off-label uses was discussed from the following three aspects: sources of evidence, levels of evidence, and recommendation strength. Results Sources of evidence included Clinical Pharmacology, DRUGDEX? System, NCCN Drugs amp; Biologics Compendium and handsearched literature. Levels of evidence and recommendation strength could refer to the 2009 grade system of Oxford Centre for Evidence-Based Medicine, and the strength of recommendations and scientific support of DRUGDEX? System. Conclusion A systematic method of evidence-based evaluation on off-label uses is initially established.
Objective To assess the response rate, improvement in neurological function and safety of cinepazide maleate injection for patients with cerebral infarction. Methods Based on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Central Register of Controlled Trials (Issue 1, 2010), PubMed (1948 to March 2010), EMbase (1966 to March 2010) and Chinese Bio-Medicine Database (1978 to March 2010). We also hand searched relevant literatures and obtained unpublished trials from pharmaceutical companies. The Cochrane Collaboration’s software RevMan5.0 was used for meta-analysis. Results Fifteen randomized controlled trials involving 1 456 patients were included. The results of meta-analyses indicated that: 1) Neurological deficits: We identified 11 trials involved 978 patients. Cinepazide maleate injection group compared with the control groups (placebo, Xuesaitong, Dansen and Nimodipine) could significantly improve the neurological deficits. The difference was statistically significant with WMD= – 4.64, 95%CI – 6.43 to – 2.85, WMD= – 2.39, 95%CI – 4.37 to – 0.42, WMD= – 3.67, 95%CI – 5.26 to – 2.07 and WMD= – 6.14, 95%CI – 8.39 to – 3.89, respectively. 2) Response rate: A total of 14 trials involved 1 349 patients were identified. Compared with control groups (placebo, Xuesaitong, Dansen and Nimodipine), cinepazide maleate injection group were more efficient, the difference was statistically significant with RR=1.33, 95%CI 1.16 to 1.54; RR=1.24, 95%CI 1.04 to 1.50; RR=1.33, 95%CI 1.23 to 1.43 and RR=1.29, 95%CI 1.12 to 1.49, respectively. 3) Adverse events: No serious adverse events were observed. But the difference of adverse events reports of headache and skin itching in cinepazide maleate injection group was statistically significant compared with the control groups. Conclusion Current evidence shows that cinepazide maleate injection can reduce neurological deficits in patients with acute cerebral infarction, improve the clinical treatment efficacy without serious adverse events. Due to limited quality of included studies, high-quality, large sample randomized controlled trials are required.
Objective To evaluate the effectiveness of Xingnaojing (XNJ) injection in the treatment of acute alcohol intoxication. Methods The Cochrane library (Issue 4, 2008), MEDLINE (1989 to 2008), WANFANG database (1991 to 2008), CBM (1991 to 2008), and CNKI (1991 to 2008) were searched. The quality of included studies was assessed according to the criteria recommended Cochrane Collaboration.Meta-analyses were performed using RevMan 4.2.2 software. Results Twenty seven trials, all published in China were included. The quality of these studies was low. Meta-analyses showed that normal treatment plus XNJ could significantly shorten action time [WMD= – 90.62 min, 95%CI (– 121.12, – 60.11)] and effective time [WMD= – 124.97 min, 95%CI (– 183.54, – 66.40)]. Normal treatment plus XNJ was similar with normal treatment plus naloxone in action time. No significant differences were observed in effective time between naloxone and XNJ. Conclusions It shows that XNJ injection plus western medical therapy is superior to western medical therapy. The curative efficacy of XNJ and Naloxone was similar.