Increasing evidences show that a gradual trend away from deep hypothermia toward moderate hypothermic circulatory arrest, which has been proved to be safe and effective in clinic. By summarizing and analyzing the research progress and applying status of the moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion, the article aims at promoting the application of this tenique as a cerebral protection strategy in aortic arch surgery for adults in China.
Objective To evaluate the efficacy and safety of Salviae miltiorrhizae Injection (include Danshen Injection and Fufang Danshen Injection) for chronic cor pulmonale. Design A systematic review of randomized clinical trials. Method Randomized trials comparing Salviae miltiorrhizae Injection plus routine treatment versus muting treatment alone were identified by electronic and manual searches. No blinding and language limitations were applied. The Jadad scale assessed the methodological quality of trials. Results Thirty randomized trials (n=2 161) were identified. The methodological quality of all trials included was low. The combined results (RR and 95%CI) of symptom scores was 1.20 (1.15 to 1.26). Because of the significant heterogeneity, many other markers of the blood rheology can not be combined. The reason for heterogeneity should include the differences among cases and studies. Because of lacking enough studies, the conclusions about mortality and oxidants/antioxidants markers were not b. Only a few studies had reported adverse events. Conclusions Based in the review, Salviae miltiorrhizae Injection may have positive effect on symptom scores in patients with chronic cor pulmonale. But for mortality, the markers of blood rheology and oxidants/antioxidants, there is no reliable conclusion. However, the evidence is not b due to the general low methodological quality, the variations among studies and experimental markers themselves, and lacking of more relevant and important markers. Further large trials are needed.
Objective To discuss how is the perinatal infant’s prognosis influenced by different cardiac function and types of heart disease in pregnant women with heart disease, and to check the importance of antenatal examination. Method Retrospective analyses were conducted on the clinical records of 102 pregnant women hospitalized due to heart disease from February 2002 to February 2011 in the First Affiliated Hospital of Xinjiang Medical University. According to the level of cardiac function, 61 patients were divided into the Level I-II group and the other 41 patients were in the Level III-IV group. Results Of all cases, 38 were congenital heart disease (37.25%), followed by 22 arrhythmia (21.57%), 17 rheumatic heart disease (16.67%), 15 perinatal cardiomyopathy (14.71%), 7 hypertensive heart disease and 3 other types of heart disease. The average gestational weeks were shorter and the neonate’s weight was lower in the Level III-IV group than the Level I-II group, with a significant difference (Plt;0.05); the incidence of premature delivery, low birth weight infant at normal gestational age, neonatal asphyxia and perinatal mortality was higher in the Level III-IV group than the Level I-II group, with a significant difference (Plt;0.05); the rate of regular antenatal examination was higher in the Level III-IV group than the Level I-II group, with a significant difference (P=0.008); and there were significant differences between the regular and irregular examination groups in the incidence of premature delivery and low birth weight infant at normal gestational age (Plt;0.05), but no significant differences were found in the incidence of asphyxia and perinatal mortality (Pgt;0.05). Conclusions Congenital heart disease is the most commonly-seen type in the pregnant women with heart disease. The maternal cardiac function directly impact the prognosis of perinatal infant, and the regular antenatal examination, timely diagnosis and treatment can improve pregnancy outcome.
ObjectiveTo systematically review the efficacy of different drugs for patients with methamphetamine-induced psychotic disorders by network meta-analysis.MethodsAn electronical search was conducted in PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, CBM, WanFang Data and VIP databases from inception to October 2016 to collect randomized controlled trials (RCTs) about different drugs for methamphetamine-induced psychotic disorders. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then RevMan 5.3, R 3.3.2 and JAGS 4.2.0 softwares were used to perform network meta-analysis.ResultsA total of 16 RCTs involving 1 676 patients and 9 kinds of drugs were included. The results of network meta-analysis showed that: compared with the placebo group, olanzapine (OR=28.00, 95%CI 8.10 to 110.00), risperidone (OR=20.00, 95%CI 7.70 to 58.00), quetiapine (OR=30.00, 95%CI 6.60 to 160.00), ziprasidone (OR=28.00, 95%CI 3.70 to 230.00), chlorpromazine (OR=29.00, 95%CI 5.00 to 200.00), aripiprazole (OR=13.00, 95%CI 1.70 to 93.00), haloperidol (OR=19.00, 95%CI 2.10 to 190.00) could significantly improve the psychotic disorders of patients with methamphetamine, respectively, in which quetiapine was the best choice. There were no significant differences between any other pairwise comparisons of these different drugs.ConclusionFor the treatment of psychotic disorders caused by methamphetamine, quetiapine should be of a priority choice, follows by ziprasidone, chlorpromazine, olanzapine, risperidone, aripiprazole or haloperidol in a descending priority. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
Objective To investigate the effect of different degrees of wound eversion on scar formation at the donor site of anterolateral femoral flaps by a prospective clinical randomized controlled study. MethodsAccording to the degree of wound eversion, the clinical trial was designed with groups of non-eversion (group A), eversion of 0.5 cm (group B), and eversion of 1.0 cm (group C). Patients who underwent anterolateral femoral flap transplantation between September 2021 and March 2023 were collected as study subjects, and a total of 36 patients were included according to the selection criteria. After resected the anterior lateral thigh flap during operation, the wound at donor site of each patient was divided into two equal incisions, and the random number table method was used to group them and perform corresponding treatments. Thirty of these patients completed follow-up and were included in the final study (18 cases in group A, 23 cases in group B, and 29 cases in group C). There were 26 males and 4 females with a median age of 53 years (range, 35-62 years). The body mass index was 17.88-29.18 kg/m2 (mean, 23.09 kg/m2). The incision healing and scar quality of three groups were compared, as well as the Patient and Observer Scar Assessment Scale (POSAS) score [the observer component of the POSAS (OSAS) and the patient component of the POSAS (PSAS)], Vancouver Scar Scale (VSS) score, scar width, and patient satisfaction score. Results In group C, 1 case had poor healing of the incision after operation, which healed after debridement and dressing change; 1 case had incision necrosis at 3 months after operation, which healed by second intention after active dressing change and suturing again. The other incisions on all groups healed by first intention. At 6 months after operation, the PSAS, OSAS, and patient satisfaction scores were the lowest in group B, followed by group A, and the highest in group C. The differences between the groups were significant (P<0.05). There was no significant difference between the groups in the VSS scores and scar widths (P>0.05). ConclusionModerate everted closure may reduce hypertonic incision proliferative scar formation to some extent.
ObjectiveTo investigate the distribution and antimicrobial resistance of the clinical strains isolated from the First Affiliated Hospital of Xi’an Jiaotong University in 2019 and provide a basis for clinical rational use of antibiotics.MethodsAll the clinical samples which were collected from January 1st to December 31st in 2019 were employed to determine antimicrobial resistance retrospectively. Results were interpreted according to Clinical and Laboratory Standards Institute 2019 breakpoints and analyzed by WHONET 5.6 software.ResultsA total of 6 784 nonduplicate strains were isolated in 2019, including 2 865 (42.2%) strains of Gram-positive bacteria and 3 919 (57.8%) strains of Gram-negative bacteria. The top five pathogens with the highest detection rate were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Pseudomonas aeruginosa, and Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 33.0% and 72.0%, respectively. The detection rate of vancomycin-resistant Enterococcus faecium was 1.0% and the detection rates of linezolid-resistant Enterococcus faecium and Enterococcus faecalis were 0.3% and 2.9%, respectively. As for the non-meningitis Streptococcus pneumoniae, the prevalence of penicillin-susceptible Streptococcus pneumoniae was 100% in the isolates from adults. Extended-spectrum β-lactamases-producing strains accounted for 58.2%, 33.6%, and 33.3% in Escherichia coli, Klebsiella spp., and Proteus mirabilis, respectively. The total detection rate of carbapenem-resistant Enterobacteriaceae was 7.8%, among which the detection rates of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae were 1.5% and 17.2%, respectively. The percentages of Pseudomonas aeruginosa strains resistant to imipenem and meropenem were 25.0% and 21.6%, respectively, and those of Acinetobacter baumannii were 73.8% and 74.2%, respectively.ConclusionsBacterial resistance is still serious in this hospital. It is necessary to strengthen rational drug use. At the same time, effective prevention and control measures should be taken to avoid cross-infection.
Objective To explore the effectiveness of passive immunization of fetus via mother on preventing the transmission of HBV from mother to infant. Methods A prospective randomized controlled study was designed. Fifty-two HBeAg positive pregnant women were randomly allocated to two groups, of which 28 women were allocated to trial group, and injected with 200 IU of hepatitis B immune globulin (HBIG) for 1 injection at the 28th, 32nd and 36th weeks of pregnancy respectively, 24 women allocated to control group were given no injection of HBIG. The samples of cord blood from the newborns in two groups were collected and tested for HBeAg and HBV-DNA by ELISA and FQ-PCR. Results The rates of HBeAg positive in the newborns were 21.4% in trial group, 79.2% in control group. There was statistically significant difference between two groups ( χ2=17.26, Plt;0.01, RR=0.27). The rates of HBV-DNA positive in newborns were 25.0% in trial group, 83.3% in control group, showing statistically significant difference between the two groups (χ2=17.62, Plt;0.01, RR=0.30). In the trial group, there were 21 newborns with HBV-DNA negative, 7 with HBV-DNA positive. HBV-DNA quantities were significantly lower in 7 newborns than in their mothers (T=28, P=0.02, Wilcoxon test). Conclusions Multiple injections of HBIG to pregnant women with HBeAg positive before labor could greatly reduce mother-infant transmission of HBV.