ObjectiveTo summarize the research progress of mixed reality (MR) technology in the field of vascular surgery.MethodWe retrieved the literatures about the application of MR technology in vascular surgery, and summarized and analyzed them.ResultsThe application of MR technology in vascular surgery could greatly improve the standardization of medical education, shorten the learning cycle, effectively shorten the operation time, and increase the benefit of patients. The application of MR in vascular surgery was still in its infancy, and it showed some attractive prospects as well as some shortcomings.ConclusionsThe application of MR technology in vascular surgery is still at the exploratory stage, but it has an attractive prospect. With the continuous improvement of registration technology and the continuous improvement of accuracy, MR technology will be more and more widely used in vascular surgery.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
ObjectiveTo systematically review the efficacy and safety of dexamethasone in the treatment of viral myocarditis.MethodsThe Cochrane Library, PubMed, EMbase, Biosis Preview, Web of Science, CBM, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on dexamethasone for patients with viral myocarditis from inception to April 30th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 7 RCTs involving 749 patients were included. The results of meta-analysis showed that the dexamethasone treatment group exhibited an increased efficacy rate (RR=1.26, 95%CI 1.18 to 1.34, P<0.000 01), decreased levels of C-reactive protein (CRP) (MD=−11.49, 95%CI −19.25 to −3.72, P=0.004), cardiac troponin I (cTnI) (MD=−26.14, 95%CI −40.82 to −11.47, P=0.0005), and creatine kinase MB (CK-MB) (MD=−20.06, 95%CI −28.35 to −11.77, P<0.000 01), and a decreased adverse event rate (RR=0.40, 95%CI 0.24 to 0.65, P=0.000 3).ConclusionsCurrent evidence shows that dexamethasone can significantly improve the efficacy rate, reduce the levels of CRP, cTnI, and CK-MB, and reduce the incidence of adverse events in patients with viral myocarditis. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify above conclusions.
Objective To systematically review the efficacy and safety of traditional Chinese medicine on clinical symptoms during the recovery period of COVID-19. Methods The CNKI, WanFang Data, SinoMed, VIP, PubMed, Cochrane Library and EMbase databases were electronically searched to collect studies related to objectives from inception to February 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 8 studies involving 740 patients were included in the meta-analysis, including 4 randomized controlled trials (RCTs) and 4 non-RCTs. The results of the meta-analysis showed that traditional Chinese medicine could effectively relieve patients’ fatigue symptoms compared with blank control (MD=−1.07, 95%CI −1.46 to −0.68, P<0.01). Chinese patent medicine combined with conventional Western medicine treatment effectively improved cough symptoms in patients compared with conventional Western medicine treatment (MD=−0.80, 95%CI −1.30 to −0.30, P<0.01), symptoms of dry pharynx (MD=−0.86, 95%CI −1.22 to −0.51, P<0.01), symptoms of chest tightness (MD=−0.58, 95%CI −0.79 to −0.36, P<0.01), and total efficiency (RR=1.42, 95%CI 1.18 to 1.71, P<0.01). Conclusion Current evidence shows that traditional Chinese medicine can effectively improve the clinical symptoms such as fatigue, cough, dry pharynx and chest tightness in patients with novel coronavirus infection in the recovery period. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
ObjectiveTo investigate the effectiveness of fixation the posterior malleolus or not to treat different Haraguchi’s classification of posterior malleolus fractures.MethodsThe clinical data of 86 trimalleolar fracture patients who were admitted between January 2015 and September 2019 and met the selection criteria were retrospectively reviewed. There were 29 males and 57 females; the age ranged from 26 to 82 years with a mean age of 55.2 years. According to Haraguchi’s classification, 38 patients were in type Ⅰ group, 30 patients in type Ⅱ group, and 18 patients in type Ⅲ group. There was no significant difference in the general data such as gender, age, and fracture location among the 3 groups (P>0.05). The fixation of the posterior malleolus was performed in 23, 21, and 5 patients in type Ⅰ, Ⅱ, and Ⅲ groups, respectively. The operation time, fracture healing time, full weight-bearing time, postoperative joint flatness, and joint degeneration degree of the patients in each group were recorded and compared. The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score was used to evaluate ankle function, including pain, quality of daily life, joint range of motion, and joint stability. The AOFAS scores were compared between fixation and non-fixation groups in each group.ResultsThe procedure was successfully completed by all patients in each group, and there was no significant difference in operation time (F=3.677, P=0.159). All patients were followed up 12-36 months with a mean time of 16.8 months. At last follow-up, 6 patients were found to have suboptimal ankle planarity, including 2 patients (5.3%) in the type Ⅰ group and 4 patients (13.3%) in the type Ⅱ group, with no significant difference between groups (χ2=6.566, P=0.161). The ankle joints of all the patients in each group showed mild degeneration; the fractures all healed well and no delayed union or nonunion occurred. There was no significant difference in the fracture healing time and full weight-bearing time between groups (P>0.05). No complications such as incision infection, fracture displacement, or plate screw loosening and fracture occurred during follow-up. At last follow-up, the total scores and pain scores of the AOFAS scores in the type Ⅱ group were significantly lower than those in the type Ⅰand Ⅲ groups (P<0.05), there was no significant difference between groups in the scores for the quality of daily life, joint range of motion, and joint stability between groups (P>0.05). There was no significant difference in any of the scores between the unfixed and fixed groups, except for the pain and quality of daily life scores, which were significantly lower (P<0.05) in the unfixed group of type Ⅱ group than the fixed group.ConclusionHaraguchi type Ⅱ posterior malleolus fractures have a worse prognosis than types Ⅰ and Ⅲ fractures, especially in terms of postoperative pain, which can be significantly improved by fixing the posterior malleolus; the presence or absence of posterior malleolus fixation in types Ⅰ and Ⅲ has less influence on prognosis.
Objective To explore the service contents of medication therapy management (MTM) for outpatient epileptic children by analyzing drug related problems (DRPs). Methods A cross-sectional study was adopted to analyze the status of DRPs in outpatient epileptic children in West China Second Hospital of Sichuan University. The focus group discussion method was adopted to formulate the specific service contents of MTM in outpatient epileptic children. Results A total of 2 754 cases of antiepileptic drug treatment were received in the pediatric clinic of West China Second Hospital of Sichuan University from October 1st, 2018 to December 31st, 2018, including 2 018 cases of monotherapy and 736 cases of combination therapy, involving 7 drugs and 10 specifications. The specifications in descending order of frequency of drug use were levetiracetam oral solution, levetiracetam tablets, sodium valproate oral solution, oxcarbazepine oral suspension, oxcarbazepine tablets, topiramate capsules, sodium valproate sustained-release tablets, lamotrigine tablets, magnesium valproate sustained-release tablets and carbamazepine tablets. We applied the Pharmaceutical Care Network Europe (PCNE) classification and found 718 DRPs, mainly focusing on drug selection and improper course of treatment. The specific service contents of MTM for children with epilepsy in the clinic included hospital pharmacy information services, medical teams established by pharmacists, doctors and nurses, child education and medication consultation, and medication follow-up for discharged children. In addition, specific measures to solve DRPs in outpatient epileptic children were designed from 2 aspects of disease management and medication education, and 3 aspects of drug prescription, dispensing, and usage. Conclusions There are various types of antiepileptic medications and treatment schemes for children, and DRPs are complicated. Therefore, MTM for children with epilepsy requires to be strengthened. In this study, the specific intervention contents of MTM for outpatient epileptic children are designed to carry out the follow-up empirical study to verify the effectiveness of MTM.
Health technology assessment is a systematic assessment of the nature and impact of health technology. It is a science that solves the problems of health intervention or health technology on society, economy, organization and ethics. Aiming at the current issues of availability, accessibility, affordability, rationality and safety in the field of medical devices, health technology assessment can systematically evaluate the characteristics, effects and impact of medical devices, and provide evidence-based basis for scientific decision-making. Starting from the current status and challenges of medical device management, this paper introduces the origin and development, basic scope, assessment process and main assessment content of health technology assessment, and introduces the application of health technology assessment in medical device management through case studies, so as to promote development of health technology assessment in the field of medical device management and make medical device management more scientific and standardized.
ObjectiveTo systematically review the research status of therapeutic drug monitoring (TDM) for traditional Chinese medicine. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, CBM, VIP databases, official websites of governments and societies associated with TDM were electronically searched to collect studies on TDM for traditional Chinese medicine from inception to January, 2022. Two reviewers independently screened literature and extracted data. Then, a qualitative systematic review was conducted. ResultsA total of 13 studies were included, all of which came from China and were small sample size studies. The studied population consisted mainly of healthy volunteers (85%), followed by patients of coronary artery disease with blood stasis pattern (31%), patients of rheumatoid arthritis (8%), and patients of acquired immune deficiency syndrome (8%). There were two types of medicine, including proprietary Chinese medicine (69%) and Chinese herbal pieces (31%). The research topics were all theoretical research of TDM, mainly concentration detection methods (77%), followed by influence factors of blood drug concentration (15%), the selection of specimen (15%), the selection of monitoring object (8%) and the concentration reference range (8%). There was no clinical practice study on TDM of traditional Chinese medicine. ConclusionTDM of traditional Chinese medicine is still in the exploratory stage in China. Published studies are mainly on the theoretical research of TDM, and no relevant studies is on clinical practice of TDM of traditional Chinese medicine.
ObjectiveTo evaluate the reliability and validity of the instrument of clinical applicability of guidelines (version 2.0). MethodsThe experts of domestic medical institutions were investigated by questionnaire, and the instrument of clinical applicability of guidelines (version 2.0) were evaluated the guidelines for the diagnosis and treatment of tinea mantis and tinea pedis (revised edition 2017) and the guidelines for the diagnosis and treatment of cerebral hemorrhage in China (2019). Using Cronbach's α coefficient and Spearman-Brown coefficient to evaluate the inherent reliability and split-half reliability. The content validity was evaluated by calculating the content validity index of the item level and the adjusted Kappa value. The correlation coefficient between each item and the dimension and the hypothesis test were used to evaluate the convergent and discriminant validity. The structural validity was evaluated by using structural equation model to evaluate the structural validity of the tool. ResultsThe Cronbach's α coefficient and Spearman-Brown coefficient of the instrument of clinical applicability of guidelines (version 2.0) were both greater than 0.7, the content validity index (S-CVI/Ave) were more than 0.8, the success rates of convergent were 100%, and the success rates of discriminant validity calibration were 100% and 96%. In the second-order confirmatory factor analysis model, the χ2/ df were less than 3, the fitting index (CFI), the goodness of fit index (GFI) and the adjustment goodness of fit index (AGFI) were all greater than 0.9. The root mean square residual (RMR) were all less than 0.05, and approximate error root mean square (RMSEA) were less than 0.09. The P value of RESEA hypothesis test were more than 0.05. ConclusionThe instrument of clinical applicability of guidelines (version 2.0) has good reliability and validity, which can be further verified in practical application in the future.
Rational drug use is a global concern. As one of the highest risk groups for drug use, children's rational drug use has always been concerned. Based on the previous research results of the research group, we developed evaluation indicator systems for assessing rational drug use to treat community-acquired pneumonia and primary nephrotic syndrome in children and proton pump inhibitors in pediatric intensive care units and finished empirical research. This study further summarizes and expounds the construction ideas of rational drug use evaluation indicators for children based on diseases or drugs, and provides a reference for constructing children's rational drug use evaluation indicators.