Objective To investigate a method of improving design of the skin flap pedicled with descending branch of lateral femoral circumflex artery, in order to increase the accuracy of preoperative Doppler location. Methods Firstly, the interspace between rectus femoris and vastus lateralis was regarded as line A, and the point of intersection between line A and the vertical line through the midpoint of the line between anterior superior iliac spine and lateral margin of patella was point A. And then the line between the midpoint of groin and point A was regarded as line B. Based on this , the perforating point of cutaneous branch could be located by Doppler along the line B. From November 2001 to October 2004, this method was used in 38 skin flaps of 37 cases, being all males and 16-48 years old. The area of the flap ranged from 7 cm×6 cm to 24 cm×16 cm. Results All the perforatingpoint of cutaneous branch were located outward the line A. The rate that the preoperative Doppler location was consistent with the utility point of formatting skin flap was 97.4%. All the cases were followed up postoperatively 1-20 months. Among the cases, 36 skin flaps of 35 cases was successful and only 2 skin flaps partially necrosed, which healed after changing dressings or skin graft.Out of 35 cases, the sensation restoration of the skin flap was S2-S3 in 6 cases owing to the anastomosis of lateral femoral cutaneous nerve and a skin nerve of the recipient site, while that of the other cases was S0-S1. Conclusion Preoperative Doppler location and improving design of lineB can be a useful instruction for the design of skin flap pedicled with descending branch of lateral femoral circumflex artery.
ObjectiveTo summary the detection methods of circulating tumor cells (CTCs) in pancreatic cancer patients and its clinical application. MethodsRelated domestic and foreign literatures were reviewed. ResultsPancreatic cancer is one of the common malignant tumors in the world. The early diagnosis rate is low, the incidence of local invasion and metastasis is high, and the prognosis is very poor. The CTCs is one of the important causes of postoperative recurrence and metastasis, its detection methods based on immunocytochemistry (ICC) and reverse transcription polymerase chain reaction (RT-PCR). ConclusionsDetection of CTCs, regarding as a "real-time liquid biopsy", it has a high application value in the early diagnosis, treatment, prognosis and effect evaluation of pancreatic cancer, and it has become research frontier and focus.
Protamine, which can be used to neutralize the anticoagulant effect of heparin in terms of surgical field extensively, is a kind of polycationic peptide extracted from the mature spermary of fish and mammal. While protamine brings convenience for clinical practice, it also produces some adverse reactions, which even endanger the patient's life. The clinical workers, therefore, pay more attention to the prevention and monitoring of adverse reactions of protamine. This paper introduces the mechanism of the interaction between protamine and heparin, monitoring methods and adverse reaction types. Furthermore, it reviews the current prevention methods of its adverse reactions, its application scale, as well as its existing problems in various clinical disciplines, suggesting that the modification of protamine from the perspective of molecular biology and genetic biology may strengthen its drug efficacy and reduce its adverse reactions, which will be the research highlights in the near future.
Objective To investigate the detection of multidrug-resistant organisms (MDRO) by targeted monitoring in a tertiary hospital, and to understand the distribution of MDRO. Methods We retrospectively analyzed the detection and distribution of methicillin-resistantStaphylococcus aureus (MRSA), carbon black alkeneAcinetobacter baumannii (CRABA), carbapenem-resistantPseudomonas aeruginosa (CRPAE), vancomycin-resistantEnterococci (VRE) and carbapenem-resistantEnterobacter (CRE) in clinical samples collected from 2013 to 2015. Results A total of 990 multidrug-resistant bacteria strains were isolated from 2013 to 2015, of which 445 were MRSA (44.95%), 328 were CRABA (33.13%), 99 were CRPAE (10.00%), 12 were VRE (1.21%), and 106 were CRE (10.71%). They were mainly distributed in the Department of Burn, Comprehensive ICU, Department of Neurosurgery, Department of Respiratory Medicine and Department of Orthopedic Surgery. The detection rates of multidrug-resistant organisms of 2013-2015 were 10.85% (352/3 244), 9.20% (304/3 303), and 7.11% (334/4 699) respectively, which reduced year by year with significant difference (χ2= 34.42,P< 0.001). The detection rates of CRPAE, CRE and VRE all reduced with significant differences (P< 0.05). Conclusions The detection rate of multidrug-resistant organisms under targeted monitoring shows an obvious downward trend. MRSA and CRABA are still the major MDROs, which show no obvious change. The detection rates of CRPAE, VRE and CRE show obvious downward trend. Department of Burn, Comprehensive ICU, Department of Neurosurgery, Department of Respiratory Medicine and Department of Orthopedic Surgery have the highest risks of MDRO. In the future, we should strengthen the monitoring of high-risk departments, and focus on the reasonable choice of special antimicrobial agents to avoid special MDROs.
ObjectiveTo systematically evaluate the detection rate of postpartum depression in Chinese maternal population and to provide a scientific basis for the prevention and treatment of postpartum depression.MethodsWe searched CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library databases to collect studies on the detection rate of postpartum depression in Chinese maternal population from January, 2001 to August, 2019. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was performed using Stata15.0 software.ResultsA total of 24 studies involving 38 357 cases were included. Meta-analysis results showed that the total detection of postpartum depression in Chinese females was 15% (95% CI 12% to 17%). Subgroup analysis showed that the detection of postpartum depression was 12.3% (95% CI 9.3% to 15.2%) in the south and 17.3% (95%CI 12.1% to 22.5%) in the north. According to the Edinburgh postpartum depression scale, the rate was 14.5% (95%CI 11.4% to 17.5%); and for other scales, the rate was 15.0% (95% CI 8.9% to 21.2%); simple random sampling method was 14.8% (95%CI 11.0% to 18.7%), and cluster sampling was 16.3% (95%CI 12.0% to 20.5%). The rate was 15.8% (95%CI 9.3% to 22.3%) from 2001 to 2010, 13.5% (95%CI 7.7% to 19.2%) from 2011 to 2014, and 14.8% (95%CI 10.9% to 18.6%) from 2015 to 2019. Sensitivity analysis showed that the combined results were stable.ConclusionsThe detection rate of postpartum depression in Chinese maternal population is high, and early screening and related intervention should be paid more attention to these population.
ObjectivesTo systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.ResultsA total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.ConclusionsThe detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
Bacterial biofilm is the key problem of chronic wound infection and difficult healing. How to prevent and control bacterial biofilm and improve the prognosis of chronic wound has become a research hotspot in the field of wound care. This paper will summarize from the following aspects: four major stages in the process of chronic wound bacteria biofilm formation (surface adhesion, formation of small colonies, biofilm maturation, and dispersion and separation); characteristics of host immune response in the presence of biofilms; morphological, microbiological, and molecular detection methods for biofilms; and progress in in vitro trials, animal trials, clinical trials, and new therapeutic methods of biofilm. The purpose of this review is to provide evidence for the treatment of biofilms for chronic wounds.
ObjectiveTo systematically review the detection rate of cognitive impairment in Chinese patients with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were searched to collect studies on the detection rate of cognitive impairment in Chinese patients with T2DM from inception to January 20th, 2021. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Meta-analysis was then performed using Stata 12.0 software.ResultsA total of 27 studies involving 7 920 cases were included. Meta-analysis results showed that the total detection rate of cognitive impairment in Chinese patients with T2DM was 43.2% (95%CI 36.9% to 49.6%). The results of subgroup analysis showed that in T2DM patients, the detection rate of cognitive impairment in males was 42.4% (95%CI 34.4% to 50.4%), and that in females was 48.2% (95%CI 40.9% to 55.6%). The detection rate of cognitive impairment was 25.4% (95%CI 14.7% to 36.0%) in patients under the age of 60 years, and 47.0% (95%CI 30.0% to 64.0%) in patients aged 60 years or above. The detection rate of cognitive impairment among those with primary school education level or below was 67.1% (95%CI 48.9% to 85.3%). The detection rate of cognitive impairment was 37.1% (95%CI 27.3% to 46.8%) among those with education level of junior high school or above. The detection rate of cognitive impairment in patients with disease duration less than 10 years was 28.4% (95%CI 16.0% to 40.9%) and that in patients with disease duration more than 10 years was 50.6% (95%CI 33.2% to 68.0%). The detection rate of cognitive impairment in married individuals was 45.6% (95%CI 35.8% to 55.4%) and that in singles was 68.1% (95%CI 57.5% to 78.7%). The detection rate of cognitive impairment in smokers was 38.9% (95%CI 30.7% to 47.2%) and in non-smokers was 40.9% (95%CI 32.1% to 49.6%). The detection rate of cognitive impairment in drinkers was 35.6% (95%CI 27.3% to 44.0%) and that in non-drinkers was 41.8% (95%CI 32.2% to 51.4%).ConclusionsThe detection rate of cognitive impairment in Chinese patients with T2DM is high. Due to the quantity and quality of included studies, more high-quality studies are needed to verify the above conclusions.