ObjectiveTo evaluate the efficacy and safety of all kinds of hemocoagulase on operative incisions. MethodsDatabases including Web of Science, MEDLINE, EMbase, EBSCO, PubMed, CNKI, WanFang Data and VIP were electronically searched to collect randomized controlled trials (RCTs) about hemocoagulase on operative incisions from the inception to June 20th, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 867 patients were included. The results of meta-analysis showed that, compared with the control group, the hemostatic time (MD=-37.84, 95%CI -52.72 to -22.96, P<0.000 01), blood loss volume per unit area (MD=-0.09, 95%CI -0.10 to -0.07, P<0.000 01), PT of the first postoperative day (MD=-0.37, 95%CI -0.65 to -0.09, P=0.009) were significantly shorter in the hemocoagulase group. However, no significant differences were found in APTT, TT and FIB between two groups. ConclusionHemocoagulase can reduce hemostatic time and blood loss volume in surgical incisions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
ObjectiveThis study aims to examine the possible association between C-reactive protein (CRP) concentration and post-stroke seizures. MethodsPatients with a first-ever ischemic stroke and no history of epilepsy before stroke who admitted to Western China Hospital were consecutively enrolled in our study. CRP levels were assessed within one week of stroke onset. After a mean follow-up period of 2.5 years, a follow-up assessment was performed to identify post-stroke epilepsy. Logistic regression and Cox regression analyses were used to assess the relationship between CRP levels and post-stroke early-onset seizures or post-stroke epilepsy. ResultsAmong the 1, 116 patients included in our study, 36 (3.2%) patients had post-stroke early-onset seizures and 65 (5.8%) patients had post-stroke epilepsy. Elevated CRP levels were associated with a higher risk of post-stroke early-onset seizures (51.4±49.2 vs 15.9±12.9, P=0.023). This correlation was persisted even after adjusting for potential confounders[OR=1.008, 95%CI (1.003, 1.018); P=0.003]. No association was observed between CRP levels and post-stroke epilepsy. ConclusionsElevated CRP levels may be associated with higher risk of post-stroke seizures. However, because of the observational nature of the study, more studies are needed to confirm the results.
ObjectiveTo explore the features of images by CT,MRI,and MRV for early cranial venous sinus thrombosis (CVST) to provide the diagnostic evidence for choosing an optimal imaging examination. MethodsThe clinical data (imaging features of CT,MRI,and MRV) of 46 patients with CVST diagnosed between January 2009 and January 2013 were retrospectively analyzed. ResultsBrain CT showed the direct signs of CVST in 15 cases (32.6%),and indirect signs of CVST in 8(17.4%).MRI showed the signs of CVST in 17 cases (68.0%);the diagnostic positive rate of MR venography (MRV) combined with MRI was 87.5%,84.6% of which was in line with that of digital subtraction angiography. ConclusionCT can be used as screening tool for those highly suspect CVST cases.MRI combined with MRV show great diagnostic value for CVST.
ObjectiveTo evaluate whether atrial fibrillation could predict poor outcomes in stroke patients receiving thrombolysis by meta-analysis. MethodsWe searched MEDLINE, the Cochrane Library and EMbase databases for cohort studies concerning the effect of atrial ribrillation on prognosis of stroke patients receiving thrombolysis up to March 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of nine retrospective cohort studies involving 6 313 patients were included. The results of meta-analysis showed that:atrial fibrillation could increase the risk of symptomatic intracerebral hemorrhage (OR=1.51, 95%CI 1.15 to 1.99, P=0.003) and mortality (OR=1.90, 95%CI 1.29 to 2.80, P=0.001) of ischemic stroke patients receiving thrombolysis; the early improvement rate (OR=0.74, 95%CI 0.60 to 0.90, P=0.002) and later improvement rate (OR=0.50, 95%CI 0.39 to 0.64, P<0.000 01) of the atrial fibrillation group were lower than that of the non-atrial fibrillation group. ConclusionAtrial fibrillation could be a risk factor of poor outcome in ischemic stroke patients receiving thrombolysis. Due to the limitation of quantity and quality of the included studies, large-scale, multi-central and high quality clinical studies are needed.
ObjectiveTo investigate the current situation of randomized controlled trials (RCTs) of thrombin like enzyme research and the ability to provide a reliable basis for the clinical practice. MethodsRCTs identified from four Chinese databases up to the year 2012 were assessed according to international standard, including SinoMed (1978-2012), CNKI (1979-2012), Wanfang Data (1986-2012), and VIP (1989-2012). ResultsA total of 2358 articles were searched and 53 RCTs were identified. The results showed that the quality of these articles was not high enough to meet the needs of clinical practice in China. ConclusionIn China, current quantity and quality of RCTs of thrombin like enzyme can not meet the need of clinical practice. In order to improve the prevention and treatment of hemorrhagic diseases, and surgical bleeding, especially for patients lacking clotting factor, more high-quality RCTs are required.
ObjectiveTo investigate the clinical manifestations, diagnosis and treatment of diaphrammatic paralysis (DP) in infants with congenital heart disease (CHD) after cardiac surgery. MethodsBetween October 2008 and June 2014, among 2 962 infant patients ( < 1 year) underwent cardiac surgery for congenital heart disease, postoperative DP was diagnosed in 31 patients. The paralysed hemidiaphragm was left side in 10 patients, right side in 15 patients, and bilateral in 6 patients. There were 22 males and 9 females. The age at operation was 1-12 (4.5±4.2) months on the average. The body weight at operation was 2.9 to 8.5 (5.6±2.2) kg on the average.All children received mechanical ventilation. ResultsNo patient died in this study.There was a statistical difference between preoperative and postoperative mechanical ventilation time at 123-832 (420±223) hours versus 15-212 (75±58) hours (P < 0.05). ConclusionsDP caused by phrenic nerve injury during surgical intervention for congenital heart disease is an important risk factor in terms of morbidity during the postoperative period. Diaphragmatic plication appears a good option, especially in infant children, to wean patients from mechanical ventilation and to prevent long-term side effects of mechanical ventilation.