Objective To explore the influence of dexmedetomidine on wake-up test during spinal orthopaedic surgery. Methods All 80 patients taking spinal orthopaedic surgery were randomly divided into the trial group and the control group, with 40 cases in each group. The endotracheal intubation anesthesia was adopted in both groups with same anesthesia induction. Additionally, dexmedetomidine 0.8 μg/ (kg·h) was infused within 10 min in the trial group before anesthesia induction, and then another 0.5 μg/ (kg·h) was also infused from the intraoperation to suture of incision. For the control group, the same amount of normal saline was infused, and all the narcotics were stopped pumping 15 min before the wake-up test, but then were continued pumping after the wake-up test. Finally, the following indexes were analyzed: wake-up time, wake-up quality, hemodynamic changes at the time of 15 min before wake-up (T1), recovery of spontaneous breathing (T2), wake-up (T3) and 15 min after wake-up (T4), dosage of narcotics, and the incidence of adverse events. Results There was no significant difference in the operation time before wake-up between the two groups (P=0.07). For the trial group, the dosage of sevoflurane (P=0.03) and sufentanil (P=0.00) used before wake-up was significantly lower, the wake-up time (P=0.04) and bleeding amount during wake-up (P=0.00) were significantly less, the wake-up quality (P=0.03) was significantly higher, the blood pressure (P=0.00) and heart rate (P=0.00) when wake-up were significantly lower, and the incidence of adverse events (P=0.04) was significantly lower, compared with the control group. Conclusion Dexmedetomidine adopted in spinal orthopaedic surgery can significantly improve patient’s wake-up quality, shorten wake-up time, reduce bleeding amount when wake-up and adverse events after wake-up, and maintain the hemodynamic stability, so it has better protective effects.
Backgroud Chronic hepatitis is the major infectious disease of liver. There is no effective drug for it up to now. Clinical trials have showed that glycyrrhizin have potentional effective for chronic hepatitis. Objective To evaluate the effectiveness, safety and economics of glycyrrhizin for chronic hepatitis B and C. Search strategy The search terms include glycyrrhizin and its products’ name, chronic hepatitis and chronic carrier status. The thais registers of the Cochrane Hepato-Biliary Group, the Cochrane Complementary Medicine Field, and the central database of The Cochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. And the free Internet search was operated to find ongoing and unpublished researches. Twenty Chinese medical journals and relevant academic conference proceedings have been searched by manual method. The reference lists of identified documents were checked as the complementary search. Inclusion criteria All randomized trials that tested glycryyhizin for chronic hepatitis B virus or hepatitis C virus infection were included in this review. Method of the review According to the principle of Cochrane systematic review, selection of thai for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted by two reviewers.
Objective To collect the report guidelines for systematic reviews and meta-analyses, so as to provide support for the standardized publish and spread of those guidelines. Methods Such databases as Ovid MEDLINE (1996-2010) and EMbase (till April, 2010) were searched with the terms of “guideline”, “report”, “systematic review” and “meta-analysis” to collect the report guidelines for systematic reviews and meta-analyses. The irrelevant literatures (e.g. systematic review of a specific disease, clinical guideline for a certain disease, and other literatures focusing on the methodology of systematic review without mentioning reporting guideline) were excluded by reading the abstracts and titles, and then the further verification was done after the full-texts had been read. The contents about how to report a systematic review or meta-analyses were extracted from the included studies which were classified by its form of the original research (e.g. randomized controlled trial, observational study, diagnostic trial, etc.). Results Primary search ended up with 285 literatures, and 26 literatures of which were included. Among the included literatures about the report guidelines for systematic reviews and meta-analyses, eight were about RCTs, two about non-RCTs, two about observational study, no literature about diagnostic trial, one about animal experiment, two about report searching strategy, five about quality assessment, six about the influence on quality, and the other two about the update of guidelines. Conclusion The report guidelines for systematic reviews and meta-analyses are considerable in number, among which the QUOROM and its updated version PRISMA are relatively mature and widely applied. Report guidelines are beneficial to improve the quality of systematic reviews and meta-analyses, and the report guideline focusing on specific field is needs to be formulate.
Objective To undertake a preliminary study of the concept and approach of patient value and preference and to learn how to understand and elicit patient preference in the light of evidence-based medicine so as to promote evidence-based practice and improve the relationship between clinicians and patients. Methods The searching key words were developed and pertinent data were retrospectively retrieved for the years of 1992-2002. MEDLINE and CBMdisc were searched along with handsearching 9 Chinese medical journals and 4 evidence-based medicine books. Data were scanned and analyzed. Results A total of 2 646 related articles were identified, most of which were found in MEDLINE (2 403), followed by CBMdisc (185) and the journals (58). Currently there is no original article to study in this field from a point of view of evidence-based medicine in China. Conclusion Patient value and preference have been emphasized in the approach of evidence-based medicine and it is a worthwhile topic for us to explore.
ObjectiveTo understand the function of long non-coding RNA (lncRNA) colon cancer associated transcript-1 (CCAT1) and summarize its relationship with gastric cancer.MethodThe published literatures on the studies of lncRNA CCAT1 function and its relationship with gastric cancer were reviewed and analyzed.ResultsThe lncRNA CCAT1 exerted the negative regulation on the genes by binding to microRNAs (miR) as a competitive endogenous RNA, mediating chromatin circulation between the c-MYC promoter and its upstream enhancer, and promoted the expression of c-MYC gene. The recent studies had found that the CCAT1 could bind to the miR-219-1 and miR-490, thereby promoting the progress of gastric cancer. The expression of lncRNA CCAT1 in the gastric cancer tissues increased, which was obviously different from that in the paracancer tissues and normal tissues. The high expression of lncRNA CCAT1 was related to the tumor size, lymphatic metastasis and TNM stage.ConclusionsThe specific mechanism, intracellular signal transduction pathway and interaction mechanism between CCAT1 and other molecules involved in the progress of gastric cancer still need to be further explored. With the in-depth study of lncRNA, especially CCAT1, it may provide a broader prospect for the diagnosis and treatment of gastric cancer as a target of CCAT1.
目的 探讨优质护理服务在妇科临床护理路径（CNP）实施中的应用效果。 方法 2010年4月－2011年4月纳入妇科CNP的住院患者中随机抽取150例，并选择同期病区全部17名护士作为对照组；在2011年5月－12月纳入妇科CNP并实施优质护理服务的住院患者中随机抽取150例，并选择同期病区全部22名护士作为试验组。比较两组患者疾病相关知识知晓率、患者及护士工作满意率、平均住院日的差异。 结果 试验组患者疾病相关知识知晓率、患者及护士满意率优于对照组，且平均住院日明显缩短。 结论 优质护理服务应用于改进CNP管理质量，可提高患者疾病相关知识知晓率和护患满意率，缩短住院时间，减轻医疗负担，有利于CNP的实施。
To explore the focus and trends in real-world studies in Chinese through knowledge mapping method, databases CNKI, VIP, Wanfang and Sinomed were retrieved, with 1 757 relevant articles published before September 30rd, 2020 finally included, whose bibliographical records were imported into NoteExpress to avoid duplication and check relativity. VOSviewer, a bibliometric analysis tool, was used to analyze their development. It was found that real-world studies have mainly taken shape after 2010, in which traditional Chinese medicine research plays an important role. China Journal of Chinese Material Medica was the leading journal with 120 papers, the China Academy of Chinese Medical Sciences the most contribution institution with 338 papers, and Xie Yanming from the institution the most contribution author with 250 papers. This study helps clinicians and researchers in better understanding the evolution of real-world research over more than two decades in China.
Objective To get known about the employment intentions to primary health service organizations (PHSO) among medical students in North Sichuan Medical College, and to assess its main influencing factors, so as to provide scientific evidence for occupational guidance in medical colleges, as well as talent introduction and retention in PHSO. Methods By cluster sampling method, medical undergraduates and college students in North Sichuan Medical College were investigated using a self-designed questionnaire from April to October, 2010. EpiData 3.1 and SPSS 16.0 software were used for inputting data and analyzing respectively. Results a) Among 900 questionnaires distributed, 870 were reclaimed (response rate 96.7%). b) Nearly 60% of medical students thought their own professional development was “average”, with following intentions after graduation in order: employment first and then postgraduate entrance exam, employment, postgraduate entrance exam; and 85% of medical students were more willing to work in medical institutions above level-2 in city or county. c) More than 70% of medical students’ employment intentions to PHSO were “average”, and “unwilling”, etc.; the main influencing factors were personal development space, salary and welfare, and comprehensive strength of hospital, etc. d) More than 90% of medical students “Do not know” or “generally” understood the related national preferential policies. Conclusion Government, PHSO and universities should take measures together and increase policy advocacy and infrastructure investment, so as to encourage medical students to work in PHSO.
Objective To investigate the quality of the randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) integrated with western medicine for severe acute respiratory syndrome (SARS). Method All the randomized controlled trials of traditional Chinese medicine integrated with western medicine for SARS worldwide were gained by electronic searching and hand searching. The quality of the RCTs was analyzed by the quality grade evaluation used in Cochrane handbook.The sample size, the baseline data, the results indexes were also analyzed. Results Seven RCTs included 501 SARS cases were identified. The quality grade of one RCT is B, the other six RCTs were graded C. None pre-specified sample size. One RCT tested the differences of the baseline data by statistic method. One RCT reported quality of life as result index. None reported the adverse events.Conclusions Current RCTs of TCM integrated with western medicine can’t provide b evidence for clinical practice because of the poor quality.
Objectives To conduct a meta-analysis to evaluate the efficacy and safety of thymosin-α1 for HBeAg-positive chronic hepatitis B. Methods We searched MEDLINE, Science Citation Index, Current Content Connect, Cochrane Controlled Trial Register and Chinese Biomedical Database (CBMdisc) to September 15, 2005, and screened the references of eligible trials by hand-searching. Randomized controlled trials (RCTs) comparing thymosin-α1 with non-antiviral interventions (placebo, no treatment and standard care) in patients with HBeAg positive chronic hepatitis B were eligible for inclusion. We conducted quality assessment and data extraction by two independent investigators with disagreement resolved by discussion. We used chi-square test and Galbraith plot to detect the heterogeneity, and used fixed (Mantel-Haenzel) and random effect model (DerSimonian-Laird) to pool the trials. When the results in two models differed, the results of random effect were reported. Subgroup analysis was performed to detect whether the duration affected the efficacy of thymosin. Results Four RCTs were included. It was found that the rate of loss of HBeAg was 38.8% in thymosin, significantly higher than that of 12.4% in control groups (RR 2.22, 95%CI 1.55 to 3.21, P=0.000). Loss of HBV-DNA was 36.9% in thymosin-α1, significantly higher than that of 13.8% in control groups (RR 2.18, 95%CI 1.50 to 3.17, P=0.000). Both short-duration (8-13 weeks) and regular duration (26-52 weeks) of thymosin-α1 achieved higher loss of HBeAg and HBV-DNA. The complete response rate was 32.3% in thymosin-α1, significantly higher than the control, 11.3% (RR 2.91, 95%CI 1.71 to 4.94, P=0.000). No statistical significance was found for HBeAg seroconversion and ALT normalization. No significant adverse drug reactions were found. Conclusions Thymosin-α1 might be efficacious in loss of HBeAg and HBV-DNA, and complete response for patients with HBeAg-positive chronic hepatitis B. Little evidence was available on HBeAg seroconversion, normalization of ALT, loss of HBsAg, and histological response. Further high-quality RCTs were needed for confirmation.