【摘要】 目的 探讨细菌性胶原酶对创口感染情况的影响。 方法 2006年11月-2006年12月，对28只新西兰兔分为实验组和对照组，分别予细菌性胶原酶溶液及生理盐水浸润创口并缝合。观察创口感染及局部皮肤的炎性细胞浸润情况。 结果 实验组与对照组创口感染率差别无统计学意（Pgt;0.05），炎性细胞差别无统计学意义（Pgt;0.05）。 结论 细菌性胶原酶在创伤修复过程中不能直接降低感染率，对炎性细胞的迁移并无明显的作用。 【Abstract】 Objective To assess the effects of bacterial collagenase on the wound infection. Methods A total of 28 New Zealand rabbits have chosen from November to December 2006, and were divided into a laboratorial group and a control group. We sutured the wounds and soaked them by the bacterial collagenase liquid or by the physiologic saline solution. The infection and the inflammatory cells of the skin around the wound were observed. Results The difference of the infection rates between the two groups was not statistically significant (P=0.62), nor the difference of inflammatory cells (P=0.84). Conclusions Bacterial collagenase can not decrease the rate of infection directly, and had no obvious effect on the transferring of inflammatory cells.
目的:比较早期预警评分(EWS)和改良早期预警评分(MEWS)预测急诊住院患者死亡风险的能力。方法:随机抽取409名四川大学华西医院急诊住院患者,采用EWS和MEWS对患者进行评分,使用ROC曲线比较两者预测急诊住院患者死亡风险的能力。结果:EWS预测患者住院的曲线面积为0.849±0.132,其最佳截断值为4分;MEWS预测急诊患者住院的曲线下面积为0.876±0.124,其最佳截断值为5分。结论:MEWS较EWS对于预测急诊住院患者死亡风险有较高的效能,还可以进一步改进提高其预测能力。
Objective To elucidate the effect of first-aid fast track in triaging earthquake trauma patients by studying the earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” so as to accumulate experience in the treatment of disaster traumas. Methods A retrospective study was done on earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” from 14:28 May 12, 2008 to 14:27 May 15, 2008. Differences in care given during the time period were analyzed. Results There were 536 earthquake trauma patients in West China Hospital within 72 hours after the earthquake. Twohundred and seven earthquake trauma patients staying in the Emergency Department had an average stay of 129 minutes during the 24 hours after the quake; 104 earthquake trauma patients staying in the Emergency Department had an average stay of 97 minutes in the second 24 hours; and 226 earthquake trauma patients staying in the Emergency Department had an average stay of 86 minutes in the third 24 hours. Each consecutive day showed shorter average stays. Conclusion The first-aid fast track not only guarantees earthquake trauma patients are saved as soon as possible but also shortens the time in the Emergency Department.
Objective To evaluate the effectiveness and safety of foscarnet sodium in the treatment of chronic hepatitis B. Methods We searched MEDLINE, EMbase, The Cochrane Library and CNKI from 1978 to June 2006. Randomized controlled trials of foscarnet sodium versus other drugs or no drugs in the treatment of chronic hepatitis B were identified. The quality of the included trials was evaluated by two reviewers independently. Meta-analysis was done using The Cochrane Collaboration’s RevMan 4.2.7. Results Seven studies (337 patients) were included; one compared foscarnet sodium versus interferon, and the other six compared foscarnet sodium versus no drugs. All the included studies were graded in terms of the quality of randomization, allocation concealment and blinding. All 7 studies were graded as level C. The meta-analysis showed that: ① foscarnet sodium was not significantly different from interferon in clinical efficacy, liver function, negative-conversion rate of virological markers and side effects. ② compared with the no drugs group, the negative-conversion rate of virological markers was significantly higher for the foscarnet sodium group, HBeAg (RR 6.20, 95%CI 1.76 to 21.79) and HBV-DNA (RR 4.13, 95%CI 1.32 to 12.86); but there were no significant differences in clinical efficacy, liver function and side effects. Conclusions Available evidence shows that: in the treatment of chronic hepatitis B the effectiveness and safety of foscarnet sodium are not significantly different from interferon, but only one trial is included in this review, so the evidence is weak. Compared with no drugs, foscarnet sodium significantly improves the negative-conversion rate of virological markers, but the evidence is insufficient to show whether foscarnet sodium could improve clinical efficacy and liver function, as well as reduce side effects.
Totally thoracoscopic surgery is a branch of minimally invasive cardiac surgeries, and its operational indicators are expanding with the development of the medical and imaging devices compared with median sternotomy and other minimally invasive cardiac surgeries (such as thoracoscope-assisted small incision surgery and robotic surgery). The learning curve is significantly shortened through the professional technique training. Totally thoracoscopic cardiac surgery has many advantages, such as minor trauma, few serious complications, fast recovery, high patient acceptance and being suitable to our country's current situation. Therefore it will be one main direction of minimally invasive cardiac surgery. This article mainly introduced the current status of totally thoracoscopic technology in the field of cardiac surgery in China.
The eye-computer interaction technology based on electro-oculogram provides the users with a convenient way to control the device, which has great social significance. However, the eye-computer interaction is often disturbed by the involuntary eye movements, resulting in misjudgment, affecting the users’ experience, and even causing danger in severe cases. Therefore, this paper starts from the basic concepts and principles of eye-computer interaction, sorts out the current mainstream classification methods of voluntary/involuntary eye movement, and analyzes the characteristics of each technology. The performance analysis is carried out in combination with specific application scenarios, and the problems to be solved are further summarized, which are expected to provide research references for researchers in related fields.
【摘要】 目的 评价简化肾脏病膳食改良试验（MDRDa）方程以及国内两个改良MDRD方程（中国方程1、2）预测中国慢性肾脏病患者肾小球滤过率（glomerular filtration rate，GFR）的适用性。 方法 选择2008年1-12月住院慢性肾病患者250例，用99mTc-DTPA肾动态显像法测定GFR（sGFR），同时测定血清肌酐、尿素氮，根据年龄和性别分别用简化MDRD方程、中国方程1和中国方程2预测GFR，即eGFRa （简化MDRD方程）、eGFR1 （中国方程1）和eGFR2（中国方程2），以sGFR为参考值，将估计的eGFRs进行比较。 结果 各方程eGFRs与sGFR之间呈显著相关关系。其中中国方程2的估算eGFR2与sGFR具有良好的一致性，总体偏差最小，准确性最高。 结论 中国方程2优于简化MDRD方程和中国方程1，可用于中国慢性肾病人群eGFR的计算。【Abstract】 Objective To evaluate the applicability of three equations for glomerular filtration rate (GFR) in Chinese patients with chronic kidney disease (CKD). Methods A total of 250 patients with CKD which were diagnosed according to K/DAQI guidelines between January and December 2008 were selected. GFR were estimated with Chinese equation 1 (eGFR1), Chinese equation 2 (eGFR2) and abbreviated MDRD (eGFRa) separately, and the results were compared with that of 99mTc-DTPA(sGFR). Results The eGFRs of the three equations were correlated significantly with sGFR. Chinese equation 2 seemed to be the best; eGFR2 showed less bias and higher accuracy than other equations. Conclusion Chinese equation 2 for estimation of GFR may be more accurate in Chinese CKD patients.
Objective To evaluate the effectiveness and safety of treatment with Fuzheng Huayu capsule for liver fibrosis of chronic hepatitis B (CHB). Methods We searched MEDLINE, EMBASE, Cochrane Database of Controlled Trials (CCTR), CBMweb and CNKI up to March 2008. The references of retrieved literature were also hand searched. Randomized controlled trials (RCTs) which compared Fuzheng Huayu capsule with placebo or other drugs were collected. Data extraction and quality assessment were performed by two reviewers independently. The Cochrane Collaboration’ s software RevMan 4.2.10 was used for data analyses. Results Seven RCTs involving 590 cases of liver fibrosis of CHB were included. As for their methodological quality, one was graded A, one was graded B and the others were graded C. We carried out subgroup analyses based on treatment course and intervention measures. In terms of reducing haluronic acid, Fuzheng Huayu capsule was more effective than Huoluo Shugan capsule when the treatment course was 3 months (WMD=–61.75, 95%CI –105.20 to –18.30); significant differences were also noted between Fuzheng Huayu capsule and placebo (WMD=–187.72, 95%CI –244.23 to –31.21) or Huoluo Shugan capsule (WMD=–120.03, 95%CI –158.41 to –81.65) when the treatment course was 6 months. In terms of reducing IV-C, Fuzheng Huayu capsule was more effective than Gantaile when the treatment course was 6 months (WMD=–72.32, 95%CI –84.30 to –60.34). As for improving liver fibrosis at stage S, significant differences were observed between Fuzheng Huayu capsule and Gantaile (RR=2.33, 95%CI 1.37 to 3.96) or Huoluo Shugan capsule (RR=1.30, 95%CI 1.03 to 1.65). Except a very small number of gastrointestinal reactions, no significant adverse reactions were reported. Conclusion Fuzheng Huayu capsule is effective in reducing haluronic acid and improving liver fibrosis at stage S, especially when the treatment course is prolonged from 3 months to 6 months. No significant adverse reactions are reported. Because most of the included trials are of poor quality and small sample size, more high-quality RCTs are needed.
Objective To evaluate the effectiveness and safety of foscarnet and ganciclovir for cytomegalovirus retinitis associated with acquired immune deficiency syndrome (AIDS). Methods We searched MEDLINE (1966 to 2005.12), EMBASE (1974 to Dec.2005), The Cochrane Library (Issue 4,2005), CBM (1978 to Dec.2005), CMCC (1994 to Dec. 2005), CNKI (1994 to Dec. 2005) and VIP (1989 to Dec. 2005). We identified randomized controlled trials of foscarnet versus ganciclovir. Two independent reviewers collected and evaluated details of study populations, interventions, and outcomes using a data extraction form. We conducted meta-analysis of the homoeonomous data. Result Three studies involving 451 patients were included. Meta-analysis showed foscarnet was better than ganciclovir with the following outcomes: mortality (RR=0.84, 95%CI 0.70 to 1.00, P=0.05); male genital ulcers (RR=1.29, 95%CI 0.60 to 2.82, P=0.002). There were no significant differences in ocular symptoms, relapses and other side effects. Conclusion Foscarnet in the treatment of cytomegalovirus retinitis in AIDS patients may be more benefical than ganciclovir with regard to mortality and male genital ulcers, but the supporting evidence is not very b because there are only three trials.
【Abstract】 Objective To study the outcome of wound-heal ing hydrogel in treating chronic venous ulcer of lowerextremities so as to find a new therapy. Methods From April 2007 to September 2007, 60 patients with chronic venous ulcer of lower extremities were randomly assigned to wound-heal ing hydrogel group (group A, 30 cases) and control group (normal sal ine, group B, 30 cases). In group A, there were 24 males and 6 females, aging (57.3 ± 6.8) years; the disease course was (2.9 ± 0.7) years; and the ulcer area was (3.4 ± 0.6) cm2. In group B, there were 20 males and 10 females, aging (60.1 ± 7.4) years; the disease course was (3.3 ± 0.9) years; and the ulcer area was (3.1 ± 0.4) cm2. There were no differences in age, area of ulcer and course of disease between two groups (P gt; 0.05). The area of ulcer was measured every week after the treatment, and the effect of treatmentwas evaluated after 15 days. Results The ulcer area of 7 days and 14 days after treatment was (2.6 ± 0.7) and (1.1 ± 0.2) cm2 in group A, and (2.8 ± 0.6) and (2.3 ± 0.7) cm2 in group B, respectively; showing no statistically significant differences 7 days after treatment (P gt; 0.05), and showing statistically significant difference 14 days after treatment between two groups (P lt; 0.05).The average heal ing time was (12.0 ± 1.7) days in group A, and (31.0 ± 2.9) days in group B, respectively, showing statisticallysignificant difference (P lt; 0.01). The results were excellent, good, fair and poor in 16, 9, 4 and 1 of group A , and were in 3, 9, 14 and 4 of group B, respectively; showing statistically significant difference (P lt; 0.01). Conclusion Wound-heal ing hydrogel is effective in treating chronic venous ulcer of lower extremities.