ObjectiveTo systematically review the methodological quality of clinical practice guidelines (CPGs) on the management of acute gastroenteritis/diarrhea in children, then to compare differences and similarities of drug recommendations, in order to provide references for clinical practice. MethodsGuidelines concerning acute gastroenteritis/diarrhea in children were searched in CNKI, VIP, WanFang Data, CBM, PubMed and EMbase databases from inception to April 2015. The websites of GIN (Guidelines International Network), CGC (China Guideline Clearinghouse), NGC (National Guideline Clearinghouse), APP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and the WHO (World Health Organization) were also searched for additional guidelines. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations of included guidelines were compared. ResultsA total of 9 guidelines on acute gastroenteritis/diarrhea in children were included. Among them, 3 guidelines were developed by USA, 1 by Malaysia, 1 by EU, 1 by UK, 1 by South Wales, 1 by Australia and 1 by South Africa. Five guidelines were evidence-based guidelines, and the other 4 were non-evidence-based guidelines. The average scores of guidelines in six domains of AGREE Ⅱ were 79% (clarity of presentations), 74% (scope and purpose), 44% (stakeholder involvement), 35% (rigor of development), 32% (applicability), and 30% (editorial independence), respectively. The recommendations of management and treatment were almost consistent. ConclusionThe overall quality of included guidelines was not high. The domain scores of "clarity of presentations" and "scope and purpose" were higher, but the domain scores of "stakeholder involvement", "rigor of development", "applicability" and "editorial independence" needed to be improved. There is still no local guideline of acute gastroenteritis/diarrhea in children in China, so it's urgent to develop guideline that should be suite able for Chinese condition.
ObjectiveTo investigate the angiogenesis mechanisms of vascular endothelial growth factor (VEGF) combined with basic fibroblast growth factor (bFGF) for arteriosclerosis obliterans of rat hind limb. MethodsThe models of hind limb arteriosclerosis obliterans of 60 male SD rats were established and randomly divided into four groups:normal saline (NS) group, VEGF group, bFGF group, and VEGF+bFGF group. The saline 1 mL and 100μg/L rhVEGF 1 mL were respectively injected into the abdominal cavity on every other day in the NS group and VEGF group. The 100μg/L rhbFGF 1 mL was multiply injected into the hind limb medial vastus muscle in the bFGF group. The 100μg/L rhVEGF 1 mL and 100μg/L rhbFGF 1 mL were respectively injected into the abdominal cavity and the hind limb medial vastus muscle on every other day in the VEGF+bFGF group. The angiogenesis of rat hind limb arteriosclerosis obliterans was observed on day 30 by digital subtraction angiography (DSA). The VEGF and bFGF protein and mRNA expressions in the hind limb medial vastus muscle tissues were tested by the Western blot and RT-PCR methods respectively. Results①The number of new collateral vessel in the VEGF+bFGF group was significantly more than that in the bFGF group (P < 0.05), VEGF group (P < 0.05), and NS group (P < 0.001), which in the VEGF group or bFGF group was significantly more than that in the NS group (P < 0.001), and which had no significant difference between the VEGF group and bFGF group (P > 0.05).②The protein and mRNA expressions of VEGF and bFGF in the VEGF+bFGF group were significantly higher than those in the bFGF group (P < 0.001), VEGF group (P < 0.001), and NS group (P < 0.001), which in the VEGF and bFGF were significantly higher than those in the NS group (P < 0.001), which had no significant difference between the VEGF group and bFGF group (P > 0.05). ConclusionsVEGF and bFGF in combination could increase the expressions of VEGF and bFGF in the rat hind limb ischemia region tissue and promote vascular endothelial cell proliferation and differentiation, and capillary sprouting growth, make angiogenesis of ischemic area, it is provided a new clinical treatment of peripheral arterial disease.