ObjectiveTo summarize clinical experience of minimally invasive non-thoracoscopic Nuss procedure for the treatment of pectus excavatum (PE). MethodsFifty-one pediatric patients received minimally invasive nonthoracoscopic Nuss procedure for PE between July 2008 and February 2014 in Department of Thoracic Surgery, Jinan Military General Hospital. There were 32 males and 19 females with their average age of 8.32 (2.5-17.0) years. Transverse incisions were made in bilateral chest wall. Supporting plate was put to right chest wall through retrosternal approach, turned over and fastened onto the ribs. ResultsDeformity of all the patients was successfully corrected. Operation time was 30-52 (38±9) minutes. One patients had heart injury which was repair after open thoracotomy, and then supporting-plate was successfully secured. Postoperative complications included subcutaneous emphysema in 7 patients, pneumothorax in 3 patients and atelectasis in 3 patients, all of whom were cured by conservative treatment. Supportingplate transposition occurred in 1 patient and was corrected by reoperation. All the patients were followed up for 1-42 (21.6±7.6) months. According to Nuss standard, there were 39 patients with excellent results, 9 patients with good results, and 3 patients with fair results. ConclusionMinimally invasive Nuss procedure is an efficacious, easy, feasible and safe procedure for the treatment of PE with low morbidity.
ObjectiveTo evaluate the effect of airway management drugs on the respiratory function and postoperative recovery of patients who had moderate or severe chronic obstructive pulmonary diseases(COPD) undergoing an open chest surgery. MethodThere were a total of 22 patients suffering from both lung cancer, esophageal cancer or gastroesophageal junction carcinoma and moderate to severe COPD(of which there were 16 males and 6 females; accepting traditional operation 5 cases and minimally-invasive operation 17 cases; lung cancer 16 cases, esophageal cancer 4 cases and gastroesophageal junction carcinoma 2 cases as the observation group). To statistic the respiratory function and arterial blood gas analysis before and after treating with airway management drugs. And compare the postoperative pulmonary complications(PPCs) and hospital-stay with 50 patients who have no COPD(of which there were 34 males and 16 females; accepting traditional operation 17 cases and minimally-invasive operation 33 cases; lung cancer 35 cases, esophageal cancer 11 cases and gastroesophageal junction carcinoma 4 cases as the control group). ResultThere was a statistical difference of forced expiratory volume in one second(FEV1), forced vital capacity(FVC) and maximal voluntary ventilation(MVV) after the above treatment by 7 to 10 days and comparing with prior treatment(P<0.05). Partial pressure of oxygen(PaO2) increased with no statistical difference(P>0.05) while PaCO2 decreased with a statistical difference(P<0.05）. Comparing with patients without COPD, the incidences of PPCs and postoperative hospital stay were of no statistical difference(P>0.05). ConclusionPatients with moderate or severe COPD with airway management drugs(antibiotics,glucocorticoids, bronchodilators and phlegm dissolving agent) in perioperative period could improve the respiratory function and operation tolerance effectively, reduce the incidence of PPCs and shorten postoperative hospital stay.
ObjectiveTo systematically review the association between the insertion/deletion (I/D) polymorphism of angiotension-converting enzyme (ACE) gene and the athletes' performance in power sports. MethodsDatabases including PubMed, EMbase, CNKI, CBM, VIP and WanFang Data were searched up to August 1st, 2015 to collect case-control studies about the association between ACE I/D polymorphism and the athletes' performance in power sports. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 26 case-control studies involving 2032 athletes and 10600 controls were included. The results of meta-analysis showed that no significant association was found between ACE I/D polymorphism and the athletes' performance in power sports (DD vs. DI+Ⅱ:OR=1.05, 95%CI 0.81 to 1.36, P=0.70; DD+DI vs. Ⅱ:OR=1.03, 95%CI 0.82 to 1.29, P=0.80; DD vs. Ⅱ:OR=1.04, 95%CI 0.74 to 1.47, P=0.82; DI vs. Ⅱ:OR=0.99, 95%CI 0.81 to 1.22, P=0.96; D vs. I:OR=1.04, 95%CI 0.88 to 1.24, P=0.62). Also, in subgroup analysis by ethnicity, no significant association was found between ACE I/D polymorphism and the performance of athletes of difference races in power sports. Conclusions Current evidence indicates that the ACE I/D polymorphism may not associate with the performance of athletes in power sports. Due to the quality limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusions.
ObjectiveTo systematically review the association between the insertion/deletion (I/D) polymorphism of angiotension-converting enzyme (ACE) gene and the athletes' performance in endurance sports. MethodsDatabases including PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were searched up to August 1st, 2015 to collect case-control studies about the association between ACE I/D polymorphism and the athletes' performance in endurance sports. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 37 case-control studies involving 3 032 athletes and 10 857 controls were included. The results of meta-analysis showed that significant association was found between ACE I/D polymorphism and the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.75, 95%CI 0.67 to 0.83, P<0.01; DD vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.87, P<0.01; DI vs. Ⅱ: OR=0.74, 95%CI 0.66 to 0.83, P<0.01; D vs. Ⅰ: OR=0.85, 95%CI 0.77 to 0.94, P<0.01). Specifically, the ACE I/D polymorphism was significantly associated with the performance of male athletes in endurance sports (DD+DI vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.88, P<0.01; DD vs. Ⅱ: OR=0.75, 95%CI 0.60 to 0.93, P=0.01; DI vs. Ⅱ: OR=0.70, 95%CI 0.60 to 0.93, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.77 to 0.97, P=0.01). Subgroup analysis of ethnicity showed that, in Caucasians, except for genetic model DD vs. DI+Ⅱ, the other 4 genetic models were significantly associated with the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.74, 95%CI 0.65 to 0.84, P<0.01; DD vs. Ⅱ: OR=0.72, 95%CI 0.58 to 0.90, P<0.01; DI vs. Ⅱ: OR=0.73, 95%CI 0.64 to 0.84, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.81 to 0.94, P<0.01); in Africans, significant associations with the athletes' performance in endurance sports were found in genetic model DD vs. DI+Ⅱ (OR=0.75, 95%CI 0.57 to 0.98, P=0.04), genetic model DD vs. Ⅱ (OR=0.62, 95%CI 0.42 to 0.92, P=0.02), and genetic model D vs. Ⅰ (OR=0.80, 95%CI 0.66 to 0.96, P=0.02); in Asians, no significant association was found between ACE I/D polymorphism and the performance of athletes of difference races in endurance sports. ConclusionCurrent evidence indicates that the ACE I/D polymorphism may be associated with the performance of athletes especially male athletes and the Caucasian subgroup in endurance sports. ACE allele D is negatively associated with the athletes' performance in endurance sports, while allele I is positively associated with the athletes' performance in endurance sports. Due to the quality limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusions.
ObjectiveTo systematically review the association between the insertion/deletion (I/D) polymorphism of angiotension-converting enzyme (ACE) gene and the athletes'performance in mixed sports. MethodsDatabases including PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were searched from inception to August 1st, 2015 to collect case-control studies about the association between ACE I/D polymorphism and the athletes'performance in mixed sports. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 13 case-control studies involving 888 athletes and 3 871 controls were included. The results of meta-analysis showed that significant association was found between ACE I/D polymorphism and the athletes'performance in mixed sports (DD vs. DI+II: OR=0.71, 95%CI 0.59 to 0.84, P < 0.01; DD vs. II: OR=0.69, 95%CI 0.54 to 0.87, P < 0.01; D vs. I: OR=0.82, 95%CI 0.72 to 0.92, P < 0.01). Specifically, the ACE I/D polymorphism was significantly associated with the performance of male athletes in endurance sports (DD vs. DI+II: OR=0.71, 95%CI 0.57 to 0.89, P < 0.01; DD vs. II: OR=0.70, 95%CI 0.51 to 0.95, P=0.02; D vs. I: OR=0.80, 95%CI 0.69 to 0.94, P=0.01). However, this significant association was not found in football and middle-distance running sports. Subgroup analysis of ethnicity showed that, the ACE I/D polymorphism was significantly associated with the performance of Caucasian (DD vs. DI+II: OR=0.71, 95%CI 0.59 to 0.87, P < 0.01; DD vs. II: OR=0.69, 95%CI 0.54 to 0.90, P=0.01; D vs. I: OR=0.80, 95%CI 0.71 to 0.92, P < 0.01) and Asian (DD vs. DI+II: OR=0.42, 95%CI 0.20 to 0.89, P < 0.01) athletes in endurance sports, but not with African athletes. ConclusionsCurrent evidence indicates that the ACE allele D is negatively associated with the athletes'performance in mixed sports. Due to the limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusion.
The present study is to explore the change process and distribution of phosphorylated DARPP-32 (p-DARPP-32) in rat brain including cortex, hippocampus and striatum and to further deduce whether p-DARPP-32 was possibly involved in epilepsy induced by repetitive low doses of pentylenetetrazol (PTZ). PTZ-induced epilepsy model in rat was established with 30 male SD rats randomly divided into 6 groups, control group and five trial groups [PTZ 1 h,PTZ 6 h,PTZ 24 h,PTZ 48 h and PTZ 72 h respectively, after onset of status epilepticus (SE)]. Immunohistochemistry and immunofluorescence double-labeling were used to detect the temporal time change and distribution of p-DARPP-32 expression and to analyze the coexpression of DARPP-32 and p-DARPP-32 in rat brain after the onset of PTZ-induced generalized SE. The results showed that there was a temporal time change of p-DARPP-32 expression in rat brain after the onset of SE. The number of p-DARPP-32-positive cells increased significantly and reached the peaks at the ends of 1 hour and 6 hours after the onset of SE, but decreased at the end of 24 hours. The moderate to strong p-DARPP-32-immunopositive neurons were observed in cortex, hippocampus and striatum, and located in cell cytoplasm and cell nucleus. Further immunofluorescence double-labeling revealed that denser colocalization of p-DARPP-32 and DARPP-32 in the neurons existed in the area mentioned above. Therefore, PTZ-induced SE may cause phosphorylation of DARPP-32 in rat brain. The temporal time change and distribution of p-DARPP-32 suggest that phosphorylation of DARPP-32 may be involved in PTZ-induced epilepsy in rat brain including cortex, hippocampus and striatum, and p-DARPP-32 may play a central role in the onset of SE.
ObjectiveTo study on the relationship of serum apelin level with inflammation in patients with atrial fibrillation (AF). MethodsWe recruited 58 patients with valvular heart disease who admitted in our hospital between October 2014 and December 2014 and planned to undergo surgery, including 29 patients with persistent AF (an AF group) and 29 patients with sinus rhythm (a SR group). There were 14 males and 15 females in the AF group at an average age of 57±8 years. There were 20 males and 9 females in the SR group at an average age of 54±10 years. The left atrial diameter (LAD) and ejection fraction (EF) were detected by echocardiography. The levels of serum apelin and interleukin-6 (IL-6) were measured by enzyme linked immuno sorbent assay, and the level of high-sensitivity C-reactive protein (hs-CRP) were determined by turbidimetric inhibition immuno assay. ResultsCompare with the SR group, the serum apelin level (201.94±71.96 pg/ml vs. 286.72±129.33 pg/ml) and EF (54.52%±3.94% vs. 56.41%±2.85%) were significantly lower in the AF group, while the hs-CRP (5.58±12.90 mg/L vs. 1.89±3.55 mg/L), IL-6 (2.59±0.64 pg/ml vs. 2.26±0.55 pg/ml) and LAD (57.10±11.69 mm vs. 43.07±5.31 mm) were significantly higher in the AF group (P<0.05). Correlation analysis showed that the apelin level was negatively correlated with hs-CRP and LAD (r=-0.308, P=0.019; r=-0.313, P=0.017), and were positively correlated with EF (r=0.265, P=0.044). ConclusionSerum apelin level is significantly lower in patients with AF and levels of inflammation makers are significantly higher. Apelin may be closely related to AF and inflammation, and may take part in the occurrence and maintenance of AF through the regulation of inflammatory processes.
ObjectiveTo systematically review the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in China. MethodsWe searched PubMed, The Cochrane Library (Issue 4, 2015), EMbase, CNKI, CBM, VIP and WanFang data from inception to April 2015, to collect diagnostic studies about HLA-B27 for AS in China. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. Pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Subgroup analysis was stratified by detection methods of HLA-B27. ResultsA total of 18 studies involving 22 comparisons, with 3 670 AS patients and 28 389 health controls were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.92 (95%CI 0.90 to 0.93), 0.94 (95%CI 0.94 to 0.95), 16.22 (95%CI 13.63 to 19.29), 0.08 (95%CI 0.06 to 0.10), and 256.49 (95%CI 168.25 to 391.00), respectively. The AUC of SROC was 0.98. The result of subgroup analysis showed that there was no significant difference for flow cytometry (FCM) and Polymerase Chain Reaction with Sequence-Specific Primer (PCR-SSP) in HLA-B27 detection for AS (Z=7.915, P=0.960). ConclusionCurrent evidence indicates that HLA-B27 detection is of great diagnostic value for AS. At present, FCM and PCR-SSP shows no significant difference in HLA-B27 detection for AS. Due to the limitation of the quality of included studies, and the exclusion of the suspected patients, higher quality studies are needed to verify the above conclusion.
Objects To retrospectively analyze the accepted abstracts by the Cochrane Colloquiums in recent 5 years, so as to learn the advances and development trend for next stage in evidence-based medicine field. MethodsAbstracts accepted by the 19th to 23rd Cochrane Colloquiums were collected, and relevant information was extracted. Then, a descriptive analysis was conducted. Outcomes A total of 2088 abstracts were accepted in recent five Cochrane Colloquiums. Europe contributed the most abstracts, in the top 10 contribution countries, five countries were located in Europe. Colleges/Universities were the major contributing institutes, McMaster University of Canada (165, 7.90%) and Lanzhou University of China (118, 5.65%) were the top two contributing institutions. The number of authors of most accepted abstracts were 3 to 5(1011, 48.42%). The top three topics focused by these abstracts were evidence (417, 19.97%), methodology (412, 19.73%) and risk of bias (220, 10.54%). ConclusionsEuropean countries are major contributing countries of abstracts of the Cochrane Colloquium, and colleges/universities are the major contributing institutions. Retrieval and methodology are research hot in recent 5 years. Attention should be paid to breakthrough progress in methodology in future.
ObjectiveTo systematically review the efficacy and safety of traditional Chinese medicine (TCM) therapies versus non-steroidal anti-inflammatory drugs (NSAIDs) for knee osteoarthritis (KOA). MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 5, 2015), EMbase, CNKI, CBM, VIP and WanFang Data from inception to 14 June 2015, to collect randomized controlled trials (RCTs) about TCM therapies for KOA. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then network meta-analysis was performed using Stata 12.0 and WinBUGS 1.4.3 softwares. ResultsA total of 56 RCTs involving 7256 patients were included, in which 19 different treatment strategies were investigated. All were short-term efficacy studies. Our work yielded 33 direct and 138 indirect comparisons, among which 76 were demonstrated statistically significant. The result of meta-analysis showed that, the TCM-based therapy group had lower complication rates, compared with the NSAIDs group. TCM internal application+acupuncture+fumigation, internal application+fumigation+moxibustion, acupuncture+massage, TCM extra-apply+massage, massage+fumigation+moxibustion, and massage+fumigation were the top six in terms of treatment effect. NSAIDs ranked 18th. ConclusionThe safety and effectiveness of TCM therapies are generally better than NSAIDs except moxibustion, particularly more remarkable for the top six TCM therapies. TCM comprehensive therapies are superior over mono-modality therapies. Due to the limitation of the present studies, the long-term efficacy of TCM therapies needs further investigation, and our findings also need to be verified by large-scale and well-designed RCTs.