ObjectiveTo review the research progress of constructing injectable tissue engineered adipose tissue by adipose-derived stem cells (ADSCs). MethodsRecent literature about ADSCs composite three-dimensional scaffold to construct injectable tissue engineered adipose tissue is summarized, mainly on the characteristics of ADSCs, innovation of injectable scaffold, and methods to promote blood supply. ResultsADSCs have a sufficient amount and powerful ability such as secretion, excellent compatibility with injectable scaffold, plus with methods of promoting blood supply, which can build forms of injectable tissue engineered adipose tissue. ConclusionIn despite of many problems to be dealt with, ADSCs constructing injectable tissue engineered adipose tissue may provide a promising source for soft-tissue defect repair and plastic surgery.
ObjectiveTo investigate the medium-term effectiveness of both side stereo suture for meniscus bucket handle tear under arthroscopy. MethodsBetween January 2009 and December 2012, 38 patients with combined injury of meniscus bucket handle tear underwent arthroscope surgery by the method of both side stereo suture. There were 26 males and 12 females with an average age of 32 years (range, 19-42 years). The injury causes included sports injury in 21 cases, traffic accident injury in 11 cases, and other trauma in 6 cases. The left knee was involved in 15 cases and the right knee in 23 cases. The interval between injury and operation was 2 days to 6 months (mean, 2.5 months). MRI examination showed meniscus injury at grade Ⅲ, including 22 cases of internal injury and 16 cases of lateral injury. The Barrett standard, Lysholm score of knee joint, and joint mobility were used to assess the function recovery of the knee joint. ResultsAll incisions healed primarily with no complication. All cases were followed up 24.5 months on average (range, 18-36 months). Based on the Barrett standard, meniscus bucket handle tear was successfully repaired in all cases. The Lysholm scores and range of motion of the knee at 6 months, 12 months, and last follow-up were significantly better than preoperative ones (P<0.05). ConclusionThe both side stereo suture of meniscus bucket handle tear under arthroscopy has an excellent medium-term effectiveness, with the advantages of firm suture and high healing rate.
ObjectiveTo introduce a new medical heat preservation device, and to explore the application value and effectiveness in replantation of severed fingers. MethodsThe medical heat preservation device was design, water was used as the heating medium, and temperature was set and controlled by microcomputer. Between November 2010 and January 2014, 421 cases undergoing replantation of severed fingers were divided into 2 groups. Within 9 days after operation, the medical heat preservation device was used in 210 cases (experimental group), and the conventional heat lamp was used in 211 cases (control group). There was no significant difference in gender, age, injury cause, the interval between injury and admission, injury finger side, and operation time between 2 groups (P>0.05). The vascular crisis rate, success rate of replantation of severed fingers, comfort, sleep quality, and the influence on roommates were compared. ResultsThe comfort and the influence on roommates were good in 188 cases (89.52%) and 201 cases (95.71%) in the experimental group, which were significantly higher than those in the control group (25/211, 11.85%; 145/211, 68.72%). According to Pittsburgh sleep quality index (PSQI) for sleep quality, the results were good in 105 cases, fair in 85 cases, and poor in 20 cases in the experimental group; the results were good in 45 cases, fair in 95 cases, and poor in 71 cases in the control group. Blood vessel crisis occurred in 35 cases (16.67%) of the experimental group, which was significantly lower than that in the control group (76/211, 36.02%) (P<0.05). The survival rate of replantation in the experimental group (196/210, 93.3%) was significantly higher than that in the control group (181/211, 85.78%) (P<0.05). Significant differences were found between 2 groups (P<0.05) in above indexs. ConclusionMedical heat preservation device for replantation of severed fingers can improve the comfortable degree of patients and the quality of sleep, increase the survival rate of finger replantation, and reduce the occurrence of vascular crisis after operation.
Objective To assess the reporting quality of systematic reviews/meta-analyses related to interventions published in Chinese Journal of Evidence-Based Medicine by PRISMA guidelines, and to analyze its influencing factors. Methods The systematic reviews/meta-analyses related to interventions were searched in the Chinese Journal of Evidence-Based Medicine from its inception to 2011. The quality of the included reviews was assessed in accordance with the PRISMA checklist. Based on the degree of conformity with each criterion of PRISMA, the reviews were scored as “1”, “0.5” or “0” orderly. The data were put into Excel, and the Meta-analyst software was used for statistical analysi. Results Among all literature in the volume 11 (95) of the Chinese Journal of Evidence-Based Medicine from 2001 to 2011, a total of 379 studies were included, and the number of publication showed a yearly rising trend. The PRISMA scale score ranged from 8.5 to 26 (X±SD) was 19.97±3.15. Among all studies, 25 (6.60%) scored 21-27 points, which were regarded as the complete reporting; 226 (59.63%) scored 15-21 points, regarded as relatively complete reporting; and 128 (33.77%) scored less than 15 points, regarded as serious lack of information. The results of stratified analysis showed that, both the issue of PRISMA and fund support could improve the reporting quality, with a significant difference (Plt;0.05); and authors more than 3, authors from universities, and authors from more than 2 institutions could improve the reporting quality, but without a significant difference (Pgt;0.05). Conclusion The overall reporting quality of systematic reviews/meta-analyses related to interventions published in the Chinese Journal of Evidence-Based Medicine is poor, and it is influenced by the factors of protocol and registration, risk of bias across studies, other analyses, and fund support, which have to be taken seriously. The reasonable utilization of the PRISMA checklist will improve the reporting quality of systematic reviews/meta-analyses.
Objective To assess the methodological quality of systematic reviews or meta-analyses of intervention published in the Chinese Journal of Evidence-Based Medicine, so as to provide evidence for improving the domestic methodological quality. Methods The systematic reviews or meta-analyses of intervention published from 2001 to 2011 were identified by searching the Chinese Journal of Evidence-Based Medicine. The methodological quality of included studies was assessed by AMSTAR scale. The Excel software was used to input data, and Mata-Analyst software was used to conduct statistical analysis. Results A total of 379 studies were included. The average score of AMSTAR was 6.15±1.35 (1.5-9.5 point). Just some items of AMSTAR scale were influenced by the following features of included studies: publication date, funded or not, number of author, author’s unit, and number of author’s unit. The total AMSTAR score of studies published after 2008 was higher than those published before 2008 (P=0.02), but the improvement of methodological quality was limited. While the total AMSTAR score of studies published by 3 or more than 3 authors were higher than those published by 2 or less than 2 authors (P=0.04). Conclusion The methodological quality of the included studies published in the Chinese Journal of Evidence-Based Pediatrics is uneven. Although the methodological quality improves somewhat after the publication of AMSTAR scale, there is no big progress, so it still needs to be further improved.
Objective To systematically review the effectiveness of amiodarone in treating repurfusion arrhythmia (RA) after thrombolytic therapy for acute myocardial infarction (AMI), so as to provide high quality evidence for formulating the rational thrombolytic therapy for AMI. Methods Randomized controlled trails (RCTs) on amiodarone in treating RA after thrombolytic therapy for AMI were electronically retrieved in PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CBM, CNKI, VIP and WanFang Data from inception to January, 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed quality. Then RevMan 5.1 software was used for meta-analysis. Results A total of 5 RCTs involving 440 patients were included. The results of meta-analysis suggested that, compared with the blank control, amiodarone reduced the incidence of RA after thrombolytic therapy in treating AMI (RR=0.60, 95%CI 0.48 to 0.74, Plt;0.000 01) and the incidence of ventricular fibrillation (RR=0.47, 95%CI 0.26 to 0.85, P=0.01). It neither affected the recanalization rate of occluded arteries after thrombolytic therapy (RR=1.00, 95%CI 0.88 to 1.15, P=0.94) nor decreased the mortality after surgery (RR=0.33, 95%CI 0.10 to 1.09, P=0.07). Conclusion Current evidence indicated that, amiodarone can decrease the incidence of RA. Unfortunately, the mortality rate can’t be reduced by amiodarone. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion
Objective To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating stroke patients with motor dysfunction. Methods The Cochrane Library, MEDLINE, EMbase, CBM, CNKI and WanFang Data were searched from inception to January 2012, and the references of the included studies were also retrieved to collect the randomized controlled trials (RCTs) on rTMS in treating stroke patients with motor dysfunction. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.0.2 software, and evidence quality and recommendation level were assessed using the GRADE system. Results A total of 11 RCTs involving 376 patients were included. The results of meta-analysis (including 3 RCTs, low quality) showed that, compared with the routine rehabilitation treatment, 2 to 4 weeks of rTMS was much beneficial to stroke patients with motor dysfunction, with significant differences (WMD=11.02, 95%CI 2.56 to 19.47). The other 8 studies only adopted descriptive analysis accordingly. Conclusion It is still uncertain of the effectiveness of rTMS in improving motor dysfunction of stroke patients, so rTMS should be applied with caution in clinic.
Objective To study the protective effects of pre-storing glycogen on warm ischemia reperfusion injury during partial hepatectomy. Methods Thirty-eight patients were randomly divided into a trial group (n=19) and a control group (n=19). In the trial group, patients were given high concentration glucose intravenously during the 24 hours before the operation. The hepatic lesion was resected after portal triad clamping in the two groups. Liver function of all patients was measured before the operation and the first and fifth days after the operation. Normal hepatic tissue was biopsied to measured hepatic tissue glycogen contents before the operation and the change of superoxide dismutase (SOD) at the point of pre-ischemia, post-ischemia, and reperfusion 2 hour. Bcl-2 mRNA, a well known anti-apoptotic factor, was also detected using quantitative polymerase chain reaction. Results The hepatic tissue glycogen content of the trial group was significantly higher than that of the control group before the operation (Plt;0.01). Liver function of the trial group was significantly better than that of the control group on the first and fifth day after operation (Plt;0.05). There was significant difference in SOD activity between the two groups at the end of hepatic vascular occlusion and at the point of 2-hour reperfusion (Plt;0.05). Furthermore Bcl-2 mRNA expression of the trial group was notably up-regulated at the point of 2-hour reperfusion compared to the control group. Conclusion Pre-store storing glycogen might protect liver ischemia reperfusion injury caused by hepatic vascular occlusion during partial hepatectomy. The potential mechanism might be that pre-storing glycogen enhances Bcl-2 expression.
Objective To investigate the best management in treating relapsed biliary calculi after endoscopic sphincterotomy (EST).Methods The clinical data of 96 patients with relapsed biliary calculi after EST in our hospital from February 1999 to February 2009 were retrospectively analysed. The patients were grouped into two groups by the size of calculi under magnetic resonance cholangiopancreatography: surgical group (the size of calculi was bigger than 1.0 cm) in 79 cases and non-surgical group (the size of stone was smaller than 1.0 cm and the patients were performed EST again) in 17 cases. The relapsed biliary calculi rate between two groups were compared. Results In the surgical group, the 79 patients (82.29%) were performed common bile duct exploration, transected common bile duct and choledochojejunostomy with Roux-en-Y anastomosis. In the non-surgical group, the 17 patients (17.17%) were performed EST again. The relapsed biliary calculi rate was 2.63% in the surgical group, 70.59% in the non-surgical group. There was marked difference in the relapsed biliary calculi rate between surgical group and non-surgical group (Plt;0.05). Conclusion The operation treatment is the best way for relapsed biliary calculi after EST, and has good curative effect. The best manner of operation treatment is common bile duct exploration, transected common bile duct and choledochojejunostomy with Roux-en-Y anastomosis.
ObjectiveTo study the relationship between hepatocellular apoptosis and glycogen contents during hepatic cold preservationreperfusion and its mechanism.MethodsBased on the model of four groups of rabbit livers with different hepatocellular glycogen contents, hepatocellular apoptosis and bax gene expression were observed during hepatic cold preservationreperfusion.ResultsApoptotic hepatocytes were obviously found in 60 minute reperfusing livers subsequent to 9 hour cold storage, and there was significant difference in the numbers of apoptotic hepatocytes among all the groups. In the same time, there was the close relationship between the levels of bax gene expression and the glycogen contents of hepatocytes.ConclusionIntracellular abundant glycogen may significantly depress the hepatocellular apoptosis during hepatic cold preservationreperfusion by decreasing hepatocellular bax gene expression.