Objective To explore the correlation between traditional Chinese medicine (TCM) blood stasis pattern of coronary heart disease (CHD) and coronary angiography result, so as to screen dangerous patterns and provide evidence for the objectification of TCM pattern differentiation. Methods Literature on correlation between blood stasis pattern and coronary angiography results from January 1992 to May 2012 were searched in the following databases: China Academic Journal Network Publishing Database (CAJD), Chinese Biomedical Literature Database (CBM), China Doctor Dissertation Full-text Database (CDFD), Chinese Selected Master’s Theses Full-Text Databases (CMFD), PubMed and MEDLINE. According to the inclusion and exclusion criteria, literature screening, data extraction and methodological quality assessment of the included studies were conducted. Then meta-analysis was performed using RevMan 5.1 software. Results A total of 28 studies involving 4 901 patients were included. The results of meta-analysis showed that, there is a significant significance between blood stasis pattern and the following coronary angiography result, namely, number of culprit vessels (OR=1.38, 95%CI 1.08 to 1.77, Plt;0.05), severity of stenosis (OR=1.79, 95%CI 1.04 to 3.08, Plt;0.05), and Gensini score (OR=7.74, 95%CI 3.99 to 11.49, Plt;0.05). Conclusion Compared with other TCM patterns, CHD with blood stasis pattern easily tends to present multi-vessels lesions, more than 75% stenosis and higher Gensini score, indicating the condition of CHD with blood stasis pattern is more severe than with other patterns. Due to the discrepancy of pattern differentiation and the limited quality of original studies, this conclusion is insufficient to be fully applied into clinical practice, and more large scale and high quality clinical trials are required.
Objective To explore the causal relationship between gut microbiota and urinary tract infections using data from genome-wide association studies. Methods The gut microbiota data were sourced from the MiBioGen consortium, comprising genetic variables from 18 340 individuals. UTI data (ieu-b-5.65) were derived from the UK Biobank. Six methods including inverse variance weighted (IVW), Mendelian randomization (MR)-Egger, maximum likelihood, simple mode, weighted mode, and weighted median were employed for two-sample MR analysis on these datasets. Additionally, MR-PRESSO was used to detect and correct for heterogeneity and outliers in the analysis. Cochran's Q test and leave-one-out analysis were applied to assess potential heterogeneity and multiple effects. Furthermore, reverse MR analysis was conducted to investigate causal relationships between UTI and gut microbiota. Results According to IVW method analysis results, bacterial genera Eggerthella (OR=1.08, 95%CI 1.01 to 1.16, P=0.034) and Ruminococcaceae (UCG005) (OR=1.10, 95%CI 1.01 to 1.20, P=0.022) were found to increase the risk of UTI, while Defluviitaleaceae (UCG011) (OR=0.90, 95%CI 0.82 to 0.99, P=0.022) appeared to decrease it. Reverse MR analysis did not reveal a significant effect of UTI on these three bacterial genera. Our study found no evidence of heterogeneity or pleiotropy based on the results of Cochran’s Q test, MR-Egger, and MR-PRESSO global test. Conclusion In this MR study, we demonstrate a causal association between Eggerthella, Ruminococcaceae, Defluvitalaceae and the risk of urinary tract infections.
Objective To systematically review and analyze the risk factors of epilepsy in children, to explore the related etiology of epilepsy in children, and to provide evidence-based strategies for reducing the occurrence of epilepsy in children. Methods PubMed, Embase, VIP, CNKI, Web of science, Cohrane, and CBM were searched for relevant studies on risk factors for childhood epilepsy since the establishment of the database, and the study type was selected as a case-control study. After screening and quality evaluation, the literatures that met the requirements were finally selected for inclusion in the study, and the extracted target data were statistically analyzed by RevMan5.3 software. Results A total of 9 literatures were included for Meta-analysis of the risk factors of epilepsy in children. A total of 3792 cases were studied, including 1 922 cases in the control group and 1 870 cases in the case group. Meta-analysis results showed that adverse perinatal period, family history of epilepsy, febrile seizures, and central nervous system infection were closely related to the occurrence of epilepsy in children, and the OR values were OR=3.46, 95%CI (2.51, 4.79), OR=4.77, 95%CI (3.83, 5.95), OR=7.81, 95%CI ( 5.64, 10.80), OR=3.00, 95%CI (1.44, 6.26), P values were all less than 0.05. Conclusions Adverse perinatal period, family history of epilepsy, febrile seizures, and central nervous system infection are the current risk factors for childhood epilepsy.
Objective To review the research progress of rapid surgery for hip fracture in elderly patients. Methods The published studies, expert consensus, and guidelines at home and abroad were systematically summarized from the aspects of the characteristics of aging population, the benefits of rapid surgery, the disadvantages of delayed surgery, and the recommendations of current guidelines, so as to further guide clinical practice. Results Hip fracture is a common fracture type in the elderly population. As elderly patients generally have poor physique and often have a variety of underlying diseases, such as hypostatic pneumonia, bedsore, lower limb vein thrombosis, and other complications in conservative treatment, its disability rate and mortality are high, so surgical treatment is the first choice. At present, most relevant studies and expert consensus and guidelines at home and abroad support rapid surgery, that is, preoperative examination should be started immediately after admission, and adverse factors such as taking anticoagulant drugs, serious cardiovascular diseases, and severe anemia should be clearly and actively corrected, and surgery should be completed within 48 hours after admission as far as possible. Rapid surgery can not only significantly reduce the mortality of patients, but also reduce the length of hospital stay and the incidence of perioperative cognitive impairment, which is conducive to the recovery of patients with pain during hospitalization and postoperative function, and improve the prognosis of patients. Conclusion In order to avoid many problems caused by delayed surgery, the elderly patients with hip fracture should be operated as soon as possible under the condition of actively correcting the adverse factors. Comprehensive evaluation and preparation, the development of an individualized surgical plan, and the formation of a multidisciplinary medical team can reduce surgical risks and improve effectiveness.