This study aims to investigate the effect ofγ-Secretase Inhibitor DAPT, (N-[N-(3, 5-Difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester), on the differentiation of neural precursor cells and the production of neurons in the neural precursor cell line GE6. GE6 was cultured in medium with 4μmol/L DAPT added as the experimental group and the untreated medium separately as the control group. After 4 days of differentiation, we carried out the following experiments. We used immuno-fluorescent staining to observe the ratio of Tuj1, GFAP and O4 positive cells. We also used qRT-PCR to detect the effect of the DAPT on Tuj1 and GFAP mRNA transcription in the GE6. The results of immuno-fluorescent staining indicated that the Tuj1 ratio of experimental group was higher compared to that of the control group, but the GFAP and O4 ratio of experimental group was lower than that of the control group. The differences were statistically significant (P < 0.05). The result of qRT-PCR was in accordance with immunofluorescent staining results. It was well concluded that DAPT could promote the neurogenic differentiation of neural precursor cell line rather than leading to gliogenic differentiation. More neurons could be obtained for transplantation with the addition of DAPT.
ObjectiveTo evaluate the medium-and long-term effectiveness of the 3rd-generation ceramic-on-ceramic total hip arthroplasty (THA) for end-stage hip disease. MethodsA retrospective analysis was made on the clinical data of 142 patients (148 hips) who underwent the 3rd-generation ceramic-on-ceramic THA between May 2001 and May 2005. There were 78 males and 64 females, aged 57.2 years on average (range, 23-81 years). Preoperative diagnosis was avascular necrosis of femoral head in 73 patients (77 hips), degenerative osteoarthritis in 35 patients (36 hips), femoral neck fracture in 18 patients (18 hips), rheumatoid arthritis in 14 patients (15 hips), and septic hip sequelae in 2 patients (2 hips). The preoperative Harris hip score was 58.3±12.9. ResultsAll incisions healed by first intention without complication. All patients were followed up 8.8 years on average (range, 7-12 years). At the last follow-up, the Harris hip score (92.5±10.2) was significantly higher than that at pre-operation (t=-25.29, P=0.00). At the last follow-up, there were 4 hips with groin pain, 6 hips with thigh pain. Complications occurred in 6 cases (6 hips), including loosening cups in 2 hips, hip dislocation in 2 hips, ceramic head fracture in 1 hip, and squeaking in 1 hip. The revision rate was 1.35% (3/148). X-ray film showed that acetabular cup loosening in 2 hips, discontinuous radiolucent line in 4 hips, and new bone formation in 88 hips; discontinuous radiolucent line around femoral component was observed in 25 hips, endosteal new bone formation in 95 hips, cortical bone hypertrophy in 2 hips, and femoral component subsidence in 9 hips (less than 2 mm). ConclusionThird-generation ceramic-on-ceramic THA is an effective treatment for end-stage hip disease, and can achieve satisfactory medium-and long-term effectiveness and a high implant survival rate.
ObjectiveTo monitor surgical quality and analyze learning curve of minimally invasive mitral valve replacement (MVR)through right minithoracotomy with cumulative sum analysis (CUSUM analysis). MethodsClinical data of 60 consecutive patients who underwent minimally invasive MVR through right minithoracotomy in the Fourth Affiliated Hospital of Guangxi Medical University from June 2011 to April 2013 were retrospectively analyzed. There were 32 male and 28 female patients with their age of 28-53 (34.67±7.11)years and their heart function ranging from NYHA class Ⅱ to Ⅳ. There were 31 patients with mitral stenosis (MS), 19 patients with mitral regurgitation (MR), and 10 patients with MS and MR. According to the surgical sequence, all the patients were divided into 3 groups (group A, B and C)with 20 patients in each group. Surgical outcomes were compared among the 3 groups, and surgical quality was analyzed with descriptive statistics and CUSUM curves. ResultsAortic cross-clamp time, cardiopulmonary bypass time and operation time of group C were significantly shorter than those of group A and group B (aortic cross-clamp time of group C vs. group A:50.35±2.30 minutes vs. 66.15±8.38 minutes; operation time of group C vs. group B:167.50±4.63 minutes vs. 178.60±4.49 minutes, P < 0.05). In-hospital mortality was 3.3% (2/60). CUSUM analysis showed a significant learning curve effect, although surgical quality remained in control during the study period. Surgical failure rate was lower than 80% after about 45 operations, indicating that failure rate was 10% lower than expectation. ConclusionMinimally invasive MVR is safe and reliable, and CUSUM analysis is a simple statistical method to monitor surgical quality.
ObjectiveChinese practice guideline for therapeutic drug monitoring of vancomycin is the first therapeutic drug monitoring guideline in the framework of GRADE in China. The guideline panels met a recommendation consensus in December 21th, 2014 and finalized 14 recommendations. The aim of the current study was to assess the property of recommendations and revise them. MethodsWe commissioned an external review of recommendations by questionnaire. Physicians, clinical pharmacists and nurses above or equal to intermediate certificate were investigated for appreciations, clarity and feasibility of 14 recommendations as well as other suggestions about guideline. The guideline panels discussed the results and revised recommendations based on the result of external review. ResultsA total of 40 physicians, clinical pharmacist and nurses from 11 departments of 4 hospitals participated in the external review. The overall appreciation degree of recommendations was 70%, the overall clarity degree of recommendations was 88%, and the overall feasibility degree of recommendations was 70%. Among them, appreciation degree of 4 recommendations and feasibility degree of 5 recommendations were fewer than 50%. 165 subjective suggestions were received. After review of the results, the guideline panels reserved 6 recommendations while revised 8 (Deleted 4, combined 2 and improved 2). ConclusionOur external review is an exploration and attempt in the region of development of Chinese evidence-based practice guideline. More interest-related individuals are involved in the development of guideline. Clarity and feasibility of recommendations are ensured.
Testing Treatments is a book to help the public understand how to validate the efficacy of testing treatments and the possible bias and error in clinical trial, as well as to call for help to promote good study thus to improve the quality of health care. No matter for the first or the second edition, this book is very popular around the world, and its second edition has been translated into more than ten languages. To help the readers understand the content of the book, we established a website (www.testingtreatments.org) and other sibling sites in different languages. The website not only provided the full-texts to download, but also collected various popular science resources (videos, audios and cartoons) to help the readers assimilate more knowledge. The editors of all the different language websites have established an TTi Editorial Alliance to share experience and provide each other with mutual support, thus to promote health professionals, patients and public around the world to use reliable research to inform their health decisions.
ObjectiveTo investigate the checkup residents' requirements for the health management and its influence factors. MethodsThe data from 741 checkup clients were randomly sampled by questionnaire in checkup center in May, 2013, including 360 males and 381 females aged from 24 to 69 with an average of 43.5±11.2. ResultsThere were 668 valid questionnaires, with an effective rate of 90.1%. In these 326 males and 342 females, 589 (88.2%) had the consciousness of health management, 79 (11.8%) had no consciousness of health management; the health management services needs included:consultation offered by experts of examination report (556, 83.2%), health promotion plan (379, 56.7%), medical follow-up (301, 45.1%), green channel (280, 41.9%), health knowledge message (276, 41.3%) and lecture on health knowledge (200, 29.9%). The demand for health management differed in sex, age and checkup format(P<0.05), not in chronic disease conditions (P>0.05); the requirement for lecture differed in age and occupation(P<0.05); the requirement for health promotion plan differed in economic condition(P<0.05); the requirement for message and green channel differed in age and checkup pattern(P<0.05). ConclusionThe checkup residents' have high requirements for the health management and differ in health management services.
ObjectiveTo explore the expression of programmed cell death 4 (PDCD4) in different subtype of breast cancer and its relationship to prognosis. MethodsThree hundred and thirty-eight patients with breast cancer from January 2007 to December 2009 in this hospital were collected. All these patients were categorized into three subtypes which was luminal, HER-2 positive, and triple negative according to the results of immunohistochemical stain. SP immunohistochemistry was used to detect the expression of PDCD4 in the different subtype of breast cancer. Kaplan-Meier and Cox proportional hazards model was used to analyze the prognosis. Results①The positive rate of PDCD4 expression was 73.37%(146/199), 30.16%(19/63), and 35.53%(27/76) in the luminal, HER-2 positive, and triple negative breast cancer, respectively. The expression of PDCD4 was downregulated especially in the HER-2 positive and triple negative breast cancer(χ2=38.315, P=0.000; χ2=33.746, P=0.000) as compared with the luminal breast cancer. 2 The disease free survival and overall survival rates in the PDCD4 positive patients were significantly higher than those in the PDCD4 negative patients(P < 0.05) despite the subtypes.③Cox model revealed that T staging, N staging, and PDCD4 were the independent prognostic factors for disease free survival and that histological grade, T staging, N staging, and PDCD4 were the independent prognostic factors for overall survival. ConclusionsPDCD4 expression is downregulated in all subtypes of breast cancer especially in HER-2 positive and triple negative breast cancer, and the loss of PDCD4 expression is correlated to poor prognosis. PDCD4 is an independent prognostic factor of breast cancer.
Patient values and preferences is one of the elements of evidence-based medicine research, which is also an important part that should be considered in the development of evidence-based guidelines in the present and future. However, the research in this field in China has just begun. This article gives a brief introduction of its concepts, methods, influence factors based on the international researches of patient values and preferences and a brief description of the development in China, in order to provide references for the development of evidence-based guidelines based on the consideration of patient values and preferences in the future.
ObjectiveTo survey on the health-related knowledge in cadres, in order to regulate corresponding health management strategies. MethodsQuestionnaires were used to collect data of 816 examinees who accepted physical examination in our hospital between June and July 2014. Factors affecting health examination service efficiency were identified to formulate a scale and a questionnaire for surveying examinees' preparatory status before examination and general information. The correlation between their preparatory status and demographic features was analyzed. The results were used to support management decision-making. ResultsOf the 816 examinees, 396 had a score over 6 points (48.5%, well prepared) and 420 had 6 points or below (51.5%, poorly prepared). The male preparation before examination was significantly poorer than the female (χ2=4.318, P=0.038). ConclusionWe should strengthen the knowledge education for cadres before physical examination.
The approaches of rating the quality of evidence of systematic reviews of diagnostic accuracy tests are different from systematic reviews of interventional studies. This article systematically introduces the application of GRADE in systematic reviews of diagnostic accuracy tests by a case interpretation and analysis. In this article we present rating workflow in systematic reviews of diagnostic accuracy tests and introduce how to use the GDT website to display the rating results, and interpret the conclusion of systematic reviews based on GRADE results.