Objective To evaluate the effectiveness and safety of gabexate mesylate in the prevention of post-endoscopic retrograde cholangiopancreatography （ERCP） pancreatitis （PEP）. Methods The literatures and corresponding references of randomized controlled trials （RCT） on gabexate mesylate in the prevention of PEP were searched from Cochrane library （1970 to December 2010），PubMed （1966 to December 2010），EMBASE （1966 to December 2010），and CBM （1978 to December 2010）.Literature screening，data extraction and methodological quality assessment were individually performed by two researchers.The software RevMan 4.2 of Cochrane Collaboration was used for statistical analysis. Results A total of 11 trails involving 3 012 patients were included. Meta analysis showed that high dose （≥1 000 mg）of gabexate mesylate with slow intravenous infusion （≥12 h） could effectively prevent from PEP （OR=0.27，95%CI： 0.11-0.64, P=0.003） and post-ERCP abdominal pain （OR=0.44，95%CI： 0.25-0.79，P=0.005） when compared with placebo. The low dose （≤500 mg） of gabexate mesylate with quick intravenous infusion （≤6.5 h） could not effectively prevent from PEP （OR=0.85, 95%CI： 0.59-1.34, P=0.570），post-ERCP hyperamylasemia （OR=0.86，95%CI： 0.69-1.07，P=0.180），and post-ERCP abdominal pain （OR=0.66，95%CI： 0.32-1.35，P=0.250）.When compared gabexate mesylate with ulinastatin, there was no statistical difference between them in the prevention of PEP （OR=1.57，95%CI： 0.39-6.24，P=0.520） and post-ERCP hyperamylasemia （OR=1.85, 95%CI： 0.83-4.13，P=0.130）. Conclusions The high dose （≥1 000 mg） of gabexate mesylate with slow intravenous infusion （≥12 h） other than low dose （≤500 mg） with quick intravenous infusion （≤6.5 h） is effective to prevent from PEP and post-ERCP abdominal pain，and can also prevent from post-ERCP hyperamylasemia to some extent.The effect which ulinastatin prevents PEP and post-ERCP hyperamylasemia is same to gabexate mesylate.The above conclusions remain to confirm by RCT with large sample and long-term follow-up of high-quality.
ObjectivesTo explore the characteristics of cognitive deficits of Benign epilepsy of childhood with centrotemporal spikes (BECTS).MethodsA total of 61 BECTS patients who visited Neurology Clinic of Xuanwu Hospital Capital Medical University between September 2010 to December 2019 and 60 healthy controls were enrolled in our study. All patients and healthy controls performed a series of neuropsychological tests to assess their cognitive function in the "Multi-dimensional psychology" of Beijing Normal University, including attention; memory; arithmetic calculation; language processing; executive function; visuospatial processing; visual perception; psychomotor speed. Lastly, independent sample t-test and friedman test were performed on the scores of BECTS group and controls using SPSS 20.0 and we conducted a multi-factor comprehensive analysis of correlation between clinical criteria and cognitive dysfunction in BECTS.ResultsCompared with 60 healthy controls, the as group got an average score of 19.56±2.91 in Paired Association Learning Test (P<0.001), (23.67±9.50) in Word Discrimination Test (P=0.017), (61.45±13.14) in Object Quantity Perception Task (P=0.040), (6.54±1.47) in Digit Span Test (P<0.001), (5.79±5.90) in Vocal Perception Test (P<0.001), (35.10±2.33) in Taylor Complex Figure Test (P<0.001) and (700.34±493.053) (P=0.008) in Choice Reaction Time Test. The results of these tests are inferior to the control group and the remaining 10 tests are of no statistical significance. There were 36 children with onset of seizure before 8 years of age. Compared with the patients experienced onset of illness at a later age, the 36 patients exhibited lower scores in most of the neuropsychological tests including Visual Tracking Task, Spatial Memory Task, Simple Subtraction Task, Number Comparison Test, Language Rhyme Test, Word Discrimination Testand Visual Perception Task (P<0.05). 34 patients received monotherapy, and 27 received a combination of 2 or 3 anti-epileptic drugs. The scores of attention, memory, visual perception and reaction tests in the multi drug treatment group were lower than those in the single drug treatment group (P<0.05).ConclusionsChildren with BECTS have impairment in attention, vocal perception, visual perception, memory and psychomotor speed. The younger the age of onset, the more severe the cognitive impairments. The degree of cognitive deficitsinchildren treated with multi drugs was more serious than that of children treated with single drugs.
Based on the guidelines of the diagnostic test systematic review, this study elaborated the statistical processing of the pooling of data detailed in the systematic review of diagnostic test, discussed the methods for identification and handling of the heterogeneity, evaluated the advantages and disadvantages of the index of the accuracy in diagnostic tests, and proposed the identification method of the publication bias. It also took the data from the published article entitled “Diagnostic Value of ProGRP and NSE for Small Cell Lung Cancer: A Meta-Analysis” as an example for analysis and illustration, which presented clearly the data processing and interpretation of the systematic review of diagnostic test, in order to provide references for clinical researchers to study and conduct the systematic review of diagnostic test.
Objective To evaluate the clinical, radiological and pathological manifestations of lipoid pneumonia, to improve the diagnosis of this rare disease. Methods Retrospective analysis of clinical data of 19 cases with confirmed lipoid pneumonia was conducted. Results There was 13 male and 6 female patients with an average age of 54. 4 years ranging from 24 to 71 years. Lipoid pneumonia presented a chronic clinical course with few physical signs. The main complaints included cough, expectation, bloody phlegmand chest pain. Finding of chest mass in routine physical examination was also a common reason for doctor visiting. Radiological features of lipoid pneumonia could be non-specific, usually presenting mass shadow in the chest, with lymph nodes enlargement in some cases. Eighteen cases were diagnosed by the histopathology of pulmonary tissue and one case was diagnosed through a combination of bronchoscopy, thoracoscopy and CT-guided percutaneous lung puncture biopsy. Histopathological finding showed accumulation of foamy macrophages in the alveolar spaces. Conclusions The clinical and radiological manifestations of lipoid pneumonia are non-specific. Histopathological examination for diagnosis is essential. If the medical therapy is not responsive, pulmonary lobectomy might be necessary.
Objective To explore the effect of spinal neural progenitor transplantation to the cervical spinal on treating brachial plexus injury with the reimplantation of the avulsed spinal roots. Methods Thebrachial plexusavulsed injury model was made on 54 rats and they were evenly divided into 3 groups: fresh group, chronic group, control group. The spinal neural progenitor was cultured and identified. Then 10 μl（1×105/μl）cells were labelled with BrdUand transplanted into the fresh group (15 rats survived, being model for 1 week) and the chronic group (14 rats survived, being model for 2 months). No cell was transplanted into the control group. Two months after the transplantation, therecovery of function of the injured limb was evaluated. Electrophysiologic study and immunohistochemical study of the injured limb were made. Results Spinal neural progenitors were isolated from the spine and became neural sphere. The neural spheres were differentiated into neurons and astrocytes. Fourteen rats out of 15 in the fresh group were recovered, 7 rats out of 14 in the chronic groupwere recovered, and 5 rats out of 12 in the control group were recovered. Immunohistochemical study indicated that the transplanted progenitors in fresh group survived and differentiated into the neural cells, and the transplanted progenitors in chronic group existed and did not differentiate well. Conclusion Transplanted spinal neural progenitors can promote the recovery of the brachial plexus injury with the reimplantation of the avulsed spinal root.
Objective To evaluate the effect of clinical pathway (CP) teaching methods versus traditional methods in nursing clinical teaching. Methods The following electronic databases as PubMed, EMBASE, The Cochrane Library, CBM and CNKI were retrieved on computer from their establishment to April 2011 to search for randomized controlled trials (RCTs) of comparing CP with traditional methods in nursing clinical teaching. The methodological quality of the included RCTs was assessed by two reviewers independently according to the scale of criteria for methodological quality developed by Smits PB, and the meta-analysis was conducted by using the Cochrane Collaboration’s RevMan5.1 software. Results A total of 12 RCTs involving 1 269 participants were included, and nine of them were of high quality. The meta-analyses showed that compared with the traditional teaching method, the CP teaching tended to be superior (Plt;0.05) in improving nursing students’ objective knowledge, nursing operating skills, professional ability and satisfaction with teaching methods, and in improving patients’ satisfaction as well. Conclusion The clinical pathway teaching method is a scientific teaching model in nursing clinical teaching; it standardizes the teaching procedure, promotes students’ active learning and further enhances the teaching effect. But it is necessary to unify the method of assessment with more researches. In addition, researchers should pay more attention to improving the comprehensive quality of nursing students.
目的 建立测定胎盘灌流液中格列苯脲浓度的高效液相色谱（HPLC）检测方法。方法 采用的色谱柱为Symmetry Shield RP C18（150 mm×4.6 mm，5 μm），柱温40℃，流动相为NaH2PO4缓冲盐（25 mmol/L，pH值5.2）︰乙腈=1︰1；内标为格列齐特，流速1.0 mL/min，检测波长228 nm，采用液-液萃取预处理方法测定胎盘灌流液中格列苯脲的浓度。 结果 格列苯脲浓度线性范围为2.0～25.0 μg/mL，线性方程为：y=0.226x+0.002，r=0.999 9 （n=6），日内相对标准偏差（RSD）＜3.1%，日间RSD＜9.5%，方法学回收率为95.32%～103.35%。 结论 HPLC检测方法灵敏、简便，可用于胎盘灌流液中格列苯脲浓度的检测。
Objective To explore the progress of the relationship between the tumor suppressor gene p53 and oncogene c-erbB-2 and gastric cancer in recent years. Methods Relevant literatures about p53 and c-erbB-2 in gastric cancer were collected and analyzed. Results The mutation of p53 gene and the over-expression of c-erbB-2 gene were a common event in gastric cancer. The mutation of p53 gene was correlated with the location of gastric cancer and its aggressive biological behavior. The over-expression of c-erbB-2 gene could be used as an independent prognostic parameter in gastric cancer. The drugs targeted on p53 and c-erbB-2 gene were being developed. Conclusion Further research on the role of p53 and c-erbB-2 gene in the development of gastric cancer is helpful to understand the biological behavior and provide theoretical basis for gene therapy.
ObjectiveTo systematically review the diagnostic value of capsule endoscopy and enteroscopy in small intestinal diseases.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect studies on the diagnosis of intestinal diseases by capsule endoscopy and enteroscopy from inception to August 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Meta-analysis was then performed by using RevMan 5.3 and Meta-DiSc software.ResultsA total of 20 studies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for capsule endoscopy were 0.86 (95%CI 0.83 to 0.87), 0.81 (95%CI 0.78 to 0.84), 117.07 (95%CI 37.98 to 360.92), 7.20 (95%CI 2.81 to 18.45), 0.11 (95%CI 0.06 to 0.21), and those for enteroscopy were 0.89 (95%CI 0.87 to 0.90), 0.91 (95%CI 0.89 to 0.93), 196.99 (95%CI 72.63 to 534.26), 13.26 (95%CI 5.00 to 35.14), 0.12 (95%CI 0.07 to 0.21). The areas under the working characteristic curve (SROC) of capsule endoscopy and enteroscopy were 0.9692 and 0.9783, respectively.ConclusionsBoth capsule endoscopy and enteroscopy have high specificity and sensitivity in the diagnosis of small intestinal diseases, and enteroscopy has higher clinical value in the diagnosis of some small intestinal diseases than capsule endoscopy. Due to limited quantity and quality of the included studies, the above conclusions are required to be verified by more high-quality studies.
目的 建立柱前衍生化反相高效液相色谱-荧光检测法测定血浆中同型半胱氨酸（Hcy）浓度的方法。 方法 以tris-(2-carboxylethyl)-phosphine hydrochloride （TCEP）为还原剂，以7-fluorbenzo-2-oxa-1,3-diazole-4-sulfonate （SBD-F）为衍生剂，色谱柱为Xterra RP18柱，柱温35℃，流动相为甲醇︰磷酸二氢钠缓冲液（pH值3.0）=3︰97，激发波长380 nm，发射波长510 nm，外标法定量。 结果 Hcy浓度在1.95～125 ?mol/L范围内线性关系良好（r=0.999 8）。日内和日间相对标准偏差均＜7%，方法回收率为103.2%～111.9%。 结论 此方法准确、灵敏、快速，是一种适合于实验室研究和临床检测血浆中Hcy浓度的方法。