ObjectiveTo compare the clinical efficacy of endoscopic minimally invasive surgery and median sternotomy thoracotomy in the treatment of atrial myxoma by meta-analysis.MethodsWe searched CBM, CNKI, Wanfang Data, VIP, PubMed, the Cochrane Library and EMbase to collect relevant researches on atrial myxoma and endoscopic minimally invasive surgery. The retrieval time was from the establishment of the database to September 2020. Two reviewers independently screened the literature, extracted data and evaluated the bias risk of included studies by the Newcastle-Ottawa scale (NOS). Then, the meta-analysis was performed by Stata 16.0.ResultsTen articles were included in the study, all of which were case-control studies. The quality of literature was grade B in 5 articles and grade A in 5 articles. The sample size of surgery was 938 patients, including 480 patients in the endoscopic minimally invasive group, 458 patients in the median thoracotomy group, and 595 patients in follow-up. A total of 18 outcome indexes were included in the meta-analysis. The combined results of 9 outcome indicators were statistically significant: cardiopulmonary bypass time (SMD=0.32, 95%CI 0.00 to 0.63, P=0.048); ventilator assisted ventilation time (SMD=−0.35, 95%CI −0.56 to −0.15, P=0.001), ICU stay time (SMD=–0.42, 95%CI −0.62 to −0.21, P<0.001); postoperative hospitalization time (SMD=−0.91, 95%CI −1.22 to −0.60, P<0.001); postoperative drainage volume (SMD=−2.48, 95%CI −5.24 to 0.28, P<0.001); postoperative new onset atrial fibrillation (OR=0.29, 95%CI 0.12 to 0.67, P= 0.005); postoperative pneumonia (OR=0.09, 95%CI 0.02 to 0.36, P=0.001); postoperative blood transfusion (OR=0.22, 95%CI 0.11 to 0.45, P<0.001); incision satisfaction (OR=83.15, 95%CI 1.24 to 5563.29, P=0.039).ConclusionAvailable evidence suggests that median thoracotomy requires shorter cardiopulmonary bypass time than endoscopic minimally invasive surgery; during the 5-year follow-up after surgery and discharge, ICU stay time, postoperative hospital stay, postoperative drainage, new atrial fibrillation after surgery, postoperative pneumonia, postoperative blood transfusion, satisfactory incision, endoscopic minimally invasive surgery showed better results than median sternotomy thoracotomy.
From June 2002 to December 2023, there were 5 patients with criss-cross admitted to the General Hospital of the Northern Theater Command, including 3 males and 2 females, aged 18 months to 25 years, and weighing 13-49 kg. There were 5 patients of atrioventricular position, 3 patients of right ventricular loop, 2 patients of left ventricular loop, 3 patients of normal atrioventricular connection, and 2 patients of inconsistent connection. Combined intracardiac malformations: 1 patient of simple ventricular septal defect combined with pulmonary hypertension, 1 patient of corrected transposition of the great arteries combined with ventricular septal defect, atrial septal defect, and pulmonary artery stenosis, 1 patient of corrected transposition of the great arteries combined with ventricular septal defect, atrial septal defect, and left atrioventricular valve insufficiency, and 2 patients of right ventricular double outlet combined with ventricular septal defect and pulmonary artery stenosis. The surgical methods included 2 patients of intracardiac anatomical correction, 1 patient of bidirectional vena cava pulmonary artery anastomosis, and 2 patients of total extracardiac ductal cava pulmonary artery anastomosis. All 5 patients were discharged smoothly.
Objective To investigate the expression of cyclooxygenase-2 (COX-2) in liver tissue of severe acute pancreatitis (SAP) rats. Methods A rat model of SAP was induced by retrograde infusion of 3.5% sodium taurocholate into the biliary-pancreatic duct. Eighty rats were randomly divided into SAP group and control group. The levels of serum amylase (AMY), alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor (TNF) -α and ascites AMY were detected dynamically at 4 h, 8 h, 16 h and 24 h after operation. The pancreatic and liver injuries were observed by light microscope. The expression of COX-2 in liver tissue was measured by immunohistochemistry. Results Compared with the control group, the levels of serum AMY, ALT, AST, TNF-α and ascites AMY increased significantly at the time point of 4 h, 8 h, 16 h and 24 h (Plt;0.05). These changes were paralleled with the histopathological changes of pancreatic and liver tissue. The expression positive rates of COX-2 at the different time in the SAP group were higer than those of the control group (Plt;0.05). There was a significantly positive correlation between the expression of COX-2 and ALT (rs=0.949, P=0.039), AST (rs=0.972, P=0.016) and serum AMY (rs=0.944, P=0.041), respectively. Conclusion Overexpression of COX-2 may play an important role in liver injury during SAP.
Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
ObjectiveBased on real-word data, and compared with two common chronic respiratory diseases, interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD), this case-control study plans to investigate the risk factors and clinical characteristics of patients with combined pulmonary fibrosis and emphysema syndrome (CPFE).MethodsA retrospective case-control study was carried out to screen the clinical data of 96 patients with CPFE, 133 patients with COPD and 164 patients with ILD, analyze their demographics, clinical data, complications and related clinical indicators. Univariate analysis was used to compare the differences among the three groups, and multivariate logistic analysis was used to screen for risk factors.ResultsAll three groups were in old age with the average age of above 71 years. In terms of male ratio and smoking rate, the CPFE group (93.8%, 85.4%) was higher than the ILD group (75.0%, 64.0%), but there was no significant difference when compared with the COPD group (90.2%, 82.0%). Regarding comorbid disease, the proportion of connective tissue disease (CTD) in the CPFE group (10.4%) and the ILD group (13.4%) was higher than that in the COPD group (1.5%). The proportion of hyperlipidemia in the CPFE group (8.3%) was higher than that in the COPD group (1.5%) and the ILD group (1.2%). There were differences in the abnormal proportion of antinuclear antibody among the three groups, but no significant difference was found when compared with the CPFE group alone. The CPFE group (46.9%, 12.5%) and the ILD group (54.9%, 9.8%) were significantly higher than the COPD group (34.6%, 2.3%) in terms of carcinoembryonic antigen (CEA) abnormal proportion and cancer rate. In terms of the prevalence of pulmonary hypertension, the CPFE group (41.7%) > the COPD group (33.1%) > the ILD group (32.9%) was shown, but no statistical significance was found among the three groups.ConclusionsMale and smoking are not only risk factors for COPD but also for CPFE. At the same time, the suffering of CPFE may be affected by immune factors and hyperlipidemia. The proportion of CPFE patients complicated with cancer and CEA abnormalities is higher than COPD patients. The severity of pulmonary hypertension in CPFE patients is significantly higher than the other two diseases.
ObjectiveTo systematically evaluate the effect of single-port totally extraperitoneal (SPTEP) and conventional totally extraperitoneal (CTEP) inguinal hernia repair in treatment of inguinal hernia. MethodsPubMed, Cochrane Library, Embase, WanFang Data, VIP, and CNKI databases were electronically searched and the randomized controlled trial (RCT) and non-RCT studies on the efficacy and safety of SPTEP versus CTEP for patients with inguinal hernia from January 2010 to November 2019 were collected. Two reviewers independently screened literatures, extracted data, and assessed risk of bias of included studies, then the meta-analysis was performed by using RevMan5.3 software. ResultsA total of 17 clinical studies were included in the analysis, with 1 106 cases in the SPTEP group and 966 cases in the CTEP group. The results of meta-analysis showed that: the hospital stay [SMD=–0.12, 95%CI (–0.22, –0.02), P=0.01] and the time to resume normal activity [SMD=–1.17, 95%CI (–2.10, –0.23), P=0.01] were shorter, the satisfaction score of incision scars [SMD=0.92, 95%CI (0.31, 1.53), P<0.01] was higher in the SPTEP group as compared with the CTEP group. However, the operative time of SPTEP group was longer than that of the CTEP group both for unilateral inguinal hernia [MD=4.08, 95%CI (0.34, 7.83), P=0.03] and bilateral inguinal hernia [MD=5.53, 95%CI (0.39, 10.68), P=0.04]. There were no statistical differences in the postoperative pain score (24 h and 7 d), incidence of postoperative complications, the rate of patients satisfied with the incision, and hospitalization costs between the two groups (P>0.05). ConclusionsFrom the results of this meta-analysis, SPTEP has some certain advantages in shortening hospital stay and returning to normal activity time, and improving incision satisfaction. However, compared with CTEP, mean operative time of SPTEP is longer. Although SPTEP has developed for several years, it is difficult to replace CTEP.
Objective To explore the risk factors of chronic postoperative inguinal pain (CPIP) after transabdominal preperitoneal hernia repair (TAPP), establish and verify the risk prediction model, and then evaluate the prediction effectiveness of the model. Methods The clinical data of 362 patients who received TAPP surgery was retrospectively analyzed and divided into model group (n=300) and validation group (n=62). The risk factors of CPIP in the model group were screened by univariate analysis and multivariate logistic regression analysis, and the risk prediction model was established and tested. Results The incidence of CPIP at 6 months after operation was 27.9% (101/362). Univariate analysis showed that gender (χ2= 12.055, P=0.001), age (t=–4.566, P<0.01), preoperative pain (χ2=44.686, P<0.01) and early pain at 1 week after operation (χ2=150.795, P<0.01) were related to CPIP. Multivariate logistic regression analysis showed that gender, age, preoperative pain, early pain at 1 week after operation, and history of lower abdominal surgery were independent risk predictors of CPIP. The area under curve (AUC) of the receiver operating characteristic (ROC) of the risk prediction model was calculated to be 0.933 [95%CI (0.898, 0.967)], and the optimal cut-off value was 0.129, while corresponding specificity and sensitivity were 87.6% and 91.5% respectively. The prediction accuracy, specificity and sensitivity of the model were 91.9% (57/62), 90.7% and 94.7%, respectively when the validation group data were substituted into the prediction model. Conclusion Female, age≤64 years old, preoperative pain, early pain at 1 week after operation and without history of lower abdominal surgery are independent risk factors for the incidence of CPIP after TAPP, and the risk prediction model established on this basis has good predictive efficacy, which can further guide the clinical practice.
Severe bee stings can trigger a systemic inflammatory response and multi-organ dysfunction, potentially resulting in fatality. Acute kidney injury (AKI) is a frequent complication in patients with severe bee stings, and conventional comprehensive treatment combined with various blood purification therapies is commonly employed in clinical practice to promptly manage the condition and reduce the average hospital stay duration. This article primarily delves into the significance of enhanced clinical nursing care for patients with bee stings-induced AKI undergoing blood purification therapy. Specifically, it underscores the importance of patient education regarding treatment-related considerations, nursing techniques for vascular access during treatment, potential complications, and corresponding nursing interventions.
目的 探讨糖耐量异常患者的焦虑抑郁状况及其与生活质量的相关性，为糖尿病相关心理问题的早期识别与干预提供参考。 方法 以2010年1月－2012年6月糖耐量异常患者145例为试验组，健康人群147例作为对照组，两组分别填写焦虑自评量表（SAS）和抑郁自评量表（SDS），试验组还需填写世界卫生组织生活质量测定量表简表（WHOQOL-BREF）并对其焦虑、抑郁得分与WHOQOL-BREF的各因子的相关性进行分析。 结果 145例患者中有51例（35.2%）存在抑郁情绪，47例（32.4%）存在焦虑情绪，焦虑合并抑郁情绪者29例（20%）。糖耐量异常患者焦虑、抑郁评分明显高于对照组（P＜0.01），其生活质量多个领域评分低于对照组（P＜0.01），且生活质量与焦虑、抑郁情绪存在负相关（P＜0.05）。 结论 糖耐量异常患者焦虑、抑郁情绪明显高于正常人群，其生活质量偏低，提示了对在该人群进行早期心理干预的必要性。
Objective To systematically review the efficacy of short message intervention on glycosylated hemoglobin (HbAlc) and blood glucose levels on patients with type 2 diabetes mellitus. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library, CNKI and CBM from inception to August 2016, to collect randomized controlled trials (RCTs) about short message intervention in type 2 diabetes mellitus patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using Stata 12.0 software. Results A total of 17 RCTs involving 2 879 patients were included. The results of meta-analysis showed that, on the basis of basic treatment, the use of text messages could lower the levels of HbA1c (SMD3 months=–0.50, 95%CI –0.67 to –0.34, P<0.001; SMD6 months=–0.33, 95%CI –0.59 to –0.07, P=0.012), FBG (SMD3 months=–0.28, 95%CI –0.45 to –0.11, P=0.001; SMD9 months=–0.99, 95%CI –1.44 to –0.54, P<0.001), PBG (SMD3 months=–0.99, 95%CI –1.54 to –0.44, P<0.001; SMD6 months=–0.81, 95%CI –1.25 to –0.36, P<0.001; SMD9 months=–0.78, 95%CI –1.23 to –0.34, P=0.001). Conclusion The current evidence shows that the use of SMS can improve glycosylated hemoglobin and blood glucose levels on type 2 diabetes patients. Due to limited quality and quantity of the included studies, the above conclusions are needed to be verified by more high quality studies.