ObjectivesTo analyze the research status and hot spots of hypertension-related clinical trials in special Chinese population registered on the Chinese Clinical Trial Registry (ChiCTR), so as to provide a basis for the development of hypertension-related research in special population in China.MethodsThe ChiCTR was searched online (up to August 31st, 2019, no limitation in the status of trial registration), all clinical trials on hypertension in special population were collected, and the general characteristics, researched diseases, research types, intervention measures and main outcomes of the trials were analyzed.ResultsA total of 64 hypertension-related clinical trials in special population registered in the ChiCTR were included, including 41 (64.1%) trials registered in last 3 years. The registration status of 46 (71.9%) trials was pre-registration. The registered authors were mainly from colleges and universities or medical institutions (n = 61, 95.3%), of which 60.9% were registered in Beijing, Shanghai, Guangdong, Zhejiang, Jiangsu and Hebei. The researched diseases mainly included elderly hypertension and hypertensive stroke, accounting for 50% of the total. Additionally, 37 (57.8%) clinical trials were intervention studies, of which 21 (56.7%) were drug-based intervention studies. Blood pressure, blood glucose, cardiovascular and cerebrovascular events, blood lipid, cranial MRI and Glasgow Coma Scale were the commonly used outcomes, accounting for 58.5% of the total outcomes. Most blood pressure measurements did not indicate the measurement method (n = 22, 64.7%).ConclusionsThe quantity of hypertension-related clinical trials in special population registered on the ChiCTR is increasing, however, there exists regional imbalance. The drug intervention-related clinical trials of elderly hypertension have become a research hot spot. However, blood pressure measurement method is not indicated in most trials, and some researchers do not register in time. Therefore, it is suggested that researchers should further strengthen the awareness of carrying out high-quality clinical trials.
ObjectiveTo explore the curative effect of synchronous resection of hepatopancreas lesions in the treatment of hepatic oligometastatic pancreatic cancer. MethodsThe patients with hepatic oligometastatic pancreatic cancer who met the inclusion and exclusion criteria in the Neijiang Second People’s Hospital from January 2016 to December 2020 were retrospectively collected. The enrolled patients were divided into resection group and non-resection group according to the treatment method. The patients in the resection group were treated with synchronous resection of hepatopancreas lesions, the patients in the non-resection group were treated with conservative treatment including palliative bypass surgery, biliary drainage, systemic chemotherapy, and so on. The patients were followed up to December 2021. The overall survival of the patients in the two groups were compared, and the factors affecting the overall survival were analyzed. ResultsA total of 54 patients who met the inclusion and exclusion criteria were collected in this study, including 31 cases in the resection group and 23 cases in the non-resection group. There were no statistical differences between the two groups in the baseline data such as age, gender, preoperative liver function indexes, and so on (P>0.05). The pancreaticojejunostomy leakage occurred in 7 cases (22.6%) of the resection group. The median follow-up time of the resection group and the non-resection group were 14 and 11 months. The median overall survival time of patients in the resection group and non-resection group were 18.0 months [95%CI (13.8, 22.1)] and 12.0 months [95%CI (8.2, 15.8)] respectively. The survival of the resection group was better than that of the non-resection group by log-rank test (χ2=4.074, P=0.045). Cox multivariate regression analysis result showed that the preoperative low albumin level (≤35.0 g/L), no perioperative chemotherapy, and no synchronous resection of hepatopancreas lesions shortened the overall survival time of patients with hepatic oligometastatic pancreatic cancer (P<0.05). For the patients who underwent the synchronous resection of hepatopancreas lesions, R0 resection and perioperative chemotherapy could prolong the overall survival time (P<0.05). ConclusionsFrom the results of this study, synchronous resection of hepatopancreas lesions can benefit survival for patients with hepatic oligometastatic pancreatic cancer. The prognosis of patients without R0 resection and perioperative chemotherapy is even worse.
Objective To investigate the medical technical services of the primary health care institutions in Chengdu and provide suggestions to improve their capability. Methods From October to November 2016, a questionnaire survey was conducted towards all the 390 primary health care institutions (including urban community health service centers and rural township health centers) in the 22 districts/cities/counties of Chengdu. Descriptive statistical methods was used for analysis. Results A total of 390 questionnaires were issued, and 379 valid questionnaires were recovered. In the primary health care institutions, the proportion of laboratory technicians, ultrasound technicians, electrocardiogram technicians and radiological technicians accounting for overall medical staffs was 3.32%, 2.04%, 1.75%, and 2.43%, respectively. The setup rate of laboratory, B-ultrasonic room, electrocardiogram room in the urban community health service centers was 94.02%, 93.16%, and 94.02%, respectively, which was similar with the rural township health centers (93.51%, 95.42%, and 90.08%, respectively). The top three medical technical services provided by the primary health care institutions were blood glucose test (96.04%), blood routine test (95.25%) and urinary routine test (95.25%), and the latter three were lung function test (18.21%), blood gas analysis (8.18%) and CT (5.28%). Conclusion Primary health care institutions in Chengdu need to improve the standardization of medical technical projcects and improve their service capability.
Acute carbon monoxide poisoning is a common and frequently occurring disease in winter and spring in China, with high disability and mortality. Delayed encephalopathy is a serious sequela after the pseudo-convalescence. Its mechanism is complex, including environmental and genetic factors, hypoxia and energy metabolism disorder, cytotoxicity and oxygen free radical damage, immune disorder and inflammatory activation, neurotransmitter disorder, brain parenchymal changes, vascular and hemorheological abnormalities, calcium overload, and cell apoptosis. At present, methods for predicting delayed encephalopathy in acute carbon monoxide poisoning include detailed inquiry of medical history, laboratory examination of relevant indicators, electrophysiological examination, brain imaging examination, and evaluation scale prediction. This review summarizes the research status of the pathogenesis and early prediction methods of delayed encephalopathy in acute carbon monoxide poisoning, with a view to providing reference for future research directions.
ObjectiveTo investigate the effect of surgical treatment on chest wall tuberculosis.MethodsA total of 407 patients with chest wall tuberculosis who met the inclusion and exclusion criteria from April 2008 to December 2017 in Chengdu Public Health Clinical Medical Center were enrolled. They were divided into two groups according to the time of admission: a control group (203 patients admitted from April 2008 to December 2012) treated with traditional focus debridement, including 135 males and 68 females, with an average age of 40.65±4.68 years, and an observation group (204 patients admitted from 2013 to 2017) undergoing complete focus debridement, including 139 males and 65 females, with an average age of 40.73±4.72 years. The general clinical data, perioperative related indexes, incision healing, incidence of complications and recurrence between the two groups were compared.ResultsThere was no significant difference in general clinical data, operation time, postoperative pain time, extubation time, hospital stay or recurrence rate between the two groups (P>0.05), but compared with the control group the grade A healing rate in the observation group was significantly higher and incidence of complications was significantly lower (P<0.05).ConclusionThorough debridement can achieve a better effect in the treatment of chest wall tuberculosis, and help to reduce complications and promote wound healing. It is suitable for clinical application.
Acute respiratory distress syndrome is one of the forms of respiratory failure that seriously threaten human life. It has the characteristics of very high morbidity, mortality and hospitalization costs. How to treat acute respiratory distress syndrome to improve the quality of life of patients is particularly important. Mechanical ventilation is an important treatment for acute respiratory distress syndrome. This article will review the progress in mechanical ventilation therapy for acute respiratory distress syndrome, including non-invasive mechanical ventilation and invasive mechanical ventilation (tidal volume, lung recruitment, positive end-expiratory pressure, prone position ventilation, and high-frequency oscillatory ventilation), aiming to provide basis and reference for future exploration of the treatment direction of acute respiratory distress syndrome.
ObjectiveTo overview the systematic reviews on the timing of different surgical interventions for severe multidrug-resistant pulmonary tuberculosis patients.MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were searched for systematic reviews about the timing of different surgical interventions for severe multidrug-resistant pulmonary tuberculosis patients from inception to December, 2018. Two reviewers independently screened literature, extracted data, evaluated the reporting and methodological qualities using the PRISMA checklist and the AMSTAR tool. After re-extraction of individual RCT data from included systematic reviews, meta-analysis was performed by Stata10.0 software.ResultsA total of 11 systematic reviews were included. The average methodological quality score was 8.13 in AMSTAR , the reporting quality score was from 19.5 to 25 in PRISMA. Re-performed meta-analysis showed that, the total success rate of operation was 93.3% (95%CI 92.9 to 93.8), the failure rate was 3.7% (95%CI 3.3 to 4.0), the mortality rate was 2.0% (95%CI 1.8 to 2.2), and the loss rate was 1.0% (95%CI 0.8 to 1.2). The cure rates of different surgical methods were all over 80%, among which single lobectomy (98.47%) and compound lobectomy (98.94%) had the higher cure rates than others. For the time of different surgical interventions, cure rate could be improved obviously in patients receiving surgery treatment after 1 months (OR=1.58, 95%CI 1.29 to 1.94, P=0.000 12), 1-8months (OR=1.66, 95%CI 1.30 to 2.12, P=0.000 05) and 9-24 months (OR=1.48, 95%CI 1.15 to 1.90, P=0.002) of anti-tuberculosis therapy compared with 0 month.There were significant differences between two groups.ConclusionCurrent evidence shows that operation is an effective way for severe multidrug-resistant pulmonary tuberculosis. Operative opportunity should be selected after 1-24 months of anti-tuberculosis drug treatment when the operation time depending on whether the tuberculosis has turned negative or not. Operative mode should be decided by the location and the scope of the lesion, which ensures the maximum excision of lesions and retention of lung function.