Objective To evaluate the influences of myocardial injury markers on the short-term and long-term mortality after coronary artery bypass grafting (CABG), so as to provide valuable references for clinical prognosis assessment. Methods Literature was electronically searched in CBM, PubMed, OVID, EMbase and CNKI from the date of their establishment to August 2011, meanwhile the manual searches were also performed to systemize the papers. According to the Cochrane Handbook for systematic reviews, the studies were screened by two reviewers independently, the quality of the included studies was evaluated, the data were extracted, and meta-analysis was conducted using RevMan5.0 software. Results A total of 10 observational studies including creatine kinase-myocardial band (CK-MB) and cardiac troponin I (cTnI), and the patients involved were 10 793 totally. Results of meta-analysis showed that the increasing release of CK-MB was associated with an increasing short-term mortality risk of both on-pump (RR=2.88, 95%CI 1.94 to 4.28, Plt;0.000 01) and off-pump group (RR=3.64, 95%CI 1.07 to 12.42), P=0.04). Also the increasing release of CK-MB was associated with an increasing long-term mortality risk of both on-pump (RR=2.55, 95%CI 1.91 to 3.40, Plt;0.000 01) and off-pump group (RR=3.36, 95%CI1.46 to 7.72, P=0.004). The increasing release of cTnI was also associated with an increasing risk of both short-term mortality (RR=6.45, 95%CI 2.50 to 16.66, Plt;0.1) and long-term mortality (RR=4.18, 95%CI 2.78 to 6.28, Plt;0.1). Conclusion The evidence shows that the increasing release of both CK-MB and cTnI is associated with an increasing risk of the short-term and long-term mortality.
Objective To introduce the surgical procedure and indication of the dorsoulnar arterial retrograde flap of the thumb in repair of soft tissue defect. Methods From March 2000 to March 2001, 12 cases of soft tissue defect with exposed bone at the distal thumb were involved. Ten flaps were pedicled distally at the proximal rotation point, 25 cm proximal to the cuticule. Two flaps were pedicled distally at the distal rotation point, 1.0 cm proximal to the cuticule. The flaps harvested in this study were 1.1 cm×1.3 cm to 1.8 cm×2.5 cm.Results All the flaps survived. After an follow-up of 2 to 14 months postoperatively, the appearance of the thumbs were satisfactory, except those of 2 thumbs repaired by the flaps transferred at the distal rotation point, which were bulkiness because of theuncovered pedicle. In 6 cases, the defect of finger pulp was repaired, and the 2point discrimination was measured 810 mm. The same range of motion of the thumb IP joint were observed in both sides in all cases.Conclusion The optimal indication of the procedure is soft tissue defect at the distal thumb.
Objective To systematically review the effectiveness and safety of safflor yellow for unstable angina. Methods Relevant studies of safflor yellow for unstable angina were collected from databases including CENTRAL (Issue 4, 2012), MEDLINE, EMbase, CNKI, VIP, WanFang Data and CBM from January, 2007 to December, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 6 RCTs involving 533 patients were included, which were of low quality. The results of meta-analysis showed: compared with conventional treatment alone, safflor yellow plus routine biomedical treatment significantly improved the symptoms f angina (excellence: OR=2.34, 95%CI 1.79 to 4.87; effectiveness: OR=1.23, 95%CI 0.86 to 1.76). Besides, it significantly improved ECG outcomes (excellence: OR=1.85, 95%CI 1.29 to 2.64; effectiveness: OR=1.43, 95%CI 1.00 to 2.05), obviously improved the hemorheology index and blood lipid, reduced plasma homocysteine concentration, and increased the decreasing of nitroglycerin stop amount. No damage of the liver and kidney were reported. Conclusion Current evidence showed that, safflor yellow plus routine biomedical treatment is effective in the treatment of unstable angina, which is superior to routine biomedical treatment alone. Due to the limited quantity and quality of the included studies, more high quality, double blind, randomized controlled trials are needed to verify the above conclusion.
ObjectiveTo systematically review the risk factors of post transplantation diabetes mellitus (PTDM) after liver transplantation for adult to provide clinical prevention and treatment basement on it.MethodsPubMed, Web of Science, The Cochrane Library (Issue 5, 2016), CNKI, VIP and WanFang Data were searched from inception to May 2016 to collect observational studies about risk factors of post transplantation diabetes mellitus (PTDM) after liver transplantation for adult. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 39 studies were included, which involving 10 043 adults. The incidence of PTDM was 27.61% (2 773/10 043). The results of meta-analysis showed that the following significant recipient factors: male (OR=1.53, 95%CI 1.32 to 1.78, P<0.000 01), advanced age (MD=3.82, 95%CI 2.74 to 4.89, P<0.000 1), higher BMI (MD=1.24, 95%CI 0.50 to 1.97, P=0.000 9), higher weight (MD=4.35, 95%CI 1.92 to 6.78, P=0.000 5), higher FPG before transplantation (MD=6.79, 95%CI 3.51 to 10.06, P<0.000 1), family history of diabetes (OR=1.62, 95%CI 1.13 to 2.31, P<0.008), HCV(+) infection (OR=2.44, 95%CI 1.88 to 3.17, P<0.000 01), CMV(+) infection (OR=2.75, 95%CI 1.67 to 4.50, P<0.000 1). The donor factors are male (OR=1.25, 95%CI 1.01 to 1.54, P=0.04), liver steatosis (OR=1.68, 95%CI 1.28 to 2.20, P=0.000 2), CMV(+) infection (OR=2.07, 95%CI 1.05 to 4.11, P=0.04), DDLT (OR=3.83, 95%CI 1.72 to 8.55, P=0.001). There were significant postoperative factors such as early acute rejection (OR=1.84, 95%CI 1.33 to 2.55, P=0.000 2), early infection (OR=4.16, 95%CI 1.94 to 8.92, P=0.000 2) and the use of tacrolimus (OR=1.50, 95%CI 1.23 to 1.83, P<0.000 1).ConclusionThe risk factors of PTDM include recipient factors such as male, advanced age, higher BMI, higher weight, higher FPG before transplantation, family history of diabetes, HCV(+) infection, CMV(+) infection. The donor factors are male, liver steatosis, CMV(+) infection, and DDLT. The postoperative factors are early acute rejection, early infection and the use of tacrolimus. Due to limited study quality, more high quality studies are needed to verify conclusion.
Objective To compare the short-term result between the high-flex (HF) and conventional posteriorstabil ized (PS) prosthesis in total knee arthroplasty (TKA). Methods From April 2005 to October 2007, 23 cases (27 knees) underwent TKA by HF prosthesis (HF group), and 35 cases (41 knees) underwent TKA by PS prosthesis (PS group).In HF group, there were 2 males (3 knees) and 21 females (24 knees) aged (64.3 ± 5.6) years, including 20 cases (23 knees) of osteoarthritis and 3 cases (4 knees) of rheumatoid arthritis; body mass index (BMI) was 27.3 ± 3.9; the course of disease was (5.3 ± 5.6) years; the Hospital for Special Surgery Scoring System (HSS) score was 58.4 ± 7.9; the Western Ontario and McMaster universities osteoarthritis index (WOMAC) score was 49.4 ± 6.9; the maximum knee flex degree was (107.6 ± 8.3)°; and the range of knee motion was (103.5 ± 7.7)°. In PS group, there were 3 males (3 knees) and 32 females (38 knees) aged (65.1 ± 5.9) years, including 33 cases (39 knees) of osteoarthritis and 2 cases (2 knees) of rheumatoid arthritis; BMI was 27.1 ± 4.1; the course of disease was (5.1 ± 4.9) years; HSS score was 60.1 ± 10.4; WOMAC score was 47.9 ± 7.2; the maximum knee flex degree was (108.4 ± 9.7)°; and the range of knee motion was (105.9 ± 11.4)°. There were no significant differences in general data between two groups (P gt; 0.05). Results All incisions achieved heal ing by first intention. No compl ication of ankylosis, blood vessel and nerve injuries, and prosthesis loosening occurred. All patients were followed up for 24-54 months (average 32.8 months). There were no significant differences in the HSS score, WOMAC score, the maximum knee flex degrees, and the range of knee motion at 3, 12, and 24 months after operation between two groups (P gt; 0.05), but there were significant differencesbetween pre- and post-operation (P lt; 0.05). Anterior knee pain occurred in 1 case of HF group and 4 cases of PS group after 24 months, the incidence rates were 3.70% in HF group and 9.76% in PS group, showing significant difference (P lt; 0.05). The X-ray films showed that no lucent zone around prosthesis and no patella baja were observed, and the force l ine was excellent. Conclusion There is no significant difference in the range of knee motion and cl inical scores between the HF prosthesis and the PS prosthesis, but the former’s incidence rate of anterior knee pain is lower.
目的：探討半椎板切開入路切除椎管內腫瘤的優缺點。方法：回顧性分析2004～2006年經手術切除病理證實的椎管內腫瘤196例的臨床資料。其中80例行了半椎板入路腫瘤切除，與同期的116例全椎板切除病人進行比較。結果：半椎板切除病人手術住院時間明顯縮短，術后起床反應輕微，遠期效果較全椎板好，對脊柱的穩定性影響小。結論：單側半椎板入路切除椎管內腫瘤損傷小，最有利于脊柱穩定性的維持。病人手術后住院時間短，反應輕微，遠期療效好。但也有暴露局限的缺點.
目的 探討顯微手術治療破裂大腦中動脈動脈瘤（MCAA）的適應證、術前評估及手術技巧。 方法 回顧性分析2008年1月－2011年1月經翼點入路行顯微外科手術治療的65例破裂MCAA患者的臨床資料。其中男40例，女25例；年齡22～78歲，平均46.8歲。術前Hunt-Hess分級：Ⅰ級15例，Ⅱ級25例，Ⅲ級13例，Ⅳ級10例，Ⅴ級2例。動脈瘤直徑＜5 mm 10個，5～15 mm 36個，15～25 mm 15個，＞25 mm 4個，平均7.8 mm。其中56例動脈瘤位于大腦中動脈分叉部，5例位于大腦中動脈的M1段，4例位于分叉后M2段。 結果 手術夾閉動脈瘤60例，余5例行動脈瘤夾閉加包裹術。患者術后獲隨訪3～36個月，平均16個月，均無動脈瘤復發或再出血發生。按格拉斯哥預后評分（GOS）結果評定：恢復良好58例（GOS 4～5分），差5例（GOS 2～3分），死亡2例（GOS 1分）。 結論 充分的術前評估，合適的手術入路選擇，以及手術技巧的靈活應用是顯微外科手術成功治療破裂MCAA的保證。
Mental disorders are a type of behavioral, emotional, cognitive, or thinking disorder that cause pain and social dysfunction, and are one of the top ten global disease burdens. Cannabidiol (CBD) is one of the main components of cannabis, with high safety and tolerability, and is a hot topic in drug research. CBD has a wide range of therapeutic effects, and research has found that CBD has neuropsychiatric effects such as anti-addiction, anti-depression, anti-anxiety, and anti-stress, making it one of the candidate drugs for mental disorders. This article summarizes the mechanism and research progress of CBD for major mental disorders, in order to provide useful references for CBD-related compounds in the treatment of mental disorders.
Objective To investigate the evaluation of nursing students on nurse teachers’ teaching quality between lessons ofBasic Nursing, in order to provide references for the improvement of teaching methods and promotion of teaching quality. Methods Questionnaire survey was used to investigate nurse students on the evaluation of nurse teachers’ teaching quality in three different clinical practice stages between lessons ofBasic Nursing. SPSS 19.0 statistical package was used to analyze the data. Results In the 5-point scale, the average score of all items was (4.72±0.38) points, and the average scores of three dimensions including timely project completion and gains in the practice, nurse teachers’ teaching, and teaching environment and resources were respectively (4.71±0.44), (4.76±0.35), and (4.66±0.52) points. The three items with the highest scores were teachers’ theoretical knowledge, teachers’ professional quality, and helping nurse students analyze existing problems; while the three with the lowest scores were teaching methods, timely completion of the practice, and participation by other nurses during the teaching. There were significant differences among the three stages in practice gains, reasonability of practice arrangement, instructing the students to solve problems, proficiency and standardization of the operation demonstration, basic theoretical knowledge, flexibility and enlightenment of the teaching methods, attitudes of the nurse teachers, participation by other nurses during the teaching, and head nurse’s support (P<0.05). Conclusions To improve the quality of clinical practice teaching, nurse teachers, other nurses in the ward, head nurse and the whole department should make collective effort. Nurse teachers should pay more attention to the improvement of teaching methods and reasonable planning of clinical practice.
Objective To compare quality of life for HIV infected people or AIDS patients and their family members of noninfected people in two counties (Zizhong and Zhaojue) with high AIDS morbidity and high HIV infective rates. Methods The quality of life for HIV infected people or AIDS patients and 162 of their family members and 97 people noninfected HIV/AIDS was measured by a questionnaire containing the generic quality of life inventory 74 (GQOLI-74) and the social support scale (SSS). Data were analyzed with SPSS. Results Total GQOLI-74 scores and each of the four dimensionality scores were significantly lower for HIV/AIDS people and their family members compared with noninfected people (total score for HIV/AIDS people 52.20 [9.41]; family members 60.46 [11.92]; noninfected people 66.36 [8.90] (Plt;0.01)). Scores for each of the disease status (physical function, psychological function, social function and material status) were all lower compared with noninfected people (all comparisons Plt;0.01). GQOLI-74 scores of HIV/AIDS people were significantly correlated with disease status and social support, but age, education level and substance abuse did not show significantly correlation. Conclusions The quality of life for HIV infected people or AIDS patients and their families is significantly lower than the general population, and this is particularly related to the severity of their disease and lack of social support.