Objective To evaluate the effectiveness and safety of dexmedetomidine for postoperative sedation in cardiac patients. Methods Such databases as PubMed, EBSCO, Springer, Ovid, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were searched electronically from the date of their establishment to May 2012, and other relevant journals and references of the included literature were also searched manually. Two reviewers independently screened the studies in accordance with the inclusion and exclusion criteria, extracted data and assessed methodology quality. Then the meta-analysis was performed using RevMan 5.1software. Results A total of 8 randomized controlled trials (RCTs) involving 1 157 patients were included. The Jadad scores of 7 RCTs were more than 3, and only 1 RCT scored 2. The results of meta-analysis showed that compared with the control group, dexmedetomidine significantly raised peripheral oxygen saturation (RR=0.90, 95%CI 0.31 to 0.49, P=0.003), decreased the incidence of average heart rate (RR=–5.86, 95%CI –7.31 to ?4.40, Plt;0.000 01), ventricular tachycardia (RR=0.27, 95%CI 0.08 to 0.88, P=0.03), delirium (RR=0.28, 95%CI 0.16 to 0.48, Plt;0.000 01) and postoperative hyperglycemia (RR=0.57, 95%CI 0.38 to 0.85, P=0.006), and reduced the number of patients who needed vasoactive agents such as epinephrine (RR=0.53, 95%CI 0.29 to 0.96, P=0.04) and β-blocker (RR=0.60, 95%CI 0.38 to 0.94, P=0.03). However, it failed to shorten the time of both ICU stay (RR=?1.24, 95%CI ?4.35 to 1.87, P=0.43) and mechanical ventilation (RR=?2.28, 95%CI ?5.13 to 0.57, P=0.12), increase mean artery pressure (RR=?2.78, 95%CI ?6.89 to 1.34, P=0.19), and well control postoperative nausea, vomiting and atrial-fibrillation. There were no significant differences between the two groups in myocardial infarction, acute cardiac failure, acute kidney failure, and mortality rate. Conclusion For postoperative sedation in cardiac patients, dexmedetomidine can effectively stabilize hemodynamic indexes, and reduce tachycardia, delirium, postoperative hyperglycemia and vasoactive agents. However, it has no marked influence on the prognosis. For the quantity and quality limitation of included studies, this conclusion needs to be proved by performing more high quality and large sample RCTs.
目的 探討血管內皮生長因子（VEGF）及受體Flt-1蛋白表達與卵巢惡性腫瘤臨床病理和預后的關系。 方法 2000年1月-2004年6月，以SABC免疫組織化學方法檢測48例卵巢惡性腫瘤組織中VEGF及其受體Flt-1蛋白的表達。 結果 VEGF和Flt-1蛋白表達與卵巢惡性腫瘤的病理學類型、分化級別及臨床分期無明顯相關性（P＞0.05）。有淋巴結轉移者VEGF和Flt-1蛋白的表達陽性率均明顯高于無淋巴結轉移者（P＜0.05）。 VEGF 和Flt-1共同表達者平均總生存期為27.88個月，明顯短于沒有共同表達者的36.04個月（95%CI 為33.42～38.65，P=0.022 3）。 結論 VEGF和Flt-1蛋白表達與卵巢惡性腫瘤的淋巴結轉移相關，可作為預測腫瘤轉移及預后的指標。