ABSTRACT
Objective To systematically review the efficacy of different artificial liver support systems in the treatment of acute-on-chronic liver failure (ACLF) using a network Meta-analysis. Methods PubMed, Embase, the Cochrane library, Clinical Trial, CNKI, SinoMed, and Wanfang Data were searched for randomized controlled trials (RCTs) on different artificial liver support systems in the treatment of ACLF. Literature screening, data extraction, and method ological quality assessment were performed according to inclusion and exclusion criteria, and Stata15.1 software and R4.1.0 software were used to perform a network Meta-analysis. Results A total of 14 RCTs were included, with 1141 patients in total. The network meta-analysis showed different intervention methods had no significant difference in reducing mortality rate based on cross comparison (all P > 0.05). The probability ranking diagram showed that plasma exchange (PE) showed the best effect in reducing 30-day mortality rate, followed by extracorporeal liver assist device (ELAD), fractionated plasma separation and adsorption with Prometheus system, molecular adsorbent recirculating system (MARS), Biologic-DT liver dialysis device, and PE+MARS. PE showed the best effect in reducing 90-day mortality rate, followed by Prometheus, ELAD, and MARS. Biologic-DT showed the best effect in improving hepatic encephalopathy, followed by MARS, PE+MARS, and ELAD. Patients undergoing ELAD had the lowest risk of bleeding, and compared with standard medical treatment, Biologic-DT might increase the risk of bleeding [risk ratio=1.9×10 8 , 95% confidence interval: (4.6-6.2)×10 27 ]. Conclusion PE might be the best option for reducing 30- and 90-day mortality rates in ACLF patients. Biologic-DT has a better effect in improving hepatic encephalopathy, but it may increase the risk of bleeding.
ABSTRACT
Studies have found that obesity is not only closely related with the occurrence and development of breast cancer,but also can significantly increase the risk of breast cancer recurrence and death,especially the occurrence of postmenopausal estrogen receptor positive breast cancer.Therefore,it is of great importance to understand the influence of obesity on the prognosis of breast cancer.The intervene of diet and lifestyle,metformin and other drags,and other obesity targeted therapies have provided direction for future research on these influence.
ABSTRACT
Objective To make a concrete analysis of micro-perfusion pump and compatible syringes used in neonatal intensive care unit (NICU) for low birth weight infants,and to find solutions to the defects in application.Methods 20 ml sterile syringes were set different infusion rates (1ml/h,5ml/h,6ml/h,10ml/h),different infusion time (5min,30min,lh).Then,the card slot on the micro-perfusion pump where the end of 20ml sterile syringe was placed was regulated.The regulated syringes were also set different infusion rates (5ml/h,6ml/h,l0ml/h) and time as before.The error accuracy was calculated.Results The results showed that at the end stage of 20ml sterile syringes pumping,there was always 0.5～1.5 ml residual liquid which could not be pumped out,but perfusion pump displayed injection was completed.Before regulation,the error accuracy between different infusion rates of 20ml sterile syringes was 6.00％,3.80％,2.33％,1.30％ respectively.However,after improvement,the regulated syringes could completely pump all liquid out,and the error accuracy between different infusion rates and different infusion time was also superior to pre-improvement.Conclusions Improved micro-infusion pump and sterile solution prefilled syringe have no drug residual,and display high accuracy and small error accuracy.