ABSTRACT
Objective To evaluate the efficacy and safety of heated gel mattress(HGM) for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods Systematic searches on PubMed, EMBASE, Cochrane Library, Web of Science CBM,CNKI,Wanfang and VIP were performed for randomized controlled trials or quasi-randomized control trials which explored the effects of HGM on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria,extracting data and assessing quality. Then, Meta-analysis and trial sequential analysis were performed by using RevMan 5.3 and TSA v0.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results This systematic review included 10 studies which comprised 7 randomized controlled trials and 3 quasi-randomized control trials, encompassing 773 patients. The results of Meta-analysis showed that in HGM group admission temperature on neonatal intensive care unit (standardized mean difference was 0.63, 95% confidence interval was 0.40-0.87, P=0.00), incidence of hypothermia (relative risk was 0.73, 95% confidence interval was 0.57-0.93, P=0.01) and hyperthermia (relative risk was 1.82, 95% confidence interval was 1.31-2.54, P=0.00) compared with the control group had significantly statistical difference;however, there was no significant difference in admission temperature on EM or TWM group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage III/IV between two groups. TSA confirmed that the pooled results of admission temperature on NICU and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusions HGM is an effective rewarming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia but not decrease the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever and complications. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, high-quality research.
ABSTRACT
Objective To observe the numerical characteristics of dendritic cells (DC),the DC subsets(myeloid dendritic cell,MDC; plasmacytoid dendritic cell,PDC) and CD4+ CD25 + CD127low/-Tr cells in peripheral blood of Graves disease (GD) patients.Methods According to the clinical manifestations and serum FT3,FT4 and TSH,the GD patients were divided into the untreated-group,the clinical remission group and the clinical stable group,and set normal control group as well.The flow cytometry was used to detect DC and CD4+CD25+CD127low/-Tr cells of the percentage of CD4+ T cells in subjects peripheral blood(EDTA-K2 anticoagulated).The indicators were compared among various groups,and the correlation between the indicators with serum FT3,FT4 and TSH were observed.Results (1) In the untreated-group,the clinical remission group,the clinical stable group,and normal control group,total DCs,MDCs and MDC/PDC gradually declined,untreated-group has a significant difference from the other three groups also the significant difference was found among other three groups; (2) In the untreated-group,the clinical remission group,the clinical stable group,and normal control group,PDCs declined successively,but only the difference was found between untreated-group and normal control group; (3)In the untreated-group,the clinical remission group,the clinical stable group,and normal control group,CD4+CD25+CD127low/-Tr cells gradually raised,but only the difference between untreated-group and normal control group make sense; (4)In the untreated-group,PDCs and CD4+CD25+CD127low/-Tr cells have a certain relevance; (5)There was good correlation between DCs and serum FT3,FT4 and TSH,but CD4+CD25+CD127low/-Tr cells only have correlation with FT3 and FT4.Conclusion DC,MDC,MDC/PDC increased in the untreated-GD patients,and decreased after the therapy of anti-thyroid.Therefore,DCs and the DC subsets are expected to be used to monitor GD in the course of disease.CD4+CD25+CD127low/-Tr cells can be used as a new indicator of the onset of GD.