ABSTRACT
Objective:To evaluate the effectiveness and safety of enhanced recovery after surgery(ERAS)in perioperative period of liver transplantation.Methods:The authors searched systematically domestic and foreign databases to collect researches on applying ERAS for liver transplantation. The retrieval period was from database inception to November 2020. Quality assessment and data extraction were performed by two researchers according to the inclusion criteria. Meta-analysis of postoperative indicators(length of ICU stay, total length of hospital stay, postoperative complications, admission rate & mortality rate)was performed by RevMan 5.3.5 software.Results:3 Three randomized controlled studies (RCTs) and 4 cohort studies were selected with a total of 1 016 patients, including 404 in ERAS group and 612 in conventional group(traditional perioperative management). The results of Meta-analysis revealed that, as compared with control group, length of ICU stay was significantly shorter in ERAS group [weighted mean difference(WMD)=-2.20, 95% CI: -2.43~-1.97, P<0.05]; Total length of hospital stay was significantly shorter in ERAS group [WMD=-5.85, 95% CI: -8.20~-3.49, P<0.05]; The incidence of postoperative complications was significantly shorter in ERAS group [OR=0.61, 95% CI: 0.42~0.88, P<0.05]. However, no inter-group statistically significant differences existed between admission rate or mortality rate( P>0.05). Conclusions:In perioperative period of liver transplantation, using ERAS protocol can shorten length of ICU stay and total length of hospital stay, lower the incidence of postoperative complications and accelerate patient recovery.
ABSTRACT
Objective To evaluate the safety of enhanced recovery after surgery (ERAS) programs in pancreas surgery.Methods A computer search was performed on databases which included the Wanfang,CNKI,VIP,PubMed,Cochrane Library,Embase and Sciencedirect for randomized controlled trials or case-control studies on ERAS programs in pancreatic surgery published between January 1995 and August 2017.Two researchers independently evaluated the quality of the studies which met the inclusion criteria and performed a meta-analysis using the RevMan5.3.5 software.Results Four randomized controlled trials and twenty one case-control studies which included 4 063 patients entered into the meta-analysis.These patients included the ERAS group (n =2 052) and the control group (n =2 011 who underwent traditional perioperative management).Compared with the control group,the ERAS group had a lower postoperative complication rate (OR =0.57,95％ CI:0.45 ～0.71,P ＜0.05),a lower delayed gastric emptying rate (OR =0.46,95％ CI:0.37 ～ 0.59,P ＜ 0.05),a lower abdominal infection rate (OR =0.68,95％ CI:0.53 ～ 0.88,P ＜ 0.05),a shorter hospital stay (WMD =-4.86,95％ CI:-6.10 ～-3.62,P ＜ 0.05)and intensive care stay (WMD =-1.04,95％ CI:-2.01 ～-0.08,P ＜ 0.05).No significant differences existed in the mortality,readmission and postoperative pancreatic fistula rates between the two groups.Conclusion Perioperative implementation of ERAS programs was safe and effective in pancreatic surgery,and decreased postoperative complication rates and promoted recovery.
ABSTRACT
Objective:To study the interaction between the SARS-S1 protein and the SARS-sensitive cells.Methods:The SARS-S1 expression in the E.coli was purified and the anti-SARS-S1 was produced.After incubate with the SARS-S1 protein,cells was staining by the mouse-anti-SARS-S1 antibody and the anti-mouse antibody labeled by FITC.The result was determined by FACS.Results:After incubate with the SARS-S1 protein,different cell line have a different reaction to the SARS-S1 antibody.Conclusion:The SARS-S1 protein expressed by E.coli has a specific binding ability to the SARS-sensitive cells.