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Objective@#To systematically evaluate the clinical efficacies of Helmet non-invasive ventilation and oxygen therapy on patients with hypoxemic respiratory failure.@*Methods@#The randomized controlled trials (RCTs) for comparison of efficacy between Helmet non-invasive ventilation and oxygen therapy for treatment of patients with hypoxemic respiratory failure published by Wanfang database, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), PubMed, Embase, Cochrane Library and Web of Science were retrieved. The retrieval time was from the establishment of database to February 1st, 2019. The indexes of the study outcomes included oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), endotracheal intubation rate, hospital mortality and intolerance rate. Literature search and data extraction was performed separately by two researchers. Quality assessment of literature was conducted according to the risk of bias criterion provided by Cochrane collaboration net. The extractive data were Meta-analyzed by RevMan 5.1.0. Funnel plot and Egger regression analysis was employed to detect publication bias.@*Results@#Six RCTs including 5 English studies and 1 Chinese study were selected. Finally, 547 patients were enrolled, with 270 patients in Helmet non-invasive ventilation group and 277 in oxygen therapy group. The study quality assessment revealed that the overall risk of bias was low, and no publication bias was detected by the funnel plot and Egger regression analysis. Meta-analysis showed that the oxygenation index in Helmet non-invasive ventilation group was significantly higher than that in oxygen therapy group [mean difference (MD) = 73.47, 95% confidence interval (95%CI) was 52.01 to 94.92, P = 0.000 01], and PaCO2 (MD = -2.46, 95%CI was -4.54 to -0.39, P = 0.02), endotracheal intubation rate [relative risk ratio (RR) = 0.38, 95%CI was 0.20 to 0.73, P = 0.004] and hospital mortality (RR = 0.35, 95%CI was 0.19 to 0.65, P = 0.000 8) in Helmet non-invasive ventilation group were significantly lower than those in oxygen therapy group. There was no significant difference in patient's intolerance between the two groups (RR = 2.38, 95%CI was 0.74 to 7.67, P = 0.15).@*Conclusion@#Compared with oxygen therapy, the Helmet non-invasive ventilation used for treatment of patients with hypoxemic respiratory failure can effectively improve the oxygenation index, decrease the PaCO2, reduce the endotracheal intubation rate and hospital mortality, and the patients are well tolerated to the Helmet method.
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Objective To systematically evaluate the clinical efficacies of Helmet non-invasive ventilation and oxygen therapy on patients with hypoxemic respiratory failure. Methods The randomized controlled trials (RCTs) for comparison of efficacy between Helmet non-invasive ventilation and oxygen therapy for treatment of patients with hypoxemic respiratory failure published by Wanfang database, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), PubMed, Embase, Cochrane Library and Web of Science were retrieved. The retrieval time was from the establishment of database to February 1st, 2019. The indexes of the study outcomes included oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), endotracheal intubation rate, hospital mortality and intolerance rate. Literature search and data extraction was performed separately by two researchers. Quality assessment of literature was conducted according to the risk of bias criterion provided by Cochrane collaboration net. The extractive data were Meta-analyzed by RevMan 5.1.0. Funnel plot and Egger regression analysis was employed to detect publication bias. Results Six RCTs including 5 English studies and 1 Chinese study were selected. Finally, 547 patients were enrolled, with 270 patients in Helmet non-invasive ventilation group and 277 in oxygen therapy group. The study quality assessment revealed that the overall risk of bias was low, and no publication bias was detected by the funnel plot and Egger regression analysis. Meta-analysis showed that the oxygenation index in Helmet non-invasive ventilation group was significantly higher than that in oxygen therapy group [mean difference (MD) = 73.47, 95% confidence interval (95%CI) was 52.01 to 94.92, P = 0.000 01], and PaCO2 (MD = -2.46, 95%CI was -4.54 to -0.39, P = 0.02), endotracheal intubation rate [relative risk ratio (RR) = 0.38, 95%CI was 0.20 to 0.73, P = 0.004] and hospital mortality (RR = 0.35, 95%CI was 0.19 to 0.65, P = 0.000 8) in Helmet non-invasive ventilation group were significantly lower than those in oxygen therapy group. There was no significant difference in patient's intolerance between the two groups (RR = 2.38, 95%CI was 0.74 to 7.67, P = 0.15). Conclusion Compared with oxygen therapy, the Helmet non-invasive ventilation used for treatment of patients with hypoxemic respiratory failure can effectively improve the oxygenation index, decrease the PaCO2, reduce the endotracheal intubation rate and hospital mortality, and the patients are well tolerated to the Helmet method.
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Objective To evaluate the potential role of the separately p73 gene polymorphism on hepatocellular carcinoma(HCC) susceptibility.Methods A hospital-based case-control study was conducted in 100 cases HCC patients and 100 cases age,sex-matched cancer-free controls in the same region.The matrix-assisted laser desorption ionization time-of-flight mass spectrometry and DNA sequencing methods were used to analyze polymorphisms of p73 genetic polymorphisms (G4C14-A4T14).Using χ2 test to exam the differences of genotype between the HCC group and control group,logistic regression was used to analysis odds ratio(Oddsratios,OR) and 95%CI(Confidence Intervals,CI),adjusted for age and sex,analysis the association between SNPs of P73 polymorphisms and HCC.All the results were analyzed by SPSS 18.0.Results (1)The differences of age(χ2=0.185,P=0.667),gender(χ2=0.026,P=0.873),drinking status(χ2=0.427,P=0.514),and family history (χ2=0.058,P=0.809)of cancer composition between HCC group and control group were not statistically significant.(2)There were CC,CT and TT three genotypes in p73 rs1801173 C/T.The frequencies of CC,CT and TT genotypes of P73 C/T in controls and HCC cases were 65.0%,28.2%,6.8 % and 62.2%,31.1%,6.7%,respectively,and there was no significant difference between the two groups(χ2=0.326,P=0.568).(3)When stratifying by age,gender,smoking status,alcohol consumption,HBV carrier status and family history of cancer we found that the variant genotypes of GC/AT + AT/AT in P73 was associated with a significantly increased risk of HCC among HbsAg-positive individuals(χ2=3.916,P=0.048) and female(χ2=6.545,P=0.01),and there were no significant correlation with age,smoking,alcohol consumption,family history of cancer.Conclusion (1)p73 G4C14-to-A4T14 dinucleotide polymorphism may play a role in the development of chronic HBV-infected HCC in the Chinese population.(2)p73 G4C14-to-A4T14 dinucleotide polymorphism may play a role in the development of chronic HCC in female of Chinese population.
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Objective To investigate the effects of prostaglandin E1 on proinflammatory and anti-inflammatory cytokines in sepsis patients.Methods One hundred and twenty cases of sepsis in ICU of our hospital were assigned to the groups:A,B,C and D,30 cases in each group.On the basis of conventional therapy,group A was added with prostaglandin El+ Xuebijing injection.The group was treated with prostaglandin E1,while the group C was treated with Xuebijing injection.The changes of APACHE Ⅱ score,Marshall score,anti-inflammatory and pro-inflammatory factors,mechanical ventilation time,ICU treatment time,28 d mortality rate in the 4 grups were observed and compared among 4 groups.Results The APACHE Ⅱ score and Marshall score after treatment in 4 groups were significantly decreased compared with before freatment (P＜0.05),Compared with the group B,C and D,The decrease of APACHE Ⅱ score,Marshace score,IL-1β,IL-6 and TNF-α levels was more significantly(P＜0.05),While the IL-10 level was significantly increastol(P＜0.05);duration of mechanical ventilation,length of stay ICU in were significantly shorter (P＜0.05),28 d mortality was significantly lower (P＜0.05).Conclusion Prostaglandin E1 combined with Xuebijing injection can effectively inhibit the inflammatory response in septic patients and promote the recovery of patients,reduces the mortality rate.
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Objective To investigate and analyze the value of using real time dynamic blood sugar monitoring during insulin pump treatment process in ICU patients.Methods Sixty-two ICU cases needing insulin intervention due to own blood glucose abnormality in this hospital from February 2015 to February 2016 were selected and divided into the control group and observation group,31 cases in each group.The control group used the fingertip method for measuring blood glucose and simultaneously used the continuous intravenous insulin injection by micropump;the observation group used real time dynamic blood sugar monitoring system to measure blood glucose level.Results The two groups completed the related study without excluded case or fallen out case.The observation group was better than the control group in the aspects of the time reaching target blood sugar level,total treatment time,insulin dosage and hypoglycemia occurrence rate,the difference was statistically significant (P ＜ 0.05).MBG,MAGE,MODD,SDBG and time percent of glucose drift (TBG≥7.8 mmol/L and TBG≤3.9 mmol/L) on 3 d in the observation group were significantly decreased compared with those on 1 d.The two monitoring methods showed significantly positive correlation (r =0.97,P=0.006).Conclusion ICU patients using the real time dynamic blood sugar monitoring system can obviously decrease blood sugar level,and is safe and effective.