Ornithine aspartate and naloxone combined therapy for hepatic encephalopathy affects cognitive function, prognosis, and neuropeptide levels / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the potential effects on cognitive function, prognosis, and neuropeptide levels of patients in response to combination therapy with ornithine aspartate plus naloxone for hepatic encephalopathy.</p><p><b>METHODS</b>Eighty-four consecutive patients diagnosed with hepatic encephalopathy were randomly divided into two equal groups. The control group (n = 42) received traditional medical treatment, and the research group (n = 42) received the traditional medical treatment as well as the combination therapy with ornithine aspartate plus naloxone. The supplemental treatment was comprised of daily intravenous injection of 10-15 g ornithine aspartate in 250 ml of 5% glucose plus intravenous drip of 3 mg naloxone in 100 ml of 5% glucose, and was given in 7-day cycles for one or two cycles. The cognitive function of patients was assessed by Hasegawa Intelligence Scale (HDS) and Mini-Mental State Examination (MMSE) questionnaires. The effective rate and time duration from coma to consciousness were recorded. Changes in blood ammonia level, markers of liver function, and neuropeptide levels were measured by standard biochemical assays. Intergroup differences were assessed by the Chi-squared test.</p><p><b>RESULTS</b>The HDS and MMSE scores of the research group were significantly higher than those of the control group after therapy. The effective rate, time duration from coma to consciousness, blood ammonia, the liver function markers alanine aminotransferase, gamma-glutamyl-transpeptidase and total bilirubin, and the neuropeptides arginine vasopressin and beta-endorphin were remarkably improved after treatment in the research group, as compared with that in the control group.</p><p><b>CONCLUSION</b>Supplementing the traditional treatment for hepatic encephalopathy with ornithine aspartate plus naloxone combination therapy provides better therapeutic outcome than traditional treatment alone.</p>

Meta-analysis of laparoscopic and open repair of perforated peptic ulcer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the safety and feasibility of laparoscopic and open repair of perforated peptic ulcer.</p><p><b>METHODS</b>Studies on comparison between laparoscopic repair(LR) and open repair(OR) of perforated peptic ulcer were collected. Data of operating time, blood loss, time to first flatus, postoperative hospital stay, postoperative complications and mortality between LR group and OR group were meta-analyzed using fixed effect model and random effect model.</p><p><b>RESULTS</b>Nineteen studies including 1507 patients were selected for this study,including laparoscopic surgery(n=673) and open surgery(n=834). There were significant differences in blood loss, time to first flatus, postoperative hospital stay, wound infection rate and mortality between LR group and OR group. However, no significant differences existed in operative time, postoperative sepsis, pulmonary infection, abdominal abscess, and suture leakage between the two groups.</p><p><b>CONCLUSIONS</b>Laparoscopic repair of perforated peptic ulcer is associated with improved outcomes in terms of less blood loss, quicker recovery, and lower rates of wound infection and mortality. Laparoscopic repair of perforated peptic ulcer is safe and feasible.</p>

Necessity of splenectomy in radical resection of gastric cancer: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the necessity of splenectomy in radical resection of gastric cancer.</p><p><b>METHODS</b>Twelve studies comparing outcomes after radical resection of gastric cancer with or without splenectomy were identified. Both fixed effect model and random effect model were used.</p><p><b>RESULTS</b>There were 2628 patients in total. There were significant differences in complications between splenectomy group and spleen-preserving group(OR=1.91, 95% CI:1.28-2.87, P<0.05), while no significant difference in 5-year survival rate was noticed(HR=0.90, 95% CI:0.73-1.11, P>0.05).</p><p><b>CONCLUSION</b>Radical resection of gastric cancer combined with splenectomy is not associated with improved survival but increased postoperative complications.</p>

Applications of multiple seasonal autoregressive integrated moving average (ARIMA) model on predictive incidence of tuberculosis / 中华预防医学杂志

<p><b>OBJECTIVE</b>To discuss the application of multiple seasonal autoregressive integrated moving average (ARIMA) predictive model of time series and to establish a predictive incidence model of tuberculosis.</p><p><b>METHODS</b>Parameters of the model were estimated using conditional least squares method according to the data of tuberculosis incidence and the averaged population in a district in Chongqing from 1993 to 2004. In a structure determined according to criteria of residual un-correlation and conclusion, ARIMA predictive model was established and the order of model was confirmed by Akaike's Information Criterion (AIC, for short) and Schwartz's Bayesian Information Criterion (SBC or BIC, for short).</p><p><b>RESULTS</b>There were significant differences of the fitted multiple seasonal moving-average coefficients with the nonseasonal and the seasonal moving-average coefficients being 0.84076 and 0.46602 respectively. The estimated variance was 0.088589, AIC = 19.75979, SBC = 23.28219. Autocorrelation check of residuals of model was white-noise residual. ARIMA(0,1,1)(0,1,1)4NOINT seemed to be the most appropriate model by chi2 test.</p><p><b>CONCLUSION</b>The multiple seasonal ARIMA model can be used to forecast for tuberculosis incidence with high prediction and precision in a short-term.</p>

Prediction of food allergy by using cord blood IgE levels / 中华儿科杂志

<p><b>OBJECTIVE</b>As more attention is paid to food allergy which is already regarded as a public health problem, there is still a lot of uncertainty as to the mechanisms and there are limited therapeutic methods for this problem. It is of importance to screen the susceptible infants as early as possible. The present study was conducted to learn whether cord blood IgE levels (CBIgE) could be used as a predictor of food allergy, and to find out factors which influence the predictive accuracy of CBIgE.</p><p><b>METHODS</b>The present study enrolled 118 infants born between April 2001and July 2001, and the authors followed up the infants until they were 4 months old. At the end of follow up, 105 infants had complete data for evaluation. Paper radioimmunosorbent tests (PRIST) were used for CBIgE assay, and parents were required to answer the standard questionnaires and the food skin prick tests (SPT) were taken for all infants.</p><p><b>RESULTS</b>At the end of follow-up, the infants were divided into 3 groups based on food allergy status: FA group with obvious food allergy, SFA group with suspected food allergy and NFA group without allergy. The median values of CBIgE levels in FA group were higher than those in SFA and NFA groups (4.80 IU/L, 0.55 IU/L, 0.87 IU/L, P < 0.01). When the cutoff value for CBIgE was set at 0.9 IU/L (CBIgE(0.9)), 42.9% of infants were found to have food allergy in the higher CBIgE group, 6.7% in the lower CBIgE group (P < 0.01, RR 95% CI = 2.715 approximately 15.221); when the cutoff value was set at 0.5 IU/L (CBIgE(0.5)), 30.9% in the higher CBIgE group and 5.00% in the lower CBIgE group (P < 0.01, RR 95% CI = 1.954 approximately 19.552). In addition, the sensitivity of CBIgE(0.9).as a predictor of food allergy, was 78.95% and the specificity, efficiency and odd product were 73.68%, 74.74%, and 10.50, generally better than CBIgE(0.5) of which the sensitivity, specificity, efficiency, odd product were 89.47%, 5.00%, 57.89%, 8.5 (P < 0.01). With the multi-factor stepwise regression analysis, our study indicated that exposure to cigarette smoke (OR 95%CI = 4.3340 approximately 71.2432), animal fur (OR 95% CI = 1.9869 approximately 30.7472), and egg supplement (OR 95% CI = 1.9340 approximately 25.8885) before 4 months of age might be the risk factors which may result in the predictive uncertainty of CBIgE.</p><p><b>CONCLUSIONS</b>Increased CBIgE levels might be the risk factor which result in food allergy; CBIgE(0.9), as a predictor of food allergy, is superior to CBIgE(0.5). However, some environmental factors, such as early exposure to cigarette smoke, animal fur and too early egg supplement would lead to predictive uncertainty of CBIgE.</p>