ABSTRACT
Objective To investigate the effect of extracorporeal membrane oxygenation (ECMO) on critical patients with non-pulmonary primary disease in the emergency department. Methods The literature of English and Chinese clinical studies on the ECMO treating critical patients with non-pulmonary primary disease published before August 2017 were electronically searched on PubMed, Embase and other databases. The obtained articles were selected, their qualities were strictly evaluated, and the in-hospital survival rate, 3-month, 6-month and 1-year survival rate, as well as the average intensive care unit (ICU) and length of hospital stay were extracted. This meta-analysis were performed using RevMan software (Version 5.0, Cochrane collaboration). Results A total of 11 articles (n=3043) were enrolled including 616 cases of ECMO treatment group and 2427 cases of control group. Fitting results showed that compared with the traditional treatment, application of ECMO can improve the in-hospital survival rate[52.1％(321/616) vs. 32.1％ (780/2427); OR=2.02; 95％CI:1.11-3.67, P=0.02] and the survival rate more than 90 days[42.1％ (61/145) vs. 17.1％ (38/222); OR=3.98; 95％CI:2.30-6.89, P<0.01];and prolong the average length of hospital stay (MD=-5.35, 95％CI:-8.10--2.60, P<0.01) and ICU time(MD=-8.99, 95％CI:-8.20--1.80, P<0.01). Conclusions Meta-analysis of existing studies showed that application of ECMO can improve the short-term and long-term prognosis of critical patients with non-pulmonary primary disease. However, due to the small number of studies and the large heterogeneity of the study population, it is necessary to carry out more, large samples and high quality randomized controlled clinical trials.
ABSTRACT
This study activated chronic epilepsy rat model with PTZ [Pentetrazole] and controlled epilepsy with VPA [valproate]. By doing that, we detected the apoptotic cells of hippocampus and figured out the expression variation of hippocampal neurons applying immunohistochemical methods. We selected 30 adolescent male SD [Sprague-Dawley] rats [201 +/- 29g], which were clean and healthy. The rats were divided into three groups and 10 were in each. Then we detected the apoptotic cells of hippocampus using TUNEL [Terminal Deoxynucleotidyl Transferase Mediated Biotinylated Deoxyuridine Triphosphate Nickel End Labeling Technique] and Bcl-2 and Bax positive cells applying immunohistochemical methods. The results showed Bcl-2 positive cells of hippocampal neuron in VPA group had no statistical variation as compared with PTZ group; Bax positive cells of hippocampal neuron in VPA group induced as compared with PTZ group; dye and density of the positive cells were both decreased, whereas there was no statistical variation when compared with normal control group. Based on the experiment, we reached the conclusion that, VPA showed no harm to epileptic rats and the hippocampal neuronal apoptosis after epilepsy and anti-epileptic drug was probably resulted from the decrease of Bcl-2 expression and increase of Bax expression