RESUMEN
Surgical resection is still the mainstay for treatment of intrahepatic cholangiocarcinoma (ICC).Gemcitabine and cisplatin is a systemic therapy practice standard for patients with non-resectable ICC.Neoadjuvant therapy with liver transplantation may be a new therapeutic option for patients with ICC.In addition, radiotherapy, hepatic intra-arterial therapy, ablation therapy and molecular targeted therapy are important components of comprehensive therapy for ICC.
RESUMEN
Objectives To analyze the effect of glucocorticoids on acute respiratory distress syndrome (ARDS) in adult patients. Method English and Chinese literature about the glucocorticoids treatment for ARDS were electronically searched. Meta-analysis was performed by Rev Man 5.0 software after the data of qualified studies were included in consistence with the criteria of inclusion and exclusion. Results Eight studies including 679 cases(steroid group 366, control group 313) met the inclusion criteria. Resuhs of meta-analysis showed that there were significant differences( P <0.05), between the steroid group and the control group, in mortality in all cases, mortality in patients treated at early stage, mortality in patients treated with low dose steroids, and PaO_2/FiO_2;the relative risks(RRs)/standardized mean difference(SMDs) and 95% confidence intervals(CIs) are 0.55(0. 34 ～ 0.87), 0.49(0.28 ～ 0.86), 0.46(0.24 ～ 0.88) and 2.99(0.63 ～ 5.34). There were no significant differences in mortality in patients treated during late stage, mortality in patients treated with high dose steroids and number of nosocomial infections(P > 0.05). Conclusions Low-dose glucocorticoids or routine dose glucocorticoids given during early stage can reduce mortality in patients with ARDS; the oxygenation of patients is significantly improved after steroid therapy; incidence of infectious complications is neither increased nor decreased by steroid therapy.