Efficacy of echocardiography-guided alone versus fluoroscopy-guided percutaneous closure of atrial septal defect: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective     To systematically evaluate the safety and efficacy of percutaneous closure of atrial septal defect (ASD) guided by echocardiography alone versus fluoroscopy. Methods     The databases of PubMed, The Cochrane Library, EMbase, VIP, Wanfang Data and CNKI from January 2000 to October 2021 were searched by computer for relevant research literature. Two reviewers independently screened the literature, extracted the data and evaluated the quality according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Results     A total of 19 cohort studies and 1 randomized controlled study were collected, including 2 825 patients. The Newcastle-Ottawa Scale score for cohort studies was≥7 points. Meta-analysis showed that there was no statistical difference in the operative success rate (RR=1.01, 95%CI 1.00 to 1.02, P=0.17), incidence of occluder displacement/shedding (RR=0.77, 95%CI 0.26 to 2.27, P=0.63), incidence of arrhythmia (RR=0.50, 95%CI 0.21 to 1.14, P=0.10), incidence of pericardial effusion (RR=0.98, 95%CI 0.32 to 2.98, P=0.97), operative time (MD=–0.23, 95%CI –7.56 to 7.10, P=0.95) or cost (SMD=–0.39, 95%CI –1.09 to 0.30, P=0.27) between the two groups. The echocardiography group reduced the incidence of total postoperative complications (RR=0.42, 95%CI 0.30 to 0.60, P<0.001) and residual shunt (RR=0.70, 95%CI 0.50 to 0.98, P=0.04), and shortened length of hospital stay (MD=–0.43, 95%CI –0.77 to 0.09, P=0.01). Conclusion     Compared with traditional fluoroscopy-guided percutaneous closure of ASD, echocardiography guidance alone is equivalent in terms of operative success rate, major postoperative complications, operative time and total cost, but it reduces the incidence of total postoperative complications and residual shunt, and has a shorter length of hospital stay.

The Clinical Outcomes of Different First-Line EGFR-TKIs Plus Bevacizumab in Advanced EGFR-Mutant Lung Adenocarcinoma / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients. @*Materials and Methods@#From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis. @*Results@#A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481). @*Conclusion@#Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients.

Protective effect of bone marrow mesenchymal stem cell-derived exosomes against the reproductive toxicity of cyclophosphamide is associated with the p38MAPK/ERK and AKT signaling pathways / 亚洲男科学杂志(英文版)

Spermatogenic dysfunction caused by cyclophosphamide (CP) chemotherapy has seriously influenced the life quality of patients. Unfortunately, treatments for CP-induced testicular spermatogenic dysfunction are limited, and the molecular mechanisms are not fully understood. For the first time, here, we explored the effects of bone marrow mesenchymal stem cell-derived exosomes (BMSC-exos) on CP-induced testicular spermatogenic dysfunction in vitro and in vivo. BMSC-exos could be taken up by spermatogonia (GC1-spg cells). CP-injured GC1-spg cells and BMSC-exos were cocultured at various doses, and then, cell proliferation was measured using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. In addition, photophosphorylation of extracellular-regulated kinase (ERK), p38 mitogen-activated protein kinase (p38MAPK), and protein kinase B (AKT) proteins was evaluated by western blotting as well as apoptosis in GC1-spg cells measured using flow cytometry. Treatment with BMSC-exos enhanced cell proliferation and reduced apoptosis of CP-injured GCI-spg cells. Phosphorylated levels of ERK, AKT, and p38MAPK proteins were reduced in CP-injured spermatogonia when co-treated with BMSC-exos, indicating that BMSC-exos acted against the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. In experiments in vivo, CP-treated rats received BMSC-exos by injection into the tail vein, and testis morphology was compared between treated and control groups. Histology showed that transfusion of BMSC-exos inhibited the pathological changes in CP-injured testes. Thus, BMSC-exos could counteract the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. The findings provide a potential treatment for CP-induced male spermatogenic dysfunction using BMSC-exos.

A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer / 亚洲男科学杂志(英文版)

Accurate methods for identifying pelvic lymph node metastasis (LNM) of prostate cancer (PCa) prior to surgery are still lacking. We aimed to investigate the predictive value of peripheral monocyte count (PMC) for LNM of PCa in this study. Two hundred and ninety-eight patients from three centers were divided into a training set (n = 125) and a validation set (n = 173). In the training set, the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses, and the optimal cutoff value was calculated by the receiver operating characteristic (ROC) curve. The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort. Finally, a nomogram based on the PMC was constructed for predicting LNM. Multivariate analyses of the training cohort demonstrated that clinical T stage, preoperative Gleason score, and PMC were independent risk factors for LNM. The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405 × 109 l

Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases / 中国当代儿科杂志

OBJECTIVE@#To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI).@*METHODS@#Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed.@*RESULTS@#A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (@*CONCLUSIONS@#In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.

Hypoglycemia caused by co-secretion of insulin from lung tumor and cardia cancer: first case report

ABSTRACT CONTEXT: Non-islet-cell-tumor-induced hypoglycemia (NICTH) is caused on rare occasions by secretion of insulin from tumor cells that are reported to have a single tissue origin. CASE REPORT: A 67-year-old male patient had cardia adenocarcinoma and concomitant lung adenocarcinoma with extensive metastases and repeated episodes of intractable hypoglycemia. Immunohistochemical staining for insulin showed that lung adenocarcinoma stained positive and gastric cardia adenocarcinoma stained weakly positive. These results indicate that tumor cells of different tissue origins co-secreted insulin. CONCLUSIONS: This is the first report on intractable hypoglycemia due to co-secretion of insulin from two kinds of primary tumor cells in a single patient.

Short-Term and Mid-Term Clinical Outcomes Following Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery Bypass: A Meta-Analysis / Resultados Clínicos de Curto e Médio Prazo após Revascularização Coronariana Híbrida versus Revascularização Miocárdica sem Circulação Extracorpórea: Uma Meta-Análise

Abstract Background: Off-pump coronary artery bypass grafting (OPCAB) is one of the standard treatments for coronary artery disease (CAD) while hybrid coronary revascularization (HCR) represents an evolving revascularization strategy. However, the difference in outcomes between them remains unclear. Objective: We performed a meta-analysis to compare the short-term and mid-term outcomes of HCR versus OPCAB for the treatment of multivessel or left main CAD. Methods: We searched the PubMed, EMBASE, Web of Science and Cochrane databases to identify related studies and a routine meta-analysis was conducted. Results: Nine studies with 6121 patients were included in the analysis. There was no significant difference in short-term major adverse cardiac and cerebrovascular event (MACCE) rate (RR: 0.55, 95% CI: 0.30-1.03, p = 0.06) or mortality (RR: 0.51, 95% CI: 0.17-1.48, p = 0.22). HCR required less ventilator time (SMD: -0.36, 95% CI: -0.55- -0.16, p < 0.001), ICU stay (SMD: -0.35, 95% CI: -0.58 - -0.13, p < 0.01), hospital stay (SMD: -0.29, 95% CI: -0.50- -0.07, p < 0.05) and blood transfusion rate (RR: 0.57, 95% CI: 0.49-0.67, p < 0.001), but needed more operation time (SMD: 1.29, 95% CI: 0.54-2.05, p < 0.001) and hospitalization costs (SMD: 1.06, 95% CI: 0.45-1.66, p < 0.001). The HCR group had lower mid-term MACCE rate (RR: 0.49, 95% CI: 0.26-0.92, p < 0.05) but higher rate in mid-term target vessel revascularization (TVR, RR: 2.20, 95% CI: 1.32-3.67, p < 0.01). Conclusions: HCR had similar short-term mortality and morbidity comparing to OPCAB. HCR decreased the ventilator time, ICU stay, hospital stay, blood transfusion rate and increased operation time and hospitalization costs. HCR has a lower mid-term MACCE rate while OPCAB shows better in mid-term TVR.

Resumo Fundamentos: A revascularização do miocárdio sem circulação extracorpórea (CRM sem CEC) é um dos tratamentos padrão para a doença arterial coronária (DAC), enquanto que a revascularização coronária híbrida (RCH) é uma estratégia de revascularização em evolução. No entanto, a diferença nos resultados entre eles ainda não está clara. Objetivo: Realizamos uma meta-análise para comparar os resultados a curto e médio prazo da RCH versus a CRM sem CEC para o tratamento de DAC de múltiplos vasos ou artéria principal esquerda. Métodos: Pesquisamos as bases de dados PubMed, EMBASE, Web of Science e Cochrane para identificar estudos relacionados e realizamos uma meta-análise de rotina. Resultados: Nove estudos com 6121 pacientes foram incluídos na análise. Não houve diferença significativa na taxa de eventos cardíacos e cerebrovasculares adversos maiores de curto prazo (ECCAM) (RR de 0,55, IC de 95% 0,30-1,03, p = 0,06) ou mortalidade (RR: 0,51, IC 95%: 0,17-1,48, p = 0,22). A RCH requereu menos tempo de ventilação (DMP -0,36; IC de 95%: -0,16 -0,55-, p < 0,001), tempo de UTI (DMP: -0,35, IC de 95%: -0,58- -0,13, p < 0,01), estadia hospitalar (DMP: -0,29; IC de 95%: -0.50 - -0,07, p < 0,05) e taxa de transfusão de sangue (RR: Cl 0,57, 95% de 0,49-0,67, p < 0,001), mas necessitou mais tempo de cirurgia (DMP): 1,29, IC de 95% 0,54-2,05, p < 0,001) e custos de hospitalização (DMP: 1,06, 95 %: 0,45-1,66, p < 0,001). O grupa RCH tinha uma taxa mais baixa de ECCAM a médio prazo (RR de 0,49, IC de 95% 0,26-0,92, p < 0,05), mas uma taxa mais elevada a médio prazo em revascularização de vaso alvo (RVA, RR: 2,20, IC 95%: 1,32). 3,67, p < 0,01). Conclusões: A RCH teve mortalidade e morbidade semelhantes no curto prazo comparada ao CRM sem CEC. A RCH diminuiu o tempo de ventilação, a internação na UTI, a internação hospitalar, a taxa de transfusão de sangue e o aumento do tempo de operação e os custos de hospitalização. A RCH tem uma taxa ECCAM mais baixa no médio prazo, enquanto a CRM sem CEC se mostra melhor em RVA a médio prazo.

Intercalated Treatment Following Rebiopsy Is Associated with a Shorter Progression-Free Survival of Osimertinib Treatment / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Epidermal growth factor receptor (EGFR) T790M mutation serves as an important predictor of osimertinib efficacy. However, little is known about how it works among patients with various timings of T790M emergence and treatment. MATERIALS AND METHODS: Advanced EGFR-mutant lung adenocarcinoma patients with positive T790M mutation in tumor were retrospectively enrolled and observed to determine the outcomes of osimertinib treatment. We evaluated the association between patients’ characteristics and the efficacy of osimertinib treatment, particularly with respect to the timing of T790M emergence and osimertinib prescription. RESULTS: A total of 91 patients were enrolled, including 14 (15.4%) with primary and 77 (84.6%) with acquired T790M mutation. The objective response rate and disease controlratewere 60.9% and 85.1%, respectively. The median progression-free survival (PFS) and overall survival were 11.5 months (95% confidence interval [CI], 9.0 to 14.0) and 30.4 months (95% CI, 11.3 to 49.5), respectively. There was no significant difference in response rate and PFS between primary and acquired T790M populations. In the acquired T790M subgroup, patientswho received osimertinib after T790M had been confirmed by rebiopsy had a longer PFS than those with intercalated treatments between rebiopsy and osimertinib prescription (14.0 months [95% CI, 9.0 to 18.9] vs. 7.2 months [95% CI, 3.7 to 10.8]; adjusted hazard ratio, 0.48 [95% CI, 0.24 to 0.98; p=0.043]). Rebiopsy timing did not influence the outcome. CONCLUSION: Osimertinib prescription with intercalated treatment following rebiopsy but not the timing of T790M emergence influenced the treatment outcome. We suggest that it is better to start osimertinib treatment once T790M mutation has been confirmed by biopsy.

The Association of Acquired T790M Mutation with Clinical Characteristics after Resistance to First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor in Lung Adenocarcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The main objective of this study was to investigate the relationship among the clinical characteristics and the frequency of T790M mutation in advanced epidermal growth factor receptor (EGFR)–mutant lung adenocarcinoma patients with acquired resistance after firstline EGFR–tyrosine kinase inhibitor (TKI) treatment. MATERIALS AND METHODS: We enrolled EGFR-mutant stage IIIB-IV lung adenocarcinoma patients, who had progressed to prior EGFR-TKI therapy, and evaluated their rebiopsy EGFR mutation status. RESULTS: A total of 205 patients were enrolled for analysis. The overall T790M mutation rate of rebiopsy was 46.3%. The T790M mutation rates among patients with exon 19 deletion mutation, exon 21 L858R point mutation, and other mutations were 55.0%, 37.3%, and 27.3%, respectively. Baseline exon 19 deletion was associated with a significantly higher frequency of T790M mutation (adjusted odds ratio, 2.14; 95% confidence interval [CI], 1.20 to 3.83; p=0.010). In the exon 19 deletion subgroup, there was a greater prevalence of T790M mutation than other exon 19 deletion subtypes in patients with the Del E746-A750 mutation (61.6% vs. 40.6%; odds ratio, 2.35; 95% CI, 1.01 to 5.49; p=0.049). The progression-free survival (PFS) of first-line TKI treatment > 11 months was also associated with a higher T790M mutation rate (54.1% vs. 39.3%; adjusted odds ratio, 1.82; 95% CI, 1.02 to 3.25; p=0.044). Patients who underwent rebiopsy at metastatic sites had more chance to harbor T790M mutation (52.6% vs. 33.8%; adjusted odds ratio, 1.97; 95% CI, 1.06 to 3.67; p=0.032). CONCLUSION: PFS of first-line EGFR-TKI, rebiopsy site, EGFR exon 19 deletion and its subtype Del E746-A750 mutation are associated with the frequency of T790M mutation.

Correlation of inflammatory response in patients with acute type A aortic dissection complicated with pul-monary injury / 实用医学杂志

Objective To detect the serum levels of IL-6 and CRP in patients with acute type A aortic dissection complicated with pulmonary injury and inflammatory response. Methods From January 2007 Month to February 2016,216 patients with acute type A aortic dissection were admitted to our hospital. Among them,there were 120 male and 96 female patients,with a mean age of 52.1 years. All patients underwent cardiac ultrasound and other imaging studies. They were diagnosed and hospitalized immediately after the onset. Treatment lasted for more than 1 week. In a calm state of oxygen ,oxygenation index ≤200 preoperative lung injury is defined as positive. In this study ,according to the definition of the lung injury ,patients were divided into positive and negative lung injury groups. There were 72 positive and 144 negative cases among 216 patients. All patients were hospitalized. Every 4 hours,arterial oxygenation index is calculated. At the same time blood samples were tested for C-reactive protein(CRP)and interleukin-6(IL-6)levels. Data was analyzes by SPSS20.0 statistical software and counted byχ2 test. The results were plotted as the percentage,the measurement data with the t test,with(x ± s) to represent,evaluate serum levels of CRP and IL-6 levels with acute type A aortic dissection complicated by the relationship between lung injury. Results The differences of patients from two lung injury groups in gender,age, smoking,alcohol consumption,and other aspects of common chronic diseases were not significant(P>0.05);the difference between the pre-operative examination of several experimental studies in echocardiography were also no statistically significant(P > 0.05);two groups of patients,serum CRP positive group lung injury peak level and peak IL-6 levels were significantly higher in patients with acute lung injury negative group (P > 0.05). Further study of lung serum CRP in patients with damage to the relationship between IL-6 levels and oxygenation index found after dissection. Patient's oxygenation index decreased ,and serum C-reactive protein and interleukin-6 levels were rising rapidly ,reaching peak levels ,and then ,with the patients with inflammatory response decreased oxygenation index showed an upward trend. Conclusion Inflammatory reaction in acute type A aortic dissection plays a key role in the lung injury. In result ,patients'sicken time is prolonged ,which was closely related to serum C reactive protein(CRP),interleukin 6 levels and hypoxemia. Active anti-inflammation treatment before surgery may improve the patient's oxygenation status.

Application value of real-time contrast-enhanced ultrasound in transrectal prostate biopsy / 中华男科学杂志

<p><b>Objective</b>To explore the application value of real-time contrast-enhanced ultrasound (RTCEU) in improving the detection rate of transrectal ultrasound-guided prostate biopsy.</p><p><b>METHODS</b>This prospective study included 91 male patients with abnormally high PSA (4－20 μg/L) or abnormalities in DRE or MRI, who underwent 12+X prostate biopsy following conventional transrectal ultrasonography (TRUS) and RTCEU examination. We compared the numbers of suspected prostatic nodules before and after RTCEU as well as the detection rates of prostate cancer between conventional TRUS-guided 12PBx and 12PBx plus lesion-targeted biopsy procedures.</p><p><b>RESULTS</b>Totally, 57 of the 86 suspected lesions on TRUS (66.3%), and 108 of the 118 abnormal nodules on RTCEU (91.5%) were confirmed to be prostate cancer. RTCEU achieved a significantly higher detection rate than TRUS (P<0.01). A total of 39 cases of prostate cancer (42.8%) were detected by RTCEU, while only 28 (30.7%) by TRUS, with statistically significant difference in the detection rate between the two procedures (P=0.033).</p><p><b>CONCLUSIONS</b>Real-time contrast-enhanced ultrasound can significantly improve the detection rate of prostate cancer and provide a valuable guide to targeted prostate biopsy.</p>

Effects of Hand Massage on Depression, Self-esteem and Vitality of the Elderly Patients in Convalescent Hospital / 한국간호교육학회지

PURPOSE: The purpose of this study was to examine the effects of hand massage on depression, self-esteem and vitality in elderly patients in convalescent hospitals. METHODS: This study employed a nonequivalent control group pretest-posttest design. The subjects were 24 elderly patients in the experimental group and 25 in a control group in a convalescent hospital located in G city. Data were collected using a questionnaire that relied on the geriatric depression scale (short form) by Sheikh and Yesavage; the self-esteem scale by Rosenberg; and the vitality scale used by Johnson and revised by Oh. The experimental group were treated with a general hand massage using only carrier oil on both hands for 10 minutes a day for seven days. The control group was given no treatment. The collected data were analyzed using t-test, χ2-test, and Fisher's exact test with SPSS Win Version 18.0. RESULTS: The results are as follows: The experimental group showed a significant improvement in depression, self-esteem and vitality than the control group. CONCLUSION: The results showed that hand massage was an effective intervention program for depression, self-esteem and vitality of elderly patients in convalescent hospitals.

Application of transesophageal echocardiography in extracorporeal circulation cardiac valve replacement / 中国介入心脏病学杂志

Objective To discuss the clinical value of transesophageal echocardiography used in extracorporeal circulationcardiac valve replacement. Methods 89 patients received extracorporeal circulation cardiac valve replacement in our hospital from January 2012 to December 2014 were included in the study. Transesophageal echocardiography were performed preoperatively, intraoperation and postoperatively and the findings were compared to the result of preoperation transthoracic echocardiography exam. The measurement of aortic annulus diameter and detection rates of calcification obtained by transthoracic and transesophaged echocardiography were compared. Changes in heart function parameters before and after operation were compared. The alternations in surgery plan made after pre-operative transesophageal echocardiography exam and any relevant treatment or procedure performed according to intra-operation transesophageal echo findings were recorded. All the patients were followed up for 6 months - 40 months. Results Before extracorporeal circulation cardiac valve replacement, the aortic annulus diameter measured and detection rates of calcification by transthoracic echocardiography were smaller and lower than actual surgical pathology results ( P 0. 05 ) . Conclusions For patients receiving extracorporeal circulation cardiac valve replacement, transesophagus echocardiography examination is helpful to guide the selection of valve stent and operation methods.

Medication Status and the Effects of a Medication Management Education Program for the Elderly in a Community

PURPOSE: This study investigated medication status by examining the effects of a medication management education program on the knowledge of medications and medication misuse behaviors in the elderly in a local community. METHODS: This study used a non-equivalent control group quasi-experimental design. For the study, 116 subjects were assigned to the control group and another 116 subjects were assigned to the experimental group. The medication management education program consisted of 1:1 education, practice in medication management, consultation, and discussion. Data were analyzed using the SPSS 21.0 program. RESULTS: Statistically significant differences were found between the experimental and control groups in terms of their knowledge of medications and medication misuse behaviors. CONCLUSION: The results indicate that the medical management education program is effective in improving the knowledge of medications and decreasing medication misuse behaviors. Therefore, this education program can be used as an intervention to improve the medication behaviors of the elderly in local communities.

A meta-analysis compare rapid rhino with merocel for nasal packing / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the efficacy and adverse reaction of nasal packing materials Rapid Rhino and Merocel.@*METHOD@#We searched the database PubMed, EMBASE, Cochrane Library, CBM, CNKI, VIP and WANFANG database on line by computer, and traced the related references. Randomized controlled trials(RCTs) of rapid rhino and merocel as nasal packing materials were included. The quality of the included documents was evaluated by the criterion of Cochrane handbook 5.1. The cochrane collaboration's Revman 5.1 software was used for data analysis.@*RESULT@#Four RCTs involving 115 patients were identified. Meta-analyses showed that Rapid Rhino produced significantly lower pain and discomfort during insert of pack [MD = 1.37, 95% CI (0.13, 2.60), P 0.05].@*CONCLUSION@#The application of Rapid Rhino caused less pain and fullness, leaded to slighter bleed than Merocel when insertion and removal. There was no significant difference between two packs on the efficiency of hemostatic when used for epistaxis or after routine nasal surgery.

The Effects of Exercise in the Frail Elderly

PURPOSE: This study was conducted to examine the effects of exercise on physiological, physical and psychological functions of the frail elderly. METHODS: The research design was a nonequivalent control group pretest-posttest design. Data were collected from September 9 to October 10, 2009. The subjects were 56 frail elders who agreed to participate in this study and each subject was randomly assigned to either the experimental group (n=28) or the control group (n=28). The exercise program was provided to each subject in the experimental group twice in a week for 6 weeks. Data were analyzed with frequency, chi2-test, Kolmogorov-Smirnor test and independent t-test using SPSS/WIN 12.0. RESULTS: There was a significant improvement in psychological functions in the experimental group compared to the control group (t=1.726, p=.045). CONCLUSION: The exercise program showed the effects to improve the psychological functions of the frail elderly with chronic disease. In recommendation, this exercise program could be utilized as a health promoting program for the frail elderly.

The Effect of Back Massage on Degree of Pain, State Anxiety and Quality of Sleep of Postoperative Patients with Gastrectomy

PURPOSE: Most of postoperative patients experience pain, state anxiety and sleep disturbance. These problems negatively influence the recovery of postoperative patients. So alleviating these problems has been one of the nurses' central roles. The purpose of this study was to examine the effects of back massage on pain, state anxiety and quality of sleep of postoperative gastrectomy patients. METHODS: A non-synchronized non-equivalent control group pre and post-test design was used. The research instruments used in this study were the Numerical Rating Scale (NRS) for pain, the State-Anxiety Inventory (STAI) for anxiety and the Verran and Synder-Halpern scale for quality of sleep. The subjects were patients admitted to a university hospital located in D city. Twenty-nine patients in the experimental group had a 10 min manual back massage stimulation for 5 days from the 1st day to the 5th day after their operation, and 25 patients in the control group did not. RESULTS: The degree of pain was significantly reduced according to post operation day and quality of sleep was significantly increased. However state anxiety was not significantly reduced. CONCLUSION: Back massage is a partially effective nursing intervention for postoperative patients with gastrectomy who experience pain and sleep disturbance.

B-ultrasound guided aspiration and sclerotherapy with 2% iodophor for renal cysts / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor for treatment of renal cysts.</p><p><b>METHODS</b>Twenty-eight cases of sympotomatic renal cysts were treated with B-ultrasound-guided aspiration followed by sclerotherapy with 2% iodopher, which was maintained for 20 min. After extraction of iodopher, another injection of 2% iodopher (5-10 ml) into the cysts was given. The patients were followed up for 6 months to 18 months.</p><p><b>RESULTS</b>Full recovery was achieved in 25 cases and improvement in 2 cases. Recurrence was found in 1 case after the treatment.</p><p><b>CONCLUSIONS</b>B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor is safe, minimally invasive, and highly effective for treatment of symptomatic renal cysts.</p>

Effects of Aroma Inhalation Therapy on Pain in Patients Following a Tonsillectomy / 기본간호학회지

PURPOSE: This study was done to examine the effects of aroma inhalation therapy on pain post tonsillectomy. METHOD: A non-equivalent control group pre- and post-test design was used. The research instruments used in this study were a pain perception measurement and vital signs (systolic & diastolic blood pressure and pulse rate levels). Twenty-five patients in the experimental group went through aroma inhalation therapy for ten minutes after the tonsillectomy. The aroma inhalation therapy used was a blended oil, a mixture of Lavender and Loman chamomile in the ratio of 2:1. The 25 patients in the control group did not receive the therapy. Before and after the experiment, both groups were tested for pain (pain perception and vital signs). Collected data were processed with the SPSS WIN. Ver. 14.0 program and analyzed using frequencies, percentages, chi2-test, Fisher's exact test, t-test and ANCOVA. RESULTS: Pain perception of patients was not significantly reduced. However systolic and diastolic blood pressure and pulse rate were significantly reduced. CONCLUSION: The results of the study indicate that aroma inhalation is a partially effective nursing intervention to reduce the post-operative tonsillectomy pain.

Effect of dexamethasone on atrial fibrillation after cardiac surgery: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the effect of preoperative dexamethasone on the occurrence of postoperative atrial fibrillation.</p><p><b>METHODS</b>Random controlled trails were gathered though searches of PubMed (1966 - 2009.11), EMBASE (1974 - 2009.11), Cochrane Library (issue 4, 2009), Chinese Biomedical Literature Database (1978 - 2009.11), China Journal Full-text Database (1994 - 2009.11), Chinese Scientific Journals Full-text Database (1989 - 2009.11). Two reviewers independently assessed eligibility and quality of trials, then extracted data. Data were synthesized using RevMan5.0 software provided by the Cochrane Collaboration.</p><p><b>RESULTS</b>A total of four randomized controlled trials (667 participants) were included for systematic review. Meta-analysis showed that there were statistical differences between dexamethasone and placebo in postoperative atrial fibrillation (RR = 0.6, 95%CI: 0.40 to 0.92, P = 0.02), dexamethasone did not reduce post-operative mortality (RR = 0.79, 95%CI: 0.28 to 2.22, P = 0.66).</p><p><b>CONCLUSIONS</b>The current evidence shows that dexamethasone could reduce the incidence of atrial fibrillation after cardiac surgery, not decrease mortality. There were few limitations in our study may lead to weaken reliability of the conclusions, such as small simple size, different operation types, or the dosage, time and frequency of dexamethasone were unclear. Its effectiveness was needed to further validate in future clinical studies.</p>