Enhanced recovery after gynecological surgery: A meta-analysis of randomized controlled trials.

Enhanced recovery after surgery protocol is a multidisciplinary and multimodal approach designed to improve perioperative outcomes for patients. This meta-analysis aimed to identify and elaborate on the efficacy of this protocol in women undergoing gynecologic surgery. Four databases were searched for randomized controlled trials from inception to December 2021. A total of 14 studies met the inclusion criteria and were analyzed. There was a significant reduction in the length of stay, the time to first flatus and first defecation, complications, and readmission rates in patients undergoing enhanced recovery after surgery when compared to routine care. The rate of discharge on the first postoperative day significantly increased in patients from the enhanced recovery group. There was no significant difference in the surgery time and blood loss. In conclusion, the enhanced recovery after surgery protocol might have a positive effect on patients undergoing gynecologic surgery. However, there is still heterogeneity between the included studies, and we need more research to draw reliable conclusions that enhanced recovery after surgery is favorable.

A best evidence synthesis in practicing early active movements in ICU patients with mechanical ventilation.

OBJECTIVE: This study summarized the best evidence of early active movements in mechanically ventilated patients in the ICU and applied it in the intensive care unit of our hospital to evaluate the practical effects. METHODS: The best evidence for early activity in patients with mechanical ventilation in the ICU was summarized by using an evidence-based nursing method, and the results were clinically applied in the ICU. Patients who were mechanically ventilated in the ICU from January to March 2020 were selected as the control-group, and their counterparts from April to June 2020 were enrolled as the practice-group. The control-group-patients received conventional early active mobilities, and the practice-group-patients performed the best evidence-based early active mobilities. The Barthel index, muscle strength, duration of mechanical ventilation and length of ICU stay between the two groups were compared. RESULTS: The scores of Barthel index and muscle strength of the practice group were remarkably higher than those of the control group, and the duration of mechanical ventilation and length of ICU stay were obviously shorter than those of the control group, and the difference was statistically significant (P<0.05). The incidence of deep vein thrombosis in practice group was substantially lower than that in control group (P<0.05), and the incidence of ICU acquired weakness in in practice group was critically lower than that in control group (P<0.05). The anxiety and depression scores of the two groups post-intervention were remarkably less than those before intervention (P<0.05), and the observation group had apparently lower scores than the control group (P<0.05). CONCLUSION: The application of the best evidence of early active movement in ICU patients with mechanical ventilation can improve the daily life ability, promote the recovery of muscle strength, reduce the incidence of deep vein thrombosis and ICU acquired weakness, decrease the duration of mechanical ventilation and length of ICU hospital stay, thereby improving the clinical outcomes.

Association between the use of antibiotics during pregnancy and obesity in 5-year-old children.

BACKGROUND: Obesity is an epidemic that must arouse our attention. The purpose of this research is to investigate the relationship between antibiotic use during pregnancy and childhood obesity in 5-year-old Chinese children. METHODS: A total of 132 5-year-old children born in our hospital from January 2014 to January 2016 were included. The children's genders, nationalities, chronic diseases, and other factors were collected as adjusted covariates. We also collected the pre-pregnancy body mass indexes (BMIs) of pregnant women, diagnosis of diabetes mellitus or gestational diabetes mellitus (GDM), maternal smoking, mode of delivery (cesarean section and vaginal delivery), and weight gain during pregnancy, which may affect childhood obesity. A linear mixed effect regression model was used to test the correlation between antibiotic use during pregnancy and the BMI of 5-year-old children, and a logistic mixed effect regression model was used to evaluate the correlation between antibiotic use during pregnancy and obesity outcome. RESULTS: When adjusted for the child's gender, birth weight, cesarean section, chronic diseases, maternal smoking during pregnancy, pre-pregnancy BMI, diagnosis of diabetes or GDM, mode of delivery (cesarean section and vaginal delivery), and weight gain during pregnancy (Model 3), antibiotic use during pregnancy was positively correlated with the BMI of 5-year-old children (ß=0.01, 95% CI: 0.01-0.03, P=0.04). Antibiotic use during pregnancy increased the risk of obesity by 4% in 5-year-old children (OR =1.04, 95% CI: 1.01-1.16, P=0.02). CONCLUSIONS: The use of antibiotics during pregnancy is positively correlated with the risk of obesity in 5-year-old children. KEYWORDS: Antibiotics; pregnancy; obesity; children.

ERCC1 rs11615 polymorphism and chemosensitivity to platinum drugs in patients with ovarian cancer: a systematic review and meta-analysis.

OBJECTIVE: To explore the relationship between ERCC1 rs11615 polymorphism and chemosensitivity to platinum drugs in ovarian cancer by the method of meta-analysis. METHODS: Pubmed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and China Wanfang databases were comprehensively searched up to September 2020, to identify the relationship between ERCC1 rs11615 polymorphism and chemosensitivity of ovarian cancer. The data was analyzed by Stata 15.0 statistic software. RESULTS: A total of 10 published papers were included, including 1866 patients with ovarian cancer. The results showed that compared allele C at ERCC1 rs11615 locus with allele T, the pooled OR was 0.92 (95%CI:0.68 ~ 1.24, P > 0.05). There were no significant differences in recessive, dominant, homozygous, and heterozygous models. In accordance with a subgroup analysis of Ethnicity, all genotypes were statistically significant in the Asian population. In the allelic, dominant, recessive, homozygous and heterozygous models, the OR was 0.70 (95%CI:0.51 ~ 0.95), 0.20 (95%CI:0.07 ~ 0.56), 0.79 (95%CI:0.63 ~ 1.00), 0.21 (95%CI:0.07 ~ 0.59), 0.19 (95%CI:0.07 ~ 0.54), respectively, while in the Caucasian population, no statistically significant genotype was found. CONCLUSION: The ERCC1 rs11615 polymorphism is associated with chemosensitivity in patients with ovarian cancer, especially in the Asian population, but not in the Caucasian population.

The effect of Omaha System-based continuous nursing care on the psychological status, self-esteem, and quality of life in epileptic children.

OBJECTIVES: This study explored and analyzed the effect of Omaha System-based continual nursing care on the psychological status, self-esteem and quality of life in epileptic children. METHODS: 127 epileptic children hospitalized from March 2018 to September 2019 were recruited as the study cohort and stochastically divided into an observation group (n=65) and a control group (n=62). The control group children were given regular out-of-hospital guidance after discharge, and the observation-group were treated with Omaha System-based continuous nursing intervention in addition to the routine out-of-hospital guidance the control group underwent. The two groups' psychological statuses, self-esteem, sense of defect, and quality of life were compared both pre- and post-intervention. RESULTS: The SAS and SDS scores in the two groups after the intervention were significantly lower than their pre-intervention scores (P<0.05), and the scores in the observation group after the intervention were evidently lower than the scores in the control group (P<0.05). The two groups' post-intervention SES and FIS scores were significantly higher than their pre-intervention scores (P<0.05), and the scores in the observation group were notably lower than the scores in the control group (P<0.05). The post-intervention quality of life scores in the two groups were dramatically higher than the pre-intervention scores (P<0.05), and the quality of life scores in the observation group were notably higher than the quality of life scores in the control group (P<0.05). CONCLUSION: The Omaha System-based continual nursing care can efficaciously elevate the psychological status of children with epilepsy, improve their self-esteem, reduce their sense of self-defect, and contribute to the improvement of their quality of life, so it is worthy of clinical promotion and application.