ABSTRACT
Objectives: In recent years, enhanced recovery after surgery (ERAS) has been widely used in the field of urology, especially in radical cystectomy and radical prostatectomy, and has demonstrated its advantages. Although studies on the application of ERAS in partial nephrectomy for renal tumors are increasing, the conclusions are mixed, especially in terms of postoperative complications, etc, and its safety and efficacy are questionable. We conducted a systematic review and meta-analysis to assess the safety and efficacy of ERAS in the application of partial nephrectomy for renal tumors. Methods: Pubmed, Embase, Cohrance library, Web of science and Chinese databases (CNKI, VIP, Wangfang and CBM) were systematically searched for all published literature related to the application of enhanced recovery after surgery in partial nephrectomy for renal tumors from the date of establishment to July 15, 2022, and the literature was screened by inclusion/exclusion criteria. The quality of the literature was evaluated for each of the included literature. This Meta-analysis was registered on PROSPERO (CRD42022351038) and data were processed using Review Manager 5.4 and Stata 16.0SE. The results were presented and analyzed by weighted mean difference (WMD), Standard Mean Difference (SMD) and risk ratio (RR) at their 95% confidence interval (CI). Finally, the limitations of this study are analyzed in order to provide a more objective view of the results of this study. Results: This meta-analysis included 35 literature, including 19 retrospective cohort studies and 16 randomized controlled studies with a total of 3171 patients. The ERAS group was found to exhibit advantages in the following outcome indicators: postoperative hospital stay (WMD=-2.88, 95% CI: -3.71 to -2.05, p<0.001), total hospital stay (WMD=-3.35, 95% CI: -3.73 to -2.97, p<0.001), time to first postoperative bed activity (SMD=-3.80, 95% CI: -4.61 to -2.98, p < 0.001), time to first postoperative anal exhaust (SMD=-1.55, 95% CI: -1.92 to -1.18, p < 0.001), time to first postoperative bowel movement (SMD=-1.52, 95% CI: -2.08 to -0.96, p < 0.001), time to first postoperative food intake (SMD=-3.65, 95% CI: -4.59 to -2.71, p<0.001), time to catheter removal (SMD=-3.69, 95% CI: -4.61 to -2.77, p<0.001), time to drainage tube removal (SMD=-2.77, 95% CI: -3.41 to -2.13, p<0.001), total postoperative complication incidence (RR=0.41, 95% CI: 0.35 to 0.49, p<0.001), postoperative hemorrhage incidence (RR=0.41, 95% CI: 0.26 to 0.66, p<0.001), postoperative urinary leakage incidence (RR=0.27, 95% CI: 0.11 to 0.65, p=0.004), deep vein thrombosis incidence (RR=0.14, 95% CI: 0.06 to 0.36, p<0.001), and hospitalization costs (WMD=-0.82, 95% CI: -1.20 to -0.43, p<0.001). Conclusion: ERAS is safe and effective in partial nephrectomy of renal tumors. In addition, ERAS can improve the turnover rate of hospital beds, reduce medical costs and improve the utilization rate of medical resources. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022351038.
ABSTRACT
Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.
ABSTRACT
Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.
ABSTRACT
Objective To observethe clinical efficacy of comprehensive acupuncture treatment in treating primary open-angle glaucoma, and to objectively evaluate the therapeutic efficacy.Method Twenty-eight patients (53 eyes) who received acupuncture treatment were recruited. By adopting a self-control design, the changes of intraocular tension, mean defect (MD) of vision field, mean sensitivity (MS), vision, and score of Quality of Life Scale for Patients with Visual Impairment (QLSPVI) were observed after 3-month acupuncture treatment.ResultThe intraocular tension of the 28 patients declined obviously after the treatment (P0.05); the QLSPVI score dropped significantly after the treatment (P0.05).Conclusion Acupuncture treatment can effectively reduce the intraocular tension, control the deterioration of MD and MS, maintain the level of vision, and enhance the quality of life of patients with primary open-angle glaucoma; with the same disease duration, the longer the treatment, the better the therapeutic efficacy.
