Effectiveness and safety of sotagliflozin adjuvant therapy for type 1 diabetes mellitus: A protocol for Systematic review and Meta-analysis.

BACKGROUND: Type 1 Diabetes Mellitus (T1DM) has long required insulin treatment. Sotagliflflozin (SOTA), as a dual SGLT-1/2 inhibitor, has the potential to be the first oral antidiabetic drug (OAD) to be approved for T1DM in the US market. It is important to evaluate the effectiveness of SOTA for T1DM. METHODS: Web of Science, PubMed datebase, Cochrane Library, Embase, Clinical Trials, and CNKI will be searched to identify randomized controlled trials (RCTs) exploring SOTA adjuvant therapy for T1DM. Strict screening and quality evaluation will be performed on the obtained literature independently by 2 researchers; outcome indexes will be extracted. The bias risk of the included studies will be evaluated based on Cochrane assessment tool. Meta-analysis will be performed on the data using Revman 5.3 software. RESULT: We will provide practical and targeted results assessing the efficacy and safety of SOTA for T1DM patients, to provide reference for clinical use of SOTA. CONCLUSION: The stronger evidence about the efficacy and safety of SOTA for T1DM patients will be provided for clinicians. TRIAL REGISTRATION NUMBER: PROSPERO CRD42019133099.

Effectiveness of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A protocol for systematic review and meta-analysis.

BACKGROUND: Chronic hepatitis b (CHB) is a serious problem worldwide. Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) both are first-line drugs for CHB, but there is debate about which is more appropriate in nucleos(t)ide analogue-naive CHB. OBJECTIVE: To systematically evaluate the effectiveness and safety of tenofovir and ETV in nucleos(t)ide analogue-naive CHB. METHODS: The Web of Science, PubMed, The Cochrane Library, EMBASE, Clinical Trials, and China National Knowledge Infrastructure databases will be electronically searched to collect randomized controlled trials regarding the comparison between tenofovir and ETV in nucleos(t)ide analogue-naive CHB since the date of database inception to July 2019. Two researchers independently screened and evaluated the obtained studies and extracted the outcome indexes. RevMan 5.3 software will be used for the meta-analysis. RESULT: We will provide practical and targeted results assessing the effectiveness and safety of TDF and ETV for nucleos(t)ide analogue-naive CHB patients, try to compare the advantages of TDF and ETV. CONCLUSION: The stronger evidence about the effectiveness and safety of TDF and ETV for nucleos(t)ide analogue-naive CHB patients will be provided for clinicians. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD42019134194.

[Characteristics of the confined space accident and its medical rescue strategy].

OBJECTIVE: To investigate the characteristics of the confined space accident and its medical rescue strategy. METHODS: Thirty-six patients with emergency rescue in the five confined space accident during June 2009 to July 2012 were retrospectively analyzed. RESULTS: Twenty-nine people were caught in four confined space accidents caused by building collapse and 7 people were caught in one confined space accident caused by a tower of babel blast furnace damage which caused severe gas and hydrogen sulfide poisoning. For the 36 wounded, the shortest rescue time was 1.5 hours and the longest was 10.5 hours. Fourteen people were killed (mortality rate 38.89%). Characteristics of the confined space accident: the wounded activity environment was very harsh, the wounded were restricted particularly, the wounded injuries were diverse, the psychological depression was very common. The confined space environment and the complexity of wounded disease determined its medical rescue specificity and were very different from the usual trauma emergency. CONCLUSIONS: Confined space accident caused very painful casualties. The key reason is that the relevant personnel failed to clearly recognize the potential risks in the confined space or nearby, making the confined space into another "quiet killer". This problem needs to be paid highly attention.

[The design and use of a mobile intensive care unit ambulance].

OBJECTIVE: To improve the range of use and efficiency of first-aid in a disaster, a mobile intensive care unit (ICU) ambulance was designed and evaluated. METHODS: The data of disasters, accidental injury in astronauts, injuries occurred in conflicts in foreign nations were reviewed and analyzed, together with our clinical experience of first-aid, a mobile ICU in an ambulance was designed. RESULTS: Provided with automatic cardiopulmonary resuscitation apparatus and instruments for surgical life-saving operation, the mobile ICU ambulance could allow the occupants to perform effective rescue means during rush hour of urban traffic. The new model of ambulance was proved to be able to afford an increased rescue rate in disaster scenario. CONCLUSION: The disability rate and fatality of accidental injuries and local conflicts could be reduced significantly by the use of our mobile ICU ambulance.

[Prospective clinical study on serum immunity in IgG-antibodies positive patients convalescent from severe acute respiratory syndrome].

OBJECTIVE: To investigate the serum immunological characteristics in patients convalescent from severe acute respiratory syndrome (SARS). METHODS: In the 1 st, 3 rd, 6 th month after their discharge, eg. SARS-IgG, T cell subsets, blood routine, and the blood biochemistry were systemically determined in SARS convalescent patients. RESULTS: The SARS-antibodies could be used as the diagnostic evidence. During the 6 months after discharge, the titers of SARS-antibodies were high, but they lowered along with passage of time. At the first recheck, the CD4(+) lymphocyte count was lower than normal level in 55.9% of patients, the CD3(+) lymphocyte count was lower than normal level in 31.2% of patients, and the CD8(+) lymphocyte count was lower than normal level in 14.0% of patients. At the second recheck, the levels of T cell subsets recovered to normal level in the most patients. CONCLUSION: T cell subsets, and the number of leukocyte are abnormal in some patients convalescent from SARS. All the indexes examined recover to normal levels half year after discharge. Therefore, it is necessary to follow up the changes in the levels of SARS-antibodies.

[Characteristic of medical support and health care for Shenzhou-5 and Shenzhou-6 astronauts at main landing site].

OBJECTIVE: To investigate the characteristics of medical support and health care for the Shenzhou-5 and Shenzhou-6 astronauts at the main landing site, with special emphasis on the technical requirements for two astronauts during flight, in order to provide reference data for medical support in the battle field and disasters. METHODS: The data associated with accidental injuries of astronauts during the space flight collected from foreign nations and domestically were reviewed retrospectively. Based on the experience in medical support for Shenzhou-5 and Shenzhou-6 astronauts and the special environments of field operations, a scheme for first-aid and emergent treatment were drafted for a system of organization, prophylactic measurements, equipment and their effective implementation pending the test in the real situation. RESULTS: Two sets of high-quality intensive care unit (ICU) equipment were set up in helicopters, and an ambulance was equipped with the instruments and facilities that could be used in the first-aid and surgical operation in case accident and injuries should happen. The three sets of highly mobile ICU mentioned above could cover a vast area of both grassland and desert at the landing site to ensure that the astronauts could be rescued should accident occur, reaction to emergency would be most rapid and technique and equipment would be best. This scheme of first-aid for emergency which might occur in astronauts would seem to be a scientific, reasonable and practical system and would also meet the need in battle field. CONCLUSION: The first-aid scheme for astronauts at the main landing site, and its equipment, first aid strategies as well as it execution might provide an advanced system for medical aid and emergency treatment in the battlefield, disasters, and other special occasions.

[Intoxication induced by unsymmetrical dimethylhydrazine: characteristics and mechanism of its acute and chronic injuries].

OBJECTIVE: To investigate the characteristics and mechanism of the acute and chronic injuries induced by unsymmetrical dimethylhydrazine (UDMH). METHODS: A total of 128 male rats were randomly divided into four groups: UDMH intoxication acute response group and chronic response group, and corresponding control groups. UDMH was administrated through inhalation at the concentration of 8x10(-4)g/m(3) for 15 minutes. Animals of each group were sacrificed at 3, 6, 12, 24, 48 and 72 hours respectively after the intoxication. Pathologic changes and blood gas were examined. Chronic injuries and pathologic changes were also observed 1 year after the intoxication. RESULTS: Major pathological changes in the intoxication group were cerebral edema, degeneration and necrosis of neuron, enlargement and hemorrhage of capillary. Damages of different degree were found in liver, kidney, lung, heart, spleen, stomach, intestine, thymus, blood, bone marrow. Pallium ischemia was also found in the intoxicated rats 1 year after the intoxication, including ischemia damage of neuron in cerebral cortex, hemorrhage and focal liquefaction of thalamus and medulla conducting bind, dissociation, rupture, not uniform circuitry in conducting fibers. CONCLUSION: Our study reveals the basic pathological induced by intoxication of UDMH. The most severe stage of the injury appears 2-6 hours after intoxication. Long term investigation reveals pallium ischemia, thalamus hemorrhage and liquefaction in the medulla oblongata 1 year after the intoxication with UDMH. All the changes are significant.

[Establishment of a mobile intensive care unit].

OBJECTIVE: To discuss the experience of establishment of a mobile intensive care unit (ICU) for emergency treatment following astronaut flight, disaster, and regional war. METHODS: The data from both foreign and our countries as well as our own clinical experience of first-aid were reviewed, and a mobile ICU was established, including the equipment, supply of drugs, training, and organization. RESULTS: The mobile ICU was set up at the site of landing of the first Chinese astronaut, and proved to be efficient. The new model could be expected to be prompt in first-aid for casualties in disasters and warfare. CONCLUSION: The first-aid on spot of casualties might reduce the rates of invalidity and mortality during disasters and regional war.

[Characteristics of acute and chronic intoxication induced by rocket propellant nitrogen tetroxide].

OBJECTIVE: To investigate the characteristics of acute and chronic injuries of the nitrogen tetroxide, a kind of propellant of rocket. METHOD: 128 male rats were divided randomly into 4 groups: acute control group (56), acute nitrogen tetroxide intoxication group (56), long-term response group (8). The animals were killed sequentially at 3, 6, 12, 24, 48 and 72 h. Nitrogen tetroxide was administrated through inhalation at the concentration of 81 mg/m3 for 15 min. Chronic injuries and pathologic changes were also observed one year after the intoxication. RESULT: Pulmonary edema was the main pathological changes after intoxication, complicated with partial haemorrhage. Data acquired from long-term observations showed 75% pulmonary fibrosis and one case of adenocarcinoma of lung. CONCLUSION: The first 2 to 6 h after intoxication is the most severe stage of the injury. During the long-term observation, we find that intoxication with nitrogen tetroxide can induce pulmonary fibrosis and adenocarcinoma.

[Measure on medical care and rescue for the first Chinese astronaut during manned space flight].

OBJECTIVE: To discuss the experience of medical care and rescue for the first Chinese astronaut during manned space flight. METHODS: Review the experiences of foreign nations in respect to accidental injuries of astronaut during manned space flight, the possible reasons were analyzed, and accordingly a reasonable and effective prophylactic measures and health care were formulated. RESULTS: An effective mobile intensive care unit (ICU) was established on desert or prairie where the capsule would land, so as to ensure the safety of the first Chinese astronaut, and to provide intensive care as well as successful emergency treatment in case of accidental injuries. CONCLUSION: Reasonable and effective prophylactic measures and health care appear to be an important aspect of the successful manned space flight.

[Characteristics of metabolism and nutrition support during different periods in abdominal surgical diseases complicated by multiple organ dysfunction syndrome].

OBJECTIVE: To evaluate the characteristics of metabolism in patients with abdominal surgical diseases complicated by multiple organ dysfunction syndrome (MODS), and the effects of nutritional support in different periods. METHODS: In 32 patients out of 66 patients suffering from MODS nutritional support was given through different channels according to different disease stages. In the first period, total parenteral nutrition (TPN) should be implemented when acute stress was just over and the functions of gastro-intestinal system was still in a bad condition. During the second period, TPN and enteral nutrition(EN) could be instituted at the same time, when the state of illness was under control. In the third period, if the condition of the patients was totally controlled, and the function of stomach and intestine had completely recovered, total EN could be given after a transitional period. RESULTS: In these 32 patients, 23 patients were cured successfully and 9 patients died; the mortality was 28.12%. In those 34 patients treated with conventional methods, 19 patients were cured while 15 patients died, and the mortality was 44.11% (P<0.01). CONCLUSION: When MODS occurred, metabolism is disturbed, and the body is unable to utilize the supplied nutrients and to get rid of the catabolic products. There fore, it seemed to be necessary to give nutrition support in different manner during different periods of the disease. Otherwise, the disease might be aggravated.