RESUMEN
This meta-analysis assesses the impact of Enhanced Recovery After Surgery (ERAS) protocols on surgical site wound infections (SSWIs) in urological procedures. Analysing data from 10 studies, our focus was on SSWI rates on the third and seventh postoperative days. The results reveal a significant reduction in SSWI rates for patients managed under ERAS protocols compared with traditional care. Notably, Figure 4 demonstrates a substantial decrease in SSWI on the third day (I2 = 93%; random: standardized mean difference [SMD]: -6.25, 95% confidence interval [CI]: -7.42 to -5.05, p < 0.01), and Figure 5 mirrors this trend on the seventh day (I2 = 95%; random: SMD: -4.72, 95% CI: -6.28 to -3.16, p < 0.01). These findings underscore the effectiveness of ERAS protocols in minimizing early postoperative wound infections, emphasizing their importance for broader implementation in urological surgeries.
Asunto(s)
Recuperación Mejorada Después de la Cirugía , Infección de la Herida Quirúrgica , Humanos , Tiempo de Internación , Complicaciones Posoperatorias , Periodo Posoperatorio , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
In this article, we analysed the therapeutic efficacy of open radical prostatectomy (ORP) and minimally invasive surgery (MIS) after operation for the treatment of post-operation complications. In summary, because of the broad methodology of the available trials and the low number of trials, the data were limited. The investigators combined the results of six of the 211 original studies. We looked up 4 databases: PubMed, EMBASE, Web of Science and the Cochrane Library. A total of six publications were selected. The main result was the rate of post-operation wound complications. Secondary results were the time of operation and the duration of hospitalization. Our findings indicate that the minimal invasive operation can decrease the incidence of wound infections (OR, 0.61; 95% CI: 0.42,0.90, p = 0.01), bleeding (MD, -293.09; 95% CI: -431.48, -154.71, p < 0.0001), and length of stay in the hospital compared with open surgery (MD, -1.85; 95% CI: -3.52, -0.17, p = 0.03), but minimally invasive surgery increased patient operative time (MD, 51.45; 95% CI: 40.99, 61.92, p < 0.0001). Compared with the open operation, the microinvasive operation has the superiority in the treatment of the wound complications following the operation of radical prostatic carcinoma. But the operation time of the microinvasive operation is much longer. Furthermore, there is a certain amount of bias among the various studies, so it is important to be cautious in interpretation of the findings.
Asunto(s)
Complicaciones Posoperatorias , Próstata , Masculino , Humanos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Prostatectomía/efectos adversos , Prostatectomía/métodos , Resultado del TratamientoRESUMEN
Photocatalytic water splitting has been regarded as one of the most promising technologies to generate hydrogen as an ideal energy carrier in the future. However, most of the experience for such process are derived from the researches based on the suspension powder photocatalysts under a stirring condition and a practical scaling application is urgently calling for the high-efficient panel reactors based on the membrane photocatalysts. Herein, we develop a new series of flexible and ultrastable membrane photocatalysts through a controllable growth of covalent organic framework (COF) photocatalysts on the polyacrylonitrile (PAN) electrospun fiber membrane. Multiple characterization techniques verify the successful anchoring of the COF-photocatalysts on the PAN fibers, forming a three-dimensional porous PAN/COF membrane photocatalyst with excellent light absorption ability, high specific surface area, and good hydrophily. As a result, the optimized PAN/COF membrane photocatalyst exhibits excellent hydrogen evolution rate up to 1.25 mmol g-1h-1 under visible-light irradiation without stirring, which is even higher than that of the corresponding suspension COF-powder photocatalyst with stirring. In particular, the PAN/COF membrane photocatalyst demonstrates a much more superior hydrogen evolution stability and also a much better recyclability. This study gives some experience for the practical scaling application of solar-driven water splitting.
RESUMEN
BACKGROUND: This study aimed to systematically evaluate the efficacy of laparoscopic radical cystectomy (LRC) surgical therapy in patients with bladder cancer (BC), and to provide evidence for the clinical treatment of BC. METHODS: The Embase, Ovid, PubMed, Medline, Springer, and Web of Sciences database were searched to screen articles with clinical controlled trials on LRC treatment of BC. The Cochrane Handbook 5.0.2 software and Review Manager 5.3 software were adopted to evaluate the risk of bias and to perform a meta-analysis of the included articles in this study. RESULTS: A total of 12 articles were obtained, including 1,283 research cases. The meta-analysis results showed that relative to the control group (Ctrl), the observation group (Observ group) had significantly lower intraoperative blood loss (IBL) after LRC [mean difference (MD) =-458.75; 95% confidential interval (CI): -505.75 to -411.76; Z=19.13; P<0.00001], blood transfusion rate (BTR) (odds ratio =0.36; 95% CI: 0.13-0.94; Z=2.08; and P=0.04), use of analgesics (MD =-24.53; 95% CI: -39.04 to -10.01; Z=3.31; and P=0.0009), and incidence of postoperative complications (Risk ratio =0.58; 95% CI: 0.39-0.85; Z=2.77; and P=0.006). However, and the length of hospital stay could not be shortened (MD =-2.43; 95% CI: -4.83 to -0.02; Z=1.98; and P=0.05). DISCUSSION: LRC treatment of BC could effectively reduce the amount of IBS, and lower the intraoperative BTR, use of analgesics, and incidence of postoperative complications. Therefore, it could be used in the clinical surgical treatment of BC patients.
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Hepatocellular carcinoma (HCC) is the second leading cause of cancer mortality in China and the third leading cause of cancer mortality worldwide. The mechanisms involved in the development and progression of HCC are not well understood. In the present study, the functions of endothelin-1 (ET-1) in HCC were studied and its underlying mechanisms were investigated. ET-1, B-cell lymphoma 2 (Bcl-2), Bcl-2 related protein 4 (Bax), matrix metalloproteinase (MMP)-2 and MMP-9 expression was measured by reverse transcription-quantitative polymerase chain reaction and western blotting. Cell proliferation was measured via Cell Counting kit-8 assay. Flow cytometry was performed for cell cycle and apoptosis analysis. Migration was measured via Transwell assay. The results demonstrated that ET-1 expression significantly increased in HCC tissues compared with the normal tissues of patients in The Cancer Genome Atlas dataset (P<0.01). Furthermore, downregulation of ET-1 was able to significantly inhibit cell proliferation and growth in vitro (P<0.01) and in vivo (P<0.01), and induce cell cycle arrest (P<0.05) and apoptosis (P<0.01) in the HCC SMMC-7721 cell line. Bioinformatics analysis demonstrated that the cell apoptosis signaling pathway was activated by ET-1. The ratio of B-cell lymphoma (Bcl-2) -related protein 4 (Bax)/Bcl-2 was significantly increased by downregulation of ET-1 (P<0.01). ET-1 downregulation also inhibited migration of SMMC-7721 cells (P<0.05) via decreasing levels of matrix metalloproteinase (MMP) -2 (P<0.05) and MMP-9 (P>0.05). These results suggest that ET-1 may be able to affect the apoptosis and migration of HCC cells via modulation of the Bax/Bcl-2 ratio and expression levels of MMP-2 and MMP-9, which indicates that ET-1 maybe a potential novel target for HCC treatment.