Objective To summarize the available clinical research evidence on gliquidone for treating diabetes mellitus. Methods The clinical research on gliquidone for diabetes mellitus was systematically searched and appraised. Result Six randomized controlled trials and eleven controlled clinical trials were identified. The methodological quality of most papers about gliquidone for diabetes mellitus was poor. Currently, clinically patient-related endpoints as outcome measures and health economic analyses are lacking in this field. Conclusions Based on the available evidence, gliquidone appears specifically applicable to elderly diabetic patients with kidney diseases. More methodologically sound and patient-related endpoints and economic analyses based on clinical research are required.
Objective To summarize the available clinical evidence on the treatment of non-proliferative diabetic retinopathy (NPDR). Methods Based on the basic methods and principles of evidence-based medicine, we searched and evaluated the NPDR-related evidence from the Cochrane Library(Issue 3,2007), PubMed (1966 to June 2007) and CBM(1979 to June 2007) Results We finally identified 1 systematic review and 20 randomized controlled trials. Clinical evidence showed that critical glycemic control and blood pressure control were essential in the treatment of NPDR, which might delay the progression of retinopathy. The effectiveness of other therapeutic measures needed to be further investigated. Conclusion NPDR is the early stage of diabetic retinopathy (DR). Relevant systematic reviews and high-quality randomized controlled trials have confirmed the effectiveness of critical control of blood glucose and blood pressure for NPDR. The effectiveness of other therapeutic measures needs to be confirmed by systematic reviews of high quality and rigorously designed randomized, multi-center and large-scale trials.
Objective Based on the methodology of evidence-based medicine, we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidence of type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer fromspontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.
Objective To summarize the available clinical research evidence for the treatment of hepatorenal syndrome (HRS). Methods Using the basic methods and principles of evidence-based medicine, we searched and evaluated clinical studies involving the treatment of HRS. Results We found that plasma expansion, vasoconstrictor, transjugular intrahepatic portosystemic shunts (TIPS) and liver transplantation were effective interventions for patients with HRS. Conclusion HRS is a common complication of end-stage liver diseases and the prognosis for patients with HRS is extremely poor. However, due to the small number of clinical trials, small sample sizes and low methodological quality, the strength of the current evidence is limited. Rigorously-designed, randomized, multi-center, large-scale trials on HRS are required.
Objective Vibration response imaging(VRI) is a new lung sound imaging technology.It provides quantitative lung data（QLD） of vibration in respiratory system.The study is to explore the value of QLD in diagnosis of obstructive lung diseases.Methods The QLD of 61 chronic obstructive pulmonary disease（COPD） patients，58 asthma patients and 64 healthy volunteers were reviewed.The QLD were transferred to abnormity and variation by a formulation and were analyzed.Results The mean QLD of healthy volunteers were 8.4，14.5，22.0，11.1，18.5，25.5 with mean abnormity as 10.0 and mean variation as 2.0.The mean QLD of the COPD patients were 11.6，16.7，21.9，12.6，17.2，20.1 with mean abnormity as 47.1 and mean variation as 10.9.The mean QLD of the asthma patients were 12.8，17.2，19.9，13.3，17.5，19.3 with mean abnormity as 58.1 and mean variation as 12.2.The abnormity and variation of the patients were different from those of volunteers（Plt;0.05）.When abnormity≥20.0 or variation≥5.0 was define as threshold value，the specificity was 87.5%.The diagnosis sensitivity for COPD is 82.0% and sensitivity for asthma is 82.8%.Conclusion COPD and asthma patients can be detected by quantitative lung data from vibration response imaging.
Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
Objective To explore the interventions for traumatic floating knee. Method We retrospectively analyzed the data of 32 patients with traumatic floating knee. The following-up time is 6 to 22 months with average time of 11 months. Result All the followed-up patients got bone union. One patient was with plate revealed, 2 patientss were infectious, 2 patients were with lock pin broken. According to Floating Knee Damage Limb Function Evaluation Scale produced by Karlstrom, 21 patients were excellent, 6 were good, 4 were fair and one was poor, and the excellent and good rate was 84.3%. Conclusion Operation for traumatic floating can recover the alignment and stability of lower limber, recover knee function and reduce complication.
Objective We intended to get good understanding of the current role of imatinib （or glivec） in the treatment of a patient with chronic-phase chronic myeloid leukemia. Methods We attempted to find the current best evidence of imatinib for treating chronic myeloid leukemia in chronic phase by searching ACP Journal Club （1991 -Jun, 2005 ）, The Cochrane Library（Issue 2, 2005 ）and MEDLINE（1990 -Jun, 2005 ） and further critically appraised the available evidence. Results Imatinib appeared to be more effective than current standard drag treatments in terms of hematologic and cytogenetic response with better quality of life and fewer side effects. However, there was uncertainty concerning long term outcomes. Given the current evidence together with our clinical experience and considering the patient and his family members＇ values and preference, imatinib （400 mg qd） was administered to him. No obvious adverse effects occurred with 3 months follow-up. Conclusions Imatinib is effective and well tolerated in the treatment of chronic myeloid leukemia in chronic phase. Further researches on long-term follow-up data from imatinib trials are definitely needed.
ObjectiveTo summarize the research progress in artificial metacarpophalangeal joint and interphalangeal joint prostheses.MethodsThe research literature on artificial metacarpophalangeal joint and interphalangeal joint prostheses at home and abroad was reviewed and summarized from anatomy, prosthesis design, and material development.ResultsThe artificial joint replacement can correct deformity, relieve pain, and improve function immediately. In the past 50 years, many researches have focused on the design and material of prostheses and surgical technique of joint replacement. There are three types of prostheses, including hinged limit-type-prosthesis, semi-limit-type-prosthesis, and non-limit-type-prosthesis. The prostheses have their own advantages and disadvantages, the long-term effectiveness of joint replacement is not ideal.ConclusionThe metacarpophalangeal joint and interphalangeal joint prostheses with more anatomical structure and biocompatible materials are needed.
Gordon Henry Guyatt(1953-)is a professor of Department of Clinical Epidemiology amp; Biostatistics and Department of Medicine in McMaster University. He has engaged in evidence-based clinical research and practice for about 20 years. In 1992, he first proposed the term “evidence-based medicine” in one of his articles published in JAMA. He is dedicated to bringing the wonderful idea of evidence-based medicine to bedside and systematically training clinicians from all over the world to acquire the basic skills for evidence-based clinical practice. His great contribution to evidence-based medicine is introduced in this article through demonstrating the development of evidence-based clinical practice.