In order to investigate the effect of vascular beds on the vascular wall of autogenously grafted vein, femoral veins were reversely placed in between the cut ends of collateral femoral arteries in 11 dogs with atraumatic technique. The grafted veins were covered with vivid muscle or skin respectively after being assured to be patent, and investigated by histomorphologic method and computerized image analysis technique at postoperative intervals of 1 week, 4 weeks and 16 weeks. The results showed that: 1. One graft developed pseudoaneurysm at 1 week, and two grafts were occulded in skin-covered group, whereas, no complications occurred in muscle-covered group. 2. Intimal thickening of grafts in skin-covered group was much more obvious than that in the muscle-covered group (P lt; 0.05). 3. The relative contents of microstructural components of the graft wall showed no significant difference quantitatively between the two groups. So, the conclusion was: 1. Subcutaneous transplantation appeared to be a potential causative factor in inducing short-term excessive dilatation and long-term intimal hyperplasia of vein graft. 2. Muscular covering is of priority in blood vessel graft.
Objective To clarify the relationship between inhibition of proliferation and cxpression of Ki-67 in cultured human retinal pigment epithelial(RPE) cells. Methods The cultured human RPE cells were treated with daunoblastina at a dose of 180 mu;g/L for 12h.Twenty-four hours later,DNA inhibiting rate was studied by using tritium-labelled thymidine deoxyribose(3H-TdR)incorporation assay.The expression of Ki-67 was evaluated by immunocytochemical staining technique and image analysis system.Flow cytometry was used to analyse cell cycle. Results DNA inhibiting rate was directly proportional to the dosage of daunoblastina.The proportion of the cells positive staining to Ki-67 in the control and the daunoblastina-treated group were 89.3% and 45.6%(Plt;0. 01),and the integral optical density values for expression of Ki-67 in the two groups were 68.1plusmn;6.2 and 27.3plusmn;5.5(Plt;0.01),respectively.The percen tage of cells in G2 phase of cell cycle increased from 8.9% to 29.5%. Conclusion G2 block was induced and poliferation was inhibited by daunoblastina in cultured human RPE cells.There is a relatively good correlation between Ki-67 immunostaining and inhibition of RPE cell proliferation. (Chin J Ocul Fundus Dis，2000，16：1-70)
Objective To explore the serious situation of injection abuse, and its influence to average prescription fee. Methods The subjects of this study were health service settings in rural area of 9 provinces/cities in Midwest of China. The treatment prescription indicators of county and village health service settings were calculated. Results Prescription injection rates of health care facility in rural area of Midwest provinces/cities of China (25.8% to 62.2%,mean: 45.1%) were higher than the standard of WHO (13.4% to 24.1%), and the injection abuse situation was serious. Injection bause caused the increase of prescription fee. Excess usage of injection in health service settings was related to the economic level of the on-site county or village, and also related to the size and load of health service facilities. Conclusion Suggestions are proposed to the government health agency according to the results of the study: enhancing the lawmaking, establishing the related policy and effective measure, training the medical personnel, promoting the mass health education, investigating the effective injection management model in rural area, and reducing the rate of injection.
Objective To compare the clinical outcomes following arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear by meta-analysis. Methods Randomized controlled trials on arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear were identified from Cochrane Library, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang database, and Chongqing VIP database, with a timespan from the inception of database to November 2024. Pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, postoperative adhesive capsulitis and postoperative retear were obtained as the outcomes to compare the clinical effect of the two methods. Meta-analyses were conducted using RevMan 5.3 software, with mean difference (MD) and relative risk (RR) as the effect scales. Results A total of 6 randomized controlled trial studies were included in the meta-analysis. The studies enrolled 370 patients, including 188 cases in the transtendon repair group and 182 cases in the repair after completion of the tear group. Pooled analyses demonstrated that the pain score [MD=0.26, 95% confidence interval (CI) (0.09, 0.42), P=0.003] and ASES score [MD=2.02, 95%CI (0.95, 3.10), P=0.0002] were higher in the transtendon repair group than those in the repair after completion of the tear group, the Constant-Murley score was lower in the transtendon repair group than that in the repair after completion of the tear group [MD=−3.32, 95%CI (−6.17, −0.46), P=0.02], and there was no significant difference in the incidence of postoperative adhesive capsulitis [RR=1.12, 95%CI (0.36, 3.42), P=0.85] or the incidence of retear [RR=0.32, 95%CI (0.10, 1.03), P=0.06] between two groups. Conclusions Transtendon technique is less effective in reducing pain for articular-sided partial rotator cuff tear. There is no significant difference in the incidence of postoperative adhesive capsulitis or retear between the two gorups.
Objective To review the current state of lung rehabilitation in China and explore the effect of lung rehabilitation on chronic respiratory diseases. Methods Database of CNKI ( 1979-2009) , VIP Chinese Periodical Database ( 1989-2009 ) , and Wanfang Data ( 1982-2009) resources were searched. Studies of lung rehabilitation were collected, and randomized and controlled trials were included. Data were extracted on study population, interfering and evaluating methods. The meta-analyses were performed by using RevMan 4. 2 software. The heterogeneity was analyzed by X2 and P value. Results A total of 3 clinical trials met the inclusion criteria. The study population were all severe and very severe chronic obstructive pulmonary diseases ( COPD) patients. Lung rehabilitation could improve daily activity( WMD:1. 29, 95% CI: 1. 05-1. 54) and dyspnea level ( SMD: - 1. 27, 95% CI: - 1. 67 to - 0. 86) of COPD patients. Conclusion The general level of studies on lung rehabilitation is not satisfied. Meta-analysis comfirmes that lung rehabilitation is beneficial in improving daily activity and dyspnea level of COPD patients.
ObjectivesTo systematically review the efficacy and safety of controlled hypotension for total hip or knee replacement.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on controlled hypotension for total hip or knee replacement from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 854 patients were included. The results of meta-analysis showed that compared with no controlled hypotension during surgery, controlled hypotension could reduce intraoperative blood loss (MD=−267.35, 95%CI −314.54 to −220.16, P<0.000 01), allogeneic blood transfusion (MD=−292.84, 95%CI −384.95 to −200.73, P<0.000 01), and 24 h postoperative mini-mental state examination (MMSE) score (MD=−1.08, 95%CI −1.82 to −0.34, P=0.004). However, there were no significant differences in 96 h postoperative MMSE score (MD=−0.11, 95%CI −0.50 to 0.28, P= 0.57) and intraoperative urine volume (MD=57.93, 95%CI −152.57 to 268.44, P=0.59).ConclusionsThe current evidence shows that controlled hypotension during total hip or knee replacement can reduce intraoperative blood loss and allogeneic blood transfusion. Furthermore, there is no obvious effect on the maintenance of blood perfusion in important organs, despite certain effects on the postoperative cognitive function, which can be recovered in short term. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To systematically evaluate the diagnostic value of artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps. Methods Pubmed, Embase, Web of Science, Cochrane Library, SinoMed, China National Knowledge Infrastructure, Chongqing VIP and Wanfang databases were searched. The diagnostic trials of the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps were comprehensively searched. The search time limit was from January 1, 2000 to October 31, 2022. The included studies were evaluated according to the Quality Assessment of Diagnostic Accuracy Studies-2, and the data were meta-analysed with RevMan 5.3, Meta-Disc 1.4 and Stata 13.0 statistical softwares. Results Finally, 11 articles were included, including 2178 patients. Meta-analysis results of the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps showed that the pooled sensitivity was 0.91, the pooled specificity was 0.88, the pooled positive likelihood ratio was 7.41, the pooled negative likelihood ratio was 0.10, the pooled diagnostic odds ratio was 76.45, and the area under the summary receiver operating characteristic curve was 0.957. Among them, 5 articles reported the diagnosis of small adenomatous polyps (diameter <5 mm) by the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system. The results showed that the pooled sensitivity and the pooled specificity were 0.93 and 0.91, respectively, and the area under the summary receiver operating characteristic curve was 0.971. Five articles reported the accuracy of endoscopic diagnosis for adenomatous polyps of those with insufficient experience. The results showed that the pooled sensitivity and the pooled specificity were 0.84 and 0.76, respectively. The area under the summary receiver operating characteristic curve was 0.848. Compared with the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system, the difference was statistically significant (Z=1.979, P=0.048). Conclusion The artificial intelligence assisted narrow-band imaging endoscopy diagnostic system has a high diagnostic accuracy, which can significantly improve the diagnostic accuracy for colorectal adenomatous polyps of those with insufficient endoscopic experience, and can effectively compensate for the adverse impact of their lack of endoscopic experience.
Objective To evaluate the effects of in situ subtalar arthrodesis with bone graft for subtalar traumatic arthritis, and to analyse the plantar pressure distribution so as to provide the evidence for effectiveness evaluation. Methods Between March 2004 and December 2008, 26 patients with unilateral subtalar arthrodesis undergoing bone graft fusion wereenrolled (test group). After operation, the imageology diversity and the effect of subtalar arthrodesis on adjacent joint wereobserved. American Orthopaedic Foot and Ankel Society (AOFAS) ankle and hindfoot score and radiographs were used to assess the foot function before and after operation. Twenty-six normal subjects served as controls. Footscan system was used to test the distribution of maximum plantar pressure and the change of gravity center curve. No significant difference was found in gender, age, height, and weight between 2 groups (P gt; 0.05). Results All patients were followed up 18.2 months on average (range, 14-71 months). The mean subtalar arthrodesis time was 5.6 months (range, 4 months and 15 days to 11 months). The mean AOFAS ankle and hindfoot score improved from 35.18 ± 8.16 preoperatively to 76.36 ± 6.90 postoperatively (t=13.910, P=0.000). Nine (34.6%) patients had satisfactory functional effects, and 13 (50.0%) patients basically satisfactory. The talocalcaneal height, talocalcaneal angle, talar decl ination angle, and calcaneus patch angle were 87.04% ± 6.17%, 76.73% ± 5.13%, 65.86% ± 7.01%, and 70.19% ± 8.33% of the contralateral side, respectively. Osteoarthritis of the adjacent joints occurred in 7 cases. The maximum plantar pressure increased in the third to fifth metatarsal bones and decreased in the first to second metatarsal bones, showing significant differences when compared with normal controls (P lt; 0.05). No significant difference was found in the plantar pressure between arthrodesis foot and contralateral foot of the test group (P gt; 0.05). The plantar pressure was well distributed in patient who was satisfied with the effect, but it was still different from normal controls. In patients who had high plantar pressure n middle foot, mild heel inversion occurred. The gravity center curve of the contralateral foot in the test group was almost the same as that of normal controls; curve medially shifted when forefoot touched down. The curve irregularly and laterally shifted in the subtalar arthrodesis foot; the curve did not medially shift when forefoot touched down. Conclusion In situ subtalar arthrodesis with bone graft has good cl inical results for subtalar traumatic arthritis. Gait analysis can be appl ied to assess the therapeutic effectiveness, and contribute to make a surgical plan. For the adaptive alteration of contralateral side after subtalar arthrodesis, a cohort of normal subjects should be used for comparison in gait analysis.
Objective To investigate the relationship of the expression between heat shock protein (HSP) 70 and 90, and Survivin and its effects on the proliferative activity in retinoblastoma (RB) cells. Methods Expression of Survivin, HSP70 and 90, and Ki-67 in conventional paraffin samples from 43 patients with RB and 6 healthy people was detected by streptavidin-biotin peroxidase (SP) immunohistochemical method. Ki67 labeling index was used to evaluate the proliferative activity in RB. Results In 43 cases of RB, positive expression of HSP70 and 90 and Survivin was found in 28 (65.12%), 37 (86.05%) and 27 (62.79%) cases, respectively. None of the 6 normal retinal tissue expressed HSP70, HSP90 or Survivin. Positive expression of Survivin was more frequent in positive expressions of HSP90 than that in negative expressions of HSP90 (P＜0.05). Ki67 labeling index was higher in positive expressions of HSP90 and positive expressions of Survivin than that in their negative expressions respectively (P＜0.05). Meanwhile, higher Ki67 labeling index was found in positive HSP90Survivin expressions than that in negative HSP90Survivin expressions and those cases where only HSP90 or Survivin was found (P＜0.05). Expression of HSP70 did not correlate with that of Survivin, nor had any significant effect on Ki67 labeling index (P＞0.05). Expression of HSPs and Survivin and Ki67 labeling index did not correlate with histological types (P＞0.05). Conclusion Expression of HSP90 correlates with that of Survivin in RB. Co-existence of Survivin and HSP90 probably plays an important role in the genesis of RB.