【摘要】 目的 觀察聚明膠肽注射液和羥乙基淀粉（130/0.4）氯化鈉注射液對創傷失血性休克患者的臨床治療效果。 方法 將2006年6月-2008年10月創傷失血性休克患者32例隨機分為聚明膠肽組和羥乙基淀粉組，每組16例。搶救時除采用止血、擴容、糾酸等綜合措施外，分別輸入聚明膠肽注射液和羥乙基淀粉（130/0.4）氯化鈉注射液1 500 mL。兩組均監測血壓、尿量和血氣分析指標，比較兩組指標恢復正常以及所需的時間。 結果 聚明膠肽組與羥乙基淀粉組上述指標恢復正常及所需的時間無差異，兩組生存率、致殘率及并發癥均無差異。 結論 聚明膠肽注射液用于創傷失血性休克的療效與羥乙基淀粉（130/0.4）氯化鈉注射液相當。【Abstract】 Objective To observe the clinical effects of polygeline injection and hydroxyethyl starch(130/0.4) NaCl injection (HES)on the traumatic hemorrhagic shock. Methods A total of 32 patients with traumatic hemorrhagic shock were randomly divided into polygeline injection group and HES group,with 16 patients in each. The same measures such as hemstasis, expanding blood volume, correction of acid base disturbance and so on were adopted in the both groups. The patients in the polygeline injection group and HES group were respectively treated with polygeline injection and HES NaCl injection in a dose of 1500 mL by intravenous infusion. The time from injection to the recovery of BP, urinary output, and blood gas to normal level was recorded. Results BP, urinary output, and blood gas were all improved significantly, there was no significant difference between the two groups (Pgt;0.05). Conclusion The clinical effect of polygeline injection on stabilizing BP and improving microcirculation appears comparable to that of HES.
ObjectivesTo systematically review the efficacy of Chinese herbal medicine (CHM) combined with chemotherapy for ovarian cancer.MethodsCNKI, VIP, WanFang Data and PubMed databases were searched to collect randomized controlled trials on the CHM combined with chemotherapy for ovarian cancer from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsThirteen studies were included. Meta-analysis showed that, CHM combined with chemotherapy group was superior to the chemotherapy alone group in effective rate of TCM syndrome (RR=1.72, 95%CI 1.46 to 2.03, P<0.00.000 1), effective rate of tumor change (RR=1.40, 95%CI 1.21 to 1.63,P<0.000 01), physical condition score (MD=9.19, 95%CI 5.89 to 12.48,P<0.000 01), tumor markers (MD=–18.00, 95%CI –20.62 to –1.538,P<0.000 01), leukocyte reduction (RR=0.67, 95%CI 0.58 to 0.77,P<0.000 01), granulocy tedepletion (RR=0.67, 95%CI 0.55 to 0.81,P<0.000 1), thrombocytopenia (RR=0.55, 95%CI 0.45 to 0.69,P<0.000 01), and digestive tract reaction (RR=0.66, 95%CI 0.50 to 0.87,P=0.004).ConclusionsThe current evidence shows that CHM combined with chemotherapy is superior to chemotherapy alone in the treatment of ovarian cancer. Due to limited quality and quantity of included studies, the above conclusions are required to be verified by more high-quality studies.
ObjectiveTo systematically review the comprehensive evaluation methods applied to estimate the medical service performance based on diagnosis-related groups (DRGs) in China and to provide suggestions for the promotion of methods in further studies.MethodsLiterature published before May 2019 were searched in China National Knowledge Infrastructure, WanFang Data, CQVIP and PubMed for studies about DRGs-based comprehensive evaluation. After literature screening and information extracting by two reviewers independently, qualitative approaches were used to describe the application of DRGs-based comprehensive evaluation methods in the performance evaluation of medical services.ResultsA total of 24 articles were included in the systematic review. Different indexes were used to evaluate the medical service performance. Delphi Method, expert discussion, Saaty’s Method and some other means were applied to determine the weights of indexes in 8 articles. Rank-sum ratio method, Technique for Order Preference by Similarity to an Ideal Solution and synthetic index method were proposed for the comprehensive evaluation in 9, 7 and 9 articles, respectively; besides, analytic hierarchy process and combination evaluation were also used.ConclusionsBased on DRGs, the choose of indicators, weighting approaches, and calculation methods of comprehensive values vary richly in different studies. More attention should be paid to weight using and combination of comprehensive evaluation methods in further studies. Meanwhile, the quality of information source used for estimation and the rationality of results application are supposed to be emphasized.
Objective To explore the clinical practice effects of multi-disciplinary team (MDT) model led by enterostomal therapist in the diagnosis and treatment of chronic wounds. Methods Three types of subspecialty patients diagnosed and treated by the MDT team for chronic wounds in the Wound Care Center of West China Hospital of Sichuan University between January 2020 and December 2022, including MDT for diabetes feet, MDT for immune ulcer and MDT for other refractory wounds, were retrospectively included. The clinical data, healing rate, healing time, and satisfaction rate of patients were analyzed. Results A total of 176 patients were included, including 103 cases of diabetes foot, 31 cases of immune ulcer, and 42 cases of other refractory wounds. The healing rate was 71.84% in patients with MDT of diabetes foot, 74.19% in patients with MDT of immune ulcer and 78.57% in patients with MDT of other refractory wound. The average healing time was 18.10 weeks for patients with diabetes foot, 19.69 weeks for patients with immune ulcer, and 20.53 weeks for patients with other refractory wounds. The satisfaction rates of patients in the three groups were relatively high (>95%). Conclusion The MDT model led by enterostomal therapist can provide comprehensive treatment plans for difficult and complex chronic wound patients, improve the treatment outcomes of chronic wounds, and is worthy of further promotion and application in the clinical diagnosis and treatment of chronic wounds.
Objective To review research progress of pancreas stellate cells in pancreas fibrosis and understand characteristics and activation of pancreas stellate cells and its mechanism on pancreas fibrosis. Method The relevant literatures about pancreas stellate cells and its studies in pancreas fibrosis were reviewed. Results The activation of pancreatic stellate cell is associated with fibrosis of pancreatitis and end stage of pancreas transplantation, but its effect and regulation mechanisms for the extracelluar and intracellular molecular network need to be further investigated. Conclusion Elucidation of activation of pancreas stellate cells will facilitate understanding of pancreas fibrosis and searching new target in treatment of pancreas fibrosis.
【摘要】 目的 評價伴骨轉移的非小細胞肺癌（non-small cell lung cancer，NSCLC）患者在接受帕米膦酸二鈉和唑來膦酸治療后的有效性和安全性。 方法 2007年6月-2008年12月，74例伴骨轉移的NSCLC，患者接受了雙膦酸鹽治療，其中50例接受帕米膦酸二鈉治療，24例接受唑來膦酸治療。帕米膦酸二鈉90 mg，靜脈滴注3 h，每4周重復1次；唑來膦酸4 mg，靜脈滴注15 min，每4周重復1次。對可能影響其骨相關事件發生時間及生存率的各種臨床﹑病理、治療方法等因素進行分析，用Kaplan-Meier曲線及Log rank檢驗生存率差異，對不良反應的發生率等采用χ2檢驗。 結果 18個月無骨相關事件生存率和總體生存率在帕米膦酸二鈉及唑來膦酸組分別為19.3%、28.9%（P=0.253）和33.4%、38.2%（P=0.745），兩組比較，差異均無統計學意義。兩組患者不良反應中帕米膦酸二鈉組8例（16.0%），唑來膦酸組6例（25.0%），兩組比較差異無統計學意義（χ2=0.200，P=0.655）。7例患者用帕米膦酸二鈉治療失敗后再用唑來膦酸治療，其中位無骨相關事件生存時間為2個月（95%CI：0~4.6）。 結論 唑來膦酸和帕米膦酸二鈉在緩解延遲骨相關事件發生時間療效和不良反應發生率相當。用帕米膦酸二鈉治療失敗后再用唑來膦酸可延緩骨相關事件發生時間。【Abstract】 Objective To retrospectively evaluate the efficacy and safety of pamidronate disoclium and zoledronic acid in treating non-small-cell lung cancer (NSCLC) patients with bone metastasis. Methods This study included 74 patients who were treated with bisphosphonate between June 2007 and December 2008. Fifty were treated with pamidronate disodium, and 24 with zoledronic acid. Pamidronate disodium was administered intravenously once for 3 hours every 4 weeks at a dose of 90 mg. Zoledronic acid was given intravenously once for 15 minutes every 4 weeks at a dose of 4 mg. Various clinical, pathological factors and treatment methods related to the occurring time of skeletal related events (SRE) and survival rate were analyzed. Kaplan-Meier curve and Log rank were adopted to detect the difference in survival rate between patients treated with different medicine, and we used χ2 test to discover the rate of adverse events of the patients. Results Eighteen-month SRE-free survival and overall survival rate in the pamidronate disodium and zoledronic acid group were 19.3% vs. 28.9% (P=0.253), and 33.4% vs. 38.2% (P=0.745) respectively. There were 8 (8/50) cases of adverse events in the pamidronate disodium group, and 6 (6/24) in the zoledronic acid group (χ2=0.200, P=0.655). The SRE-free survival time for seven patients who were treated with zoledronic acid after pamidronate disodium failed was 2 months (95%CI: 0-4.6). Conclusions Compared with zoledronic acid, pamidronate has equal efficacy in delaying SRE and incidence of adverse effects. Administering zoledronic acid after pamidronate failed can also delay the occurring time of SRE.