Prevention and treatment of traumatic neuroma by implanting the proximal neural stump into the muscle were studied. Sixteen SD rats were used for the experimental study. The proximal stump of the left sciatic nerve was implanted into the nearby muscle as the experiment side, whereas the proximal stump of the right sciatic nerve was left untreated as the control side. The results were assessed with histological and electrophysiological methods. The experiment demonstrated that neuroma was formed in the control side one month postoperatively, whereas in the experimental side the nerve fibers were dispersed among the muscle fibers and no definite neuroma was formed. Implantation of neural stump into muscle could prevent and treat traumatic neuroma.
ObjectiveTo systematically review the efficacy of statins for contrast induced nephropathy (CIN) prevention in cardiac intervention surgery patients. MethodsWe electronically searched databases including PubMed, Web of Knowledge, The Cochrane Library (Issue 5, 2015), VIP, WanFang Data and CNKI to collect randomized controlled trials (RCTs) about statins for CIN prevention in cardiac intervention surgery patients from inception to May 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 25 RCTs involving 37 353 patients were included, among them, 3 794 were CIN patients. The results of meta-analysis indicated that: compared with the placebo/blank group, the incidence rate of CIN was decreased in the statins group with a significant difference (OR=0.68, 95%CI 0.63 to 0.73, P<0.000 01). ConclusionCurrent evidence shows statins can reduce incidence of CIN in cardiac intervention surgery patients. Due to limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.
ObjectiveTo systematically review the efficacy of antidepressants in the prevention of poststroke depression (PSD). MethodsWe searched The Cochrane Library (Issue 2, 2015), PubMed, MEDLINE, EMbase, CNKI and VIP databases to collect randomized controlled trials (RCTs) about antidepressants in preventing PSD from inception to April 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 26 RCTs involving 2 190 patients were included. The results of meta-analysis showed that:compared with the control group, the antidepressants group could significantly reduce the incidence of PSD (OR=0.24, 95%CI 0.17 to 0.36, P<0.000 01). Subgroup analysis based on types of drugs showed that:the selective serotonin reuptake Inhibitor (SSRI) could significantly reduce the incidence of PSD (OR=0.23, 95%CI 0.15 to 0.37, P<0.000 01). Subgroup analysis based on length of time showed that antidepressants could decrease the incidence of PSD in short term (OR=0.11, 95%CI 0.06 to 0.19, P<0.000 01), middle term (OR=0.31, 95%CI 0.21 to 0.46, P<0.000 01) and long term (OR=0.30, 95%CI 0.19 to 0.49, P<0.000 01). In addition, there was no statistical difference in the incidence of adverse effect between the antidepressants group and the control group (P>0.05). ConclusionAntidepressants is effective in the prevention of PSD, and may not affect patient's life quality. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Abstract： Air leak is still a common postoperative complication after selective lobectomy. The majority of patients undergoing lobectomy have some risk factors of postoperative air leak or persistent air leak. Nowadays，preventive measures of postoperative air leak mainly include preoperative, intraoperative （surgical technique，reinforcement material，pleural cavity reduction），and postoperative （pleurodesis，chest drainage management） strategies. Many of these new measures have been applied in clinical practice with satisfactory outcomes.
ObjectiveTo explore the distribution of multidrug resistant organism in neonates admitted to the hospital through various ways, and analyze the risk factors in order to avoid cross infection of multidrug resistant organism in neonatology department. MethodsA total of 2 124 neonates were monitored from January 2012 to July 2013, among which 1 119 were admitted from outpatient department (outpatient group), 782 were transferred from other departments (other department group), and 223 were from other hospitals (other hospital group). We analyzed their hospital stays, weight, average length of stay, and drug-resistant strains, and their relationship with nosocomial infection. ResultsAmong the 105 drug-resistant strains, there were 57 from the outpatient group, 27 from the other department group, and 21 from the other hospital group. The positive rate in the patients transferred from other hospitals was the highest (9.42%). Neonates with the hospital stay of more than 14 days and weighing 1 500 g or less were the high-risk groups of drug-resistant strains in nosocomial infection. Drug-resistant strains of nosocomial infection detected in the patients admitted through different ways were basically identical. ConclusionWe should strengthen screening, isolation, prevention and control work in the outpatient neonate. At the same time, we can't ignore the prevention and control of the infection in neonates from other departments or hospitals, especially the prevention and control work in neonates with the hospital stay of more than 14 days and weighing 1 500 g or less to reduce the occurrence of multiple drug-resistant strains cross infection.
Retinopathy of prematurity (ROP) is a serious ophthalmic disease threatening the vision of premature infants, characterized by abnormal retinal vascular development and pathological neovascularization. Its pathogenesis follows a two-stage model of “early hyperoxia inhibiting angiogenesis - late hypoxia promoting neovascularization,” in which oxidative stress damage, inflammatory immune activation, and abnormal expression of growth factors such as vascular endothelial growth factor and insulin-like growth factor-1 play key roles. Current studies indicate that the occurrence of ROP is closely associated with maternal factors (such as gestational hypertension, diabetes, smoking during pregnancy) and fetal factors (including low birth weight, low gestational age, inappropriate oxygen therapy, anemia, blood transfusion, multiple pregnancies, nutritional imbalances, infections, and genetic susceptibility), among which low birth weight and low gestational age are independent risk factors, while the clinical management of oxygen therapy parameters (duration, concentration, and fluctuations) is particularly important. Given the rapid progression, high blindness rate, and poor prognosis of ROP, there is an urgent need to achieve early precise identification and intervention through multifactorial integration models. Future research should further explore the interaction mechanisms of risk factors and develop individualized prevention and treatment strategies to improve the long-term quality of life for affected children.
For a long time, the monitoring of ventilator-associated pneumonia (VAP) has many drawbacks, such as complex diagnostic criteria, high subjectivity, low comparability, low attributable mortality, and difficulty in automated monitoring. The U.S. Center for Disease Control and Prevention proposed a new monitoring definition of ventilator-associated event (VAE) in January 2013 to address the existing problems of VAP. VAE monitoring can better predict the adverse prognosis of patients, adopt objective diagnostic criteria, and realize automatic monitoring. However, VAE surveillance also has some shortcomings: poor identification of VAP patients, lack of sufficient evidence of preventive strategies so far, inconclusive application in neonates and children groups, as easy to be interfered with as VAP. The applicability of VAE in China, its risk factors and preventive strategies need to be further studied.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.
Objective To evaluate the effect of a health education for preventing HIV/AIDS in floating population. Methods A computerized literature search was carried out in PubMed, CBM (Chinese Biomedical Database), CNKI (Chinese National Knowledge Infrastructure), Wanfang (Chinese) and VIP (Chinese) databases to collect articles published between 1996 and 2006 concerning the effect of a HIV/AIDS education intervention in floating population. We also checked the reference lists of relevant articles. The study type was self-control intervention study. Meta-analyses were performed to assess 3 outcomes of the intervention, i.e. knowledge about HIV transmission, means of prevention and attitudes towards HIV/AIDS patients. Fixed and random effect models were employed to combine results after a heterogeneity test, with rate difference (RD) used as the indicator of intervention effect. Results The analysis showed that the RD for knowing the sexual transmission route of HIV, the RD for knowing the effect of condoms for HIV prevention, and the RD for changing attitudes towards HIV/AIDS patients, i.e. treating them as ordinary people, were increased by 16% (0.10, 0.22), 22% (0.17, 0.28) and 19% (0.13, 0.25), respectively. Conclusion Health education for preventing HIV/AIDS is effective in changing knowledge and attitudes in floating population.