As one of the most sophisticated research methods of evidence-based medicine, systematic review is an activity of collecting, arranging and analyzing medical information. The methodological characteristics of systematic review reflect the value orientation of this activity. By analyzing and summarizing these characteristics, this paper points that the process of systematic review reflects the value orientation of attaching importance to obtaining universal information sources, treating individual information in an add-weight way, discretion in interpreting results and updating of time-limited information in medical information activities.
Objective To compare preventive effect between continuous dissecting suture and traditional interrupted suture, silver ion dressing and traditional dressing, on the incisional surgical site infection (SSI) after ostomy for colorectal surgery, and to explore the influencing factors of SSI. Methods ① Sixty patients underwent the firstly elective open ostomy for colorectal surgery, who were treated in Department of Colorectal Tumor Surgery and Department of Colorectal&Hernial Minimally Invasive Surgery of Shengjing Hospital from Mar. 2015 to Jan. 2016, were collected to equivalently divided into continuous dissecting suture group and traditional interrupted suture group randomly. ② Twenty-seven patients with emergency open ostomy for colorectal surgery, who were treated in Department of Colorectal Tumor Surgery and Department of Colorectal&Hernial Minimally Invasive Surgery of Shengjing Hospital from Jan. 2009 to Jun. 2015, as well as 33 patients with elective open ostomy for colorectal surgery, who were treated in the same 2 Departments from Jul. 2015 to May. 2016, were collected to equivalently divided into silver ion dressing group and traditional dressing group. ③ Clinical data of 184 patients with elective open ostomy for colorectal surgery who were treated in Department of Colorectal Tumor Surgery and Department of Colorectal&Hernial Minimally Invasive Surgery of Shengjing Hospital from Jan. 2009 to May. 2016 were collected to analyze the influencing factors of SSI after elective open ostomy for colorectal surgery. Results ① There was no significant difference in the incidence of SSI between continuous dissecting suture group (3.3%, 1/30) and traditional interrupted suture group (16.7%, 5/30), P=0.085. ② The incidence of SSI in silver ion dressing group (6.7%, 2/30) was significantly lower than that of traditional dressing group (30.0%, 9/30), P=0.020. ③ There were 28 patients (15.2%) of the 184 elective patients and 11 patients (40.7%) of the 27 emergency patients suffered from SSI after open ostomy for colorectal surgery, and the incidence of SSI in elective surgery group was lower than that of emergency surgery group (P=0.001). ④ Results of logistic regression model showed that, patients with body mass index (BMI) <25 kg/m2 had lower risk of SSI than patients with BMI≥25 kg/m2(OR=0.383, P=0.023), patients received permanent colostomy had higher risk of SSI than patients received protective ileostomy (OR=4.370, P=0.004), patients underwent Mile’s surgery had higher risk of SSI than patients received distal anastomosis (OR=4.406, P=0.005). Conclusions The ostomy is a high risk factor for incisional SSI after elective open ostomy for colorectal surgery, especially for the obesity patients and patients who receive colostomy. The using of silver ion dressing play an important role in preventing the incisional SSI.
Objective To identify new potential drug targets for idiopathic pulmonary fibrosis (IPF) in order to improve the current situation where there are very few effective treatments for IPF. Methods This study integrates protein quantitative trait loci (pQTL) data from the deCODE cohort and the Atherosclerosis Risk in Communities (ARIC) study, expression quantitative trait loci (eQTL) data of whole blood from the GTEx-V8 and eQTLGen databases, and genome-wide association study (GWAS) data of IPF, and employs a multi-dimensional genetic epidemiology approach for analysis. Specifically, it includes: assessing the causal relationship between protein levels and IPF risk using two-sample Mendelian randomization (MR) methods; examining the potential associations between gene expression and IPF using summary-data-based Mendelian randomization (SMR) analysis; and determining the sharing of genetic variants between pQTL/eQTL and GWAS signals using Bayesian colocalization analysis. On this basis, a protein-protein interaction (PPI) network was further constructed, and target druggability assessment and potential drug prediction were performed to evaluate the biological significance and therapeutic potential of candidate targets. Results This study identified two proteins significantly associated with IPF: BRSK2 (β=1.222 7, P=1.12×10–10) and AP2A2 (β=2.854 3, P=1.22×10–7). The analysis suggests that these two proteins may participate in the occurrence and progression of IPF by affecting the balance of lung tissue injury and repair or by modulating fibrosis-related signaling pathways, and increased levels of both BRSK2 and AP2A2 proteins were significantly associated with an increased risk of IPF. Further Bayesian colocalization analysis indicated that AP2A2 shares genetic variant loci with IPF, with posterior probabilities of PPH0=1.49×10–11, PPH1=7.6×10–5, PPH2=1.99×10–10, PPH3=1.33×10–5, and PPH4=0.999 9, suggesting a high degree of genetic signal concordance between them. For external validation, analyses based on the ARIC and UK Biobank databases further supported a potential causal association between BRSK2 and IPF, showing that genetic variants leading to increased BRSK2 protein levels also increased the risk of developing IPF (P=0.004). Conclusions At the protein and gene expression levels, this study provides genetic evidence supporting a potential causal association of AP2A2 and BRSK2 with IPF. These proteins may participate in the pathogenesis and progression of IPF by influencing the balance of lung tissue injury and repair or fibrosis-related signaling pathways. They may also serve as potential therapeutic targets for IPF. However, their specific mechanisms of action require further elucidation.