ObjectiveTo evaluate the effect on complication after esophagectomy by comparing the different methods of anastomosis (cervical versus thoracic anastomosis). MethodsWe searched the following databases including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang database to identify randomized controlled trials (RCTs) of cervical versus thoracic anastomosis for esophagectomy patients from establishment of each database to October 30, 2014. Quality of the included RCT was evaluated. Meta-analysis was conducted by using RevMan 5.2 software. ResultsWe finally identified 4 RCTs involving 267 patients. In terms of the postoperative complication, the incidence of anastomotic leakage (RR=3.83, 95%CI 1.70 to 8.63, P=0.001) with cervical anastomosis was significantly higher than that of the patients with thoracic anastomosis. However, there was no statistical difference in incidence of anastomotic stricture (RR=1.04, 95%CI 0.62 to 1.76, P=0.87), pulmonary complication (RR=0.73, 95%CI 0.27 to 1.91, P=0.52), and mortality (RR=0.89, 95%CI 0.40 to 1.97, P=0.77) between cervical and thoracic anastomosis. ConclusionCompared with thoracic anastomosis, the method of cervical anastomosis is associated with a higher incidence of anastomotic leakage. But there are many unclear factors about anastomotic stricture, pulmonary complication and mortality, further measurement should be taken.
Occupational therapy practice should be informed by the model of practice, with a focus on the needs of the clients and conducting activity analysis and occupational analysis on these needs. Intervention plans are developed in collaboration with clients/family members and they should be in control in decision making. In occupational therapy, the client is the active agent of activity, and the therapist serves as a helper or a facilitator. The design of therapeutic activities should not only consider restoring lost function and using residual functions but also pay attention to the impact of environmental factors on the client’s role and occupational performance. Occupational therapy helps the clients to return to family and society through improving their occupational performance via grading and adapting activities, providing information such as social resources, and implementing individualized interventions. This paper reviews the clinical reasoning and implementation of occupational therapy.
ObjectiveTo investigate the predictive value of thyroid transcription factor-1 (TTF-1) in the treatment of advanced lung adenocarcinoma with different chemotherapy regimens.MethodsA total of 126 patients with advanced lung cancer were divided into three groups according to the chemotherapy regimen, namely a pemetrexed+nedaplatin group (PEM+NDP group), a pemetrexed+cisplatin/carboplatin group (PEM+DDP/CBP group) and a third-generation (3G) chemotherapy+cisplatin/carboplatin group (3G agent+DDP/CBP group). The predictive value of TTF-1 in the above three treatment regimens was analyzed. The patients were followed up by telephone or outpatient visit until April 2017.ResultsThere were no significant differences in disease control rate or objective response rate between the three different chemotherapy regimens (all P>0.05). The survival rate of PEM+NDP group was significantly higher than that of PEM+DDP/CBP group and 3G agent+DDP/CBP group (9.68%vs. 5.56% and 6.80%, both P<0.05). ECOG score and brain metastasis were independent risk factors for the prognosis of chemotherapy regimens. TTF-1 was an independent risk factor for PEM+NDP therapy.ConclusionTTF-1 is an independent risk factor for PEM+NDP chemotherapy, but not for 3G agent + DDP/CBP or PEM+DDP/CBP regimens.
ObjectiveTo evaluate the value of incision closure device in laparoscopic cholecystolithotomy. MethodsThe clinical data of 130 patients underwent laparoscopic cholecystectomy from Oct. 2014 to Feb. 2015 were retrospectively analyzed. According to the methods of gallbladder suture, 130 cases were divided into two groups, 72 cases underwent traditional manual suture (MS group), and 58 cases underwent incision closure device (ICD group). The operative time, postoperative gastrointestinal function recovery time, bleeding volume, postoperative hospitalization time, hospitalization expenses, complications, and postoperative 6-12 months follow-up of patients in 2 groups were observed.Results One hundred and thirty cases were performed laparoscopic cholecystolithotomy successfully. The operative time and postoperative gastrointestinal function recovery time of ICD group were significantly shorter than those of MS group, the difference was statistically significant (P < 0.05). The hospitalization expenses of the patients in ICD group were significantly higher than those in the MD group (P < 0.05). There were no significant difference between the two groups in the bleeding volume and postoperative hospital stay (P > 0.05). The patients were followed up for 6-12 months, with an average of 8 months, and no complications occurred and stone recurrence. ConclusionIncision closure device can shorten the time of laparoscopic cholecystolithotomy and postoperative recovery of gastrointestinal function, but the cost is higher. Next development, still need decrease the expend and strengthen clinical promotion.
ObjectiveTo systematically evaluate the effect of mucin 1 (MUC1) expression on the prognosis and clinicopathologic characteristics of patients with colorectal cancer.MethodsThe cohort studies on the relationship between MUC1 expression and the prognosis of colorectal cancer patients were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, China Biology Medicine, WanFang, VIP, and other databases from the establishment of the database to December 2020. The two researchers screened the literatures according to the inclusion and exclusion criteria, extracted relevant data, and performed meta analysis using Stata 12.0 software.ResultsA total of 17 eligible studies comprising 2 516 patients with colorectal cancer were included. The results of meta-analysis showed that the overall survival (OS) of patients with high MUC1 expression was worse than that with low MUC1 expression [HR=1.51, 95%CI (1.33, 1.71), P<0.001], but not statistically significant with disease-free survival [HR=1.39, 95%CI (0.41, 4.68), P=0.565]. Subgroup analysis results showed the same results as the overall analysis regardless of analysis method (multivariate or survival curve), different ethnic groups (Asian or Caucasian), and different sample sizes (≥100 or <100). The results of clinicopathologic analysis showed that the high expression of MUC1 was correlated with lymph node metastasis, distant metastasis, depth of invasion, and TNM stage (P<0.05), but not correlated with gender, age, degree of tumor differentiation, and tumor location (P>0.05).ConclusionsHigh expression of MUC1 is closely associated with poor prognosis, lymph node metastasis, distant metastasis, tumor invasion depth, and TNM stage in patients with colorectal cancer, which is expected to be an important reference indicator for disease monitoring and prognosis judgment of colorectal cancer.
ObjectiveTo systematically review the efficacy of cognitive behavioral therapy (CBT) for improving mental health and social functions in patients with multiple sclerosis (MS). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 4, 2016), CBM and CNKI from inception to May 2016, to collect randomized controlled trials (RCT) about CBT on mental health and social function in patients with MS. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 RCTs involving 1 102 patients were included. The results of meta-analysis showed that, the HADS scores (depression: MD=-1.28, 95%CI-2.07 to-0.48, P=0.002; anxiety: MD=-1.52, 95%CI-2.99 to-0.06, P=0.04), BDI scores (MD=-9.11, 95% CI-15.82 to-2.40, P=0.008), HRDS scores (MD=-7.23, 95% CI-13.65 to-0.82, P=0.03), Chalder scores (MD=-4.88, 95% CI-6.61 to-3.16, P < 0.000 01), MFIS scores (MD=-2.98, 95% CI-4.52 to-1.44, P=0.000 2) and GHQ-12 scores (MD=-3.61, 95%CI-5.20 to-2.02, P < 0.000 01) in the CBT group were lower than that in the control group. No significant difference was found in WSAS scores (MD=-1.98, 95%CI-4.88 to 0.93, P=0.18) between two groups. ConclusionCBT may be effective for improving the negative mental experience, fatigue and quality of life in MS. No evidence to support CBT has benefits in social functions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality studies.
ObjectiveThe diagnostic efficacy of long non-coding RNA (lncRNA) for tuberculosis was evaluated by systematic review. MethodsData from PubMed, Web of Science, Cochrane Library, Embase, CMJFD, CNKI and WanFang Data were searched. Literatures on the diagnostic value of lncRNA in tuberculosis from the database establishment to August 20, 2024 were selected, and the quality of literatures was assessed using QUADAS-2 tool. Meta-Disc 1.0 software tested the threshold heterogeneity of the included studies. Stata 18.0 software calculated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and other effect sizes, and performed subgroup analysis and meta regression to explore the source of heterogeneity. Deeks funnel plot evaluates publication bias. Results A total of 28 case-control studies were included in 14 literatures. The meta-results showed that the combined sensitivity was 0.88 (95%CI 0.81 to 0.93), the specificity was 0.90 (95%CI 0.84 to 0.94), and the PLR was 9.05 (95%CI 5.16 to 15.87). The NLR and DOR were 0.13 (95%CI 0.08 to 0.22) and 67.96 (95%CI 27.27 to 169.39), and the AUC were 0.95 (95%CI 0.93 to 0.97). Subgroup analysis showed that lncRNA was more effective in the diagnosis of tuberculosis when PMBC samples, lncRNA expression was down-regulation, the study sample size was ≤100, there was cut-off value, GAPDH was used as the internal reference, and RNA extraction kit was used. meta regression indicated that lncRNA expression level and sample size were the main sources of heterogeneity. Conclusion LncRNA has high accuracy in the diagnosis of tuberculosis, and is expected to become a new biomarker to assist the diagnosis of tuberculosis.
Objective To evaluate the efficacy, safety and economics of digestive enzyme for dyspepsia. Methods Electronic databases such as PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, VIP and CNKI were searched from establishment dates of databases to June 2010 to identify the randomized controlled trials (RCTs) of digestive enzyme for dyspepsia. Then studies were identified according to predefined inclusion and exclusion criteria, and their quality was evaluated. The meta-analysis was performed using RevMan 5.0 software. Results Eight studies involving 1 092 patients were included, 3 of which were Grade B while the rest were Grade C. The results of the meta-analysis showed that the total efficacy rate of oryz-aspergillus enzyme and pancreatin tablet, compound digestive enzymes capsule, and compound azintamide enteric-coated tablet for dyspepsia were better than either placebo or blank intervention, with the results as (OR=49.70, 95%CI 17.16 to 143.96), (OR=7.71, 95%CI 3.88 to 15.33) and (OR=16.27, 95%CI 6.85 to 38.66), respectively. The efficacy for treating loss of appetite, abdominal distension, abdominal pain, diarrhea and belching was superior to either placebo or blank intervention. Oryz-aspergillus enzyme and pancreatin tablet was inferior to compound digestive enzyme capsule in treating dyspepsia following cholecystectomy. No significant difference was observed in treating dyspepsia following chronic pancreatitis between compound azintamide enteric-coated tablet and compound digestive enzymes capsule. Drug-related adverse reactions as well as economic evaluation were not reported in included studies. Conclusion Digestive enzyme is effective for dyspepsia caused by various diseases. The OR of digestive enzyme versus the placebo/blank-control group shows that oryz-aspergillus enzyme and pancreatin tablet is better than other digestive enzyme drugs.
Objective To determine the concentration of int erleukin-12(IL-12),interleukin-2(IL-2) and tumor necrosis factor(TNF)and the irpossible role in the pathogenesis of proliferative vitreoretinopathy(PVR) ． Methods Patients were divided into 3 groups:18 with PVR,7 with simples retinal detachment caused by macular hole and 4 samples from normal eyes were used as control.Sample s of vitreous were obtained by aspiration through pars plana before cryotherapy ,vitrectomy and gas injection and stored in liquid nitrogen at －70℃ within 30 minites for ELISA. Results ①The levels of IL-12,IL-2，and TNF in the vitreous of PVR were positively correlated with the degree of severity of disease.②The levels of IL-12, IL-2,and TNF in the PVR were higher than those in simple retinal detachment caused by macular hole and those in control group(Plt;0.01 ).③The levels of IL-12,IL-2，and TNF in retinal detachment caused by macular hole were also higher than those in the control group(Plt;0.01). Conclusion IL-12,IL-2，and TNF may play a role at lease to some extent in the pathogenesis of PVR. (Chin J Ocul Fundus Dis,1999,15:75-77)
ObjectiveTo systematically review the incidence of social isolation in Chinese elderly population. MethodsCNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Web of Science and CENTRAL databases were electronically searched to collect studies on the incidence of social isolation in China from inception to May 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies, then, meta-analysis was performed by using Stata 15.1 software. ResultsA total of 20 studies involving 86 111 subjects were included. Meta-analysis results showed that the incidence of social isolation among the elderly in China was 27.54% (95%CI 22.15% to 57.74%). The results of subgroup analysis showed that gender, age, educational level, marital status, self-assessment of health, living style, year of publication, and region surveyed were all influential factors of the incidence of social isolation among the elderly in China. ConclusionCurrent evidence shows that the incidence of social isolation among the elderly in China is relatively high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.