ObjectiveTo compare the efficacy and compliance of children children with refractory epilepsy receiving ketogenic diet (KD) in outpatient department with children receiving KD treatment in inpatient department. MethodsA retrospective study of 44 children with intractable epilepsy receiving the modified classical ketogenic diets in outpatient department from June 2014 to December 2015, who were followed-up during the third, sixth and twelfth month. Records of epileptic seizures and adverse reactions were used to evaluate the efficacy and retention rate of inpatient department KD treatment in children with refractory epilepsy, and compared with 104 children receiving KD treatment in inpatient department at the same period. ResultsThirty-four of the forty-four children comleted observation after 12-month follow-up, 15 cases had been seizure freedom, 22 cases had more than 50% reduction in seizure frequency, 12 patients had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in outpatient department was 64.7%, and the retention rate was 71%. 18 of of the 104 children with KD treatment in inpatient department at the same period comleted observation after 12-month follow-up, 3 cases had been seizure freedom, 5 cases had more than 50% reduction in seizure frequency, 13 cases had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in inpatient department was 27.8%, and the retention rate was 17.3%. ConclusionThe KD therapy in outpatient department is effective to children with intractable epilepsy, and there is a highly efficacy and compliance of children receiving KD in outpatient department comparing with children receiving KD in inpatient department. Therefore, it's optional to children with refractory epilepsy who can't received KD by inpatient department because of insufficient number of beds.
Objective To assess the efficacy and safety of levoamlodipine besylate for essential hypertension. Methods We searched MEDLINE (1999 to October 2007), EMBASE (1999 to October 2007), The Cochrane Library (Issue 3, 2007), CNKI (1999 to 2007), Wanfang (1999 to 2007), VIP (1999 to 2007) and CBM (1999 to October 2007). The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration’ s RevMan 4.2 software. Results A total of 345 articles were retrieved, but only 17 were finally included. Meta-analyses showed that the effective rate in patients receiving levoamlodipine besylate was significantly higher than that in patients receiving indapamide (RD 0.14, 95%CI 0.06 to 0.22, P=0.0004), while no significant differences were noted between the levoamlodipine besylate group and other control groups. The incidence of adverse effects was significantly lower in the levoamlodipine besylate group compared to the indapamide group (RD –0.12, 95%CI –0.21 to –0.03, P=0.01), the amlodipine group (RD –0.06, 95%CI –0.11 to –0.01, P=0.02) and the nitrendipine group (RD –0.27, 95%CI –0.46 to – 0.08, P=0.006). No significant differences were observed between the levoamlodipine besylate group and other control groups. Conclusion Levoamlodipine besylate tends to have better efficacy and safety profiles compared with other antihypertensive drugs. However, most trials included in the review were of poor quality and, so, multi-center large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective A multicenter, randomized, single-blind, parallel-controlled noninferiority study was used to evaluate the short-term safety and effectiveness of domestic polyether-ether-ketone (PEEK) suture anchor for rotator cuff repair by comparing with the imported PEEK suture anchor commonly used in clinical practice. Methods A total of 59 patients with rotator cuff tears who were admitted between May 2019 and October 2019 were selected as the research objects. Among them, 3 patients were excluded because they did not meet the selection criteria, and 1 patient withdrew from the study because of serious adverse events. A total of 55 patients were included in the study. They were randomly divided into trial group (n=27) and control group (n=28). The trial group used PEEK suture anchors produced from REJOIN Company, and the control group used PEEK suture anchors from American Arthrex Company. Two patients in control group were lost to follow-up. Twenty-seven patients in trial group and 26 patients in control group were included in the final quantitative analysis. There was no significant difference (P>0.05) in gender, age, disease duration, side and sizes of rotator cuff tears, composition ratio of patients with type 2 diabetes, and preoperative American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, University of California at Los Angeles (UCLA) score, and visual analogue scale (VAS) score. The patients were followed up regularly after operation. The postoperative follow-up included safety evaluation (complications, anchor position, and anchor bone reaction) and effectiveness evaluation (shoulder joint function and pain scores, rotator cuff integrity based on Sugaya classification criteria). Results The operations in both groups were successfully completed, and there was no complication related to the operation and suture anchor. All incisions healed by first intention. There was no significant difference in follow-up time between trial group [(5.85±0.77) months] and control group [(5.96±0.72) months] (t=0.535, P=0.595). MRI examination indicated that the repaired tendons were fixed and the anchors did not get loose or torn. At 1 day, 3 months, and 6 months after operation, there was no patient with grade 3-4 anchor bone reaction in the two groups, and there was no significant difference in the bone reaction grading between groups (P>0.05). After operation, the VAS scores of the two groups gradually decreased, and the ASES scores, Constant-Murley scores, and UCLA scores gradually increased, and there were significant differences between groups at each time point (P<0.05). There was no significant difference between groups at different time points (P>0.05). There was no significant difference in Sugaya classification of rotator cuff integrity at 1 day, 3 months, and 6 months after operation between groups (P>0.05). Conclusion The short-term safety and effectiveness of domestic PEEK suture anchors in rotator cuff tear repair are not significant different from those of imported PEEK suture anchors commonly used in clinical practice.
ObjectivesTo systematically review the efficacy of pelvic floor electrical stimulation on urinary dysfunction.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on the efficacy of pelvic floor electrical stimulation on urinary dysfunction from inception to August 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 559 patients were included. The results of meta-analysis showed that the pelvic floor electrical stimulation group was superior to the control group in bladder volume before and after treatment(MD=79.25, 95%CI 40.36 to 118.15, P<0.000 1), residual urine volume (MD=35.50, 95%CI 7.60 to 63.41, P=0.01), maximum detrusor pressure (MD=5.19, 95%CI 2.11 to 8.27, P<0.001), number of leaks (RR=1.95, 95%CI 1.39 to 2.52, P<0.000 01), daily average urination frequency (RR=2.64, 95%CI 1.97 to 3.31, P<0.000 01), and international lower urinary tract score (MD=5.07, 95%CI 2.17 to 7.96, P=0.000 6).ConclusionsCurrent evidence shows that pelvic floor electrical stimulation is an effective therapy for urinary dysfunction. Due to limited quality and quantity of the included studies, more high quality-studies are required to verify the above conclusion.
Exploring the functional network during the interaction between emotion and cognition is an important way to reveal the underlying neural connections in the brain. Sparse Bayesian network (SBN) has been used to analyze causal characteristics of brain regions and has gradually been applied to the research of brain network. In this study, we got theta band and alpha band from emotion electroencephalogram (EEG) of 22 subjects, constructed effective networks of different arousal, and analyzed measurements of complex network including degree, average clustering coefficient and characteristic path length. We found that: ① compared with EEG signal of low arousal, left middle temporal extensively interacted with other regions in high arousal, while right superior frontal interacted less; ② average clustering coefficient was higher in high arousal and characteristic path length was shorter in low arousal.
【摘要】 目的 评价中药治疗贝尔(Bell’s)面瘫的有效性和安全性。 方法 以中药、中西医结合、Bell’s面瘫、特发性面瘫、面神经疾病和(或)麻痹、颅神经、颅神经疾病/麻痹为主题词,检索ECSCO数据库系列的ASP(Academic Source Premier)、 NSTL数据库系列的ACP美国医师协会电子期刊数据库及Medicines Complete英国医药出版社医药数据库、MEDLINE数据库、CNKI中国期刊全文数据库、VIP中文科技期刊全文数据库和万方数据库,并在因特网上检索相关学位论文和正在进行的研究。相关的学术会议论文和学位论文汇编也同时予以检索。鉴定相关文章附录的参考文献作为补充检索。 结果 所有以中药治疗Bell’s面瘫的随机对照试验均被纳入。 结论 对纳入的随机对照试验进行方法学质量的评估,数据提取和数据分析。【Abstract】 Objective To evaluate the efficacy and safety of Chinese herbs on Bell’s palsy. Methods With the searching terms including chinese herbs, integrated chinese and western medicine, Bell’s palsy, peripheral facial palsy,facial nerve disease/paralysis, cranial nerve,cranial nerve disease/paralysis were searched in the database of ASP, ACP, Medicines Complete, MEDLINE, CNKI,VIP and Wanfang. While to search the related academic dissertation and ongoing researches on internet. Relevant academic conference and dissertation proceedings have also been searched. Results All randomized trials about Chinese herbs for Bell’s palsy were included in this review. Conclusion Assessment of methodological quality, data extraction and syntheses were carried out.
ObjectiveTo investigate safety and effectiveness of laparoscopic pancreaticoduodenectomy (LPD) in municipal hospitals.MethodsThe clinic data of patients underwent pancreatoduodenectomy in the Leshan People’s Hospital from November 2017 to January 2020 were retrospectively analyzed. The patients were divided into LPD group and open pancreaticoduodenectomy (OPD) group according to the operation methods, and the indicators of perioperative safety and effectiveness of the two groups were compared.ResultsA total of 72 patients were enrolled in this study, including 30 patients in the LPD group and 42 patients in the OPD group. There were no significant differences in the age, gender, and other baseline indicators between the two groups (P>0.05). Although the operative time of the LPD group was longer than that of the OPD group (P<0.05), the intraoperative blood loss in the LPD group was significantly less than that in the OPD group (P<0.05), the postoperative hospital stay, postoperative exhaust time, and postoperative ambulation time in the LPD group were shorter than those in the OPD group (P<0.05). And there were no significant differences in the terms of intraoperative red blood cell transfusion, intraoperative blood transfusion rate, postoperative ICU hospitalization time, hospitalization expenses, overall complications and specific complications (except incision infection rate of LPD group was significantly lower than OPD group, P=0.031) between the two groups (P>0.05). There were no significant differences in the positive rate of resection margin, number of lymph node dissection, and positive rate of lymph node between the two groups (P>0.05).ConclusionLPD has the same safety and effectiveness as OPD in the perioperative period in municipal hospitals, and is more conducive to postoperative recovery of patients.
ObjectiveTo evaluate the safety, efficacy, and cost-effectiveness of different uses of oxidized regenerated cellulose (ORC) in video-assisted thoracoscopic surgery (VATS) for lung cancer resection to provide a reference for the selection, clinical use, and rational utilization of absorbable hemostatic materials. MethodsA retrospective analysis of relevant data from inpatients who underwent VATS for lung cancer resection at a tertiary hospital from July 2019 to January 2020 and from July 2020 to December 2020 was conducted. Patients were divided into two groups based on the use of ORC: 1) combined use group (ORC and collagen sponge) and 2) sole-use group (ORC). Safety, efficacy, and economic outcome indicators were compared between the two groups. ResultsThe main analysis included a total of 904 patients, with 466 in the combined use group and 438 in the sole-use group. Compared to the combined use group, the sole-use group had a significantly longer hospital stay, used fewer hemostatic drugs, had a lower average cost of hemostatic materials, and a lower median total hospitalization cost (P<0.05). No statistically significant difference was found between the two groups in terms of intraoperative blood loss volume, massive blood loss rate, perioperative transfusion rate, reoperation rate, postoperative 48-hour drainage volume, bloody drainage fluid rate, or postoperative laboratory test indicators. ConclusionThere was no significant difference in the safety or efficacy of VATS for lung cancer resection between the sole use of ORC and the combined use of ORC, but the sole use of ORC was associated with a lower cost of hemostatic materials and a lower total hospitalization cost. The sole use of hemostatic gauze in VATS for lung cancer resection may be a more cost-effective choice.