ObjectiveTo investigate the effect of 24-week intradialytic progressive resistance exercise on hemoglobin and iron metabolism in maintenance hemodialysis (MHD) patients.MethodsFrom April to May 2019, 62 MHD patients were enrolled and randomly assigned into exercise group (n=31) and control group (n=31). Both groups of patients received regular routine hemodialysis, on that basis, patients in the exercise group completed intradialytic resistance exercise three times per week for 24 weeks. Each exercise included 8-10 muscle groups (grasping the grip ring with both hands, flexion and extension of the elbows and shoulders on the non-vascular side and lower limbs with sandbag), 3 sets of 15 repetitions with a rest of 1-2 min between 2 sets. Exercise began with a low load, the sandbag weight was gradually increased, and the Borg score was aimed to be 11-13 points after exercise. Hemoglobin, serum ferritin, transferrin saturation, serum creatinine, high-sensitivity C-reactive protein, urea clearance index, recombinant human erythropoietin (rHuEPO) dosage at baseline and after 24 weeks, as well as the cumulative iron supplement dose and hemoglobin variation of the two groups during the study period were evaluated.ResultsThere were 20 patients in the exercise group and 30 ones in the control group who completed the study. After 24 weeks of progressive resistance exercise, the medium (lower quartile, upper quartile) of the amount of rHuEPO in the exercise group decreased from 6 000 (6 000, 9 000) U/week to 6 000 (4 500, 7 125) U/week (Z=−2.599, P=0.009), while that in the control group had no statistically significant difference (Z=−1.340, P=0.180); there was no statistically difference in hemoglobin, hemoglobin coefficient of variation, serum ferritin, transferrin saturation, or 24-week cumulative iron supplementation between the two groups.ConclusionIntradialytic progressive resistance exercise can reduce the amount of rHuEPO in MHD patients, which is benefitial to optimizing the management of hemoglobin.
ObjectiveTo analyze the progress in biological tissue engineering scaffold materials and the clinical application, as well as product development status. MethodsBased on extensive investigation in the status of research and application of biological tissue engineering scaffold materials, a comprehensive analysis was made. Meanwhile, a detailed analysis of research and product development was presented. ResultsConsiderable progress has been achieved in research, products transformation, clinical application, and supervision of biological scaffold for tissue engineering. New directions, new technology, and new products are constantly emerging. With the continuous progress of science and technology and continuous improvement of life sciences theory, the new direction and new focus still need to be continuously adjusted in order to meet the clinical needs. ConclusionFrom the aspect of industrial transformation feasibility, acellular scaffolds and extracellular matrix are the most promising new growth of both research and product development in this field.
Abstract: Coronary artery bypass grafting (CABG) has become more and more popular, but how to decrease the thrombotic stenosis of saphenous vein grafts remains a tough problem clinically. Some researchers raised that aspirin resistance (AR) may be one of the most principal causes of graft thrombus and many correlative studies have been reported in recent years．In this article, we reviewed and analyzed the concept and evaluation criterion, incidence rate, mechanisms, clinic significance, and preventing strategy of AR, expecting to deepen the understanding of AR and help to optimize the antiplatelet therapy for postCABG patients with AR.
Objective To review the appl ication of and the research progress on acellular matrix (ACM) in cartilage tissue engineering. Methods Related l iteratures both at home and abroad were retrospected and analyzed. Results Manyresearchers improved the properties of cartilage ACM scaffold through co-appl ication of solution diosmosis method, freezedrying method and physical and chemical cross-l inking method etc., and the experimental results of applying cartilage ACM scaffold for the construction of tissue engineered cartilage were closely related to the properties of ACM. Conclusion ACM has a wide appl ication prospect for the construction of tissue engineered cartilage, and further in-depth studies are needed to improve its property.
Sepsis is not only a common critical disease , but also a common complication and cause of death of patients in intensive care unit. It has the characteristics of dangerous condition, rapid development and high mortality. How to treat sepsis to improve the prognosis and quality of life of patients is very important. Timely and reasonable anti-infection is a vatal part in the treatment of sepsis. This article will review the progress of anti-infective therapy in adult patients with sepsis, starting from empirical anti-infection, procalcitonin-guided anti-infection, bacterial culture combined drug sensitivity test-guided anti-infection and anti-infection with antimicrobial peptides, aiming to provide a certain basis and reference for the anti-infective treatment of adult sepsis.
Total hip arthroplasty is an end-stage treatment for hip diseases such as hip osteoarthritis and osteonecrosis of the femoral head. Traditional surgery models are still mostly used in China, and related day surgery models abroad have shown that day surgery for total hip arthroplasty is as safe and feasible as traditional pattern without increase in complications and readmission. It can also shorten the length of hospitalization for patients, reduce hospitalization costs, thereby speeding up bed turnover and increasing the utilization of medical resources. This article reviews the patient admission, perioperative management, anesthesia and surgical techniques, post-discharge rehabilitation and nursing care of patients undergoing day surgery for total hip arthroplasty, and aims to providea reference for the development of day surgery for total hip arthroplasty in China.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
Objective To review the basic research and cl inical progress of elbow heterotopic ossification after injury. Methods The recent l iterature concerning heterotopic ossification of the elbow was reviewed. Results Heterotopic ossification was caused by variety of stimul i and conditions. The current methods of prevention and treatment were to improve surgical techniques, to reduce trauma and bleeding, to rinse the area with bone fragments with plenty of salt water, and to use non-steroidal anti-inflammatory drugs. Conclusion Once heterotopic ossification occurred, surgical treatment is unique treatment method, so emphasis is to prevent heterotopic ossification.
ObjectiveTo observe the effect of kinesio tape (KT) combined with progressive resistance training (PRT) in patients with subacromial impingement syndrome (SIS), and to explore whether the direction of KT affects the therapeutic effect of SIS.MethodsBetween May 2017 and March 2019, 90 participants with SIS in West China Hospital, Sichuan University were randomly divided into three groups, with 30 participants in each group. Participants were treated with KT combined with PRT, and the direction of the KT is from the proximal end of the rotator cuff muscles to the distal end in group A. Participants were treated with KT combined with PRT, and the direction of the KT is from the distal end of the rotator cuff muscles to the proximal end in group B. Participants were treated with PRT alone in group C. Visual Analog Scale (VAS) was used to evaluate the pain in patients at rest, during movement and at night; range of motion (ROM) of shoulder and the disabilities of the arm, shoulder and hand (DASH) outcome questionnaire were used to measure the physical function before treatment and after 1 week and 2 weeks.ResultsAfter 1 week of treatment, ROM of shoulder abduction, internal rotation and DASH scores in group A were significantly improved compared with those in group B and C (P<0.05). After 2 weeks of treatment, the nighttime VAS score, ROM of shoulder abduction, internal rotation and DASH score scores in group A were significantly improved compared with those in group B and C (P<0.05). The VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) and DASH score in group A were significantly improved after 1 week and 2 weeks of treatment (P<0.05); and after 2 weeks of treatment, the nighttime VAS score, ROM of shoulder flexion and internal rotation in group B were significantly improved compared with those before treatment (P<0.05). After 2 weeks of treatment, the VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) in group C were significantly improved compared with those before treatment (P<0.05).ConclusionKT combined with PRT is more effective than PRT alone in the treatment of SIS, and the therapeutic effect is related to the direction of the tape.
Objects To retrospectively analyze the accepted abstracts by the Cochrane Colloquiums in recent 5 years, so as to learn the advances and development trend for next stage in evidence-based medicine field. MethodsAbstracts accepted by the 19th to 23rd Cochrane Colloquiums were collected, and relevant information was extracted. Then, a descriptive analysis was conducted. Outcomes A total of 2088 abstracts were accepted in recent five Cochrane Colloquiums. Europe contributed the most abstracts, in the top 10 contribution countries, five countries were located in Europe. Colleges/Universities were the major contributing institutes, McMaster University of Canada (165, 7.90%) and Lanzhou University of China (118, 5.65%) were the top two contributing institutions. The number of authors of most accepted abstracts were 3 to 5(1011, 48.42%). The top three topics focused by these abstracts were evidence (417, 19.97%), methodology (412, 19.73%) and risk of bias (220, 10.54%). ConclusionsEuropean countries are major contributing countries of abstracts of the Cochrane Colloquium, and colleges/universities are the major contributing institutions. Retrieval and methodology are research hot in recent 5 years. Attention should be paid to breakthrough progress in methodology in future.