ObjectivesTo systematically review the efficacy and safety of controlled hypotension for total hip or knee replacement.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on controlled hypotension for total hip or knee replacement from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 854 patients were included. The results of meta-analysis showed that compared with no controlled hypotension during surgery, controlled hypotension could reduce intraoperative blood loss (MD=−267.35, 95%CI −314.54 to −220.16, P<0.000 01), allogeneic blood transfusion (MD=−292.84, 95%CI −384.95 to −200.73, P<0.000 01), and 24 h postoperative mini-mental state examination (MMSE) score (MD=−1.08, 95%CI −1.82 to −0.34, P=0.004). However, there were no significant differences in 96 h postoperative MMSE score (MD=−0.11, 95%CI −0.50 to 0.28, P= 0.57) and intraoperative urine volume (MD=57.93, 95%CI −152.57 to 268.44, P=0.59).ConclusionsThe current evidence shows that controlled hypotension during total hip or knee replacement can reduce intraoperative blood loss and allogeneic blood transfusion. Furthermore, there is no obvious effect on the maintenance of blood perfusion in important organs, despite certain effects on the postoperative cognitive function, which can be recovered in short term. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To observe the effect of Twist gene interference on the migration and pAkt protein expression of Rhesus retinal vascular endothelial cell line. Methods The Rhesus retinal vascular endothelial cells (RF/6A) were divided into Twist interference plasmid group, negative control group, and phosphate buffered solution (PBS) group; plasmid vectors were transfected via liposome gene transfection method. Migrated endothelial cells was detected and counted by Transwell chamber assay. Matrigel was used in endothelialcell tube formation; the inhibitory effect of Twist gene interference on endothelial cell tube formation was observed.The effect of Twist gene interference on the expression of pAkt protein in RF/6Acells was measured by Western blot. Results The number of migrated endothelial cells in Twist interference plasmid group was lower than that in the negative control and PBS group (F=23.786，P=0.000).The number of endothelial cell tubes in Twist interference plasmid group was apparently less than that in the negative control and PBS gorup (F=7.159，P=0.014). The expression of pAkt protein in Twist interference plasmid group decreased markedly.Conclusion Twist gene interference can suppress the migration of retinal endothelial cells via inhibiting the expression of pAkt protein.
Light emitting diode (LED) can be used in the treatment of jaundice. Blue and green LED irradiation affected with the newborn is currently considered the most effective treatment of the jaundice in the world. A jaundice phototherapy system with blue and green LED as light source utilizing fly eye lens array was built to achieve uniform illumination in the present study. AMC7150 chip was used to build the constant current drive module, and AT89C52 MCU and LCD12864 LCD screen were used to build the human-computer interaction module. Based on national particular phototherapy equipment requirements (YY0669-2008) for the safety, we designed and implemented a phototherapy system which spot area was 250 mm×500 mm, blue light irradiance reached 2 mW/cm2, green light irradiance reached 1.5 mW/cm2, and the uniformity of light was over 90%. Compared with the traditional system, the new one designed in this study has better therapeutic effect, higher biological safety, easier to achieve man-machine interaction, and more economical and convenient.
OBJECTIVE: To investigate protection of biological activity and controlled release of growth factor by means of drug controlled release technique in tissue engineering. METHODS: Using drug controlled release technique that to embed or microcapsulate the biological drug with biodegradable polymer. RESULTS: The aliphatic polylactone could be used as drug carrier for each drug including the biological matter. And the release behavior of the drug could be controlled by adjusting the molecular structure of the carrier and the controlled release method. The successful example, that to realize regeneration of rat’s sciatic nerve with 5, 10, 15 and 20 mm of gap by using polylactide as nerve guide and the embedding growth factor, had been obtained. CONCLUSION: It is possible to realize protection of biological activity and sustained release of growth factor by using aliphatic polylactone as drug carrier.
Objective To investigate and analyze the epidemic characteristics and factors of pulmonary tuberculosis (PTB) to provide foundation and make prevention and treatment policy. Methods Statistical analysis was conducted to analyze the current existing PTB prevention and control data in the Center for Disease Control and Prevention of Zhushan County and corresponding prevention and treatment policy was proposed. Results Since 1997 when PTB was included into B infectious diseases in Zhushan County, 4 431 cases of PTB had been reported by the end of 2009. Annual reported incidence rate was 74.73 per 100 000 and the disease was found in 17 towns. All seasons witnessed the incidence but winter and summer had more sufferer. The youngest patient was 4 months whereas the oldest was 86 years old. The majority of the patients were from 20 to 59 years old, peasants were the main patients, and the incidence of male was higher than that of female. The use of chemotherapy resulted in a significant decline of PTB death rate. Poor immunity of elder group, population flow caused by poverty, low detection rate of patients and AIDS were the major causes to PTB epidemic. A lack of prevention and treatment in the grassroots hospital and difficulty to fully implement the Directly Observed Treatment, Short-course (DOTS) strategy in remote areas were also bottlenecks to PTB control process. Conclusion The followings should be performed to improve the quality of DOTS strategy implementation: strengthen the government’s commitment, provide policy and funding safeguard, conduct health education and health promotion widely, reinforce management according to the law, fully implement the DOTS strategy, and fortify the prevention and control construction.
Objective To establish a risk prediction model of diabetic retinopathy (DR) for type 2 diabetic patients (T2DM). Methods A total of 315 T2DM patients (600 eyes) were enrolled in the study. There were 132 males (264 eyes) and 183 females (366 eyes). The mean age was (67.28±12.17) years and the mean diabetes duration was (10.86±7.81) years. The subjects were randomly assigned to model group and check group, each had 252 patients (504 eyes) and 63 patients (126 eyes) respectively. Some basic information including gender, age, education degree and diabetes duration were collected. The probable risk factors of DR including height, weight, blood pressure, fasting glucose, glycosylated hemoglobin (HbA1c), blood urea, serum creatinine, uric acid, triglyceride, total cholesterol, high-density lipoprotein, low density lipoprotein cholesterol and urinary protein. The fundus photograph and the axial length were measured. Multivariate logistic regression was used to analyze the correlative factors of DR and establish the regression equation (risk model). Receiver operating characteristic (ROC) curves were used to determine the cut-off point for the score. The maximum Youden Index was used to determine the threshold of the equation. The check group was used to check the feasibility of the predictive model. Results Among 504 eyes in the model group, 170 eyes were DR and 334 eyes were not. Among 126 eyes in the check group, 45 eyes were DR and 81 eyes were not. Multivariate logistic regression analysis revealed that axial length [β=–0.196, odds ratio (OR)=0.822,P＜0.001], age (β=-0.079,OR=0.924,P＜0.001), diabetes duration (β=0.048,OR=1.049,P=0.001), HbA1c (β=0.184,OR=1.202,P=0.020), urinary protein (β=1.298,OR=3.661,P＜0.001) were correlated with DR significantly and the simplified calculation of the score of DR were as follows:P=7.018–0.196X1–0.079X2+0.048X3+0.148X4+1.298X5 (X1= axial length, X2=age, X3=diabetes duration, X4=glycosylated hemoglobin, X5= urinary protein). The area under the ROC curve for the score DR was 0.800 and the cut-off point of the score was -1.485. The elements of the check group were substituted into the equation to calculate the scores and the scores were compared with the diagnostic threshold to ensure the patients in high-risk of DR. The result of the score showed 84% sensitivity and 59% specificity. ROC curve for the score to predict DR was 0.756. Conclusion Axial length, age, diabetes duration, HbA1c and urinary protein have significant correlation with DR. The sensitivity and specificity of the risk model to predict DR are 84.0% and 59.0% respectively. The area under the ROC curve was 0.756.
With nearly four decades of progress in healthcare-associated infection prevention and control in China, the national quality control efforts in this field have been ongoing for the past ten years, advancing rapidly with significant achievements. Over the last decade, the team of infection control professionals involved in quality management and control in China has consistently expanded, accompanied by an enhancement of their skills. Management capabilities have steadily grown, and operational mechanisms have been continuously refined. As public hospitals transition into a new phase of high-quality development, emphasizing refined management models and intrinsic development of medical quality, it becomes crucial to further fortify the foundation and foster innovation in infection control work to ensure quality. This article provides an overview of the establishment and implementation of the National Center for Quality Control of Infection Prevention and Control, examines the current shortcomings and challenges in the field, and collectively explores the positioning and direction of the development of quality control efforts for infection prevention and control in China.
It has been absent from an accepted criteria for normalization and quality control of the thoracic surgery until now. The ideal assessing instrument which will be used to evaluate the technical skills and surgical procedures should present a few vital characterizations below: objectivity, speciality in the content, detailed structure, and quantifiability. Objective structured assessment of technical skills (OSATS) has developed as a reliable method of surgical skills measurement. This article focuses on the history of OSATS and its prospect in the thoracic surgery area by reviewing relevant literatures.
In surgery operations, wound should be cleaned with warm sterilized saline solution. In order to reach rapidly warming the washing solution from the room temperature during the surgery, we designed a thermostatic medical infusion pump. The present paper mainly presents researches on the two temperature control methods in the standby mode and in the flushing mode of the system. In the standby mode, the traditional proportional-integral-derivative (PID) control algorithm was adopted. In the flushing mode, dynamic characteristics of the system was changed in real time, which made the thermostatic control process more complex, and the fitted control function combined with the PID control algorithm was adopted in this mode. The temperature control parameters were adjusted in real time according to the initial temperature and the flow rate of the washing solution to obtain a constant temperature of the washing solution, no matter how the initial temperature and the flow rate are changed. The experiment results showed that this kind of control system performed well with a high accuracy.