Objective To investigate the impact of edaravone on serum reactive oxygen species during the perioperative period of off-pump coronary artery bypass grafting （OPCAB）. Methods A total of 40 patients who underwent selective OPCAB in the First Hospital of Hebei Medical University between June 2011 and November 2012 were prospectively enrolled in this study. All the patients were randomly divided into a trial group and a control group by a random digitaltable method with 20 patients in each group. There were 13 males and 7 females in the trial group with their age of 40-67（51.8±11.5） years， and 9 males and 11 females in the control group with their age of 42-70 （53.5±13.1） years. Afteranesthesia induction， patients in the trial group received continuous intravenous infusion of edaravone 60 mg （diluted in 100 ml saline）， while patients in the control group received continuous intravenous infusion of saline 100 ml， both of whichwere finished within 30 minutes. Venous blood samples were taken 24 hours preoperatively （T1）， 1 hour after skin incision（T2）， at the end of the surgery （T3） and 24 hours postoperatively （T4） to examine the concentration of superoxide dismutase（SOD） and malondialdehyde （MDA）. The data of the two groups were compared. Results All the patients successfully underwent their surgery and were included in the analysis. At the T2， T3 and T4 time point， SOD concentration was 80.3±21.3 U/ml， 78.5±17.4 U/ml and 81.4±17.5 U/ml， and MDA concentration was 10.2±1.8 nmol/ml， 11.3±1.9 nmol/ml，14.8±2.1 nmol/ml respectively in the control group；SOD concentration was 92.8±18.4 U/ml，90.0±18.1 U/ml，and 88.7±18.7 U/ml，and MDA concentration was 7.2±1.7 nmol/ml，8.2±1.2 nmol/ml，10.2±1.3 nmol/ml respectively in the trial group. At each above time point， SOD activity was significantly higher in the trial group than the control group （F=2.90，P=0.003；F=2.80，P=0.003；F=2.80，P=0.001）， and MDA concentration was significantly lower in the trial group than the control group （F=2.79，P=0.001；F=2.80，P=0.001；F=2.90，P=0.000）. Conclusion Edaravone can decrease serum reactive oxygen species caused by OPCAB and reduce myocardial injury.
目前,新型农村合作医疗正在我国300多个县(市)开展试点工作.然而,在农村总体经济实力不强又面临市场经济冲击的大形势下,建立新型农村合作医疗制度将是一项十分艰难、复杂的工程.本文讨论了新型农村合作医疗制度产生的历史背景及如何增强农民对新型农村合作医疗制度的信心问题.
Objectives To assess the effectiveness and safety of carnitine in the treatment of idiopathic asthenozoospermia. Methods The Cochrane Library, MEDLINE, EMbase, and CNKI were searched between Jan 1995 and Dec 2006. Both English and Chinese studies were included in the review if they were randomized controlled trials (RCTs) involving men with idopathic asthenozoospermia who were treated with carnitine. Trial screening, data extraction, and quality assessment of included trials were conducted by method recommended by Cochrane Collaboration. Statistical analysis was conducted using RevMan 4.2.10 software. Results Five RCTs involving 346 patients met the inclusion criteria, and 307 patients were included in the meta-analysis. The results showed that: after being treated with carnitine for 3 and 6 months, the difference of the patients’ partners’ spontaneous pregnancy rate between treatment group and control group was statistically significant with RR2.46 and 95% CI1.12 to 5.43 (Z=2.23, P=0.03). After being treated with carnitine for 3 and 6 months, the difference of forward motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 9.16 and 95%CI 0.14 to 18.18 (Z=1.99, P=0.05) and WMD 5.28 and 95%CI –4.45 to 15.01 (Z=1.06, P=0.29). After being treated with carnitine for 3 and 6 months, the difference of percentage of forward sperm motility between treatment group and control group was not statistically significant with WMD 14.56 and 95%CI –4.49 to 33.61( Z=1.50 ,P=0.13), and WMD 7.34 and 95%CI –5.93 to 20.61 (Z=1.08, P=0.28). After being treated with carnitine for 3 and 6 months, the difference of total motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 15.32 and 95%CI –1.34 to 31.98 (Z=1.80, P=0.07) and WMD 6.20, 95%CI –3.00 to 15.39 (Z=1.32, P=0.19).After being treated with carnitine for 3 and 6 months, the difference of percentage of total sperm motility between treatment group and control group was not statistically significant with WMD 2.97 and 95%CI –5.75 to 11.69 (Z=0.67, P=0.50) and WMD 4.48 and 95%CI-9.17 to18.14 (Z=0.64, P=0.52). After being treated with carnitine for 3 and 6 months, the difference of semen volume between treatment group and control group was not statistically significant with WMD –0.12 and 95%CI –0.55 to 0.30 (Z=0.57, P=0.57) and WMD 0.03 and 95%CI –0.38 to 0.45 (Z=0.16, P=0.87). After being treated with carnitine for 3 and 6 months, the difference of sperm concentration between treatment group and control group was not statistically significant with WMD 7.92 and 95%CI – 2.85 to18.68 (Z=1.44, P=0.15), and WMD 1.02 and 95%CI –5.09 to 7.14 (Z=0.33, P=0.74). Three RCTs reported that there were no serious side effects of carnitine during the treatment period. Conclusions The available evidence indicates that spontaneous pregnancy rate would increase with carnitine therapy, while it is short of improvement of semen parameters. There is no serious side effect of carnitine. Because of lack of evidence, we cannot conclude that carnitine is effective in improving the prognosis of infertile patients with idiopathic asthenozoospermia. More high quality trials with large sample are proposed.
Individual patient data meta-analyses are conducted through development of collaboration with trial investigators, central collection and checking of individual patient data of all eligible trials, and pooling of patient data to produce the best estimate of effects of health care interventions. They ensure study data to be update, accessible, reliable and complete so as to minimize the risk of bias, and are the gold standard of systematic reviews addressing effects of health care interventions. Meta-analyses using individual patient data enable higher flexibility of data analyses and more completeness and balance of results interpretation. The study conduct differs between individual patient data versus conventional meta-analyses. This article discussed the steps of conducting individual patient data meta-analyses.
Objective To compare and assess the efficacy of ventral/dorsal onlay graft urethroplasty in the treatment of urethral stricture. Methods We searched pertinent English literature via MEDLINE (1966 to 2007), EMBASE (1977 to 2007) and The Cochrane Library (Issue 4, 2007) for the use of ventral/dorsal graft urethroplasty in the reconstruction of urethral defect associated with urethral stricture. Data were extracted by two reviewers independently and analyzed by SPSS 13.0 software. Results A total of 50 studies involving 1 264 patients were included. Ventral onlay graft urethroplasty was used in 751 patients with a success rate of 82.6%, while dorsal onlay graft urethroplasty was used in 513 patients with a success rate of 86.9% (ventral vs. dorsal, χ2=4.432, P=0.035). Oral mucosa graft had the highest success rate (88.1%) of all grafts, and the success rate of free skin graft onlay urethroplasty was associated with the location of graft placement (ventral vs. dorsal, P=0.016). Concerning the location of stricture, urethroplasty for bulbar urethral stricture achieved the best results, with a success rate of 87.7%, which was also associated with the location of graft placement (ventral vs. dorsal, P=0.025). Conclusion Dorsal onlay graft urethroplasty is better than ventral onlay. It is better to place the free skin graft in the dorsal part of urethra. Bulbar urethral stricture is more suitable for graft onlay urethroplasty than penile urethral stricture.