ObjectiveTo investigate the domestic and abroad hypertension-related clinical trial registration and to analyze the registration of hypertension-related clinical researches in China.MethodsUsing hypertension as the keyword, we searched ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR) from January 2008 to December 2018. We analyzed the collected data on the distribution of registered clinical researches, annual trends, sample sizes, trial progress, research types, study designs, blind methods, clinical stages, the number of participating institutions, the leading institutions, etc.ResultsThe total number of registered hypertension-related clinical trails was 4 991 all over the world, and 551 items were conducted in China. Most of the sample sizes of Chinese hypertension-related clinical trials were 100 to 999. The main types of trials were interventional studies (393 items, 71.32%), followed by observational studies (126 items, 22.87%). Randomized parallel control studies (300 items, 76.34%) were the key component of interventional studies, while cohort studies (61 items, 48.41%) were the chief component of observational studies. The main stages of clinical trials were stage Ⅲ (80 items) and stage Ⅳ (122 items). There were 369 domestic single-center clinical trials (66.97%), 89 domestic multi-center clinical trials (16.15%), and 93 international multi-center clinical trials (16.88%). Among the 93 international multi-center trials of hypertension, only 25 were led by China.ConclusionsThe number of Chinese hypertension-related clinical trial registrations increased year by year and then decreased slightly, but the amount of registrations is limited. The quantity and scale of multicenter clinical studies were not as good as America. China should strengthen the awareness of clinical research registration, strengthen the publicity and supervision of the registration of clinical researches by the department of science and management, improve the number of clinical trial registrations, make Chinese clinical researches more transparent, and strive to lead more international multi-center clinical trials.
高血压是我国重点防治的心血管疾病, 血压的控制率备受关注。在一些血压控制不良的患者中睡眠呼吸暂停是导致顽固性高血压的重要原因。以睡眠过程中反复、频繁出现呼吸暂停和低通气为特点的睡眠呼吸暂停低通气综合征( sleep apneahypopnea syndrome, SAHS) 自20 世纪80 年代以来也受到广泛关注, 临床和基础研究取得了迅速发展。目前, 多项临床、流行病学和基础研究证实SAHS可以导致和/ 或加重高血压, 与高血压的发生发展密切相关。
Abstract In order to find a new method to repair large bone defect, the free periosteum autograft was investigated in experiment, and then the method was used clinically. In the experiment, a 6mm×18mm×5mm bone defect was made at upper end of both tibiae of 42 rabbites. The periosteum of each rabbit was cut into 1mm cubes, and implanted randomly into the tbial bone defect on one side and the other side was used as control. After 2, 4, 8 weeks, the bone defects of each group were examined for bone formation by roentgenography, radionuclide and histology. The results showed that the defects treated by free periosteum autografts healed twice as fast as the controls (its natural healing). The reason probably was that the periosteum provided with many osteogenic cells. On thebasis of these results, 21 cases of bone defects (the largest was 10.5cm×4cm×4cm, the smallest was 2cm×2cm×2cm) including 17 cases of benign bone tumor and4 cases of chronic osteomyelitis, were treated by free periosteum autografts. The defects were all healed, and the function of the joints was restored.
Objective To evaluate the effects of emergency coronary artery bypass grafting (ECABG) in the treatment of emergent patients, and to summarize our experience. Methods We retrospectively analyzed the clinical data of 160 patients who underwent coronary artery bypass grafting (CABG) in Nanjing General Hospital of Nanjing Command from January 2010 through December 2013. The patients were divided into an ECABG group (operation underwent on the day diagnosed, n=27, 22 males and 5 females, at age of 70.2±10.2 years) and a conventional group (CABG operation underwent on 5 days after diagnosed, n=133, 104 males and 29 females, at age of 66.3±8.9 years). Results Statistical differences were found between the ECABG group and the conventional group in EuroSCORE (5.8±3.2 versus 3.4±2.1, P=0.001), acute myocardial infarction (33.3% vs. 11.3%, P=0.007), rate of application of IABP (29.6% versus 12.0%, P=0.034), pericardium and mediastinal tube drainage (533.4±132.8 ml versus 414.8±124.3 ml, P=0.018). There was no statistical difference in continuous renal replacement therapy (P=0.677), postoperative sternal wound complication (P=1.000), the length of hospital stay (P=0.589), or 30-day-mortality (P=0.198) between the two groups. We followed up 24 patients(88.89%) for 3-36 months in the ECABG group. One patient occurred angina symptoms at the end of 1 year follow-up. The symptoms disappeared after treatment. The other patients had no symptoms of angina pectoris and myocardial ischemia. Conclusion ECABG as a lifesaving therapy is an effective procedure in the treatment of severe and acute patients. Sufficient preoperative assessment, good myocardial protection, full revascularization, and comprehensive treatment plays an important role in the success of ECABG.
OBJECTIVE To investigate the clinical result and influence factors of prognosis after repair of ruptured Achilles tendon with operative treatment. METHODS From 1961 to 1994, 62 cases with ruptured Achilles tendon were treated operatively. Among them, "8"-shaped suture was used in 8 cases, aponeurosis flap repair in 30 cases, transfer repair of tendon of peroneus longus muscle in 2 cases, reverse "V-Y" shaped tendon plastic operation in 10 cases, and mattress suture of opposite ends in 12 cases. RESULTS Followed up 3 to 33 years, there was excellent in 40 cases, better in 13 cases, moderate in 6 cases, poor in 3 cases, 85.5% in excellent rate. Postoperative infection and re-rupture were occurred in 6 cases respectively. CONCLUSION Different operative procedures are adopted to achieve better long-term clinical result according to the injury types.
Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Objective To investigate early clinical manifestations of osteogenic sarcoma to help establishment of an early diagnosis of the disease.Methods A total of 92 patients with osteogenic sarcoma in the extremities were admitted to our hospital from April 1984 to October 2002. Of the 92 patients, 71 (42 males and 29 females; averaged age 17.4 years, range 666 years; illness course 1-28 weeks) had a complete record of their medical history and examination. From their first medical visits, we obtained their clinical symptoms, physical sings, diagnoses, and duration of the delayed diagnoses. The patients were pathologically confirmed as having osteogenic sarcoma in the extremities, with the lesions located in the distal femur in 38 patients, proximal tibia in 22, proximal femur in 3, proximal fibula in 3, proximal humerus in 2, distal tibia in 2, and distalradius in 1. Results Of the 71 patients, 70 had a local pain and/or a palpable mass, 37 had a persistent pain with no difference between day and night, 23 had an intermittent pain, and 11 had a nocturnal pain. Of the 71 patients, 42 had an initial pain related to trauma, and 3 of the 42 patients had a pathologic fracture. The patients with the local mass had a delayed diagnosis of osteogenic sarcoma with a delayed duration of 1-14 weeks, averaged 4 weeks; however, the patients without the local mass had a delayed diagnosis of this disease, with a delayed duration of 3-30 weeks averaged 14 weeks. In the patients undergoing an X-ray examination at the first medical visit, the duration of the delayed diagnoses was 1-20 weeks, averaged 8 weeks, but in the patients without an X-ray examination at first, the duration was 4-30 weeks, averaged 16 weeks. Conclusion Intermittent and persistent pains and local masses are the most characteristic clinical manifestations in the early stage of osteogenic sarcoma. A history of trauma often helps to make a diagnosis of the disease. Carefulclinical examination and observation should be given to adolescent patients whohave a recurrent pain around the joint.
Objective To summarize the progress of clinical research on triple-negative breast cancer (TNBC). Methods Domestic and international publications on the study of TNBC in recent years were collected and reviewed. Results The patients with TNBC were younger, and their prognosis was poorer. Besides operation, chemotherapy was the major therapeutic tool for them. Currently the targeted therapy for epidermal growth factor receptor and its signal conducting system was applied to clinical therapy gradually， and it might benefit the patients with TNBC. Conclusion The study on TNBC may bring a new way for therapy.
Objective To reinforce the recognization of deltoid contracture inchildren and probe its causes, pathomechanism,diagnosis and treatments. Methods The Clinical data were summarized and analysed, including etiological factors, clinical situations, examinations and treatments from 9 child patients with deltoid contracture from 1992 to2004. The 9 child patients were followed up to evaluate therapeutic efficacy. Results Nine child patients with deltoid contractureincluded 4 boys and 5 girls, who aged from 5 to 14 years. The main clinical features were presented as abductive deformity,limitation of adduction of the shoulder, winging of the scapula, and dimpling of the skin with a palpable fibrous hard band in deltoid muscle. Four cases had a history of intramuscular injections in deltoid and 1 case was accompanied with bilateral gluteul contracture.Among the 9 patients, 8 cases were misdiagnosed before correct diagnosis and treatment. The misdiagnosis rate was up to 90%. All the cases received the operative treatments to release fibrous bands and were followed up for 8 months to 12 years. Abductive deformity disappeared and functions of the shoulders recovered inall patients, except 1 patient who had a lightly winged scapula. Conclusion Deltoid contracture may be caused by multiple factors,but its clinical features are conductive to correct diagnosis and excellent therapautic efficacy can be acquired by operation early.