Objective To preliminarily assess the ameliorative effect of Mom’s Good Mood (MGM) on the prevalence of antenatal depression based on a pilot study, and to provide evidence for a scale-up study. Methods This study was conducted in Ma’anshan Maternal and Child Health Center as a pilot study of an implementation study conducted in China called the Perinatal Depression Screening and Management (PDSM) program. In 2019, 1 189 participants (gestational week ≤14+6 weeks) were included in the implementation group. Females were recruited in the first trimester and followed up in the second and third trimesters. At each time point, the participants’ depression status was screened by the Edinburgh postpartum depression scale (EPDS), and those who were screened as having depression were provided the MGM intervention. In 2020, 1 708 participants who underwent screening with the EPDS in either the first, second or third trimester at Ma’anshan Maternal and Child Health Center were included in the control group. Mann‒Whitney U test, Chi-square, and multivariate logistic regression analysis were used to compare the EPDS scores and depression prevalence between the control and implementation groups to assess the ameliorative effect of MGM (screening and intervention) on antenatal depression. Results In the first trimester, there were no statistically significant differences in EPDS scores or depression prevalence between the two groups (P>0.05). In the second and third trimesters, both the EPDS scores and depression prevalence of the implementation group were lower than those of the control group (P<0.05). After adjusting for confounders, logistic regression analysis showed that the risks of depression in the implementation group in both the second and third trimesters were lower than those in the control group (ORsecond trimester=0.55, 95%CI 0.37 to 0.81, P=0.003; ORthird trimester=0.51, 95%CI 0.35 to 0.74, P<0.001). Conclusion Implementation of the MGM based on the primary care system can effectively reduce the prevalence of antenatal depression, providing evidence for further scale up.
OBJECTIVE: To demonstrate the effectiveness of operative resection for patients with huge hemangioma. METHODS: Eight cases were adopted in this study, including 5 males and 3 females. Among them, 5 cases with hemangioma on the face and neck, 1 case on the back, 1 case on the buttock, and 1 case on the leg. The maximal size of the hemangioma was 31.2 cm x 9.1 cm and the minimal size was 27.3 cm x 6.0 cm. Before operation, angiography was taken to find out the size of tumor. During operation, intervention-embolism and circumferential suture were carried out to control bleeding so that resection of tumor was practicable. RESULTS: There had been successful result in all the cases with huge hemangioma. No recurrence were found with following up 8 months to 4 years(averaged 13 months). CONCLUSION: Angiography of the hemangioma is important in providing the informations for the operation design. The intervention-embolism and circumferential suture can control and reduce the bleeding in operation. Combine of these techniques is essential for the treatment of huge hemangioma.
ObjectiveTo systematically review the effect of intermittent fasting on type 2 diabetes mellitus. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, The Cochrane Library and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) on intermittent fasting intervention in the treatment of type 2 diabetes mellitus from inception to April 2022. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. The RevMan 5.4 software and Stata 17.0 software were used for meta-analysis. ResultsA total of 17 RCTs comprising 1 428 patients with type 2 diabetes mellitus were included. The results of meta-analysis showed that intermittent fasting improved body weight (WMD=−2.84, 95%CI −3.79 to −1.88, P<0.05), body mass index (BMI) (WMD=−1.07, 95%CI −1.52 to −0.61, P<0.05), glycosylated hemoglobin levels (SMD=−0.78, 95%CI −1.19 to −0.38, P<0.05), and fasting glucose levels (SMD=−0.65, 95%CI −1.01 to −0.3, P<0.05). ConclusionThe current evidence suggests that intermittent fasting improves body weight, BMI, glycated hemoglobin, and fasting blood glucose levels in patients with type 2 diabetes. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To discuss the clinical effect and value of minimally invasive therapy on lower extremity deep venous thrombosis （DVT）. Methods The clinical data of 911 patients with acute lower extremity DVT from April 1998 to December 2011 were analyzed retrospectively. There were 489 males，422 females；the age ranged from 23-86 years old with （58.72±11.95） years old. Five hundred and sixty-eight patients occurred on the left leg，343 patients on the right leg. There were 487 cases of central type，166 cases of peripheral type，258 cases of mixed type. All the patients were implanted inferior vena cava filter under local anesthesia，then inserted an 8-14 F catheter via the femoral vein of the affected limbs to suck mechanically thrombus. Five hundred and twenty-seven cases of iliofemoral vein thrombus were inserted into sheathing canal with the help of technique of guide wire griped. The guide wire could be plugged into femoral vein，even more far，with the help of sheathing canal. Following the guide wire，a diameter-10 mm balloon catheter was used to pull the thrombus to iliac vein，with the watching of DSA，so it could be sucked from iliac vein. Before sucking thrombus，a diameter-12 mm balloon was put into the confluence of inferior vena cava and iliac vein，in case of thrombus fall off with blood flow to block inferior vena cava. Results Among 911 patients，423 cases were only treated by sucking thrombus，275 cases sucking thrombus plus endovascular thrombolysis，91 cases sucking thrombus plus endovascular thrombolysis plus percutaneous transluminal angioplasty （PTA），122 cases sucking thrombus plus endovascular thrombolysis plus PTA plus stenting，the average hospital stay was 7.5 d. ① Discharge success rate：907 （99.56%） cases were successful by interventional therapy，4 （0.44%） cases were failed. Nine hundred and eleven patients were performed mechanical thrombus suction，which was 556 cases of gradeⅢ，142 cases of gradeⅡ，213 cases of gradeⅠ. Among 213 cases of gradeⅠ，there were 91 cases only underwent PTA treatment for economic reasons or advanced stage malignant tumors，122 cases underwent PTA plus stenting. The circumferences of affected limb and the differences of circumference of healthy and affected limbs knees above and below 15 cm at discharge were significantly smaller than those at admission （P＜0.01）. Twenty-seven cases underwent anticoagulation and thrombolytic therapy after operation，which occurred mild subcutaneous bleeding，gum bleeding，epistaxis，hematuria，and the symptoms were disappearance after adjusting drugs. All the patients did not appear to complications such as bleeding，vessel dissection. ② Follow-up effective rate：After 6 to 12 months follow-up，there were 714 （78.38%） cases of excellent，136 （14.92%） cases of good，57 （6.26%） cases of middle，4 （0.44%） cases of poor. After 13 to 24 months follow-up，there were 691 （76.18%） cases of excellent，151 （16.65%） cases of good，65 （7.17%） cases of middle；65 cases occurred restenosis that the PTA and stent placement was underwent again， blood flow of 58 cases completely restored，blood flow of 7 cases partly recovered，and the contrast agent didn’t retent. After 25 to 36 months follow-up，there were 681 （75.08%） cases of excellent，128 （14.11%） cases of good，98 （10.81%） cases of middle；98 cases of limb swelling were not satisfied，and the patients still had a sense of pain after walking，but the symptoms obviously improved as compared with preoperative symptoms，the patients were advised to wear stretch socks with no further interventional therapy. Conclusions Minimally invasive therapy on lower extremity DVT can eliminate thrombus from venous cavity more early，restore the unobstructed flow instantly，preserve the function of venous valve in a greater degree. It has an advantage of minimally invasive，less complications，and notable clinic effect of short-term and medium-term follow-up.
ObjectiveTo systematically evaluate the efficiency and safety of interventional embolization versus laparoscopic surgery in the treatment of varicocele. MethodsWe searched the Chinese Journal Full-text Database, Wanfang Medical Journal Database, and VIP Chinese Science and Technology Journal Full-text Database with such keywords as interventional therapy, embolization, laparoscope, and varicocele. For PubMed and Cochrane Library, MESH terms or keywords were interventional embolization, interventional therapy, embolization, laparoscope, laparoscopic surgery, and varicocele. All database were searched up to March 2015. Then we selected trials comparing interventional embolization versus laparoscopic surgery in the treatment of varicocele according to the including criteria. We assessed the quality of the included studies with the Newcastle-Ottawa Scale and conducted meta-analysis with revman 5.2 for the primary outcomes sperm improvement rate, recurrence rate, complication rate, pregnant rate, etc. ResultsWe included 7 trials comparing interventional embolization with laparoscopic surgery, including 1 prospective study and 6 retrospective studies, with a total of 349 patients receiving interventional therapy and 400 patients receiving laparoscopic surgery. Meta analysis of the included studies showed that there were no significant differences for sperm improvement rate[OR=1.17, 95%CI (0.70, 1.96), P=0.54], pregnant rate[OR=0.58, 95%CI (0.29, 1.13), P=0.11], recurrence rate[OR=0.84, 95CI% (0.40, 1.78), P=0.66] or complication rate[OR=0.68, 95%CI (0.34, 1.32), P=0.25] between the two groups. ConclusionPresent evidence shows that there is no significant difference between interventional embolization and laparoscopic surgery for varicocele.
Abstract: Percutaneous balloon pulmonary valvuloplasty (PBPV) has become the first choice for the treatment of pulmonary valve stenosis (PS). PBPV is used not only in the independent way to relieve Milo-Ⅰ amp; Ⅱ type of PS as an alteration of surgery, but also in the combination way with surgical treatment to some multiple or complex congenital heart defect,where it plays a part as a pre-operative appeasement or a co-operative procedure, even a supplementary expedience to some failed surgery post-operatively. In this paper, the anatomic classification of PS, the usage of ultrasounic examination, the indication and contraindication, the method and skill during operation, and the effect evaluation of PBPV are reviewed.
Objective To evaluate the trends, dominant diseases and clinical outcomes of the global interventional therapy for tumors based on evidence, so as to provide references for standard access of interventional technology. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI and VIP were electronically and comprehensively searched for relevant clinical or fundamental studies about interventional therapy for tumors from inception to September, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. Then, descriptive analysis was performed using SPSS 13.0 and Microsoft Excel 2003 software. Results Totally, 4 544 studies were included, consisting of 4 136 (91.0%) clinical studies and 408 (9.0%) fundamental studies. These clinical studies including 155 systematic reviews (SRs), 338 randomized controlled trials (RCTs), 1 191 clinical controlled trials (CCTs), and 2 451 case series or case reports (CSs/CRs). Transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were the most clinically frequenly-used interventional technologies for tumors, accounting for 32.6% and 17.1% of the total, respectively. Hepatocellular carcinoma (HCC) was the dominant tumor, which was mentioned in 99 SRs (57.6%), 198 RCTs (58.6%), 824 CCTs (69.1%) and 1 191 CSs/CRs (48.6%), following by colorectal liver metastases (CLM). Radiofrequency ablation (RFA) treating HCC resulted in a higher rate of 3-year survival (12 SRs/Meta-analyses) and lower recurrence (10 SRs/Meta-analyses) compared with percutaneous ethanol injection (PEI). Compared with hepatic resection (HR), RFA treating HCC resulted in lower rates of 3-year (11 SRs/Meta-analyses) and 5-year survival (9 SRs/Meta-analyses), and no significant difference was found in 1-year survival between the two groups (17 SRs/Meta-analyses). Preoperative TACE before HR or liver transplantation could not improve the survival for patients with advanced HCC (6 SRs/Meta-analyses), but postoperative TACE might prolong the 1-and 3-year survival (3 SRs/Meta-analyses). TACE combined with other interventional therapy (i.e., RFA, PEI) could also prolong the survival of HCC patients. For the treatment of uterine leiomyoma, uterine artery embolization (UAE) resulted in less hospital duration or operative time, and it caused a higher re-intervention rate, compared with surgery, but it lacked long-term outcomes. Conclusion Interventional therapy is an optional and promising technology for patients with tumors. We should well-consider currently available best clinical evidence as well as local medical facilities or skill level when applying them to clinical practice, so as to perform relevant interventional techniques with scientific, rational and standardized methods.
The planning and reporting of synthesis questions in systematic review of intervention have a direct and important impact on the validity of the evaluation and the credibility of the results. Planning helps to reduce bias in the evaluation process and ensure the reproducibility of data synthesis. However, the field of systematic review currently lacks specific checklists and tools to guide how to plan and report these issues. The InSynQ (Intervention Synthesis Questions) checklist is a tool designed for planning and reporting data synthesis issues in systematic reviews of interventions. Its goal is to promote the standardization of systematic review methods, support systematic review participants in planning and comprehensively reporting data synthesis issues and structures, and provide a more accurate evidence base for clinical decision-making.
Abstract： Objective To analyze clinical outcomes of interventional therapy for common congenital heart diseases （CHD）. Methods We retrospectively analyzed the clinical records of 57 patients with CHD who underwent catheter interventional therapy in People’s Hospital of Deyang City between March 2009 and January 2012. There were 31 male patients and 26 female patients with their mean age of 29.4±3.5 years（ranging from 1.5 to 75.0 years）. There were 21 patients with patent ductus arteriosus （PDA）, 12 patients with ventricular septal defect （VSD）, and 20 patients with atrial septal defect（ASD）；and 2 patients with VSD plus ASD, 1 patient with VSD plus PDA, and 1 patient with ASD plus PDA. Occluder and supplying system made in China were used in the interventional therapy. For the patients with ASD plus PDA, PDA was blocked before ASD；for the patients with VSD plus PDA, PDA was blocked before VSD；and for the patients with VSD plus ASD, VSD was blocked before ASD. Results The duration of interventional therapy ranged from 30 to 90 minutes. The success rate of operation was 98.3%（56/57）. Operation was given up in an old female patient with ASD and chronic obstructive pulmonary disease because of pulmonary hypertension. The hospital stay was 3 -7 days. All the patients were followed up at the outpatient department for 1 month to 2 years by color Doppler echocardiogram, chest X-ray and electrocardiograph, and no complication occurred during follow-up. Conclusion With complete understanding of surgical indications and strict compliance with procedures, catheter interventional therapy is safe, minimal invasive, and effective in CHD treatment.
Objective To study the effect of the intracavity thrombolysis, aspiration of debris, percutaneous transcathete angioplasty (PTA) and percutaneous transtuminl angioplasty and stenting (PTAS) on treating peripheral arterial obliterans disease (PAOD). Methods From May 1994 to May 2008, interventional treatment was performed in 285 patients with PAOD. Intracavity thrombolysis and aspiration of debris were performed in 63 patients suffering from acute arterial occlusion. Intracavity thrombolysis and PTA were performed in 61 patients suffering from arteriostenosis combined with acute occlusion. Intracavity thrombolysis, PTA and PTAS were performed in 161 patients suffering from chronic arteriostenosis occlusion. Results Total success rate was 98.25% (280/285). The success rate in intracavity thrombolysis and aspiration of debris was 96.83% (61/63), with 88.89% (56/63) of the blood vessels restored, 7.94% (5/63) of the blood vessels partially restored, and another 3.17% (2/63) failed. The success rate in intracavity thrombolysis and PTA was 85.25% (52/61). The success rate in PTA and PTAS was 98.14% (158/161). The total complication rate was 7.02% (20/285), of them the local thrombolysis and thromboclasis accounting for 7.94% (5/63), the local thrombolysis and PTA accounting for 14.75% (9/61), the PTA and stent implantation accounting for 3.73% (6/161). Conclusion Percutaneous transluminal treatment for stenotic and occlusive lesions of peripheral artery can effectively keep the blood vessel unobstructed for a long time and raise the haemodynamics index remarkably.