ObjectiveTo evaluate the effects of duct-to-mucosa pancreaticojejunostomy (dmPJ) and invagination pancreaticojejunostomy (iPJ) during pancreaticoduodenectomy (PD) on postoperative outcomes. MethodsPubmed, The Cochrane Library, Embase, Wanfang and CNKI database were searched to identify randomized controlled trials (RCTs) evaluating different type of pancreaticojejunostomy during PD. The literatures were screened according to inclusion and exclusion criteria. Quality assessment was conducted according to Jadad scoring system. ResultsNine RCTs were included, 1 032 patients were recruited, including 510 patients in dmPJ group and 522 patients in iPJ group. Meta-analysis indicated that there were no significant differences between two groups in terms of the incidence of pancreatic fistula in total (OR=0.95, P=0.78), clinical relevant pancreatic fistula (OR=0.78, P=0.71), overall morbidity (OR=0.93, P=0.60), perioperative mortality (OR=0.86, P=0.71), reoperation rate (OR=1.18, P=0.59), and length of hospital stay (WMD=-1.11, P=0.19). ConclusionDmPJ and iPJ are comparable in terms of pancreatic fistula and other complications.
ObjectiveTo explore the value of ultrasonic score, blood vessels and vascular resistance index in predicting and diagnosing benign and malignant ovarian tumor. MethodsA total of 157 patients with ovarian tumors (77 benign and 80 malignant) aged from 19 to 68 years old (average 56 years) between January 2008 and June 2012 were enrolled in the research. The ultrasonic score, blood vessels and vascular resistance index were recorded, and the differences between benign and malignant tumor were compared according to the pathological diagnosis; Their sensitivities and specificities were analyzed with the preoperative prediction. ResultsIn benign ovarian tumor, ultrasound scores and blood vessels index were obviously lower than that in the malignant tumor (P<0.05); the vascular resistance index was much higher than that in the malignant tumor (P<0.05). The sensitivities and specificities in diagnosing malignant tumor were high when the ultrasonic score was ≥ 2, vascular index was>0.02/cm3, and blood flow resistance index was ≤ 0.6. The sensitivities were 92.5%, 90.0%, 87.5%, respectively; while the specificities were 90.9%, 89.6%, 84.4%, respectively. ConclusionUltrasonic score, blood vessels and vascular resistance index have significance for identifying benign and malignant ovarian tumors; ultrasonic score is more accurate which has high value of clinical application and popularization.
ObjectiveTo comprehensively collect quality assessment tools of systematic review/meta-analysis (SR/MA) of randomized controlled trials (RCTs), and compare the differences of numbers and contents of items, in order to provide references for optimizing and using these quality assessment tools. MethodsWe searched PubMed and EMbase databases up to December 31th, 2013 for quality assessment tools of SR/MA of RCTs. EndNote X3 software was used for screening literature and Excel 2010 software was used for data extraction. A descriptive analysis was performed. ResultsA total of 61 studies including 32 quality assessment tools were included. Among them, 30 tools were for methodological quality and 2 tools for reporting quality. These tools were developed by different medical universities or colleges, research institutes, national health institutes, and some famous epidemiologists and methodologists from 1984 to 2007. Among the 32 tools, 4 tools were scales, while 28 were checklists. The numbers of items of these tools ranged from 5 to 101, among them, 9 tools had more than 20 items. ConclusionThere are many quality assessment tools for SR/MA, but none of them is generally acknowledged. The quality, contents of items, and applicability of these tools are different, and some of them are too long to use. In practice and decision-making, most of the tools have the problems of low relevance and applicability. How to regularly use these tools to guide the research, practice and decision-making of SR/MA is still needed to be further researched.
ObjectiveTo investigate the efficacy and safety of internal rib fixation for patients with multiple rib fractures. MethodsA total of 141 patients with multiple rib fractures who were admitted to Department of Thoracic Surgery of the Sixth Affiliated Hospital of Xinjiang Medical University between January 2010 and January 2013 and whose chest trauma score (AIS-ISS) was 9-20 (16±2) were recruited in this study. Using the random number generator of SPSS, all the patients were randomly divided into an internal fixation group [69 patients including 41 males and 28 females with their age of 25-61 (37±4) years] who underwent internal rib fixation, and a control group [72 patients including 43 males and 29 females with their age of 24-63 (35±5) years] who received conservative therapy. Plasma C-reactive protein (CRP) patients' satisfaction degree with thoracic appearance,incidence of lung infection,pain-relieving efficacy,postoperative chest drainage duration and length of hospital stay were compared between the 2 groups. ResultsPlasma CRP levels of the internal fixation group were not statistically different from those of the control group in 1-3 days after injury (P>0.05) but were significantly lower than those of the control group in 4-12 days after injury (P<0.05). Patients' satisfaction degree with thoracic appearance (97.1% vs. 48.6%,P<0.05) and pain-relieving efficiency (91.3% vs. 68.1%,P<0.05) of the internal fixation group were significantly higher than those of the control group. Incidence of lung infection of the internal fixation group was significantly lower than that of the control group(11.6% vs. 37.5%,P<0.01). Postoperative chest drainage duration [(3±2) d vs. (7±4) d,P<0.05] and length of hospital stay [(9±4) d vs. (15±7) d,P<0.05] of the internal fixation group were significantly shorter than those of the control group. ConclusionsFor patients with multiple rib fractures and stable vital signs,internal fixation surgery is helpful to shorten length of hospital stay, relieve chest pain and improve thoracic appearance. It can also reduce lung inflammation and increase surgical safety so as to improve treatment outcomes of multiple rib fractures.
ObjectiveTo investigate the expression of tumor necrosis factor-α (TNF-α) in prostate cancer tissue and explore its relations with tumor angiogenesis. MethodsThe expression of TNF-α and CD105 were detected with two-step immunohistochemical staining technique in 20 cases of benign prostatic hyperplasia and 50 cases of prostate cancer between January 2010 and January 2012, and microvessel density (MVD) marked with CD105 was also measured. ResultsThe expressions of TNF-α and CD105 were higher in prostate cancer (41.72±8.67, 20.15±2.67) than those in benign prostatic hyperplasia (21.01±3.85, 4.34±1.67) (t'=13.990, P<0.001; t'=29.771, P<0.001). TNF-α and MVD were not correlated with age and size of tumor, but were positively correlated with tumor differentiation degree (rs=0.847, P<0.001; rs=0.776, P<0.001) and negatively correlated with clinical grades (rs=-0.769, P<0.001; rs=-0.842, P<0.001). ConclusionThe result indicates that over expression of TNF-α exists in prostate cancer. It may play an important role in the anginogenesis and carcinogenesis of prostate cancer.
The method for detecting the negative terms in Chinese electronic medical record (EMR) is useful in providing evidence for constructing concept index. In this respect, we adopted an improved method which combined maximum matching with mutual information in order to extract terms in EMRs. This method can overcome the influence of overlay ambiguity. In addition, for the determination of negative semantic, we also adopted an improved method which combined rule-based method with word co-occurrence. This new method can reduce the probability of appearance of false positive terms caused by punctuation input errors. The result showed that the negative predictive value is 7.85% higher than the rule-based method.
Clinic expert information provides important references for residents in need of hospital care. Usually, such information is hidden in the deep web and cannot be directly indexed by search engines. To extract clinic expert information from the deep web, the first challenge is to make a judgment on forms. This paper proposes a novel method based on a domain model, which is a tree structure constructed by the attributes of search interfaces. With this model, search interfaces can be classified to a domain and filled in with domain keywords. Another challenge is to extract information from the returned web pages indexed by search interfaces. To filter the noise information on a web page, a block importance model is proposed. The experiment results indicated that the domain model yielded a precision 10.83% higher than that of the rule-based method, whereas the block importance model yielded an F1 measure 10.5% higher than that of the XPath method.
ObjectiveTo discuss the relationship between antinuclear antibody (ANA) fluorescence pattern detected by indirect immunity fluorescence (IIF) and antinuclear antibody profiles (including anti-dsDNA, RNP, Sm, SSa, SSb, Scl-70, Jo-1 and rib-P) in human serum. MethodsA total of 7385 cases of ANA pattern and ANA profiles were retrospectively analyzed from January 2010 to December 2013. ANA was detected by IIF substrated as HEp-2 cells, anti-dsDNA by IIF substrated as crithidia, and the other 7 antibodies by enzyme immunoblot with purified antigen. ResultsGranular pattern mostly presented as anti-RNP, anti-Sm, anti-SSa and anti-SSb (P < 0.001); homogeneous pattern was anti-dsDNA and anti-SSa (P < 0.001); nucleolus, centromere, and mixed pattern was anti-SSa (P < 0.05); cytoplasm pattern was anti-rib-P and anti-SSa (P < 0.05). But few above antibodies could be detected in Golgi, dots, rim, actin, actotropomyosin, prolifevating cell nuclear antigen (PCNA) and vementin pattern. Homogeneous pattern was shown up to 77.91% in only anti-dsDNA positive serum; granular was 96.84%, 52.01%, and 82.35% respectively in only anti-RNP or anti-SSa or anti-Sm positive. Homogeneous and nucleolus mix pattern was up to 30.53% in only anti-Scl-70 positive. Cytoplasm pattern was 50.00% and 61.54% respectively in only anti-rib-P or anti-Jo-1 positive. But no fixed relationship was found between ANA pattern and anti-SSb. ConclusionsThere is a certain relationship between ANA and antinuclear antibody profiles. Granular, homogeneous and cytoplasm pattern often can be detected more than one autoantibodies. Eight kinds of specific autoantibodies often are negative when ANA patterns are centromere, Golgi, dots, rim, actin, tropomyosin, PCNA, and vimentin. Anti-dsDNA is mainly corresponding to homogeneous, anti-RNP, anti-SSa and anti-Sm to granular, anti-Scl-70 to homogeneous and nucleoli, anti-rib-P and anti-Jo-1 to cytoplasm. The study can give suggestions for further tests application and lab result checking.
Objective To explore the relationship between immune state and disease progression or severity of patients with hepatitis B virus (HBV). Methods A total of 332 patients infected with HBV diagnosed and treated from January 2012 to December 2013 were divided into acute hepatitis B (AHB) group (n=25), chronic hepatitis B (CHB) group (n=237) and cirrhosis group (n=70) according to disease progression. Moreover, CHB group was divided into mild (n=24), moderate (n=103), serious (n=72) and severe group (liver failure group,n=38) according to disease severity, while cirrhosis group was divided into hepatocellular carcinoma (HCC) group (n=13) and non-HCC group (n=57). The immune indexes including immunoglobulin (Ig), complement (C) and T-lymphocyte subsets were tested and compared. Results The immune indexes were not significantly different between AHB group and CHB group (P>0.05). Compared with AHB group and CHB group, cirrhosis group had higher levels of IgG and IgA, and lower levels of CD3+, CD4+ and CD8+ T cells count (P<0.05). Compared with non-HCC group, HCC group had more male patients without antiviral therapy, who had higher levels of C3 and C4 (P<0.05). As disease progressed, the levels of alanine fcell couaminotransferase, aspartate aminotransferase, total cholesterol, Fibroscan index, IgG, and IgA of CHB patients all gradually increased, while the levels of C3 and C4 and the counts of CD3+ and CD4+ T cells gradually declined. Conclusions The immune state of patients infected with HBV has a certain relationship with disease progression or severity, and immunoglobulin, complement and T cells count can partly reflect the severity of the disease. Cirrhosis patients accompanied with high levels of C3 and C4 should pay high attention to antiviral therapy and be vigilant on HCC.
Objective To investigate the current situations of human resource management in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of human resource management, we designed the questionnaire to investigate the human resource management among 307 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results 56% participants considered that the public pharmacists had professional qualities. Nearly 73% considered that there were good interpersonal relationship; 45% wanted to do present job. Nearly 75% thought that the mechanism of performance appraisal should be consummated. About 63% considered that the learning and training was not fitting and proper. 63%thought they could not develop their ability and talent. Conclusion The human resource management system in public pharmacies should be improved.