Objective:To explore the clinical effect of applying emergency gastroscopy in the treatment of patients with acute bleeding of gastric cancer.Methods:A total of 80 patients with upper gastrointestinal bleeding caused ...Objective:To explore the clinical effect of applying emergency gastroscopy in the treatment of patients with acute bleeding of gastric cancer.Methods:A total of 80 patients with upper gastrointestinal bleeding caused by gastric cancer who were admitted in our hospital from December 2017 to December 2018 were selected and recruited.These patients were divided into two groups,namely the control group and experimental group by random number method,and were given conventional drug treatment and emergency gastroscopy treatment respectively.There were 40 patients in each group.The treatment effect and complication rate of the patients in each group were compared.Results:The rate of efficacy of emergency gastroscopy treatment in patients of the experimental group was 95.00%,whereas the rate of efficacy of conventional drug treatment in patients of the control group was 82.50%.The efficacy rate in the experimental group was higher,and the data were significantly different after statistical comparison.Before treatment,the Karnofsky functional status scores of the patients in both control group and experimental group were not significantly different.After treatment,the patients’scores were all improved.Compared with the control group,the experimental group had a higher degree of improvement,and the effect was more significant.There was a statistically significant difference in data between the two groups(P<0.05).Conclusion:Gastroscopy treatment of patients with acute gastrointestinal bleeding caused by gastric cancer can effectively shorten the bleeding time of patients,reduce the incidence of postoperative complications,and have positive impact for the prognosis of patients.展开更多
BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distin...BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.展开更多
BACKGROUND The incidence of esophageal cancer is high,and its prognosis is poor.Endoscopic submucosal dissection(ESD)is an important,minimally invasive treatment for early esophageal cancer,but the risk of postoperati...BACKGROUND The incidence of esophageal cancer is high,and its prognosis is poor.Endoscopic submucosal dissection(ESD)is an important,minimally invasive treatment for early esophageal cancer,but the risk of postoperative bleeding affects its efficacy.AIM To explore risk factors of bleeding after ESD and evaluate the predictive value of a gradient boosting machine(GBM)model for postoperative bleeding.METHODS The clinical data of 178 early esophageal cancer patients who underwent ESD at the Affiliated Hospital of Xuzhou Medical University from October 2019 to October 2024 were analyzed retrospectively.Patients were divided into two groups(bleeding and non-bleeding).Univariate and multivariate logistic regression analyses identified risk factors for postoperative bleeding,leading to the construction of the GBM prediction model.The receiver operating characteristic(ROC)curve evaluated the predictive efficacy of the GBM model and bleeding after ESD trend from Japan(BEST-J)score.RESULTS Among 178 patients who received ESD treatment,29 cases(16.29%)had bleeding,and 149 cases(83.71%)had no bleeding.The average BEST-J score and the proportion of high-risk and extremely high-risk patients were higher in the bleeding group than in the non-bleeding group(P<0.05).Multivariate logistic regression analysis showed that tumor size≥3 cm,surgical bleeding,and Creactive protein(CRP)were independent risk factors for bleeding after ESD in patients with early esophageal cancer(P<0.05).The ROC curve showed that the area under the curve of the GBM prediction model based on the influencing factors was greater than that of the BEST-J score(0.818 vs 0.653,P<0.05).CONCLUSION The GBM prediction model based on tumor size≥3 cm,surgical bleeding,and high CRP levels is more effective than the BEST-J score at predicting bleeding after ESD.展开更多
Objective: to explore the clinical treatment measures and therapeutic effects of functional uterine bleeding. Methods: from January 2020 to January 2022, 20 patients with functional uterine bleeding were selected and ...Objective: to explore the clinical treatment measures and therapeutic effects of functional uterine bleeding. Methods: from January 2020 to January 2022, 20 patients with functional uterine bleeding were selected and randomly divided into the control group and the observation group according to the coin toss method. The number of patients in each group was n 25. Twenty-five patients in the control group were treated with medroxyprogesterone and 25 patients in the observation group were treated with mifepristone. After two different drug treatments, the two groups were compared. Results: twenty-five patients in the control group were treated with progesterone and 25 patients in the observation group were treated with mifepristone. The total effective rate of 25 patients in the observation group was 96.00%, while that of 25 patients in the control group was 72.00%. Conclusion: mifepristone can inhibit endometrial growth, promote menopause and correct anemia in patients with functional uterine bleeding, and it has less side effects on patients. It is an ideal drug for the treatment of menopausal dysfunctional uterine bleeding, and it is worthy of being widely used clinically.展开更多
AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-...AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-of-hours emergency endoscopy service,even at weekends.A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled.Analyzed parameters included time from patients' arrival until endoscopy,mortality,rebleeding,need for surgery and length of hospital stay.RESULTS:The weekday and weekend admission groups comprised 326 and 62 patients,respectively.There were no significant differences in baseline characteristics between the two groups,except for younger age in the weekend group.Most patients (97%) had undergone early endoscopy,which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend).The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%,P = 0.030).However,multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding,rather than weekend admission.CONCLUSION:Early endoscopy for peptic ulcer bleeding can prevent the weekend effect,and nighttime admission was identified as a novel risk factor for rebleeding,namely the nighttime effect.展开更多
BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection(ESD)in early gastric cancer(EGC)patients.There are limited studies on estimating the bleeding risk after ESD using an artifi...BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection(ESD)in early gastric cancer(EGC)patients.There are limited studies on estimating the bleeding risk after ESD using an artificial intelligence system.AIM To derivate and verify the performance of the deep learning model and the clinical model for predicting bleeding risk after ESD in EGC patients.METHODS Patients with EGC who underwent ESD between January 2010 and June 2020 at the Samsung Medical Center were enrolled,and post-ESD bleeding(PEB)was investigated retrospectively.We split the entire cohort into a development set(80%)and a validation set(20%).The deep learning and clinical model were built on the development set and tested in the validation set.The performance of the deep learning model and the clinical model were compared using the area under the curve and the stratification of bleeding risk after ESD.RESULTS A total of 5629 patients were included,and PEB occurred in 325 patients.The area under the curve for predicting PEB was 0.71(95%confidence interval:0.63-0.78)in the deep learning model and 0.70(95%confidence interval:0.62-0.77)in the clinical model,without significant difference(P=0.730).The patients expected to the low-(<5%),intermediate-(≥5%,<9%),and high-risk(≥9%)categories were observed with actual bleeding rate of 2.2%,3.9%,and 11.6%,respectively,in the deep learning model;4.0%,8.8%,and 18.2%,respectively,in the clinical model.CONCLUSION A deep learning model can predict and stratify the bleeding risk after ESD in patients with EGC.展开更多
Objective: to explore the value of Baogong Zhixue Granule combined with hysteroscopic electrotomy in the treatment of perimenopausal abnormal uterine bleeding. Methods: 323 patients with perimenopausal abnormal uterin...Objective: to explore the value of Baogong Zhixue Granule combined with hysteroscopic electrotomy in the treatment of perimenopausal abnormal uterine bleeding. Methods: 323 patients with perimenopausal abnormal uterine bleeding admitted by the department of gynecology in our hospital were selected for the study, which lasted from 2008 to 2021. The patients were divided into control group (n161) and observation group (n162). The control group was treated with routine hysteroscopic electrotomy, while the observation group was treated with Baogong Zhixue Granule. The clinical efficacy, postoperative complication rate, anemia status, sex hormone level and menstrual blood loss graph score were compared between the two groups. Results: the clinical effective rate of the observation group was 98.77%, higher than that of the control group (P0.05). The postoperative complication rate in the observation group was 1.85%, lower than that in the control group (P0.05). The anemia rate and repeated bleeding rate in the observation group were 12.35% and 0.62%, respectively, lower than those in the control group (P0.05). The bleeding stop time in the observation group was (4.52 ± 1.54) days, which was shorter than that in the control group (P0.05). After treatment, the menstrual blood loss graph score, LH level, FSH level and E2 level in the observation group were (3.04 ± 0.65) points, (8.89 ± 2.13) IU/L, (7.26 ± 2.55) IU/L and (208.65 ± 26.13) poml/L, respectively, compared with the control group (P0.05). Conclusion: Baogong Zhixue Granule combined with hysteroscopic electrotomy is effective in the treatment of perimenopausal abnormal uterine bleeding, which can improve the sex hormone level of patients, reduce postoperative complications, prevent anemia, and promote rehabilitation. It is worth popularizing.展开更多
BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE...BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.展开更多
BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Altho...BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Although these modalities are widely used,their comparative efficacy and safety across different patient populations and anatomical sites remain controversial.AIM To evaluate the clinical outcomes and safety of endoscopic hemostasis combined with vascular interventional therapy for NVUGIB.METHODS A systematic search was done on PubMed,EMBASE,Cochrane Library,and Web of Science(from database establishment to April 2025).Randomized controlled trial(RCT)quality was assessed via Cochrane RoB 2.0,and observational studies via the Critical Appraisal Skills Program.RevMan 5.4 was used for quantitative analysis;fixed/random-effects models were chosen through I^(2)-assessed heterogeneity.Publication bias was checked using funnel plots and sensitivity analysis via model switching.RESULTS Twenty-one studies(3 RCTs,12 single-group studies,and 6 retrospective cohort studies)with good quality were included.For single-group data,combined therapy had risk differences of 0.70(clinical success),0.24(mortality),and 0.22(rebleeding;all P<0.00001,I^(2)=0).Moreover,the≥60-year rebleeding risk difference was 0.43.Reintervention was found to differ by approach(Z=3.03,P=0.002,inter-subgroup I^(2)=99%).In the RCT and cohort studies,combined vs standard therapy had similar initial hemostasis(Z=0.04,P=0.97)and mortality(Z=1.56,P=0.12)but lower rebleeding(Z=3.26/P=0.001;Z=2.95/P=0.03).Symmetrical funnel plots and robust sensitivity analysis showed no publication bias.CONCLUSION Combined endoscopic hemostasis and vascular interventional therapy for acute NVUGIB can significantly reduce rebleeding,without differences in mortality.Age and vascular interventional methods may influence the therapeutic efficacy.展开更多
In this editorial we comment on the article by Wang et al,recently published on World Journal of Clinical Cases.Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a common and potentially serious ga...In this editorial we comment on the article by Wang et al,recently published on World Journal of Clinical Cases.Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a common and potentially serious gastroenterological emergency.Wang et al conducted a detailed study on the management of AN-VUGIB in a high-volume center in the Shaanxi region,China.Analyzing data from over 530 patients provided a comprehensive overview of clinical,epidemio-logical,and treatment characteristics.Results highlighted a younger patient population compared to European studies,with a higher prevalence of gastric and duodenal ulcers as the leading cause of bleeding.Endoscopic treatment is cur-rently the preferred therapeutic option,offering a variety of effective techniques.This study emphasizes the importance of implementing current guidelines in ANVUGIB management and highlights the crucial role of endoscopy in its management.展开更多
BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counselin...BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.展开更多
Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gast...Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gastrointestinal bleeding as the main direction.160 patients with upper gastrointestinal bleeding who received treatment in our hospital were selected as samples,and the grouping software was used to divide them into the reference group and the study group,with 80 patients each.The reference group and the study group used routine health education and staged health education respectively.Relevant research data were recorded during the nursing process,analyzed,and used as research indicators.Results:The compliance behavior of the study group was higher than that of the reference group after the staged nursing care,and at the same time,the nursing care satisfaction of the study group was higher than that of the reference group(P<0.05).Conclusion:The use of staged health education for the care of patients with upper gastrointestinal bleeding not only enhances the degree of patient awareness and compliance but also improves nursing satisfaction,which is worthy of promotion and application.展开更多
Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups ...Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.展开更多
A newly developed mouthrinse, Allantoin Powder for Gargle, was clinically investigated. The compound of this agent is mainly allantoin, which is believed easy to penetrate into gingival sulcus and periodontal pockets ...A newly developed mouthrinse, Allantoin Powder for Gargle, was clinically investigated. The compound of this agent is mainly allantoin, which is believed easy to penetrate into gingival sulcus and periodontal pockets as well as other places (such as tongue, soft palate, etc.) where it is inconvenient to use medication, 219 patients with various diseases of oral cavity were investigated in the double blind randomlized placebo controlled study. It was observed that apparent efficient rates of the experimental mouthrinse on periodontitis and marginal gingivitis were 81.25% and 56.86% respectively; and the efficient rate of it on aphthous ulcer was 68.57%. The data show that this agent has effective as an adjuctive on the treatments of periodontal diseases and aphthous ulcer.展开更多
Thermal performance is the most important factor in the development of a borehole heat exchanger utilizing geothermal energy.The thermal performance is affected by many different design parameters and different operat...Thermal performance is the most important factor in the development of a borehole heat exchanger utilizing geothermal energy.The thermal performance is affected by many different design parameters and different operating conditions such as bleeding.This eventually determines the operation and cost efficiency of the borehole heat exchanger system.The thermal performance of an open standing column well (SCW) type geothermal heat exchanger was assessed under the influence of bleeding.For this,a thermal response test rig was established with line-source theory.The test rig also had a bleeding function by releasing fluid while taking additional underground water through the heat exchanger.The thermal response test was performed with an additional constant input heat source.Effective thermal conductivity and thermal resistance were obtained from the measured data.From the measurement,the effective thermal conductivity is found to have 1.47 times higher value when bleeding is applied.The thermal resistance also increases by 1.58 times compared to a non-bleeding case.This trend indicates enhanced heat transfer in the SCW type heat exchanger with a bleeding function.Bleeding,therefore,could be an effective method of achieving a high heat transfer rate in the SCW type heat exchanger with sufficient underground water supply.展开更多
Objective:Objective to explore the curative effect of transforaminal endoscopic surgery in the treatment of lumbar disc herniation.Methods:From October 2018 to October 2020,36 patients with lumbar disc herniation were...Objective:Objective to explore the curative effect of transforaminal endoscopic surgery in the treatment of lumbar disc herniation.Methods:From October 2018 to October 2020,36 patients with lumbar disc herniation were randomly divided into group A and group B.the curative effect,pain,lumbar function and quality of life were analyzed.Results:The curative effect of group A was 94.44%,better than that of group B 61.11%,P<0.05;The visual analogue scale(VAS)of group A was lower than that of group B on 3D,5D and 7d after operation(P<0.05);The KSS of group A was higher than that of group B(P<0.05);The score of quality of life in group A was better than that in group B(P<0.05).Conclusion:Lumbar disc herniation patients underwent transforaminal endoscopic surgery,the effect is good,can improve lumbar function,relieve pain,improve the quality of life of patients.展开更多
Objective:The application of Chinese materia medica(CMM)in clinical diseases is the embodiment and continuation of the property theory of CMM(PTCMM).However,due to a lack of precise quantitative description methods,it...Objective:The application of Chinese materia medica(CMM)in clinical diseases is the embodiment and continuation of the property theory of CMM(PTCMM).However,due to a lack of precise quantitative description methods,it is difficult to systematically analyze the property of CMM(PCMM)and clinical effect features at the micro molecular level.Methods:The therapeutic drugs and targets were obtained from the Drugbank database.The molecular descriptors of these drugs were calculated based on Dragon software.Drug-effect relationships that integrated the molecular descriptors and effect descriptors were plotted as grayscale images.These images were used to train the Le Net-5 model and the Alex Net model.The best-performing model was used to predict the effect features of the CMM compounds.Finally,the effect features of the PCMM combinations were calculated based on the support vector machine recursive feature elimination algorithm.Results:The Alex Net model showed a superior prediction performance.The results showed that its accuracy,precision,sensitivity,F-measure,and Matthews correlation coefficient on the training set were 0.940,0.936,0.945,0.940,and 0.880,respectively,and those of the test set were 0.909,0.901,0.920,0.910,and 0.819,respectively.A total of 399 compounds in the 42 CMMs for promoting blood circulation and removing blood stasis were predicted by this model.The key effect features of the Han-Ku-Gan combination were anti-inflammatory,anti-tumor,anti-atherosclerosis,anti-Parkinson,hypoglycemic,and anti-coagulant properties,as well as excitation of uterine smooth muscle.The key effect features of the Wen-Xin-Gan combination were anti-inflammatory,anti-atherosclerosis,anti-hypertensive,anticoagulant,anti-tumor,and anti-cardiac insufficiency effects,as well as enhanced immunity,sedation and hypnosis,and analgesia.Conclusion:This study provides a new method for the further exploration of the relationship between the PCMM and clinical effect features.展开更多
BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years...BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.展开更多
Objective:To research the effect of conventional treatment(Gingko biloba extract(GBE)+continuous positive airway pressure(CPAP)ventilation)combined with acupuncture on the changes of blood pressure,respiratory efficie...Objective:To research the effect of conventional treatment(Gingko biloba extract(GBE)+continuous positive airway pressure(CPAP)ventilation)combined with acupuncture on the changes of blood pressure,respiratory efficiency,oxidative index,and clinical effect in patients with OSAHS combined with hypertension.Method Selecting 80 patients with OSAHS combined with hypertension,then they were randomly divided into observation group(n=40)and control group(n=40).The patients in the control group were given conventional drug therapy(GBE)and rehabilitation and CPAP,and the observation group were given acupuncture on this basic,they were treated 14 days.The primary endpoints were the changes from baseline to day 14 in blood pressure;the secondary endpoints were changes from baseline to day 14 in the respiratory efficiency(PSG);the tertiary endpoints were changes from baseline to day 14 in the oxidative related substances(SOD,GSH-Px,ROS,and MDA).Results After 14-day treatment,the respiratory efficiency index were better than pretherapy(p<0.05),and the observation group were better than control group(p<0.05);the blood pressure were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the ROS and MDA were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the SOD,GSH-Px were higher than pretherapy(p<0.05),and the observation group were higher than control group(p<0.05);the clinical effect of hypotensive in the observation group were better control group(p<0.05).Conclusion 14-day treatment of conventional treatment combined with acupuncture can improve the imbalance of oxidation and antioxidation and blood pressure.展开更多
Reticulocytosls in rats was induced by repetitive bleeding. Both the in vitro and the in vivo studies showed that the detected reductive speed of methemoglobin of the bleeding group was faster than that of the control...Reticulocytosls in rats was induced by repetitive bleeding. Both the in vitro and the in vivo studies showed that the detected reductive speed of methemoglobin of the bleeding group was faster than that of the control group at all time intervals. At the same time, the NADH-cytochrome b5 methemoglobin reductase activity and the molybdenum content in erythrocytes of the bleeding group were significantly increased. Regressional analysis showed that there was a significantly positive correlation between the enzyme activity and the molybdenum content. It is proposed that molybdenum might be required for the enzyme activity展开更多
文摘Objective:To explore the clinical effect of applying emergency gastroscopy in the treatment of patients with acute bleeding of gastric cancer.Methods:A total of 80 patients with upper gastrointestinal bleeding caused by gastric cancer who were admitted in our hospital from December 2017 to December 2018 were selected and recruited.These patients were divided into two groups,namely the control group and experimental group by random number method,and were given conventional drug treatment and emergency gastroscopy treatment respectively.There were 40 patients in each group.The treatment effect and complication rate of the patients in each group were compared.Results:The rate of efficacy of emergency gastroscopy treatment in patients of the experimental group was 95.00%,whereas the rate of efficacy of conventional drug treatment in patients of the control group was 82.50%.The efficacy rate in the experimental group was higher,and the data were significantly different after statistical comparison.Before treatment,the Karnofsky functional status scores of the patients in both control group and experimental group were not significantly different.After treatment,the patients’scores were all improved.Compared with the control group,the experimental group had a higher degree of improvement,and the effect was more significant.There was a statistically significant difference in data between the two groups(P<0.05).Conclusion:Gastroscopy treatment of patients with acute gastrointestinal bleeding caused by gastric cancer can effectively shorten the bleeding time of patients,reduce the incidence of postoperative complications,and have positive impact for the prognosis of patients.
基金Supported by Xi’an Health Commission Residential Training Base Construction Project,No.2023zp09.
文摘BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.
文摘BACKGROUND The incidence of esophageal cancer is high,and its prognosis is poor.Endoscopic submucosal dissection(ESD)is an important,minimally invasive treatment for early esophageal cancer,but the risk of postoperative bleeding affects its efficacy.AIM To explore risk factors of bleeding after ESD and evaluate the predictive value of a gradient boosting machine(GBM)model for postoperative bleeding.METHODS The clinical data of 178 early esophageal cancer patients who underwent ESD at the Affiliated Hospital of Xuzhou Medical University from October 2019 to October 2024 were analyzed retrospectively.Patients were divided into two groups(bleeding and non-bleeding).Univariate and multivariate logistic regression analyses identified risk factors for postoperative bleeding,leading to the construction of the GBM prediction model.The receiver operating characteristic(ROC)curve evaluated the predictive efficacy of the GBM model and bleeding after ESD trend from Japan(BEST-J)score.RESULTS Among 178 patients who received ESD treatment,29 cases(16.29%)had bleeding,and 149 cases(83.71%)had no bleeding.The average BEST-J score and the proportion of high-risk and extremely high-risk patients were higher in the bleeding group than in the non-bleeding group(P<0.05).Multivariate logistic regression analysis showed that tumor size≥3 cm,surgical bleeding,and Creactive protein(CRP)were independent risk factors for bleeding after ESD in patients with early esophageal cancer(P<0.05).The ROC curve showed that the area under the curve of the GBM prediction model based on the influencing factors was greater than that of the BEST-J score(0.818 vs 0.653,P<0.05).CONCLUSION The GBM prediction model based on tumor size≥3 cm,surgical bleeding,and high CRP levels is more effective than the BEST-J score at predicting bleeding after ESD.
文摘Objective: to explore the clinical treatment measures and therapeutic effects of functional uterine bleeding. Methods: from January 2020 to January 2022, 20 patients with functional uterine bleeding were selected and randomly divided into the control group and the observation group according to the coin toss method. The number of patients in each group was n 25. Twenty-five patients in the control group were treated with medroxyprogesterone and 25 patients in the observation group were treated with mifepristone. After two different drug treatments, the two groups were compared. Results: twenty-five patients in the control group were treated with progesterone and 25 patients in the observation group were treated with mifepristone. The total effective rate of 25 patients in the observation group was 96.00%, while that of 25 patients in the control group was 72.00%. Conclusion: mifepristone can inhibit endometrial growth, promote menopause and correct anemia in patients with functional uterine bleeding, and it has less side effects on patients. It is an ideal drug for the treatment of menopausal dysfunctional uterine bleeding, and it is worthy of being widely used clinically.
文摘AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-of-hours emergency endoscopy service,even at weekends.A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled.Analyzed parameters included time from patients' arrival until endoscopy,mortality,rebleeding,need for surgery and length of hospital stay.RESULTS:The weekday and weekend admission groups comprised 326 and 62 patients,respectively.There were no significant differences in baseline characteristics between the two groups,except for younger age in the weekend group.Most patients (97%) had undergone early endoscopy,which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend).The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%,P = 0.030).However,multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding,rather than weekend admission.CONCLUSION:Early endoscopy for peptic ulcer bleeding can prevent the weekend effect,and nighttime admission was identified as a novel risk factor for rebleeding,namely the nighttime effect.
文摘BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection(ESD)in early gastric cancer(EGC)patients.There are limited studies on estimating the bleeding risk after ESD using an artificial intelligence system.AIM To derivate and verify the performance of the deep learning model and the clinical model for predicting bleeding risk after ESD in EGC patients.METHODS Patients with EGC who underwent ESD between January 2010 and June 2020 at the Samsung Medical Center were enrolled,and post-ESD bleeding(PEB)was investigated retrospectively.We split the entire cohort into a development set(80%)and a validation set(20%).The deep learning and clinical model were built on the development set and tested in the validation set.The performance of the deep learning model and the clinical model were compared using the area under the curve and the stratification of bleeding risk after ESD.RESULTS A total of 5629 patients were included,and PEB occurred in 325 patients.The area under the curve for predicting PEB was 0.71(95%confidence interval:0.63-0.78)in the deep learning model and 0.70(95%confidence interval:0.62-0.77)in the clinical model,without significant difference(P=0.730).The patients expected to the low-(<5%),intermediate-(≥5%,<9%),and high-risk(≥9%)categories were observed with actual bleeding rate of 2.2%,3.9%,and 11.6%,respectively,in the deep learning model;4.0%,8.8%,and 18.2%,respectively,in the clinical model.CONCLUSION A deep learning model can predict and stratify the bleeding risk after ESD in patients with EGC.
文摘Objective: to explore the value of Baogong Zhixue Granule combined with hysteroscopic electrotomy in the treatment of perimenopausal abnormal uterine bleeding. Methods: 323 patients with perimenopausal abnormal uterine bleeding admitted by the department of gynecology in our hospital were selected for the study, which lasted from 2008 to 2021. The patients were divided into control group (n161) and observation group (n162). The control group was treated with routine hysteroscopic electrotomy, while the observation group was treated with Baogong Zhixue Granule. The clinical efficacy, postoperative complication rate, anemia status, sex hormone level and menstrual blood loss graph score were compared between the two groups. Results: the clinical effective rate of the observation group was 98.77%, higher than that of the control group (P0.05). The postoperative complication rate in the observation group was 1.85%, lower than that in the control group (P0.05). The anemia rate and repeated bleeding rate in the observation group were 12.35% and 0.62%, respectively, lower than those in the control group (P0.05). The bleeding stop time in the observation group was (4.52 ± 1.54) days, which was shorter than that in the control group (P0.05). After treatment, the menstrual blood loss graph score, LH level, FSH level and E2 level in the observation group were (3.04 ± 0.65) points, (8.89 ± 2.13) IU/L, (7.26 ± 2.55) IU/L and (208.65 ± 26.13) poml/L, respectively, compared with the control group (P0.05). Conclusion: Baogong Zhixue Granule combined with hysteroscopic electrotomy is effective in the treatment of perimenopausal abnormal uterine bleeding, which can improve the sex hormone level of patients, reduce postoperative complications, prevent anemia, and promote rehabilitation. It is worth popularizing.
基金the Major State Basic Research and Development Pro-gram of China, No.2006CB504504
文摘BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.
文摘BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Although these modalities are widely used,their comparative efficacy and safety across different patient populations and anatomical sites remain controversial.AIM To evaluate the clinical outcomes and safety of endoscopic hemostasis combined with vascular interventional therapy for NVUGIB.METHODS A systematic search was done on PubMed,EMBASE,Cochrane Library,and Web of Science(from database establishment to April 2025).Randomized controlled trial(RCT)quality was assessed via Cochrane RoB 2.0,and observational studies via the Critical Appraisal Skills Program.RevMan 5.4 was used for quantitative analysis;fixed/random-effects models were chosen through I^(2)-assessed heterogeneity.Publication bias was checked using funnel plots and sensitivity analysis via model switching.RESULTS Twenty-one studies(3 RCTs,12 single-group studies,and 6 retrospective cohort studies)with good quality were included.For single-group data,combined therapy had risk differences of 0.70(clinical success),0.24(mortality),and 0.22(rebleeding;all P<0.00001,I^(2)=0).Moreover,the≥60-year rebleeding risk difference was 0.43.Reintervention was found to differ by approach(Z=3.03,P=0.002,inter-subgroup I^(2)=99%).In the RCT and cohort studies,combined vs standard therapy had similar initial hemostasis(Z=0.04,P=0.97)and mortality(Z=1.56,P=0.12)but lower rebleeding(Z=3.26/P=0.001;Z=2.95/P=0.03).Symmetrical funnel plots and robust sensitivity analysis showed no publication bias.CONCLUSION Combined endoscopic hemostasis and vascular interventional therapy for acute NVUGIB can significantly reduce rebleeding,without differences in mortality.Age and vascular interventional methods may influence the therapeutic efficacy.
文摘In this editorial we comment on the article by Wang et al,recently published on World Journal of Clinical Cases.Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a common and potentially serious gastroenterological emergency.Wang et al conducted a detailed study on the management of AN-VUGIB in a high-volume center in the Shaanxi region,China.Analyzing data from over 530 patients provided a comprehensive overview of clinical,epidemio-logical,and treatment characteristics.Results highlighted a younger patient population compared to European studies,with a higher prevalence of gastric and duodenal ulcers as the leading cause of bleeding.Endoscopic treatment is cur-rently the preferred therapeutic option,offering a variety of effective techniques.This study emphasizes the importance of implementing current guidelines in ANVUGIB management and highlights the crucial role of endoscopy in its management.
基金Supported by Guangdong Provincial Medical Scientific Research Fund Project,No.B2016109.
文摘BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.
文摘Objective:To investigate the application effect of staged health education in the care of patients with upper gastrointestinal bleeding.Methods:This study takes health education in the care of patients with upper gastrointestinal bleeding as the main direction.160 patients with upper gastrointestinal bleeding who received treatment in our hospital were selected as samples,and the grouping software was used to divide them into the reference group and the study group,with 80 patients each.The reference group and the study group used routine health education and staged health education respectively.Relevant research data were recorded during the nursing process,analyzed,and used as research indicators.Results:The compliance behavior of the study group was higher than that of the reference group after the staged nursing care,and at the same time,the nursing care satisfaction of the study group was higher than that of the reference group(P<0.05).Conclusion:The use of staged health education for the care of patients with upper gastrointestinal bleeding not only enhances the degree of patient awareness and compliance but also improves nursing satisfaction,which is worthy of promotion and application.
文摘Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.
文摘A newly developed mouthrinse, Allantoin Powder for Gargle, was clinically investigated. The compound of this agent is mainly allantoin, which is believed easy to penetrate into gingival sulcus and periodontal pockets as well as other places (such as tongue, soft palate, etc.) where it is inconvenient to use medication, 219 patients with various diseases of oral cavity were investigated in the double blind randomlized placebo controlled study. It was observed that apparent efficient rates of the experimental mouthrinse on periodontitis and marginal gingivitis were 81.25% and 56.86% respectively; and the efficient rate of it on aphthous ulcer was 68.57%. The data show that this agent has effective as an adjuctive on the treatments of periodontal diseases and aphthous ulcer.
基金Project supported by the Second Stage of Brain Korea 21 Projects and Changwon National University in2011-2012
文摘Thermal performance is the most important factor in the development of a borehole heat exchanger utilizing geothermal energy.The thermal performance is affected by many different design parameters and different operating conditions such as bleeding.This eventually determines the operation and cost efficiency of the borehole heat exchanger system.The thermal performance of an open standing column well (SCW) type geothermal heat exchanger was assessed under the influence of bleeding.For this,a thermal response test rig was established with line-source theory.The test rig also had a bleeding function by releasing fluid while taking additional underground water through the heat exchanger.The thermal response test was performed with an additional constant input heat source.Effective thermal conductivity and thermal resistance were obtained from the measured data.From the measurement,the effective thermal conductivity is found to have 1.47 times higher value when bleeding is applied.The thermal resistance also increases by 1.58 times compared to a non-bleeding case.This trend indicates enhanced heat transfer in the SCW type heat exchanger with a bleeding function.Bleeding,therefore,could be an effective method of achieving a high heat transfer rate in the SCW type heat exchanger with sufficient underground water supply.
文摘Objective:Objective to explore the curative effect of transforaminal endoscopic surgery in the treatment of lumbar disc herniation.Methods:From October 2018 to October 2020,36 patients with lumbar disc herniation were randomly divided into group A and group B.the curative effect,pain,lumbar function and quality of life were analyzed.Results:The curative effect of group A was 94.44%,better than that of group B 61.11%,P<0.05;The visual analogue scale(VAS)of group A was lower than that of group B on 3D,5D and 7d after operation(P<0.05);The KSS of group A was higher than that of group B(P<0.05);The score of quality of life in group A was better than that in group B(P<0.05).Conclusion:Lumbar disc herniation patients underwent transforaminal endoscopic surgery,the effect is good,can improve lumbar function,relieve pain,improve the quality of life of patients.
基金supported by the National Natural Science Foundation of China(81430094)。
文摘Objective:The application of Chinese materia medica(CMM)in clinical diseases is the embodiment and continuation of the property theory of CMM(PTCMM).However,due to a lack of precise quantitative description methods,it is difficult to systematically analyze the property of CMM(PCMM)and clinical effect features at the micro molecular level.Methods:The therapeutic drugs and targets were obtained from the Drugbank database.The molecular descriptors of these drugs were calculated based on Dragon software.Drug-effect relationships that integrated the molecular descriptors and effect descriptors were plotted as grayscale images.These images were used to train the Le Net-5 model and the Alex Net model.The best-performing model was used to predict the effect features of the CMM compounds.Finally,the effect features of the PCMM combinations were calculated based on the support vector machine recursive feature elimination algorithm.Results:The Alex Net model showed a superior prediction performance.The results showed that its accuracy,precision,sensitivity,F-measure,and Matthews correlation coefficient on the training set were 0.940,0.936,0.945,0.940,and 0.880,respectively,and those of the test set were 0.909,0.901,0.920,0.910,and 0.819,respectively.A total of 399 compounds in the 42 CMMs for promoting blood circulation and removing blood stasis were predicted by this model.The key effect features of the Han-Ku-Gan combination were anti-inflammatory,anti-tumor,anti-atherosclerosis,anti-Parkinson,hypoglycemic,and anti-coagulant properties,as well as excitation of uterine smooth muscle.The key effect features of the Wen-Xin-Gan combination were anti-inflammatory,anti-atherosclerosis,anti-hypertensive,anticoagulant,anti-tumor,and anti-cardiac insufficiency effects,as well as enhanced immunity,sedation and hypnosis,and analgesia.Conclusion:This study provides a new method for the further exploration of the relationship between the PCMM and clinical effect features.
文摘BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.
基金Chinese fundamental research funds for the central universities(No.3332018027)
文摘Objective:To research the effect of conventional treatment(Gingko biloba extract(GBE)+continuous positive airway pressure(CPAP)ventilation)combined with acupuncture on the changes of blood pressure,respiratory efficiency,oxidative index,and clinical effect in patients with OSAHS combined with hypertension.Method Selecting 80 patients with OSAHS combined with hypertension,then they were randomly divided into observation group(n=40)and control group(n=40).The patients in the control group were given conventional drug therapy(GBE)and rehabilitation and CPAP,and the observation group were given acupuncture on this basic,they were treated 14 days.The primary endpoints were the changes from baseline to day 14 in blood pressure;the secondary endpoints were changes from baseline to day 14 in the respiratory efficiency(PSG);the tertiary endpoints were changes from baseline to day 14 in the oxidative related substances(SOD,GSH-Px,ROS,and MDA).Results After 14-day treatment,the respiratory efficiency index were better than pretherapy(p<0.05),and the observation group were better than control group(p<0.05);the blood pressure were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the ROS and MDA were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the SOD,GSH-Px were higher than pretherapy(p<0.05),and the observation group were higher than control group(p<0.05);the clinical effect of hypotensive in the observation group were better control group(p<0.05).Conclusion 14-day treatment of conventional treatment combined with acupuncture can improve the imbalance of oxidation and antioxidation and blood pressure.
文摘Reticulocytosls in rats was induced by repetitive bleeding. Both the in vitro and the in vivo studies showed that the detected reductive speed of methemoglobin of the bleeding group was faster than that of the control group at all time intervals. At the same time, the NADH-cytochrome b5 methemoglobin reductase activity and the molybdenum content in erythrocytes of the bleeding group were significantly increased. Regressional analysis showed that there was a significantly positive correlation between the enzyme activity and the molybdenum content. It is proposed that molybdenum might be required for the enzyme activity
