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目的系统评价曲美他嗪(TMZ)预防肾功能不全患者造影剂肾病(CIN)的临床疗效。方法计算机检索PubMed、Embase、Cochrane Library、EBSCO与Scopus数据库,检索时间为建库至2018年12月,同时查阅相关会议摘要和网站。采用RevMan 5.3软件进行Meta分析。结果最终纳入符合要求的文献6篇,共920例患者。其中,TMZ(+)组456例,TMZ(-)组464例。荟萃分析结果显示,TMZ(+)组的CIN发生率明显低于TMZ(-)组(OR=0.31, 95%CI 0.20~0.48;P0.01);术后3 d内患者的血清肌酐值在TMZ(+)组更低,但与TMZ(-)组相比,尚未达到统计学差异(MD=-0.22, 95%CI-0.48~0.04;P=0.10)。结论 TMZ对预防肾功能不全患者CIN的发生具有积极作用。不过,TMZ对血清肌酐水平的真实影响,仍需要更多高质量、大样本的随机对照研究进一步证实。  相似文献   
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ObjectiveParotidectomy is the most classic and unequivocal intervention for parotid neoplasm. The operative outcomes and postoperative complications of parotidectomy between harmonic scalpel and electrocautery gained more prominence in physician. In spite of much research work within the past years, there was an obvious lack of randomized controlled trial to resolve this question. Hence, a quantitative and qualitative meta-analysis was essential to evaluate the differences in these two types of hemostasis method.MethodThe major electronic databases, including Pubmed, Embase, Cochrane library, Google Scholar, China National Knowledge Infrastructure and Chinese Scientific and Technological Journal databases were using the key words “electrocautery”, “electrocoagulation”, “harmonic scalpel”, “ultrasonic scalpel”, “ultrasonic dissector”, “parotidectomy” and “parotid surgery”. 9 articles were included in our systematic review and meta-analysis. The operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis were the outcome measures. Odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the effect size for categorical outcomes and mean differences (MDs) with 95% confidence intervals (CIs) for continuous outcomes.ResultsIn our meta-analysis, there was a significant reduction in operation time [mean difference: ?20.97; 95%CI=(?24.02,?17.92); P < 0.00001], intraoperative blood loss [mean difference: ?20.75, 95%CI=(?22.32,?19.18); P < 0.00001], hospital stay [mean difference: ?0.83; 95%CI=(?1.10,?0.57); P < 0.00001], salivary fistula [ORs: 0.30, 95%CI=(0.08,1.14)] and transient facial nerve paralysis [OR:0.33, 95%CI=(0.19,0.58),P = 0.0001] in harmonic scalpel group compared with electrocautery group.ConclusionThis meta-analysis indicated that compared with electrocautery, harmonic scalpel (HS)was transcendent in the aspects of operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis. The harmonic scalpel, as an efficient and useful instrument, was advocated in parotidectomy.  相似文献   
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1927年,江苏试行大学区制,境内公立医学学府硕果无存?1934年,时任江苏省政府主席的陈果夫创建省立医政学院,后因抗战西迁与南通学院医科合并,改组国立江苏医学院?从省立医政学院到国立医学院的嬗变,涉及到办学理念?办学体制及当时社会背景的诸多变化?全面对照分析前后时期的差异与特点,对于了解民国时期江苏医学教育发展具有很强的现实意义?  相似文献   
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BackgroundEvidence emerges that cardiorespiratory fitness (CRF) might be implicated in the development of heart failure (HF). This meta-analysis aimed to quantify the association between CRF exposed at baseline and HF risk with dose–response analysis and to assess whether CRF changes over time are correlated with alterations in HF risk.Methods and ResultsCohort studies that assessed the association between CRF and risk of HF in subjects without baseline HF were included. Study-specific multivariate-adjusted relative risks (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Ten studies from 8 articles were included, enrolling 8987 incident HF cases from 154,598 participants. The RR of HF per 1-metabolic equivalent (MET) higher CRF at baseline was 0.82 (95% CI 0.80–0.84) in the overall population. The RRs were similar in men (0.82, 95% CI 0.80–0.85) and women (0.81, 95% CI 0.78–0.84), and remained minorly changed in patients with existing diabetes, hypertension, or cardiovascular disease at entry. No evidence of a nonlinear relationship between CRF at baseline and risk of HF was observed (Pnonlinearity = .18). The RR of HF per 1-MET increase in CRF over time was 0.79 (95% CI 0.67–0.93), and the measurement of CRF provided incremental value to the prediction of HF beyond conventional models.ConclusionsHigh or increased CRF resulted in reduced risk of HF in a dose-dependent manner, supporting the necessity to increase CRF to prevent HF in clinical practice.  相似文献   
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Background

People with prehypertension are highly likely to develop hypertension and other cardiovascular diseases. Lifestyle modifications may prevent hypertension in patients with prehypertension, but evidence remains scarce in developing countries. This study aimed to investigate whether a community-based intervention could prevent hypertension through lifestyle modifications in people with prehypertension in the rural areas of China.

Methods

A community-based quasi-experiment design was applied. Eighteen villages from six townships in Sheyang county, a rural area in eastern China, were randomly sampled. Of these local residents, patients with prehypertension—a systolic blood pressure (SBP) of 120–139 mm Hg or a diastolic blood pressure (DBP) of 80–89 mm Hg—and who were 30–60 years old were screened. Participants from three of the townships (n=206) were randomly assigned to the intervention group, and those from the other three townships (n=250) were assigned to the control group. At the outset, intervention group participants received individual consultations from a community health management team to assess their self-management ability, determine their lifestyle, set goals for a healthier lifestyle, and design individualised action plans. A guideline booklet was provided to intervention group participants, which contained detailed explanations of hypertension, prehypertension, healthy lifestyles and their impacts, and methods to lose weight, cease smoking, and deal with mental pressure. Intervention group participants also received quarterly follow-ups to assess the implementation of action plans, identify difficulties in changing unhealthy lifestyles, and find feasible solutions. In both intervention and control groups, usual care was provided to participants according to national guidelines, and the available resources were the same across the townships. Evaluations were conducted at baseline, and at the end of months 6, 12, 18, and 30. Between-group analyses were performed using repeated measures ANOVA. Written informed consent was obtained from the participants.

Findings

At 30 months, 18 participants in the intervention group (n=188) showed progression to hypertension, whereas 47 in the control group (n=234) developed hypertension. This difference between intervention and control groups was statistically significant (9·6 vs 20·1%, p=0·007). Significant changes in DBP (–2·7 vs 0·7 mmHg, p<0·0001), weight (–0·79 vs ?0·66 kg, p=0·029), and daily walking steps (11?500 vs 8000 steps, p<0·0001) were observed between intervention and control groups. No differential effects were found for SBP, drinking, and smoking, with both groups showing substantial improvements.

Interpretation

This intervention could prevent hypertension among patients with prehypertension by improving health-related behaviours. This study might be one of the first community-based experiments implemented among people with prehypertension in the rural areas of China. Further investigations are required to assess the sustainability of this intervention.

Funding

This study was funded by the Postgraduates Innovation Project of Jiangsu Province (KYZZ15_0267).  相似文献   
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Background

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in oral cancer, however, the mechanism underlying OSCC tumorigenesis is unknown. SIRT1, has been considered a prominent tumor-suppressing/promoting gene in various solid tumors, although the precise role of SIRT1 in OSCC progression remains unknown.

Methods

SIRT1 expression was assessed in surgically resected specimens from patients with OSCC for histopathologic factors. SIRT1 levels in OSCC were determined, SIRT1 overexpression was achieved on transfecting OSCC cells with a SIRT1-containing plasmid, followed by evaluation of proliferative ability and invasiveness of these cells.

Results

SIRT1 levels were significantly lower in patients with OSCC than in controls (p < 0.05). Moreover, SIRT1 levels in patients with OSCC were significantly associated with the lymphovascular permeation but not with the sex, age, stage and location. Furthermore, SIRT1 overexpression inhibited proliferation and invasion in OSCC cells.

Conclusion

The present results suggest that SIRT1 is a potential tumor suppressor in OSCC.  相似文献   
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