Sacubitril/Valsartan for heart failure: A protocol for systematic review and meta-analysis

Background:Sacubitril–valsartan has been shown to have superior effects over angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients with heart failure (HF). However, the effects of sacubitril–valsartan have never been systematically evaluated. Therefore, we performed a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of sacubitril–valsartan in patients with HF.Methods:We selected 8 databases, including PubMed, the Web of Science, Embase, Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Science Journal Database, Wanfang Data, and the Chinese Biomedical Literature Database. The search time was from database establishment to March 2022. Two reviewers will screen the records and include quality studies according to inclusion criteria independently. Two reviewers will assess the risk of bias of the included studies by the “Risk of Bias Assessment Tool” of the Cochrane Handbook for randomized controlled trials. Statistical analysis will be performed with Review Manager software 5.3.Results:A synthesis of current evidence of sacubitril–valsartan for treating HF will be provided in this protocol.Conclusion:The results of this study will provide a theoretical basis for the clinical use of sacubitril–valsartan to treat HF.     

对促宫颈成熟与引产孕产妇的全程分娩管理模式

目的 探讨在全程分娩管理模式下,为孕产妇提供促宫颈成熟与引产服务的可行性。方法 选择2018年1月1日至2020年12月31日,在南京大学医学院附属鼓楼医院接受待产、分娩到产后康复(LDRP)一体化全程分娩管理模式(以下简称为LDRP管理)的848例孕产妇为研究对象。根据孕产妇进入产房时是否进入自然产程,将其分为自然临产组(n=441)和引产组(n=407)。采用回顾性分析法,对2组孕产妇的一般临床资料,如分娩年龄、孕次、孕龄、妊娠并发症,以及母儿结局进行比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》的要求,并经过南京大学医学院附属鼓楼医院伦理委员会审核批准(审批文号：201702001)。结果 (1)2组孕产妇分娩年龄、孕次和高龄孕产妇所占比例比较,差异无统计学意义(P>0.05)。2组孕产妇分娩孕龄、经产妇占比、早产率、缩宫素使用率、分娩时长比较,差异有统计学意义(P<0.05)。(2)引产组孕产妇均使用前列腺素类药物促宫颈成熟或缩宫素进行引产,其中使用地诺前列酮栓、米索前列醇、缩宫素、地诺前列酮栓+米索前列醇分别为26.5%(108/407)、...     

特发性黄斑裂孔患者术后裂孔愈合形态与视功能恢复的研究

目的探讨特发性黄斑裂孔患者术后裂孔愈合形态与视功能恢复的关系。方法选择特发性黄斑裂孔1次性术后裂孔愈合患者36例(38只眼)的连续临床资料,进行回顾性分析。应用相干光断层扫描(OCT)观察裂孔愈合形态,采用激光扫描检眼镜(SLO)测定患者术前,术后1、3、6个月黄斑区光敏度、绝对暗点、相对暗点平均面积及中心视力,并对检测结果进行分析。结果根据OCT图像,裂孔形态分为完全愈合型(22只眼)、部分愈合型(10只眼)及未愈合型(6只眼)。术后6个月,完全愈合型和部分愈合型眼的中心视力、光敏度、绝对暗点和相对暗点的平均面积均较术前有明显改善(均P<0.05);未愈合型眼的中心视力、光敏度虽较术前改善,但绝对暗点、相对暗点差异则无显著意义(P>0.05);完全愈合型眼的视力、光敏度、绝对暗点改善程度与部分愈合型和未愈合型眼比较,差异有显著意义(P<0.05)。Ⅱ期裂孔眼术后黄斑中心凹形态可完全恢复。结论术后黄斑区中心凹部视网膜正常形态的恢复与视功能改善程度呈正相关(P<0.05)。术后中心凹的形态恢复越好,视功能改善程度越高。裂孔早期阶段(Ⅱ期裂孔)行手术,更有机会获取良好的视功能。(中华眼科杂志,2004,40:443-447)     

青光眼滤过术后浅前房的预防和处理

目的:探讨青光眼滤过性手术浅前房的发生、发展和预防处理。方法:回顾性研究了我院过去102例(112眼),其中急性闭角型青光眼64例(67眼),慢性闭角型青光眼7例(11眼),开角型青光眼26例(29眼),继发性青光眼5例(5眼)的治疗经过。结果:112眼中术后24h有77眼前房形成,占68.8%,发生I型浅前房23眼,II型9眼,III型3眼,共占32.2%,其中5眼分别于术后2～4d变浅。荧光素试验发现结膜切口渗漏者3眼,有较明显睫状体脉络膜脱离5眼,小眼球并发晶状体膨胀2眼,恶性青光眼1眼,均经相应处理后前房恢复。结论:青光眼滤过性手术浅前房的发生率是较高的,但只要加强手术前后的治疗处理,术中仔细操作,多数浅前房是可以预防的,即使发生了浅前房只要处理及时和恰当,预后也是良好的。     

Construction of developmentally inspired periosteum-like tissue for bone regeneration

The periosteum, a highly vascularized thin tissue, has excellent osteogenic and bone regenerative abilities. The generation of periosteum-mimicking tissue has become a novel strategy for bone defect repair and regeneration, especially in critical-sized bone defects caused by trauma and bone tumor resection. Here, we utilized a bone morphogenetic protein-2(BMP-2)-loaded scaffold to create periosteum-like tissue(PT) in vivo, mimicking the mesenchymal condensation during native long bone developmen...     

Angiographic uterine artery embolization followed by immediate curettage: an efficient treatment for controlling heavy bleeding and avoiding recurrent bleeding in cervical pregnancy

Two cases of cervical pregnancy with heavy bleeding successfully treated by uterine artery embolization (UAE) followed by immediate curettage are described in this report. Case 1 demonstrated intermittent bleeding after serious bleeding was successfully controlled by UAE. Serum beta human chorionic gonadotropin (beta-hCG) level rose remarkably after a short time decline. Transvaginal sonography consistently revealed a heterogeneous mass in the cervix. Repeated UAE followed by immediate curettage was performed and complete resolution was achieved. Case 2 was also successfully managed by UAE followed by immediate curettage after failure of medical treatment. This report suggests that UAE followed by immediate curettage is a safe and efficient procedure for controlling heavy bleeding and avoiding recurrent bleeding when fertility capacity is desired in cases of cervical pregnancy with fetal cardiac activity and high beta-hCG concentration.     

人胃癌SGC7901细胞膜钾离子通道的特性

目的　研究人胃癌细胞系 SGC790 1细胞膜钾离子通道特性 .方法　以人胃癌细胞系 SGC790 1为研究对象 ,采用穿孔膜片钳全细胞记录法 .结果　人的胃癌 SGC790 1细胞系的静息膜电位为 (- 32 .2± 2 .2 ) m V,在钳制电压 - 40 m V,阶跃电压在 - 80～ +80 m V,记录到一种跨膜电流 ,该跨膜电流具有电压依赖、外向整流特性 ,该电流在延迟 2 5 ms后最大激活 ,80 0 m s内不失活 ,翻转电位在 - 6 0～ - 40 m V,能被已知的钾通道的阻断剂 4- AP或 TEA阻断 .结论　在人胃癌SGC790 1细胞系细胞膜上存在延迟整流钾离子通道 .     

心脏死亡供体原位肝移植术后胆道并发症的原因探讨和诊疗经验

目的: 探讨心脏死亡供体（donation after cardiac death,DCD）原位肝移植术后胆道并发症的发生因素、诊断要点和治疗方法。方法: 对2015年1月—2016年8月于南京医科大学第一附属医院肝移植中心实施的87例DCD供肝肝移植患者临床资料进行回顾性分析。87例中29例行经典原位肝移植,58例行改良背驮式肝移植,胆管重建方式均为胆总管端端吻合,无1例放置T管。结果: 87例肝移植患者中9例通过胆道造影确诊为肝移植术后胆道并发症, 8例治愈, 1例好转, 无死亡。胆道并发症发生率10.1%(9/87)。结论: DCD供体原位肝移植术后胆道并发症的发生与供肝缺血时间、DCD供肝质量、胆管吻合技术及供肝修剪技术等因素有关,术后胆道造影有助于及时诊断胆道并发症。介入技术是胆道并发症的主要治疗手段。     

Factors Associated with Macular Staphyloma Area on Ultra-widefield Fundus Images

PurposeTo assess the feasibility of applying ultra-widefield fundus (UWF) images for macular staphyloma area (MSA) measurement and investigate the associated factors with MSA.MethodsThis is a retrospective study. MSA was measured by UWF imaging. Central foveal thickness, subfoveal choroidal thickness, subfoveal scleral thickness were measured on spectral domain optical coherence tomography. Intraclass correlation coefficients of MSA measurement would be evaluated. Multiple linear regression analysis was used to analyze the associated factors with MSA.ResultsIn total, 135 eyes of 92 patients were enrolled. The mean age was 64.73 ± 10.84 years. Mean MSA on UWF image was 279.67 ± 71.70 mm². Intraclass correlation coefficients of MSA measurement was 0.965 (95% confidence interval [CI], 0.946 to 0.977; p < 0.001). In the multiple linear regression analysis, after adjusting for subfoveal choroidal thickness, best-corrected visual acuity, central foveal thickness, and subfoveal scleral thickness, the factors independently related to MSA were axial length (β = 8.352; 95% CI, 3.306 to 13.398; p = 0.001), sex (β = −26.673; 95% CI, −51.759 to −1.586; p = 0.037), age (β = 1.184; 95% CI, 0.020 to 2.348; p = 0.046).ConclusionsIt is feasible to measure MSA on UWF image. Female, longer axial length, and older age may indicate larger MSA.