腹股沟区膜解剖与全腹膜外疝修补术的初步探讨

目的 探讨全腹膜外疝修补术(totally extraperitoneal herniorrhaphy,TEP)的游离层面,寻找疝膜解剖的标准模型.方法 回顾性分析118例男性单侧原发疝临床资料,结合文献及临床实践,对腹股沟区的局部解剖进行再认识.结果 手术均获成功,术中出血少,5例腹膜破裂,23例血清肿,3例阴囊血肿...     

颅内微小动脉瘤微导管插管稳定到位的不利因素与对策

目的 探讨颅内微小动脉瘤血管内治疗时妨碍微导管插管和稳定到位的不利因素及其对策.方法 回顾2001年6月至2009年10月间46例51个颅内微小动脉瘤的血管内治疗资料,分析术中微导管插管和稳定到位的影响因素及其相应的可能对策.结果 在血管内治疗时可能妨碍微导管插管和稳定到位的因素有:微导管走行的路径,载瘤动脉迂曲,路径、载瘤动脉直径与微导管直径相差较大,路径、载瘤动脉的走行方向与动脉瘤瘤顶的指向不在同一方向且差异较大,以及载瘤动脉内动脉瘤颈处放置了支架.结论 根据路径、载瘤动脉的走行、动脉瘤的位置和瘤顶的指向,选择顺应性、稳定性与导引性、支撑性适宜并匹配的微导管与微导丝,并对其头端进行塑形,酌情选用球囊或(和)支架辅助,加之娴熟的插管技术,是颅内微小动脉瘤血管内治疗时微导管插管和稳定到位的有效方法 .     

Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

独活寄生汤在类风湿关节炎患者常规治疗药物中疗效的Meta分析

目的:研究独活寄生汤对于类风湿关节炎(RA)的疗效及安全性。方法:在中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库、Pub Med、MEDLINE、Embase检索2015年1月之前有关独活寄生汤治疗类风湿关节炎的随机对照试验,并依据所收集文献的参考文献,进行补充检索,以及手工检索相关文献。结果:共纳入5篇随机对照试验,共计328例患者,其中常规西药组164例,常规西药联合独活寄生汤组164例。Meta分析结果显示:常规西药与联合独活寄生汤组总体疗效比较差异有统计学意义[RR=1.24,95%CI(1.12,1.38),P0.000 1]。结论:独活寄生汤是治疗风湿病的常用方剂。     

Acetone vapour-assisted growth of 2D single-crystalline organic lead halide perovskite microplates and their temperature-enhanced photoluminescence

We adopt an acetone vapour-assisted method to grow high quality single-crystalline microplates of two-dimensional (2D) perovskite, 2-phenylethylammonium lead bromide [(C₆H₅C₂H₄NH₃)₂PbBr₄]. The microplates, converted from the spin-coated films, are well-defined rectangles. Temperature dependent photoluminescence (PL) spectroscopy shows that the band gap PL is enhanced markedly with increasing temperature up to 218 K, accompanied by the quenching of the PL related to the trap states, which perhaps results from the exciton–phonon couplings. The optical phonon energy around 50 meV and the exciton binding energy around 120 meV are derived by fitting the band gap PL linewidths and intensities at different temperatures, respectively.

We report an acetone vapour-assisted method to grow single-crystalline 2D perovskite microplates and find their temperature-enhanced photoluminescence.     

Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department

Objectives (1) To develop an automated eligibility screening (ES) approach for clinical trials in an urban tertiary care pediatric emergency department (ED); (2) to assess the effectiveness of natural language processing (NLP), information extraction (IE), and machine learning (ML) techniques on real-world clinical data and trials.Data and methods We collected eligibility criteria for 13 randomly selected, disease-specific clinical trials actively enrolling patients between January 1, 2010 and August 31, 2012. In parallel, we retrospectively selected data fields including demographics, laboratory data, and clinical notes from the electronic health record (EHR) to represent profiles of all 202795 patients visiting the ED during the same period. Leveraging NLP, IE, and ML technologies, the automated ES algorithms identified patients whose profiles matched the trial criteria to reduce the pool of candidates for staff screening. The performance was validated on both a physician-generated gold standard of trial–patient matches and a reference standard of historical trial–patient enrollment decisions, where workload, mean average precision (MAP), and recall were assessed.Results Compared with the case without automation, the workload with automated ES was reduced by 92% on the gold standard set, with a MAP of 62.9%. The automated ES achieved a 450% increase in trial screening efficiency. The findings on the gold standard set were confirmed by large-scale evaluation on the reference set of trial–patient matches.Discussion and conclusion By exploiting the text of trial criteria and the content of EHRs, we demonstrated that NLP-, IE-, and ML-based automated ES could successfully identify patients for clinical trials.     

A systematic review and meta‐analysis of randomized controlled trials: Skin‐patch of Chinese herbal medicine for patients with acute gouty arthritis

Aims

To evaluate the evidence of the effectiveness and safety of Chinese herbal medicine skin‐patches for patients with acute gouty arthritis.

Background

Acute gouty arthritis is a problem that can limit the level of activity and impair the quality of life. In China, many clinical studies have demonstrated that skin‐patches of Chinese herbal medicines benefit patients with acute gouty arthritis. However, the reported clinical effects vary.

Design

A systematic review and meta‐analysis of randomized controlled trials.

Data sources

Three English databases including CENTRAL (1993 to February 2017), PubMed (1966 to February 2017) and EMBASE (1974 to February 2017) and four Chinese databases including Chinese National Knowledge Infrastructure, Chinese VIP Information, SinoMed and Wanfang (all, 1949 ‐ February 2017) were searched. Randomized controlled trials that compared skin‐patches of Chinese herbal medicine with or without conventional treatments to conventional treatments, no treatment or a placebo treatment for patients with acute gouty arthritis were included.

Review methods

We conducted a systematic review and meta‐analysis following the Cochrane process. Two authors selected the studies, extracted the data and evaluated the risk of bias of the included trials.

Results

Nineteen studies met our inclusion criteria. After synthesizing the data, the results showed that skin‐patches of CHM combined with Western medicine seemed to be more effective than Western medicine alone for pain relief in patients with acute gouty arthritis and had fewer adverse events.

Conclusion

Due to the quality of the data, larger and more rigorously designed clinical trials with proper outcome measures are necessary.     

Superlattice-like structure and enhanced ferroelectric properties of intergrowth Aurivillius oxides

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties. In this work, Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ and Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ compounds were successfully synthetised using a simple solid-state reaction method. X-Ray diffraction patterns and scanning transmission electron microscopy high angle annular dark field (STEM-HAADF) images confirm the 2–3 and the 3–4 intergrowth structures in Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ compounds, respectively. A superlattice-like distortion in these oxides was proposed resulting from the combination of sub-lattices with different a and b parameters, which was validated by XRD refinements and Raman spectra. Polarization-electric field tests and pulsed polarization positive-up negative-down measurements demonstrate that such superlattice-like structures can effectively enhance the intrinsic ferroelectric polarization and coercive field of these oxides, especially when compared with their component oxides Bi₃TiNbO₉, Bi₃LaTiNbFeO₁₂ and Bi₅Ti₃FeO₁₅. Simultaneously, ferroelectric Curie temperatures of Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ oxides are lowered because of the internal stress in the superlattice-like structure. Nevertheless, the paramagnetism of the samples is hardly influenced by their structure, while mainly related to their iron content, in which iron has a similar effective magnetic moment around 3.4–3.9.

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties.