Meta-analysis on the treatment options and outcomes of carotid blood blister aneurysms

ObjectiveCarotid blister aneurysms remain a formidable surgical challenge with varied surgical options. There have been significant advancements in the endovascular management of these aneurysms with the introduction of flow diverters. The comparative risk profiles for different endovascular options compared to surgical management of these lesions is not completely understood.MethodsThe study is a comprehensive systematic review and meta-analysis on the treatment of carotid blood blister aneurysms. Pubmed searches were used to identify relevant articles and patient level data was extracted. Two and three group analyses were conducted comparing surgical and endovascular strategies and surgical, stent coil and flow diversion techniques respectively. Patient outcomes were graded on the modified Rankin Scale with a score of 2 or less defined as favorable.ResultsIn total, 83 studies (41 and 42 studies on surgical and endovascular interventions, respectively) with 1119 patients met our inclusion criteria. A statistically significant difference (at the 5% level of significance) in the effect among three different interventions was not found (Q = 3.41, p = 0.1815) under the random-effect model. Our results did show summary proportions of favorable outcomes were higher in the stent coil (0.87, 95% CI: 0.79 – 0.94) and flow diversion (0.87, 95% CI: 0.75 – 0.96) than that of surgery (0.76, 95% CI: 0.71 – 0.83).ConclusionsOur results suggest a trend towards improved patient outcomes with endovascular techniques compared to surgical strategies but statistical significance was not achieved. We also found that endovascular techniques compare favorably. Increasing retreatments were found to negatively affect patient outcomes.     

管理伦理学视角下医学高校教师量化考核的反思

从管理伦理学的角度对高校教师量化考核进行探讨,认为应进一步完善教师量化考核制度,尽可能减少其不利影响.教师量化考核制度应符合管理伦理学的基本原则,即以人为本的原则、义利统一的原则和公平与效率相结合的原则.同时,在高校教师量化考核制度的设计上,还应注重对员工健康的维护.     

应对方式与社会支持对糖耐量异常患者生活质量的影响

目的：探讨糖耐量异常患者的应对方式与社会支持分别作为内外两种调节方式对其生活质量的影响。方法：采用焦虑自评量表、抑郁自评量表、特质应对方式问卷、社会支持评定量表及生存质量量表等工具对全国不同地区6家三甲医院的283名糖耐量异常患者进行调查。结果：人口统计学变量不能预测糖耐量异常患者的生活质量：焦虑、抑郁、社会支持及应对方式对生活质量有显著影响。结论：情绪障碍、社会支持、应对方式对糖尿病患者生活质量的影响机制在糖耐量异常患者中同样存在。