近7年中医药治疗特发性面神经麻痹随机对照试验结局指标的现状分析

目的：评价中医药治疗特发性面神经麻痹（IFP）随机对照试验（RCT）的结局指标应用现状。方法：全面检索7个数据库、2个临床试验注册中心，按预先制定的遴选标准筛选出相关的RCT，根据Cochrane风险偏倚评估工具对纳入文献进行偏倚风险评估，对结局指标、测量时间点、研究时间、结局指标等级情况进行统计描述。结果：初步检索出相关文献13 489篇，最终纳入45篇RCT（中文文献44篇，英文文献1篇），报告95个结局指标，使用频次233次。研究发现中医药治疗IFP的RCT总体偏倚不明确，临床研究中结局指标存在参考标准、命名、测量时间点杂乱，选用类别不均，主次不明确的问题。结论：中医药治疗IFP的RCT结局指标集研究尚处于起步阶段，参考国际经验，结合中医药特点制定实用的研究流程，仍需要精确的临床及统计工作来构建规范、统一、公认的核心指标集。     

脉波指示剂连续心排血量(PiCCO)中的胸内血容量(ITBV)测定

在新近推向临床的脉波指示剂连续心排血量(PiCCO)监测中,用单一温度稀释法所测定的胸内血容量(IT-BV),已被许多学者证明是一项可重复、又敏感,而且比肺动脉阻塞压(PAOP)、右心室舒张末期压(RVEDP)、中心静脉压(CVP)更能准确反映心脏前负荷变化的实用指标.本文从心脏生理学、病理生理学及临床应用等方面,系统阐述了前负荷的定义及其影响因素,列举了上述压力监测数据不能准确反映心脏前负荷的机理及临床报道.详细讲述了单一温度稀释法测定ITBV的原理、计算方法、修正公式、测定中注意事项、正常范围值.列举了ITBV作为心脏前负荷的具有代表性的实验与临床统计分析资料.有鉴于左心功能减退伴有中度容量不足病人.恒速补液过程中显示充盈压比ITBV更敏感的报道,笔者建议:临床工作者在应用PiCCO新技术、确认ITBV作为前负荷指标的同时,仍然不应该忽略相关心血管腔的传统压力监测.     

教研室评估指标体系的研究与实践

为了规范教研室的管理、促进教研室的建设和发展，我校根据教育部《普通高等学校本科教学工作水平评估方案》中的有关要求、教育部2005年《关于进一步加强高等学校本科教学工作若干意见》文件的精神，结合我校自身的情况，制定了《贵阳中医学院教研室评估指标体系》，并对全校50个教研室进行了评估。通过评估，教研室的管理水平得到明显提高，教师深化教学改革的意识得到加强，教学在学校的中心地位得到确认。     

Completeness of lymph node dissection in patients undergoing minimally invasive- or open surgery for non-small cell lung cancer: A nationwide study

ObjectiveIn patients with NSCLC, lymph node metastases are an important prognostic factor. Despite an accurate pre-operative work up, for optimal staging an intrapulmonary- and mediastinal lymph node dissection (LND) as part of the operation is mandatory. The aim of this study is to assess the completeness of LND in patients undergoing an intended curative resection for NSCLC in the Netherlands and to compare performance between open surgery and minimally invasive surgery (MIS).Materials and methodsThe intraoperative LND was evaluated in 7460 patients who had undergone a lobectomy for clinically staged N0-1 NSCLC (2013–2018). The LND was considered complete, when three mediastinal (N2) lymph node stations, including station 7, were sampled or dissected, in addition to the lymph nodes from station 10 and 11. A comparison was made between open surgery and MIS.ResultsOf 5154 patients, who had MIS, a sufficient intrapulmonary LND was performed in 47.9% and a sufficient mediastinal LND in 58.6%. A complete LND was performed in 31.6%. For 2306 patients who had an open resection, these numbers were 45.0%, 59.0%, and 30.6%, respectively. The overall between-hospital variation in a complete LND ranged between 0 and 72.5%.ConclusionIn the Netherlands, a complete LND of both intrapulmonary- and mediastinal lymph nodes is performed only in a minority of patients with clinically staged N0-1 NSCLC, with substantial between-hospital variation. No differences were seen between open surgery and MIS. Because of poor performance, completeness of lymph node dissection will be recorded as a mandatory performance indicator in our national audit, to improve the quality of resection.     

H3K27me3 and VEGF is associated with poor prognosis in patients with synovial sarcoma

Purpose

Previous studies have shown a correlation between the expression of H3K27me3 and pathological characteristics of malignant tumors. This study aimed to investigate the association of H3K27me3 and VEGF expression with clinical outcomes of synovial sarcoma patients.