BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Objective： There is little information focusing on the nutritional issue of pediatric recipients before they receive living donor liver transplantation. This study illustrates the relationship between nutriti...Objective： There is little information focusing on the nutritional issue of pediatric recipients before they receive living donor liver transplantation. This study illustrates the relationship between nutritional status and graft liver function and provides a reference regarding nutritional interventions in future studies.Methods： We prospectively collected data from 30 pediatric living donor liver transplant recipients from January 1, 2016, to June 30, 2016. The information included demographic data, preoperative nutritional assessment, and postoperative laboratory examinations. The nutritional assessment included the serum concentration of vitamin D, bone density, trace element, and weight Z value. The laboratory examinations included white blood cell count, neutrophil percentage, hemoglobin, blood platelet, total protein, albumin, total bilirubin, direct bilirubin, alanine transaminase, aspartate aminotransferase （AST）, alkaline phosphatase, gamma-glutamyl transpeptidase, creatinine, bile acid, blood glucose （Glu）, prothrombin time, international normalized ratio, tacrolimus concentration, and graft-to-recipient weight ratio （GRWR）. The data were collected on Days 1 ,2 ,3 ,4 ,5 ,6 ,7 ,1 4 ,3 0 , and 60 after liver transplantation. Results： The recipients consisted of 15 （50%） males and 15 （50%） females. K median age was 7 months （4-48 months）. The mean height and weight were 69.07±9.98 cm and 8.09±2.63 kg, respectively. According to the univariate analysis, the gender, diagnosis, blood type, and GRWR did not significantly impact the liver function after the operation. The posttransplantation AST levels and Glu showed significant differences in terms of the nutritional status, with P〈0.05. The multivariate correlation analysis showed that the serum concentrations of vitamin D and AST were midrange positively correlated, with P〈0.05.Conclusions： The nutritional status of patients with biliary atresia is relatively poor. There is a definite midrange positive correlation between nutrition and graft liver function that might play a relatively important role in the recovery of the graft.展开更多
In order to improve the properties of silica sol shell for investment casting process, various contents of cattail fibers were added into the slurry to prepare a fiber-reinforced shell in the present study. The bendin...In order to improve the properties of silica sol shell for investment casting process, various contents of cattail fibers were added into the slurry to prepare a fiber-reinforced shell in the present study. The bending strength of fiber-reinforced shell was investigated and the fracture surfaces of shell specimens were observed using SEM. It is found that the bending strength increases with the increase of fiber content, and the bending strength of a green shell with 1.0 wt.% fiber addition increases by 44% compared to the fiber-free shell. The failure of specimens of the fiber-reinforced green shell results from fiber rupture and debonding between the interface of fibers and adhesive under the bending load. The micro-crack propagation in the matrix is inhibited by the micro-holes for ablation of f ibers in specimens of the f iber-reinforced shell during the stage of being fired. As a result, the bending strength of specimens of the fired shell had no significant drop. Particularly, the bending strength of specimens of the fired shell reinforced with 0.6wt.% fiber reached the maximum value of 4.6 MPa.展开更多
For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making...For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.展开更多
Objective:To investigate the relationship between body mass index(BMI),waist circumference(WC),hip circumference(HC),waist-hip ratio(WHR),waist height ratio(WHtR),fasting blood glucose(FPG),fasting blood glucose varia...Objective:To investigate the relationship between body mass index(BMI),waist circumference(WC),hip circumference(HC),waist-hip ratio(WHR),waist height ratio(WHtR),fasting blood glucose(FPG),fasting blood glucose variation(FPG-CV)and glycosylated hemoglobin(HbA1C)to provide a reference for predicting the risk and development trend of diabetes mellitus.Methods:From October 2016 to December 2017,111 subjects from the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected to measure their height and weight.BMI,WHR and WHtR were calculated and the concentrations of FPG and HbA1C were detected.Statistical analysis was carried out with SPSS21.0 software,and the data were processed by multiple linear regression analysis.Results:The concentration dependence of WHtR,FPG,FPG-CV and HbA1C were more closely related.There was a significant difference between WHtR and FPG,FPG-CV and HbA1C by multiple linear regression analysis(t=8.531,6.910 and 6.905,respectively,P<0.01),and the correlation coefficient was 0.633,0.552 and 0.552 respectively(P<0.01).Conclusion:There is a significant correlation between WHtR and FPG,FPG-CV and HbA1C.Therefore,measuring the height and waist circumference for the predictive potential of diabetes needs to be emphasized and intensified.展开更多
Objective:To study the influence of sacubitril/valsartan on plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels in patients with heart failure. Methods: To choose 42 cases of chronic he...Objective:To study the influence of sacubitril/valsartan on plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels in patients with heart failure. Methods: To choose 42 cases of chronic heart failure in our hospital form August 2017 to December 2017 as the study group, and 42 cases of chronic heart failure form January 2017 to June 2017 as the control group. The patients in the control group were treated with 80 mg valsartan on the basis of general treatment, 1 times a day, and the patients in the study group were added with 50mg sacubitril/valsartan on the basis of general treatment, 2 times a day. To compare the plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels before and after treatment in the two groups.Results:Before treatment, there was no statistical difference between the levels of plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 in the two groups;(1) After treatment, the levels of plasma NE, AngⅡ, ALD in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two groups;(2) After treatment, the levels of serum sCD40L, sICAM-1, sFas, sFasL in the control group compared with those before treatment in the same group, there were significant differences, and there were significant differences between the two groups;(3) After treatment, the levels of serum cTnI, MMP-9 in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two groups.Conclusion: The application of sacubitril/valsartan to patients with heart failure on the basis of general treatment, not only could significantly improve the levels of plasma NE, AngⅡ, ALD, and also could significantly improve the levels of serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9, the curative effect was more significant, it was worthy for clinical research and application.展开更多
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金supported by Shanghai Municipal Education Commission-Gaoyuan Nursing Grant Support(No.Hlgy15004yjx)
文摘Objective： There is little information focusing on the nutritional issue of pediatric recipients before they receive living donor liver transplantation. This study illustrates the relationship between nutritional status and graft liver function and provides a reference regarding nutritional interventions in future studies.Methods： We prospectively collected data from 30 pediatric living donor liver transplant recipients from January 1, 2016, to June 30, 2016. The information included demographic data, preoperative nutritional assessment, and postoperative laboratory examinations. The nutritional assessment included the serum concentration of vitamin D, bone density, trace element, and weight Z value. The laboratory examinations included white blood cell count, neutrophil percentage, hemoglobin, blood platelet, total protein, albumin, total bilirubin, direct bilirubin, alanine transaminase, aspartate aminotransferase （AST）, alkaline phosphatase, gamma-glutamyl transpeptidase, creatinine, bile acid, blood glucose （Glu）, prothrombin time, international normalized ratio, tacrolimus concentration, and graft-to-recipient weight ratio （GRWR）. The data were collected on Days 1 ,2 ,3 ,4 ,5 ,6 ,7 ,1 4 ,3 0 , and 60 after liver transplantation. Results： The recipients consisted of 15 （50%） males and 15 （50%） females. K median age was 7 months （4-48 months）. The mean height and weight were 69.07±9.98 cm and 8.09±2.63 kg, respectively. According to the univariate analysis, the gender, diagnosis, blood type, and GRWR did not significantly impact the liver function after the operation. The posttransplantation AST levels and Glu showed significant differences in terms of the nutritional status, with P〈0.05. The multivariate correlation analysis showed that the serum concentrations of vitamin D and AST were midrange positively correlated, with P〈0.05.Conclusions： The nutritional status of patients with biliary atresia is relatively poor. There is a definite midrange positive correlation between nutrition and graft liver function that might play a relatively important role in the recovery of the graft.
基金financially supported by the Foundation for Chunhui Program of the Ministry of Education of the People's Republic of China under contract No.Z2011-062
文摘In order to improve the properties of silica sol shell for investment casting process, various contents of cattail fibers were added into the slurry to prepare a fiber-reinforced shell in the present study. The bending strength of fiber-reinforced shell was investigated and the fracture surfaces of shell specimens were observed using SEM. It is found that the bending strength increases with the increase of fiber content, and the bending strength of a green shell with 1.0 wt.% fiber addition increases by 44% compared to the fiber-free shell. The failure of specimens of the fiber-reinforced green shell results from fiber rupture and debonding between the interface of fibers and adhesive under the bending load. The micro-crack propagation in the matrix is inhibited by the micro-holes for ablation of f ibers in specimens of the f iber-reinforced shell during the stage of being fired. As a result, the bending strength of specimens of the fired shell had no significant drop. Particularly, the bending strength of specimens of the fired shell reinforced with 0.6wt.% fiber reached the maximum value of 4.6 MPa.
文摘For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.
文摘Objective:To investigate the relationship between body mass index(BMI),waist circumference(WC),hip circumference(HC),waist-hip ratio(WHR),waist height ratio(WHtR),fasting blood glucose(FPG),fasting blood glucose variation(FPG-CV)and glycosylated hemoglobin(HbA1C)to provide a reference for predicting the risk and development trend of diabetes mellitus.Methods:From October 2016 to December 2017,111 subjects from the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected to measure their height and weight.BMI,WHR and WHtR were calculated and the concentrations of FPG and HbA1C were detected.Statistical analysis was carried out with SPSS21.0 software,and the data were processed by multiple linear regression analysis.Results:The concentration dependence of WHtR,FPG,FPG-CV and HbA1C were more closely related.There was a significant difference between WHtR and FPG,FPG-CV and HbA1C by multiple linear regression analysis(t=8.531,6.910 and 6.905,respectively,P<0.01),and the correlation coefficient was 0.633,0.552 and 0.552 respectively(P<0.01).Conclusion:There is a significant correlation between WHtR and FPG,FPG-CV and HbA1C.Therefore,measuring the height and waist circumference for the predictive potential of diabetes needs to be emphasized and intensified.
基金Funded Project of Hebei Natural Science Foundation(H2016102348).
文摘Objective:To study the influence of sacubitril/valsartan on plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels in patients with heart failure. Methods: To choose 42 cases of chronic heart failure in our hospital form August 2017 to December 2017 as the study group, and 42 cases of chronic heart failure form January 2017 to June 2017 as the control group. The patients in the control group were treated with 80 mg valsartan on the basis of general treatment, 1 times a day, and the patients in the study group were added with 50mg sacubitril/valsartan on the basis of general treatment, 2 times a day. To compare the plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels before and after treatment in the two groups.Results:Before treatment, there was no statistical difference between the levels of plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 in the two groups;(1) After treatment, the levels of plasma NE, AngⅡ, ALD in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two groups;(2) After treatment, the levels of serum sCD40L, sICAM-1, sFas, sFasL in the control group compared with those before treatment in the same group, there were significant differences, and there were significant differences between the two groups;(3) After treatment, the levels of serum cTnI, MMP-9 in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two groups.Conclusion: The application of sacubitril/valsartan to patients with heart failure on the basis of general treatment, not only could significantly improve the levels of plasma NE, AngⅡ, ALD, and also could significantly improve the levels of serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9, the curative effect was more significant, it was worthy for clinical research and application.
