摘要:目的:探討接受超聲引導下經直腸前列腺穿刺活檢術(transretal prostatic biopsy,TPB)檢查的臨床護理相關問題,為前列腺穿刺活檢臨床護理提供參考。方法:通過心理疏導接解除者術前對TPB的恐懼心理,明確TPB是比較安全、可靠的、不可替代的檢查方法,了解手術過程、護理方法和一般并發癥,提高TPB的檢查效果及護理質量。結果:71例患者進行TPB檢查,全部患者均能主動配合檢查操作,檢查術中并發迷走神經心血管反射1例,術后并發血尿4例,短期內疼痛5例,均早期發現,給與相應的護理與治療后治愈。結論:TPB是前列腺占位性病變患者有效的定性有創性檢查方法,對行TPB檢察患者患者應采取針對性的護理措施,提高護理質量及檢查安全性。 Abstract: Objective: To investigate correlative nursing measure of patients with transretal prostatic biopsy (TPB) guided by ultrasound, provide reference for clinical nursing of TPB. Methods: We dismissed patient’s fear by psychological nursing, and explained that TPB was a safe, reliable and nosubstitutive checking, and help them understand procedure of operation, nursing measure and common complication, so as to improve effect of checking and quality of care. Results: Seventyone patients received checking with TPB, all patients could initiativiy go with checking, one patient took place pneumogastric nerve reflect, 4 patients take place hematuria postoperation, 5 patients feel soreness in shortterm. All complications were found in morning, and were cure by nursing and treatment. Conclusion: TPB is valid checking method to occupy lesion of prostate for qualitation. Because TPB is a traumatic operation, homologous nursing measure must be take to improve safety of TPB and quality of care.
Objective To evaluate the efficacy and safety of prostaglandin E1 (PGE1) for diabetic peripheral neuropathy (DPN). Methods We searched the Cochrane Library, PubMed, EMbase, CNKI, VIP and handsearched Chinese Journal of Metabolism, Chinese Journal of Diabetes and New Chinese Medicine. Randomized controlled trials of clinical therapeutic studies on PGE1 for DPN were included. The quality of included studies was evaluated and Meta-analysis was performed. Results Thirty-one trials involving 2 497 participants were included. Meta-analysis indicated that PGE1 was more effective than Vitamin B, Placebo and other microcirculation improving drugs in improving symptoms and signs of DPN. The RR (95%CI) were ［RR=1.75, 95％CI (1.54, 2.00)］, ［RRpooled=1.57, 95％CI (1.42, 1.74)］and［RR=1.31, 95％CI (1.19, 1.45)］respectively. PGE1 was more effective than Vitamin B, Placebo and other microcirculation improving drugs in improving nerve conduction velocity (NCV) of DPN patients. For spontaneous pain and hypesthesia of DPN patients, Lipo-PGE1 was more effective compared with PGE1-CD and the RR (95%CI) was［RR=1.43, 95％CI (1.16, 1.76)］. Slight adverse effects were reported in 16 studies. Conclusion Based on this review, PGE1 is effective for DPN. However, the evidence is not b enough due to the low quality of included trials. Further large-sample and multi-center studies are needed.
Objective To observe the content of thromboxane (TXA2 ) and prostacyclin (PGI2) in optic nerves after forehead impact injury.Methods The right forehead zones of 32 rabbits were struck by biology impact machine. Tweenty-four rabbits that had afferent papillary defect after injury were chosen, and randomly divided into four groups: 1 day, 2, 4, and 7 days group. Right eyes were in the experimental group and left eyes were in the control group. Flash visual evoked potentials were examined before and after the traumatic injury. The rabbits ′eyes were removed, the optic nerves were pathologically examined, and the content of TXB2 and 6-Keto-PGF1αwhich were the products of TXA2 and PGI2 were assayed 1, 2, 4, and 7 days after traumatic injury respectively.Results Histopath ological examination revealed the findings of injuries of optic nerves of all the 24 rabbits. The latency of wave P1 was significantly delayed after traum atic injury (Plt;0.01), and amplitude of wave P1 was significantly decreased after traumatic injury (Plt;0.01). The content of TXB2 ［(172.35±26.52) pg/mg ］and 6-Keto-PGF1α［(161.78±24.83) pg/mg］were significantly higher in the injured optic nerves than in the uninjured ones 1 day after the traumatic injury (Plt;0.01). The rate of TXB2 /6-Keto-PGF1α (1.077±0.18) was significantly increased compared to the control group (Plt;0.05), and lasted to the 7th day.Conclusions The content of TXA2 and PGI2 significantly increases and the ratio of them is lopsided after forehead impact injury in rabbits. (Chin J Ocul Fundus Dis，2003，19：49-51)
ObjectivesTo systematically review the association between the variants of HNF1B gene and the risk of prostate cancer.MethodsPubMed, EMbase, The Cochrane Library, CNKI, CBM and WanFang Data databases were electronically searched to collect case-control studies on the association between the variants of HNF1B gene and risk of prostate cancer from inception to December, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 15 case-control studies involving 30 532 patients and 38 832 controls were included. The results of meta-analysis showed that: there was a strong significant association between rs4430796 variants (Gvs.A: OR=0.802, 95%CI 0.784 to 0.821, P<0.001; GGvs.AA: OR=0.659, 95%CI 0.606 to 0.717, P<0.001; AGvs.AA: OR=0.762, 95%CI 0.714 to 0.814, P<0.001), rs11649743 variants (Avs.G: OR=0.875, 95%CI 0.820 to 0.941, P<0.001; AAvs.GG: OR=0.669, 95%CI 0.564 to 0.792, P<0.001; AGvs.GG: OR=0.855, 95%CI 0.798 to 0.916, P<0.001), rs7501939 variants (Avs.G: OR=0.833, 95%CI 0.807 to 0.859, P<0.001), rs3760511 variants (Avs.C: OR=0.834, 95%CI 0.803 to 0.868, P<0.001) and risk of prostate cancer.ConclusionsCurrent evidence shows that HNF1B gene variants are associated with risk of prostate cancer. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the above conclusion.
ObjectiveTo assess the methodological and reporting quality of systematic reviews/Meta-analyses (SRs/MAs) of transurethral procedure for benign prostatic hyperplasia (BPH).
MethodWe electronically searched databases including PubMed, The Cochrane Library (Issue 12, 2014), Sciverse, CNKI, VIP and WanFang Data from inception to December 2014 to collect SRs/MAs of transurethral procedure about BPH. Two reviewers independently screened literature and assessed the methodological and reporting quality of included SRs/MAs by AMSTAR and PRISMA checklists.
ResultsA total of 33 SRs/MAs were included. The results of qualitative analysis showed that:the main methodological weakness of included SRs/MAs included the lack of protocol, disappropriate conclusion formulation, the lack of publication bias assessment, and the lack of stating the conflict of interest. The average score of AMSTAR scale was 6.27±2.14. There were 11 items in PRISMA checklist with coincidence rate over 80%, 8 items between 50% to 80%, and 8 items less than 50%.
ConclusionThe methodological and reporting quality of SR/MA of transurethral procedure for BHP is low, and that may decrease the reliability and value of results from SRs/MAs in the field. Future SRs/MAs should strictly follow the related reporting guidelines in order to improve the methodological and reporting quality, so as to provide more reliable evidence for clinical decision.
Objective To evaluate the effectiveness and safety of misoprostol versus gemeprost for the first and second-trimester induction of abortion. Methods We searched randomized controlled trials（RCTs） and quasi-randomized controlled trials of misoprostol versus gemeprost for the first and second-trimester induction of abortion operation. MEDLINE （1974 - 2003 ）, EMBASE （1974 - 2003 ）, The Cochrane Library （Issue 3, 2003 ）, CBM （1979 - 2003 ）, CNKI （1989 - 2003 ）, CMCC （1994 - 2003 ）, VIP （1989 - 2003 ） were searched. Twelve journals and reference lists of eligible studies were handsearched. Two reviewers independently screened the studies for eligibility, evaluated the quality, and extracted data from eligible studies with confirmation by cross checking. Any disputes were decided by a third person. Meta-analysis was conducted using RevMan 4.2 software. Results Seven RCTs were included, three for the first-trimester and four for the second- trimester. Statictical differences were tested between the misoprostol and gemeprost groups with OR 4. 79,95% CI 1.35 to 16.94 in laxation and dilation rate,with WMD -1.50,95% CI -3.00 to 0.00 in operation time for the first-trimester abortion. However, there was no statistical difference in the amount of bleeding during operation with WMD - 14. 40, 95% CI 30.30 to 1.30. For the second-trimester abortion, compared with gemeprost, no consistent results of gravid excluding time were obtained. Compared with gemeprost, the rate of complete abortion was higher and digest system morbidity was lower in misoprostol alone group. But there was no statistical difference between the two groups when they were both combined with mifestone.Conclusions Some evidence indicates that compared with gemeprost, misoprostol may increase laxation and dilation rate of the cervix, shorten gravid exclusion time, improve the rate of complete abortion and make the laxation and dilation range of the cerix larger than gemeprost before the first and second-trimester abortive surgery. Due to the hmited evidence indentified, we can not draw a b conclusion. More radomiased controlled trails of high quahty are required.
Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in men undergoing transurethral resection of prostate (TURP) who have sterile preoperative urine. Method MEDLINE, EMBASE and Cochrane Library were searched for RCTs comparing antibiotic prophylaxis and placebo/blank controls for men undergoing TURP with preoperative sterile urine. The search strategy was established according to the Cochrane Prostatic Diseases and Urologic Cancers Group search strategy. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results Fifty three relevant trials were searched, of which 27 trials were included and 26 were excluded. Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria.The pooled relative risk (RR) and 95% confidence interval were 0.36 (0.28, 0.46). Conclusions Prophylactic antibiotics could significantly decrease the incidence of post-TURP bacteriuria. Further comparative RCTs and cost-effective should be performed analysis to establish the optimal antibiotic regimes for the benefit of patients undergoing TURP.
