Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
Objective To evaluate the effectiveness and safety of autologous hemopoietic stem cell implantation for peripheral arterial disease (PAD). Methods Randomized controlled trials (RCTs) were identified from CBM (1978 to September 2010), CNKI (1979 to September 2010), MEDLINE (1950 to September 2010), Pubmed (1950 to September 2010), Embase (1970 to September 2010), and Cochrane l ibrary (issue 4, 2010). The papers of the RCTs of cl inical therapeutic studieson PAD treated by autologous hemopoietic stem cell implantation were included and analyzed according to the criteria of the Cochrane handbook. Results Eight RCTs involving 280 patients and 322 extremities were included, with majority of trials of low methodological qual ity. Meta-analysis indicated that autologous hemopoietic stem cell transplantation had an increased ulcer cure rate [RD=0.38, 95% CI= (0.25, 0.50)], a significant improvement in the ankle brachial index [MD=0.11, 95%CI= (0.04, 0.18)], transcutaneous oxygen tension [MD=7.33, 95%CI= (3.14, 11.51)], and pain-free walking distance [SMD=1.35, 95%CI= (0.90, 1.79)], a significant reduction in rest pain scores [MD= —1.70, 95%CI= (—2.15, —1.25)], and a significant benefit in terms of l imb salvage [RD= —0.19, 95%CI= (—0.31, —0.07)]. Only 2 trials reported the side effects of autologous hemopoietic stem cell transplantation, such as l imbs swell ing and concentrations of serum creatine phosphokinase increasing, and the long-term safety was not reported. Conclusion Based on the review, autologous hemopoietic stem cell transplantation may have positive effect on “no-option” patients with PAD. However, the evidence is not b enough due to the general low methodological qual ity, so we can not draw a rel iable conclusion about the effects of autologous stem cell transplantation for PAD at the moment. Further larger, randomized, double bl ind, placebo-controlled, and multicenter trials are needed.
ObjectiveTo investigate the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease (CKD).MethodsA total of 336 patients with CKD were investigated by a general data questionnaire, the CKD Self-care Behavior Scale, Social Support Scale, Generalized Anxiety Self-assessment Scale, and 9-item Patients Health Questionnaire through WeChat platform, and the influencing factors of self-care behavior were explored by binary logistic regression analysis.ResultsThe median score of self-care behavior of CKD patients without dialysis was 60, and the patients with median and high level of self-care behavior accounted for 97.6%. The score of self-care behavior of CKD patients without dialysis was positively correlated with the total score of social support (r=0.210, P<0.001), objective support score (r=0.127, P=0.020), subjective support score (r=0.195, P<0.001), and social support utilization score (r=0.164, P=0.002), and negatively correlated with the anxiety score (r=–0.132, P=0.015), depression score (r=–0.230, P<0.001), body mass index (r=–0.181, P=0.001), and systolic blood pressure (r=–0.168, P<0.001). The results of binary logistic regression analysis showed that the influencing factors of non-dialysis CKD patients’ self-care behavior were gender [(odds ratio, OR)=2.179, 95% confidence interval, CI (1.134, 4.187), P=0.019], systolic blood pressure [OR=0.967, 95%CI (0.947, 0.987), P=0.002], and depression score [OR=0.844, 95%CI (0.765, 0.931), P=0.001].ConclusionsThe self-care behavior of CKD patients without dialysis is at the median and high level. Healthcare workers can improve the self-care behavior of CKD patients by reducing their negative emotions such as depression, and guiding patients to carry out blood pressure management, to delay the progress of the disease.
We carried out study on surface electromyogram (sEMG) signal generated from cluster muscles in trunk and lower limbs on condition of human body walking with heavily burdened shoulder to explore functional status and fatigue property of human muscles and to offer an important reference for finding better ways of loading, improving the performance and design of backpack as well as weight-bearing system more suitable for ergonomics. We measured and obtained surface electromyography signals from the primary muscles clusters in neck, shoulder, back and leg of 20 test recipients loaded with different burdens on their shoulders. The eigenvalue of mean power frequency (MPF) were processed with SPSS 16.0. It could be concluded that with the increase of loading weights, male are more likely to be fatigued due to dramatic decrease of trapezius' MPF. While for the female test recipients, the cervical extensor muscles' MPF dropped significantly and were more easily fatigued. Moreover, there was a remarkable difference in terms of electromyography signal before and after the weight reaches certain limit (P<0.05) . The maximum weight limit loaded on shoulders for man is 12% of the total bodyweight while such limit for woman is just 9%.
ObjectiveTo sort out the key evidence-based data and recent advances in the systemic treatment of advanced triple-negative breast carcinoma (TNBC), to summarize the therapeutic strategies so as to provide guidance for clinical practice. MethodsThe key evidence and research progress on immune checkpoint inhibitors, antibody–drug conjugates (ADCs), poly ADP-ribose polymerase (PARP) inhibitors, anti-angiogenic agents, and novel microtubule inhibitors were summarized. ResultsThe treatment landscape for advanced TNBC has shifted from chemotherapy-centric approaches to biomarker-driven, stratified precision therapy. Based on programmed cell death ligand 1 (PD-L1) expression levels, immune therapy combined with chemotherapy is prioritized. For cases with germline breast cancer gene 1/2 (gBRCA1/2) mutations, PARP inhibitors are recommended. ADCs are suggested for second-line treatment, while novel microtubule inhibitors, either alone or in combination with anti-angiogenic agents, are preferred for later-line therapy to extend patient survival. ConclusionDynamic monitoring of molecular biomarkers such as PD-L1 and gBRCA, combined with sequential or combined "targeted–immunotherapy–ADC" regimens in a "chemotherapy-free" approach, has shown promise in improving overall survival in advanced TNBC.
Objective To provide references for fast assessment after disasters in China by assessing articles on fast assessment of health needs after disasters. Methods We systematically searched CNKI, VIP, CBM, and PubMed from their establishments to Jan. 2011. The main results of the eligible articles were described. Results A total of 65 articles were included, of which introductions for methodology and cross-sectional studies accounted for 52.31% and 44.62%, respectively. Articles which focused on natural disasters made up 86.15% of the total. Post-disaster rapid assessment should include seismic death estimate and on-site public health assessment which contained the public health status in affected areas, health coping capacity, health condition of victims and health needs. Rapid assessment of seismic death mainly used methods based on GIS and ANN model. On-site public health assessment mainly used epidemiological field investigation. Questionnaires, interviews and surveillance of diseases were adopted. Conclusion Rapid post-disaster health needs assessment is one of the most important tasks after disasters, and the current rapid assessment methods need to be refined and improved.
