Resuming oral anticoagulant (OAC) after intracerebral hemorrhage (ICH) is still a dilemma to clinical decision. To date, no high-quality randomized controlled trials demonstrate the timing and mode of safely resuming OAC. In recent years, some moderate-quality researches have suggested that OAC resuming after ICH can decrease the incidence of thromboembolic events and long-term mortality, without significantly increasing the risk of ICH; it is safer to resuming OAC in patients with non-lobar ICH than in patients with lobar-ICH; new OACs are superior to vitamin K antagonists; patients with high thromboembolic risk should resume OAC 2 weeks or even earlier after ICH, otherwise, a time-window for optimal resumption is between 4-8 weeks; meanwhile, individual patient characteristics should be considered and blood pressure should be strictly controlled.
【摘要】 目的 總結2例特重燒傷患者在ICU的救治經驗和體會，旨在進一步提高特重燒傷患者的救治水平。 方法 回顧分析2009年6月2例重癥燒傷患者的診治經過程和臨床資料。 結果 1例患者病情好轉，轉出ICU繼續治療，1例患者傷后37 d因消化道出血死亡。 結論 特重燒傷患者的治療需要整體計劃和多科協作。【Abstract】 Objective To summarize the experiences of the management of two patients with severe burn, so as to improve the treatment of severe burn patients. Method Treating processes and clinical data of two patients with severe burn in June 2009 were analyzed retrospectively. Result After prompt treatments, one patient died of severe bleeding in the digestive tract 37 days after the burn and the other patient recovered and left ICU for further treatment. Conclusion Bundle treatment and multi-subject cooperation are important for treating patients with severe burn.
Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital. Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006. There were 15 males and 28 females, aging from 26 years to 77 years 〔(58.88±13.90) years〕. The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA. The follow-up ranged from 1 month to 39 months. The following factors, which might influence the prognosis, were analysed through multiple linear regression of SPSS 10.0: age, sex, uper limb or lower limb, location of embolus, ischemic time, clinical categories of acute limb ischemia, history of smoking, atherosclerosis and other combined diseases, pervious history of acute limb arterial embolism, operative or nonoperative treatment, and postoperative complications. Results Clinical categories of acute limb ischemia include: Ⅰ (n=0),Ⅱa (n=16), Ⅱb (n=29), Ⅲ (n=7). The ischemic time varied from 3 h to 2 weeks. The sources of embolus: heart (n=39), vessle (n=7), iatrogenic origin (n=1), unidentidied origin (n=5). The therapies included embolectomy (n=38), catheter-directed thrombolysis (n=2) and medical treatment (n=12). The following postoperative complications occured: compartment syndrome (n=12), respiratory failure (n=3), alkalolsis (n=3), acute renal failure (n=2), wound infection (n=2) and pulmonary infection (n=1). Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge. Thirty-eight patients with 45 diseased limbs were followed up. The results were excellent in 13 limbs, good in 15 ones, fair in 8 ones and poor in 9 ones. The statistically significant influencing factors of prognosis include ischemic time, clinical categories of acute limb ischemia and history of smoking (P＜0.05). Conclusion The operation of embolectomy is the main treatment of acute limb arterial embolism. In selected patients, catheter-directed thrombolysis and medical treatment could be used to alleviate the limb ischemia. The treatment against the etiological factors should not be ignored. The prognosis of this disease could be influenced by ischemic time, clinical categories of acute limb ischemia and history of smoking.
ObjectiveTo systematically review the effects of condom use before and after AIDS behaviour intervention among Chinese unlicensed prostitutes.
MethodsDatabases such as PubMed, The Cochrane Library (Issue 5, 2014), VIP, WanFang Data and CNKI were searched to collect nationally/internationally-published before-after studies about the effects of condom use before and after aids behaviour intervention among Chinese unlicensed prostitutes up to June 1st, 2014. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.0 software.
ResultsA total of 26 studies were finally included. The results of meta-analysis showed that:significant differences were found at two points of "use condoms in the latest sex behaviour" (RR=0.76, 95%CI 0.72 to 0.82, P<0.05) and "use condoms every time in the latest month" (RR=0.61, 95%CI 0.53 to 0.70, P<0.05) before and after intervention.
ConclusionAIDS behaviour intervention can significantly promote condom use in Chinese unlicensed prostitutes, which is effective in the prevention of AIDS.
