ObjectiveTo investigate the domestic and abroad hypertension-related clinical trial registration and to analyze the registration of hypertension-related clinical researches in China.MethodsUsing hypertension as the keyword, we searched ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR) from January 2008 to December 2018. We analyzed the collected data on the distribution of registered clinical researches, annual trends, sample sizes, trial progress, research types, study designs, blind methods, clinical stages, the number of participating institutions, the leading institutions, etc.ResultsThe total number of registered hypertension-related clinical trails was 4 991 all over the world, and 551 items were conducted in China. Most of the sample sizes of Chinese hypertension-related clinical trials were 100 to 999. The main types of trials were interventional studies (393 items, 71.32%), followed by observational studies (126 items, 22.87%). Randomized parallel control studies (300 items, 76.34%) were the key component of interventional studies, while cohort studies (61 items, 48.41%) were the chief component of observational studies. The main stages of clinical trials were stage Ⅲ (80 items) and stage Ⅳ (122 items). There were 369 domestic single-center clinical trials (66.97%), 89 domestic multi-center clinical trials (16.15%), and 93 international multi-center clinical trials (16.88%). Among the 93 international multi-center trials of hypertension, only 25 were led by China.ConclusionsThe number of Chinese hypertension-related clinical trial registrations increased year by year and then decreased slightly, but the amount of registrations is limited. The quantity and scale of multicenter clinical studies were not as good as America. China should strengthen the awareness of clinical research registration, strengthen the publicity and supervision of the registration of clinical researches by the department of science and management, improve the number of clinical trial registrations, make Chinese clinical researches more transparent, and strive to lead more international multi-center clinical trials.
Objective To review progress of clinical application ofmorselized bone and to investigate relative exploration on it.Methods The recent articles on morselized bone in the field of clinicand experimental research were extensively reviewed, and relative examination of morselized bone referring to method and mechanism were investigated carefully.Results Morselized bone worked well clinically, especially inrevision ofartificial total hip joint, and it was proved effective with lots of advantages.Conclusion Morselized bone functions well clinically. Although its mechanism requires a further research, it still has a promising value in clinical application.
Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.
OBJECTIVE: To investigate the feasibility of segmentation of latissimus dorsi on the basis of anatomy and electrophysiology. METHODS: Ten cadaveric latissimus dorsi was dissected according to the blood supply, nerve innervation. Electromyelogram (EMG) of latissimus dorsi of 13 healthy persons was recorded with superficial electrode plate in the motion of shoulder joint. The results of record were managed with statistic methods. Ten patients(including reconstruction of breast and repair of scar on elbow joint and on chest wall) were treated with the lateral inferior myocutaneous island flap. RESULTS: According to the medial and lateral vasculonervous branches, latissimus dorsi can be divided into the medial superior and lateral inferior segments. The clinical application of the segment achieved good results in reconstructing breast and in repairing scars on elbow and on chest wall. CONCLUSION: Latissimus dorsi can be divided into two segments and applied separately. The lateral inferior segment is more useful in shoulder motion.
To study the effect of intraperitoneal hyperthermic double distiled water and cis-diamminedichloro-platinum(DDP) perfusion to the peritoneal cancerous ascites,intraperitoneal injection of H22 cancer cells (2×107 tumor cell,each mouse) were performed in LACA mice. Five days after cancer cells injection, intraperitoneal perfusion of simple hypertherrnic (43℃) double distiled water(group Ⅰ) isotonic fluid (group Ⅱ ). DDP (group Ⅲ ), and hypertherrnic double distiles water perfusion combined with DDP (guoup Ⅳ ) were performed .The results showed that cancer cells in the peritoneal cavity of LACA mice were seriously damaged, the production of ascites was markedly inhibited and the survival days of LACA mice were prolonged in all groups . .The intraperitoneal hyperthermic double distilled water perfusion with DDP group showed more effective result as compared with the other groups,Only 1 peritoneal implanted dissemination was found after treatment in this group,Basing on the experimental from September 1991 through September 1993,intraperitoneal hyperthermic double distiled water perfusion with DDP was used to treat 32 advanced gastric cancer patients after radical gastrectomy with satisfactory results.
Objective
To evaluate the effects of emergency coronary artery bypass grafting (ECABG) in the treatment of emergent patients, and to summarize our experience.
Methods
We retrospectively analyzed the clinical data of 160 patients who underwent coronary artery bypass grafting (CABG) in Nanjing General Hospital of Nanjing Command from January 2010 through December 2013. The patients were divided into an ECABG group (operation underwent on the day diagnosed, n=27, 22 males and 5 females, at age of 70.2±10.2 years) and a conventional group (CABG operation underwent on 5 days after diagnosed, n=133, 104 males and 29 females, at age of 66.3±8.9 years).
Results
Statistical differences were found between the ECABG group and the conventional group in EuroSCORE (5.8±3.2 versus 3.4±2.1, P=0.001), acute myocardial infarction (33.3% vs. 11.3%, P=0.007), rate of application of IABP (29.6% versus 12.0%, P=0.034), pericardium and mediastinal tube drainage (533.4±132.8 ml versus 414.8±124.3 ml, P=0.018). There was no statistical difference in continuous renal replacement therapy (P=0.677), postoperative sternal wound complication (P=1.000), the length of hospital stay (P=0.589), or 30-day-mortality (P=0.198) between the two groups. We followed up 24 patients(88.89%) for 3-36 months in the ECABG group. One patient occurred angina symptoms at the end of 1 year follow-up. The symptoms disappeared after treatment. The other patients had no symptoms of angina pectoris and myocardial ischemia.
Conclusion
ECABG as a lifesaving therapy is an effective procedure in the treatment of severe and acute patients. Sufficient preoperative assessment, good myocardial protection, full revascularization, and comprehensive treatment plays an important role in the success of ECABG.
ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.
ObjectiveTo analyze the clinical presentations and radiological characteristics of pulmonary vein stenosis after radiofrequency ablation.
MethodsClinical and radiological data of 2 patients with pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation were retrospectively analyzed and literatures were reviewed.
ResultsBoth patients had undergone circumferential pulmonary vein isolation. The symptoms appeared approximately 2 months after the operation. The major symptoms were cough, hemoptysis, exacerbation of dyspnea and chest pain. Both patients were misdiagnosed as other diseases such as pneumonia in other hospitals, and the anti-infection therapy was invalid. Both CT scans showed parenchymal exudative consolidation with varying degrees of interstitial septal thickening and small nodules. Both patients were confirmed as pulmonary vein stenosis by CT angiography. Literature review identified 21 cases of pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation. The main clinical features are hemoptysis, chest pain, shortness of breath and cough. The most common features of thoracic radiological imaging are consolidation, groud-glass attenuation, pleural effusion and interstitial septal thickening.
ConclusionsIf a patient presents with hemoptysis, dyspnea, chest pain or other clinical manifestations after ablation therapy and image findings show parenchymal exudative consolidation with interstitial septal thickening and multiple small nodules, the possibility of pulmonary vein stenosis should be considered. Contrast-enhanced CT combined with pulmonary vein imaging technology can clearly show the opening diameter of each pulmonary vein and its branches, so it is an important non-invasive examination method for the evaluation and diagnosis of pulmonary vein stenosis.
