Objective To summarize the available clinical research evidence on gliquidone for treating diabetes mellitus. Methods The clinical research on gliquidone for diabetes mellitus was systematically searched and appraised. Result Six randomized controlled trials and eleven controlled clinical trials were identified. The methodological quality of most papers about gliquidone for diabetes mellitus was poor. Currently, clinically patient-related endpoints as outcome measures and health economic analyses are lacking in this field. Conclusions Based on the available evidence, gliquidone appears specifically applicable to elderly diabetic patients with kidney diseases. More methodologically sound and patient-related endpoints and economic analyses based on clinical research are required.
Objective To summarize the available clinical research evidence for the treatment of hepatorenal syndrome (HRS). Methods Using the basic methods and principles of evidence-based medicine, we searched and evaluated clinical studies involving the treatment of HRS. Results We found that plasma expansion, vasoconstrictor, transjugular intrahepatic portosystemic shunts (TIPS) and liver transplantation were effective interventions for patients with HRS. Conclusion HRS is a common complication of end-stage liver diseases and the prognosis for patients with HRS is extremely poor. However, due to the small number of clinical trials, small sample sizes and low methodological quality, the strength of the current evidence is limited. Rigorously-designed, randomized, multi-center, large-scale trials on HRS are required.
Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
Objective Vibration response imaging(VRI) is a new lung sound imaging technology.It provides quantitative lung data（QLD） of vibration in respiratory system.The study is to explore the value of QLD in diagnosis of obstructive lung diseases.Methods The QLD of 61 chronic obstructive pulmonary disease（COPD） patients，58 asthma patients and 64 healthy volunteers were reviewed.The QLD were transferred to abnormity and variation by a formulation and were analyzed.Results The mean QLD of healthy volunteers were 8.4，14.5，22.0，11.1，18.5，25.5 with mean abnormity as 10.0 and mean variation as 2.0.The mean QLD of the COPD patients were 11.6，16.7，21.9，12.6，17.2，20.1 with mean abnormity as 47.1 and mean variation as 10.9.The mean QLD of the asthma patients were 12.8，17.2，19.9，13.3，17.5，19.3 with mean abnormity as 58.1 and mean variation as 12.2.The abnormity and variation of the patients were different from those of volunteers（Plt;0.05）.When abnormity≥20.0 or variation≥5.0 was define as threshold value，the specificity was 87.5%.The diagnosis sensitivity for COPD is 82.0% and sensitivity for asthma is 82.8%.Conclusion COPD and asthma patients can be detected by quantitative lung data from vibration response imaging.
Objective Based on the methodology of evidence-based medicine, we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidence of type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer fromspontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.
Objective To summarize the available clinical evidence on the treatment of non-proliferative diabetic retinopathy (NPDR). Methods Based on the basic methods and principles of evidence-based medicine, we searched and evaluated the NPDR-related evidence from the Cochrane Library(Issue 3,2007), PubMed (1966 to June 2007) and CBM(1979 to June 2007) Results We finally identified 1 systematic review and 20 randomized controlled trials. Clinical evidence showed that critical glycemic control and blood pressure control were essential in the treatment of NPDR, which might delay the progression of retinopathy. The effectiveness of other therapeutic measures needed to be further investigated. Conclusion NPDR is the early stage of diabetic retinopathy (DR). Relevant systematic reviews and high-quality randomized controlled trials have confirmed the effectiveness of critical control of blood glucose and blood pressure for NPDR. The effectiveness of other therapeutic measures needs to be confirmed by systematic reviews of high quality and rigorously designed randomized, multi-center and large-scale trials.
【摘要】 目的 探討納米羥基磷灰石/聚酰胺66（nano-hydroxyapatite polyamide66，n-HA/PA66）頸椎融合器在頸椎間盤突出癥前路手術重建中的臨床療效。 方法 2008年12月-2010年6月，對14例頸椎間盤突出癥患者行前路椎間盤切除、椎管減壓，以n-HA/PA66椎間融合器支撐植骨、鋼板螺釘內固定治療。隨訪時間3～12個月，平均6.3個月；隨訪時以日本矯形外科學會（Japan Orthopaedic Assoctiation， JOA）評分改善率評價患者神經功能恢復情況，復查X線片評估椎間融合器植骨融合情況，包括椎間高度及椎間融合器下沉情況。 結果 14例患者均成功完成頸椎前路減壓手術以及椎間融合器的安放固定。所有患者術前癥狀均得到不同程度的改善，術后3、6、12個月的JOA改善率分別為87.0%、94.0%、97.0%。影像學檢查顯示所有患者植骨融合，椎間高度及椎間融合器的位置維持良好，無下沉、移位。 結論 n-HA/PA66頸椎間融合器具有早期支撐穩定功能，可有效維持頸椎椎間高度；術后植骨融合率高且便于X線片觀察，是頸椎間盤突出癥患者前路手術植骨的理想支撐材料，但長期效果需進一步隨訪觀察。【Abstract】 Objective To evaluate the clinical effect of artificial cervical vertebra fusion apparatus of n-HA/PA66 in anterior reconstruction of cervical intervertebral disc herniation. Methods From December 2008 to June 2010, 14 patients with cervical intervertebral disc herniation underwent anterior cervical discectomy,spinal canal decompression,spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. The patients were followed up for 3 to 12 months with an average of 6.3 months. Neurological function was evaluated by improvement rate of JOA score and situations of the supporting body was observed by X-ray in 3,6,and 12 months after the surgery.The intervertebral height,the 1ocations, and the fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements. Results All the patients had undergone the operation successfully.The preoperative symptoms improved to varying degrees.JOA improvement rate were 87.0%, 94.0%, and 97.0% 3,6,and 12 months after the operation,respectively.Imaging studies showed that in all cases graft fusion were achieved,and cervical alignments,intervertebral height,cervical spine stability and the locations of the artificial vertebral body were well maintained.No displacement and subsidence of the artificial vertebral body occurred. Conclusion n-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and cervical intervertebral height.It has a high rate of graft fusion and is convenient to observe by X-ray.Therefore,n-HA/PA66 can be taken as an ideal graft for anterior degenerative cervical spine operation,but further follow-up study is still needed to evaluate the long-term effects.
【摘要】 目的 應用調查問卷分析培訓前后成都市社區醫生對肺炎球菌疫苗的認識，為推動社區肺炎球菌疫苗接種奠定基礎。 方法 對215名成都市社區醫生進行肺炎球菌疾病及預防知識的培訓，并在培訓前后行問卷調查，回收問卷并分析。 結果 經培訓，社區醫生提高了對肺炎球菌疾病及疫苗接種知識的掌握程度，加深了對肺炎球菌疾病及疫苗接種重要性的認識。 結論 對社區醫生進行肺炎球菌相關知識的培訓，有利于提高社區醫生對肺炎球菌疫苗接種推薦的專業性和成功率。【Abstract】 Objective To know the community doctors’ understanding of pneumococcal vaccine before and after the education via questionnaire. Methods A total of 215 community doctors in Chengdu were educated in pneumococcal disease and the prevention knowledge. Questionnaire investigation was performed before and after the education and the results were analyzed. Results After the education, the acknowledgement of pneumococcal vaccination of the community doctors was improved. Conclusion The education of the knowledge of pneumococcal vaccine for the community doctors helps to improve the acknowledgement of pneumococcal vaccination.
Gordon Henry Guyatt(1953-)is a professor of Department of Clinical Epidemiology amp; Biostatistics and Department of Medicine in McMaster University. He has engaged in evidence-based clinical research and practice for about 20 years. In 1992, he first proposed the term “evidence-based medicine” in one of his articles published in JAMA. He is dedicated to bringing the wonderful idea of evidence-based medicine to bedside and systematically training clinicians from all over the world to acquire the basic skills for evidence-based clinical practice. His great contribution to evidence-based medicine is introduced in this article through demonstrating the development of evidence-based clinical practice.
Objective To explore the shortcomings of the traditional clinical probation teaching mode, propose and implement the interactive teaching mode, so as to stimulate the students’ interest in knowledge and achieve better teaching effects. Methods The students of Grade 2017 who had clinical probation in the Orthopaedic Trauma Center of West China Hospital of Sichuan University from September 2020 to December 2021 were selected. Students were randomly divided into traditional clinical probation teaching mode group and interactive teaching mode group according to random number table method. Wechat mini program anonymous questionnaire survey was used to evaluate students’ satisfaction with the interactive teaching model of orthopaedic trauma and the teaching effect. Results A total of 110 students were enrolled, 55 in the traditional clinical probation teaching mode group and 55 in the interactive teaching mode group. There was no significant difference in gender or age between the two groups (P>0.05). The students in the interactive teaching mode group were better than those in the traditional clinical probation teaching mode group in orthopedic theory test (90.13±3.65 vs. 88.39±3.74; t=2.469, P=0.015) in the orthopedic theory test, teacher evaluation (89.15±2.94 vs. 87.56±3.12; t=2.751, P=0.007) and student self-evaluation (89.07±3.18 vs. 87.41±2.89; t=2.865, P=0.005). The teaching satisfaction of the interactive teaching group was higher than that of the traditional teaching group (96.36% vs. 87.27%; Z=?2.159, P=0.031). Conclusion Interactive teaching mode can effectively stimulate students’ interest in knowledge seeking, improve the enthusiasm and interaction of clinical probation, and effectively improve the satisfaction of undergraduate orthopaedic trauma clinical probation teaching.
