Transcatheter aortic valve replacement (TAVR) is an important treatment for patients with symptomatic severe aortic stenosis. The 2020 updated version of Chinese Expert Consensus on Transcatheter Aortic Valve Replacement was born in the process of Chinese exploration for TAVR. It is of epochal guiding significance for TAVR in China, which has entered a stage of rapid development from the initial stage. Moreover, it further promotes the standardized and healthy development of TAVR in China. The 2020 updated version of Chinese Expert Consensus on Transcatheter Aortic Valve Replacement, based on its 2015 version, has included aortic valve stenosis with a low risk of surgical operation as an indication, made more detailed recommendations on the operating specifications of balloon dilation and valve placement during TAVR, added the antithrombotic program after TAVR, and important opinions on the treatment of coronary atherosclerotic heart disease, renal insufficiency, and emergency TAVR. In this article, we will focus on all these updates to interpret the updated consensus in detail.
Objective To systematically review the efficacy and safety of non-ergoline dopamine agonists (pramipexole, ropinirole, and rotigotine) and α2δ ligands (pregabalin and gabapentin-enacarbil) in the treatment of restless legs syndrome (RLS). Methods The PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, and CNKI databases were electronically searched for randomized controlled trials (RCTs) assessing different medications for RLS from 2000 to 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The network meta-analysis was then performed using Stata 16.0 software and R 4.1.0 software. Results A total of 36 RCTs involving 7 666 patients were included. The results of the network meta-analysis showed that gabapentin-enacarbil decreased IRLS scores to the greatest extent among all drugs (MD=?6.42, 95%CI ?8.8 to ?4.16), was superior to pramipexole (MD=?3.27, 95%CI ?6.54 to ?0.15), and was associated with the highest CGI-I response rates (RR=1.73, 95%CI 1.52 to 2.00). In terms of tolerance and safety, patients receiving rotigotine presented an increased incidence of withdrawal due to adverse events. Ropinirole had the highest incidence of nausea. Headache was most common side effect in rotigotine, while the incidences of somnolence and dizziness were higher in gabapentin-enacarbil than other treatments. Conclusion Current evidence suggests that gabapentin-enacarbil may be the best treatment for RLS. Rotigotine is associated with the worst tolerance. For safety, nausea is most common in ropinirole, headache is most common for rotigotine, and patients receiving gabapentin-enacarbil show increased incidences of somnolence and dizziness.
【摘要】 目的 探討護理不良事件報告機制的構建與完善情況。 方法 根據護理工作不良事件發生的類別、范圍，確定不良事件報告原則，報告程序，構建護理不良事件報告機制。 結果 護理不良事件申報機制形成后，院內護理不良事件發生率及重復發生率逐月下降、主動申報率上升，與構建護理不良事件報告機制前一年比較，差異有統計學意義（Plt;0.05）。 結論 護理不良事件報告機制有助于護理安全管理。【Abstract】 Objective To investigate the construction and improvement of reporting system of nursing adverse events. Methods According to the types and scales of the nursing adverse events, reporting principles and procedures were confirmed, and the reporting system of nursing adverse events was constructed. Results The rates of nursing adverse events and repetition incidence decreased gradually and the rate of initiative declaring increased significantly compared with those one year before the construction of the reporting system (Plt;0.05). Conclusion Reporting system of nursing adverse events helps to improve the management of nursing security.
ObjectiveTo investigate the correlation between UBE2Q1 expression and clinicopathologic features and prognosis of lung adenocarcinoma. MethodsThis study retrospectively chose the cancer tissue and para-carcinoma tissue samples of 74 patients with stage I to III lung adenocarcinoma who received radical resection in Nanjing Chest Hospital from January 2013 to December 2016. Immunohistochemistry staining was used to detect the expression level of UBE2Q1, and patients were divided into high-expression group and low-expression group according to the Immunohistochemistry staining score. The correlation of UBE2Q1 expression level and clinicopathological characteristics was analyzed by Chi-square test. Kaplan-Meier survival curve analyzed the correlation between UBE2Q1 and prognosis of lung adenocarcinoma patients. The risk factors affecting the survival of lung adenocarcinoma patients were analyzed by univariate and multivariate Cox proportional risk models. ResultsUBE2Q1 was highly expressed in lung adenocarcinoma tissues, and the expression level was correlated with tumor diameter, lymph node metastasis, and TNM stage (P<0.05), and did not correlate with patients’ gender, age, smoking history, and tumor differentiation (P>0.05). The results of the Kaplan-Meier survival analysis showed that patients with low expression of UBE2Q1 compared with those with high expression of UBE2Q1 had longer DFS and OS (both P<0.05). Cox proportional risk model showed that tumor diameter, lymph node metastasis, TNM stage, and high UBE2Q1 expression were the risk factors for DFS and OS, among which TNM stage was an independent risk factor. ConclusionUBE2Q1 was highly expressed in lung adenocarcinoma tissues and correlated with large tumor diameter, lymph node metastasis, late TNM stage and poorer prognosis in lung adenocarcinoma, and UBE2Q1 was a risk factor for lung adenocarcinoma.
ObjectivesTo evaluate the reporting quality of individual/focus group interviews published in nursing journals included in the Chinese science citation database (CSCD).MethodsCSCD database was electronically searched to collect qualitative studies published in nursing journals included in CSCD from January 2016 to December 2018. Two researchers independently screened literatures, extracted data, and assessed the quality of included studies by COREQ guidelines, SPSS 25.0 software was then used for statistical analysis.ResultsA total of 223 qualitative researches were included. The results of COREQ evaluation showed that full report rate of 43.8% (14/32) studies were less than 50%, 78.6% (11/14) were less than 20%, and the full report rate of item 4 was even 0%. There were no significant differences between different total cites and the availability of funding in COREQ guidelines.ConclusionThe reporting quality of the qualitative researches published in the four nursing journals included in the CSCD requires further improvement. Therefore, we suggest that domestic nursing journals should introduce COREQ guidelines in contribution and strictly implement it in editorial review and peer review.
Temporomandibular joint disorder (TMD) is a common oral and maxillofacial disease, which is difficult to detect due to its subtle early symptoms. In this study, a TMD intelligent diagnostic system implemented on edge computing devices was proposed, which can achieve rapid detection of TMD in clinical diagnosis and facilitate its early-stage clinical intervention. The proposed system first automatically segments the important components of the temporomandibular joint, followed by quantitative measurement of the joint gap area, and finally predicts the existence of TMD according to the measurements. In terms of segmentation, this study employs semi-supervised learning to achieve the accurate segmentation of temporomandibular joint, with an average Dice coefficient (DC) of 0.846. A 3D region extraction algorithm for the temporomandibular joint gap area is also developed, based on which an automatic TMD diagnosis model is proposed, with an accuracy of 83.87%. In summary, the intelligent TMD diagnosis system developed in this paper can be deployed at edge computing devices within a local area network, which is able to achieve rapid detecting and intelligent diagnosis of TMD with privacy guarantee.
