Cerebral hemorrhage is a common clinical critical disease, and venous thromboembolism is one of its common complications. How to diagnose and treat venous thromboembolism early is still the main problem in the management of patients with cerebral hemorrhage. This article reviews the concept, pathogenesis, risk factors, evaluation tools, prevention and treatment of venous thromboembolism in patients with cerebral hemorrhage. Suggestions are put forward on the development of evaluation tools and improvement of prevention and treatment, in order to provide reference for clinical management and related research of patients with cerebral hemorrhage complicated with venous thromboembolism.
ObjectiveTo explore the cause, clinical diagnosis and treatment, and prevention strategies of iatrogenic bile duct injury (IBDI).
MethodsBy means of literature retrieval, the clinical diagnosis and treatment measures of patients with IBDI were summarized.
ResultsThe related risk factors of IBDI include man-made factors, the local anatomy variation factors, and pathological factors. According to the damage diagnosis time and local pathological state, the repair operations such as bile duct suture repair, biliary tract end to end anastomosis, bile duct jejunum Roux-en-Y anastomosis, bile duct jejunum Roux-en-Y anastomosis, and jejunal artificial valve forming, or liver resection, and liver transplantation were performed. Moreover, it was also available that biliary stent or papillary balloon dilation through ERCP for the bile duct distal stricture.
ConclusionsIt is important that prevention of IBDI. Operation should pay attention to upper abdominal operation prior to the implementation of the correct understanding of IBDI. In case of IBDI, the reasonable repair operation mode should be choose according to the damage types and time, and it can significantly improve the treatment effect and quality of life of patients.
ObjectiveTo investigate the capability and demands of medical students of medical information retrieval, and to provide information for medical information literacy education.MethodsWe conducted an online questionnaire survey among medical students from 15th to 21st July, 2019, aiming to analyze basic characteristics of the subjects and their ways and capability to acquire medical information, and evaluated their demands and satisfaction about relevant courses.ResultsFour hundred and nine valid questionnaires were collected. The average age of the respondents was (21±3) years old. Among the respondents, 279 (68.2%) were female, 290 (70.9%) were undergraduates, and 187 (45.7%) majored in clinical medicine. The mostly accessed ways to obtain medical information were textbooks (87.8%) and search engines (84.4%). Among Chinese literature databases, the most commonly used was China National Knowledge Infrastructure (67.7%), followed by Wanfang (54.3%). As for English literature databases, the most commonly used was PubMed (66.0%), while the proportions of respondents who used other databases was less than 1/4. As for the problems when obtaining information, 84.8% of the respondents supposed that no access to some online databases was the main problem. Obtaining information from search engine scored the highest [(3.21±1.00) points, 5 points totally] when they were asked to self-evaluate their ability to obtain medical information by different methods. In terms of training demands, the need for courses about literature authenticity and accuracy evaluation was the highest [(4.05±1.07) points, 5 points totally]. The trainings were expected to be conducted within 1-2 years after enrollment (83.9%). Training through professional courses (86.8%) was the most welcomed training form, followed by courses on MOOC (51.3%), an online course platform. More than 50% of the respondents were satisfied with the current relevant courses and trainings.ConclusionBoth the students’ capability of medical information retrieval and the design of relevant trainings should be improved to better prepare the medical students for further clinical practice and scientific research.
The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis. Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy. The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound, and the emphasis should be put on retinal reattchment and stable repairment.
Literature bias, which can reduce the validity of a systematic review, comes mainly from the fact that all the related studies can not be collected without exception. The following three types of literature bias are most common. (1) Publication bias. The reason is that some studies can not get published, or the publication has been delayed. (2) Literature retrieval bias. This bias is the result that not all published studies are retrieved during the course of systematic review. (3) Literature inclusion bias. While an improper literature selection strategy is adopted, some useful studies are kicked out by error, leading to such bias. A funnel plot (Y-axis is rumple size, X-axis effect) is usually useful to assess literature bias in a systematic review.
Purpose
To analyze the contents of domestic and inter national public ations in neuro-ophthalmology during the past decade.
Methods
CBM and Medline were separately searched in 2007, by using Medical subject heading for retrieving Chinese and English language neuro-ophthalmic articles which were published between 1997 and 2006.
Results
A total of 13052 Englishwritten a rticles available for analysis were contributed from more than 70 countries, mainly from USA, United Kingdom, Japan, Germany, Italy and Canada. The order of frequency was visual cortex（4496/13052，34.4%），optic nerve diseases（3870/13052，29.7%），ocular mo tility disorders（2899/13052,22.2%），visual pathway（1191/13052,9.1%）pupil dis orders(596/13052，5.6%). While a total of 3726 articles were retrieved from CBM, the order of frequency being optic nerve diseases（1854,49.8％），ocular motili ty disorders(excluding strabismus, 1357,36.4%),pupil disorders (242, 6.5%)，visual cortex(202, 5.4%), visual pathway(excluding retina, optic nerve, visual cortex, 71). Researchers with diverse specialties contributed to the neuro-ophthalmic publications. Compared with international counterpart, domestic articles relate d to basic researches were much less.
Conclusion
Neuro-ophtha lmoloy is interdisc iplinary with a wide range of researches and various study hotspots. Domestic basic researches on neuro-ophthalmology remain to be strengthened and improved.
(Chin J Ocul Fundus Dis,2008,24:99-102)
ObjectiveTo review the association of gut microbiota and postoperative gastrointestinal dysfunction (GID) in patients after abdominal surgery and to provide a new idea for the pathogenesis, prevention, and treatment of postoperative GID in patients after abdominal surgery.MethodThe related and latest literatures were reviewed by searching the literatures on “intestinal flora” “gut microbiota” “intestinal microbial population” “brain-gut axis” “gastrointestinal function” “gastric paralysis” “intestinal paralysis” and “ileus” from January 1, 2000 to April 2, 2021 in Chinese and English databases.ResultsGut microbiota diversity was closely related to postoperative GID symptoms in patients after abdominal surgery. Gut microbiota regulated gastrointestinal motility and mucosal barrier function by metabolizing food to produce metabolites such as 5-hydroxytryptamine, melatonin, short-chain fatty acid, succinic acid, lactic acid, and so on.ConclusionsThe imbalance of gut microbiota is closely related to postoperative GID in patients after abdominal surgery. However, the relevant bacterial metabolites that have been found are limited at present, and the relevant mechanism needs to be further investigated.
ObjectiveThis study proposes employing large language models (LLMs) for medical literature quality assessment, exploring their potential to establish a standardized and scalable intelligent evaluation framework for off-label drug use (OLDU). MethodsThe study used two freely available LLMs platforms in China, DeepSeek-R1 and Doubao. Following the medical literature quality assessment tools recommended in the evidence-based evaluation specification for OLDU issued by the Guangdong Pharmaceutical Association, we selected the Jadad scale and the MINORS criteria. These tools were employed to assess the quality of the two most prevalent types of medical literature in OLDU evidence evaluation: randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs). Utilizing chain-of-thought (CoT) prompting techniques, we developed standardized evaluation templates. The quality scores generated by the LLMs were then compared against those reported in systematic reviews or assigned by clinical pharmacists. ResultsFor RCT, DeepSeek-R1 demonstrated consistency with human assessments in quality appraisal. However, discrepancies exist between the Doubao model and manual evaluation results, with three repeated evaluations yielding inconsistent outcomes and inaccurate identification of "allocation concealment" items. For non-RCT, all models achieved concordant quality assessment outcomes with human evaluators, while demonstrating unique capacity to detect systematic evaluation inaccuracies attributable to human subjective bias. ConclusionThis study demonstrates that prompt engineering-driven LLMs can efficiently conduct quality assessments of medical literature. However, the selection of models requires rigorous validation against domain-specific benchmarks, alongside mandatory expert validation of scoring outputs. Our findings further reveal the necessity of refining current quality appraisal criteria through granular operational definitions, thereby facilitating standardized automation. This approach not only enhances the efficiency and transparency of evidence-based decision-making for OLDU but also extends to systematic reviews and rapid health technology assessments. By replacing traditional literature quality evaluation models with automated scoring mechanisms, it enables a paradigm shift in the efficiency of evidence processing.
Objective
To discuss the clinical characteristics, radiological characteristics, diagnosis, and treatment of hepatocellular carcinoma with bile duct tumor thrombus (HCCBDTT), and to improve the level of diagnosis and treatment for it.
Methods
Clinical data of 2 cases of HCCBDTT admitted in March 2016 and July 2016 in our hospital were analyzed retrospectively, and the related literatures were reviewed.
Results
Two cases of HCCBDTT were misdiag- nosed as hilar cholangiocarcinoma before operation, and then proved to be HCCBDTT after operation. The 2 cases were both alive during the follow-up period (20 months and 13 months respectively).
Conclusions
HCCBDTT patients should be comprehensively analyzed basing on the clinical data for diagnosis, and avoiding misdiagnosis. Active surgical treatment can effectively improve the quality of life in HCCBDTT patients, and prolong the survival time.
Objective
To investigate the clinical features, diagnosis, and surgical methods of left-sided appendicitis (LSA).
Methods
We retrieved LSA-related literatures through Pubmed, Google Scholar English databases, Wanfang, CNKI, VIP, and SinoMed databases (published from January 1981 to June 2017), as well as 2 cases of LSA who treated in Beibei Traditional Chinese Medical Hospital, to analyze the clinical characteristics of LSA and its diagnosis and treatment methods.
Results
There were 92 articles in a total of 212 LSA patients were retrieved, and 2 cases treated in Beibei Traditional Chinese Medical Hospital, a total of 214 LSA patients were included in the analysis. Pain fixed position of LSA: 139 cases (65.0%) located in left-lower quadrant, 30 cases (14.0%) located in right-lower quadrant, 8 cases (3.7%) located in peri-umbilical, 15 cases (7.0%) located in mid-lower abdomen, 15 cases (7.0%) located in left-upper quadrant, 3 cases (1.4%) located in right-upper abdomen, 2 cases (0.9%) located in mid-upper abdomen, 2 cases (0.9%) located in pelvic cavity, respectively. LSA had occurred in association with several types of abnormal anomalies: 131 cases (61.2%) suffered from situs inversus totalis (SIT), 53 cases (24.8%) suffered from midgut malrotation (MM), 21 cases (9.8%) suffered from cecal malrotation, 4 cases (1.9%) suffered from long appendix, 2 cases (0.9%) suffered from free ascending colon, and 3 cases (1.4%) were unclear. The diagnosis of 114 LSA cases (53.3%) before operation was correct, in which the correct diagnosis rates of SIT-LSA and MM-LSA were 74.8% (98/131) and 22.6% (12/53), respectively. Three patients (1.4%) underwent conservative treatment, and 211 patients (98.6%) underwent surgical treatment, including 25 cases (11.7%) of laparoscopic surgery, 145 cases (67.8%) of open abdominal surgery, and unknown of 41 cases (19.1%). Laparotomy incision: abdominal incision in 74 cases (51.0%), ventral midline incision in 16 cases (11.0%), the left side of the anti McBurney incision in 43 cases (29.7%), right McBurney incision in 12 cases (8.3%).
Conclusions
LSA mainly occurs in association with 2 types of congenital anomalies: SIT and MM. There is some difficult to make diagnosis for abnormal anatomy and inaccurate pain location of LSA, so it is easy to cause the delay in diagnosis or misdiagnosis. For LSA, the choices of laparoscopy or laparotomy operation methods are applicable.
