Objective To evaluate the evidence-based prevention and treatment of post-dural puncture headache (PDPH) for parturient women. Methods We searched The Cochrane Library (Issue 3, 2006), Medline (Jan. 1980 to Oct. 2006) and CBM-disc (Jan. 1980 to Oct. 2006) to identify current best evidence on the prevention and treatment of PDPH for parturient women. The quality of available evidence was critically appraised.Results We identified 2 Cochrane systematic reviews, 2 meta-analyses and 9 randomized controlled trials. Evidence indicated that posture, fluid, and pharmacological managements had no significant effect on PDPH except epidural blood patch. The selection of appropriate spinal needle and the technique of needle insertion may reduce the incidence of PDPH, whereas the effect of intrathecal saline infusion and catheter insertion need further clinical validation. Conclusions Epidural blood patch has definite therapeutic effect on PDPH. Appropriate spinal needle and insertion technique may effectively prevent PDPH for parturient women.
Objective To observe the inhibitory effect of kallikrein-binding protein (KBP) on choroidal neovascularization. Methods Forty Brown Norway rats were randomly divided into the KBP groups and the control group, 20 rats in each group, the right eye as the experimental eye. The rats were photocoagulated by 532 nm laser to induce CNV model. One week after laser photocoagulation, the rats were received FFA examination. At the second day after FFA examination, the rats of KBP group were received an intravitreal injection of KBP 5 mu;l (4 mg/ml KBP). The same volume of deionized water was injected into the rats in the control group. The rats of two groups received FFA examination at one, two and three weeks after injection. The expressions of vascular endothelial growth factor and pigment epithelium derived factor were observed using hematoxylin and eosin stain and immunohistochemistry stain. CNV leakage area and the cumulative absorbance of laser spot area were analyzed by Image-Pro plus 6.0 software. Results FFA examination showed that there were CNV and fluorescence leakage at one week after laser photocoagulation; one, two and three weeks after injection, the leakage decreased gradually in KBP group, but increased with time in control group. Compared with control group, the spot area and CNV in KBP group reduced gradually, but CNV was always there in control group. The differences of VEGF (F=1.29) and PEDF (F=6.29) expressions at one week after laser photocoagulation were not statistically significant (P＞0.05). The differences of VEGF and PEDF expressions at one, two and three weeks after injection were statistically significant（VEGF:F=14.16,66.89,24.34; PEDF：F=4.22,62.04,233.05;P＜0.001）.Conclusion Intravitreal injection with KBP can inhibit CNV.
When a clustered coronavirus disease 2019 epidemic occurs, how to prevent and control hospital infection is a challenge faced by each medical institution. Under the normalization situation, building an effective prevention and control system is the premise and foundation for medical institutions to effectively prevent and control infection when dealing with clustered epidemics. According to the principles of control theory, medical institutions should quickly switch to an emergency state, and effectively deal with the external and internal infection risks brought by clustered epidemics by strengthening source control measures, engineering control measures, management control measures and personal protection measures. This article summarizes the experience of handling clustered outbreaks in medical institutions in the prevention and control of coronavirus disease 2019, and aims to provide a reference for medical institutions to take effective prevention and control measures when dealing with clustered outbreaks.
Objective To summarize the related risk factors and preventive measures of acute pancreatitis (AP) combined with portal vein system thrombosis (PVST). Method The literatures on the general clinical characteristics, pathogenesis, risk factors and prevention prognosis of AP with PVST in recent years at home and abroad were reviewed. Results The incidence of AP combined with PVST was increasing, and the pathogenesis was complex, primarily related to pancreatitis and direct venous compression, which caused blood flow stagnation and hemodynamic disturbance, followed by induced venous thrombosis. Pancreatic necrosis, peripancreatic fluid volume accumulation and the severity of pancreatitis were the main risk factors for the onset of pancreatitis. Other local and systemic factors such as coagulation dysfunction, malnutrition, esophageal and gastric varices had also been reported in the literatures. At present, the prevention methods reported in relevant studies include anticoagulation treatment, pancreatic surgery debridement and drainage, nutritional support, systemic and local inflammation intervention, and early fluid resuscitation, etc. Conclusions The risk factors and pathogenesis of AP combined with PVST are complex and diverse, which requires early identification by clinical workers, early intervention and treatment to avoid or reduce the occurrence of PVST as much as possible to improve the prognosis of patients. However, some preventive measures still need further research to verify their safety and effectiveness.
ObjectiveTo review the research progress of medicine biomaterials in prevention and treatment of adhesion after tendon injury, and to provide reference for clinical treatment.MethodsThe literature on the application of medical biomaterials in the prevention and treatment of tendon adhesions in recent years was reviewed, and the biological process, treatment methods, and current status of tendon adhesions were summarized.ResultsTendon adhesion as part of the healing process of the tendon is the biological response of the tendon to the injury and is also a common complication of joint dysfunction. Application of medical biomaterials can achieve better biological function of postoperative tendon by reducing the adhesion of peritendon tissues as far as possible without adversely affecting the tendon healing process.ConclusionThe use of medical biomaterials is conducive to reduce the adhesion of tendon after operation, and the appropriate anti-adhesion material should be selected according to the patients’ condition and surgical needs.
Objective To discuss the epidemiological characteristics of young and middle-aged people infected with COVID-19 in Gansu province under the new epidemic policy. Methods A total of 1800 people were collected from two tertiary hospitals in Gansu province from November 8, 2022 to January 28, 2023. The vaccination status, nucleic acid antigen detection, the specific time of infection, main symptoms and severity of the disease were investigated. Results Among 1800 participants, 1685 (93.6%) were vaccinated and 1565 (86.9%) were infected with COVID-19. Among the 1565 infected persons, 523 (33.4%) completed both nucleic acid and antigen testing, 382 (24.4%) completed nucleic acid testing, 490 (31.3%) completed antigen testing, 170 (10.9%) received IgG testing. 1490 (95.2%) were slight ill, 75 (4.8%) were critical ill, and 96 (6.1%) were hospitalized, and no one died. In 2022, 92 cases (5.9%) were infected in the first half of November, 141 cases (9.1%) in the second half of November, 630 cases (40.3%) in the first half of December, and 553 cases (35.4%) in the second half of December. 109 cases (7.0%) were infected in the first half of January, 38 cases (2.2%) in the second half of January, and 2 cases (0.1%) in the first half of February of 2023. and no cases in the second half of February. Among the 1565 infected persons, 825 (52.7%) had respiratory symptoms, 293 (18.7%) had gastrointestinal symptoms, 257 (16.4%) had autonomic disorders, 140 (8.9%) had other symptoms such as decreased smell and taste, and 48 (3.3%) had no symptoms after infection. Conclusions The vaccination rate of young and middle-aged people in Lanzhou city of Gansu Province is high. Since the new policy, the infection rate of the novel coronavirus among young and middle-aged people is high, the number of antigen tests is more than nucleic acid tests, most of the infected patients are slight, with fewer critical patients, and the hospitalization rate is low. The peak of infection occurred in early December 2022, and the infection rate was basically zero by February 2023. The main symptoms of COVID-19 infection are mainly respiratory tract, followed by digestive tract and autonomic nervous system disorders, and few patients are completely asymptomatic.
Objective To observe the the inhibitory effect of recombined adenovirus mediated delivery of p21 (rAd-p21) on oxygen-induced retinal neovascularization in mice. Methods A total of 56 C57BL/6 mice at the age of seven days were divided into control group, phosphate buffer solution (PBS) group, rAd-p21 group and rAdno purpose gene control (rAd-NC) group, 14 mice in each group. The retinal neovascularization of PBS, rAd-p21and rAd-NC group were induced by oxygen, and received an intravitreal injection 1 mu;l PBS, rAd-p21 and rAd-NC at postnatal day 11, respectively.The rats of control group were not intervened. At postnatal day 17,RNV was determined by retinal flat mounts and retinal section; non-perfusion areas of retina were analyzed by Image-Pro plus 6.0 software; reverse transcription-polymerase chain reaction (RT-PCR) and Western blot was used to measure the mRNA and protein expression of p21 and CDK2. Results Compared with PBS and rAdNC groups, the retinal nonperfusion areas, neovascularization and the numbers of endothelial cell nuclei breaking through the internal limiting membrane in rAd-p21 group were reduced significantly. Nonperfusion areas of retina in rAd-p21 group was less than that in PBS and rAd-NC groups, the difference among these three groups was significantly (F=101.634，P＜0.05). Compared with the other three groups, the level of p21 mRNA and protein in rAd-p21 group increased significantly (F=839.664, 509.817;P＜0.05); the level of CDK2 mRNA and protein in rAd-p21 group decreased significantly (F=301.858, 592.882;P＜0.05). Conclusion rAd-p21can inhibit oxygen-induced retinal neovascularization, up-regulated p21 expression and down-regulated CDK2 expression may be the mechanism.
Objective
To investigate the inhibitory effects of IBI302 on experimental choroidal neovascularization (CNV).
Methods
Affinity of IBI302 to vascular endothelial growth factor (VEGF) family cytokines (including VEGF-A165, VEGF-A121 and placental growth factor PlGF) and complements (C3b, C4b) was determined by enzyme-linked immunosorbent assay (ELISA). The antagonist effect of IBI302 on VEGF was measured by proliferation, migration and tube formation tests of human umbilical vein endothelial cells (HUVEC). The anti-complement activity of IBI302 was measured by hemolysis test mediated by complement classical pathway and alternative pathway.
Rhesus
laser-induced CNV model was divided into 5 groups including model control group, bevacizumab group, IBI302 0.25 mg group, IBI302 0.50 mg group and IBI302 1.25 mg group. Fluorescein angiography and optical coherence tomography were performed on these monkeys at 14 and 28 days after drug delivery to observe the fluorescein leakage area and retinal thickness. The aqueous VEGF concentration was measured at 29 days after drug delivery. Results IBI302 showed good affinity to VEGF-A165, VEGF-A121 and PlGF, as well as C3b and C4b. IBI302 significantly inhibited the proliferation, migration and tube formation of HUVEC induced by VEGF-A165. IBI302 inhibited the hemolysis induced by complements obviously. At 14 and 28 days after drug delivery, the area of fluorescein leakage and retinal thickness in IBI302 0.25 mg group, IBI302 0.50 mg group, IBI302 1.25 mg group were reduced. The differences of the area of fluorescein leakage and retinal thickness in three IBI302 groups were not significant (P > 0.05). At 29 days after drug delivery, the VEGF concentration in the aqueous of rhesus monkey in bevacizumab group [(38.644±6.521) pg/ml] was decreased than that in model control group [(94.203±17.360) pg/ml], the difference was significant (P < 0.05). The VEGF concentration in the aqueous of rhesus monkey in three IBI302 groups were less than 31.300 pg/ml.
Conclusion
IBI302 inhibited experimental CNV through blocking the activity of VEGF and complement.
ObjectiveTo develop a standardized venous thromboembolism (VTE) prevention program for burn patients and verify its safety and effectiveness by comparing with traditional thrombus prophylaxis.MethodsAll burn patients admitted and met selection criteria betweem April 2017 and September 2018 were included. Patients between January 2018 and September 2018 were included as the interventional group to implement standardized VTE prevention programs, while patients between April 2017 and December 2017 were included as the control group and traditional active and passive exercises were used to prevent VTE. There was no significant difference in the age, gender, ethnic group, marriage, education, occupation, type and site of the injury, burn area, operation time, and hospital stay between the two groups (P>0.05), which was comparable. The incidence of VTE, number of cases of tissue or organ hemorrhage, survival rate of skin grafting, and time of wound healing were compared.ResultsThe incidence of VTE was obviously lower in the interventional group (1.56%, 1/64) than in the control group (10.17%, 6/59) (χ2=?2.05, P=0.04). No bleeding occurred in any tissue or organ in the two groups. The survival rate of skin grafting and the time of wound healing were 89.06% (57/64) and (11.78±3.08) days respectively in the interventional group and 91.53% (54/59) and (11.66±2.30) days respectively in the control group; and the differences between the two groups were not statistically significant (χ2=0.21, P=0.65; t=?0.22, P=0.83).ConclusionThe standardized VTE prevention program can effectively prevent the occurrence of VTE, and its safety is relatively high.
Echinococcosis is a zoonotic and parasitic disease caused by tapeworms of the genus Echinococcus. The most common forms of the disease are cystic echinococcosis (CE) and alveolar echinococcosis (AE), caused by Echinococcus granulosus and Echinococcus mutilocularis, respectively, and posing a serious health challenge and economic burden to human society. The most adapted treatment is surgical excision plus chemotherapy, although which mostly is effective, the traumatic damage from the invasive procedure and the adverse effects of the prolonged chemotherapy are profound. Conventional preventions include controlling the source of infection, improving the sanitation in livestock slaughter, strengthening surveillance, and increasing public health education. However, the outcome is limited by the complicity of the geographical nature, cultural background, and unique lifestyle. Vaccination is the most safe and cost-effective way to control infectious diseases. The partial success of recombinant Eg95 as a veterinary vaccine had established a theoretical foundation for the development of a human echinococcosis vaccine, which will shed a light on the prevention, control, and eventual elimination of the human infection. There are promising vaccine candidates in the research and development pipelines in the form of parasite tissue extract proteins, recombinant proteins, nucleic acids, synthetic antigenic epitopes, and vector vaccines. These candidates have shown potential to induce protective humoral and cellular immune responses that block the invasion, eradicate the worm at an early stage, or prevent the onset of infection. We reviewed the progress in the vaccine development and discussed the challenges and solutions in the research and development to facilitate the licensure of a vaccine against human echinococcosis.
