Objective To evaluate the reporting quality of Meta-analyses published on Chinese journals of geriatrics.Methods Papers of Meta-analyses on geriatrics published in nine major Chinese journals of geriatrics before November 21,2013 were retrieved,their basic information were abstracted and evaluated through system assessment and preferred reporting items for systematic reviews and Meta-analyses (PRISMA) statement.Statistical analyses were performed with the SPSS17.0 software.Results Among the 71 internalized papers,1 was from 《Geriatrics & Health Care》,1 from 《Practical Geriatrics》,10 from 《Chinese Journal of Geriatric Care》,45 from 《Chinese Journal of Gerontology》,3 from 《Chinese Journal of Multiple Organ Diseases in the Elderly》,1 from 《Chinese Journal of Geriatric Dentistry》,5 from 《Chinese Journal of Geriatric Heart Brain and Vessel Diseases》,5 from 《Chinese Journal of Geriatrics》.55 papers (77.5％) were published in recent 3 years.The mean overall PRISMA score was(16.75±3.04)ranged from 4 to 24.The main influencing factor for the quality of Meta-analyses was the year of publication (adjusted β=-0.342,P=0.003).Conclusions The quantity and quality of Meta-analyses published on Chinese journals of geriatrics are increased and improved in recent years,but there are still some problems on the writing norms.We should promote PRISMA statement and standardize reporting format to improve the quality of Meta-analyses in the field of geriatric medicine.

Objective To investigate the effect of lung protective and ventilatory management strategies for brain death donors on eligibility and availability of lungs for transplantation.Method The clinical data of two brain dead patients who accepted lung protective ventilatory management strategies from Feb.2015 to Mar.2015 were retrospectively analyzed.Two cases of brain-dead patients,due to severe cerebral trauma,accepted the aggressive lung protective ventilatory management strategies and airway management for 9 days and 4 days respectively.PaO2/FiO2,chest imaging manifestations,surface of the lung harvested and pulmonary rehabilitation of recipients after operation were observed.Result Two lung recipients were liberated from ventilation and pulmonary function improved significantly after double lung transplantation.Conclusion The application of lung protective ventilatory strategies in potential organ donors with brain death can increase the number of eligible and harvested lungs.

Objective In order to prevent the infection of Acinetobacter baumannii and use antibiotics rationally,the clinical infection and drug resistant data of multi-drug resistance Acinetobacter baumannii (MRAB)detected in intensive care unit (ICU)of Beijing Friendship Hospital from 2011 to 2013were analyzed.Methods This study is a retrospective study.One hundred and eighty five strains of MRAB were collected from the patients in ICU from January 2011 to December 2013.Identificationand antibiotic susceptibility of strains were determined with Vitek-2 Compact automatic bacteria identification system.The annual infection rate of MRAB was counted.PCR was used to detect the resistance genes.The clinical features of the patients with MRAB were analyzed.The average age,acute physiology and chronic health evaluation (APACHE) Ⅱ score,duration in ICU and mortality ratio of the MRAB patients were compared with the patients without MRAB.Rank-sum test was used to analyze the average age,APACHE Ⅱ score and duration in ICU.Chi-squared test was used to analyze the mortality ratio and annual infection rate.Results The average age [(67 ± 17)vs (59-± 19) years old,Z =-5.365,P =0],APACHE Ⅱ score [(25.68±7.93) vs (17.62±8.39),Z=-14.821,P=0],duration in ICU [(27 ±29) vs (5 ±8) d,Z =-4.342,P =0] and mortality ratio [10.82％ (53/185) vs 28.65％ (147/1 359),x2 =45.92,P =0] of the patients infected by MRAB were significantly higher than those without the infection.The MRAB was found mostly in sputum and bronchial precipitates (83.78％,155/185).Though detection rate reduced yearly and there was a significant reduction in 2013 compared with 2011 [11.07％ (69/469) vs 8.37％ (52/621),x2 =8.755,P =0.003],the drug resistant rate was in high level and did not show any change in the 3 years.OXA-23 and OXA-51 were detected in all MRAB.Conclusions The main drug resistant mechanism of MRAB in ICU is related to OXA-23.More active methods of coutrol and prevention of MRAB should be used in elderly aud severely pneumonic patients.Intensive disinfection and isolation measures can decrease MRAB detection rate.Combined antibiotics should be used in patients with MRAB infection.

Objective To study the effects of constant and intermittent high glucose on the apoptosis of cultured bovine retinal capillary pericytes (BRPs), and to investigate the role of mitochondrial apoptotic pathway in the apoptosis of BRPs. Methods After being cultured under glucose with different concentrations tot 6 days, the change of uhrastructure of BRPs was observed under electronmieroscope, the apoptosis of pericytes was detected by TUNEL method, the mitochondrial inner transmembrane potential (△Ψm) was detected by laser scanning confocal microscopy, the change of cytochrome c (cyt-c) was assayed by spectrophotometer and the expression of apoptotic genes was detected by immunohistochemical method and RT-PCR. Results (1) BRPs showed typical changes of apoptosis in constant and intermittent high glucose concentrations. The apoptosis induced by constant high glucose concentration was more obvious than that by intermittent high glucose. (2) Constant and intermittent high glucose concentrations obviously decreased △Ψm compared with control group. The △Ψm of BRPs was correlated negatively with the apoptotie rate of BRPs (r = - 0.89, P < 0.01) ; (3) Constant and intermittent high glucose concentrations increased the release of cyt-c from mitochondria to cytoplasm, and the concentration of cyt-c in the cytoplasm was correlated positively with the apoptotic rate of BRPs (P < 0.01) ; (4) Constant and intermittent high glucose concentrations increased the expression of proapoptotie gene Bax and decreased the expression of prosurvival gene Bcl-2, resulting in increased Bax/Bcl-2 ratio. Bax/Bcl-2 ratio was negative correlatied with the △Ψm of BRPs, and positively eorrclaticd with the concentration of cyt-c in cytoplasm and apoptotic rate (both P < 0.01).Conclusion Constant and intermittent high glucose concentrations could decrease △Ψm, increase the release of cyt-c and induce the apoptosis of BRPs, the effects being stronger with constant high glucose concentration. The mitochondrial apoptotic pathway plays an important role in the apoptosis of BRPs, in which Bax and Bcl-2 are involved.

Objective To detect changes of regional grey matter and white matter volume in patients of neuromyelitis optica (NMO) by voxel-based morphometry (VBM),and investigate its relationship with clinical variables.Methods Conventional magnetic resonance imaging (MRI) and structural threedimensional MRI were obtained from 20 NMO and 20 sex-and age-matched healthy volunteers.The comparison of grey matter and white matter volume between the two groups was analyzed by VBM tools of statistical parametric mapping (SPM) 5.Pearson correlational analysis was used to assess correlations between regional volume decrease and disease duration and expanded disability status scale (EDSS) scores in NMO patients.Results Compared with normal controls,NMO patients had grey matter atrophy in several cortical regions,such as right inferior frontal gyrus (cluster size 514),left superior temporal gyrus (282),right middle temporal gyvus (229) and right insula (211) (t =3.58-5.11,AlphaSim corrected,P ＜0.05).White matter atrophy was found in several subcortical regions in NMO patients,such as right precentral and postcentral gyrus (cluster size 457,110),left middle frontal gyrus (285),and right inferior parietal lobule (231) (t =2.90-4.25,AlphaSim corrected,P ＜ 0.05).Grey matter and white matter volume loss were not significantly correlated with clinical duration or EDSS score in NMO.Conclusion By means of VBM,regional atrophy of grey matter and white matter is found in NMO patients,which may provide evidence for brain structural abnormality in NMO.

This paper presented a new method based on down-sampling for QRS complexes detection for the reason that ECG's frequency components mostly centralize 0.05-35 Hz. Firstly, the original ECG signals were down-sampled. Secondly, self adapting and self study theory were used to select the amplitude threshold and slope threshold for R-wave detection. At the same time, the refractory idiosyncrasy of heart was taken into account to reduce the misdetection. Thirdly, back-trace technique was used to reduce undetected error. Finally, the corresponding R-wave position was up-dated in the original ECG signals. The performance of the method was tested by MIT/BIH ECG database and the clinical data were collected from the affiliated hospital of Chongqing Medical University. The detection rate of 98% was achieved. Experimental results indicated that the method was simple, effective, accurate and unaffected on sample rate.
Algorithms ; Electrocardiography ; methods ; Humans ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted

OBJECTIVETo observe the difference between the combination therapy of alpha-interferon (IFN-alpha) therapy Yixuesheng Capsule and the monotherapy of IFN-alpha in treatment of chronic hepatitis B.

METHODA total of 288 patients with HBeAg-positive chronic hepatitis B proven by liver biopsy were included in this study. During the individualized therapy, they received hypodermic injection of IFN-alpha 1b, with 5 MU x time(-1) and three times x w(-1). Of them, 125 patients received combination therapy with Yixuesheng Capsule for three months, with 1.0 g/time and three times/d; and 163 patients received only IFN-alpha 1b (the IFN-alpha monotherapy group). After the course of therapy, all patients were followed up for at least 24 months. The intention-to-treat analysis was adopted for statistic analysis.

RESULTThe two groups showed no statistical significance by gender, age, liver necroinflammation grading, liver fibrosis staging, serum ALT levels, serum HBV DNA levels and IFN-alpha therapy course. The whole course and the 24-month follow-up visit cover all of 112 patients in the combination treatment group and 141 cases in the IFN-alpha monotherapy group. The response rates of the combination treatment group and the IFN-alpha monotherapy group were 48.0% (60/125) and 35.0% (57/163) (x = 4.980, P = 0.026) at the end of treatment, respectively, 45.6% (57/125) and 33.1% (54/163) (x2 = 4.645, P =0.031) at the end of 12-month-follow-up period, respectively, and 38.4% (48/125) and 32.5% (53/163) (x2 = 1.076, P = 0.300) at the end of 24-month follow-up period, respectively.

CONCLUSIONThe combination treatment with IFN-alpha and Yixuesheng Capsule shows a slightly better sustained efficacy on HBeAg-positive chronic hepatitis B patients compared with IFN-alpha monotherapy.

Adult ; Capsules ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Treatment Outcome

Objective To investigate the types of common chronic diseases and common drugs in the elderly visiting primary medical institutions in China.Methods Cluster sampling was adopted in eight provinces/cities/autonomous region of Zhejiang,Jilin,Henan,Shanghai,Chongqing,Gansu,Guangxi and Jiangsu.Sampling sites were selected and information was collected through the online reporting system of common diseases and drug costs of the elderly in primary hospitals at all levels in China.On these grounds,the basic situation of primary medical institutions,the common chronic diseases and common drugs for people aged 65 years and above were investigated.Results Primary hypertension(65.7％ or 46/70)and arthropathy(10.0％ or 7/70)were the most common chronic diseases in the elderly visiting primary medical institutions.The consultation rate of primary hypertension was highest both in rural areas(58.3％,i.e.the ratio of 21 over 36 primary medical institutions)and in urban areas(73.5％,i.e.the ratio of 25 over 34 primary medical institutions).The primary medical institutions with consultation rates of hypercholesterolemia/hyperlipidemia (x2 =5.137,P=0.023),diabetes(x2 =3.868,P =0.049)and dyspepsia(Fisher's exact test,P =0.026)as the top 3 chronic diseases were more often seen in urban areas than in rural areas,while the primary medical institutions with consultation rates of cerebrovascular diseases as the top 3 chronic diseases were more often seen in the rural areas than in urban areas(x2=9.974,P =0.002).More primary medical institutions with consultation rates of benign prostatic hyperplasia and primary osteoporosis as the top 10 chronic diseases were found in urban areas than in rural areas(x2 =4.054 and 3.861,P =0.044 and 0.049,respectively),while more primary medical institutions with consultation rates of heart failure as the top 10 chronic diseases were found in rural areas than in urban areas(x2 =3.865,P =0.049).Aspirin,nifedipine and simvastatin one by one were most commonly used in people aged 65 years and over in primary medical institutions.Conclusions Primary hypertension is the most common chronic disease among the elderly visiting primary medical institutions in both rural and urban.Common chronic diseases in primary medical institutions are different between the urban and rural areas.Regional differences and urban-rural differences should be taken into account in drug preparation.There are some irregularities in the use of drugs and insufficient stocks of essential drugs in basic-level medical institutions.

Objective:To study the clinical characteristics and imaging features of neonatal ovarian cysts and to analyze treatment and prognosis of ovarian torsion.Methods:From January 2011 to December 2021,neonates with ovarian cysts admitted to the department of neonatology and pediatric surgery of our hospital were retrospectively studied. They were assigned into ovarian torsion group and non-torsion group. Their clinical manifestations, imaging features, pathological results, treatment and prognosis were reviewed and compared.Results:A total of 44 neonates with ovarian cysts were included, all without specific clinical manifestations. 10 neonates were treated with conservative therapy and 34 received surgery. Ovarian torsion were confirmed during surgery in 23 patients. All 34 patients received abdominal ultrasound preoperatively and 31 (91.2%, 31/34) were diagnosed with ovarian cysts. The accuracy rates of ultrasound for cyst location and ovarian torsion were 85.3% (29/34) and 82.6% (19/23),respectively. 30 patients received abdominal CT scan and 23 (76.7%, 23/30) were diagnosed with ovarian cysts. The accuracy rates of CT scan for cyst location and ovarian torsion were 53.3% (16/30) and 47.8% (11/23), respectively. Among the 34 patients treated with surgery, ovarian cyst dissection was performed in 11 patients and cyst resection in 23 patients with torsion necrosis. 24 patients had simple cysts including 15 torsion necrosis (62.5%, 15/24) and 10 had complicated cysts including 8 torsion necrosis(80.0%, 8/10). The average diameter of ovarian cysts was significantly larger in the torsion group [(8.4±1.6) cm] than the non-torsion group [(4.7±1.2) cm] ( P<0.05). Conclusions:Neonatal ovarian cysts are mostly unilateral without specific clinical manifestations. Large, bilateral and complex cysts are prone to torsion necrosis. Abdomen ultrasound has advantages than CT scan for the localization of the ovarian cyst and diagnosis of ovarian torsion. Surgical treatment is necessary after diagnosis.