Objective To evaluate the therapeutic effect of silver ion dressings combined with hydro gel in treatment of diabetic foot by using Meta-analysis.Methods The Cochrane Library,EMbase and domestic main databases were searched,the quality of included studies which screened by certain standards was evaluated.The Review Manager 5.0 software was taken for analysis.Results Totally 11 studies were included,containing 765 patients with diabetic foot.The Meta-analysis showed that there were significant differences between two groups in treatment efficiency,granulation tissue growth time and basic healing time.But the epithelial formation time showed no significant difference between two groups.Conclusions Silver ion dressings combined with hydro gel in treatment of diabetic foot was effective.However,the quality and quantity of most studies included in this review are low,studies of higher quality and quantity are needed to confirm the results in the future.

Angelica ; chemistry ; Animals ; Animals, Newborn ; Cell Count ; Female ; Fetal Hypoxia ; pathology ; Hippocampus ; cytology ; drug effects ; Male ; Neuroglia ; cytology ; Neurons ; cytology ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Integrative Medicine ; Medicine, Chinese Traditional

Objective To evaluate the therapeutic effect of intravenously use of ambroxol in treatment of mechanical ventilator patients.Methods Meta-analysis was used.The Cochrane Library,PubMed,Elsevier (ScienceDirect),OVID series medical databases and domestic main databases were searched,the quality of included studies was evaluated by certain standards.The Review Manager 5.0 software was used for analysis.Results 14 studies were included,1 184 mechanical ventilation patients were involved.The Meta-analysis showed that there were significant differences between two groups in blood gas analysis,airway resistance and pressure and lung compliance.However,there were no differences between two groups in expectorant effect and VAP incidence.Conclusions Intravenously use of ambroxol in treatment of mechanical ventilator patients was effective.A large multi-center sample of high-quality clinical studies is needed to confirm the results.

Objective The change of thyroid hormones affects male sexual function, but the underlying physiological mechanism is not yet clear.The aim of this study was to explore the association of thyroid hormones with abnormal penile neuro-electrophysiology in patients with premature ejaculation (PE).Methods This retrospective study included 52 acquired PE (APE) patients aged 35.36 ± 8.39 years and 24 healthy males aged 32.87±7.45 years.We measured the levels of thyroid hormones in all the subjects and, based on the latency time of penile sympathetic skin responses (PSSR), classified the APE patients into a normal (n=31) and an abnormal PSSR type (n=31).Results The concentration of total tetraiodothyronine (TT4) in the serum was significantly higher in the APE patients than in the normal control ([102.81±18.37] vs [92.68±11.56] nmol/L, P=0.018).The levels of serum TT4 and free tetraiodothyronine (FT4) were both markedly increased in the APE patients of the abnormal PSSR type as compared with those of the normal PSSR type ([113.28±20.89] vs [95.72±12.42] nmol/L, P<0.001 and [12.02±0.88] vs [10.81±1.63] nmol/L, P=0.003).The FT4 concentration was correlated negatively with the latency time of PSSR (r=-0.363, P=0.008) and positively with the Premature Ejaculation Diagnostic Tool (PEDT) scores (r=0.455, P=0.001).Conclusion Abnormal PSSR may be associated with elevated levels of thyroid hormones in APE patients, and regulation of thyroid hormone levels may help improve the symptoms of PE with abnormal PSSR.

The training of airway management plays a vital role in standardized residency training plan during the rotation in the department of anesthesiology.Problem based-learning and airway simulation practice should be applied step by step based on the different requirements of standardized residency training plan.The training should be started from mask ventilation to endotracheal intubation,meanwhile clinical thinking ability and teamwork ability should be cultivated for the residents so that they can master the technique of airway management skillfully whenever and wherever.

Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Dyspnea ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Young Adult

ObjectiveTo discuss the method and significance of concentric circumareolar approach in treatment of gynecomastia.MethodsThe incision was designed with the patient in a standing position.The location of the new nipple was determined,around which a outer cycle with the diameter of 5 cm was marked.And then a concentric inner circle with the diameter of 2.5 -3 cm was marked around the original nipple.The bilateral nipple position should be on the same level.A rim of tissue around the nipple-areola complex( NAC )was deepithelialized,excision of excess glandular tissue was performed subcutaneously and vascular network of dermis was preserved as much as possible.The purse string suture was applied in the circumareolar incision.Results 30 patients with gynecomastia were treated with this method.The result of the operation was pleasing with good aesthetic appearance,normal blood supply,and inconspicuous scars.Conclusion As a surgical approach of gynaecomastia,concentric circumareolar incision can remove excess glandular tissues and redundant skin,and has the benefit of concealing incision,simple procedure and satisfactory outcome.

Objective To explore neurocognitive characteristics of human immunodeficiency virus (HIV)-infected patients ,and to compare the efficacy of highly active antiretroviral therapy (HAART ) among patients with different cognitive functions .Methods Cognitive function was evaluated using the Montreal cognitive assessment (MoCA) Chinese version in 118 HIV-positive patients and 62 HIV-negative controls .Among 59 patients on HAART ,CD4 + T cell count and viral load were assessed at enrollment and one-year follow-up .The mean of measurement data was compared using t test ,and enumeration data was analyzed using chi-squared or Fisher exact test when appropriate .Univariate and multivariate analysis were examined using bivariate Logistic regression models .Results Compared with control group ,HIV-infected group was characterized by higher rate of neurocognitive impairment (46 .6% vs 12 .9% , t =20 .30 ,P< 0 .05) ,and generally lower MoCA subscores for visuospatial abilities ,the clock drawing test , naming ,attention ,abstraction and delayed recall (t= - 3 .761 , - 2 .638 , - 4 .263 , - 3 .769 , - 3 .858 and- 3 .111 ,respectively ,all P< 0 .05) .Among patients on HAART ,subjects who scored < 26 showed no significant differences in viral load at three time points (pre-HAART ,post-HAART at enrollment and one-year follow-up) with those who scored ≥ 26 (t = 0 .557 ,0 .737 and - 0 .758 ,respectively ,all P >0 .05) .The former group had lower CD4 + T cell counts both at enrollment ([286 ± 127]/μL vs [363 ± 160]/μL) and one-year follow-up ([334 ± 122]/μL vs [411 ± 152]/μL) than the latter group (t= - 2 .027 and - 2 .067 ,respectively ,both P < 0 .05 ) ,while there were no obvious differences of pretreatment CD4 + T cell counts ([135 ± 77]/μL vs [155 ± 80]/μL) and HAART duration ([22 .29 ± 21 .20] months vs [18 .74 ± 16 .63] months) between these two groups (t= - 0 .968 and 0 .702 ,respectively ,both P>0 .05) .Multivariate analysis revealed that age (OR = 1 .044 ,95% CI :1 .008 - 1 .081 , P < 0 .05) and education time (OR = 0 .820 ,95% CI :0 .723 - 0 .930 , P < 0 .05 ) were independent predictors for neurocognitive impairment among HIV-infected patients . Conclusions Neurocognitive impairment is common among HIV-infected patients ,which is characterized by poor performance in multiple domains , and patients with neurocognitive impairment performed poorly in immune recovery .MoCA could be a useful screening tool of cognitive function in HIV-infected patients . Neurocognitive function has no relationship with pre- and post-treatment viral levels .

Background The advantages of endothelium keratoplasty(EK)include without corneal surface incision and sutures,remaining normal corneal topography,minimizing astigmatism and providing a healthy donor endothelial cell count and function.Using anterior segment optical coherence tomography(AS-OCT) to examine the morphology of the corneal graft after EK is helpful for the evaluation of the outcome of EK.ObjectiveThis study applies AS-OCT to observe the relationship of recipient cornea and donor graft and offer a basis for the evaluation of operative outcome.MethodsThe clinical data from 44 eyes of 42 patient who received DSAEK in Peking University Eye Center from September 2007 through April 2009 was reviewed retrospectively.These patients included 30 male and 12 female with the age from 15 to 83 years.Structure of cornea and relationship between recipient cornea and graft disc after surgery were clinically examined and recorded by slit-lamp digital camera and AS-OCT.This study was approved by the Ethics Committee of Peking University.Written informed consent was obtained from all of the patients before the operation.ResultsThe donor graft attached to posterior central surface of recipient in 28 eyes under the slit-lamp microscopy and AS-OCT.The thickness of donor graft was decreased,and graft sticked more closely to recipient cornea and was more transparent with the lapse of time.Complete dislocation of the donor graft in early stage was found in 5 eyes(11.36%) and partial dislocation in 2 eyes(4.55%).Curliness of graft edge occurred in 1 eye(2.27%) and eccentricity of donor graft in 8 eyes(18.18%).ConclusionAS-OCT can display the morphology and structure of cornea as well as the relationship between donor graft and recipient after DSAEK.It is helpful for evaluating the clinical effectiveness of DSAEK.