China ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Treatment Outcome

Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension.
Aged ; Arteries ; Endosonography ; Epinephrine ; Hemorrhage ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Hypotension ; Minerals ; Torque ; Ulcer

Databases as Topic ; Evidence-Based Medicine ; Humans ; Information Systems

Purpose: Controlling blood pressure minimizes the risk of cardiovascular events among patients with hypertension. Despite regular follow-ups, the hypertension management for patients aged ≥45 years is limited as evidenced from a decreased control rate. This pilot study aimed to test a theory-guided educational program for community-dwelling patients with hypertension. Methods: Sixty-nine patients with hypertension aged ≥45 years and having high blood pressure (>130/80 mmHg) were recruited in this two-arm pilot randomized controlled trial. Participants in the intervention group underwent a program guided by the Health Promotion Model, whereas those in the control group received usual care. Data were collected at baseline, week 8, and week 12 and used to assess the blood pressure, pulse pressure, self-efficacy, and adherence to hypertension management. Data were analyzed using a generalized estimating equation based on the intention-to-treat principle. Process evaluation was conducted to assess the feasibility and acceptability of the educational program. Results: The results obtained using the generalized estimating equation revealed that the educational program led to reduction in the systolic blood pressure (β = −7.12, p = .086) and pulse pressure (β = −8.20, p = .007) and to improve self-efficacy (β = 2.61, p = .269) at week 12. The program had a small-to-moderate effect on the reduction of systolic blood pressure (effect size = −0.45) and pulse pressure (effect size = −0.66) and self-efficacy (effect size = 0.23). The participants were highly satisfied with the educational program. Conclusions The educational program was found to be feasible and acceptable and may be incorporated into current hypertension management practices at the community level.

AIM:To observe the changes of macular thickness in patients after cataract operation.
METHODS: A total of 126 patients ( 133 eyes ) were divided into two groups that were included in this study. The group (68 eyes of 64 case) with phacoemulsification combined intraocular lens implantation and ( 65 eyes of 62 cases ) with manual small incision cataract surgery ( MSICS) . There was no complication before and during the surgery. Optical coherence tomography ( OCT) was examined 1, 3mo before and after surgery. The visual acuity and macular thickness were compared after surgery. The SPSS 17. 0 software was used for statistical analysis. The paired t-test was used before and after surgery. Independent-samples t test was used in two groups before and after surgery,α=0. 05.
RESULTS: The cataract phacoemulsification group:preoperative and 1mo after surgery, the mean macular thickness was 241. 3±10. 9μm and 279. 7±16. 5μm, with significant difference ( P < 0. 01 ). The mean macular thickness was 245. 6±12. 6μm 3mo after surgery without statistical difference compared with preoperative ( P>0-05). The mean macular thickness was 279. 7±16. 5μm 1mo after surgery and 245. 6±12. 6μm 3mo after surgery with statistical difference(P<0. 05). Three eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes of them was resolved 3mo after surgery. The group of MSICS: preoperative and 1mo after surgery, the mean macular thickness was 240-5±11. 9μm and 280. 7±16. 8μm, with significant difference (P<0. 01). The mean macular thickness was 246. 6±13. 2μm 3mo after surgery without statistical difference compared with preoperative ( P >0-05). One month after surgery and 3mo after surgery, the mean macular thickness were 280. 7±16. 8μm and 246-6±13. 2μm, with statistical difference (P<0. 05). Two eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes were resolved 3mo after surgery. Between the two groups pre-operation or after operation for 1, 3mo respectively P values were without statistical difference (P>0. 05).
CONCLUSION: The macular thickness and macular edema can be found 1mo after cataract phacoemulsification and MSICS. Three months post-operatively, macular edema disappears and does not show statistical difference compared with preoperative. The increase of macular thickness has no obvious relationship with the choice of surgery.

OBJECTIVETo study the flavone constituents in Chrozophora sabulosa (Xinjiang origin).

METHODThe compounds were extracted with 95% ethyl alcohol, isolated by various column chromatography and identified by spectroscopic methods.

RESULTSeven flavanoids were isolated and identified as quercetin (I), kaempferol (II), apigenin (III), chrysoerid (IV), isoquercitrin (V), chrysoerin-7-O-beta-D-glucoside (VI) and quercetin-3-O-alpha-D-arabinfuranoside (VII).

CONCLUSIONAll of these seven compounds were obtained from this genus for the first time.

Apigenin ; chemistry ; isolation & purification ; Euphorbiaceae ; chemistry ; Flavones ; chemistry ; isolation & purification ; Kaempferols ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Quercetin ; chemistry ; isolation & purification

PURPOSETo evaluate the performance of a prehospital trauma diversion system in Hong Kong, China.

METHODSA retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from 1 January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited. Need for trauma center level of care was based on a consensus-based criterion standard published in 2014. Performance of the protocol in terms of over- diversion and under-diversion was determined.

RESULTSA total of 209 patients were included for analysis. About 30% of the patients required trauma center level of care. The most common reason was the need for vascular, neurologic, abdominal, thoracic, pelvic, spine or limb-conserving surgery within 24 h of presentation. The over-diversion rate and under- diversion rate were 69.6% and 19.7% respectively.

CONCLUSIONThe trauma patient diversion protocol currently in use in Hong Kong is not accurate enough. Further revision and refinement is needed.

Adult ; Aged ; Aged, 80 and over ; Emergency Medical Services ; Female ; Hong Kong ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Trauma Centers

OBJECTIVETo critically evaluate the currently available randomized clinical trials regarding the effectiveness of acupuncture in palliative care for cancer patients, hence, to provide sufficient evidences for the widespread use of acupuncture in cancer treatment.

METHODSTwo independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of acupuncture in palliative care for cancer patients. Seven databases were searched from their respective inception to December 2010. All eligible trials identified were evaluated by two independent reviewers using the Jadad scale, and data from the articles were validated and extracted.

RESULTSIn total, 33 RCTs met the inclusion criteria. The effects of acupuncture on different cancer-related aspects were shown, including chemotherapy or radiotherapy-induced side effects (13/33, 39.4%), cancer pain (6/33, 18.2%), post-operative urinary retention (4/33, 12.1%), quality of life (2/33, 6.1%), vasomotor syndrome (2/33, 6.1%), post-operative gastrointestinal dysfunction (2/33, 6.1%), prevention of prolonged postoperative ileus (2/33, 6.1%), joint symptoms (1/33, 3.0%), and immunomodulation (1/33, 3.0%).

CONCLUSIONSThe result of our systematic review suggested that the effectiveness of acupuncture in palliative care for cancer patients is promising, especially in reducing chemotherapy or radiotherapyinduced side effects and cancer pain. Acupuncture may be an appropriate adjunctive treatment for palliative care.

Acupuncture Therapy ; adverse effects ; Drug Therapy ; Humans ; Neoplasms ; surgery ; therapy ; Palliative Care ; Postoperative Complications ; etiology ; therapy ; Quality of Life ; Radiotherapy ; adverse effects ; Randomized Controlled Trials as Topic ; Treatment Outcome

BACKGROUNDAge-associated decrease in type IIA/B human skeletal muscle fibers was detected in human biopsies in our previous study. The relationship between change in muscle fiber typing and bone mineral density (BMD) is, however, unknown either cross-sectionally or longitudinally. We therefore conducted a cross-sectional study to investigate their correlation using human muscle biopsies.

METHODSForty human subjects aged (53.4 ± 20.2) years were recruited. Histomorphometric parameters of their muscle biopsies were measured by ATPase staining and image analysis, including average area percentage, fiber number percentage, mean fiber area, and area percentage of connective tissues. Hip and spine BMD was measured by dual-energy X-ray absorptiometry. Partial correlation with adjusting age was performed.

RESULTSType IIB muscle fiber was found positively correlated with hip BMD irrespective to age and demonstrated significantly stronger relationship with BMD among all fiber types, in terms of its cross-sectional area (r = 0.380, P = 0.029) and size (r = 0.389, P = 0.025). Type IIA muscle fibers associated with hip BMD in mean fiber area only (r = 0.420, P = 0.015).

CONCLUSIONSType IIB muscle fiber may play an important role in maintaining bone quality. This may also be a relatively more sensitive fiber type of sarcopenia and osteoporosis. These findings further consolidate the muscle-bone relationship.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Density ; physiology ; Female ; Humans ; In Vitro Techniques ; Male ; Middle Aged ; Muscle Fibers, Fast-Twitch ; cytology ; metabolism ; Prospective Studies ; Young Adult

OBJECTIVETo explore the association between occupational stress and other socio-psychological factors and work-related unintentional injury in off-shore oil production.

METHODSA cross-sectional survey was conducted among 561 Chinese off-shore oil workers. They were inquired with a self-administered questionnaire involving in socio-demographic characteristics, occupational stress, type A behavior personnel, social support and coping style, and work-related unintentional injury in the past year.

RESULTSSeventy-six (13.5%) workers experienced work-related unintentional injury for once time or more in the past year. A total 141 number of person-times were counted including 18 person-times being serious injury, 26 person-times moderate, and 97 person-times light. After adjustment for age, educational level, marital status, duration of off-shore work and job title, logistic regression indicated that perceived stress from "management problem and relationship with others" were significantly associated with work-related unintentional injuries in the past year (OR = 1.33, 95% CI: 1.05-1.68; P < 0.05). Workers lack of emotional support from friends seemed to less reporting on work-related unintentional injuries (OR = 0.37, 95% CI: 0.22-0.63).

CONCLUSIONThe results implied emphasizing on that the training and guidance as well as better cooperation among the workers might reduce work-related unintentional injuries in off-shore oil industry.

Accidents, Occupational ; prevention & control ; statistics & numerical data ; Adult ; Fuel Oils ; Humans ; Male ; Middle Aged ; Occupational Diseases ; complications ; Stress, Psychological ; complications ; Wounds and Injuries ; etiology ; prevention & control