OBJECTIVE:To systematically review the effect of stroke efficacy and bleeding risk of edoxaban versus warfarin in the prevention of patients with atrial fibrillation,and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Cochrane Library,Medline,EMBase,CJFD,Wangfang Database and VIP Database,randomized controlled trials (RCT)about the stroke efficacy and bleeding risk of edoxaban versus warfarin in patients with atrial fibrillation were collected. Me-ta-analysis was performed for the incidences of stoke and excessive hemorrhage by using Rev Man 5.3 software after data extract. RESULTS:Totally 13 RCTs were included,involving 24 950 patients. Results of Meta-analysis showed,compared with warfarin group,there were no significant differences in the incidences of stoke [RR=0.97,95%CI(0.88,1.08),P=0.60] and excessive hem-orrhage [RR=0.84,95%CI(0.59,1.19),P=0.33] in edoxaban group. But the subgroup analysis showed,when daily dose of edoxa-ban was more than 30 mg,the incidence of stroke in edoxaban group was significantly lower than warfarin group [RR=0.84,95%CI(0.72,0.97),P=0.02];when it was 30 mg,the incidence of excessive bleeding in edoxaban group was significantly lower than warfarin group [RR=0.46,95%CI(0.35,0.61),P<0.001],the difference was statistically significant. CONCLUSIONS:Compared with warfarin,higher doses(>30 mg/d)of edoxaban can more effectively prevent the occurrence of stroke and low doses(30 mg/d) can reduce the risk of excessive bleeding.

Objective:To compare the clinical efficacy of femoral neck system (FNS) and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 76 young and middle-aged patients with femoral neck fracture admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2018 to September 2020, including 45 males and 31 females, aged 23-63 years [(49.5±8.2)years]. Garden classification of the fracture was 25 patients with type II, 34 with type III and 17 with type IV. Pauwels classification of the fracture was 16 patients with type I, 31 with type II and 29 with type III. A total of 40 patients were treated with cannulated screw fixation (cannulated screw group) and 36 patients with FNS fixation (FNS group). Operation time, frequency of fluoroscopy, length of hospital stay, weight-bearing time and bone union time were compared between the two groups. Hip function was assessed by Harris hip score at 6, 12 months after operation. The incidence of postoperative complications was observed.Results:All patients were followed up for 12-20 months [(15.2±1.7)months]. The frequency of fluoroscopy [(13.4±1.9)times], weight-bearing time [(11.1±1.9)weeks] and bone union time [(13.8±1.6)weeks] in FNS group were lower or shorter than those in cannulated screw group [(18.2±2.6)times, (15.7±1.6)weeks, (14.6±1.6)weeks] (all P<0.05 or 0.01). There were no significant differences in operation time, length of hospital stay and Harris hip score at 6, 12 months after operation between the two groups (all P>0.05). No postoperative infection occurred in both groups. In cannulated screw group, there were 4 patients with femoral neck shortening, 3 with deep venous thrombosis, 2 with internal fixation loosening, 2 with nail withdrawal and 1 with fracture non-union, showing the incidence of complications of 30% (12/40). In FNS group, there was 2 patients with femoral neck shortening, 1 with deep vein thrombosis and 1 with internal fixation loosening, showing the incidence of complications of 11% (4/36) ( P<0.05). Conclusion:For femoral neck fracture in the young and middle-aged patients, both FNS and cannulated screw fixation can obtain satisfactory efficacy, but FNS has the advantages of decreased frequency of intraoperative fluoroscopy, early weight bearing, reduced time to bone union and low incidence of complications.

随着铜绿假单胞菌（铜绿）的耐药性逐年增强，铜绿感染已经成为公共医疗卫生的重点关注问题。线粒体自噬及其介导的线粒体功能障碍在多种细菌感染中已被报道，但线粒体功能障碍在宿主调控铜绿感染中的作用尚不明确。因此，本研究建立铜绿刺激小鼠巨噬细胞感染模型和小鼠急性铜绿感染模型，探讨铜绿是否通过诱导线粒体自噬改变线粒体功能，进而影响宿主免疫炎症反应和细胞毒性，并通过监测生存率和肺组织病理学变化进一步确定线粒体自噬在小鼠铜绿体内感染模型中的作用。结果表明，铜绿引起小鼠腹腔巨噬细胞线粒体功能障碍，并通过线粒体自噬途径清除铜绿刺激引起的活性氧（ROS）累积，从而抑制铜绿引起的促炎性细胞因子分泌并增强细胞毒性。体内实验进一步确认线粒体自噬在铜绿体内感染中的作用。
Mice ; Animals ; Reactive Oxygen Species/metabolism* ; Pseudomonas aeruginosa ; Macrophages/metabolism* ; Mitochondria ; Cytokines/metabolism*