1.The Effects of Prone Position Ventilation in Patients Receiving Extracorporeal Membrane Oxygenation:a Meta-analysis
Lili LI ; Jing WU ; Junhui WANG ; Hangyan YE ; Chaonan WO ; Miaojie YU ; Fei LI ; Huiping YAO
Chinese Circulation Journal 2025;40(10):999-1005
Objectives:To analyze the effects of prone position ventilation in patients receiving extracorporeal membrane oxygenation(ECMO).Methods:A systematic search was conducted in databases including CNKI,Wanfang Data,China Biomedical Literature Database,PubMed,Embase,Cochrane Library,and Web of Science,from the inception of each database to October 2024,to identify studies on prone position ventilation for ECMO patients.Two researchers independently screened the literature,extracted data,and assessed the quality of the studies.Meta-analysis was performed using RevMan 5.4 software.Results:A total of 10 studies were included in this analysis,comprising 2 randomized controlled trials and 8 cohort studies.A total of 1 513 patients were included,674 were in the prone position ventilation group and 839 were in the supine position ventilation group.Analysis results of 6 studies showed that compared with supine position ventilation,prone position ventilation could increase the successful weaning rate of ECMO(OR=1.47,95%CI:1.07-2.01,P=0.02).Analysis results of 8 studies showed that compared with supine position ventilation,prone position ventilation could prolong the duration of ECMO treatment(mean difference[MD]=4.86 days,95%CI:0.95-8.77,P=0.01).Analysis results of 6 studies showed that the length of stay in the intensive care unit in the prone position ventilation group was significantly longer than that in the supine position ventilation group(MD=5.16 days,95%CI:1.08-9.25,P=0.01).Analysis results of 5 studies showed that the total length of hospital stay in the prone position ventilation group was significantly longer than that in the supine position ventilation group(MD=7.72 days,95%CI:2.10-13.34,P<0.01).Analysis results of 6 studies showed that compared with supine position ventilation,prone position ventilation could prolong the duration of mechanical ventilation(MD=6.06 days,95%CI:0.63-11.49,P=0.03).Prone position ventilation had no obvious advantage in improving patient survival rate.Conclusions:Prone position ventilation can improve the successful weaning rate from ECMO and prolong the duration of ECMO treatment as well as the duration of mechanical ventilation,but it has no significant impact on patient survival rate.Due to the generally small sample size in the studies,further research with larger sample sizes is needed to confirm the effective impact of prone position ventilation in patients receiving ECMO treatment.
2.Progress in the application of JAK inhibitors in atopic dermatitis
Chinese Journal of Preventive Medicine 2025;59(9):1566-1574
Atopic dermatitis is a chronic recurrent inflammatory skin disorder associated with heterogenous presentation and immense patient burden. Previous therapeutic drugs include topical glucocorticoids, topical calcineurin inhibitors, oral antihistamines, systemic immunosuppressants, glucocorticoids and biologcis, etc. In recent years, a variety of small molecule drugs have been approved for the treatment of atopic dermatitis.Two selective JAK inhibitors Upadacitinib and Abrocitinib, have been approved for AD treatment indications in China. This mini-review summarizes the clinical application of these two drugs in the treatment of AD, including the underlying molecular mechanisms, clinical trials, and clinical experiences, highlighting the value of selective JAK inhibitors in AD therapy.
3.The Effects of Prone Position Ventilation in Patients Receiving Extracorporeal Membrane Oxygenation:a Meta-analysis
Lili LI ; Jing WU ; Junhui WANG ; Hangyan YE ; Chaonan WO ; Miaojie YU ; Fei LI ; Huiping YAO
Chinese Circulation Journal 2025;40(10):999-1005
Objectives:To analyze the effects of prone position ventilation in patients receiving extracorporeal membrane oxygenation(ECMO).Methods:A systematic search was conducted in databases including CNKI,Wanfang Data,China Biomedical Literature Database,PubMed,Embase,Cochrane Library,and Web of Science,from the inception of each database to October 2024,to identify studies on prone position ventilation for ECMO patients.Two researchers independently screened the literature,extracted data,and assessed the quality of the studies.Meta-analysis was performed using RevMan 5.4 software.Results:A total of 10 studies were included in this analysis,comprising 2 randomized controlled trials and 8 cohort studies.A total of 1 513 patients were included,674 were in the prone position ventilation group and 839 were in the supine position ventilation group.Analysis results of 6 studies showed that compared with supine position ventilation,prone position ventilation could increase the successful weaning rate of ECMO(OR=1.47,95%CI:1.07-2.01,P=0.02).Analysis results of 8 studies showed that compared with supine position ventilation,prone position ventilation could prolong the duration of ECMO treatment(mean difference[MD]=4.86 days,95%CI:0.95-8.77,P=0.01).Analysis results of 6 studies showed that the length of stay in the intensive care unit in the prone position ventilation group was significantly longer than that in the supine position ventilation group(MD=5.16 days,95%CI:1.08-9.25,P=0.01).Analysis results of 5 studies showed that the total length of hospital stay in the prone position ventilation group was significantly longer than that in the supine position ventilation group(MD=7.72 days,95%CI:2.10-13.34,P<0.01).Analysis results of 6 studies showed that compared with supine position ventilation,prone position ventilation could prolong the duration of mechanical ventilation(MD=6.06 days,95%CI:0.63-11.49,P=0.03).Prone position ventilation had no obvious advantage in improving patient survival rate.Conclusions:Prone position ventilation can improve the successful weaning rate from ECMO and prolong the duration of ECMO treatment as well as the duration of mechanical ventilation,but it has no significant impact on patient survival rate.Due to the generally small sample size in the studies,further research with larger sample sizes is needed to confirm the effective impact of prone position ventilation in patients receiving ECMO treatment.
4.Progress in the application of JAK inhibitors in atopic dermatitis
Chinese Journal of Preventive Medicine 2025;59(9):1566-1574
Atopic dermatitis is a chronic recurrent inflammatory skin disorder associated with heterogenous presentation and immense patient burden. Previous therapeutic drugs include topical glucocorticoids, topical calcineurin inhibitors, oral antihistamines, systemic immunosuppressants, glucocorticoids and biologcis, etc. In recent years, a variety of small molecule drugs have been approved for the treatment of atopic dermatitis.Two selective JAK inhibitors Upadacitinib and Abrocitinib, have been approved for AD treatment indications in China. This mini-review summarizes the clinical application of these two drugs in the treatment of AD, including the underlying molecular mechanisms, clinical trials, and clinical experiences, highlighting the value of selective JAK inhibitors in AD therapy.
5.Long-term prophylactic therapy combined with on-demand therapy for the control of hereditary angioedema——Comment on the 2021 edition of the international WAO/EAACI guideline for the management of hereditary angioedema
Huiying WANG ; Yinshi GUO ; Wo YAO ; Lei CHENG
Chinese Journal of Preventive Medicine 2024;58(5):698-705
The 2021 edition of the international World Allergy Organization (WAO)/European Academy of Allergy and Clinical Immunology (EAACI) guideline for the management of hereditary angioedema (HAE) is mainly based on high-quality randomized controlled trials. It provides clinical classification for HAE and offers graded recommendations for on-demand therapy, short-term prophylactic therapy, and long-term prophylactic therapy. Additionally, it provides management strategies for people with different HAE types. This article focused on the interpretation of short-term, long-term prophylactic therapy and on-demand therapy for HAE, supplemented with the latest clinical evidence, aiming to provide references for the long-term management of HAE.
6.The management mode of hereditary angioedema: intra-hospital multi-diciplinary treatment, linkage of cooperation network, online and offline whole process management
Wo YAO ; Dingqian WU ; Ying SHEN ; Lei SHEN ; Yan LI ; Liuya GE ; Songzhao ZHANG ; Jiong CHEN ; Huiying WANG
Chinese Journal of Preventive Medicine 2024;58(3):406-413
Hereditary angioedema (HAE) is an autosomal dominant inherited disease characterized by recurrent and unpredictable episodes of subcutaneous or submucosal edema. These attacks could induce fatal risk when larynx is involved. The estimated prevalence of HAE is about 1 in 50 000. Due to its rarity and the diversity of clinical manifestations, HAE is known little by related physicians and misdiagnosis and mistreatment happens very often. Therefore, it is crucial to improve physicians′ understanding of HAE. To address this, a comprehensive management approach for the diagnosis and treatment of HAE have developed in our hospital. This approach includes intra-hospital multi-disciplinary treatment (MDT), collaboration with provincial network hospitals, patient education online and offline interacting with media propaganda. By implementing this approach, the diagnostic precision was significantly improved, the diagnostic time was significantly shortened, and the frequency of emergency interventions for severe laryngeal edema was significantly reduced. Additionally, the collection of data from HAE patients has provided valuable clinical insights for the diagnosis and treatment of HAE in China.
7.Long-term prophylactic therapy combined with on-demand therapy for the control of hereditary angioedema——Comment on the 2021 edition of the international WAO/EAACI guideline for the management of hereditary angioedema
Huiying WANG ; Yinshi GUO ; Wo YAO ; Lei CHENG
Chinese Journal of Preventive Medicine 2024;58(5):698-705
The 2021 edition of the international World Allergy Organization (WAO)/European Academy of Allergy and Clinical Immunology (EAACI) guideline for the management of hereditary angioedema (HAE) is mainly based on high-quality randomized controlled trials. It provides clinical classification for HAE and offers graded recommendations for on-demand therapy, short-term prophylactic therapy, and long-term prophylactic therapy. Additionally, it provides management strategies for people with different HAE types. This article focused on the interpretation of short-term, long-term prophylactic therapy and on-demand therapy for HAE, supplemented with the latest clinical evidence, aiming to provide references for the long-term management of HAE.
8.The management mode of hereditary angioedema: intra-hospital multi-diciplinary treatment, linkage of cooperation network, online and offline whole process management
Wo YAO ; Dingqian WU ; Ying SHEN ; Lei SHEN ; Yan LI ; Liuya GE ; Songzhao ZHANG ; Jiong CHEN ; Huiying WANG
Chinese Journal of Preventive Medicine 2024;58(3):406-413
Hereditary angioedema (HAE) is an autosomal dominant inherited disease characterized by recurrent and unpredictable episodes of subcutaneous or submucosal edema. These attacks could induce fatal risk when larynx is involved. The estimated prevalence of HAE is about 1 in 50 000. Due to its rarity and the diversity of clinical manifestations, HAE is known little by related physicians and misdiagnosis and mistreatment happens very often. Therefore, it is crucial to improve physicians′ understanding of HAE. To address this, a comprehensive management approach for the diagnosis and treatment of HAE have developed in our hospital. This approach includes intra-hospital multi-disciplinary treatment (MDT), collaboration with provincial network hospitals, patient education online and offline interacting with media propaganda. By implementing this approach, the diagnostic precision was significantly improved, the diagnostic time was significantly shortened, and the frequency of emergency interventions for severe laryngeal edema was significantly reduced. Additionally, the collection of data from HAE patients has provided valuable clinical insights for the diagnosis and treatment of HAE in China.
9.Contemporary Evidence Summary of Strategies for Weaning From Extracorporeal Membrane Oxygenation in Adult Patients
Chaonan WO ; Shuai ZHANG ; Weifang FAN ; Huiping YAO ; Lili GE ; Ruoyu LUO ; Dechuan DENG ; Juanhong CHEN
Chinese Circulation Journal 2024;39(9):896-902
Objectives:To retrieve,evaluate and summarize the contemporary evidence of strategies for weaning from extracorporeal membrane oxygenation(ECMO)of adult patients,and to provide evidence-based reference for clinical practice. Methods:The Web of Science,Embase,Cochrane Library,PubMed,Wanfang Database,CNKI,VIP website,SinoMed,BMJ Best Practice,National Institute for Health and Care Excellence,Joanna Briggs Institute Library,UpToDate and the website of Agency for Healthcare Research and Quality,Society of Critical Care Medicine,American Association of Critical-Care Nurses,European Society of Intensive Care Medicine and Extracorporeal Life Support Organization were researched to collect the literature related to randomized controlled trials,systematic reviews,guidelines,evidence summaries,expert consensuses and clinical decisions in this field.The time limit for the retrieval is from the inception of databases until July 2023. Results:A total of 13 related literature were retrieved,including 4 guidelines,4 expert consensuses,3 clinical decisions and 2 system reviews.Totally 42 evidences were formulated based on retrieved literature,including adequately accessing the ability of gas exchange before weaning from veno-venous ECMO(V-V ECMO)and withdrawing from veno-arterial ECMO(V-A ECMO)as soon as possible when patients's heart function has recovered,involving six aspects such as team composition,anticoagulation measures,assessment before weaning,weaning implementation,cannula and wound management and quality measures. Conclusions:It is suggested to build a professional ECMO team based on the actual hospital situation,to follow the contemporary evidence to standardize the weaning process of patients from ECMO to ensure the patients'safety and improve the outcomes.
10.Correlation between acute carbon monoxide poisoning-induced myocardial damage and delayed encephalopathy
Fei YAO ; Xin XIAO ; Jinshan WO
Chinese journal of nautical medicine and hyperbaric medicine 2021;28(5):599-601,606
Objective:To study the correlation between myocardial damage and delayed encephalopathy in patients with acute carbon monoxide poisoning (ACOP).Methods:The clinical data of 205 patients with ACOP treated in No. 971 Hospital of the PLA Navy from November 2016 to November 2020 were retrospectively analyzed. The patients were divided into encephalopathy group ( n=110) and non-encephalopathy group ( n=95) based on whether they had delayed encephalopathy. Myocardial damage-related indicators and the results of electrocardiogram (ECG) analysis within 24 hours after admission were compared between the two groups. Results:The levels of serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), myoglobin (Mb), and lactate dehydrogenase (LDH) in the encephalopathy group were higher than those in the non-encephalopathy group, with statistically significant differences ( P<0.01). The incidences of ECG ST-T changes and atrioventricular block in the encephalopathy group were higher than those in the non-encephalopathy group, with statistically significant differences ( P<0.05). Conclusion:Myocardial damage-related indicators and the early ECG results in patients with ACOP are closely correlated with the incidence of delayed encephalopathy.

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