ABSTRACT
Objective To evaluate the efficacy and safety of high flow nasal cannula (HFNC) oxygen therapy in preventing postoperative respiratory failure. Methods HFNC, nasal catheter high flow oxygen therapy, high flow nasal catheter oxygen therapy, high-flow nasal humidifiers and oxygen inhalers, and patients with postoperative respiratory failure were used as Chinese terms, and high flow nasal cannulae, high flow nasal cannulae oxygen therapy, nasal high flow, adult, postoperative respiratory failure were used as English terms to retrieve, a computer was used to retrieve already published all available randomized controlled trials (RCTs) about using HFNC therapy to prevent patients from the occurrence of postoperative respiratory failure; the search was carried out from PubMed in literature database of American National Library, the Cochrane Library, Holland Medical Abstract Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Database, China Biomedicine Database (CBM), and the articles were collected from the creation of various above databases to June 2017. The collected RCTs should be carefully read, and the inclusion or exclusion of an article should strictly follow the respective criteria. Two authors independently extracted data, conducted quality assessments , extract the elevation of respiratory support rate, hospital mortality and hospital length of stay, etc. Revman 5.3 software was used to carry out Meta analysis; funnel plots were applied to analyze the publication bias. Results Finally, after Meta analyses, 6 RCTs were included, involving 935 adult patients with existence of moderate to high risks of respiratory failure after the tube drawn out post-operationally, and there were 467 patients in the experimental group and 468 in control group. Compared with the control group, the escalation of respiratory support rate was reduced in the experimental group [odds ratio (OR) = 0.55, 95% confidence interval (95%CI) = 0.39 - 0.76, P = 0.000 3]; There were no statistical significant differences in improving hospital mortality (OR = 0.77, 95%CI = 0.17 - 3.48, P = 0.73) and shortening hospital length of stay [mean difference (MD) =-0.48, 95%CI = -1.37 - 0.41, P = 0.29] in the comparisons between the two groups, but experimental group tended to be the one with more advantage. The funnel plot analysis suggested that the publication bias was relatively low, because the distribution of the included articles was basically symmetrical. Conclusion Compared with COT, HFNC could reduce the escalation of respiratory support rate in patients with postoperative respiratory failure, although there were no statistical significant differences in hospital mortality and hospital length of stay between HFNC and COT, the advantage tends toward the HFNC.
ABSTRACT
Objective To understand the related influencing factors of pleural effusion caused by severe congestive heart failure to provide an idea for clinical diagnosis and treatment.Methods Three hundreds patients with severe congestive heart failure admitted to the cardiology department of this hospital from January to June 2015 were selected.The sex,age,heart failure degree,pleural effusion,type of heart disease,diabetes mellitus,atrial fibrillation,B-type pro-brain natriuretic peptide,white blood cell,neutrophil percentage,hemoglobin,blood urea nitrogen,serum albumin and hospital stay were recorded and performed the statistical analysis.Results The sex,heart failure degree,ejection fraction,B-type pro-brain natriuretic peptide,neutrophil percentage and serum albumin had statistical differences between the patients with pleural effusion caused by severe congestive heart failure and patients without pleural effusion(P＜0.05).The left atrial diastolic diameter/left ventricular end-diastolic diameter,white blood cell,hemoglobin,blood urea nitrogen,type of heart disease,diabetes,atrial fibrillation and hospitalization stay had no statistically significant differences(P＞0.05).Conclusion Pleural effusion caused by severe congestive heart failure has the correlation with the sex,heart failure degree,hypoproteinemia and neutrophil percentage.
ABSTRACT
Wnt/β-catenin signaling pathway plays an important role in the initiation and progression of colorectal cancer. The key to its carcinogenicity is related to the inhibition of β-catenin degradation, and the subsequent cytoplasmic accumulation and nuclear translocation of β-catenin, which activates the transcription of downstream target genes such as coding region instability determinant-binding protein (CRD-BP). In cancercells ,the expression of CRD-BP mediates the stabilization of β-Trcp, which in normal cells regulates the degradation of β-catenin. The activation of Wnt/β-catenin signaling pathway, overexpression of β-catenin and CRDBP, and the upregulation of β-Trcp by CRD-BP play important roles in the initiation, progression, and metastasis of colorectal cancer.
ABSTRACT
OBJECTIVE To improve the management of the use of antibiotics in the hospital through investigating and analyzing the cases of inpatients.METHODS From Jan 2005 to Dec 2006,totally 810 cases of operated patients and 1220 cases of non-operated patients were investigated retrospectively,and the usage of antibiotic was analyzed.RESULTS The need of using antibiotic drugs was proven in all cases in which antibiotic drugs were used.However,only 56 cases in the total 810 operated cases used drugs were completely reasonable,which accounted for 6.91%.Unreasonableness was found in the other 754 operated cases(ccounted for 93.01%),who had used inappropriate antibiotic drugs or those drugs in an improper time during the preoperative period.The average time of using prevention drugs for Type Ⅰand Type Ⅱ incisions were 6.59 and 6.44 days after the operation,respectively.In the 1220 non-operated cases,only 730 cases used antibiotic drugs,which accounted for 59.83%.From them,432 cases(accounted for 59.18%) used the antibiotic drugs were completely reasonable and other 298 cases(accounted for 40.82%) were found have used the antibiotic drugs unreasonably.The unreasonableness mainly included in the dose and method used and a lack of examination in the pathogens in some adaptive cases.CONCLUSIONS Enhancing the training and encouraging the study of rational use of antibiotic drugs,establishing and optimizing the management system on the use of antibiotic drugs are the key tasks involved to ensure the reasonable use of the antibiotic drugs.