RESUMEN
Objective To evaluate the efficacy and safety of budesonide combined with pulmonary surfactant(PS)in the treatment of meconium aspiration syndrome(MAS)in neonates.Methods PubMed,Cochrane Central Register of Controlled Trials(Central),Embase,Web of Science,SinoMed,VIP,WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials(RCTs)of budesonide combined with PS in the treatment of neonatal MAS from inception to September 2,2023.Two researchers independently screened literature,extracted data and assessed the risk of bias of the included studies,meta-analyses were performed by using the RevMan 5.4 software.Results A total of 6 RCTs involving 544 patients were included.The results of meta-analysis showed that compared with PS group,budesonide combined with PS group had higher overall effective rate(RR=1.29,95％CI 1.17 to 1.41,P＜0.001),shorter hospital stay(MD=-6.35,95％CI-9.25 to-3.46,P＜0.001)and shorter time of oxygen inhalation(MD=-1.61,95％CI-2.23 to-0.98,P＜0.001),shorter the duration of ventilator use(MD=-26.46,95％CI-35.98 to-16.95,P＜0.001),improved the blood gas analysis indexes at each time after treatment(P＜0.05);In terms of safety,the incidence of total complications and adverse reactions in budesonide combined with PS group was significantly lower(RR=0.35,95％CI 0.25 to 0.47,P＜0.001).Subgroup analysis showed that the incidence of persistent pulmonary hypertension of the newborn(PPHN)in the budesonide combined with PS group was decreased(RR=0.38,95％CI 0.19 to 0.74,P=0.004),and the incidence of pneumorrhagia was decreased(RR=0.26,95％CI 0.10 to 0.69,P=0.007),and the difference was statistically significant;the incidence of heart failure and sepsis was not statistically significant compared with the PS group(P＞0.05).Conclusion Current evidence shows that budesonide combined with PS in the treatment of neonatal meconium aspiration syndrome can improve the symptoms and signs of MAS children,improve the blood gas analysis index,accelerate disease rehabilitation,shorten the course of the disease,can help reduce the risk of complications and PPHN,pneumorrhagia,and doesn't increase the incidence of heart failure,sepsis.Due to the limited quantity of the included studies,more high-quality and large-sample RCTs are needed to further validate the above conclusions.
RESUMEN
Objective:To explore the postprandial plasma low-density lipoprotein cholesterol (LDL-C) changes by various detection methods.Methods:A total of 85 subjects admitted to the Second Xiangya Hospital of Central South University from November 2017 to May 2019 were included. Serum samples were collected from fasting and the 2 nd hour and the 4 th hour after breakfast. Serum lipid levels were measured with enzymatic assays and nuclear magnetic resonance spectroscopy (NMRS), and proprotein invertase subtilisin/kexin type 9 (PCSK9) levels were measured with enzyme-linked immunosorbent assays. The differences of blood lipid components at different time points were compared by Friedman two-way rank analysis of variance and Wilcoxon signed rank test, and the correlation between PCSK9 level and lipoprotein particles was analyzed by Spearman correlation. Results:Measured by enzymatic assays, compared with the fasting state, LDL-C decreased at the 2 nd hour and the 4 th hour after the meal (2.58[2.09, 3.12], 2.47[1.92, 3.02], 2.37[1.82, 2.80] mmol/L, P<0.001). Measured by NMRS, the concentration of LDL particles (1 086[830, 1 239], 1 083[848, 1 213], 1 061[814, 1 213] nmol/L, P=0.417) did not change significantly, and cholesterol in LDL particles were 2.13 (1.56, 2.54), 2.16 (1.68, 2.50), 2.06 (1.58, 2.50) mmol/L, respectively ( P=0.047)，and postprandial cholesterol in LDL particles in the 2 nd hour and in the 4 th hour did not change significantly compared with fasting ( P>0.05). while the concentration of large LDL particles (185.2[150.6,221.6], 173.0[144.8,220.3], 178.1[144.0,233.6] nmol/L, P=0.001), and the cholesterol level in large LDL particles (0.49[0.39, 0.57], 0.47[0.38, 0.57], 0.46[0.37, 0.58]mmol/L, P<0.001) decreased after the meal. The PCSK9 level also decreased significantly after the meal (299[233, 397], 257[208, 342], 251[215, 340] ng/ml, P<0.001). There was an independent positive correlation between the decrease of PCSK9 levels and the increase of remnant cholesterol detected by MNRS after the meal ( r=0.232, P=0.035). Conclusions:The postprandial LDL-C level measured by NMRS and enzymatic assays is not consistent. The decrease of LDL-C measured by enzymatic assays is not caused by the clearance of LDL particles, but by the redistribution of cholesterol in each LDL subfraction.
RESUMEN
Objective To investigate the death risk of patients with severe cerebral vascular disease. Methods The clinical data of 80 cases of patients with severe cerebral vascular disease were analyzed retrospectively. According to the clinical outcome,80 cases were divided into the survival group and death group,and the factors of death risk were analyzed by Logistic regression.Results The cases of the survival group and death group patients were 59 cases(73.75%) and 21 cases(26.25%) respectively.After multiple regression analysis,age,temperature, glasgow coma score,hypertension,stroke,diabetes,chronic obstructive disease,digestive tracthemorrhage,pneumonia, intracranial hemorrhage or infarction and multiple organfailure were correlated with the death of patients with severe cerebral vascular disease significantly(P=0.023,0.011,0.002,0.028,0.004,0.023,0.029,0.028,0.001,0.007, 0.001).Conclusion The death of patients with severe cerebral vascular disease is associated with age,combined disease,syndrome and disease attributes.
RESUMEN
Objective To investigate the effects of tuina manipulation on creep rate and maximal breaking stress of contractural Achilles tendons of rabbits. Methods Twenty-four rabbits were randomly divided into contrac-tural Achilles tendon model group, free activities group and tuina manipulation group. The opposite legs of model group were used as normal controls. Creep rate and maximal breaking stress of Achilles tendons were compared among the 4 groups. Results The average creep rate in tuina manipulation group approximated to that in normal group and was lower than that in model and free activities groups. The average maximal breaking stress in tuina manipulation group approximated to that in normal group and was higher than that in model and free activities groups. Conclusion Tuina manipulation can promote the creep rate and maximal breaking stress of contractura Achilles tendon approximately to normal level. Tuina manipulation may be useful in rehabilitation.
RESUMEN
Objective To determine the changes of serum IL-10 level in perioperative period in patients with hepatocellular carcinoma (HCC) and discuss its significance. Methods The serum IL-10 level was determined with ELISA in 30 patients with HCC and 30 healthy volunteers. Results The serum IL-10 level was significantly higher in the perioperative period in patients with HCC than in the healthy volunteers. In the patients with HCC, the level was higher before than after the operation. Meanwhile, it was markedly higher in patients with poorly differentiated tumor or the tumor with a diameter over 5 cm than in those with well-differentiated tumor or the tumor with a diameter less than 5 cm (P<0.01). Conclusion HCC cells might produce IL-10 that may participate in immune response of HCC. Furthermore, IL-10 might be a factor that can reflect the differentiation grade, assess the prognosis and predict recurrence of HCC.