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  • Author: Xin Jiang x
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Abstract

Background

Gastric cancer (GC) is the common cause of cancer-related deaths worldwide and inflammation represents the early phases in the GC.

Objective

To review the tumor necrosis factor (TNF)-α-308 G>A (GG, GA, and AA) in GC by meta-analysis studies for any differences in TNF-α-308 G>A gene polymorphisms.

Methods

Case–control studies published from 2003 to 2017 were identified by searching PubMed, EMASE, and the Internet with the English language. The analysis published on TNF-α-308 G>A polymorphism was analyzed and a limited number of articles were included in the present study. TNF-α-308 G>A from 4,157 patients and 5,185 healthy controls was evaluated. Studies were evaluated using Cochrane Q-test and publication bias was evaluated by constructing funnel plots.

Results

Overall, TNF-α-308 GA genotype showed significant association [P < 0.0001, odds ratio (OR), 95% confidence interval (CI) = 0.82 (0.74–0.91)]. However, meta-analysis of TNF-α-308 genotypes (GG, GA, AA, and GA + AA) between GC patients and controls showed nonsignificant association with GC [P > 0.05, recessive model: OR = 1.38, 95% CI: 1.15–1.66; dominant model: OR = 1.23, 95% CI: 1.09–1.39; (G/A) vs. (G/G): OR = 1.15, 95% CI: 1.02–1.28; (A/A) vs. (G/G): OR = 1.44, 95% CI: 1.19–1.73]. Analysis stratified by ethnicity showed same results in Asian and Caucasian populations.

Conclusions

Results revealed nonsignificant association of TNF-α-308 genotypes (GG, GA, AA, and GA + AA) and GC. TNF-α-308GA genotype showed significant association whereas homozygous genotype AA did not show association with GC risk.

Abstract

Background: Hemiarthroplasty and total hip arthroplasty are the two most common methods for displaced femoral neck fracture. However, the efficacy of the two methods is still controversial and needs a comprehensive analysis.

Objective: This meta-analysis was to investigate whether total hip arthroplasty (THA) is associated with lower reoperation rate, mortality, complications, better function and quality of life than hemiarthroplasty (HA) for patients with displaced femoral neck fractures.

Materials and Methods: Thirty-one trials involving a total of 4324 patients were included. Six randomized controlled trials, 8 lower-quality randomized trials, and 17 retrospective cohort studies comparing HA with THA for displaced femoral neck fractures were assessed for eligibility. Incidence rate and risk ratios (RR) were pooled using random-effects or fixed-effects models depending on the heterogeneity of included studies.

Results: Meta-analysis showed that THA was associated with a lower risk of reoperation (incidence rate 2.8%, 95%CI 1.8%-3.8%) compared with HA (incidence rate 7.4%, 95%CI 5.3%-9.6%) (RR = 0.42, 95%CI 0.30-0.58, P < 0.001) and higher excellent and good rate by Harris hip score (RR = 1.12, 95%CI 1.06-1.19, P < 0.001). There was a tendency of better prognosis in patients undergoing THA (RRmortality = 0.82, 95%CI 0.67-1.01), but it was not statistically significant (P = 0.067). However, there was a higher risk of dislocation in patients undergoing THA (incidence rate 4.2%, 95%CI 2.7%-5.8%) compared with HA (incidence rate 2.3%, 95%CI 1.4%-3.2%) (RR = 1.79, 95%CI 1.24-2.57, P = 0.002), but there was no difference in both local infections and general complications (P = 0.201 and P = 0.712).

Conclusion: THA can benefit patients of displaced femoral neck fractures with a reduced reoperation rate and better hip function, though it can result a higher incidence of postoperative dislocation. The impact of different hip arthroplasty on prognosis need further studies.

Abstract

Background: Coronary artery bypass grafting (CABG) is an effective method to afford sufficient blood flow for that ischemic myocardium. Off-pump coronary bypass surgery (OPCAB) has been rediscovered and refined to avoid cardiopulmonary bypass. However, it’s a high technique demanding skill. And evaluation of the blood flow should be reliable. Transit time flow measurement (TTFM) is introduced to evaluate graft flow and anastomosis patency intraoperatively. The accuracy of graft flow depends on how to explain the parameters of TTFM. Here, we introduce our experiences on the explanation of TTFM parameters.

Objective: We compared the graft patency of off-pump coronary artery bypass grafting with those of on-pump coronary artery bypass grafting by intraoperative transit time flow measurement (TTFM).

Methods: Three hundred patients were divided into off-pump group and on-pump group. TTFM was routinely performed for assessment of graft patency during operation. Revision of the grafts depends on the TTFM findings.

Results: One patient in OPCAB group was converted to conventional CABG group due to ventricular fibrillation. One patient died of multiple organ failure 21 days post-operation. Seven grafts were revised based on unsatisfactory TTFM findings. There was no statistical difference in the variables between the two groups except for anastmosis to right coronary artery.

Conclusions: Off-pump surgery can provide the same flow of grafts as that of on-pump surgery. TTFM is an effective tool to decide if a well-function graft is or not, and it allows for revision of failure graft during operation.

Abstract

Introduction: The study aimed to clarify the changes in the concentration of inflammatory mediators, proteases, and cartilage degradation biomarkers in the synovial fluid of joints in an equine osteoarthritis model.

Material and Methods: Osteoarthritis was induced in eight Mongolian horses by a sterile intra-articular injection of amphotericin B, which was injected into the left carpal joint in a dose of 2 mL (25 mg/mL). The control group comprised five horses which were injected with an equal dose of sterile physiological saline into the left carpal joint. Synovial fluid was obtained at baseline and every week after injection. Test methods were based on ELISA.

Results: In the course of the osteoarthritis, the concentration of biomarkers in joint synovial fluid showed an increasing trend. IL-1, IL-6, MMP-9, MMP-13, ADAMTS-5, CS846, GAG, HA, CTX-II, and COMP concentrations sharply increased before the onset of significant symptoms of lameness, whereas TNF-α, MMP-2, and MMP-3 concentrations rose sharply after the occurrence of such symptoms.

Conclusion: The results obtained confirm that the concentrations of IL-1, IL-6, MMP-9, MMP-13, ADAMTS-5, CS846, GAG, HA, CTX-II and COMP increase substantially in equine osteoarthritis, which provides a theoretical basis for the rapid diagnosis of the disease.

Abstract

Objective

This study aimed to develop and apply a closed-loop medication administration system in a hospital in order to reduce medication administration errors (MAEs).

Methods

The study was implemented in four pilot general wards. We used a before-and-after design to collect oral medication administration times before and after the implementation of the closed-loop medication administration system, evaluated MAE alert logs after the intervention, and conducted a survey of the nurses’ satisfaction with the system in the pilot wards.

Results

(a) Nursing time of oral medication administration: before the adoption of the closed-loop medication administration system, the average nursing time was 31.56 ± 10.88 minutes (n = 78); after the adoption of the system, the time was 18.74 ± 5.60 minutes (n = 54). Independent sample t-tests showed a significant difference between two groups (t = 8.85, P <0.00). (b) Degree of nurses’ satisfaction with the closed-loop medication administration system: 60.00% (n = 42) of nurses considered the system to be helpful for their work and nearly half of the nurses (47.14%, n = 33) believed that the system could facilitate clinical work and reduce workload; 51.43% (n = 36) believed that the system could reduce checking time and enhance work efficiency; 82.86% (n = 58) believed that the system was helpful in improving checking accuracy to reduce MAEs and ensure patient safety. More than 60% of the nurses considered the system to be a method that could help to track MAEs to improve nursing quality. (c) The MAE alert logs during observation period: it revealed only 27 alerts from the repeated scans of 3,428 instances of medication administration.

Conclusions

The nurses were satisfied with the closed-loop medication administration system because it improved their work efficiency and reduced their workload. The current investigation was limited by time; therefore, further research is needed to more closely examine the relationship between the system and MAEs.

Abstract

Background

The mainstay therapy for locally advanced non-small cell lung cancer is concurrent chemoradiotherapy. Loco-regional recurrence constitutes the predominant failure patterns. Previous studies confirmed the relationship between increased biological equivalent doses and improved overall survival. However, the large randomized phase III study, RTOG 0617, failed to demonstrate the benefit of dose-escalation to 74 Gy compared with 60 Gy by simply increasing fraction numbers.

Conclusions

Though effective dose-escalation methods have been explored, including altered fractionation, adapting individualized increments for different patients, and adopting new technologies and new equipment such as new radiation therapy, no consensus has been achieved yet.

Abstract

Background: The Marshall computed tomography (CT) system for classification of traumatic brain injury (TBI) includes the most important independent prognostic variables except for traumatic subarachnoid hemorrhage (tSAH).

Objectives: To evaluate the prognostic effect of tSAH on different injury types based on the Marshall CT system.

Methods: We performed a retrospective study. All patients with severe closed head injury admitted from February 2011 to July 2012 were included. Their scans were classified into two groups: localized injury and diffuse injury using the Marshall classification. Outcomes were compared between patients with tSAH and those without tSAH among the two groups.

Results: Ninety-six patients were included in this study. Seventy-two (75%) were found to have tSAH, and outcomes significantly negatively correlated with tSAH in both localized injury and diffused injury groups.

Conclusions: tSAH had an important effect on the patients’ outcome. Although the Marshall classification includes important independent prognostic variables, tSAH should also be added.