Esophageal cancer (ESCA) is a form of malignant tumor associated with chronic inflammation and immune dysregulation. However, the specific immune status and key mechanisms of immune regulation in this disease require further exploration.
Transcatheter aortic valve replacement (TAVR) has become an essential alternate option for people suffering from aortic stenosis. However, the efficacy and safety of TAVR for elderly population (aged over 80 years) is still unclear.We plan to perform a systematic review and meta-analysis of clinical controlled trials and propensity-match cohort studies to evaluate the short- and long-term outcomes in elderly aortic stenosis patients who undergo a transcatheter or surgical aortic valve replacement. We will search PubMed, EMBASE, and Cochrane Library using a comprehensive strategy. The related conference proceedings and reference lists of the included studies will also be checked to identify additional studies. Two reviewers will screen retrieved records, extract information, and assess the risk of bias independently. STATA software will be used to conduct data synthesis. There is no requirement of ethical approval and informed consent.This study will be submitted to a peer-reviewed journal for publication.This is the first systematic assessment of TAVR for elderly patients with aortic stenosis. We hope it will provide a relatively comprehensive reference for clinical practice and future relevant clinical trials.Ethics approval and patient consent are not required as this study is a systematic review and meta-analysis.CRD42019140857.The protocol has been registered in PROSPERO, which is an International Prospective Register of Systematic Reviews. The registration number is CRD42019140857.
Clinical practice guidelines (CPGs) play an important role in healthcare in China as well as in the world. However, the current status and trends of Chinese CPGs are unknown. The aim of this study was to systematically review the present situation and the quality of Chinese CPGs published in the peer-reviewed medical literature.To identify Chinese CPGs, a systematic search of relevant literature databases (CBM, WANFANG, VIP, and CNKI) was performed for the period January 1978 to December 2010. We used the AGREE II instrument to assess the quality of the included guidelines.We evaluated 269 guidelines published in 115 medical journals from 1993 to 2010 and produced by 256 different developers. Only four guidelines (1%) described the systematic methods for searching and selecting the evidence, 14 (5%) guidelines indicated an explicit link between the supporting evidence and the recommendations, only one guideline used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Thirty-one guidelines (12%) mentioned updates and the average frequency of update was 5.5 years; none described a procedure for updating the guideline. From the assessment with the Appraisal of Guidelines for Research and Ecaluation II (AGREE II), the mean scores were low for the domains "scope and purpose" (19%) and "clarity of presentation" (26%) and very low for the other domains ("rigour of development" 7%, "stakeholder involvement" 8%, "applicability" 6% and "editorial independence" 2%).Compared with other studies on the quality of guidelines assessed with the AGREE instrument in other countries, Chinese CPGs received lower scores, which indicates a relatively poor quality of the guidelines. However, there was some increase over time.
Review question / Objective: This meta-analysis aims to evaluate whether intracytoplasmic sperm injection (ICSI) improved reproductive outcomes for non-male factor infertility versus in vitro fertilization (IVF). Condition being studied: The use of ICSI has increased dramatically in recent years and is being applied for indications other than male factor infertility. However, despite its increased use, there is no clear evidence of the benefit of using ICSI over conventional IVF for non-male factor infertility. Eligibility criteria: Studies will be excluded if one of the following conditions is met: (1) unqualified male perm count and motility; (2) rescued ICSI; (3) non-RCTs of study design; (4) a significant amount of research data is missing or not available.
Abstract Background: Tolvaptan is a receptor antagonist of highly selective vasopressin V2, and it can promote excretion of water without electrolyte. Aims: To evaluated curative effect and safety of Tolvaptan in treatment of cirrhotic ascites, and its relationship with drug dose. Methods : Computer retrieval of PubMed, EMbase and The Cochrane Library was carried out to search the clinical trials of cirrhotic ascites treatment by Tolvaptan. The time limit of retrieval is from the database setup to May 31, 2019. 2 researchers independently screened studies, extracted the data and crosschecked. RevMan 5.3 software was used for Meta-analysis. Results : Finally, 6 articles and 848 patients were included in the study. Meta-analysis indicates that after the intervention for 7 days, serum sodium ion concentration of the combined diuretic group obviously increased, compared with the traditional diuretic group (WMD=2.92mmol/L, 95%CI [2.15, 3.70], P<0.001). In addition, Tolvaptan also can decrease patients’ ascites amount through increasing liquid discharge. However, the drug dose has no obvious correlation with the reduction degree of ascites amount. The rise of blood uric acid is the major adverse event in the treatment of cirrhotic ascites patients by Tolvaptan (OR=6.01, 95%CI [1.11, 32.56], P=0.04). When the dose of Tolvaptan rose to 15mg or 30mg, the total incidence of adverse events was obviously higher than it of traditional diuretic group. Conclusion : Tolvaptan combined with traditional diuretics has good curative effect for the patients with cirrhotic ascites. As its adverse reactions, the recommended dose of Tolvaptan is 7.5mg in the combined therapy.
To enhance the operability of the rat orthotopic left lung transplantation model, we implemented several improvements and meticulously detailed the procedure. One hundred and thirty-one healthy male Sprague Dawley rats, weighing between 250 and 300 g, were utilized, with 64 serving as donors, 64 as recipients, and 3 as sham controls. We employed a modified three-cuff technique for the orthotopic left lung transplantation. Notably, our modified perfusion method could prevent donor lung edema, while waist-shaped cuffs minimized suture slippage during anastomosis. Additionally, positioning the recipient rat in a slightly left-elevated supine position during anastomosis reduced tension on the lung hilum, thus mitigating the risk of vascular laceration. The introduction of a unique two-person anastomosis technique significantly reduced operation time and substantially improved success rates. Furthermore, maximizing inflation of donor lungs both during preservation and surgery minimized the occurrence of postoperative atelectasis. Various other procedural refinements contributed to the enhanced operability of our model. Sixty-four rat orthotopic left lung transplantations were performed with only one surgical failure observed. The acquisition time for donor lungs averaged (19 ± 4) minutes, while (11 ± 1) minutes were allocated for donor lung hilum anatomy and cuff installation. Recipient thoracotomy and left lung hilar anatomy before anastomosis required (24 ± 8) minutes, with anastomosis itself taking (31 ± 6) minutes. Remarkably, the survival rate at the 4-h postoperative mark stood at 96.7 %. Even six months post-operation, transplanted left rat lungs continued to exhibit proper inflation and contraction rhythms, displaying signs of chronic pathological changes. In summary, our modified rat model of orthotopic left lung transplantation demonstrates robust operability, significantly reducing surgical duration, improving operation success rates, and enhancing postoperative survival rates. Furthermore, its long-term survival capacity enables the simulation of acute and chronic disease processes following lung transplantation.
Abstract Background Tolvaptan is a receptor antagonist of highly selective vasopressin V2, and it can promote excretion of water without electrolyte.Aims To evaluated curative effect and safety of Tolvaptan in treatment of cirrhotic ascites, and its relationship with drug dose.Methods Computer retrieval of PubMed, EMbase and The Cochrane Library was carried out to search the clinical trials of cirrhotic ascites treatment by Tolvaptan. The time limit of retrieval is from the database setup to May 31, 2019. 2 researchers independently screened studies, extracted the data and crosschecked. RevMan 5.3 software was used for Meta-analysis.Results Finally, 6 articles and 848 patients were included in the study. Meta-analysis indicates that after the intervention for 7 days, serum sodium ion concentration of the combined diuretic group obviously increased, compared with the traditional diuretic group (WMD=2.92mmol/L, 95%CI [2.15, 3.70], P<0.001). In addition, Tolvaptan also can decrease patients’ ascites amount through increasing liquid discharge. However, the drug dose has no obvious correlation with the reduction degree of ascites amount. The rise of blood uric acid is the major adverse event in the treatment of cirrhotic ascites patients by Tolvaptan (OR=6.01, 95%CI [1.11, 32.56], P=0.04). When the dose of Tolvaptan rose to 15mg or 30mg, the total incidence of adverse events was obviously higher than it of traditional diuretic group.Conclusion Tolvaptan combined with traditional diuretics has good curative effect for the patients with cirrhotic ascites. As its adverse reactions, the recommended dose of Tolvaptan is 7.5mg in the combined therapy.Registration number: The meta-analysis was registered prospectively on the PROSPERO database (ID: CRD42019143480).
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