Chinese Journal Full-text Database Research Articles

Risk factors related to contralateral hip fracture following hip fracture in elderly patients: a meta analysis and review

Objective To evaluate the factors related to contralateral hip fracture in the elderly patients with hip fracture by meta analysis. Methods Pubmed, Cochrane, CBMdisc, CNKI Chinese Journal Full Text Database and Wan Fang Database were searched for publications at home and abroad from January 2005 to April 2018 on factors related to contralateral hip fracture after hip fractures in the elderly. The publication quality was strictly evaluated before the data were extracted concerning gender and age(>65 years) of the patients, concomitant osteoporosis (Singh sign ≥4), primary fracture type, concomitant Parkinson disease, concomitant stroke, concomitant senile dementia, concomitant cataract, concomitant rheumatoid arthritis, concomitant diabetes, type of internal fixation for primary fracture and therapeutic compliance. Revman5.0 was used to perform the statistical analysis and the OR value and 95% CI were calculated fore each index. Results A total of 17 studies were included involving 1,504 patients with contralateral hip fracture among 13,717 elderly patients with hip fracture. The factors related to the refracture of the contralateral hip were the age of the patients (OR=-3.55, 95% CI:-5.60~-1.50, P<0.001), osteoporosis (OR=2.38, 95% CI: 1.36~4.17, P=0.002), Parkinson disease (OR=4.54, 95% CI: 2.74~7.53, P<0.001), stroke (OR=0.33, 95% CI: 0.18~0.59, P<0.001), senile dementia (OR=0.43, 95% CI: 0.29~0.62, P<0.001), cataract (OR=0.37, 95% CI: 0.22~0.63, P< 0.001), rheumatoid arthritis (OR=0.32, 95% CI: 0.21~0.50, P<0.001), diabetes (OR=0.65, 95% CI: 0.47~0.91, P=0.01), type of internal fixation for primary fracture (OR=0.51, 95% CI: 0.30~0.85, P=0.01), and therapeutic compliance (OR=0.36, 95% CI: 0.21~0.64, P<0.001). However, the refracture of the contralateral hip was not related to gender (OR=1.07, 95% CI: 0.45~2.56, P=0.88), smoking (OR=0.86, 95% CI: 0.40~1.86, P=0.70), fracture type (OR=0.97, 95% CI: 0.60~1.57, P=0.90), or hypertension (OR=0.70, 95% CI: 0.41~1.21, P=0.20). Conclusions In elderly patients with hip fracture, the risks for contralateral hip fracture may be advanced age, concomitant osteoporosis, Parkinson disease, stroke, senile dementia, cataract, rheumatoid arthritis and diabetes, type of internal fixation for primary fracture, and poor therapeutic compliance. However, no sufficient evidence has suggested that gender, smoking, type of hip fracture or concomitant hypertension might be associated with the contralateral hip fracture. Key words: Elderly; Hip fracture; Meta-analysis; Contralateral hip fracture; Related factors

Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis.

BackgroundSmoke inhalation injury increases overall burn mortality. Locally applied heparin attenuates lung injury in burn animal models of smoke inhalation. It is uncertain whether local treatment of heparin is benefit for burn patients with inhalation trauma. We systematically reviewed published clinical trial data to evaluate the effectiveness of nebulized heparin in treating burn patients with inhalation injury.MethodsA systematic search was undertaken in PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Journals Full-text Database, the China Biomedical Literature Database and the Wanfang Database to obtain clinical controlled trails evaluating nebulized heparin in the treatment of burn patients with inhalation injury. Patient and clinical characteristics, interventions and physiological and clinical outcomes were recorded. Cochrane Risk of Bias Evaluation Tool and the Newcastle–Ottawa Scale were used to evaluate data quality. Potential publication bias was assessed by Egger’s test. A sensitivity analysis was conducted to assess the stability of the results. The meta-analysis was conducted in R 3.5.1 software.ResultsNine trials were eligible for the systematic review and meta-analysis. Nebulized heparin can reduce lung injury and improve lung function in burn patients with inhalation injury without abnormal coagulation or bleeding, but the findings are still controversial. Mortality in the heparin-treated group was lower than that of the traditional treatment group (relative risk (RR) 0.75). The duration of mechanical ventilation (DOMV) was shorter in the heparin-treated group compared to the traditional treatment group (standardized mean difference (SMD) −0.78). Length of hospital stay was significantly shorter than that in the traditional treatment group (SMD −0.42), but incidence rates of pneumonia and unplanned reintubation were not significantly different in the study groups (RRs 0.97 and 0.88, respectively). No statistically significant publication biases were detected for the above clinical endpoints (p > 0.05).ConclusionsBased on conventional aerosol therapy, heparin nebulization can further reduce lung injury, improve lung function, shorten DOMV and length of hospital stay, and reduce mortality, although it does not reduce the incidence of pneumonia and/or the unplanned reintubation rate.

Spatial Distribution and Dynamic Changes in Research Hotspots for Desertification in China Based on Big Data from CNKI

Desertification research plays a key role in the survival and development of all mankind. The Normalized Comprehensive Hotspots Index (NCH) is a comprehensive index that reveals the spatial distribution of research hotspots in a given research field based on the number of relevant scientific papers. This study uses Web Crawler technology to retrieve the full text of all Chinese journal articles spanning the 1980s–2018 in the Chinese Academic Journal full-text database (CAJ) from CNKI. Based on the 253,055 articles on desertification that were retrieved, we have constructed a research hotspot extraction model for desertification in China by means of the NCH Index. This model can reveal the spatial distribution and dynamic changes of research hotspots for desertification in China. This analysis shows the following: 1) The spatial distribution of research hotspots on desertification in China can be effectively described by the NCH Index, although its application in other fields still needs to be verified and optimized. 2) According to the NCH Index, the research hotspots for desertification are mainly distributed in the Agro-Pastoral Ecotone and grassland in Inner Mongolia, the desertification areas of Qaidam Basin in the Western Alpine Zone and the Oasis-Desert Ecotone in Xinjiang (including the extension of the central Tarim Basin to the foothills of the Kunlun Mountains, the sporadic areas around the Tianshan Mountains and the former hilly belt of the southern foothills of the Altai Mountains). Among these three, the Agro-Pastoral Ecotone in the middle and eastern part of Inner Mongolia includes the most prominent hotspots in the study of desertification. 3) Since the 1980s, the research hotspots for desertification in China have shown a general downward trend, with a significant decline in 219 counties (10.37% of the study area). This trend is dominated by the projects carried out since 2002. The governance of desertification in the eastern part of the Inner Mongolia-Greater Khingan Range still needs to be strengthened. The distribution of desertification climate types reflects the distribution of desertification in a given region to some extent. The Normalized Comprehensive Hotspots Index provides a new approach for researchers in different fields to analyze research progress.

The effect of empowerment education on depression level and laboratory indicators of patients treated with hemodialysis: a meta-analysis

Abstract Objective The objective of this study was to evaluate the effect of empowerment education on depression level and laboratory indicators of patients treated with hemodialysis. Methods We searched databases including Cochrane Library, Web of Science, Embase, PubMed, Chinese Biomedical Literature Database (CBM), Chinese Academic Journals Full-text Database (CNKI), VIP, and Wanfang. We included all the researches about the application of empowerment education in patients treated with hemodialysis. We used RevMan 5.3 to analyze the data after assessing the quality of researches. Results We included 10 studies eventually. The results of meta-analysis showed that the self-efficacy [MD = 1.10, 95% confidence interval (CI; 0.71, 1.48), P &lt; 0.01], depression [MD = -6.94, 95% CI (-8.53, -5.34), P &lt; 0.01], serum creatinine [Scr; MD = -116.46, 95% CI (-171.90, -61.03), P &lt; 0.01], albumin [Alb; MD = 2.93, 95% CI (2.00, 3.86), P &lt; 0.01], and blood urea nitrogen [BUN; MD = -0.95, 95% CI (-1.89, -0.01), P = 0.05] in the empowerment education group had significantly statistical difference compared with those in the usual education group. However, there was no significant difference in hemoglobin [Hb; MD = 3.03, 95% CI (-0.64, 6.70), P = 0.11] between two groups. Conclusions Empowerment education can improve the self-efficacy in patients treated with hemodialysis, relieve depression, and improve Scr, Alb, and BUN. However, there is no significant improvement in Hb; it needs further exploration in clinical practice.

An Overview of Systematic Reviews of Randomized Controlled Trials on Acupuncture Treating Migraine.

Objectives To review the evidence of acupuncture for acute and preventive treatment of migraine for further awareness of the effect of acupuncture for migraine. Design An overview of systematic reviews and meta-analyses (SR/MAs) for randomized controlled trials. Material and Methods We searched PubMed, Embase, the Cochrane Library, China Knowledge Resource Integrated Database, VIP Chinese Journal Full Text Database, WANFANG Data, and China Biology Medicine disc from their establishment to May 27, 2018. SR/MAs of randomized controlled trials comparing the effect of the acupuncture intervention with another treatment control in migraine patients were included. Results 428 SRs were identified, and 15 of them were included. Only 4 SR/MAs were assessed by GRADE, which showed certainty of most evidence being low or very low. Assessed by AMSTAR-2, fourteen was critically low rating overall confidence in the results, and 1 was low rating overall confidence in the results. Evidence suggested that acupuncture has a significant advantage of pain improvement, efficacy, and safety relative to blank control, sham acupuncture, or drug treatment, but some of these results are contradictory. Conclusions We found that acupuncture on treating migraine has the advantage for pain improvement and safety, but the quality of SR/MAs of acupuncture for migraine remains to be improved.

Meta-analysis of efficacy of pressure therapy in treating patients with hypertrophic scars

Objective: To systematically evaluate the efficacy of pressure therapy in treating patients with hypertrophic scars by meta-analysis. Methods: Databases including PubMed, Embase, Web of Science, and Cochrane Library were retrieved with the search terms"hypertrophic scar, hyperplastic scar, HTS, pressure therapy, pressure treatment, and the Chinese Journals Full-text Database was retrieved with the search terms in Chinese version",,,,"to obtain the publicly published randomized controlled trials about pressure therapy in the treatment of patients with hypertrophic scar from the establishment of each database to July 2017. The measurement indexes included the effective ratio, Vancouver Scar Scale (VSS) score, scar vascularity, scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow). RevMan 5.3 and Stata 12.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 667 hypertrophic scar patients were enrolled in 11 articles, including 362 patients in pressure therapy group who received pressure treatment and 305 patients in untreated group who received no treatment. The bias risks of the 11 studies included were uncertain. Compared with those of untreated group, the effective ratio of patients in pressure therapy group was significantly increased, with the relative risk of 5.98 (95% confidence interval=1.83-19.46, P<0.01); the VSS score and scar vascularity of patients in pressure therapy group were obviously decreased, with weighted mean differences of -2.24 and -0.66 respectively (95% confidence interval=-4.16--0.33, -1.21--0.12, P<0.05); the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow) of patients in pressure therapy group were not changed obviously (P≥0.05). Significant heterogeneity existed in the included studies of the effective ratio, VSS score, scar vascularity, scar hardness, scar pigment, and scar thickness, P<0.01, I(2)=90%, 87%, 80%, 93%, 86%, 94%. Pressure range might be the heterogeneity source of effective ratio, and pressure clothing combined with pressure pad therapy might be a heterogeneous source of VSS score. Sensitivity analysis showed that the combined effect size results were stable in the effective ratio and scar pigment, but not stable in the VSS score, scar thickness, scar hardness, and scar vascularity. There was no publication bias in the effective ratio, VSS score, scar hardness, scar pigment, and scar vascularity (P>0.1), while there was publication bias in the scar thickness (95% confidence interval=-19.77--3.30, P<0.1). Conclusions: Compared with patients without treatment, in the treatment of hypertrophic scars, pressure therapy can obviously increase the effective ratio, reduce the VSS score and scar vascularity, but can not obviously improve the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow).

Summary and application analysis of clinical herniorrhaphy mesh materials

It is widely believed in the medical community that the pathological and anatomical basis for the occurrence of external abdominal hernia is the fascia defect, and how to correctly deal with this kind of fascia defect is the key point in the treatment of external abdominal hernia. Theodore Billorth famously said that if we could artificially create dense and tough tissues like fascia and tendons, the secret to the complete healing of hernia would be solved. These similar theories largely guide the research and practice in the treatment of external abdominal hernia. along with the breakthrough progress in the mesh treatment of external abdominal hernia, According to the chemical composition and biological characteristics, the patch materials can be divided into non-absorbable materials, absorbable materials, composite repair materials and biological materials. Methods In this paper, Pubmed database and Chinese journal full-text database literatures were searched,and all mesh materials used in inguinal hernia repair were comprehensively studied, summarized and analyzed in clinical application.&#x0D; Keywords: external abdominal hernia; patch material; conclusion; application

Influence of different lying positions on monitoring of central venous pressure in patients with mechanical ventilation: a systematic review

Objective To review systematically the influence of different lying positions on monitoring of central venous pressure (CVP) in patients with mechanical ventilation. Methods Relevant articles published publicly from database establishment date to June, 30th, 2018 in PubMed, Cochrane Library, Embase, Web of Science, CBM, Chinese Academic Journal Full-text Database (CJFD) , Wanfang and VIP Database were searched on computer. Two researchers independently screened and extracted the literature. RevMan 5.3 software was used for meta-analysis of the included studies. Results Nine literatures were included, including 380 subjects. Meta-analysis showed that there were significant statistical differences in CVP values between 30 degree semi-recumbent position and supine position (WMD=-0.70, 95%CI: -1.15--0.24, P=0.003) , and between 45 degree semi-recumbent position and supine position (WMD=-1.34, 95%CI: -1.82--0.86, P<0.001) , and between 60 degree semi-recumbent position and supine position (WMD=-2.96, 95%CI: -3.91--2.00, P<0.001) . Conclusions There are differences between the CVP measurements in the 30°, 45°, 60° hemi-recumbent position and the supine position. To ensure the accuracy of the CVP measurement values in mechanical ventilation patients, we should take the supine position for measurement. Key words: Central venous pressure; Lying position; Monitoring; Mechanical ventilation; Systematic review

Acupoint selection rules of hyperthyroidism and related exophthalmos treated with acupuncture

To explore the clinical acupoint selection rules for hyperthyroidism and related exophthalmos treated with acupuncture. By taking "hyperthyroidism" "acupuncture and moxibustion" as keywords，literature regarding acupuncture for hyperthyroidism and related exophthalmos published was collected in the Chinese Journal Full-text Database (CNKI), VIP Database (VIP) and WANFANG database. The literature was organized, the database of acupuncture prescription was established and the characteristics and rules of acupoint selection were analyzed. A total of 46 papers were included, involving 89 acupoints, the frequency of acupoint application was 449 times. The most commonly used 6 acupoints for hyperthyroidism treated with acupuncture were Sanyinjiao (SP 6), Neiguan (PC 6), Zusanli (ST 36), Shuitu (ST 10), Hegu (LI 4), Taichong (LR 3). And the most meridians of acupoints were the stomach meridian and the pericardium meridian. The most commonly used 6 acupoints for hyperthyroidism related exophthalmos treated with acupuncture were Fengchi (GB 20), Shangtianzhu (Extra), Hegu (LI 4), Sanyinjiao (SP 6), Cuanzhu (BL 2), Yangbai (GB 14). And the most meridian of acupoints was the gallbladder meridian. The most commonly used specific acupoints for hyperthyroidism treated with acupuncture were crossing points, yuan-source points and five-shu points. The most commonly used specific acupoints for hyperthyroidism related exophthalmos treated with acupuncture were crossing points, yuan-source points and five-shu points. Acupuncture masters in modern times have achieved significant therapeutic effect in the treatment of hyperthyroidism，which has showed the principles of searching for the primary cause of disease in treatment and giving consideration to both the root cause and symptoms. But there is a lack of simple and effective treatment methods that can be rapidly promoted in clinical practice.

Research progress of acupuncture and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years

To summarize the research progress of acupuncture-moxibustion and the related adjuvant therapy for promoting pressure ulcer healing in recent 10 years and explore the future research direction. By retrieving Chinese Journal Full-text Database (CNKI), VIP Database (VIP) and PubMed database, dated from January 2008 through to December 2017, the articles for the treatment of pressure ulcers with acupuncture-moxibustion and the related adjuvant therapy were collected. In terms of clinical research and experimental research, the research progress and the related effect mechanisms were analyzed and summarized. Through screening, 78 articles for the treatment of pressure ulcer with acupuncture-moxibustion and the adjuvant therapy were collected finally, of which, 71 articles were Chinese and 7 articles were English. The therapies with the highest frequency for pressure ulcer were the simple moxibustion or moxibusiton combined with other adjuvant measures. The local surrounding needling therapy, electroacupuncture, transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES) and laser therapy were followed by regarding the use frequency. All of these interventions promoted the healing of pressure ulcers to different degrees. The underlying mechanisms were related to the regulation of the local blood perfusion, differentiation and migration of vascular endothelial growth factor, angiogenesis, superoxide dismutase SOD and eNOS/NO signaling pathway so as to promote tissue migration and proliferation. Acupuncture-moxibustion and the related adjuvant therapies achieve the definite therapeutic effects on pressure ulcers. The researches on the treatment of pressure ulcers at home and abroad are diversified, but it is still limited in the research on the effect mechanism.

Systematic review of physical and psychosocial problems of burned children aged 5 years and below after discharge

Objective: To summarize the physical and psychosocial problems of burned children aged 0 to 5 years so as to explore their demands of care after discharge. Methods: Databases including Embase, PubMed, PsycARTICLES, and CINAHL Complete were searched using key words " child(*,) infant(*,) toddler, preschool, kid, baby, junior, burn, scald, empyrosis, nursing, care" , and Chinese Journals Full-text Database, China Biology Medicine disc, and VIP Database were searched using key words in Chinese version ",,,,,,,," to obtain the articles about physical and psychosocial health-related problems of burned children aged 0 to 5 years after discharge from the establishment of each database to February 2018. After screening of extracted articles, the physical and psychosocial problems of burned children aged 0 to 5 years after discharge and psychosocial problems of their caregivers were summarized. Results: (1) A total of 3 880 articles were obtained, after screening layer by layer, 9 English articles were finally included, including 4 prospective observational studies, 3 cross-sectional studies, 1 cohort study, and 1 case-control study, with 1 high-quality literature and 8 medium-quality literatures. (2) After discharge, burned children aged 0 to 5 years mainly had physical problems such as pain, itching, fine motor developmental disorders, and gross motor developmental disorders. They had psychosocial problems such as negative emotional behavior, delayed language development, affected game interaction, post-traumatic stress disorder (PTSD), and disrupted family life. The caregivers had psychosocial problems such as worrying about the appearance and the future of children, dissatisfaction with the current status of children, anxiety and depression, pain, and PTSD. The influencing factors of the above health problems were post-discharge time, post-injury time, total burn area, and burn site, etc. There were 12 kinds of measuring tools used in this group to evaluate the health problems of burned children and psychosocial problems of their caregivers. Only the burn outcomes questionnaire for children aged 0 to 5 years was developed for burned children aged 0 to 5 years. Conclusions: After discharge, burned children aged 0 to 5 years still face many physical and psychosocial problems, which are influenced by factors such as post-discharge time, post-injury time, total burn area and burn site, which suggests that there are certain care needs for them. Appropriate tools for evaluating the health problems of burned children aged 0 to 5 years should be developed.

Association between PNPLA3 rs738409 polymorphism and nonalcoholic fatty liver disease (NAFLD) susceptibility and severity: A meta-analysis.

Objective:This meta-analysis is to investigate the relationship between the patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 polymorphism and the susceptibility and severity of nonalcoholic fatty liver disease (NAFLD).Methods:Chinese Journal Full-text Database, Wanfang Database, VIP Database, and PubMed Database were subjected to case-control study retrieving, from January 2008 to December 2014. Following key words were used: fatty liver, PNPLA3, and rs738409 gene or variants or polymorphism or alleles. Meta-analysis was performed based on the retrieved articles.Results:In total 65 studies were first retrieved according to the key words, and finally 21 studies with 14,266 subjects were included. Meta-analysis showed that PNPLA3 rs738409 polymorphism exerted strong influence not only on fatty liver but also on the histological injury. PNPLA3 rs738409 [G] allele was a risk factor for NAFLD (GG vs CC, OR = 4.01, 95% CI 2.93–5.49; GC vs CC, OR = 1.88, 95% CI 1.58–2.24). PNPLA3 gene variant was significantly associated with the increased serum alanine aminotransferase (ALT) levels (GG vs CC, standardized mean difference = 0.47, 95% CI 0.14–0.81). In addition, nonalcoholic steatohepatitis (NASH) was more frequently observed in G allele carriers (GG vs CC, OR = 3.24, 95% CI 2.79–3.76; GC vs CC, OR = 2.14, 95% CI 1.43–3.19).Conclusion:PNPLA3 rs738409 polymorphism is not only a factor significantly associated with the susceptibility of NAFLD, but also related to the susceptibility of aggressive diseases.

Systematic review of Shenqi Fuzheng Injection combined with chemotherapy for treatment of breast cancer

Databases including China Biological Medicine database(CBM), Chinese scientific journals full-text database(VIP), China National Knowledge Infrastructure database(CNKI), WanFang Data, PubMed, and EMbase were searched from inception to March 2018 to collect the randomized controlled trials(RCTs) on Shenqi Fuzheng Injection combined with chemotherapy for the treatment of breast cancer. All included studies were critically appraised by two independent reviewers by following the cochrane systematic review method and using Revman 5.3 software and State 12.0 for data analysis. After screening, 20 RCTs involving 2 095 patients were included in the study. Meta-analysis showed that as compared with control group of chemotherapy alone, Shenqi Fuzheng Injection combined with chemotherapy could improve the clinical curative efficiency, the KPS score, and immune function indexes such as total T cells, Th cells and Ts cells; inhibit the decline of white blood cells(WBC), platelets in blood system, T-lymphocyte subsets such as CD3~+, CD4~+, CD4~+/CD8~+, alleviate myelosuppression and reduce the incidence of side effects such as gastrointestinal adverse reaction, liver and kidney dysfunction and abnormal electrocardiogram. The results revealed that for clinical breast cancer patients, Shenqi Fuzheng Injection combined with chemotherapy could significantly improve its clinical efficacy and reduce adverse reactions. However, the conclusions still need to be verified by high-quality, multi-center, large-sample, prospective, randomized and double-blind clinical trials. In conclusion, this study has systemically evaluated the efficacy and safety of Shenqi Fuzheng Injection combined with chemotherapy in treatment of breast cancer and provided the reference of evidence-based medicine for safe and effective clinical application of medicines.

Association between GSTT1 Homozygous Deletion and Risk of Pancreatic Cancer: A Meta Analysis.

Association between GSTT1 Homozygous Deletion and Risk of Pancreatic Cancer: A Meta Analysis.

PO-231 Effects of exercise on muscle atrophy in simulated weightless rats

Objective Insufficient physical activity, aerospace weight loss, and fixed treatment of fractures, tendons, and neuropathy, or the resulting muscle atrophy caused by reduced exercise, have become an urgent health problem. Exercise has received widespread attention as an effective means of preventing muscle atrophy. Through the literatures related to "sports and muscle atrophy" at home and abroad, the effects of exercise on muscle atrophy in simulated weightless rats were analyzed, in order to provide theoretical basis and guidance for exercise prevention and treatment of muscle atrophy.&#x0D; Methods The electronic databases PubMed, EMBASE and SPORTDiscus were searched for relevant studies reporting on the effects of physical exercise on muscle therapy. The keywords are: “aerobic exercise or resistance exercise”; "muscle atrophy"; "weightless or weightlessness"and the limitation period is 2013-2018. At the same time, the relevant literatures of the Chinese Journal Full-text Database were searched. The search terms were:“aerobic exercise; resistance exercise; muscle atrophy”, and the language of the article was limited to Chinese. Inclusion criteria: exercise and sarcopenia; effects of exercise on muscle atrophy; relationship between muscle atrophy and exercise. Exclusion criteria: repetitive studies. A total of 54 literature reviews were included in the literature.&#x0D; Results (1)The simulated weightless model is mainly for unloading and tail suspension. After the tail suspension, the soleus muscle becomes thinner and thinner, the elasticity decreases, the volume and mass decrease, the cross-sectional area of the muscle fiber decreases, and the cross-sectional area of the muscle fiber increases after exercise intervention. , suggesting that exercise can effectively slow down the quality of the soleus muscle caused by simulated weightlessness.&#x0D; (2)After 4 weeks of tail suspension, IGF-1 was found to change significantly. Exercise can stimulate the secretion of IGF-1, TESTO and myogenin to some extent, and promote the synthesis of muscle protein. At the same time, myogenin showed different expression under different exercise forms, suggesting myogenin. It may not be used as a predictor of muscle atrophy change.&#x0D; (3) Oxidative stress occurs after 4 weeks of tail suspension, aggravating muscle atrophy, and activity of SOD and GSH-Px is enhanced after exercise intervention. The possible mechanism is to exercise the body SOD and GSH-Px. Vitality, thereby reducing muscle atrophy caused by oxidative stress in the body. (4)Exercise to reduce muscle atrophy may be through down-regulation of atrogin-1 expression and reduction of Caspase-3 expression.&#x0D; (5) Regardless of endurance exercise or resistance exercise, long-term low-intensity exercise or high-intensity exercise can down-regulate atrogin-1 expression in skeletal muscle. However, different exercise intensity and different exercise patterns have irregular expression of atrogin-1. The effects of different exercise patterns and exercise intensity on the expression of atrogin-1 under simulated weightlessness and its specific mechanism need to be further explored.&#x0D; Conclusions Exercise improves muscle atrophy by promoting the secretion of anabolic hormones in the body, increasing the antioxidant capacity in the body and inhibiting the expression of atrogin-1 protein in the ubiquitin proteasome pathway, which promotes the synthesis and inhibition of skeletal muscle protein to a certain extent. Decomposition of skeletal muscle proteins to reduce muscle atrophy caused by tail suspension. &#x0D;

Chinese clinical practice guidelines for acute infectious diarrhea in children.

The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population. The experts group of evidence development put forward clinical problems, collects evidence, forms preliminary recommendations, and then uses open-ended discussions to form recommendations. The literature review was done for developing this guideline in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to June 2013. Search the topic "acute diarrhea" or "enteritis" and "adolescent" or "child" or "Pediatric patient" or "Baby" or "Infant". For the treatment of mild, moderate dehydration, hypotonic oral rehydration solutions (ORS) are strongly recommended. Intravenous (IV) rehydration is recommended for severe dehydration, with a mixture of alkali-containing dextrose sodium solution. Nasogastric feeding tube rehydration is used for children with severe dehydration without IV infusion conditions with ORS solution. Regular feeding should resume as soon as possible after oral rehydration or IV rehydration. The lactose-free diet can shorten the diarrhea duration. Zinc supplements are recommended in children with acute infectious diarrhea. Saccharomyces boulardii and Lactobacillus Rhamnus are recommended to be used in acute watery diarrhea. Saccharomyces boulardii is recommended in children with antibiotic-associated diarrhea as well. Montmorillonite and Racecadotril (acetorphan) can improve the symptoms of diarrhea or shorten the course of acute watery diarrhea. Antibiotics are recommended with dysenteric-like diarrhea, suspected cholera with severe dehydration, immunodeficiency, and premature delivery children with chronic underlying disease; otherwise, antibiotics are not recommended. The principles of the most controversial treatments with of acute infectious disease are reaching to a consensus in China.

Efficacy of romiplostim in the treatment of ITP in children: a meta-analysis.

We aimed to analyze the efficacy and safety of romiplostim in the treatment of primary immune thrombocytopenia (ITP) in children. PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database (CBM), Chinese Journal Full Text Database (CNKI), Wanfang and VIP database were searched. The bibliography was screened according to the inclusion and exclusion criteria and the target literature was selected. The data were extracted, and the quality of included literature was evaluated. RevMan 5.3 software was used to carry out the meta-analysis. The rate of effective, adverse and bleeding events was collected, and meta-analysis was performed. 3 out of 43 papers met the inclusion criteria. Meta-analysis showed that there was a statistical significance in effective rate and median time to platelet rise to response criteria of in romiplostim group, RR=5.05, [95% CI (2.21, 11.53), p<0.01] and RR=9.67, [95% CI (1.89, 49.46), p<0.01]. Similar results occurred in the rate of adverse event and serious adverse event, [RR=0.95, 95% CI (0.69,1.31), p>0.05] and [RR=1.65, 95% CI (0.53,5.31), p>0.05]; bleeding event of the two groups was similar [RR=1.27, 95% CI (0.92,1.75), p>0.05]. On the aspect of treating ITP, romiplostim is more effective and safer than placebo.

The Efficacy and Safety of Pharmacological Treatments for Post-stroke Aphasia.

Aphasia is a common complication after stroke, and traditional speech and language therapy (SLT) has a limited effect on post-stroke aphasia (PSA). While there has been an increasing number of controlled clinical trials on the efficacy of drugs in the treatment of PSA, there have been very few systematic reviews on the efficacy and safety of pharmacological treatments in people with PSA. To evaluate the efficacy and safety of pharmacological interventions for PSA. The Cochrane Central Register of Controlled Trials (CENTRA), PubMed, Embase, Chinese Journal Full-text Database (CJFD), China Biology Medicine disc (CBMdisc), Wanfang Data and VIP Information System were searched for randomized controlled trials about pharmacological treatments for PSA. Literature screening using the inclusion and exclusion criteria, data extraction and methodological quality assessment of the included studies were completed by two independent reviewers. Methodological quality was considered high for modified Jadad quality scale scores of 4 to 7. RevMan 5.3 software was used to conduct a meta-analysis of high-quality studies. Fifteen studies (578 participants) satisfied the eligibility criteria for this systematic review. Five trials (277 participants) assessed donepezil, four studies (124 participants) assessed memantine, three studies (72 participants) assessed bromocriptine, one trial (45 patients) evaluated galantamine, one study (21 patients) evaluated amphetamine, and one trial (39 patients) evaluated levodopa. The systematic review showed that donepezil achieved remarkable results in terms of the aphasia quotient (AQ) (SMD 0.82, 95% CI 0.48-1.17, P < 0.00001), repetition ability (SMD 0. 81, 95% CI 0.57-1.06, P < 0.00001), naming ability (SMD 0.56, 95% CI 0.29-0. 84, P < 0.00001), auditory comprehension (SMD 0.85, 95% CI 0.58-1. 13, P< 0.00001) and oral expression (SMD 0.90, 95% CI 0.54-1.26, P < 0.00001). Memantine showed no pronounced improvement in auditory comprehension (SMD 0.35, 95% CI -0.05-0.74, P = 0.09) but did improve the AQ (SMD 0.57, 95% CI 0.09-1.06, P = 0. 02), naming ability (SMD 0.81, 95% CI 0.38-1.25, P = 0.0002), spontaneous speech (SMD 0.76, 95% CI 0. 39- 1.13, P < 0.0001), and repetition ability (SMD 0.37, 95% CI 0.01-0.73, P = 0.04). Bromocriptine showed pronounced improvement in naming ability (SMD -0.20, 95% CI- 0.67-0.26, P = 0.39), verbal fluency (SMD 0.02, 95% CI 0.53-0.56, P = 0.95), and repetition ability (SMD 0.29, 95% CI -0.23-0. 81, P = 0.28). There is limited and inconclusive evidence for galantamine, amphetamine and levodopa. Current evidence suggests that drugs, such as donepezil and memantine, can improve the prognosis of PSA. Donepezil has a significant effect in improving the ability of auditory comprehension, naming, repetition and oral expression. Memantine has a significant effect in improving the ability of naming, spontaneous speech and repetition. Bromocriptine showed no significant improvements in the treatment of aphasia after stroke. Data regarding galantamine, amphetamine and levodopa in the treatment of aphasia after stroke are limited and inconclusive.

Meta analysis on effectiveness of epidermal growth factor in treating patients with inhalation injury

Objective: To systematically evaluate the effectiveness of epidermal growth factor (EGF) in treating patients with inhalation injury by meta analysis. Methods: Databases including PubMed, Cochrance Library, and Embase were searched using key words " inhalation injury, smoke inhalation injury, epidermal growth factor, and EGF" , and Chinese Journals Full-text Database, China Biology Medicine disc, VIP Database, and Wanfang Database were searched using key words in Chinese version "," to obtain the randomized controlled trails about EGF published publicly in the treatment of patients with inhalation injury from the establishment of each database to December 2017. The measurement indexes included content of total protein and albumin, colloid osmotic pressure (COP), the number of total cells, percentages of neutrophils, lymphocytes, and fibroblasts in bronchoalveolar lavage fluid (BALF), the time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, the time of removal of tracheal tube, the amount of respiratory secretions, and the incidence of lung infection. Meta-analysis was conducted by RevMan 5.3 statistical software. Results: A total of 6 trials involving 375 patients were included, with 182 patients in group EGF who received EGF treatment and 173 patients in conventional treatment group who received conventional treatment. All of the 6 trails had unclear risk of bias. The content of total protein and albumin and COP in BALF of patients in group EGF were lower than those in conventional treatment group, with standardized mean differences (SMDs) respectively -9.37, -26.77 , and -8.13 [with 95% confidence intervals (CIs) respectively -14.11--4.63, -41.85--11.69, -9.54--6.73, P<0.001]. The number of total cells and percentages of neutrophils and lymphocytes in BALF of patients in group EGF were lower than those in conventional treatment group, while the percentage of fibroblasts in BALF of patients in group EGF was higher than that in conventional treatment group, with SMDs respectively -20.22, -13.08, -12.28, 2.99 (with 95% CIs respectively -22.27--17.66 , -14.76--11.40, -13.86--10.70, 2.48-3.50, P<0.001). The time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, and the time of removal of tracheal tube of patients in group EGF were shorter than those in conventional treatment group, with SMDs respectively -1.05, -1.22 , -1.11 (with 95% CIs respectively -1.36--0.74, -1.54--0.91, -1.39--0.82, P<0.001). The amount of respiratory secretions of patients in group EGF was lower than that in conventional treatment group, with SMD -1.44 (with 95% CI -1.90--0.98, P<0.001). The incidence rate of pulmonary infection of patients in group EGF was lower than that in conventional treatment group, with relative risk 0.46 (with 95% CI 0.24-0.89, P<0.05). There may be publication bias in the content of total protein, albumin, and COP in BALF (P<0.05), while the time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, and the time of removal of tracheal tube showed no significant publication bias (P>0.05). Conclusions: Conventional treatment combined with EGF therapy can reduce respiratory inflammation of inhalation injury, promote restoration of respiratory epithelium, shorten the time of removal of tracheal tube, reduce the incidence of pulmonary infection of patients, and therefore has good effect on inhalation injury.

A meta-analysis on the association between genetic polymorphisms of osteoprotegerin and cardiovascular disease

Objective: To explore the association between genetic polymorphisms of rs2073617T/C (950T/C) and rs2073618G/C(1181G/C) in the osteoprotegerin gene and cardiovascular disease with meta-analysis. Methods: A computer-based search for the study of relationship between genetic polymorphisms of rs2073617T/C and rs2073618G/C in the osteoprotegerin gene and cardiovascular disease were performed in electronic databases including China National Knowledge Infrastructure(CNKI), China Biomedical Literature Database, Wanfang Database, Chinese Journal Full-text Database, Embase, PubMed, and Cochrane Library, supplemented by manual search, from the beginning of library to February 28, 2017. The quality of the included studies were assessed by the Newcastle-Ottawa Scale (NOS) scoring system. Data were analyzed using STATA 12.0 software. Results: Eleven clinical case-control studies that enrolled 2 115 patients with cardiovascular disease and 1 467 healthy subjects were included.The results indicated that osteoprotegerin gene polymorphisms of rs2073617T/C and rs2073618G/C might be closely associated with the susceptibility to cardiovascular disease(rs2073617T/C allele model: OR=0.79, 95%CI 0.73-0.87, P=0.001;rs2073618G/C M allele and W allele: OR=0.83, 95%CI 0.74-0.92, P=0.001). The osteoprotegerin gene polymorphisms of rs2073617T/C and rs2073618G/C were significantly related to the incidence of coronary artery disease and acute coronary syndrome(coronary artery disease allele model: OR=0.83, 95%CI 0.75-0.92, P=0.001; acute coronary syndrome allele model: OR=0.73, 95%CI 0.62-0.85, P<0.001). However, there was no significant correlation between the genetic polymorphisms of these two sites and the lesion vessel number of coronary artery (rs2073617T/C allele model:OR=1.00, 95%CI 0.81-1.24, P=0.985;rs2073618G/C allele model:OR=0.98, 95%CI 0.80-1.21, P=0.626). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and polymerase chain reaction-ligase detection reaction(PCR-LDR) evidenced the association between osteoprotegerin gene polymorphisms and cardiovascular disease(allele model: OR=0.79, 95%CI 0.72-0.86, P<0.001), but no obvious relationship was found with fluorogenic quantitative detection and molecularprobe(allele model: OR=0.86, 95%CI 0.65-1.12, P=0.263). Conclusion: This meta-analysis indicates that the osteoprotegerin gene polymorphisms of rs2073617T/C and rs2073618G/C may be closely related to the increased risk of cardiovascular disease.