AIM To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction(ASBO).METHODS A systematic search of Pub Med(MEDLINE),CINAHL,the Cochrane Library and Ichushi Web was con...AIM To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction(ASBO).METHODS A systematic search of Pub Med(MEDLINE),CINAHL,the Cochrane Library and Ichushi Web was conducted,and the reference lists of review articles were handsearched.The outcomes of interest were the incidence rate of surgery,the length of hospital days and mortality.The quality of the included studies,publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials(RCTs)and three retrospective cohort studies were selected for analysis.In the three RCTs,Daikenchuto significantly reduced the incidence of surgery(p OR=0.13;95%CI:0.03-0.50).Similarly,Daikenchuto significantly reduced the incidence of surgery(p OR=0.53;95%CI:0.32-0.87)in the three cohort studies.The length of hospital stay and mortality were not measured or described consistently.CONCLUSION The present meta-analysis demonstrates that administering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population.In order to better generalize these results,additional studies will be needed.展开更多
Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermi...Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermia, acidosis, and dilution. Primary coagulopathy consists of disseminated intravascular coagulation and acute coagulopathy of trauma shock (ACOTS). The pathophysiology of ACOTS is the suppression of thrombin generation and neutralization of plasminogen activator inhibitor-1 mediated by activated protein C that leads to hypocoagulation and hyperfibrinolysis in the circulation. This review tried to clarify the validity of activated protein C hypothesis that constitutes the main pathophysiology of the ACOTS in experimental trauma models.展开更多
文摘AIM To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction(ASBO).METHODS A systematic search of Pub Med(MEDLINE),CINAHL,the Cochrane Library and Ichushi Web was conducted,and the reference lists of review articles were handsearched.The outcomes of interest were the incidence rate of surgery,the length of hospital days and mortality.The quality of the included studies,publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials(RCTs)and three retrospective cohort studies were selected for analysis.In the three RCTs,Daikenchuto significantly reduced the incidence of surgery(p OR=0.13;95%CI:0.03-0.50).Similarly,Daikenchuto significantly reduced the incidence of surgery(p OR=0.53;95%CI:0.32-0.87)in the three cohort studies.The length of hospital stay and mortality were not measured or described consistently.CONCLUSION The present meta-analysis demonstrates that administering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population.In order to better generalize these results,additional studies will be needed.
文摘Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermia, acidosis, and dilution. Primary coagulopathy consists of disseminated intravascular coagulation and acute coagulopathy of trauma shock (ACOTS). The pathophysiology of ACOTS is the suppression of thrombin generation and neutralization of plasminogen activator inhibitor-1 mediated by activated protein C that leads to hypocoagulation and hyperfibrinolysis in the circulation. This review tried to clarify the validity of activated protein C hypothesis that constitutes the main pathophysiology of the ACOTS in experimental trauma models.
