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含多黏菌素B抗菌方案治疗多重耐药革兰阴性菌HAP/VAP的贝叶斯网状Meta分析
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作者 涂超超 周权 +3 位作者 黄玉琴 万冬丽 王汉琴 涂明利 《药物流行病学杂志》 CAS 2023年第4期434-445,共12页
目的采用贝叶斯网状Meta分析方法比较含多黏菌素B的抗菌方案与其他抗菌方案治疗多重耐药革兰阴性菌医院获得性肺炎/呼吸机相关性肺炎(HAP/VAP)的临床疗效。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、... 目的采用贝叶斯网状Meta分析方法比较含多黏菌素B的抗菌方案与其他抗菌方案治疗多重耐药革兰阴性菌医院获得性肺炎/呼吸机相关性肺炎(HAP/VAP)的临床疗效。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、SinoMed、ChiCTR、WanFang Data和VIP数据库,搜集含多黏菌素B的抗菌方案治疗多重耐药革兰阴性菌HAP/VAP的临床对照研究,检索时限均从建库到2022年10月15日。由2位研究员独立筛选文献、提取资料并评估纳入研究的偏倚风险后,采用Stata 17.0和R 4.1.2软件进行贝叶斯网状Meta分析。结果共纳入1个随机对照试验(RCT)和10项观察性研究,共1385例患者,涉及8种治疗方案。贝叶斯网状Meta分析结果表明,在临床有效率方面,8种用药方案组间差异无统计学意义(P>0.05),累积排序概率曲线下面积(SUCRA)显示多黏菌素B静脉滴注联合多黏菌素B雾化吸入方案的临床有效率高于多黏菌素B静脉滴注单用或其联合替加环素等方案;在病死率方面,文中涉及的4种用药方案中,SUCRA显示多黏菌素B静脉滴注联合多黏菌素B雾化方案的病死率较低,低于多黏菌素B静脉滴注、替加环素单用或两者联用等方案,其中多黏菌素B静脉滴注联合多黏菌素雾化吸入方案的病死率低于多黏菌素B静脉滴注联合替加环素方案,且差异有统计学意义[OR=0.21,95%CrI(0.05,0.94),P<0.05],其余涉及的治疗方案组间差异无统计学意义(P>0.05);在细菌清除率方面,涉及的4种用药方案组间差异无统计学意义(P>0.05)。结论现有证据表明,就生存获益而言,推荐使用多黏菌素B静脉滴注联合多黏菌素B雾化吸入方案治疗多重耐药革兰阴性菌HAP/VAP。受纳入研究数量和质量限制,上述结论尚待更多大样本、高质量、多中心的RCT予以验证。 展开更多
关键词 多黏菌素B 医院获得性肺炎 呼吸机相关性肺炎 多重耐药菌 网状Meta分析
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Comparison of different methods of intestinal obstruction in a rat model 被引量:10
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作者 Meng-Lang Yuan Zheng Yang +10 位作者 Yu-Cheng Li Lan-Lan Shi Jia-Ling Guo yu-qin huang Xia Kang Jing-Jing Cheng Yang Chen Ting Yu De-Qi Cao Huan Pang Xiao Zhang 《World Journal of Gastroenterology》 SCIE CAS 2013年第5期692-705,共14页
AIM:To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic,morphologic and histologic characteristics. METHODS:Rat ileum was partially obs... AIM:To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic,morphologic and histologic characteristics. METHODS:Rat ileum was partially obstructed by the respective application of:braided silk(penetrated the mesentery and surrounded intestine);half ligation (penetrated directly and ligated 1/2 cross-section of the intestine);wide pipe(6 mm in width,surrounded the intestine);narrow pipe(2 mm in width,surrounded the intestine).A control was also included(no obstruction). Various behavioral and electrophysiologic variables, as well as morphologic and immunohistochemical observations were recorded by blinded investigators at different time points(12,24,48,72 h),including daily general condition,ileal wet weight and circumference, macromorphous and micromorphous intestine,bowel movement capability in vivo and in vitro,slow wave and neural electrical activity,and the number of c-Kit positive interstitial cells of Cajal(ICC). RESULTS:Despite being of a similar general condition, these methods resulted in different levels of obstruction in each group compared with the control at different time points(12,24,48,72 h).However,these fields of the wide pipe rat showed significantly differences when compared with the other three obstructed groups at 12 to 72 h,including macroscopic and histological presentation,intestinal transit ratio and contractility,circumference and wet weight,amplitude and frequency of nerve electrical discharge and slow wave,and ICC numbers(all P<0.01). CONCLUSION:The wide pipe rat method is significantly more reliable and stable than the other methods of obstruction,demonstrating that use of the wide pipe method can be a useful model of incomplete intestinal obstruction. 展开更多
关键词 INTESTINAL OBSTRUCTION Model COMPARATIVE study ELECTROPHYSIOLOGY Morphology INTERSTITIAL cells of CAJAL
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