目的系统评价胃癌根治术后患者发生肺部感染的危险因素。方法检索PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,检索时间为建库至2021年12月17日。由2名研究者独立筛选文献、提取资料,采...目的系统评价胃癌根治术后患者发生肺部感染的危险因素。方法检索PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,检索时间为建库至2021年12月17日。由2名研究者独立筛选文献、提取资料,采用NOS量表进行质量评价,应用RevMan 5.4、Stata15.1软件进行Meta分析。结果共纳入23项研究,总样本量为10696例。Meta分析结果显示,胃癌根治术后并发肺部感染的危险因素包括高龄[OR=2.67,95%CI(1.90,3.74),P<0.001)]、吸烟史[OR=3.09,95%CI(2.44,3.92),P<0.001]、糖尿病[OR=4.48,95%CI(1.91,10.53),P<0.001]、围手术期输血[OR=4.49,95%CI(2.65,7.61),P<0.001]、手术时间长[OR=2.19,95%CI(1.19,4.03),P=0.01]、术中出血[OR=2.46,95%CI(1.62,3.74),P<0.001]、留置胃管时间长[OR=4.03,95%CI(3.74,4.33),P<0.001]、营养风险[OR=1.82,95%CI(1.43,2.33),P<0.001]、肺部疾病史[OR=3.09,95%CI(1.89,5.05),P<0.001]、手术方式[OR=3.33,95%CI(2.93,3.79),P<0.001]、白蛋白≤30 g/L[OR=1.82,95%CI(1.39,2.37),P<0.001]、TNM分期[OR=2.18,95%CI(1.75,2.72),P<0.001]、引流管放置时间长[OR=1.48,95%CI(1.22,1.79),P<0.001]、合并基础疾病[OR=2.48,95%CI(1.83,3.35),P<0.001]、高血压史[OR=2.59,95%CI(1.48,4.52),P<0.001]、低蛋白血症[OR=3.02,95%CI(2.87,3.18),P<0.001]、伤口疼痛[OR=3.42,95%CI(1.96,5.99),P<0.001]、肺功能不全[OR=2.74,95%CI(1.84,4.09),P<0.001];胃癌根治术后并发肺部感染的保护因素为血红蛋白≥110 mg/L[OR=0.67,95%CI(0.56,0.79),P<0.001]和第1秒用力呼气容积>2 L[OR=0.22,95%CI(0.12,0.40),P<0.001]。结论高龄、吸烟史、围手术期输血、糖尿病、高血压、肺部疾病史、手术时间长、术中出血、留置胃管时间长和营养风险等是胃癌根治术后并发肺部感染的危险因素,但受纳入研究质量和数量限制,未来还需开展更多高质量的研究予以验证。展开更多
Background： It is an urgent matter to relieve the side effects induced by chemotherapy. In recent years, auricular acupoints therapy, which is a nursing technique used in traditional Chinese medicine （TCM）, has bee...Background： It is an urgent matter to relieve the side effects induced by chemotherapy. In recent years, auricular acupoints therapy, which is a nursing technique used in traditional Chinese medicine （TCM）, has been used on many patients who are undergoing chemotherapy without causing any side effects. Furthermore, it has a good efficacy and is inexpensive. Aim： The aim of this study was to provide evidence for the need of further research in the treatment and nursing of patients during chemotherapy. Methods： We conducted an integrated review of the reports in CNK1, WanFang Data, SinoMed, and PubMed databases for journal articles published after 1990. The search terms included auricular acupoints taping and pressing, auricular acupoints therapy, auricular point sticking, ear points, chemotherapy, and side effects and relevant Medical Subject Heading terms. We then analyzed the mechanism, acu- points, and operation method and summarized the application of auricular acupoints therapy in patients suffering from chemotherapy side effects. Results： This review included 102 articles published between 1990 and 2016, and we brought 63 other articles into the study. Eighteen articles focused on auricular acupoints therapy, combined with other therapy, to relieve patient side effects during chemotherapy. Conclusions： Auricular acupoints therapy can prevent and relieve the side effects induced by chemotherapy. It deserves further clinical applications.展开更多
Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement ac...Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement according to the various color classifications. Methods include combined sharp and hydrogel debridement, combined ultrasonic and enzymatic debridement, ultrasonic debridement combined with surgical debridement and vacuum aspiration on debridement, and other types of debridement. This article also explores why each combined debridement mentioned above can achieve a good effect.展开更多
Decidual natural killer （dNK） cells actively participate in the establishment and maintenance of maternal-fetal immune tolerance and act as local guardians against infection. However, how dNK cells maintain the immu...Decidual natural killer （dNK） cells actively participate in the establishment and maintenance of maternal-fetal immune tolerance and act as local guardians against infection. However, how dNK cells maintain the immune balance between tolerance and anti-infection immune responses during pregnancy remains unknown. Here, we demonstrated that the inhibitory molecule T-cell immunoglobulin domain and mucin domain-containing molecule-3 （Tim-3） are expressed on over 60% of dNK cells. Tim-3^＋ dNK cells display higher interleukin （IL）-4 and lower tumor necrosis factor （TNF）-α and perforin production. Human trophoblast cells can induce the transformation of peripheral NK cells into a dNK-like phenotype via the secretion of galectin-9 （Gal-9） and the interaction between Gal-9 and Tim-3. In addition, trophoblasts inhibit lipopolysaccharide （LPS）-induced pro-inflammatory cytokine and perforin production by dNK cells, which can be attenuated by Tim-3 neutralizing antibodies. Interestingly, a decreased percentage of Tim-3-expressing dNK cells were observed in human miscarriages and murine abortion-prone models. Moreover, T helper （Th）2-type cytokines were decreased and Thl-type cytokines were increased in Tim-3^＋ but not Tim-3- dNK cells from human and mouse miscarriages. Therefore, our results suggest that the Gal-9/Tim-3 signal is important for the regulation of dNK cell function, which is beneficial for the maintenance of a normal pregnancy.展开更多
文摘Background： It is an urgent matter to relieve the side effects induced by chemotherapy. In recent years, auricular acupoints therapy, which is a nursing technique used in traditional Chinese medicine （TCM）, has been used on many patients who are undergoing chemotherapy without causing any side effects. Furthermore, it has a good efficacy and is inexpensive. Aim： The aim of this study was to provide evidence for the need of further research in the treatment and nursing of patients during chemotherapy. Methods： We conducted an integrated review of the reports in CNK1, WanFang Data, SinoMed, and PubMed databases for journal articles published after 1990. The search terms included auricular acupoints taping and pressing, auricular acupoints therapy, auricular point sticking, ear points, chemotherapy, and side effects and relevant Medical Subject Heading terms. We then analyzed the mechanism, acu- points, and operation method and summarized the application of auricular acupoints therapy in patients suffering from chemotherapy side effects. Results： This review included 102 articles published between 1990 and 2016, and we brought 63 other articles into the study. Eighteen articles focused on auricular acupoints therapy, combined with other therapy, to relieve patient side effects during chemotherapy. Conclusions： Auricular acupoints therapy can prevent and relieve the side effects induced by chemotherapy. It deserves further clinical applications.
文摘Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement according to the various color classifications. Methods include combined sharp and hydrogel debridement, combined ultrasonic and enzymatic debridement, ultrasonic debridement combined with surgical debridement and vacuum aspiration on debridement, and other types of debridement. This article also explores why each combined debridement mentioned above can achieve a good effect.
文摘Decidual natural killer （dNK） cells actively participate in the establishment and maintenance of maternal-fetal immune tolerance and act as local guardians against infection. However, how dNK cells maintain the immune balance between tolerance and anti-infection immune responses during pregnancy remains unknown. Here, we demonstrated that the inhibitory molecule T-cell immunoglobulin domain and mucin domain-containing molecule-3 （Tim-3） are expressed on over 60% of dNK cells. Tim-3^＋ dNK cells display higher interleukin （IL）-4 and lower tumor necrosis factor （TNF）-α and perforin production. Human trophoblast cells can induce the transformation of peripheral NK cells into a dNK-like phenotype via the secretion of galectin-9 （Gal-9） and the interaction between Gal-9 and Tim-3. In addition, trophoblasts inhibit lipopolysaccharide （LPS）-induced pro-inflammatory cytokine and perforin production by dNK cells, which can be attenuated by Tim-3 neutralizing antibodies. Interestingly, a decreased percentage of Tim-3-expressing dNK cells were observed in human miscarriages and murine abortion-prone models. Moreover, T helper （Th）2-type cytokines were decreased and Thl-type cytokines were increased in Tim-3^＋ but not Tim-3- dNK cells from human and mouse miscarriages. Therefore, our results suggest that the Gal-9/Tim-3 signal is important for the regulation of dNK cell function, which is beneficial for the maintenance of a normal pregnancy.
