1引言澳大利亚新干预措施安全性和有效性评价数据库-外科部分(Australian Safety and Efficacy Reg-ister of New Interventional Procedures-Surgical,ASERNIP-S)于1998年初由澳大利亚皇家外科医师学院(Royal Australasian College of ...1引言澳大利亚新干预措施安全性和有效性评价数据库-外科部分(Australian Safety and Efficacy Reg-ister of New Interventional Procedures-Surgical,ASERNIP-S)于1998年初由澳大利亚皇家外科医师学院(Royal Australasian College of Surgeons,RACS)创建,旨在评估各种外科新技术的安全性和有效性.HTA--否到该考虑非随机化资料的时候了?Jan展开更多
2.1.3 腹腔镜结直肠恶性肿瘤切除术
评价组成员:
Advisory外科医师 Mr Michel Levitt
Protocol外科医师 Mr Peter Hewett
Nominated外科医师 Mr Rodnev Woods
Other Specialty外科医师 Mr Harry Sheiner
ASERNIP-S研究者 Mr Andrew Chap...2.1.3 腹腔镜结直肠恶性肿瘤切除术
评价组成员:
Advisory外科医师 Mr Michel Levitt
Protocol外科医师 Mr Peter Hewett
Nominated外科医师 Mr Rodnev Woods
Other Specialty外科医师 Mr Harry Sheiner
ASERNIP-S研究者 Mr Andrew Chapman Mr Daniela DeNichillo Dr Wendy Babidge
主席 Professor Guy Maddern
背景
结肠癌患者的外科治疗包括肿瘤原发灶及局部淋巴结的切除.1991年前进行此类手术需要开腹.经腹腔镜胆囊切除术的成功开展和其他结直肠手术中腹腔镜的应用,特别是可选择的非切除性手术方式,促进了腹腔镜直肠或结肠切除术的发展和进步.展开更多
Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing o...Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.展开更多
This paper mainly discusses the evaluation effect of charitable donation actions of the enterprise, to solve the problem on ＂achievement＂ of this kind of donation actions. The evaluation is based on the enterprise＇...This paper mainly discusses the evaluation effect of charitable donation actions of the enterprise, to solve the problem on ＂achievement＂ of this kind of donation actions. The evaluation is based on the enterprise＇s overall perspective, mainly to evaluate the internal and external effects for the charitable donation actions of the enterprise, and its purpose is through the scientific evaluation to find the advantages and disadvantages of this donation actions, and further to guide the enterprise to establish a correct conception of charity, select the appropriate charitable ways and conduct the professional management to enhance the level of the charitable donation of the enterprise.展开更多
AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients...AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method. Relationships between the initiation of TM-α and patient demographics were also evaluated.RESULTSAbscess formation or bacteremia was the most frequent cause of DIC (33%), followed by digestive tract perforation (31%). Twenty-six patients developed DIC after surgery, frequently within 1 wk (81%). TM-α was most often administered within 1 d of the DIC diagnosis (72%) and was continued for more than 3 d (64%). Although bleeding tendency was observed in 7 patients (19%), a hemostatic procedure was not needed. DIC scores, systemic inflammatory response syndrome (SIRS) scores, quick-sequential organ failure assessment (qSOFA) scores, platelet counts, and prothrombin time ratios significantly improved after 1 wk (P < 0.05, for all). The overall survival rate at 28 d was 71%. The duration of TM-α administration (≥ 4 , ≤ 6) and improvements in DIC-associated scores (DIC, SIRS and qSOFA) at 1 wk were significantly better prognostic factors for 28-d survival (P < 0.05, for all). TM-α was administered significantly earlier to patients with severe clinical symptoms, such as high qSOFA scores, sepsis, shock or high lactate values (P < 0.05, for all).CONCLUSIONEarly administration of TM-α and improvements in each parameter were essential for treatment of DIC. The diagnosis of patients with mild symptoms requires further study.展开更多
Objective： To retrospectively evaluate the early results of anatomic double-bundle anterior cruci- ate ligament （ACL） reconstruction and compare with the results of native ACL of the contralateral knee. Methods： ...Objective： To retrospectively evaluate the early results of anatomic double-bundle anterior cruci- ate ligament （ACL） reconstruction and compare with the results of native ACL of the contralateral knee. Methods： The results of a consecutive series of 118 patients receiving arthroscopic ACL reconstruction were evaluated. Eight patients were lost to the latest follow-up, leaving a total of 110 patients available for study within at least 3 years＇ clinical follow-up. Among them, 63 patients underwent postoperative MRI and CT scan, as well as clini- cal evaluation. Results： After reconstruction, the knees were stable and pain-free. Mean postoperative Lysholm score was 95.54 in 110 patients after 3 years. CT and MRI assessment showed that the reconstruction centered in the femoral footprint of ACL （n=63）. The sagittal ACL angle in the reconstructed ACL （52.16°±2.45°） was much close to that in the contralat- eral intact ACL （51.31 °±2.18°, P〉0.05）. By ACL-Blumensaat line angle analysis, there was no difference between doublebundle reconstructed knees and their contralateral normal knees （4.67°±0.43° vs. 4.62°±＊0.60°, P〉0.05）. Conclusion： Anatomic double-bundle ACL reconstruction can place grafts more precisely in the anatomic foot- print of the ACL and better restore knee kinematics.展开更多
文摘1引言澳大利亚新干预措施安全性和有效性评价数据库-外科部分(Australian Safety and Efficacy Reg-ister of New Interventional Procedures-Surgical,ASERNIP-S)于1998年初由澳大利亚皇家外科医师学院(Royal Australasian College of Surgeons,RACS)创建,旨在评估各种外科新技术的安全性和有效性.HTA--否到该考虑非随机化资料的时候了?Jan
文摘2.1.3 腹腔镜结直肠恶性肿瘤切除术
评价组成员:
Advisory外科医师 Mr Michel Levitt
Protocol外科医师 Mr Peter Hewett
Nominated外科医师 Mr Rodnev Woods
Other Specialty外科医师 Mr Harry Sheiner
ASERNIP-S研究者 Mr Andrew Chapman Mr Daniela DeNichillo Dr Wendy Babidge
主席 Professor Guy Maddern
背景
结肠癌患者的外科治疗包括肿瘤原发灶及局部淋巴结的切除.1991年前进行此类手术需要开腹.经腹腔镜胆囊切除术的成功开展和其他结直肠手术中腹腔镜的应用,特别是可选择的非切除性手术方式,促进了腹腔镜直肠或结肠切除术的发展和进步.
文摘Objective: To assess the effect of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Methods: Eighteen databases were searched for randomized controlled trials, focusing on evaluation of fast track surgery care on knee joint function in patients with knee joint replacement surgery. Two people independently screened literatures and extracted data according to the inclusion criteria. Then the available data were analyzed with RevMan software (version 5.3.0). Descriptive techniques were performed when no available data could be used. Results: A total of 8 studies were included, for a total sample of 635 patients. The results showed that fast track surgery care can improve Hospital for Special Surgery Knee score at 2 months, 3 months, 6 months, and 1 years after operation [after 2 months (weighted mean difference (WMD), 15.2;95%CI, 13.58 to 16.82;P < 0.01);after 3 months (WMD, 9.42;95%CI, 7.80 to 11.04;P < 0.01);after 6 months,(WMD, 11.01;95%CI, 9.73 to 12.28;P < 0.01);after 1 years (WMD, 10.78;95%CI, 9.33 to 12.24;P < 0.01)]. Fast track surgery care can improve the knee score of American Knee Society Knee Score(WMD, 9.23;95%CI,0.86 - 17.6;P < 0.05), and reduce the incidence of postoperative deep vein thrombosis, constipation, pulmonary infection, urinary tract infection and other complications. Conclusion: Fast track surgery care can promote knee joint function recovery, reduce postoperative deep venous thrombosis, constipation, pulmonary infection and urinary tract infection. However, rigorous large sample and multicenter randomized controlled trials are needed for further validation.
文摘This paper mainly discusses the evaluation effect of charitable donation actions of the enterprise, to solve the problem on ＂achievement＂ of this kind of donation actions. The evaluation is based on the enterprise＇s overall perspective, mainly to evaluate the internal and external effects for the charitable donation actions of the enterprise, and its purpose is through the scientific evaluation to find the advantages and disadvantages of this donation actions, and further to guide the enterprise to establish a correct conception of charity, select the appropriate charitable ways and conduct the professional management to enhance the level of the charitable donation of the enterprise.
文摘AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method. Relationships between the initiation of TM-α and patient demographics were also evaluated.RESULTSAbscess formation or bacteremia was the most frequent cause of DIC (33%), followed by digestive tract perforation (31%). Twenty-six patients developed DIC after surgery, frequently within 1 wk (81%). TM-α was most often administered within 1 d of the DIC diagnosis (72%) and was continued for more than 3 d (64%). Although bleeding tendency was observed in 7 patients (19%), a hemostatic procedure was not needed. DIC scores, systemic inflammatory response syndrome (SIRS) scores, quick-sequential organ failure assessment (qSOFA) scores, platelet counts, and prothrombin time ratios significantly improved after 1 wk (P < 0.05, for all). The overall survival rate at 28 d was 71%. The duration of TM-α administration (≥ 4 , ≤ 6) and improvements in DIC-associated scores (DIC, SIRS and qSOFA) at 1 wk were significantly better prognostic factors for 28-d survival (P < 0.05, for all). TM-α was administered significantly earlier to patients with severe clinical symptoms, such as high qSOFA scores, sepsis, shock or high lactate values (P < 0.05, for all).CONCLUSIONEarly administration of TM-α and improvements in each parameter were essential for treatment of DIC. The diagnosis of patients with mild symptoms requires further study.
文摘Objective： To retrospectively evaluate the early results of anatomic double-bundle anterior cruci- ate ligament （ACL） reconstruction and compare with the results of native ACL of the contralateral knee. Methods： The results of a consecutive series of 118 patients receiving arthroscopic ACL reconstruction were evaluated. Eight patients were lost to the latest follow-up, leaving a total of 110 patients available for study within at least 3 years＇ clinical follow-up. Among them, 63 patients underwent postoperative MRI and CT scan, as well as clini- cal evaluation. Results： After reconstruction, the knees were stable and pain-free. Mean postoperative Lysholm score was 95.54 in 110 patients after 3 years. CT and MRI assessment showed that the reconstruction centered in the femoral footprint of ACL （n=63）. The sagittal ACL angle in the reconstructed ACL （52.16°±2.45°） was much close to that in the contralat- eral intact ACL （51.31 °±2.18°, P〉0.05）. By ACL-Blumensaat line angle analysis, there was no difference between doublebundle reconstructed knees and their contralateral normal knees （4.67°±0.43° vs. 4.62°±＊0.60°, P〉0.05）. Conclusion： Anatomic double-bundle ACL reconstruction can place grafts more precisely in the anatomic foot- print of the ACL and better restore knee kinematics.
