Medicine
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Observational Study
Can bioimpedance cardiography assess hemodynamic response to passive leg raising in critically ill patients: A STROBE-compliant study.
Passive leg raising (PLR) is a convenient and reliable test to predict fluid responsiveness. The ability of thoracic electrical bioimpedance cardiography (TEB) to monitor changes of cardiac output (CO) during PLR is unknown. In the present study, we measured CO in 61 patients with shock or dyspnea by TEB and transthoracic echocardiography (TTE) during PLR procedure. ⋯ Bias between TEB and TTE measured CO was 0.12 L/min, and the percentage error was 65.8%. TEB parameters had promising performance in predicting PLR responders, and the Δd2Z/dt2 had the best predictive value. The CO values measured by TEB were not interchangeable with TTE in critically ill settings.
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Randomized Controlled Trial
The comparison of the effectiveness and safety of drospirone ethinyl estradiol and ethinyl estradiol cyproterone in the treatment of polycystic ovarian syndrome: A protocol for systematic review and meta-analysis.
Polycystic ovarian syndrome (PCOS) is an endocrine disorder syndrome with reproductive dysfunction and abnormal glucose metabolism. Persistent non-ovulation, excessive androgens and insulin resistance are important features and they are the most common causes of menstrual disorders in women during childbearing years. At present, the cause of PCOS is not clinically clear. Current studies suggest that it may be due to the interaction of certain genetic genes with environmental factors. It is an important cause of infertility or early miscarriage with the characteristics of various causes and complex clinical manifestations. At present, for the treatment of PCOS patients, clinical treatment mainly includes hypoglycemia, insulin and menstrual regulation and other symptomatic and supportive treatment. Drospirone ethinyl estradiol and ethinyl estradiol cyproterone are 2 of the most commonly used drugs in clinical treatment of PCOS, but there is lack of the evidence of evidence-based medicine. Therefore, this study systematically evaluates the therapeutic effect and safety of PCOS patients with 2 short-acting oral contraceptives, drospirone ethinyl estradiol and ethinyl estradiol cyproterone, which provides the guidance for clinically selecting the appropriate drug to treat PCOS. ⋯ 10.17605/OSF.IO/8GW9M.
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Observational Study
Clinical features of velamentous umbilical cord insertion and vasa previa: A retrospective analysis based on 501 cases.
To identify the risk factors associated with velamentous cord insertion (VCI) and investigate the association between adverse pregnancy outcomes and VCI in singleton pregnancies and those with vasa previa. A total of 59,976 single cases admitted from Qinhuangdao Maternal and Child Health Hospital and Qinhuangdao Beidaihe Hospital from January 2004 to January 2014 were included in this study. We retrospectively analyzed the perinatal complications, neonatal complications, and the clinical features, as well as the Color Doppler ultrasonography findings of the velamentous placenta and placenta previa. ⋯ Of the women with VCI, 16.1% underwent emergency cesarean section compared to 8.9% (P < .001) of women without VCI. The prevalence of VCI was 0.84% in singletons. The results suggest that VCI is a moderate risk condition resulted in increased risks of prematurity and impairment of fetal growth.
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This study aimed to investigate the recurrence patterns of advanced gastric cancer (AGC) after curative total gastrectomy and further explore predictors for each pattern of recurrence. Data of 299 AGC patients between 2010 and 2014 were retrospectively analyzed to investigate the clinicopathologic factors affecting the recurrence pattern of AGC patients underwent curative total gastrectomy. Sixty-eight (22.7%) AGC patients had recurrence after total gastrectomy. ⋯ Multivariate analyses revealed that the extent of lymphadenectomy (P = .034, 95% CI: 1.074-6.414) and T4b status (P = .015, 95% CI: 0.108-0.785) were independent predictors for LR; histological type (P = .041, 95% CI: 0.016-0.920) and T4b status (P = .007, 95% CI: 0.102-0.690) for PR; and pN status (P = .032) for DM. In AGC patients following total gastrectomy, recurrent predictors various among locoregional, peritoneal, and distant recurrence. Recurrent predictors of tumor invasion, lymph node metastasis, and histological type could guide follow-up and risk-oriented adjuvant treatment, extended lymphadenectomy was considered to reduce LR of AGC patients after curative total gastrectomy.
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This study aims to identify the expression of lipoma preferred partner (LPP) in Paget disease (PD) and to further understand the pathogenesis of PD. ⋯ While LPP is expressed in both MPD and EMPD, the intensity of this expression is greater in MPD. LPP expression is positively correlated with Ki-67 and is more prevalent in middle-aged versus senior MPD patients. Further research is needed to determine its potential role in tumorigenesis and distribution.